Transcript Oppositional Defiant Disorder (ODD)

CONDUCT DISORDERS (CD)
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Normal Development
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Often defined simply as:
VIOLATIONS OF
PERSON OR
PROPERTY
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BOYS WITH CD
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Boys are at a high risk if biological father was an alcoholic (Arluke,
1999, 965)
fighting in the hall
overtly violating rules
vandalize property
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GIRLS WITH CD
2nd most common psychiatric disorder in girls
Girls at higher risk for conduct disorder if stepfather was an
alcoholic
(Arluke, 1999, 965)
Aggression may appear as:
gossip intended to significantly hurt another
purposely withdraw friendship or acceptance in order to hurt
or control another (icing)
spreading malicious rumors, revengefulness, lying, firesetting,
vandalism.
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CASE STUDY
Sharon
15-year-old girl
Suspended from school for the tenth time
assaulting a teacher
fighting,
carrying a knife to school
smoking marijuana
stealing money from other students' lockers.
Runs away from home for days
Father was incarcerated for auto theft and assault.
Mother frequently leaves Sharon and her eight-year-old brother
unsupervised overnight.
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Types of Violent Perpetuators
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Self-indulger has the
view that others must
cater to him/her. NPD
Self-defender is
intensely afraid of
others and acts as a
bully (the best
defense is a good
offense)
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Undercontrolled lacks
inhibitions--may be TBI
or impulsive.
Overcontrolled is overly
afraid of catastrophies
and inhibits aggression
until frustration reaches a
point where they explode
--thus reinforcing their
fears (e.g., women in
abusive relationships)
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Nature or Biology
SpeciesFactors
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Aggression protects territory and gets resources and is
seen often in tribes when the population is at capacity or
the availability of women decrease
Cooperation also has advantages, e.g., wolves hunt in
packs, sharing food among chimps and whales)
Individual Factors
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Difficult temperament predict behavioral problems at age
3, which can show up as CD at age 5, 8, and 10
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Setting Factors
Entering a new situation
 Scarce resources
 Frustration (sibling preferred; severe
punishment/coersion/threat)
 Teacher and peer models, who are aggressive
 Heightened arousal situations of:

competitive activities
 vigorous exercise
 loud noise, lots of people or activity (crowding)
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Zentall, 2006
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School Factors
that contribute to delinquency and low
academic performance:
Low teacher availability
 Low teacher use of praise
 Low teacher to student ratio
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Family Factors
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“Early maternal rejection, separation from
parents without an adequate alternative
caregiver, family neglect, abuse or
violence, parental mental illness, parental
divorce, large family size, and crowding
and poverty”
.
(Foley, 2004, p. 687)
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Family Factors cont.
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Marital problems in parents
(psychopathology & depression)
Severe & inconsistent of punishment
 Extent of parental disagreement
 Punitive, rejecting, or permissive parents
 Lack of attention to children (neglect)
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Insular mothers = more serious behavior
problems of children
Low SES increases secondary disorder
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Differences between:
Aggression
 Focus on
observable
behavior
 Immediate
consequences
 Physical effects
 Gross gains and
losses
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Altruism
 Focus on motives
and intentions
 Long term
consequences
 Psychological
effects
 Net gains and
losses
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Using these differences:
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1. Is giving money to beggars altruistic?
2. Is hitting someone more aggressive
than talking behind their back?
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Accommodations
Positive social experiences
Rules must be explicit with consistent
consequences for misbehavior
Praise for mundane behaviors to get
them to do them more often.
Provide quiet time to unwind and calm
down (walk in the hall and complain).
Plan ahead (entering/leaving,
resources)
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Gangs as Replacement Families
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Roles: leader, treasurer, thieves, hit men,
etc.
Strict norms: clothes, hair styles, colors,
jargon, symbols (tatoos, logo), codes of
honor, territory (graffiti)
Member similarity: age, ethnicity,
physique, intellectual and phyical abilities,
personality
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Passive-Aggressive
Personality Disorder
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Behavioral Characteristics

manipulative with superficial charm
(Lilienfeld & Penna,
2001)
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scorns and criticizes authority (Millon, 1993)
whining and grumbling more than feel despair
(Millon, 1993);
complaint of being misunderstood by others -- the
most efficient passive-aggressive diagnostic
criteria (Fossati et al., 2000)
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Passive-aggressive behavior does not alternate between
passive and aggressive behavior, but combines them
into one behavior that is both conforming and irritating to
others.
stubborn and resistant behavior is a passive means
through which anger can be directed at others, since
such behavior is likely to frustrate and irritate others
(McCann, 1988); a deliberate and masked way of expressing
covert feelings of anger (Long & Long, 2001)
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Cognitive Distortion

Negativism based on the assumption that,
considering how important they feel, no one has
the right to ask them to do anything and they
have no obligations towards others (Fossati et al.,
2000 from Millon & Davis, 1996)

Misunderstood and unappreciated, life is
treacherous and full of people who will take
advantage of you therefore it is better not to put
yourself out for people because you will end up
getting hurt (Millon & Radovanov, 1995 from Murray, 1988)
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Academic Characteristics
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Student uses excuses to delay or not do an assigned
activity
Completes assignments in a manner and at a quality
level that are certain to upset the teacher; inefficient and
erratic in their work (McCann, 1988z0
Gets back at authority behind a mask of inefficiency
A student may have hostile feelings toward a teacher
and consciously decide to get hidden revenge at a later
time without the teacher knowing that he or she did it
(Long & Long, 2001)
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Narcissistic Personality Disorder
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Look at this link
http://www.angriesout.com/
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Definition

A psychological condition recognized by
a pattern of traits which exemplify an
obsession with one’s self for
gratification and dominance of others.
(Richard, 2005)
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Case
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Marcos, a fourth-grade boy, has trouble when playing with his peers at
recess and has been observed to always want to be the hero, and the winner
without accepting anything less. Often when he is playing with other
students if he is not the boss of the game, he quits saying that he is bored.
Playing his way is something he is very passionate and proud of because he
is good at it. While playing cars one day with two other boys, they were
not following his rules of the game, so he hit one of them and verbally
attacked the other child. After that, he just walked away and went to tell on
them because in his opinion they offended him by not listening to him.
Marcos, always is very demanding, wants to get everything he asks for, or
else he threatens his parents, or even his teacher. Every time he does
something he is told, he expects payback even if it is something that is his
own responsibility.
Negative and Positive entitlement
 http://www.angriesout.com/teach9.htm
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History of Narcissism
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In Greek Mythology there
was a man named Narcissus
He rejected the sexual
advances of a nymph
named Echo.
Echo punished Narcissus by
dooming him to fall in love
with his reflection in a pool
of water.
From then on people who
seemed to be infatuated
with themselves were called
narcissists.
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Subtypes
1.
2.
Physical
Mental (intellectual)
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Etiology
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Developmentally the mother is not
available or dangerous or unpredictable
Mother treats child as an extension of her
own life
Child returns to own self for gratification
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Social Characteristics
Lies and doesn’t recall (memory of false events)
Sense of positive entitlement and deserves special
treatment and negative entitlement and deserves that
no bad things happen
Manipulative and exploitative--popular for the short
term but people are just short-term solutions to
the need for adoration, recognition,etc.
Excessively bossy--constantly trying to be leader of
group
Self-sufficient (alone, privacy, and spatial paranoia & need
for order)
Superior attitude (gives only if he can take) and does
not recognize the reality of the rights of others
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Social Aggressive Behavior
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Hold grudges
Aggression has also been found to be
positively correlated with narcissism
May fly into rage if criticized or when frustrated (a
person with an inflated sense of self will respond
in an inflated manner to perceived threats)
May react with extreme violence out of a sense of
wounded pride (murderers, rapists, wife
beaters).
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Emotional Characteristics
Greater:
 Humiliation and
embarrassment
 Despair and
remorse
 Apathy
 Anger, rage, and
envy
Lower:
 Empathy
 True self esteem
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Academic Characteristics
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Learning can be hindered by the pursuit of selfesteem
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Tend to perform well under pressure
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Do not perform well in groups
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Accommodations
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People surrounding the narcissist typically
do the changing
Tips:
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Butter him or her up; keep yourself on their good side
Competition with the narcissist to motivate them to learn,
because they always have to be the smartest (Barry, 2003).
Let them be the center of attention because they do well under
pressure.
Make a contract with the narcissist saying they are not going to
get praise until the teacher gets what he/she is looking for.
Keep a sense of humor, because well, being so full of yourself
can be a bit humorous and just realize they have a problem that
you cannot control
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Sum: NPD
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Etiology:
Emotionally/physically
abandoned/abused
Behavior:Develops false self
(image) that is useful
(charming, simulated
emotions, attends to others’
needs) but entitled and may
respond with rage/aggression
Cognition & emotion:
Grandiosity (lives in an
invented world), no empathy,
can’t love,
Function: to get adoration,
control, things.
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Aggression and Co-Occurring
conditions
EXTERNALIZING DISORDERS
ADD/ADHD
Oppositional Defiant Disorder (ODD)
INTERNALIZING DISORDERS
Bipolar disorder
Depression
Learning disability
Seizure disorder (unusually common in very violent children)
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CASE STUDY
Tim
Six years old
Aggressive and destructive behavior
Four school suspensions during kindergarten
“Uncontrollable“
has broken dishes and furniture
Started fires
threw a can of soup at his sister
Father is a long-haul truck driver who sees Tim every three
to four weeks
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Family Factors Contributing to
Aggression in ADHD
Fathers
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More physical fights as adolescents
Half in prison at least once before child 9
More antisocial, alcoholic, abusing, absent fathers
than fathers of ADHD without aggression
Mothers
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More verbal and physical aggression directed toward
and received from partner
Parents
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Child rearing strategies = retaliation
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Family of ADHD
Negative Factors
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Disengagement
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‘Let sleeping dogs lie’ w/
hectic life style
Parents punishment,
aggression, and high
control produces
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short term results
long term failure =
escalation then
disengagement
High c. aggression = little
parent monitoring
Positive Factors
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Overinvolvment
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Mothers over
protective = less
aggression
Strict mother =
children higher selfesteem
Parents self-rated too
strict = good c. social
outcomes [< job
changes, < vagarancy,
>employment]
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