Copy of Externalizing Disorders

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PRESENTATION OUTLINE

Externalizing Disorders

Conduct Disorder and Antisocial Personality Disorder

Lecture Goals

  • Conduct Disorder
  • Antisocial Personality Disorder
  • Life course of disorders
Photo by Peter Ras

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CD
A. A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal rules or norms are violated; presence of at least 3 of the following 15 in the past 12 months
Aggression to People or Animals
1. often bullies, threatens, or intimidates others
2. often initiates physical fights
3. has used a weapon that can cause serious harm to others ( bat, brick, broken bottle, knife)
4. has been physically cruel to people
5.has been physically cruel to animals
6. has stolen while confronting a victim
7. has forced someone into sexual activity
Destruction of Property
8. has deliberately engaged in fire setting with intention of causing physical harm
9. has deliberately destroyed others’ property
Deceitfulness or Theft
10. has broken into someone else’s house, building, or car
11. often lies to obtain goods or favors or to avoid obligations
12. has stolen items of value
Serious Violation of Rules
13. often stays out at night despite parental prohibition, beginning before age 13
14. has run away from home overnight at least twice while living with parents
15. is often truant from school, beginning before age 13
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Limited Prosocial Emotions

  • Lack of remorse or guilt
  • Callous - Lack of empathy
  • Unconcerned about performance
  • Shallow or deficient affect
Need two of the following

Minority of children or youth show callous/unemotional. It's important though because it predicts a severe and chronic course

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Personality Disorder

  • Stable over time
  • Consitent across contexts
Next we're going to talk about antisocial personaility disorder. the two are highly related. 40% - 50% of those who receive a diagnosis for conduct disorder eventually meet criteria for ASPD
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Antisocial Personality Disorder

  • Conduct Disorder present before age 15
  • Pattern of antisocial behavior in adulthood
Conduct disorder includes a pattern of behaviors (lying, truancy, running away from home, theft, arson, aggression, destruction of property)

Disregard for Rights of Others

  • Law breaking
  • Deceiptfulness
  • Impulsivity
  • Irritability and aggressiveness
  • Disregard for safety (self and others)
  • Irresponsible behavior (e.g. missing work)
  • Lack of remorse
A pervasive pattern of disregard for and violation of the rights of others:

Course of Disorder

  • Childhood onset vs. adolescent onset
  • Life course persistent vs. adolescent-limited
Antisocial behaviors can be seen across the lifespan, but rates of antisocial behaviors increase dramatically in adolecence - almost 10 X increase in this kind of behavior

-comparing onset in childhood and adolescence - childhood onset tends to be associated with more severe behaviors, poorer prognosis and higher genetic loading
-adolescent onset is associated with greater association with antisocial peers

-Another way of distinguishing between trajectories is by differentiating between life course persistent and adolescent limited - this is similar to above
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