Oppositional Defiant Disorder and Conduct Disorder in Childhood

Walter Matthys, John E. Lochman

• Publisher: Wiley-Blackwell
• Year: 2016
• ISBN:
  9781118972540
• Edition: 2
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

Newly updated, this is a comprehensive guide to ODD and conduct disorder (CD) in children aged 3-14 for professionals, students, and researchers.

• Summarizes the most important empirical knowledge across a broad array of topics, with a focus on the latest research and meta-analyses, as well as high-quality older studies
• Includes revised diagnostic conceptualizations for ODD and CD from DSM-V and the upcoming ICD-11 classification systems, with particular attention to similarities, differences, and information about an angry-irritable subtype for ODD
• Provides updated reviews of biological and social-cognitive risk and protective factors and the evidence base for relevant treatment and prevention procedures
• Describes best practices for assessment, treatment, and prevention for children and their families, based on the clinical and research work of the well-respected author team

1
Behaviors and Disorders

All children sometimes refuse to comply. And a lot of children occasionally get involved in fights. Also, various children lie at times. Although these behaviors are inappropriate, from a clinical point of view, they need not be of great concern if they occur infrequently and in an isolated manner. However, when these behaviors occur in a cluster and repeatedly in a particular child, there is reason to be worried. In this chapter, we first look at the various types of socially inappropriate, disruptive behaviors that have been discerned, and then consider related clusters of behaviors or diagnostic categories that have been distinguished. Finally, we discuss appropriate behaviors that may be underdeveloped in children with maladjustment.

Disruptive Behaviors

Oppositional Behavior

Oppositional behavior or noncompliance is behavior in which a child resists a caregiver. A range of oppositional behaviors may be discerned, from passive forms of noncompliance to active forms of noncompliance (Kochanska & Aksan, 1995). Thus, children may ignore a parental direction, which is an example of passive noncompliance, but children may also directly refuse a parental command, which is a form of mildly active noncompliance. In addition, children may angrily reject parental commands or prohibitions, which is a form of severe noncompliance or defiance. In preschool children, moreover, a distinction needs to be made between normative noncompliance and clinically significant noncompliance or oppositionality (Wakschlag & Danis, 2004). Normative noncompliance reflects the young child’s self‐assertion and is driven by the desire to do something autonomously (Wakschlag & Danis, 2004). Normative or self‐assertive noncompliance generally is short‐lived, whereas clinically significant noncompliance is more intransigent (Wakschlag & Danis, 2004).

Aggressive Behavior

Aggression is behavior deliberately aimed at harming people (Parke & Slaby, 1983). Hitting other children is an example of physical aggression. There are, however, other forms of aggression. Speech also may harm people, either as a possible precursor of physical aggression such as in verbal threats, or as a means to denigrate or provoke another child. For example, this occurs when children call each other names. Relational aggression is another form of aggressive behavior (Crick & Grotpeter, 1995). It is defined as damaging interpersonal relationships or feelings of inclusion. Malicious gossiping and threatening to withdraw friendship are examples of relational aggression. In this book, use of the term “aggression” implies physical or verbal aggression. When relational aggression is discussed, this is made explicit.

Among these various forms of aggressive behavior, distinction has been made between reactive and proactive aggression (for reviews, see Dodge, 1991; Kempes, Matthys, de Vries, & Van Engeland, 2005; Vitaro, Brendgen, & Barker, 2006). Reactive aggression is an impulsive aggressive response to a frustration, a perceived threat, or a provocation. On the other hand, proactive aggression is controlled aggressive behavior that anticipates a reward. Reactive aggression also has been called defensive or “hot‐blooded” aggression, whereas proactive aggression has been called instrumental or “cold‐blooded” aggression.

When considering aggression, one may distinguish differences in the underlying motivation (or the “whys” of aggressive behavior) from differences in the various forms of aggression (the “whats” of aggressive behavior) (Little, Jones, Henrich, & Hawley, 2003). Thus, the distinction between reactive and proactive aggression (the “whys”) may be applied both to physical, verbal, and relational aggression (the “whats”). One example of verbal reactive aggression in children is to get angry and swear at adults when corrected. One example of physical reactive aggression is to strike back when teased by a peer. To threaten another child in order to get his/her own way is an example of verbal proactive aggression. To incite other children to act against a child whom he or she dislikes is an example of proactive relational aggression. Although reactive aggression and proactive aggression are highly correlated, correlations drop dramatically after the distinction has been made between the form and the motivation of aggression (Polman, Orobio de Castro, Koops, van Boxtel, & Merk, 2007).

Antisocial and Delinquent Behavior

Antisocial behavior is defined as behavior by which basic norms, rights, and rules are violated. Thus, when children lie, they violate the norm of speaking the truth; when they steal, they violate the right of the protection of one’s property; and when they are truant, they violate a rule. “Antisocial behavior” is often used as a general term for the various inappropriate behaviors such as oppositional and aggressive behavior. When children repeatedly resist requests, instructions, or corrections given by adults, they indeed violate the norm to be obedient to their parents, elders, or teachers. Further, when children beat their peers, they violate their peers’ right of physical integrity.

When antisocial behaviors are legal violations, they are called delinquent behaviors. Depending on the age of the child, behaviors such as theft, running away, truancy from school, and setting fires are considered to be delinquent. Legislation among countries, and among states within countries, largely vary, so that the same behavior, for example, drinking alcohol, is considered as illegal in one country or state but not in another.

Psychopathic Features and Callous–Unemotional Traits

There is another term that is relevant here—“psychopathy.” Psychopathy refers to personality characteristics such as an absence of empathy, an absence of guilt, an absence of anxiety, shallow emotions, and the inability to form and sustain lasting relationships (Cleckley, 1976; Hare, 1993). Thus, psychopathy does not refer to a specific set of behaviors but to underlying characteristics of individuals.

The construct of psychopathy in adults consists of various dimensions. The several dimensions which have been found to be useful in children and adolescents are callous–unemotional traits (for a review, see Frick, Ray, Thornton, & Kahn, 2014) and narcissism (Barry et al., 2007). Callous–unemotional traits are characterized by lack of guilt and remorse, lack of concerns for the feelings of others, shallow or superficial expressions of emotions, and lack of concern regarding performance in important activities (Frick, 2009). Callous–unemotional traits constitute the affective factor of psychopathy and designate a particularly aggressive subgroup of children and adolescents with antisocial behavior (Frick et al., 2014). Callous–unemotional traits have been found to have moderate stability in longitudinal research (Barry, Dunlap, Lochman, & Wells, 2009; Pardini, Lochman, & Powell, 2007). Among children and adolescents with antisocial behavior, those with high levels of callous–unemotional traits display more instrumental aggression and show a more stable pattern of antisocial behavior (Frick et al., 2014).

Disruptive Behaviors

The inappropriate behaviors discussed in the foregoing section are also called disruptive behaviors. These behaviors not only disrupt child–child interactions and child–adult interactions, but when these behaviors occur frequently, the relations among children and the relations between children and adults are disrupted as well. “Externalizing behavior” is another general term for these inappropriate behaviors (Achenbach & Edelbrock, 1978). It is used to distinguish these behaviors from overcontrolled or internalizing behaviors such as withdrawal and anxious behaviors.

In addition to the ones discussed in the preceding section, there are more types of behaviors that are disruptive. Impulsive behaviors such as interrupting others and having difficulty in waiting turn indeed are clearly disruptive. Hyperactive behavior, such as running about in the living room or leaving one’s seat in the classroom and during meals at home, are troublesome as well. Finally, attention problems may occur unnoticed such as the difficulty in sustaining attention, but other behaviors related to attention problems such as not following through on instructions are quite upsetting.

Diagnostic Categories

Disruptive behaviors may occur either infrequently or in isolation in individual children and in these cases the behaviors can then be considered as “normative.” However, they may also occur as clusters. These clusters of co‐occurring patterns of inappropriate behaviors or syndromes form the basis of the psychiatric categories from the classification systems DSM‐5 (American Psychiatric Association, 2013) and ICD‐10 (World Health Organization, 1996). Although these syndromes originate from hypotheses about covarying symptoms or behaviors derived from observations of patients by clinicians, factor analytic studies of child and adolescent problem behavior support how these behaviors are associated to each other (see further in this chapter).

In the DSM‐IV, the two Disruptive Behavior Disorders (DBDs), i.e., oppositional defiant disorder (ODD) and conduct disorder (CD), with characteristic features of oppositional, aggressive, and antisocial behavior, were included in the chapter titled “Attention Deficit and Disruptive Behavior Disorders.” Attention deficit/hyperactivity disorder (ADHD), with characteristic features of hyperactive behavior, impulsive behavior, and attention problems, also was included in this chapter. In the DSM‐5, however, ADHD is included in the chapter titled “Neurodevelopmental Disorder” while ODD and CD are part of the disruptive, impulse‐control, and conduct disorders together with pyromania, kleptomania, ...

Table of contents

• Cover
• Title Page
• Table of Contents
• About the Authors
• Foreword
• Preface
• 1 Behaviors and Disorders
• 2 Developmental Perspectives
• 3 Basic Issues on Etiology
• 4 Individual Characteristics
• 5 Environmental Characteristics
• 6 Clinical Assessment
• 7 Intervention and Intervention Development
• 8 Behavioral Parent Training
• 9 Cognitive Behavioral Therapy
• 10 Pharmacotherapy
• 11 Multicomponent Intervention
• 12 Factors which Influence Intervention Delivery and Outcomes
• References
• Index
• End User License Agreement