PSYCY3018 Mental Health Conditions - Externalising Disorders

Flashcards about Externalising Disorders

Externalising Disorders

MHCs characterized by outwardly directed behaviours including impulsivity, aggression, and rule-breaking

Oppositional Defiant Disorder (ODD) Prevalence

Approximately 1.4% in females and 3.2% in males

Conduct Disorder (CD) Prevalence

Approximately 0.8% in females and 2.1% in males

Oppositional Defiant Disorder (ODD)

Pattern of negativistic, defiant, and disobedient behaviour toward authority figures

Conduct Disorder (CD)

Involves a persistent pattern of behaviors that violate the rights of others and societal norms

DSM-5-TR: Oppositional Defiant Disorder Criterion A

Pattern of angry/irritable mood, argumentative/defiant behaviours, or vindictiveness lasting at least 6 months, during which at least 4 symptoms are present.

Oppositional Defiant Disorder Severity - Mild

Symptoms confined to one setting

Oppositional Defiant Disorder Severity - Moderate

Some symptoms are present in at least two settings

Oppositional Defiant Disorder Severity - Severe

Some symptoms are present in three+ settings

3 Dimensions of Oppositionality

Angry/Irritable mood, Argumentative/defiant behaviour, Vindictiveness

Irritable (angry/irritable mood)

Frequent temper outbursts, easily annoyed

Headstrong (argumentative/defiant)

arguing with adults and defying rules

Hurtful (vindictiveness)

being spiteful or vindictive

Argumentative/defiant behaviour association

Strongly associated with ADHD

Angry/Irritable mood association

Strongly associated with depression and anxiety (mood disorders)

Vindictiveness association

Particularly associated with Callous-unemotional traits, and higher likelihood of developing Conduct Disorder

Conduct Disorder (CD)

A repetitive and persistent pattern of behaviour that violates the basic rights of others or societal norms

Four Domains of Conduct Disorder (CD)

Aggression to people and animals, Destruction of Property, Deceitfulness or theft, Serious violations of rules/norms

Childhood-onset type Conduct Disorder

Onset of at least one criterion characteristic of conduct disorder prior to age 10

Adolescent-onset type Conduct Disorder

Absence of any criteria characteristic of conduct disorder prior to age 10

Limited Prosocial Emotions Specifier Characteristics

Lack of remorse/guilt, Callousness or lack of empathy, Unconcerned about performance in important activities, Shallow or deficient affect (restricted emotional expression)

Callous-Unemotional Traits (CU)

Persistent pattern of behaviour that reflects a disregard from others and a lack of empathy.

Children with conduct problems and high CU traits (CP/HCU)

Showed significant deficits in recognising fear in others’ faces, linked to reduced attention to the eye region of faces, reduced amygdala activation

High CU traits Heritability

Moderate genetic & environmental influence

Low CU traits Heritability

Extremely strong genetic influence; minimal environmental influence

Biological factors of Biopsychosocial model of MHCs

Genetics, Neurobiology

Psychological factors of Biopsychosocial model of MHCs

Temperament, Cognition, Emotion regulation

Social factors of Biopsychosocial model of MHCs

Family environment, Peer influence, Low SES

Patterson’s (1982) coercion theory

The dominant causal model for explaining how aggressive and antisocial behaviours develop in children

Understanding day to day interactions between parents and children which escalate and reinforce aggressive behaviour

Cycles of Coercion

Developmental Perspective Stages

Early Childhood, Middle Childhood, Adolescence

Targets for early intervention in developmental model

Family and Peer Network

Guiding Principles For Effective Treatment

Target the ecology of the child, Take a developmental perspective, Be formulation/hypothesis-driven, Form a strong therapeutic team

Treatment for Early to middle childhood

Parent training

Treatment for Late -childhood and adolescence

Parent training, Youth-focused components are added

A Developmental Perspective informs

Optimal time for intervention, family variables, involve the child for their level of development

Parent-Training Targets

Breaking coercive cycles, Effective discipline strategies for non-compliance, Model non-aggressive interpersonal style, Attachment neutral responses, Increase prosocial interaction, Monitor the child’s activities