Conduct Disorder

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Conduct Disorder

• Dr. Aubrey H. Fine

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Overt Aggression

• How is Overt Conduct Disorder Identified and
  Treated?

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Conduct Disorder

• Characterized by persistent antisocial behavior
  that violates
• The rights of others
• Age-appropriate social norms
• Includes
• Aggression to people and animals
• Destruction of property
• Deceitfulness and theft
• Violation of rules

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Students with Conduct Disorder

• Differ from peers in
• Rate of noxious behaviors
• Persistence of such conduct beyond age at which
  most children have adopted less aggressive
  behaviors

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How Do These Students Do in School?

• Teachers see these students as
• Uninterested
• Unenthusiastic
• Careless
• Students with Conduct Disorder have
• Poor interpersonal relations
• Rejected by their peers
• Poor social skills
• Students with Conduct Disorder are most likely to
  be
• Left behind in grades
• Show lower achievement levels
• End school sooner than same-age peers

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The Vile Weed Stages in the Coercion Model
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Conduct Disorder Case Study

• Tony is 13 and has conduct disorder and
  depression. He is living with his Uncle and Aunt
  who have basically raised him since birth.
  Occasionally his mom comes by, but not on a
  regular basis. The father is unknown. Tonys
  Uncle and Aunt adopted him. They are the head of
  a team which cares for Tony. This includes
  respite foster parents two weekends a month,
  Tonys other Uncle one weekend a month, and his
  grandparents or his adopted parents the other
  weekend. At the moment, Tony is doing well. After
  the last sentencing, they were able to get better
  cooperation from their probation officer and a
  more workable probation agreement. Tony is
  supervised more than his adopted parents four
  year old. Last year he was hospitalized after he
  cut his wrist when he was caught drinking. Tony
  is now part of a group at school who are putting
  together a house. For once he is doing really
  well, expect when he tried to steal an electric
  saw. But Tonys parents had warned the school to
  watch for this, and they did, and they caught
  him. The punishment? No electric guitar for four
  days. Every week or so while Tony is at school,
  his parents go through all his stuff. They have
  told Tony they will do this. Tony now thinks it
  is mean and unfair. On the other hand, their have
  been no knives in the house for a month now. His
  parents call it room service.

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Conduct Disorder

• Is often comorbid with other disorders
• Is one of the most prevalent psychopathological
  disorders
• Affects
• 6 16 of males
• 2 9 of females
• 1.3 to 3.8 million children have conduct disorder

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Conduct Disorder

• Males exhibit
• Fighting
• Stealing
• Vandalism
• Overly aggressive
• Females exhibit
• Lying
• Truancy
• Running away
• Substance abuse
• Prostitution
• Less aggressive

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Conduct Disorder

• May be classified by age of onset
• Earlier onset usually predicts more serious
  impairment

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The Causal Wheel
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Classified As

• Mild (resulting in only minor harm to others)
• Moderate
• Severe (causing considerable harm to others)
• Undersocialized (violent behavior)
• Socialized (more covert antisocial acts)
• Versatile (both overt and covert forms of
  antisocial conduct)

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Conduct Disorder

• Subtypes
• Overt Aggression
• Covert Antisocial
• Versatile

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Causes of Aggression

• Learned through
• Modeling
• Reinforcement
• Ineffective punishment
• Risk can be increased through these factors
• Personal
• Family
• School
• Peer
• Cultural

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Preventing Aggression

• Consequences that deter aggression
• Instruction in nonaggressive responses
• Early intervention
• Restriction of tools of aggression
• Correction of living conditions
• More effective school options

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Assessing Aggression

• Behavior rating scales, AND
• Direct observation
• Must include
• Evaluation of a variety of domains
• Prosocial skills
• Social deficits
• Functional assessment of behavior

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Interventions for Aggression

• Interventions based on social learning
• Most reliable
• Include strategies such as
• Rules
• Teacher praise
• Positive reinforcement
• Verbal feedback
• Stimulus change
• Contingency contracts
• Modeling and reinforcement

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Uses and Misuses of Punishment

• Punishment should
• Be reserved for serious misbehavior
• Be instituted in ongoing behavioral management
  and instructional programs
• Be used only by people who are warm and loving
  toward the individual
• Be administered matter-of-factly, without anger,
  threats, or moralizing
• Be fair, consistent, and immediate
• Be of reasonable intensity
• Involve response cost
• Be related to the misbehavior
• Be discontinued if it is not quickly apparent
  that it is effective
• Have written guidelines for using specific
  punishment procedures

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Behavior Cycle and Precorrection

• Calm Behaving in ways that are expected and
  appropriate
• Trigger First stage in moving towards a major
  blowup
• Agitation Overall behavior in unfocused and off
  task
• Acceleration Student engages the teacher in a
  coercive struggle
• Peak Students behavior is out of control
• De-escalation Student is beginning to disengage
  from the struggle and is in a confused state
• Recovery Eager for busy work and a semblance of
  ordinary glasswork

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The Acting Out Cycle
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School-Wide Discipline

• School-wide discipline plans must
• Focus on earlier phases in the acting out cycle
• Focus efforts on positive attention to
  appropriate behavior
• Provide clear expectations and monitoring of
  student behavior
• Provide staff communication and support
• Provide consistent consequences

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Covert Aggression

• How is Covert Conduct Disorder Identified and
  Treated?

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Definition

• Covert Antisocial Behavior includes
• Untrustworthiness and manipulation of others
• Running away and
• Concealment of ones acts.
• Masculine Antisocial Behaviors
• Vandalism, fighting, and stealing.
• Feminine Antisocial Behaviors
• Lying, running away, and substance abuse.
• Behaviors Clustered Together for Males and
  Females
• Truancy, expulsion, underachievement, and
  discipline

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Casual Factors and Prevention
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Assessment

• Covert behaviors are difficult to observe
• Involves
• Long periods of observation
• Self reports

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Definitions of Animal Abuse

• Social Science Socially unacceptable behavior
  intentionally causes unnecessary pain, suffering,
  distress, or death.
• Law Unnecessarily overloads, overdrives,
  torments, deprives of necessary sustenance or
  shelter, or unnecessarily mutilates, or kills any
  animal (misdemeanor) intentionally commits an
  act that results in cruel death, or excessive
  infliction of unnecessary pain or suffering
  (felony)

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Types of Animal Abuse

• Neglect - no satisfaction derived due to
• carelessness, callousness and
• ignorance
• Abuse - satisfaction derived from dominance
• or from behavioral response
• Sadistic- takes satisfaction from suffering
• Hoarding
• Sexual abuse crush videos
• Subcultural abuse socially acceptable

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Animal Abuse and Adult Criminality

• MSPCA Study 1975-1996
• 80,000 complaints
• 268 efforts to prosecute
• 119 convictions
• 91 fined
• 28 served time (average of 4.5 months)
• Compared to next door neighbors, men prosecuted
  for animal abuse were
• 5 X more likely to commit violent crimes
• 4 X more likely to commit property crime
• 3 X more likely to have record for drug or
• disorderly conduct offense

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Adult Criminality and Childhood Animal Abuse

• Alan Felthous and Stephen Kellert Studies-
• Compared criminals to non-criminals and
  psychiatric to normal
• Significant association between acts of cruelty
  to animals in childhood and serious, recurrent
  aggression against people as an adult most
  aggressive criminals
• committed more severe acts of animal cruelty
• Frank Ascione
• 48 of individuals incarcerated for sexual
  homicide abused animals as children
• 46 of convicted rapists abused animals as
  children

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Child Abuse and Animal Abuse

• New Jersey Study - 53 families met criteria for
  child abuse or neglect. 60 had confirmed
  instances of cruelty to animals in families
  referred for physical abuse, 88 had instances of
  animal abuse 2/3 by fathers 1/3 by children.
• 1980 study in England Of 23 families with
  history of animal abuse, 83 had children at risk
  for abuse or neglect.
• Pennsylvania study corroborated that behavior
  patterns toward children and pets are similar.

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Abused Children Abuse Animals

• In one study, 4.7 of normal children
  acknowledged animal abuse, compared to
• 13 who were sexually abused
• 24.5 who were physically abused
• 34 who were both physically and sexually
  abused
• Children who witness violence are at greater risk
  of becoming abusers or victims
• 26 to 32 of children in abusive families cruel
  to animals

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Responses

• Primary Prevention
• Humane education
• Secondary Prevention
• Programs for at-risk children
• Tertiary Prevention
• The AniCare Model of Treatment for Animal Abuse
• AniCare Child

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ProgramsPairing At-Risk Children and Families
with Animals in Need

• Forget Me Not Farm, collaboration of Humane
  Society of Sonoma County, the San Francisco Child
  Abuse Council, and the YWCA of Sonoma County,
  which includes the Womens Emergency Shelter
• and a therapeutic child care services program.
  Teaching gentleness with gardens and animals
• to children from violent homes and communities.

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Safe Haven for Pets Programs

• Various arrangements, depending on local
  community
• Local vets provide shelter and medical care
• Fostering
• Negotiating extra kennel space off-site

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AniCare Child

• Practical, concrete tools for assessment,
  prevention, and intervention
• Designed for all professionals working with
  children--counselors, teachers, social service
  workers, probation department officials, clergy
• Focuses on empathy development and self
  management skills
• Includes case studies, projective materials, and
  individual and group exercises

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The AniCare Model of Treatment for Animal Abuse

• Stresses accountability and empathy development
• Cognitive-behavioral
• Active therapist, directly addresses problem
• Pre- and Post-Treatment Questionnaires
• Ten AniCare Exercises, with homework
• Becoming the Victim
• Fostering Flexibility
• Learning to Nurture
• Establishing Intergenerational Accountability

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Responding to Stealing

• Define stealing
• Parents decide when theft has occurred
• Parents apply consequences
• Every instance of stealing receives consequences
• Parents keep eyes open and ask questions
• Consequences involve specified interval of work
  or period of restriction
• No positive reinforcement for periods of
  non-stealing
• Program remains in effect for at least 6 months

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Responding to Lying

• Careful monitoring of verbal and written products
• Providing reinforcement for honest behavior
• Punishing occurrences of lying
• Determining if child can differentiate truth from
  non-truth
• Avoiding getting caught up in arguments about the
  veracity of statements

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Firesetting

• Children may be more likely to set fires if
• They do not understand the danger of fire
• They do not have the necessary social skills to
  obtain gratification in other ways
• They engage in other antisocial behaviors
• They are motivated by anger and revenge

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Vandalism

• Appears to be a reaction to aversive
  environments
• Vague rules
• Punitive discipline
• Rigid punishment
• School curriculum not matched with student needs
• Little recognition for appropriate behavior or
  achievement

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Responding to Truancy

• Social Learning Principles
• Attendance is praised
• Systems where attendance earns rewards
• School work that is interesting
• Connecting school and home
• Stopping harassment by peers
• Decreasing fun outside of school during school
  hours

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Problem Behaviors of Adolescence

• How are problem behaviors identified and treated
  in adolescence?

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Juvenile Delinquency

• Delinquent acts
• Index crimes
• Status offenses

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Types of Delinquents

• Those who commit a few delinquent acts vs. repeat
  offenders
• Age at first offense
• Prognosis is worse for juveniles who offend
  before the age of 12

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Causes of Delinquency

• History of child abuse
• Hyperactivity and impulsivity
• Low intelligence and achievement
• Lax parental supervision
• Family history of criminality
• Poverty and large family size
• Antisocial behavior or conduct disorder

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Causes of Delinquency
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Responding to Delinquency

• Families
• Intervention is extremely difficult
• Juvenile Courts and Correction
• Harsher punishments seem counterproductive
• Schooling
• Typical punishment is usually ineffective

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Street Gangs

• The typical gang member has
• A notable set of personal deficiencies
• A notable tendency toward defiance
• A greater-than-normal desire for status,
  identity, and companionship
• A boring, uninvolved lifestyle

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Substance Abuse

• Usually episodic for most adolescents
• Alcohol and tobacco are the largest problems
• Important Terms
• Intoxication
• Symptoms of a toxic amount of substance in the
  blood stream
• Tolerance
• Physiological adoption to a substance so that an
  increasing amount is required to produce the same
  effects
• Addiction
• Compulsive use of a substance and that obtaining
  and using the substance has become a central
  concern and pattern of behavior
• Dependence
• The need to continue using a substance to avoid
  physical or emotional discomfort or both
• Withdrawal
• Physical or emotional discomfort associated with
  a period of abstinence

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Preventing Substance Abuse

• Must be designed for the individual case
• School based interventions must
• Require clear school policies
• Require systematic efforts to provide information
• Provide referral to other agencies
• Involve families and peers

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Preventing Substance Abuse cont

• Skills for students to learn
• Resist peer pressure
• Change attitudes, values, and behavioral norms
  related to substance use
• Recognize and resist adult influences toward
  substance use
• Use problem-solving strategies such as
  self-control, stress management, and appropriate
  assertiveness
• Set goals and improve self-esteem
• Communicate more effectively

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Seven Possible Symptoms of Drug Involvement

• Change in school or work attendance or
  performance
• Alteration of personal appearance
• Mood swings or attitude changes
• Withdrawal from responsibilities / family
  contacts
• Association with drug-using peers
• Unusual patterns of behavior
• Defensive attitude concerning drugs

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Early Sexual Activity

• Increases
• Risk of pregnancy
• Sexually transmitted diseases
• Psychological and health problems
• Current school based interventions may be
  ineffective