Lecture 9

Disruptive behaviour disorders

emotions, behaviours

People with disruptive behaviour disorders have problems in the self-control of _______ and _______

1. Oppositional Defiant Disorder

2. Conduct Disorder

What are the 2 diagnoses inside disruptive behaviour disorders?

Destructive and overt dimensions

The 4 dimensions present in disruptive behaviour disorders are overt-covert and destructive-non-destructive. On what 2 dimensions people tend to more at risk for long-term severe problems?

• 6

• 4

• sibling

Oppositional Defiant Disorder (ODD) must:

• Last for at least ___ months

• Be evidenced by at least ___ symptoms

• Be exhibited during interaction with a least one individual who is not a ______

1. Negative

2. Defiant

3. Hurtful

The 3 categories of symptoms for ODD are:

1. _______ affect → angry/irritable mood

2. _______/headstrong behaviour

3. _______ behaviour → less common but more severe

• most

• week

• normative

• settings

  • 1

  • 2

  • 3

ODD diagnostic criteria:

• For children < 5 years old, behaviours should be occurring on _____ days for a 6-month period

• For children > 5 years old, the behaviours should be occurring at least once a _____ for a 6-month period

• The children must be engaging in the behaviours more than is _______ for children of their developmental level, gender, and culture

• Severity of ODD is based on number of ______:

  • Mild = ___ setting

  • Moderate = symptoms present in at least ___ settings

  • Severe = symptoms present in ___ or more settings

• harmful

• problems

• relationships

Even though fighting between siblings is common;

• Sibling aggression is ______

• Sibling conflict, hostility, and negativity predict greater emotional and behavioural _____ over time

• Conflict with siblings may lead to maladaptive behaviour problems in other _____

interviews, observation

→ 3, disruptive

For assessing ODD, we can use ______/checklists or ______

→ An example is the Disruptive Behavior Diagnostic Observation Schedule, which assesses preschoolers interacting in ___ contexts (w/ interactive examiner, busy examiner, parent) and they are pressed for _______ behaviour

1. people, animals

2. property

3. theft

4. rules

The 4 categories for Conduct Disorder (CD) in young people:

1. Aggression to _____ and ______

2. Destruction of _______

3. Deceitfulness or ______

4. Serious violations of _______

Antisocial Personality Disorder can only be diagnosed at 18 years old, but there are similarities in both disorders

What’s the difference between CD and Antisocial Personality Disorder?

• 3 in the past year

• 1 in the past month

How many of the 15 symptoms are needed to be diagnosed as having CD?

10

CD can either be childhood-onset (having at least 1 symptoms before the age of ___) or adolescent-onset

We use the number of symptoms and the level of impairment/harm it causes

• Mild = few symptoms + mild impairment/harm to others

• Moderate = mild-severe number of symptoms + impairment/harm to others

• Severe = a lot of symptoms OR behaviours causing serious harm

How do we assess the severity of CD?

combinations

Per diagnostic criteria for CD, there are many possible ______ of symptoms

severe

→ below

There are certain combinations of 2 symptoms (which are considered subclinical) that are more ______ than certain combinations of 3 symptoms

→ If the cut-off stays 3, we might be missing some high severity people who happen to be right _____ the cut-off

Having limited prosocial emotions

What is the additional specifier for CD?

2

• guilt

• empathy

• performance

• emotions

→ 12, relationships, settings

To be diagnosed with CD - with limited prosocial emotions, you need ___ of these callous and unemotional traits:

• Lack of remorse or ______

• Callous, lack of ______

• Unconcerned about ______

• Shallow or deficient affect → doesn’t express _______

→ They must be persistently present over the last ___ months and in many _______ and ______

• 2,6

• earlier, severe, instrumental

• punishment

Having callous and unemotional traits (CU):

• ___% to ___% of youth with CD have these traits significantly

• When youth have CU traits, CD is _____ onset, aggression is more ______ and more ______

• Associated with insensitivity to ______ so it’s harder to treat

• same

• 50

• CD

CD and ODD:

• Can be diagnosed at the ______ time

• ___% of all children with CD have not been diagnosed with ODD

• Some children may start with a ODD diagnosis then add _______ diagnosis with age