What is the difference between children and adults when diagnosing them w/ depression?
Children and adolescents irritable mood replaces depressed mood in the diagnostic criteria.
What is the difference between children and adults when diagnosing them w/ bipolar?
- Children will show depression first as a opposed to mania in adults
- More continuous rapid cycling in children as oppose to more episodic cycling in adults
- More ongoing in children as oppose to remission for adults
What is the diagnostic criteria for disruptive mood dysregulation disorder?
- Severe verbal or behavioral outburst
- Developmentally inappropriate
- Recurrent temper outbursts at least 3x per week
- Along with a persistently irritable or angry mood between temper outbursts.
How long must the sxs be present and how many setting in order to diagnose a pt with disruptive mood dysregulation disorder?
- Sxs must be present for at least a year
- 2 settings and are severe in at least 1 setting
At what age must the onset of sxs for disruptive mood dysregulation disorder be present in order to diagnose them?
Onset of symptoms must be present by the age of 10 years old but cannot be diagnosed before the age of 6
What are the tx options for disruptive mood dysregulation disorder?
- SSRI
- Stimulants
- CBT
What is the prognosis for disruptive mood dysregulation disorder?
- Chronic disorder
- High risk of progressing to major depressive disorder, dysthymic disorder, anxiety, and anxiety disorders
What are the three types of oppositional defiant disorder?
- Angry/Irritable Mood
- Argumentative/Defiant Behavior
- Vindictiveness
What is the diagnostic criteria for oppositional defiant disorder?
A 6-month pattern of at least 4 sxs from any of the three type and exhibited during interaction with at least 1 individual who is not a sibling
What are characteristic of the angry/irritable mood type in oppositional defiant disorder?
- Often lose their tempers
- Are easily annoyed
- Feel irritable much of the time.
What are the characteristic of the argumentative/defiant behavior type in oppositional defiant disorder?
- Pattern of arguing with authority figures, and adults
- Actively refuse to comply with requests
- Deliberately break rules
- Purposely annoy others
- Do not take responsibility for their actions
- Blame others for their misbehavior.
What are the characteristic of the vindictive type in oppositional defiant disorder?
Spiteful and vindictive actions
How many times must a pt show vindictive or spiteful actions to meet the diagnostic criteira?
Have to shown vindictive or spiteful actions at least 2 times in 6 months
What is the primary tx option for oppositional defiant disorder?
Family intervention using both direct training of the parents in child management skills and careful assessment of family interactions.
What are the non-primary tx options for oppositional defiant disorder?
- CBT
- Individual psychotherapy
What is the prognosis of oppositional defiant disorder?
- Varies over time, with ~ 25% of children with the disorder no longer meeting dx criteria
- Persistence of the disorder poses an increased risk of additional disorders: mood disorders, conduct disorder and substance use disorders.
- Positive outcomes are more likely for intact families who can modify their own expression of demands and give less attention to the child’s argumentative behaviors.
- Prognosis for oppositional defiant disorder in a child depends somewhat on family functioning and the development of comorbid psychopathology
What is the diagnostic criteria for conduct disorder?
At least 3 of the sxs from any category in the past 12 months w/ at least 1 sx present in the past 6 months
What are the 4 categories for conduct disorder?
- Aggression to People and Animals
- Destruction of Property
- Deceitfulness or Theft
- Serious Violations of Rules
What are characteristics of aggression to people and animals?
- Bullies, threatens, or intimidates others.
- Initiates physical fights.
- Has used a weapon that can cause serious physical harm to others
- Been physically cruel to people and/or animals
- Stolen while confronting a victim
- Forced someone into sexual activity.
What are the characteristics of destruction of property?
- Deliberately engaged in fire setting w/ the intention of causing serious damage.
- Deliberately destroyed others’ property (other than by fire setting).
What are the characteristics of deceitfulness or theft?
- Broken into someone else’s house, building, or car.
- Lies to obtain goods or favors or to avoid obligations
- Stolen items of nontrivial value without confronting a victim.
What are the characteristics of serious violations of rules?
- Stays out a night despite parental prohibitions, beginning before age 13 years.
- Has run away from home overnight at least 2x while living in the parental or parental surrogate home, or 1x without returning for a lengthy period.
- Often truant from school, beginning before age 13 years.
What are the tx options/resources for conduct disorder?
- A prevention program, the Fast Track Preventive Intervention
- CBT
- PSST (Kazdins Problem Solving Skills Training)
- PMT (Parent management training)
- IY (The Incredible Years training)
What is the prognosis of conduct disorder?
The best prognosis is predicted for mild conduct disorder in the absence of coexisting psychopathology and the presence of normal intellectual functioning.
