Child PsychopathologyChild Psychopathology

Oppositional-Defiant DisorderOppositional-Defiant Disorder

Conduct DisorderConduct Disorder

Reading: Chapter 6Reading: Chapter 6

Does Bart Simpson have a Does Bart Simpson have a Disruptive Behavior Disruptive Behavior

Disorder?Disorder?7G02 I will not waste chalk 7G03 I will not skateboard in the halls 7G04 I will not burp in class 7G06 I will not instigate revolution 7G09 I will not draw naked ladies in class 7G07 I did not see Elvis 7G10 I will not call my teacher "Hot Cakes" 7G13 Garlic gum is not funny 7G12 They are laughing at me, not with me 7G01 I will not yell "Fire" in a crowded classroom 7F03 I will not encourage others to fly 7F03x I will not fake my way through life 7F02 Tar is not a play thing

7F01 I will not Xerox my butt

Ways of thinking of antisocial Ways of thinking of antisocial behaviorbehavior

Overt vs. covertOvert vs. covert Destructive vs. nondestructiveDestructive vs. nondestructive Verbal vs. physical aggressionVerbal vs. physical aggression Instrumental vs. hostile aggressionInstrumental vs. hostile aggression Direct vs. indirect aggressionDirect vs. indirect aggression Reactive vs. proactive agressionReactive vs. proactive agression Four types of youth violence (Figure 6.4):Four types of youth violence (Figure 6.4):

– SituationalSituational– RelationshipRelationship– PredatoryPredatory– PsychopathologicalPsychopathological

DSM-IV Criteria DSM-IV Criteria Oppositional-Defiant Disorder (T: 6.1)Oppositional-Defiant Disorder (T: 6.1)

– age inappropriate stubborn, irritable, and age inappropriate stubborn, irritable, and defiant behaviorsdefiant behaviors

Conduct Disorder CD (T: 6.2)Conduct Disorder CD (T: 6.2)– persistent pattern of violating basic rights of persistent pattern of violating basic rights of

others and societal norms or rulesothers and societal norms or rules Antisocial personality disorder (<18 yrs)Antisocial personality disorder (<18 yrs)

– repetitive aggressive, law-breaking behaviorsrepetitive aggressive, law-breaking behaviors– signs of psychopathy (no guilt or remorse) signs of psychopathy (no guilt or remorse)

Gender differencesGender differences

For CD, 3:1 male-female ratioFor CD, 3:1 male-female ratio Boys show earlier onset and greater Boys show earlier onset and greater

persistencepersistence Gender disparity decreases in Gender disparity decreases in

adolescence adolescence Early signs:Early signs:

– Boys - aggression and theftBoys - aggression and theft– Girls - early menarche, sexually precociousGirls - early menarche, sexually precocious– Note: CD boys & girls are drawn togetherNote: CD boys & girls are drawn together

Developmental pathwaysDevelopmental pathways

Life-Course-Persistent PathwayLife-Course-Persistent Pathway

Figure 6.6: Patterson’s 1992 Dev’t Figure 6.6: Patterson’s 1992 Dev’t ModelModel

Adolescent Limited PathwayAdolescent Limited Pathway

Difficult

Temperament

Attentional

Problems

Oppositional

Behavior

Conduct

Disorder

Contact

with Law

CD arises during teen years

Young adulthood: “Normal” adjustment

What kind of trouble? How permanent is impact? Life trajectory?

Biological Causes of CDBiological Causes of CD

Temperament, impulsivity, emotional Temperament, impulsivity, emotional lability, lack of persistance, lability, lack of persistance, restlessness, negativity, poor copingrestlessness, negativity, poor coping

Genetic contributions for overt Genetic contributions for overt behaviors and LCP path (parent behaviors and LCP path (parent criminality)criminality)

Insensitivity to rewardsInsensitivity to rewards Low psychological arousal & autonomic Low psychological arousal & autonomic

reactivity: Sensation-seeking reactivity: Sensation-seeking

Social cognitive factorsSocial cognitive factors

Cognitive deficiencies and distortionsCognitive deficiencies and distortions– misinterpretation of neutral events as misinterpretation of neutral events as

hostilehostile– Bill: he “looked at me” wrongBill: he “looked at me” wrong

Deficits may occur encoding and Deficits may occur encoding and interpretinginterpreting

Problem solving:Problem solving:– searching for R, choosing one, searching for R, choosing one,

implementing implementing

Family factorsFamily factors

Dysfunctional family functioningDysfunctional family functioning– Family conflict, violence, inconsistent or Family conflict, violence, inconsistent or

ineffective parenting, transitions, antisocial ineffective parenting, transitions, antisocial family values (e.g., police are stupid)family values (e.g., police are stupid)

Bidirectional causalityBidirectional causality Coercive parenting cycleCoercive parenting cycle Insecure attachment may predict Insecure attachment may predict

antisocial behaviorantisocial behavior Other family stress (e.g., financial)Other family stress (e.g., financial)

Societal factorsSocietal factors

Poverty, crime areas, residential Poverty, crime areas, residential mobility, no sense of communitymobility, no sense of community

Media influence: Reinforces pre-Media influence: Reinforces pre-existing tendencies towards violent or existing tendencies towards violent or exploitive actsexploitive acts

Culture and ethnicity are confounded Culture and ethnicity are confounded with SES, may exacerbate problems in with SES, may exacerbate problems in teen years (gangs & “turf” may be teen years (gangs & “turf” may be along ethnic lines)along ethnic lines)

TreatmentTreatment

Poor prognosis for antisocial behaviors & Poor prognosis for antisocial behaviors & LCPLCP– this includes psychotherapy, group therapy, this includes psychotherapy, group therapy,

tutoring, punishment, boot campstutoring, punishment, boot camps Early intervention for ODD and CD:Early intervention for ODD and CD:

– Parent-management trainingParent-management training– Cognitive problem solving skills training focus Cognitive problem solving skills training focus

on distortions and deficiencieson distortions and deficiencies– Multi-systemic treatment: Family system Multi-systemic treatment: Family system

manipulation manipulation

CD and Violent OffenseCD and Violent Offense

Lexis Jones-O’RourkeLexis Jones-O’Rourke

Conduct Disorders as a Conduct Disorders as a function of impulsivity and function of impulsivity and

anxietyanxiety

Impulsivity

Yes

No

Anxiety

Yes No

Suicide CD

Depression, No

Anorexia Problem