Behavioral Med Disruptive, Impulse-Control, and Conduct Disorders

kleptomania

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

females

Are males or females more likely to be kleptomaniacs?

monomania instinctives

irreversible urges WITHOUT apparent motives

impulse

a disposition to act to decrease heightened tension caused by buildup of instinctual drives or by diminished ego defenses against the drives

intermittent explosive disorder

discrete episode of losing control of aggressive impulses

"spell" or "attack"

people have genuine regret/remorse

2x/wk for 3 months

How frequently must verbal OR physical aggression occur toward property, animals, or other individuals to be considered intermittent explosive d/o?

* the physical aggression DOES NOT result in damage or injury

3 behavioral outbursts in 12 months

How many behavioral outbursts must someone have and in what period of time in order to be considered intermittent explosive d/o?

* the physical aggression DOES cause damage or injury

6 years old

How old must someone be chronologically in order to be dx with intermittent explosive d/o?

< 35 y/o

With what age group is intermittent explosive d/o most common?

pyromania

deliberate and purposeful fire setting on more than 1 occasion

oppositional defiant disorder

diagnosis applied when a youth demonstrates a recurrent pattern of negativistic, defiant, disobedient, hostile behavior toward authority

6 months

How long must the duration of anger, irritable mood, argumentative, defiant behavior or vindictiveness directed at someone not a sibling be in order to be considered oppositional defiant d/o?

4

How many sxs must be present in the "angry/irritable mood," "argumentative/defiant behavior," or "vindictiveness" categories to be considered ODD?

True

True or false:

- Many children with ODD have coexisting conditions.

conduct disorder

dx applied when a youth demonstrates a repetitive and persistent pattern of violating the basic rights of others and societal norms

at least 3 sxs in past 12 months with ≥1 the past 6 months

What is the dx criteria (timewise) for conduct d/o?

childhood-onset type (before 10)

adolescent-onset type (after 10)

What are the different types of conduct d/o?

antisocial personality d/o

a pattern of socially irresponsible, exploitative, and guiltless behaviors

antisocial personality d/o

What does this mnemonic explain?:

Conduct d/o before age 15, at least 18 now

Acts that are grounds for Arrest

Lies frequently, cons others for profit/pleasure

Lacks remorse

Obligations not honored

Unstable, can't plan ahead, impulsivity

Safety of self and others ignored

Money: spouse, children not supported

Aggressive, Assaultive

Not occurring exclusively during course of schizophrenia/mania

CBT

What is the best non-pharm tx for kleptomania?

therapy/counseling

What is the best tx for intermittent explosive d/o?

benzos

What type of drugs should be avoided in pts with intermittent explosive d/o?

CBT

What is the best tx for pyromania?

treat aggression and comorbidities

set firm limits, and hold them accountable

What is the best tx for ODD?

treat aggression and comorbidities

set firm limits, and hold them accountable

What is the best tx for conduct disorder?

empathy

What is the greatest protective factor for the course/prognosis of conduct d/o?

benzos, stimulants

What drugs should you not prescribe someone with antisocial personality disorder?

treat coexisting conditions

treat aggression

What is the best tx for antisocial personality d/o?