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Disruptive, Impulse Control & Conduct Disorders for NCMHCE Study

Quick review of the essential points— DSM5 diagnosis criteria, assessments, treatments—of these disorders to better prepare for the National Clinical Mental Health Counseling Exam. This can be used like flashcards or as a presentation.

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Disruptive, Impulse Control & Conduct Disorders for NCMHCE Study

  1. 1. Review of DSM5 Mental Disorders for NCMHCE Study
  2. 2. 1. Oppositional defiant disorder 2. Intermittent explosive disorder 3. Conduct disorder 4. Pyromania 5. Kleptomania 6. Other specified/unspecified disruptive, impulse control and conduct disorder
  3. 3. Assessments Achenbach System of Empirically Based Assessment ASEBA Conner's Revised 3 Rating Scale Brown Attention-Deficit Scale Woodcock-Johnson III Wechsler Intelligence Scale for Children IV (WISC-IV) Level 1 Cross-Cutting-rated Symptom Measure 6-17
  4. 4. Treatment 1. Medications Lithium/antipsychotics 2. Therapy CBT Parent training Parent-child Interaction Therapy Behavior Modification Therapy Emotion Regulation & Social Skills Training Group therapy Family therapy Engagement of teachers and other involved adults
  5. 5. Risk factors for ODD, Conduct Disorder Having a parent with a mood or substance abuse disorder Being abused or neglected Harsh or inconsistent discipline Lack of supervision Poor relationship with one or both parents Family instability such as multiple moves, changing schools frequently  Parents with a history of ADHD, or conduct problems  Financial problems in the family  Peer rejection  Exposure to violence  Frequent changes in daycare providers  Parents who have a troubled marriage or are divorced  Poverty
  6. 6. Disruptive Mood Dysregulation 2-3 times weekly For 12 or more months Ages 6-10, until age 18 Persistently irritable or angry Verbal and/or physical rages Oppositional Defiant Difficult behavior for 6 months Verbal rages Argumentative Aggressive More severe Intermittent Explosive 3 times yearly Verbal aggression Assaults Outbursts causing damage Ages 6-adult Remorseful
  7. 7. Diagnosis Recurrent behavioral outbursts showing a failure to control aggressive impulses Not premeditated Age 6 or older 1. Verbal aggression 2 times weekly for 3 months 2. Behavioral outbursts causing damage and/or physical assault against animals or people 3 times within 1 year
  8. 8. S4. Treatment 1. Medications 2. Therapy CBT Group therapy
  9. 9. Diagnosis Difficult behavior for 6 months Negativity Defiance Disobedience Hostility directed toward authority figures Leads to: Frequent temper tantrums Argumentativeness with adults Refusal to comply with adult requests or rules Deliberate annoyance of other people Blaming others for misbehavior Being touchy and easily annoyed Anger and resentment Spiteful or vindictive behavior Aggressiveness toward peers Comorbid ADHD 50% of time
  10. 10. S1. Find Out More Detailed history of presenting problem, symptoms Detailed developmental history Medical history Affective functioning Cognitive functioning Trauma history Destructiveness and self destructiveness Family and social history Abuse of substances Exposure to pornography Academic performance on tests Psychological testing S2. Assess & Refer Consult with both parents and other involved adults Psychological testing Tests Achenbach System of Empirically Based Assessment ASEBA Conner's Revised 3 Rating Scale Brown Attention-Deficit Scale Woodcock-Johnson III Wechsler Intelligence Scale for Children IV (WISC-IV) Level 1 Cross-Cutting-rated Symptom Measure 6-17
  11. 11. S4. Treatment Long-term, multi-modal Family therapy Engagement of teachers and other involved adults Parent training Parent-child Interaction Therapy Supportive therapy Training in problem solving CBT Behavior Modification Therapy Emotion Regulation & Social Skills Training
  12. 12. S5.Monitoring Change in behavioral functioning at home and school S6. Termination Follow-up family visit
  13. 13. Diagnosis Repetitive and persistent pattern of behavior 1. Requires 3 of the following in the past 12 months, with at least 1 in the past 6 months Aggression to people and animals Intimidates others often Initiates physical fights often Used a dangerous weapon Physically cruel to people or animals Stolen while confronting a victim  Forced sex on someone  Destruction of property  Arson  Deceitfulness or theft  Broken into someone’s place  Deceives and manipulates others  Serious violations of rules  Run away from home 2 times  Beginning before age 13 years 2. Onset before age 13
  14. 14. Diagnosis II Comorbidity ADHD Generalized Anxiety Disorder Major Depressive Disorder Rule Out Antisocial Personality Disorder: Over age 18, and more severe
  15. 15. S1. Find Out More Detailed history of presenting problem, symptoms Detailed developmental history Medical history Affective functioning Cognitive functioning Trauma history Destructiveness and self destructiveness Family and social history Abuse of substances Exposure to pornography Academic performance on tests Psychological testing S2. Assess & Refer Consult with both parents and other involved adults Psychological testing Tests Achenbach System of Empirically Based Assessment ASEBA Conner's Revised 3 Rating Scale Brown Attention-Deficit Scale Woodcock-Johnson III Wechsler Intelligence Scale for Children IV (WISC-IV) Level 1 Cross-Cutting-rated Symptom Measure 6-17
  16. 16. S4. Treatment Therapy School-based therapies Behavioral therapy Parental skills training Medications Lithium/antipsychotics
  17. 17. Diagnosis Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value Increasing sense of tension immediately before committing the theft Pleasure, gratification or relief at the time of committing the theft Stealing is not committed to express anger and is not in response to delusion/hallucination Not explained better by CD, manic episode, or Antisocial Personality Disorder
  18. 18. S4. Treatment CBT Behavior therapy
  19. 19. Diagnosis 1. Deliberate and purposeful fire setting on more than one occasion Tension or affective arousal before the act Fascination with, interest in, curiosity about or attraction to fire 2. Motive does not include: Monetary gain To conceal a crime Ideology Express anger Response to delusion/hallucination Impaired judgement Rule Out Conduct Disorder Manic Episode Antisocial Personality Disorder

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