CHAPTER 15 Integrative Management of Disordered Impulse Control

What risks are associated with untreated impulsive and disruptive behaviors in adolescents?

Assault, theft, property damage, sexual abuse, and mortality.

How do impulsive and disruptive behaviors change as adolescents mature?

They often outgrow even moderately disruptive behavior.

What does the integrative General Aggression Model (GAM) encompass in understanding aggression?

Developmental, biological, social, environmental, cognitive, and personality factors.

What factors affect the expression of aggression according to the holistic context?

How power is deployed or abused within the client’s world.

What is the relationship between attachment styles in childhood and later impulsive or disruptive behaviors?

Extremely anxious, avoidant, and disorganized attachments can destabilize stress responses and influence behavior.

What are the two types of responses associated with insecure attachment in children?

Hot (anxious/impulsive) and cold (avoidant/disruptive) responses.

What early relationship is protective of an infant's psycho-neuro-immunological, endocrinological, and socioemotional health?

Secure attachment relations with the mother.

How do environmental toxins impact neurodevelopment and behavior?

They contribute to cognitive impairment and increase risks of ADHD and other behavioral issues.

What is the significance of childhood aggressive behaviors linked to maternal substance use?

Maternal smoking, alcohol consumption, and chemical exposures are strongly associated with increased aggression in children.

Why is early intervention crucial in preventing impulsive and disruptive disorders in children?

To prevent problems from growing, enhancing emotional and social development before puberty.

What is the role of oxytocin and vasopressin in mother-child interactions?

They play key roles in establishing synchrony and support adaptive and resilient brain development.

What is the primary focus of therapies for children with disruptive behaviors?

To improve emotional self-regulation and coping mechanisms within a supportive relationship.

What are the main strategies involved in Parent-Child Interaction Therapy (PCIT)?

Combining high nurturance with focused control through coaching parents during child-directed play.

How does Borderline Personality Disorder (BPD) typically manifest in children?

Emotional reactivity, impulsive and disruptive behavior, and identity instability.

What distinguishes Bipolar Disorder (BP) from Borderline Personality Disorder (BPD)?

BP is genetically based with mood cycles, while BPD is influenced by early bonding and traumatic experiences.

What key therapeutic approach is recommended for adults with BPD?

Psychodynamic therapy within a trusting therapeutic relationship.

What is the significance of neuropsychological assessments in evaluating impulsive and disruptive disorders?

They help to understand the underlying medical and developmental disorders linked to behavior.

What are the limits of pharmacological interventions for managing impulsive disorders?

They are not first-line treatments and should complement psychotherapies to manage severe symptoms.

Why will early detection and intervention strategies be effective in managing behavioral issues?

They focus on addressing emotional sources of distress, reducing impulsive behaviors over time.