DISRUPTIVE BEHAVIOR DISORDERS

 

 

Conduct Disorders (CD) and Oppositional Defiant Disorders (ODD) are referred to as ___________________________________ disorders.

 

They are the most common ______________________ disorders seen in children and adolescents.

 

Because the community is often _________________________ by children with CD or ODD, there is a strong consensus that these disorders deserve special attention.

 

______________________________ children often exhibit some CD/ODD components.

 

Initial __________________________ challenged any ________________________ between CD/ODD

 

More recent _______________________ suggests there is a ___________________.  Achenbach (developer of the CBC’s) has consistently found 2 “disruptive behavior” factors in his studies.

 

One of the factors—___________________________– captures the components of aggression, anger, and disobedience.  The Aggressive Behavior component roughly corresponds to ______________________.

 

The other factor – ____________________________– includes components of lawbreaking and violation of societal norms.  The Delinquent Behavior component roughly corresponds to ___________.

 

Overall, ODD and CD represent _______________________ constructs, but are __________________ to each other.  To summarize this relationship:

 

1)                  The mean age of onset for ODD symptoms is _________________ than for CD symptoms.

 

2)                  ODD and CD are ____________________ related.  Many children with ODD _________________ develop CD, but almost all children with CD have had an earlier ____________________ of _______________.  CD, in turn, predicts _______________________ Personality Disorder in adulthood.

 

_______________________ Personality Disorder can include the following:  failure to _____________________ to social norms,

repeatedly performing acts that are grounds for ______________, __________________, ___________________

conning others for personal ___________________ or pleasure aggressiveness, physical __________________

disregard for _________________ of self or others,

not honoring _______________________ obligations, poor_______________ history, lack of _____________________.

 

3)                  ____________________ correlation for ODD and CD are similar, but children with CD have a greater _________________ and ___________________ of the correlational ___________________. 

 

4)                  Treatment for ___________________ is more likely to be __________________ than treatments for CD.  This is probably because of lower symptom severity and the younger age of the child with ODD.

 

 

Oppositional Defiant Disorder

 

Diagnostic Considerations

 

DSM-IV defines ODD as “______________________ patterns of negativistic, _________________, disobedient, and _____________________ behavior toward authority figures”. 

 

Characterized by symptoms such as _____________________ with authorities, refusal to _____________________ with requests, losing _____________________, irritability, externalizing _________________________ for misbehavior, __________________ behavior, appearing angry or ______________________. 

 

ODD is not ______________________ if the child qualifies for the CD diagnosis.  Without this _________________________ criterion, virtually all children with CD would also receive an ODD label.

 

ODD symptoms are more ____________________ or more ____________________ versions of typical child behaviors.

 

The child’s disruptive behaviors must exceed the ______________________, ________________________, and ________________________ of behaviors typical for the child’s age.

 

ODD is usually diagnosed before age ___________ and almost always before ___________________. 

 

ODD is a common disorder, with prevalence rates of _________________% in the child population.  Males are diagnosed approximately 3 _________________ as often as females. 

 

At _____________________ age ODD manifests itself in frequent, severe temper _________________ and intolerance of _______________.  He/She will respond to frustration with an extremely ____________________ and ______________ display.

 

Kicking, power struggles, and _________________________ of property are common.

 

If parents ___________ ______ to the child’s demands, the child learns that escalation of the power struggle results in ________________________.

 

At older ages, tantrum behavior may persist, but oppositionality and defiance usually becomes more _________________________. 

 

“Talking back” and _______________________ refusal to comply are typical during adolescence.  ____________________________ and __________________ behaviors persist and are often incorporated into power struggles. 

 

Parents/adults may feel held ______________________ by the child’s threats to destroy property or to become ______________________ aggressive.

 

The child may appear to be __________________________ or testing adults for the limits of _________________________ behavior.

 

ODD children tend to be most oppositional toward certain __________________ or in certain ________________________.

 

Parents are often able to _________________________ one parent who receives most of the ______________________ and ________________________ behavior.

 

Additionally, the child may be _______________________ at home, but not in school.  There is a tendency for children with ODD to be at risk for ______________________, as well.

 

Etiology

 

There is mounting ________________________ that parental psychopathology, family ____________________, and behavioral ____________________ are responsible for the ODD child. 

 

Families of children with ODD show higher rates of parental _________________, substance _____________________, and ______________________ Personality Disorders than do families of other children.

 

Behavioral factors, such as parental ____________________ and parental ________________are also associated with the development of ODD symptoms.

 

Harsh _______________________ punishment of children can create _______________, reduced _________________________, and provide a model of _____________________. 

 

Inconsistent ____________________ can _________________________ children for escalating until the parents _______________ them what they want.  The children then learn to ________________________ the pattern of defiant, _________________ behavior in order to be __________________ by getting their way.

 

Oppositional behavior is __________________________ when the child gains attention and _____________________________ as a result of this.  To the extent that _____________, control, and _________________________________ result from oppositional behavior, the child will be prone to show ODD ____________________.

 

Some research suggest that _______________________ factors may also play a role in ODD symptomology.

 

Some studies suggest that _______________________ children of antisocial biological ________________ are more likely to exhibit _____________________ behavior than are adopted children of normal fathers.

 

Twin studies also support a __________________________ component to ODD. 

 

_____________________ factors seem to explain only a _________________ of the reason for the emergence of ODD symptoms, however.

 

 

 

 

 

 

Conduct Disorders

 

Diagnostic Considerations

 

DSM-IV defines CD as “a ________________________ and persistent __________________ of behavior in which the basic rights of others or age-appropriate societal norms or _______________________ are violated”.

 

This behavior will occur across multiple social arenas, including ___________________, _________________, and ____________________.

 

Symptoms of  CD include: _________________, intimidating others, ______________, use of weapons, stealing, cruel behavior toward people or animals, sexual ________________, lying, fire setting, running away, breaking into a house or car, and __________________.

 

CD occurs in 6-16% of boys and 2-9% of girls.

 

There are 2 CD subtypes:

 

______________________-Onset type:  requires at least one conduct problem b/4 age ____

_________________-Onset type: requires no conduct problems b/4 age _________

 

Childhood-Onset type is more ____________________ and _________________ as the child develops;  it is more likely to ___________________ into Antisocial Personality Disorder.

 

CD is ______________________ with a number of other disorders (co-morbidity):  substance __________________, ________________, _________________, Bipolar Disorder, Eating Disorders, etc.

 

ADHD is the most ____________________ co-occurring diagnosis with CD/ODD.  CD or ODD is found in up to ____% of ADHD cases.

 

When ADHD and CD co-occur the onset of _________________ generally ___________ the onset of CD.

 

When ADHD and CD are co-morbid the symptoms are _________________ than with either condition ____________________, with greater symptom __________________, and an increased risk for later _____________________ Personality Disorder, more environmental problems, more ______________ __________________, and show deficiencies in processing of social information.

 

CD typically develops as a _____________________ process that expands from ______________ to parents to opposition to adults, all authorities, and eventually to ________________ as a whole.

 

Typically, the school is the ____________________ non-home __________________ in which the child exhibits oppositional and rule-breaking behavior.

 

Most CD-type school/social behaviors _____________________ in ________________ school.  This leads to _____________________ in school and in most social settings.  These failures further __________________ the child from rules/norms/society.

 

Separated from the _____________________, the child may identify with a __________ peer group.  This deviant peer group provides _________________________ social modeling and social ____________________ for ________________________ behavior.

 

Activities that lead to immediate ________________________ (drug use, stealing) are chosen as alternatives to “unattainable” socially ___________________ means of gratification.

 

CD appears to emerge out of early ______________________ struggles and ______________ and ______________________ failures that develop into oppositional, defiant, and eventually, ______________________ behaviors. 

 

There is evidence that CD children score lower on ______________________ tests, along with performing __________________ in ______________________.

 

Low ______________________ has been shown to be _____________ times more likely for CD children than with control groups.

 

Studies have suggested that the intellectual deficiencies of CD children extend to social _____________________ and ___________________________ skills.

 

Compared to their peers, CD children more often perceive neutral social cues as having ____________________ meaning.

 

CD children tend to interpret neutral situations as _______________________.  Because they view these situations as such, CD/aggressive children feel _____________________ by peers and adults.

 

CD is associated with early __________, ___________________, marital conflict, financial ___________________, and poor interpersonal ________________________.

 

 

 

Etiology

 

Biological

 

Most children with CD are __________________.  Whether this is a biological/hormonal or cultural factor is _________________ yet __________________.

 

Slow heart ________________ has been linked to CD.

 

Some findings suggest that CD children may be less responsive to __________________ stimuli and may need a higher level of external stimulation.

 

Researchers have found correlations between frontal lobe functioning and delinquency .  The frontal lobe is partially responsible for the ___________ and ______________ of behavior.

 

The findings suggest that CD children have less frontal-lobe mediated inhibition of behavior, increasing the likelihood they will act and behave ______________________.

 

_____________________________ studies are suggestive (but preliminary) in explaining the emergence of CD.

 

It appears that CD runs in ______________________________ and is associated with cognitive ____________________.  The effects of environmental factors, as well as the magnitude of the effect of biological factors, remain to be determined.

 

 Family-Behavioral

 

Nearly all major psychological theories regarding the etiology of CD suggest a role for parent/family ___________________________ in CD symptoms.

 

There is suggestion that issues as fundamental as _________________________ problems may be _____________________ of later CD.

 

Examples of attachment problems include: extended separation from the ____________________, multiple ___________________, marital _________________, poor __________________, etc. predict later antisocial behavior.

 

The child develops little _________________ to rules and social ______________________ because __________________ figures have done little to earn such ______________________.

 

Instead of being nurtured, the child expects _______________________ and _____________________ from authorities and society.

 

An association between parent _________________ and CD is possible due to the problems with the observational report of a depressed parent.

 

_____________________________ parents tend to overestimate _____________________ problems in their children.  These discrepancies seem to be more prevalent with mother reporting than with father.