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Childhood Externalizing Disorders. Lori Ridgeway PSYC 3560. What are they?. Disorders you can “________” Oppositional Defiant Disorder (ODD) Conduct Disorder (CD) Attention Deficit / Hyperactivity Disorder (ADHD). Oppositional Defiant Disorder. Negative, _____________, defiant behavior
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Childhood Externalizing Disorders Lori Ridgeway PSYC 3560
What are they? • Disorders you can “________” • Oppositional Defiant Disorder (ODD) • Conduct Disorder (CD) • Attention Deficit / Hyperactivity Disorder (ADHD)
Oppositional Defiant Disorder • Negative, _____________, defiant behavior • Losing temper • Arguing • Noncompliance • Deliberately annoy/blame others • Angry/resentful or spiteful • At least _____________
Age & Gender • More common in __________ before puberty • Generally similar Sx’s • Exceptions • Males more confrontational • Males more persistent Sx’s • Number of Sx’s __________ with age
Families & ODD • Hx of mood disorder, ODD, CD, ADHD, Antisocial Personality, substance-use disorders • Maternal _____________ • Marital discord • Inconsistency/harsh parenting
Treating ODD • Parent management training • Principles of reinforcement & learning • _____________ • Behavior charts/token economies • Praise for incompatible behaviors • School consultations
Parent-Child Interaction Therapy (PCIT) • Principles of learning & ____________ theory • Approx. 20 weeks • In vivo treatment • Two phases • Child Directed Interaction (CDI) • Parent Directed Interaction (PDI)
Child Directed Interaction • Focus on positive parenting skills • _____________ • _____________ • Reflection • Imitation • Description • Enthusiasm
CDI, cont’d… • Avoid • _____________ • Questions • Criticisms • Purpose = relationship building • 5-minute practice daily • Criteria to move on
Parent Directed Interaction • _____________ phase • Teach effective commands • Consistency • Simple • Clear • Direct
PDI, cont’d… • Teach behavior management • Behavior _____________ • Consistent consequences • Selective attention • Time-out • Gradual = home to public • Criteria to complete treatment
PCIT Outcomes • Significant decreases in ODD Sx’s • Gains persist for up to 6 years • Reduces re-reports of _____________ • Group format • Foster parents, Head Start, ADHD
Conduct Disorder • Violate societal norms & _________ of others • Aggression to people/animals • Destruction of property • Deceitfulness or theft • Serious rule violations (running away/truancy) • 3 in 12 months (with 1 in 6 months)
Subtypes:Childhood-Onset • 1 Sx prior to _____________ • Aggressive & poor peer relations • Usually male • ODD as young children • Full criteria by puberty • Persistent/chronic course • Antisocial Personality Disorder
Subtypes:Adolescent-Onset • No Sx’s before _____________ • Less aggressive & better peer relations • Ratio of males to females lower • Less chronic course • Better outcomes
Culture, Age, & Gender • Settings where Bx is protective • Progress in severity over time • Early severity = worse outcomes • Males = confrontation • Females = non-confrontation
Families & CD • Genetic & environmental influences • Adoptive or biological parent with ____ • Sibling with CD • Biological parents with alcohol dependence, mood d/o, schizophrenia, ADHD, CD
Treating CD • Parent management training • _____________ treatment • Multi-systemic Therapy • 60-70% success rate • Intensive intervention within social system • Low case load & high burn out • On-call 24/7