Antisocial behaviour

What is ASB?

Behaviour that transgresses a societies rules and norms that is likely to cause harm to others

LEGALLY = behaviour that a person that causes/ is likely to cause harassment. alarm or distress to people not in the same household

How common is ASB?

4.6% pf 5-19yr olds meet criteria of ASB

• around 1/20

Are rates of ASB higher in males or females?

Higher in males (5.8%) than females (3.4%)

What % of all years of disability does ASB account for?

1% of all disability years (exceeding autism and ADHD)

What are cost associated with conduct disorders associated with?

• Policing'

• social work

• education provision

• impact of crime

• criminal justice process

Which age group have the highest prevalence of ASB?

15-17yr olds

Oppositional Defiant Disorder (ODD)

• Tends to be younger children (<10yrs)

• Challenge adult authority

Conduct Disorder

Tends to be adolescents

• Repeated rule/law breaking

• Disregard or the rights or wellbeing of others

• lack of empathy - with or without prosocial emotions

What do adults exhibiting ASB tend to be diagnosed with?

Antisocial personality disorder (ASPD)

Behaviour associated with ASPD?

• Lack of empathy

• Repeated flaunting of social norms

• Failure to respond to punishment

• Risk taking, manipulative, superficial charm

Comorbid conditions of CD?

• specific/ generalise learning problems

• literacy issues

• speech and language problems

• ASD

• ADHD

• Global learning disability

Comorbid mental health conditions of CD?

• anxiety and depression

• PTSD

• attachment disorders

• personality disorders

• psychosis

What are important things to consider when addressing patients with CD?

• NICE guidelines

• Holistic MDT

• Use multiple sources of information

• Developmental history and assessment

• Cognitive assessment

• Mental health assesment

• ACEs

Hereditary component to ASB?

YES - in criminal behaviour

Genomic causes of ASB?

• ‘Warrior gene’

• MAOA gene - normally breaks down dopamine, NA & 5-HT. Low activity of allele = aggression?

• Childhood adversity

• GABAergic function in hippocampus and cognition

Role of medication in ASB?

• Can be used for comorbid conditions (ADHD, depressiojn, anxiety)

• Low dose of antipsychotics licenced for ST use

Parent management training

Supports carers in delivering consistent, effective parenting

• more effective in U16s

How can CBT be useful in ASB?

• Useful in anger management

• Children 12 +

Multisystemic therapy

• Based on family therapy

• involves people and organisations involved in young persons care