Childhood Psychopathology
Chapter 9
Oppositional and Defiant Disorder and Conduct Disorder
*Externalizing psychopathology
*Externalizing psychopathology
*Oppositional defiant disorder
*Conduct disorder
*ADHD
*(plus, maybe encopresis)
*Related by the construct of impulsivity
*Highly comorbid (esp. CD and ADHD)
*Differences can be found in family histories
*CD patients have SA and ASPD in family history (FH)
*ADHD patients have attentional and learning probs in FH
*Antisocial behavior through the lifespan
*Toddlerhood
*Irritable, difficult temperament
*Preschool
*Harshly defiant, argumentative behavior
*School-age
*Fighting, lying, petty theft
*Preadolescence
*Assault, sexual precocity
*Adolescence
*Robbery, substance abuse
*Adulthood
*Repetitive criminal activities, callous relationships, and spousal/child abuse
*Oppositional defiant disorder (ODD)
*ODD is a fairly common disorder of childhood, with estimates ranging from 2-16%
(depending on methods of assessment and sample being evaluated)
*M>F before puberty
*Males more confrontational and more likely to have persistent symptoms
*ODD is the developmental precursor of CD, when symptoms become more serious
*52% of ODD continues to hold dx 3 years later; about half of this 52% will
continue onto CD
*ODD: DSM-5
*Pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness
lasting at least 6 months. Four or more of the following need to be present:
*Often loses temper
*Touchy or easily annoyed
*Angry or resentful
*Argues with authority figures/adults
*Actively defies or refuses to comply with adults’ requests/rules
, *Deliberately annoys people
*Blames others for own mistakes/misbehavior
*Spiteful or vindictive
*Behaviors must occur more frequently than typically observed in individuals of a
comparable age and developmental level
*Use caution during adolescence and preschool age
*Affects ability to function in school, home, or community
*Behaviors do not occur exclusively during a psychotic or mood disorder
*Criteria are not met for conduct disorder (CD trumps ODD)
*Conduct disorder
*Persistent pattern of behavior in which the basic rights of others and major age-
appropriate social norms or riles are violated
*CD is the most common reason for referral to inpatient clinics and hospitals in the
U.S., and is a substantial source of referrals to outpatient facilities as well
*About 6-16% of boys and 2-9% of girls eventually develop CD. It is even more common
in poor, inner-city environments
*Conduct disorder: DSM-5
*3 of 15 criteria in past 12 months
*Aggression to people and animals
*Bullying/threatening
*Initiating fights
*Using a dangerous weapon
*Cruelty to people or animals (2)
*Stolen while confronting victim
*Forced sexual activity
*Destruction of property
*Deliberate fire-setting
*Property destruction
*Deceitful or theft
*Broken into another’s home or car
*Cons others
*Stolen from others without confrontation
*Serious violations of rules
*Repeated breaking of curfew, beginning before age 13
*Running away from home at least twice
*Repeated truancy, beginning before age 13
*More prevalent in boys (4:1)
*Boys- direct aggression (physical), confrontation
*Girls- indirect aggression (mental, group affiliation
*Genetic and environmental etiology
*Heritability of aggression behavior = .52 to .94
*DSM-5 Childhood vs. Adolescent onset
*Childhood onset (evidence prior to age 10)
*Preschool age
Chapter 9
Oppositional and Defiant Disorder and Conduct Disorder
*Externalizing psychopathology
*Externalizing psychopathology
*Oppositional defiant disorder
*Conduct disorder
*ADHD
*(plus, maybe encopresis)
*Related by the construct of impulsivity
*Highly comorbid (esp. CD and ADHD)
*Differences can be found in family histories
*CD patients have SA and ASPD in family history (FH)
*ADHD patients have attentional and learning probs in FH
*Antisocial behavior through the lifespan
*Toddlerhood
*Irritable, difficult temperament
*Preschool
*Harshly defiant, argumentative behavior
*School-age
*Fighting, lying, petty theft
*Preadolescence
*Assault, sexual precocity
*Adolescence
*Robbery, substance abuse
*Adulthood
*Repetitive criminal activities, callous relationships, and spousal/child abuse
*Oppositional defiant disorder (ODD)
*ODD is a fairly common disorder of childhood, with estimates ranging from 2-16%
(depending on methods of assessment and sample being evaluated)
*M>F before puberty
*Males more confrontational and more likely to have persistent symptoms
*ODD is the developmental precursor of CD, when symptoms become more serious
*52% of ODD continues to hold dx 3 years later; about half of this 52% will
continue onto CD
*ODD: DSM-5
*Pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness
lasting at least 6 months. Four or more of the following need to be present:
*Often loses temper
*Touchy or easily annoyed
*Angry or resentful
*Argues with authority figures/adults
*Actively defies or refuses to comply with adults’ requests/rules
, *Deliberately annoys people
*Blames others for own mistakes/misbehavior
*Spiteful or vindictive
*Behaviors must occur more frequently than typically observed in individuals of a
comparable age and developmental level
*Use caution during adolescence and preschool age
*Affects ability to function in school, home, or community
*Behaviors do not occur exclusively during a psychotic or mood disorder
*Criteria are not met for conduct disorder (CD trumps ODD)
*Conduct disorder
*Persistent pattern of behavior in which the basic rights of others and major age-
appropriate social norms or riles are violated
*CD is the most common reason for referral to inpatient clinics and hospitals in the
U.S., and is a substantial source of referrals to outpatient facilities as well
*About 6-16% of boys and 2-9% of girls eventually develop CD. It is even more common
in poor, inner-city environments
*Conduct disorder: DSM-5
*3 of 15 criteria in past 12 months
*Aggression to people and animals
*Bullying/threatening
*Initiating fights
*Using a dangerous weapon
*Cruelty to people or animals (2)
*Stolen while confronting victim
*Forced sexual activity
*Destruction of property
*Deliberate fire-setting
*Property destruction
*Deceitful or theft
*Broken into another’s home or car
*Cons others
*Stolen from others without confrontation
*Serious violations of rules
*Repeated breaking of curfew, beginning before age 13
*Running away from home at least twice
*Repeated truancy, beginning before age 13
*More prevalent in boys (4:1)
*Boys- direct aggression (physical), confrontation
*Girls- indirect aggression (mental, group affiliation
*Genetic and environmental etiology
*Heritability of aggression behavior = .52 to .94
*DSM-5 Childhood vs. Adolescent onset
*Childhood onset (evidence prior to age 10)
*Preschool age
