Disruptive, Impulse-Control and Conduct Disorders

Disorders that involve problems with self-control of emotions and behaviors that typically violate the rights of others and/or bring the individual into significant conflict with societal norms or authority figures

disruptive and impulse-control disorders

what age range are tantrums normal

2-5 ish

A tantrum is abnormal if:

-aggressiveness is in more than half the cases

-self-injury

-frequency (more than 10 a month or 5 in a day)

-length (consistent at least 25 minutes)

-unable. to self-soothe

a sudden strong and unreflective urge or desire to act

impulse

which type of impulse aligns with values and beliefs

Ego-SYStonic

Which type of impulse goes against values and beliefs

Ego-DYStonic

what is the primary problem with impulse control disorders

control (or lack therof)

t/f: people with impulse-control behavioral disorders may or may not plan the acts, but the acts generally fulfill their immediate, conscious wishes

true

what characterizes impulse control disorders

increasing tension or arousal before committing the act

with impulse control behavioral disorders, what is the hallmark of psychological immaturity

strong desire to be satisfied almost immediately- decreased ability to delay gratification or pleasure

with impulse control behavioral disorders, individuals have a history of acting out in at least two areas that are potentially _____________

self-damaging (ex: spending money, sexual activity, reckless driving, addictive behavior)

Which disorder is this: 

-irritable or angry (often loses temper, easily annoyed…)

-argumentative/defiant behavior (argues with authority figures, refuses to comply) 

-vindictiveness (spiteful on at least 2 occasions in 6 months)

oppositional defiant 

-requires at least 4 symptoms from the categories of irritable or angry mood, argumentative or defiant behavior, or vindictiveness

-instances that have occurred over a period of 6 months and is outside of the normal limits of childhood behavior

-behavior is associated with distress either within the individual or by others in his or her immediate social context

oppositional defiant pediatric disorder

how often is oppositional defiant disorder behavior observed in individuals younger than 5 years

behavior is observed on most days

how often is oppositional defiant disorder behavior observed in individuals older than 5 years

behavior observed at least once per week

which disorder is more prevalent in families where there is a disruption in caregivers or in families where there is harsh, inconsistent, or neglectful child-rearing practices

oppositional defiant disorder

what is oppositional defiant disorder often co morbid with

ADHD and Conduct disorder

when do first symptoms of oppositional defiant disorder appear

during preschool

can intermittent explosive disorder be for pediatrics and adults? 

yes

recurrent behavioral outbursts representing a failure to control aggressive impulses as indicated by either:

-having episodes that occur at least 2 times per week for 3 months

-3 outbursts that include damage to property or physical assault in a period of 12 months

intermittent explosive disorder

when is primary onset for intermittent explosive disorder

primary onset in adolescence-rare onset after age 40

who are at risk for developing intermittent explosive disorder

increased risk in individuals who have experienced trauma before age 20

intermittent explosive disorder often occurs with: 

depression, anxiety, and substance disorders

what might be comorbid with intermittent explosive disorder

ADHD, conduct, and ODD

what disorder is categorized under mood not impulse disorders, but is very similar to IED

disruptive mood dysregulation disorder

-severe temper, physical aggression

-tantrum inconsistent with developmental level

-tantrums occur at least 3x per week

-general mood is angry or irritable

-previous symptoms present at least 12 months

-previous symptoms present in 2 of 3 settings

-diagnosis apparent after age 6 and before 18

disruptive mood dysregulation disorder

when is age of onset for disruptive mood dysregulation disorder

around 10 years

a repetitive and persistent pattern of behavior in which the basic rights of others (and age-appropriate societal rules) are violated

conduct disorder

what are some criteria for conduct disorder

-aggression to people and animals

-destruction of property

-deceitfulness. or theft

-serioius violation of rules

how many criteria must occur over a period of a year to be considered for conduct disorder

3 of 15, but one criterion must have occurred in the last 6 months

when is onset for childhood type conduct disorder

onset prior to age 10

when is onset for adolescent type conduct disorder

no symptoms before age 10

what are some specifiers of conduct disorder

lack of remorse, callous (lack of empathy), unconcerned about performance, shallow or deficient affect

t/f: people with conduct disorder frequently mis-perceive others intentions as hostile and threatening and respond with a behavior that is felt to be reasonable and justified

true

when is onset rare for conduct disorder

rare after age 16

what is a common precursor for conduct disorder

oppositional defiance

is an earlier onset of conduct disorder worse or better?

worse! you have a worse prognosis and higher risk of criminality

t/f: childhood onset of conduct disorder has a higher family risk

true

Intermittent is ___________ wheras conduct may be _____________

impulsive; premeditated

does conduct disorder or intermittent disorder include non-aggressive acts

conduct disorder

________________ is typically less severe than conduct disorder and does not include aggression toward individuals and animals. ordestruction of property, theft, or deceit

oppositional defiance

what has an emotional dysregulation (angry and irritable) that is not included for conduct

oppositional defiance

if there has been. arecent stressor-such as loss of a parent, change in schools, new baby, WHAT should be diagnosed until the problem becomes pervasice and consistent

adjustment

-feeling of tension or affective arousal before the act

-fascination or attraction to fire

-pleasure, gratification or relief when setting or witnessing fires

-fire setting is not for monetary gain or a statement

pyromania- deliberate fire setting

failure to resist impulses to steal objects that are not needed for personal use or for their monetary value

kleptomania

what are some techniques to improve impulsivity SHORT TERM

-distraction (take thoughts away from strong emotion, count backwards, exercise, name colors)

what are some techniques to improve impulsivity LONG TERM

-find a new behavior that feels equally as good

-indentify short and long term pros/cons

-resist the urge

-reward when successful

-change the consequence. ofthe behavior

t/f: research shows that a possible seizure disorder may be linked with intermittent explosive disorder

true