14.4 Oppositional Defiant Disorder and Conduct Disorder Notes

Overview of Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD)

  • Definition:

    • ODD and CD are behavioral disorders that can develop in children.

    • Most children occasionally misbehave but may qualify for diagnosis if their behavior is extreme and persistent.

Oppositional Defiant Disorder (ODD)

  • Characteristics:

    • ODD involves a pattern of angry, irritable mood, argumentative/defiant behavior, and vindictiveness.

    • Common behaviors include:

    • Frequent arguing with adults

    • Deliberately annoying others

    • Refusing to comply with rules

    • Holding onto resentment and anger

  • Prevalence:

    • Approximately 11% of children have ODD.

    • More common in boys than girls before puberty, affecting both genders equally post-puberty.

Conduct Disorder (CD)

  • Characteristics:

    • CD is characterized by more severe behaviors such as:

    • Aggression towards people and animals

    • Destruction of property

    • Deceitfulness (theft, lying)

    • Serious violations of rules (truancy, running away)

  • Prevalence:

    • 5-10% of children are diagnosed with CD (3/4 of whom are boys).

    • Symptoms typically appear between ages 7-15.

  • Examples of Behavior:

    • Physical assaults, committing crimes like arson and robbery.

    • Case Study: 15-year-old Derek, involved in shoplifting and vandalism without feelings of remorse.

Developmental Considerations

  • Long-term Outcomes:

    • Severe conduct issues can result in life-long behavioral problems, including antisocial personality disorder.

    • Early onset leads to poorer outcomes in adulthood.

    • ODD often precedes CD in over 80% of cases.

Types of Conduct Disorder

  • Variants:

    1. Overt Destructive Pattern: Openly aggressive behaviors.

    2. Overt Nondestructive Pattern: Offensive but non-confrontational behaviors.

    3. Covert Destructive Pattern: Secretive harmful behaviors.

    4. Covert Nondestructive Pattern: Non-aggressive secretive actions like truancy.

  • Relational Aggression: More common in girls; involves social manipulation rather than overt violence.

Legal Context

  • Juvenile Delinquency:

    • Legal classifications of children (aged 8-18) engaging in criminal behaviors.

    • High rates of recidivism among juvenile delinquents.

  • Racial Disparities:

    • Disproportionate rates of arrests among Black youth compared to White youth, regardless of the severity of offenses.

Causes of Conduct Disorder

  • Genetic and Biological Factors:

    • Genetic predispositions linked to behaviors related to antisocial personality disorder.

  • Environmental Factors:

    • Family dynamics—truancy, maltreatment, and harsh parenting can contribute.

    • Community factors such as drug abuse, violence, and poverty play a role.

Treatment Approaches

  • Parent Management Training:

    • Focuses on family support to change behavior patterns.

  • Parent-Child Interaction Therapy (PCIT):

    • Engages parents with children through positive interaction models.

  • Cognitive Behavioral Interventions:

    • Teach problem-solving skills and coping mechanisms, often in a group setting.

  • Multisystemic Therapy:

    • Involves family dynamics, school, and community to promote positive change.

  • Residential Treatment:

    • Community-based foster care with ongoing family involvement, as opposed to institutional settings, which often exacerbate delinquency.

Prevention Strategies

  • Interventions:

    • Effective prevention requires changing social conditions, offering educational opportunities, and improving parenting skills.