Disruptive, Impulse-Control, and Conduct Disorders

What are the main disorders included in the category of Disruptive, Impulse-Control, and Conduct Disorders?

Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and Intermittent Explosive Disorder.

Multisystemic Therapy

Bronfenbrenner's ecological model and is for adolescents 12 to 18 years of age who are at imminent risk for out-of-home placement due to antisocial behaviors, substance use problems, and/or serious psychiatric problems

What is the primary characteristic of Oppositional Defiant Disorder (ODD)?

A recurrent pattern of angry/irritable mood, argumentative/defiant behavior, and/or vindictiveness.

How many characteristic symptoms are required for a diagnosis of Oppositional Defiant Disorder (ODD)?

Four or more characteristic symptoms.

What is a common symptom of Oppositional Defiant Disorder (ODD)?

Often loses temper, is angry and resentful, or often blames others for his/her mistakes.

What is the duration of symptoms required for a diagnosis of Oppositional Defiant Disorder (ODD)?

Symptoms must last for at least six months.

In which demographic is Oppositional Defiant Disorder (ODD) more common in young children?

Boys.

What percentage of children diagnosed with ODD eventually receive a diagnosis of Conduct Disorder (CD)?

About 30%.

What type of treatment is recommended for individuals with Oppositional Defiant Disorder (ODD)?

Multimodal treatment tailored to the individual's age, symptoms, and comorbidities, with evidence-based psychosocial interventions as first-line treatments.

What is the primary characteristic of Conduct Disorder (CD)?

A persistent pattern of behavior that violates the basic rights of others and/or age-appropriate social norms.

How many characteristic symptoms are required for a diagnosis of Conduct Disorder (CD)?

At least three symptoms during the past 12 months and at least one symptom in the past six months.

What are the four categories of symptoms for Conduct Disorder (CD)?

Aggression to people and animals, destruction of property, deceitfulness or theft, and serious violation of rules.

What is the age limit for diagnosing Conduct Disorder (CD) in individuals?

The diagnosis cannot be assigned to individuals over age 18 who meet the criteria for antisocial personality disorder.

Which gender is Conduct Disorder (CD) more common in?

Males.

What are the three subtypes of Conduct Disorder (CD) according to the DSM-5-TR?

Childhood-onset type, adolescent-onset type, and unspecified onset.

What is associated with the childhood-onset type of Conduct Disorder (CD)?

A higher degree of aggressiveness and a greater risk for future diagnosis of antisocial personality disorder and/or a substance-related disorder.

At what age must at least one symptom occur for a diagnosis of childhood-onset type Conduct Disorder (CD)?

Before age 10.

What is the typical age range for the emergence of symptoms of Conduct Disorder (CD)?

Middle childhood to middle adolescence.

What is the significance of the onset of symptoms in Conduct Disorder (CD)?

The childhood-onset type is associated with more severe outcomes compared to adolescent-onset type.

What must symptoms of Conduct Disorder (CD) cause to meet diagnostic criteria?

Significant impairment in functioning.

What is a common treatment approach for Conduct Disorder (CD)?

Evidence-based psychosocial interventions.

What is the relationship between early onset of symptoms and future diagnoses?

An early age of onset of symptoms is associated with a higher risk for conduct disorder.

What are the specifiers for the severity of conduct disorder?

Mild, moderate, and severe, based on the number of conduct problems and their consequences.

What biological and environmental factors are linked to the etiology of conduct disorder?

Heredity, abnormalities in brain structure and functioning, neurotransmitter and neuroendocrine abnormalities, prenatal exposure to opiates or alcohol, and negative parenting practices.

Which neurotransmitter abnormalities are associated with increased aggression in conduct disorder?

Reduced serotonin and dopamine.

What did Fairchild and colleagues (2008) find regarding cortisol levels in adolescents with conduct disorder?

Adolescents with conduct disorder had higher evening cortisol levels compared to those without a psychiatric disorder and did not experience the typical increase in cortisol levels during stress.

What discrepancy did Fairchild et al. (2008) note in adolescents with conduct disorder?

A discrepancy between subjective emotional responses and physiological arousal, suggesting poorer coordination between the two.

What are the two types of antisocial behavior distinguished by Moffitt (1993)?

Life-course-persistent type and adolescence-limited type.

What characterizes the life-course-persistent type of antisocial behavior?

A pattern of increasingly serious antisocial behaviors that begins in early childhood and continues into adulthood, influenced by neuropsychological deficits and adverse child-rearing environments.

What is the adolescence-limited type of antisocial behavior according to Moffitt?

A temporary and situational type of behavior due to a 'maturity gap' between biological and social maturity.

What is the prognosis for individuals with childhood-onset conduct disorder according to DSM-5?

Worse prognosis with an increased risk of criminal behavior, conduct disorder, and substance-related disorders in adulthood.

What is the typical course of conduct disorder for most individuals?

It remits by adulthood, especially for those with adolescent-onset symptoms.

How does Moffitt's theory relate to the DSM-5 description of conduct disorder?

Her outcomes for life-course persistent and adolescent-limited types align with the DSM-5's description of the disorder's course.

What parenting practices are associated with the development of conduct disorder?

Negative parenting practices, such as harsh and inconsistent punishment.

What did studies suggest about the relationship between conduct disorder and aggression?

Reduced serotonin and dopamine contribute to increased aggression and risk-taking behaviors.

What is the significance of the 'maturity gap' in adolescence-limited conduct disorder?

It explains how antisocial behaviors are used to attain mature status.

What physiological response is typically absent in adolescents with conduct disorder during stress?

The typical increase in cortisol levels and cardiovascular response.

What is the impact of early childhood onset of conduct disorder on future behavior?

An increased risk of criminal behavior and other disorders in adulthood.

What did the research by Efferson & Glenn (2018) indicate about conduct disorder?

It highlighted the role of neurotransmitter and neuroendocrine abnormalities in the disorder.

How does the severity of conduct disorder relate to its consequences?

Severity is based on the number of conduct problems and their consequences.

What is the relationship between conduct disorder and negative affect during stressful situations?

Adolescents with conduct disorder report similar increases in negative affect as those without the disorder.

What does the term 'adverse child-rearing environment' refer to in the context of conduct disorder?

An environment characterized by negative parenting practices that can contribute to the development of conduct disorder.

What are the implications of Moffitt's distinction between types of conduct disorder for treatment?

Understanding the type of conduct disorder can inform tailored interventions and treatment strategies.

What is the significance of baseline cortisol levels in adolescents with conduct disorder?

They differ from those without a psychiatric disorder, indicating potential physiological differences.

What are the first-line treatments for Conduct Disorder (CD) and other disruptive behavior disorders?

Evidence-based psychosocial interventions categorized as child-focused, parent-focused, family-focused, or multimodal.

What is the focus of Problem-Solving Skills Training (PSST) for children with Conduct Disorder?

It focuses on cognitive processes underlying problematic behaviors, helping children perceive others' feelings, understand consequences, and identify prosocial conflict resolution methods.

What is the Parent Management Training - Oregon model (PMTO) designed to address?

It is designed for parents of children aged 2 to 18, aiming to replace coercive parenting practices with positive parenting techniques.

What are the key components of Parent Management Training (PMT)?

It is based on operant conditioning principles, focusing on replacing negative antecedents and consequences with those that promote desirable behaviors.

What evidence supports the effectiveness of combining PMT with PSST?

Research suggests that combining PMT with PSST is more effective than either treatment alone for improving child and parent functioning.

What is Parent-Child Interaction Therapy (PCIT) and its target age group?

PCIT is an intervention for parents of children aged 2 to 7 with severe behavioral problems, focusing on improving parent-child interactions.

What are the two phases of Parent-Child Interaction Therapy (PCIT)?

The child-directed interaction phase enhances the parent-child relationship, while the parent-directed interaction phase teaches effective disciplinary practices.

What is Functional Family Therapy (FFT) designed for?

FFT is for families with a child aged 11 to 18 who has an externalizing behavior disorder or substance use problem.

What is the primary goal of Functional Family Therapy (FFT)?

To replace problematic behaviors within the family with non-problematic behaviors that serve similar functions.

What is Multidimensional Family Therapy (MDFT) and its target age group?

MDFT is for families with a member aged 11 to 21 who has a substance use disorder and comorbid internalizing or externalizing symptoms.

What assumption underlies the Parent Management Training - Oregon model (PMTO)?

It assumes that children's aggressive and antisocial behaviors result from coercive interactions between children and parents.

What age range does Parent Management Training (PMT) cover?

PMT is for parents of children aged 2 to 17 years old.

What does the child-directed interaction phase of PCIT focus on?

It focuses on enhancing the parent-child relationship.

What does the parent-directed interaction phase of PCIT focus on?

It focuses on teaching parents effective disciplinary practices.

What is the relationship between problematic behaviors and family dynamics in FFT?

Problematic behaviors help regulate relational connections and hierarchies within the family.

What is the significance of the age range 11 to 21 in Multidimensional Family Therapy (MDFT)?

This age range includes individuals who may have substance use disorders and comorbid symptoms.

What is the main outcome expected from Parent Management Training (PMT)?

Positive effects on child symptoms, parent symptoms, and family relationships.

What is the role of positive reinforcement in Parent Management Training (PMTO)?

It is a key component of positive parenting practices that replace coercive methods.

How does PSST help children with interpersonal problems?

By helping them accurately perceive feelings, understand consequences, and resolve conflicts prosocially.

What type of behaviors does Functional Family Therapy (FFT) aim to address?

Externalizing behaviors and substance use problems within the family context.

What is the overarching goal of psychosocial interventions for Conduct Disorder?

To improve child behavior and family dynamics through structured therapeutic approaches.

What are the primary goals of interventions for adolescents with substance use and aggression issues?

To reduce or eliminate substance use, aggression, and other symptoms, and to improve adolescent and family functioning by facilitating change in four interdependent domains: adolescent, parents, family interactions, and extrafamilial sources of influence.

What is Multisystemic Therapy (MST)?

An intensive family and community-based intervention for adolescents aged 12 to 18 at imminent risk for out-of-home placement due to antisocial behaviors, substance use problems, or serious psychiatric issues.

What theoretical framework does Multisystemic Therapy (MST) rely on?

Bronfenbrenner's ecological theory, which posits that problematic behaviors result from multiple risk factors at individual, family, peer, school, and community levels.

What is MST-CAN?

A version of Multisystemic Therapy designed for families of abused and neglected children aged 6 to 17.

What is Multidimensional Treatment Foster Care (MTFC)?

An alternative to residential care for children and adolescents needing intensive support due to child maltreatment, severe emotional disturbance, or juvenile delinquency, involving a tailored behavioral management plan.

What is the role of foster parents in Multidimensional Treatment Foster Care (MTFC)?

Children reside with highly trained and supervised foster parents while their biological parents receive training and support for positive reunification.

What have studies shown about the effectiveness of Scared Straight programs for conduct disorder?

Research indicates that these programs tend to have harmful effects, increasing the likelihood of future criminal behaviors among juvenile offenders and at-risk juveniles.

What types of approaches in Scared Straight programs have shown negative effects?

Both confrontational 'rap sessions' and nonconfrontational (educational) approaches have similar negative effects, particularly for seriously delinquent juveniles.

What characterizes Intermittent Explosive Disorder?

Recurrent behavioral outbursts due to failure to control aggressive impulses, with specific criteria regarding frequency, severity, and impact on functioning.

What are the criteria for diagnosing Intermittent Explosive Disorder?

(a) Verbal or physical aggression occurring twice weekly for at least three months without property damage or injury, or (b) three outbursts in a year resulting in damage or injury, with additional requirements on proportionality and premeditation.

At what age can Intermittent Explosive Disorder be diagnosed?

At least six years old or at the equivalent developmental level.

When does the onset of Intermittent Explosive Disorder typically occur?

Usually in childhood or adolescence.

What is the significance of the ecological theory in Multisystemic Therapy?

It emphasizes that interventions must address multiple levels of risk factors, including individual, family, peer, school, and community influences.

What types of families have been included in research on the effectiveness of MST?

Economically impoverished families, single-parent families, and African American and other racial/ethnic minority families.

What is the goal of interventions targeting extrafamilial sources of influence?

To improve adolescent functioning by addressing influences outside the family unit.

What are the consequences of aggressive outbursts in Intermittent Explosive Disorder?

They must cause significant distress, impaired functioning, or negative financial or legal consequences.

Why is it important that outbursts in Intermittent Explosive Disorder are not premeditated?

To differentiate the disorder from other aggressive behaviors that are planned or intended to achieve a specific outcome.

What is the impact of behavioral outbursts on interpersonal functioning in individuals with Intermittent Explosive Disorder?

They can lead to significant impairment in occupational or interpersonal relationships.

What is the relationship between adolescent substance use and family functioning?

Interventions aim to improve family functioning as a means to reduce adolescent substance use and related symptoms.

What is a key feature of Multidimensional Treatment Foster Care (MTFC) regarding treatment delivery?

The behavioral management plan is tailored to the individual child and implemented by a treatment team across various settings.

What is the age range for adolescents targeted by Multisystemic Therapy (MST)?

12 to 18 years of age.