Odd and cd 9 13

Odd and cd 9 13

• 1.
  Jacqueline Corcoran, Ph.D. From: Corcoran, J., & Walsh, J. (2012 2nd ed.). Mental Health in Social Work: A Casebook on Diagnosis and Strengths-Based Assessment. Boston: Allyn & Bacon. Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD)
• 2.
  Oppositional Defiant Disorder(ODD) and Conduct Disorder (CD) Classified as Disruptive, Impulse- Control, and Conduct Disorders Rationale for discussing together:  both feature anger, defiance, rebellion, lying, and school problems  ODD is often a developmental antecedent to CD (40% of those with ODD go on to CD)
• 3.
  Differences between •ODD characterized by a pattern of angry/irritable mood, argumentative/defiant behavior and/or vindictiveness for at least 6 mos but don’t seriously violate basic rights of others • CD includes aggression toward people or animals, destruction of property, or a pattern of theft or deceit over 1 year
• 4.
  Prevalence and Co-Morbidity ODD: lifetime prevalence rate of 10.2% CD: 1-10% More common in boys Comorbodity High Substance use disorders, ADHD, mood disorders
• 5.
  Assessment Guidelines Because transient oppositional behavior is common in preschool children and adolescents, caution should be exercised in diagnosing ODD during these developmental periods.  Oppositional behaviors in children and adolescents should be distinguished from the disruptive behavior resulting from inattention and impulsivity that is associated with attention-deficit/hyperactivity disorder  should not be made when the symptomatic behavior is protective for a child living in an impoverished, high-crime community or war zone  ODD should be distinguished from a failure to follow directions that is the result of impaired language comprehension due to hearing loss or a learning disability.  In cases in which both CD and ODD are present, only CD should be diagnosed.  When ODD or CD is diagnosed, a child and family relational problem should not be included because the ODD or CD diagnosis includes conflict.  A less severe diagnosis should be considered initially—either an adjustment disorder with disturbance of conduct in response to an identifiable stressor or the V-code for “child or adolescent antisocial behavior.”  Conduct disorder should be diagnosed in adults older than 18 only if the criteria for antisocial personality disorder are not met.
• 6.
  Risk and ProtectiveFactors for Onset Genetics may account for 50% or more of the variance in conduct disorder Interaction of genes and environment (child maltreatment, living in urban area)
• 7.
  Risk and ProtectiveFactors for Course 2% of youth with no childhood risk showed persistencein adolescence vs. 71% of youth who had risk influences in 5 different areas Childhood onset – more severe Male – ODD to CD
• 8.
  TREATMENT – PARENTTRAINING Specifying goals for behavioral change Tracking target behaviors Positively reinforcing pro-social conduct through the use of attention, praise, and point systems Employing alternative discipline methods, such as withdrawal of attention, time out from reinforcement, imposition of costs on inappropriate behavior, and removal of privileges
• 9.
  Parent Training Programs The Parent Management Training Oregon Model (ages 3–12) (Patterson & Gullion, 1968) Helping the Noncompliant Child (ages 3–8) (Forehand & McMahon, 1981) Parent-Child Interaction Therapy (ages 2-7) (Brinkmeyer & Eyberg, 2003) The Incredible Years (ages 2–8) (Webster-Stratton, 2001) the Positive Parenting Program (called Triple P) (preschool through adolescence)
• 10.
  ADOLESCENTS – MULTI-DIMENSIONAL MODELS Multi-Systemic Therapy Functional family therapy integrates systems, cognitive, and behavioral theories Treatment foster care
• 11.
  Cognitive-Behavioral anger management, assertiveness training, cognitive restructuring, relaxation, social problem solving or social skills development
• 12.
  Medication the stimulants,selective norepinephrine reuptake inhibitors, antipsychotics, mood stabilizers