Conduct Disorder, Aggression, and Violence

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Conduct Disorder, Aggression, and Violence
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April 20, 1999.
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and Every Day...
Trauma room specialists stand helplessly as the
mother and brother of a teenager killed in a
drive-by shooting collapse in grief on the
hospital floor. The family was allowed to see the
boy's body, which lies in a nearby room, just
moments after the emergency room team failed to
revive him.
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Washington, DC. Thursday, February 10, 2000
'JUST TOTALLY SENSELESS' TWO WILSON HIGH
SENIORS SHOT DOWN AFTER LEAVING GAME
Two Students Shot Outside D.C. School The
Associated Press Wednesday, April 5,
2006 Public Schools spokeswoman Roxanne Evans
said that a 19-year-old male student was shot in
the back around 915 a.m. E DT, and that he was
being treated for serious injuries.
SANTEE, Calif., March 6 -- San Diego County
sheriff's investigators said today that
15-year-old Charles "Andy" Williams took a
.22-caliber long-barrel revolver from his
father's locked collection of weapons, brought as
many as 40 rounds of ammunition to his high
school in his backpack and fired 30 of them
during the shooting rampage in which the boy
allegedly killed two schoolmates and injured 13
others.
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For Schools, a Calculus of Rights and Safety
Washington Post, March 7, 2001 In the nearly two
years since the massacre at Columbine High
School, officials at Santana High School
developed elaborate security plans for the
campus. There were phones in every classroom.
Security guards patrolled the hallways with
two-way radios. And a sheriff's deputy was
assigned to visit the campus each day. But even
with that elaborate security net, school
officials could not avert Monday's shooting
rampage at the suburban San Diego school because
friends of accused gunman Charles "Andy" Williams
-- and the one adult who heard Williams's plans
-- did not turn him in.
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Violence Every Day

• Between 1985 and 1991, annual homicide rates
  among males 15-19 years old almost tripled (from
  13 to 33 per 100,000).
• In 2002, 5,219 young people 15-24 years old were
  victims of homicide.
• 4,317 were by firearm (83 of homicides).
• That translates to 14 youth homicide victims per
  day in the U.S. (12 by firearm).
• In Iraq since the invasion, we have averaged 2
  U.S. servicemen killed per day.

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Homicide in Black Male Youths

• Homicide is the second leading cause of death for
  persons 15-24 years of age, and is the leading
  cause of death for African-American youths in
  this age group.
• Rates of homicide/100,000 (2002) age 15-24
• White males 11
• Latino males 30
• Black males 83 (1 of every 1,200 murdered/year)
• By contrast, motor vehicle accident deaths
• White males 41/100,000
• Black males 30/100,000

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Carrying a weapon or gun, past 30 days (h.s.
students)
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H.S. students carrying a gun, past 30 days
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Threatened or Injured With a Weapon on School
Property, Past Year, 2003
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Property Stolen or Intentionally Damaged at
School, Past Year, 2003
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Homicides in U.S. Schools 1992/3-2002/3 (per
100,000)
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A Few Definitions

• Antisocial Behavior
• Conduct Disorder
• Juvenile Delinquency

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Conduct Disorder (DSM-IV)

• Aggression to people and animals
• Bullies, intimidates
• Often initiates physical fights
• Used a weapon than could physically harm
• Physically cruel to people, or animals
• Stolen while confronting victim
• Forced someone into sexual activity
• continued...

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Conduct Disorder Continued

• Destruction of Property
• Fire setting with intent to cause damage
• Deliberately destroy others property
• Deceitfulness or theft
• Broken into house, building, car
• Often lies to obtain desired goal
• Stealing without confrontation
• Serious rule violations
• Often stays out past curfew
• Run away from home overnight gt 2x
• Often truant at school

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Course of Antisocial Symptoms

• 31 of antisocial teens later qualify as adults
  for diagnosis (Antisocial Personality)
• 94 later have employment problems
• Multiple moving traffic violations (72)
• Severe marital difficulties (67)
• Fewer than 20 show good social functioning as
  adults

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Why Do Youth Become Antisocial?
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Characteristics Beginning in Childhood

• Impulsivity (and ADHD diagnosis)
• Irritability
• Inattention
• Peer rejection in middle childhood
• Poor relationships with teachers
• Academic deficiencies
• Affiliation with deviant peer group in childhood

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Neuropsychological Deficits

• Deficiencies in
• Attention modulation
• Self control and impulsivity
• Verbal skills
• Memory
• IQ
• Visual-motor integration
• Deficits worse among those with chronic
  antisocial problems, beginning in childhood

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Biological Deficits

• Low levels of serotonin metabolite
  5-hydroxyinadolacetic acid acid (5-HIAA) in
  spinal fluid
• Under-responsive to electrodermal stimulation, an
  index of processes involving anxiety and
  inhibition

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Social Cognitive Deficits

• Inaccurate interpretations of peers
  intentions--biased towards assuming hostile
  intent in others
• Misjudging aggression as means to positive
  outcomes
• Deficient problem-solving skills

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Family Coercion Process

• Gerald R. Patterson, John B. Reid
• Involves maternal irritability, child provocation
• Negative reciprocity ends with parent backing
  down
• Negative reinforcement of aggressive behavior
  results

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Other Social Factors

• Experiencing or witnessing violence within the
  family
• Viewing violence on TV and films
• Access to firearms
• Poverty, economic inequality, discrimination

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Treatment

• Not reimbursable by both insurance plans
• Parent management training (Patterson and
  Forgatch)
• FAST Track program

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Prevention

• Parent training at early age (when children are
  preschoolers)
• Teaching emotion regulation, conflict resolution
  in schools
• Reducing availability of weapons
• Addressing discrimination, economic disparity
• Reduction of violence in media--not glorifying it