45 Questions
Oppositional defiant disorder (ODD) is characterized by socially acceptable behaviours.
False
Conduct disorders (CDs) often involve behaviours that intrude on others.
True
ODD and CDs are characterized by prosocial behaviours.
False
Individuals with conduct disorders typically adhere to socially acceptable norms.
False
Both ODD and CDs fall under the category of antisocial behaviours.
True
Intrusion is a common characteristic of oppositional defiant disorder.
True
Conduct disorders are typically associated with conformity to societal norms.
False
Parent training programmes use behavioural principles to treat ODD/CD.
True
In parent training programmes, parents are taught to unintentionally reinforce antisocial behaviour by ignoring it completely.
False
Anger management programmes help young people by teaching them how to appraise the intentions of other people.
True
The use of atypical antipsychotics is highly effective for all cases of reactive aggression in children with emotional regulation disorders.
False
In interventions in schools, teachers deliver preventive programmes focusing on promoting social and emotional learning to all children.
True
Remedial teaching is recommended if a child with ODD/CD has associated reading difficulties.
True
The evidence base for the effectiveness of school-based interventions and the use of teaching assistants in classrooms is strong.
False
Parenting quality and neighbourhood environment are significant predictors of antisocial behaviour.
False
Children from inner-city areas with high disorganization and residential mobility are more likely to attend schools with high delinquency rates.
True
Corporal punishment has no significant effect on the likelihood of developing conduct problems.
False
The prognosis for individuals whose first presentation of conduct disorder occurs in adolescence is generally worse than for those who present earlier.
False
Children exposed to domestic violence are less likely to become aggressive.
False
Harsh, inconsistent discipline and low warmth in parenting are associated with ODD/CD.
True
There is strong evidence that any treatment significantly affects the long-term prognosis of conduct disorder.
False
The primary feature of Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) is persistent abnormal conduct that is more serious than ordinary childhood mischief.
True
Fire-setting is a common behavior associated with Conduct Disorder (CD) in older children and adolescents.
False
In ICD-10, Oppositional Defiant Disorder (ODD) is considered a subtype of Conduct Disorder (CD).
True
In younger children, persistent stealing is a significant concern and indicates Conduct Disorder (CD).
False
Disobedience, tantrums, and physical aggression towards siblings or adults are common manifestations of Oppositional Defiant Disorder (ODD) during the preschool period.
True
There is a clear dividing line that separates Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) from ordinary bad behavior.
False
Conduct Disorder (CD) in later childhood manifests both within the home and outside, often involving truanting, delinquency, and reckless behavior.
True
The prevalence of combined CD/ODD in children and adolescents is estimated between 3-5%.
False
ODD is more common in boys than girls.
True
A variant of the monoamine oxidase (MAOA) gene predisposes to CD only when combined with positive environmental factors.
False
Children with low IQ are likely to have higher self-esteem and a positive perception of school.
False
Abnormalities in the paralimbic system, involved in motivation and affect, can contribute to the development of CD.
True
Conduct disorders have a strong genetic component, independent of environmental influences.
False
Cognitive behavioral therapy (CBT) and parent management training (PMT) are commonly used treatments for conduct disorder.
True
Onset of conduct disorder before age 8 years is considered a predictor of poor outcome.
True
High IQ is a factor predicting poor outcome in children with conduct disorder.
False
Severe, frequent, and varied antisocial behaviors are indicative of poor outcomes in children with conduct disorder.
True
Parental criminality and alcoholism are unrelated to the outcomes of children with conduct disorder.
False
A supportive and nurturing family environment predicts worse outcomes in children with conduct disorder.
False
Conduct disorder outcomes are not influenced by the socioeconomic status of the family.
False
Living in an economically deprived area is a predictor of poor outcomes in children with conduct disorder.
True
Effective schooling is linked to poor outcomes in children with conduct disorder.
False
Effective family management and high income can mitigate risks associated with poor outcomes in children with conduct disorder.
True
Hyperactivity and attention problems do not predict poor outcomes in children with conduct disorder.
False
Study Notes
Oppositional and Conduct Disorders
Overview
- Characterized by antisocial behaviors outside of socially acceptable norms
- Often overlap with symptoms and criteria of other disorders
- Prevalence of combined CD/ODD is estimated between 5-10% in children and adolescents
Prevalence
- ODD is more common in younger children, while CD is more common among adolescents
- Prevalence is estimated to be between 5-8% in general population studies
- ODD is twice as common in boys than girls, while CD is 3-7 times more common in boys
- Socioeconomic factors contribute significantly to prevalence, with individuals in the lowest socioeconomic strata showing 5 times greater prevalence
- Children with a history of maltreatment, residential care, or intellectual disabilities have a higher prevalence of these disorders
- Prevalence has been increasing over the past few decades
Aetiology
- Many factors influence the development of CD and ODD, with a cumulative effect
- Individual-level influences include:
- Genetic factors: strong genetic contribution, heritable trait of liability for externalizing disorders
- Temperament: early temperament predicts later conduct problems, especially traits like negative emotionality and poor emotional regulation
- Brain functioning: abnormalities in the paralimbic system, including limbic structures and prefrontal cortices
- Language, IQ, and educational attainment: low IQ and low school achievement are major predictors of ODD/CD and delinquency
- Family-level influences include:
- Interplay between familial environment and individual temperament
- Relationship between individual and family-level influences is complex and close
Treatment
- Early intervention is key to preventing more serious consequences
- Treatment options include:
- Psychotherapy: cognitive behavioral therapy (CBT) and parent management training (PMT)
- Family therapy: to improve family communication and function
- Medication: to address specific symptoms, such as aggression or anxiety
- Social skills training: to enhance social interaction skills and reduce conflicts
- Environmental interventions: to address challenging environmental factors
Clinical Features
- Fundamental feature of ODD and CD is persistent abnormal conduct that is more serious than ordinary childhood mischief
- Behaviors center around defiance, aggression, and antisocial behavior
- Negative impacts on family, peers, schools, and society can be significant
Classification
- Both ICD-10 and DSM-5 classify ODD/CD as characterized by repetitive antisocial behavior
- ICD-10 considers ODD as a subtype of CD, while DSM-5 considers ODD as a separate entity
Parent Training Programmes
- Mainstay of treatment of ODD/CD, using behavioral principles
- Parents are taught how to reinforce normal behavior and how to set limits on abnormal behavior
Anger Management
- Young people who are habitually aggressive have been shown to misperceive hostile intentions in others
- Anger management programmes seek to correct these ideas and teach how to inhibit sudden inappropriate responses to angry feelings
Conduct Disorder: Family-Level Influences, Child-Rearing Practices, and Prognosis
- Family-level influences include:
- Parenting quality and gender are significant predictors of antisocial behavior
- Children from unstable, insecure, and rejecting families living in deprived areas are more likely to exhibit antisocial behavior
- Child-rearing practices and attachment:
- Less than optimal parenting characterized by harsh, inconsistent discipline, low warmth, and involvement
- Insecure attachment, especially of the disorganized type, is strongly associated with antisocial behavior
- Prognosis:
- Long-term outcome of CD varies greatly
- Almost 50% of people with CD in adolescence exhibited some form of antisocial behavior in adulthood
- Factors that predict poor outcome in children with conduct disorder include:
- Early onset (before age 8 years)
- Severe, frequent, and varied antisocial behaviors
- Hyperactivity and attention problems
- Low IQ
- Pervasiveness (at home, in school, and elsewhere)
- Parental criminality and alcoholism
- High hostility/discord focused on the child
- Harsh inconsistent parenting
- Low income
- Economically deprived area
- Ineffective schools
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