age inappropriate actions and attitudes that violate family expectations, societal norms, and the personal property or rights of others
Externalizing- negativistic behaviors that commonly co-occur in childhood such as, noncompliance, aggression, tantrums, classroom and authority violations, and violations of the community.
I. OPPOSITIONAL DEFIANT DISORDER (ODD)
Diagnostic Criteria
A. A pattern of negativistic, hostile, and defiant
behavior lasting at least 6 months, during which four (or more) of the
following are present:
1. often loses temper
2. often argues with
adults
3. often actively defies
or refuses to comply with adults' requests or rules
4. often deliberately
annoys people
5. often blames others
for his mistakes or misbehavior
6. is often touch or
easily annoyed by others
7. is often angry and
resentful
8. is often spiteful
or vindictive
B. The disturbance causes clinically significant
distress or impairment in social, academic (occupational), or other important
areas of functioning.
C. The behaviors do not occur exclusively during
the course of a Psychotic or Mood Disorder.
D. Criteria are not met for Conduct Disorder,
and, if the individual is age 18 years or older, criteria are not met for
Antisocial Personality Disorder.
II. CONDUCT DISORDER (CD)
Diagnostic Criteria
A. A repetitive and persistent pattern of behavior
in which the basic rights of others or major age-appropriate societal norms
or rules are violated, as manifested by the presence of three (or more)
of the following criteria in the past 12 months, with at least one criterion
present in the past 6 months:
Aggression to people and
animals
1. often bullies, threatens
or intimidates others
2. often initiates physical
fights
3. has used a weapon
that can cause serious physical harm to others (e.e., a brick, bat, broken
bottle, knife, gun)
4. has been physically
cruel to people
5. has been physically
cruel to animals
6. has stolen while confronting
a victim (e.g., mugging, purse snatching, armed robbery)
7. Has forced someone
into sexual activity
Destruction of property
8. has deliberately engaged
in fire setting, with the intention of causing serious damage
9. has deliberately destroyed
others' property (other than by fire setting)
Deceitfulness or theft
10. has broken into someone
else's house, building or car
11. often lies to obtain
goods or favors or to avoid obligations (i.e., cons others)
12. has stolen items
of non trivial value without confronting a victim (e.g., shoplifting, but
w/out breaking and entering, forgery)
Serious violations of rules
13. often stays out at
night despite parental prohibitions, beginning before age 13
14. has run away from
home overnight at east twice while living in a parental or parental surrogate
home (or once without returning for a lengthy period)
15. is often truant from
school, beginning before age 13 years
B. The disturbance causes clinically significant
distress or impairment in social, academic (occupational), or other important
areas of functioning.
C. If the individual is age 18 years or older,
criteria are not met for Antisocial Personality Disorder.
III. Other classifications
A. Undersocialized Aggressive vs Socialized-Aggressive
B. Overt dimension-(i.e.,physical aggression,
disobedience, destruction of property) vs
Covert dimension- (i.e.,cheating,
lying, stealing, truancy)
IV. Comorbidity
A. ADHD
1. It occurs in 48%-75%
of children w/CD
2. Some researchers believe
that ADHD serves as a catalyst for CD/ODD
3. Studies have found
support for the separation of ADHD from CD/ODD
4. Children who display
concurrent CD/ODD and ADHD have a much higher risk for later antisocial
behavior.
B. The differences between ODD and CD:
1. Symptoms of ODD emerge
2-3 years before symptoms of CD
2. Symptoms of CD often
don't occur in very young children
3. ODD is a good predictor
of CD and almost always precedes CD
4. However, 75% of children
who display ODD do not progress to CD
V. Statistics and Course
A. Age of Onset- ODD= 6yrs, CD= 9yrs
B. Risk factors for continuation of CD
1. Early age of onset
2. Deviance across multiple
settings
3. Increased frequency
and intensity of the behavior
4. Diversity of the behavior
5. Family history and
poor parenting/home environment
C. Gender Differences
VI. Causes of disruptive behavior disorders:
A. Genetic
1. Stable across generations,
but little direct evidence for genetic contributions.
2. Genetic factors can
interact with environmental factors.
B. Neurobiological
1. Increased rates of
CD have been associated with neurological abnormalities.
2. Low resting heart
rate, lower skin conductance
C. Familial
1. Parent Psychological
Factors
2. Divorce, Marital Distress,
and Violence
3. Family Adversity
4. Family Insularity
5. Parent-Child Interactions
D. School-Related Factors
1. Academic Performance
2. Learning Disabilities
3. Characteristics of
the School Environment
VII. Treatment
A. Child Training
B. School and Community Interventions
1. Teaching problem solving
skills
2. Social skills training
3. Contingency management
programs
4. Anger Management
C. Parent/Family Intervention
1. Teaching parenting
skills
2. Making the family
aware of poor interaction styles
3. Anger Management