Psychopathology - Misc (ODD, IED, CD; Gender/Sex)

Oppositional Defiance disorder (2 sx categories, # of sxs + duration)

Mood (angry) + bx (defiant/arguing) disorder

1.) mood: angry, irritable

2.) behavior: arguing, defiant, vengeful/vindictive

4+ sxs present during (non-sibling) interactions for ≥ 6 months

Gender comparison in ODD, % that goes on to develop Conduct Disorder

(all teens are defiant, & little girls are good girls)

***older children + teens: B = G (teen girls are just as likely to be defiant!)

-young children: B > G

30% of ODD → CD

IED (key characteristics)

Impulse-control disorder

-recurrent aggression/violence d/t failure to control (not planned or for specific gain)

-onset: usually childhood/adolescence

-dxed in people 6+ yo

Sx frequency needed for IED Dx (non-injurious aggression vs. leading to injury/damage presentation)

1.) Violent bx (that led to injury of other, property destruction)

• 3 incidences in 1 yr

2.) Aggression (did not lead to injury of others or property destruction)

• Twice-weekly over 3 months (104 incidences in a yr)

-aggression can’t be planned or d/t specific gain (it’s d/t impulse-control)

Conduct Disorder

Violates others’ rights, or social norms

LARPing (think psychopathy, not actually connected to real life)

Lying, stealing

Aggression to others (ppl/animals)

severe Rule violations

Property destruction

Sx frequency needed for Conduct Disorder

-same as injury/damage-causing IED (3 sxs over 1 yr)

-AND, 1 sx needed in past 6 months

(Moffitt) Life-course-persistent type vs. adolescent-limited Conduct Disorder

Life-course-persistent type: early onset, increasingly antisocial bx into adulthood

• d/t neuropsychological deficits (temperament, cognition) + adverse child-rearing environment

Adolescence-limited type – temporary/situational d/t “maturity gap” btwn sexual/biological vs. social maturity

• antisocial bx = way to attain mature status

Risk factors for Conduct Disorder

1.) Genetics: greater heritability in B (65%) vs G (43%)

2.) Reduced stress response (physiological and self-report)

• low resting HR is risk factor

• poor coordination between emotional vs. physiological arousal

3.) Trauma

• physical/sexual abuse, neglect

• frequent caregiver changes

• parent criminology and substance abuse

• discipline that’s harsh + inconsistent

Treatments for CD

Child-focused: Problem-solving skills training

Parent-focused: PMT/PMT-O (coercive cycle), PCIT

Family-focused:

• Functional family therapy (FFT): teen’s bx serves fx (rship distance, power/control)

• multidimensional family therapy

Multimodal:

• Multisystemic therapy (MST): offending teens at-risk for out-of-home placement; address contributing factors and tx team at each system level

• multidimensional treatment foster care