CONDUCT DISORDERS CD

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CONDUCT DISORDERS (CD)
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Normal Development
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Often defined simply as

• VIOLATIONS OF PERSON OR PROPERTY

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BOYS WITH CD

• Boys are at a high risk if biological father was
  an alcoholic (Arluke, 1999, 965)
• fighting in the hall
• overtly violating rules
• vandalize property

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GIRLS WITH CD

• 2nd most common psychiatric disorder in girls
• Girls at higher risk for conduct disorder if
  stepfather was an alcoholic
• (Arluke, 1999, 965)
• Aggression may appear as
• gossip intended to significantly hurt another
• purposely withdraw friendship or acceptance in
  order to hurt or control another (icing)
• spreading malicious rumors, revengefulness,
  lying, firesetting, vandalism.

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CASE STUDY

• Sharon
• 15-year-old girl
• Suspended from school for the tenth time
• assaulting a teacher
• fighting,
• carrying a knife to school
• smoking marijuana
• stealing money from other students' lockers.
• Runs away from home for days
• Father was incarcerated for auto theft and
  assault.
• Mother frequently leaves Sharon and her
  eight-year-old brother unsupervised overnight.

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Types of Violent Perpetuators

• Self-indulger has the view that others must cater
  to him/her. NPD
• Self-defender is intensely afraid of others and
  acts as a bully (the best defense is a good
  offense)

• Undercontrolled lacks inhibitions--may be TBI or
  impulsive.
• Overcontrolled is overly afraid of catastrophies
  and inhibits aggression until frustration reaches
  a point where they explode --thus reinforcing
  their fears (e.g., women in abusive relationships)

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Nature or Biology

• SpeciesFactors
• Aggression protects territory and gets resources
  and is seen often in tribes when the population
  is at capacity or the availability of women
  decrease
• Cooperation also has advantages, e.g., wolves
  hunt in packs, sharing food among chimps and
  whales)
• Individual Factors
• Difficult temperament predict behavioral problems
  at age 3, which can show up as CD at age 5, 8,
  and 10

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Setting Factors

• Entering a new situation
• Scarce resources
• Frustration (sibling preferred severe
  punishment/coersion/threat)
• Teacher and peer models, who are aggressive
• Heightened arousal situations of
• competitive activities
• vigorous exercise
• loud noise, lots of people or activity (crowding)

Zentall, 2006
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School Factors

• that contribute to delinquency and low academic
  performance
• Low teacher availability
• Low teacher use of praise
• Low teacher to student ratio

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Family Factors

• Early maternal rejection, separation from
  parents without an adequate alternative
  caregiver, family neglect, abuse or violence,
  parental mental illness, parental divorce, large
  family size, and crowding and poverty (Foley,
  2004, p. 687).

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Family Factors cont.

• Marital problems in parents (psychopathology
  depression)
• Severe inconsistent of punishment
• Extent of parental disagreement
• Punitive, rejecting, or permissive parents
• Lack of attention to children (neglect)
• Insular mothers more serious behavior problems
  of children
• Low SES increases secondary disorder

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Differences between

• Aggression
• Focus on observable behavior
• Immediate consequences
• Physical effects
• Gross gains and losses

• Altruism
• Focus on motives and intentions
• Long term consequences
• Psychological effects
• Net gains and losses

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Using these differences

• 1. Is giving money to beggars altruistic?
• 2. Is hitting someone more aggressive than
  talking behind their back?

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Accommodations

• Positive social experiences
• Rules must be explicit with consistent
  consequences for misbehavior
• Praise for mundane behaviors to get them to do
  them more often.
• Provide quiet time to unwind and calm down (walk
  in the hall and complain).
• Plan ahead (entering/leaving, resources)

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Gangs as Replacement Families

• Roles leader, treasurer, thieves, hit men, etc.
• Strict norms clothes, hair styles, colors,
  jargon, symbols (tatoos, logo), codes of honor,
  territory (graffiti)
• Member similarity age, ethnicity, physique,
  intellectual and phyical abilities, personality

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Passive-Aggressive Personality Disorder
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Behavioral Characteristics

• manipulative with superficial charm (Lilienfeld
  Penna, 2001)
• scorns and criticizes authority (Millon, 1993)
• whining and grumbling more than feel despair
  (Millon, 1993)
• complaint of being misunderstood by others -- the
  most efficient passive-aggressive diagnostic
  criteria (Fossati et al., 2000)

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• Passive-aggressive behavior does not alternate
  between passive and aggressive behavior, but
  combines them into one behavior that is both
  conforming and irritating to others.
• stubborn and resistant behavior is a passive
  means through which anger can be directed at
  others, since such behavior is likely to
  frustrate and irritate others (McCann, 1988) a
  deliberate and masked way of expressing covert
  feelings of anger (Long Long, 2001)

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Cognitive Distortion

• Negativism based on the assumption that,
  considering how important they feel, no one has
  the right to ask them to do anything and they
  have no obligations towards others (Fossati et
  al., 2000 from Millon Davis, 1996)
• Misunderstood and unappreciated, life is
  treacherous and full of people who will take
  advantage of you therefore it is better not to
  put yourself out for people because you will end
  up getting hurt (Millon Radovanov, 1995 from
  Murray, 1988)

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Academic Characteristics

• Student uses excuses to delay or not do an
  assigned activity
• Completes assignments in a manner and at a
  quality level that are certain to upset the
  teacher inefficient and erratic in their work
  (McCann, 1988z0
• Gets back at authority behind a mask of
  inefficiency
• A student may have hostile feelings toward a
  teacher and consciously decide to get hidden
  revenge at a later time without the teacher
  knowing that he or she did it
• (Long Long, 2001)

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Narcissistic Personality Disorder
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Look at this link

• http//www.angriesout.com/

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Definition

• A psychological condition recognized by a pattern
  of traits which exemplify an obsession with ones
  self for gratification and dominance of others.
  (Richard, 2005)

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Case

• Marcos, a fourth-grade boy, has trouble when
  playing with his peers at recess and has been
  observed to always want to be the hero, and the
  winner without accepting anything less. Often
  when he is playing with other students if he is
  not the boss of the game, he quits saying that he
  is bored. Playing his way is something he is very
  passionate and proud of because he is good at it.
  While playing cars one day with two other boys,
  they were not following his rules of the game, so
  he hit one of them and verbally attacked the
  other child. After that, he just walked away and
  went to tell on them because in his opinion they
  offended him by not listening to him. Marcos,
  always is very demanding, wants to get everything
  he asks for, or else he threatens his parents, or
  even his teacher. Every time he does something he
  is told, he expects payback even if it is
  something that is his own responsibility.
• Negative and Positive entitlement
• http//www.angriesout.com/teach9.htm

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History of Narcissism

• In Greek Mythology there was a man named
  Narcissus
• He rejected the sexual advances of a nymph named
  Echo.
• Echo punished Narcissus by dooming him to fall in
  love with his reflection in a pool of water.
• From then on people who seemed to be infatuated
  with themselves were called narcissists.

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Subtypes

• Physical
• Mental (intellectual)

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Etiology

• Developmentally the mother is not available or
  dangerous or unpredictable
• Mother treats child as an extension of her own
  life
• Child returns to own self for gratification

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Social Characteristics

• Lies and doesnt recall (memory of false events)
• Sense of positive entitlement and deserves
  special treatment and negative entitlement and
  deserves that no bad things happen
• Manipulative and exploitative--popular for the
  short term but people are just short-term
  solutions to the need for adoration,
  recognition,etc.
• Excessively bossy--constantly trying to be leader
  of group
• Self-sufficient (alone, privacy, and spatial
  paranoia need for order)
• Superior attitude (gives only if he can take)
  and does not recognize the reality of the rights
  of others

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Social Aggressive Behavior

• Hold grudges
• Aggression has also been found to be positively
  correlated with narcissism
• May fly into rage if criticized or when
  frustrated (a person with an inflated sense of
  self will respond in an inflated manner to
  perceived threats)
• May react with extreme violence out of a sense of
  wounded pride (murderers, rapists, wife beaters).

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Emotional Characteristics

• Greater
• Humiliation and embarrassment
• Despair and remorse
• Apathy
• Anger, rage, and envy
• Lower
• Empathy
• True self esteem

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Academic Characteristics

• Learning can be hindered by the pursuit of
  self-esteem
• Tend to perform well under pressure
• Do not perform well in groups

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Accommodations

• People surrounding the narcissist typically do
  the changing
• Tips
• Butter him or her up keep yourself on their good
  side
• Competition with the narcissist to motivate them
  to learn, because they always have to be the
  smartest (Barry, 2003).
• Let them be the center of attention because they
  do well under pressure.
• Make a contract with the narcissist saying they
  are not going to get praise until the teacher
  gets what he/she is looking for.
• Keep a sense of humor, because well, being so
  full of yourself can be a bit humorous and just
  realize they have a problem that you cannot
  control

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Sum NPD

• Etiology Emotionally/physically
  abandoned/abused
• BehaviorDevelops false self (image) that is
  useful (charming, simulated emotions, attends to
  others needs) but entitled and may respond with
  rage/aggression
• Cognition emotion Grandiosity (lives in an
  invented world), no empathy, cant love,
• Function to get adoration, control, things.

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Aggression and Co-Occurring conditions

• EXTERNALIZING DISORDERS
• ADD/ADHD
• Oppositional Defiant Disorder (ODD)
• INTERNALIZING DISORDERS
• Bipolar disorder
• Depression
• Learning disability
• Seizure disorder (unusually common in very
  violent children)

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CASE STUDY

• Tim
• Six years old
• Aggressive and destructive behavior
• Four school suspensions during kindergarten
• Uncontrollable
• has broken dishes and furniture
• Started fires
• threw a can of soup at his sister
• Father is a long-haul truck driver who sees Tim
  every three to four weeks

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Family Factors Contributing to Aggression in ADHD

• Fathers
• More physical fights as adolescents
• Half in prison at least once before child 9
• More antisocial, alcoholic, abusing, absent
  fathers than fathers of ADHD without aggression
• Mothers
• More verbal and physical aggression directed
  toward and received from partner
• Parents
• Child rearing strategies retaliation

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Family of ADHD

• Negative Factors
• Disengagement
• Let sleeping dogs lie w/ hectic life style
• Parents punishment, aggression, and high control
  produces
• short term results
• long term failure escalation then disengagement
• High c. aggression little parent monitoring

• Positive Factors
• Overinvolvment
• Mothers over protective less aggression
• Strict mother children higher self-esteem
• Parents self-rated too strict good c. social
  outcomes lt job changes, lt vagarancy, gtemployment

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