Child Psych ODD/CD/SUD

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How long must ODD behavior be present for?

6 months

What is the frequency and duration for vindictiveness in ODD?

At least twice in 6 months

In ODD: For children younger than ______, the behavior should occur on most days for a period of at least 6 months unless otherwise noted

5 years

For ODD: individuals 5 years or older, the behavior should occur __________, unless otherwise noted

At least once per week for at least 6 months

For ODD: describe the differences in frequency of mild, moderate, to severe

Mild is in one setting, moderate is in two settings, and severe is in three or more settings

Symptoms may appear in preschool, but rarely occur later than early adolescence (age 11 or 12)

ODD

How many criteria for CD must be met and for how long?

At least three of the following 15 criteria in the past 12 months

What is the age threshold for differentiating childhood-onset type vs adolescent-onset type CD?

Before or after age 10

What brain structures are linked to CD?

Frontotemporal-limbic connections involving the brain’s ventral prefrontal cortex and amygdala

Recurrent behavioral outbursts representing a failure to control aggressive impulses as manifested by either of the following: 1. Verbal aggression (e.g., temper tantrums, tirades, verbal arguments or fights) or physical aggression toward property, animals, or other individuals, occurring twice weekly, on average, for a period of 3 months. The physical aggression does not result in damage or destruction of property and does not result in physical injury to animals or other individuals. 2. Three behavioral outbursts involving damage or destruction of property and/or physical assault involving physical injury against animals or other individuals occurring within a 12-month period.

Intermittent Explosive Disorder

How is IED different than CD and ODD?

Their actions are not premeditated and must be at least 6 years old

Rarely begins for the first time after age 40

IED

This abnormally function neurotransmitter is associated with IED

Serotonin

Disruptive behavior disorder Person is “obnoxious". Irritability is a common factor, but not required for a diagnosis. Shows patterns of defiant and resistive behavior towards authority figures. At least 6 months for behavior

ODD

Impulsive control disorder. Behavioral disorder. Sudden rage/anger outbursts. Outbursts are triggered by identifiable stressor (lasts for <30 minutes). Reaction far exceeds stressor. Not due to other mood/anxiety/behavioral disorders. Occurs twice weekly on average for 3 months.

IED

Disruptive behavior disorder. Person “commits crimes”. Serious violation of rules. Lack of empathy and conscience. No mood or anxiety criteria. Can be comorbid with ODD in DSM-5. 3 criteria within 12 months, with at least 1 in the past 6 months.

Depressive Disorder Mood expression significantly abnormal. Irritability is a core feature. Irritability or anger persists most of the day, nearly every day with intermittent impulses of aggression. Impacts more than one setting. Impacts the environment and associates with dangerous behavior 12 or more months.

DMDD

More common in females and is strongly coexisting with bulimia

Kleptomania

Name two assessment screenings for kleptomania

Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Kleptomania Symptom Assessment Scale

What drug(s) help with urges in kleptomania?

Naltrexone and memantine

Lower concentration of norepinephrine and serotonin metabolites 3-methoxy-4- hyroxyphenylglycol (MHPG) and 5-hydroxyindoleacetic acid (5-HIAA)

Pyromania

These areas of the brain associated with binge/intoxication behavior

Ventral and dorsal striatum, global pallidus, and thalamus

These areas of the brain are associated with withdrawal/negative affect

Amygdala and ventral striatum

These areas of the brain are associated with preoccupation/anticipation

Anterior cingulate, PFC, OFC, basolateral nucleus of the amygdala, and hippocampus

-Screening for brief substance use and its severity, including tobacco, alcohol, marijuana, etc -Discriminates between no use, no SUD, moderate SUD, and severe SUD

S2BI

-Brief Screener for Tobacco, Alcohol, and Other Drugs -Identifies problematic tobacco, alcohol, and marijuana use

BSTAD

-Two-question alcohol screen -Screens for friends' use and for personal use in children and adolescents aged ≥9 y

NIAAA Youth Alcohol Screen

-Car, Relax, Alone, Friends/Family, Forget, Trouble -Quickly asses for problems associated with substance use

CRAFFT

Assesses for both SUDs and mental health disorders

GAIN

Assesses for risky drinking

AUDIT

Assess for substance use in a nonjudgmental manner in ALL patients ages ________

9 and older

Short-term alcohol and marijuana therapy

MET

Shown to be effective for cannabis treatment, less expensive than intensive or lengthy modalities

MET/CBT

Aims to foster family collaboration with school/juvenile justice and facilitate reentry of juvenile detainees into community

Multi-Dimensional Family therapy (MDFT)

Effective with adolescents who have severe SUD and other delinquent/violent behavior

Multi-Systemic family therapy (MSFT)

Aims to improve communication, parenting skills, problem solving, conflict resolution

Functional family therapy

What is the timeline for developing mild ETOH withdrawl?

6-12 hours

What is timeline for developing moderate ETOH withdrawl?

12-48 hrs

What is the timeline for developing severe ETOH withdrawal?

48-72 hrs

What is the timeframe for developing delirium tremens?

30-120 hrs, peaks at 24-48 hrs

When does withdrawal symptoms begin with short-acting opiates?

6-12 hrs

What is the timeframe for developing withdrawal symptoms with long-acting opiates?

30 hrs

When does opiate withdrawal symptoms peak?

72 hrs

For CD (with limited prosocial emotions), they must have 2 characteristics (lack of remorse and empathy) persistently over the last ______.

12 months

If someone with CD does not show emotions except in was that seem shallow, insincere, or superficial you would specify?

Unconcerned about performance

Compare and contrast ODD vs CD with it comes to being controlled

Both hate to be controlled but CD will try to control others

What’s the frequency and duration of verbal aggression in IED?

Twice a week for 3 months

In IED, Criteria #2 requires three behavior outbursts that involves injury or destruction of property within ____

12 months

Can be adapted for a range of situations in various settings and treatment modalities

Brief strategic family therapy

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