Abnormal Child Psychology International Edition 5th Edition By Eric J. Mash - Test Bank

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6 Conduct Problems

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 Chapter Summary:

Conduct problems (CP) and antisocial behavior in children can be described as actions and attitudes that are age-inappropriate, violate expectations of family and society, and damage others’ personal or property rights. Conduct problems have been defined in various ways depending on the perspective taken (e.g., legal, psychological).  The DSM-IV-TR includes Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) as two types of disruptive behavior disorders.  Behavior of children with ODD is age-inappropriate, hostile, stubborn, and defiant, and can lead to very negative parent-child interactions.  Children with CD engage in severe behaviors that may include aggression to people and animals, destruction of property, deceitfulness or theft, and serious violations of rules.  Child-onset CD is diagnosed when symptoms occur before age 10 and is more severe than adolescent-onset CD. CD and ODD greatly overlap, and there is debate over whether these are truly separate disorders. CPs are associated with a number of characteristics including, cognitive and verbal deficits, school and learning problems, self-esteem deficits, peer and family problems, and health-related problems.  CD is often comorbid with ADHD and depression/anxiety disorders. Gender differences increase through middle childhood, narrow in early adolescence, and then increase again during late adolescence, with boys being more violence-prone, and girls being indirectly aggressive. Numerous causes for CPs have been proposed, and current research suggests that genetics may predispose children to be more at risk of developing ASB.  The interaction of neurobiological risks with negative environmental circumstances also seems to be a factor in CPs.  Other factors that have been implicated include social-cognitive factors, family disturbances (e.g., poor parenting, marital conflict, family instability and stress), societal factors, and cultural factors. Three treatment approaches that have demonstrated some success in treating children with CPs include parent management training, cognitive problem-solving skills training, and multisystemic treatment.  Intensive programs of early intervention/prevention have recently been developed with the goal of preventing CPs at an early age. The amount of success or failure in treating ASB is dependent upon risk and protective factors in the child’s environment and the type and severity of the child’s problems.

Chapter Outline:

I. Description of Conduct Problems

A. Age-inappropriate actions and attitudes that violate family expectations, societal norms, and the personal or property rights of others

B. The types, causes, and outcomes of CPs in children are wide ranging, requiring that we consider several different types and pathways

C. Children with CPs often grow up in unfortunate family and neighborhood circumstances

II. Context, Costs, and Perspectives

A. Context

1. Antisocial acts are relatively normal in childhood

2. Antisocial behaviors vary in severity, from minor disobedience to fighting

3. Most antisocial behaviors decline over time during normal development (with the major exception of aggression, which is highly stable over time)

4. Antisocial behaviors are more common in boys than girls, but this difference decreases or disappears by adolescence

B. Social and Economic Costs

1. Antisocial behavior is the most costly mental health problem in North America

2. An early, persistent, and extreme pattern of antisocial behavior occurs in about 5% of children, and these children account for over half of all crime in the U.S. and about 30-50% of clinic referrals

C. Perspectives

1. Legal Perspective

a. CPs are defined as delinquent or criminal acts

b. The minimum age of responsibility is 12 in most states and provinces

c. Only a subgroup of children who meet legal definitions will also meet the definition of a mental disorder

2. Psychological Perspective

a. CPs are seen as falling along a continuous dimension of externalizing behavior, which includes a mix of impulsive, overactive, aggressive, and delinquent acts

b. Children at the upper extreme of the dimension (usually one or more standard deviations above the mean) are considered to have conduct problems

c. The externalizing dimension is seen as consisting of several related but independent sub-dimensions: delinquent-aggressive, overt-covert, destructive-nondestructive

3. Psychiatric Perspective

a. CPs are viewed as distinct mental disorders based on DSM symptoms

b. In the DSM, CPs fall under the category of disruptive behavior disorders, and include Oppositional Defiant Disorder and Conduct Disorder

4. Public Health

a. Blends the other perspectives with public health concepts of prevention and intervention

b. Goal is to reduce injuries, deaths, personal sufferings, and economic costs that are associated with youth violence

III. DSM-IV-TR Defining Features

A. Oppositional Defiant Disorder (ODD)

1. Age-inappropriate pattern of stubborn, hostile, and defiant behaviors which usually appear by age 8

2. Included in DSM to capture early displays of antisocial and aggressive behaviors by pre-school and school-age children

3. Potential symptoms include:

a. Losing temper

b. Arguing with adults

c. Active defiance or refusal to comply

d. Deliberately annoying others

e. Blaming others for mistakes or misbehavior

f. “Touchy” or easily annoyed by others

g. Anger and resentfulness

h. Spitefulness or vindictiveness

B. Conduct Disorder (CD)

1. A repetitive and persistent pattern of violating basic rights of others and/or age-appropriate societal norms or rules

2. Potential symptoms may consist of:

a. Aggression toward people and animals (e.g., bullying, threatening, fighting, using a weapon)

b. Destruction of property (e.g., deliberate fire setting)

c. Deceitfulness or theft (e.g., breaking into someone’s house or car, “conning” others, shoplifting)

d. Serious violations of rules (e.g., running away from home, missing school, staying out at night without permission)

3. Childhood-onset versus adolescent-onset

a. Children with childhood-onset CD display at least one characteristic of the disorder before age 10, are more likely to be boys, show aggressive symptoms, account for a disproportionate amount of illegal activity, and persist in their antisocial behavior over time

b. Children with adolescent-onset CD are as likely to be girls as boys, do not display the severity or psychopathology that characterizes the early-onset group, and are less likely to commit violent offenses or to persist in their antisocial behavioral as they get older

4. CD and ODD

a. There is much overlap between CD and ODD

b. Although most cases of CD are preceded by ODD and most children with CD continue to display ODD symptoms, most children who display ODD do not progress to more severe CD

C. Antisocial Personality Disorder (APD) and Psychopathic Features

1. Persistent aggressive and antisocial patterns of behavior in childhood may be a precursor of adult antisocial personality disorder (APD), a pervasive pattern of disregard for, and violation of the rights of others as well as engagement in multiple illegal behaviors

2. As many as 40% of children with CD develop APD as adults

3. A subgroup of children with CPs display callous and unemotional interpersonal style, characterized by traits such as lacking guilt, not showing empathy, not showing emotion, and displays of narcissism and impulsivity

IV.    Associated Characteristics

A. Cognitive and Verbal Deficits

1. Although most children with CPs are of normal intelligence, they score about 8 points lower than their peers on IQ tests

2. Verbal IQ is consistently lower than performance IQ, which suggests a specific and pervasive deficit in language

3. Lower IQ and verbal intelligence are present in early development, before the emergence of CPs

4. Evidence of deficits in executive functions, which may be due to the co-occurrence of ADHD

B. School and Learning Problems

1. High rates of academic underachievement (particularly in language and reading), grade retention, special education placement, school dropout, suspension, and expulsion

2. Little evidence that academic failure is the primary cause of antisocial behavior

3. Academic underachievement seems to be best accounted for by the presence of co-occurring ADHD

C. Self-Esteem Deficits

1. Although children with CPs may have low self-esteem, there is little evidence that low self-esteem is the primary cause

2. ASBs may be influenced by an inflated, unstable, and/or tentative view of self

D. Peer Problems

1. Display verbal and physical aggression toward peers and poor social skills

2. Often rejected by peers; social rejection a strong risk factor for adolescent CPs

3. Friendships that are established are often with other deviant peers

4. Associated with a tendency to underestimate their own aggression and overestimate aggression directed toward them; display a hostile attribution bias

5. Often a lack of concern for others and have few solutions to social problems

6. Bullying is when one or more children repeatedly expose another child to negative actions; boys are more likely to bully then girls and display impulsivity and domination while their victims display anxiety and submission; use of electronics and the internet has become very common to harass, manipulate, defame and start rumors

E. Family Problems

1. Family problems are among the strongest and most consistent correlates of antisocial behavior

2. Two types of family disturbances related to CPs:

a. General family disturbances (e.g., parental psychopathology, family history of antisocial behavior, marital discord, family instability, limited resources, and antisocial family values)

b. Specific disturbances in parenting practices and family functioning (e.g., use of harsh discipline, lack of supervision, lack of emotional support)

3. High levels of conflict and poor parenting practices are common in families of children with CPs; conflict especially high between siblings

F. Health-Related Problems

1. Engage in behaviors that place them at high risk for personal injuries, illnesses, overdoses from drug abuse, STDs, and physical problems as adults

2. Rates of premature death are 3 to 4 times higher in boys with conduct problems

3. Strong association between drug use and adolescent antisocial activities; evidence suggests CPs during childhood are a risk factor for adult substance abuse, and this relationship is mediated by drug use and delinquency during early and late adolescents

V. Accompanying Disorders and Symptoms

A. Attention-Deficit/Hyperactivity Disorder (ADHD)

1. About 50% of children with CD also have ADHD

2. Despite overlap, CD and ADHD appear to be distinct disorders

B. Depression and Anxiety

1. About 1/3 are diagnosed with depression or a co-occurring anxiety disorder

2. Anxiety displayed by shyness, inhibition, and fear may be a protective factor against CPs; anxiety displayed by negative emotions and avoidance/withdrawal based on lack of caring about others may increase risk for CPs

VI. Prevalence, Gender, and Course

A. Prevalence

1. Lifetime prevalence rates are 12% for  ODD (13% for males and 11% for females) and 8 % for CD (9% for males and 6% for females)

2. ODD declines or stays constant from early childhood to adolescence whereas CD increases over the same time period

B. Gender

1. During childhood, conduct problems are about 2 to 4 times more common in boys than girls

2. Gender disparity in CPs increases through middle childhood, narrows greatly in early adolescence, and then increases again in late adolescence

3. Boys remain more violence-prone than girls throughout lifespan; girls are more likely to use indirect and relational forms of aggression

C. Developmental Course and Pathways

1. There is a general progression of antisocial behavior from difficult early temperament and hyperactivity, to oppositional and aggressive behavior, to social difficulties, to school problems, to delinquent behavior in adolescence, to criminal behavior in adulthood

2. About 50% of children with early CPs do improve while others display maximum progression

3. Two Pathways:

a. The life-course-persistent (LCP) path describes children who engage in antisocial behavior at an early age and who continue to do so into adulthood

b. The adolescent-limited (AL) path describes youth whose antisocial behavior begins around puberty and continues into adolescence, but who later desist from these behaviors in young adulthood (less serious than LCP)

D. Adult Outcomes- Many children with CPs, especially those on the LCP path, go on as adults to display criminal behavior, psychiatric problems, social maladjustment, health problems, lost productivity, and poor parenting of their own children

VII. Causes

A. Genetic Influences

1. Although CPs are not inherited, biologically based traits, such as a difficult temperament or hyperactivity-impulsivity, may predispose children to develop ASB

2. Adoption and twin studies suggest that about 50% of the population variance in ASB is attributable to heredity

3. Different pathways reflect the interaction between genetic and environmental risk and protective factors of ASB

4. Gene-Environment Interactions

a. Maltreated children with a genotype related to low neurotransmitter metabolizing enzyme monoamine oxidase-A (MAOA) are more likely to develop antisocial behavior then maltreated children not having this genotype

b. Brain image studies show that people with low-active MAOA genotype show arousal in the areas of the brain associated with aggression

c. MAOA and other gene and gene-environment interactions have been implicated in childhood conduct problems

B. Prenatal Factors and Birth Complications – Malnutrition during pregnancy is associated with later ASB, which may be mediated by protein deficiency; lead poisoning before birth and maternal use of substances during pregnancy may also lead to later CPs; however, evidence in this area is lacking

C. Neurobiological Factors

1. Antisocial behavior patterns may result from an overactive behavioral activation system (BAS) and an underactive behavioral inhibition system (BIS), which is believed to be determined primarily by genetic predisposition

2. Children with early-onset CD show low psychophysiological and/or cortical arousal, as well as low autonomic reactivity, which may lead to diminished avoidance learning in response to usual socialization practices

3. CPs have also been associated with higher rates of neurodevelopmental risk factors, neuropsychological deficits, and structural and functional deficits in the prefrontal cortex

4. Strong evidence that cause of CD is the interaction between neurobiological risks and negative environmental circumstances

D. Social-Cognitive Factors

1. Antisocial behavior has been linked to immature forms of thinking, cognitive deficiencies, and cognitive distortions

2. Crick & Dodge model suggests that aggressive children’s thinking and behavior in social situations is deficient in one or more of these steps: encoding, interpretation, response search, response decision, enactment

E. Family Factors

1. Family difficulties are related to the development of both CD and ODD, with a stronger association for CD than for ODD, and for children on the LCP versus the AL path

2. Reciprocal influence – a child’s behavior is both influenced by and influences the behavior of others

3. Coercion Theory – contends that parent-child interactions provide a training ground for the development of antisocial behavior; through an escape-conditioning sequence the child learns to use increasingly intense forms of noxious behavior to escape and avoid unwanted parental demands

4. Attachment Theories

a. Contend that most children refrain from antisocial behavior because they have a stake in conformity; children with CPs often show little internalization of parent and societal standards

b. Antisocial behavior in childhood and adolescence is associated with insecure parent-child attachment

5. Family Instability and Stress

a. Families of children with CPs are often characterized by an unstable family structure with frequent transitions

b. Family stress may be a cause or an outcome of CPs

6. Parental criminality and psychopathology

a. Parents of antisocial children have higher rates of arrests, motor vehicle violations, license suspensions, and substance abuse

b. Antisocial personality disorder (especially in fathers) is strongly and specifically related to CD in children; for mothers, both histrionic personality and depression are related to children’s antisocial behavior

F. Societal Factors

1. Neighborhood and School

a. Antisocial behavior is concentrated in neighborhoods characterized by a criminal subculture

b. Antisocial people tend to select neighborhoods with other people like them (social selection hypothesis)

c. In high-risk neighborhoods, enrollment in a poor school is associated with antisocial and delinquent behavior, whereas a positive school experience can be a protective factor

2. Media

a. Exposure to media violence can be a short term precipitating factor for aggressive behavior (priming, excitation, or imitation of specific behaviors) and a long term predisposing factor for aggressive behavior (desensitization to violence and learning an aggression-supporting belief system)

b. Long-term studies found that childhood exposure to media violence, identification with aggressive TV characters, and perceived realism of TV violence can predict criminal/aggressive behavior 15 years later

G. Cultural Factors – Minority status is associated with antisocial behavior in the U.S.; however, this is likely related to economic difficulties, limited employment opportunities, living in high-risk urban neighborhoods, and membership in antisocial gangs

VIII. Treatment and Prevention

A. The most optimistic treatments use a combination of approaches, applied across individual, family, school, and community settings; other related family problems also need to be addressed

B. In general, the further along a child is in the progression of antisocial behavior, the greater the need for intensive interventions and the poorer the prognosis

C. Parent management training (PMT) teaches parents to change their child’s behavior in the home, based on the assumption that changing the way parents interact with their child will lead to improvements in the child’s behavior

D. Problem-solving skills training (PSST) focuses on the cognitive deficiencies and distortions in interpersonal situations and provides instruction, practice, and feedback to teach new ways of interacting

E. Multisystemic treatment (MST) is an intensive family and community approach for adolescents with severe CPs; draws on a number of techniques and is carried out with all family members, school personnel, peers, juvenile justice staff, and other individuals in the child’s life

F. Preventive Interventions

1. Recent efforts have focused on trying to prevent CPs through intensive programs of early intervention

2. One example is FAST Track, which includes parents management training, home visiting/case management, cognitive-behavioral social skills training, academic tutoring, and teacher-based classroom intervention

a. Fast Track overall results indicate that the intervention had a significant impact, particularly reducing conduct problems and enhancing social competence and family relations

b. Fast Track interventions were less successful in reducing disruptive behaviors in the classroom or improving academic performance

G. The degree of success or failure in treating antisocial behavior depends on the type and severity of the child’s conduct problem and related risk and protective factors

Learning Objectives:

1. To consider how CPs are viewed differently from various perspectives (legal, psychological, psychiatric, and public health)

2. To describe and consider the implications of characteristics associated with children’s CPs and antisocial behaviors (ASBs)

3. To differentiate between ODD and CD

4.To discuss how ADHD, depression, and anxiety are related to CPs

5. To explain gender differences in ASB

6. To understand the general progression and pathways of ASB

7. To describe some of the risk and protective factors of CPs

8. To discuss some of the family factors implicated in children’s ASB

9. To describe Coercion theory and Attachment theory as possible causes of children’s ASB

10. To explain the findings of adoption and twin studies with regards to CPs

11. To describe empirically supported treatments for CPs and to compare and contrast these approaches

Warning Signs of Conduct Problems:

 Argues with adults

 Uncontrollable temper tantrums

 Active defiance, refuses to comply with requests

 Narcissistic, thinks others have no rights or feelings

 Deliberately annoys others

 Cruelty to people and animals

 Blames others for behavior

 Irritable, easily annoyed

 Angry, resentful

 Spiteful, vindictive

 Bullies, intimidates others

 Destroys property

 Deceitful

 Steals from others

 Manipulative of others

 Breaking into others’ property

 Violations of serious rules (e.g., running away, staying out at night without permission)

 Truancy

 Academic difficulties

 Morbid fascination with violence and death

Key Terms and Concepts:

adolescent-limited (AL) path

adolescent-onset conduct disorder

amplifier hypothesis

antisocial behavior(s)

antisocial personality disorder (APD)

behavioral activation system (BAS)

behavioral inhibition system (BIS)

bullying

callous and unemotional interpersonal style

childhood-onset conduct disorder

coercion theory

conduct disorder (CD)

conduct problem(s)

destructive-nondestructive dimension

disruptive behavior disorders

externalizing behavior

hostile attributional bias

juvenile delinquency

life-course-persistent (LCP) path

multisystemic therapy (MST)

oppositional defiant disorder (ODD)

overt-covert dimension

parent management training (PMT)

problem-solving skills training (PSST)

psychopathic features

reciprocal influence

social-cognitive abilities

social selection hypothesis

subclinical levels of symptoms

Test Items:

1. Which of the following is true regarding antisocial behavior in adolescents?

a. Very few adolescents completely refrain from antisocial behavior, and they tend not to be well-adjusted.

b. Antisocial behavior in adolescence is generally not common, and is typically associated with poor adjustment.

c. Antisocial behavior tends to increase in adolescence.

d. Antisocial behavior is as common in adolescence as it is in childhood.

ANS: A REF: p.160 DIF: Moderate COG: Factual

2. Which of the following is true regarding gender differences in antisocial behavior?

a. Boys and girls do not differ in rates of antisocial behavior in childhood.

b. Throughout the lifespan, males display more antisocial behavior than females.

c. Boys are more aggressive than girls in childhood, but this difference decreases or disappears by adolescence.

d. Boys are more aggressive in childhood, but girls are more aggressive in adolescence.

ANS: CREF: p.161DIF: ModerateCOG: Factual

3. Which of the following statements about the stability of antisocial behavior is true?

a. Aggressive behavior is relatively unstable over the course of the lifespan.

b. Aggressive behavior is highly stable over the course of the lifespan.

c. Aggressive behavior is about as stable as IQ scores.

d. Aggressive behavior is highly stable over the course of the lifespan, about as stable as IQ scores.

ANS: D REF: p.161 DIF: Moderate COG: Factual

4. Delinquency, in the legal sense, may result from _____________, whereas a mental disorder requires ______________.

a. one or two isolated acts, several isolated acts

b. a persistent pattern of antisocial behaviors, one or two isolated acts

c. one or two isolated acts, a persistent pattern of antisocial behaviors

d. related acts, unrelated acts

ANS: C REF: p.162 DIF: Easy COG: Factual

5. Rule violations such as running away, setting fires, skipping school, and using drugs and alcohol are referred to as:

a. aggressive behaviors

b. delinquent behaviors

c. externalizing behaviors

d. externalizing and delinquent behaviors

ANS: D REF: p.162-163 DIF: Easy COG: Factual

6. Behaviors such as fighting, destructiveness, and threatening others are referred to as:

a. aggressive behaviors

b. delinquent behaviors

c. externalizing behaviors

d. externalizing and aggressive behaviors

ANS: D REF: p.162-163 DIF: Easy COG: Factual

7. Children who engage in covert behaviors only are typically:

a. aggressive as well

b. negative, irritable, and resentful in their reactions to stressful situations

c. from families that experience significant conflict

d. less social, more anxious, and more suspicious of others

ANS: D REF: p.162-163 DIF: Moderate COG: Factual

8. Children who engage in primarily overt behaviors are typically:

a. from families that provide little family support

b. less social, more anxious, and more suspicious of others

c. negative, irritable, and resentful in their reactions to hostile situations

d. sneaky with others

ANS: CREF: p.162-163DIF: ModerateCOG: Factual

9. Children who display _________________ are at high risk for later psychiatric problems and impairment in functioning.

a. covert-destructive

b. overt-destructive

c. covert-nondestructive

d. overt-nondestructive

ANS: B REF: p.163 DIF: Moderate COG: Factual

10. In the DSM-IV-TR, oppositional defiant disorder and conduct disorders fall under the larger category of:

a. disruptive behavior disorders

b. destructive behavior disorders

c. conduct problems

d. aggressive behavior disorders

ANS: A REF: p.164 DIF: Easy COG: Factual

11. The public health perspective of conduct problems attempts to reduce ____________ associated with youth violence.

a. injuries and deaths

b. personal suffering

c. economic costs

d. all of the above

ANS: D REF: p.164 DIF: Easy COG: Factual

12. _______________ describes children who display an age-inappropriate recurrent pattern of stubborn, hostile, and defiant behaviors.

a. Oppositional defiant disorder

b. Conduct disorder

c. Early-onset psychopathy

d. Callous behavior disorder

ANS: A REF: p.164 DIF: Easy COG: Easy

13. The purpose of placing Oppositional Defiant Disorder in the DSM was to:

a. use early intervention to help children

b. identify early displays of antisocial and aggressive behavior

c. detain children in age appropriate facilities

d. create more diagnostic categories for children

ANS: B REF: p.165 DIF: Easy COG: Factual

14. _______________ describes children who display severe aggressive and antisocial acts involving inflicting pain on others or interfering with others’ rights.

a. Oppositional defiant disorder

b. Conduct disorder

c. Early-onset psychopathy

d. Callous behavior disorder

ANS: B REF: p.165 DIF: Easy COG: Factual

15. Children with adolescent-onset CD are ________________ than those with childhood-onset CD.

a. more likely to be girls

b. more likely to display psychopathology

c. more likely to be aggressive

d. less likely to persist in their antisocial behavior as they get older

ANS: DREF: p.167DIF: ModerateCOG: Factual

16. Which of the following is true regarding the relationship between ODD and CD?

a. Most children who display ODD go on to later develop CD.

b. There is no relationship between ODD and CD.

c. CD is almost always preceded by ODD.

d. ODD is almost always preceded by CD.

ANS: C REF: p.167 DIF: Moderate COG: Factual

17. The lifetime prevalence rate for ODD and CD are about:

a. 12% and 8% respectively

b. 20% and 15% respectively

c. 5% and 10% respectively

d. 9% and 7% respectively

ANS: A REF: p.175 DIF: Moderate COG: Factual

18. During childhood, conduct problems are about _____ times more common in boys then in girls.

a. 5 to 7

b. 1 to 2

c. 2 to 4

d. 10 to 12

ANS: C REF: p. 176 DIF: Moderate COG: Factual

19. Psychopathic features are marked by:

a. a pattern of deceitful, callous, manipulative, and remorseless behavior

b. repeated criminal acts

c. diminished intelligence and inability to distinguish right from wrong

d. excessive anxiety

ANS: A REF: 167 DIF: Easy COG: Factual

20. On tests of cognitive ability, children with conduct disorder typically:

a. score in the below average to borderline range

b. display lower performance (nonverbal) scores than verbal scores

c. show no unique patterns of deficits

d. show impairments prior to the onset of their conduct problems

ANS: DREF: p.169DIF: ModerateCOG: Factual

21. Deficits in executive functions in children with conduct problems are likely due to:

a. poor parenting practices

b. co-morbid borderline cognitive abilities

c. the presence of ADHD

d. co-morbid learning disorders

ANS: C REF: 170 DIF: Moderate COG: Factual

22. Underachievement in language and reading among children with conduct problems is most likely mediated by:

a. truancy

b. poor parenting practices

c. the presence of ADHD

d. co-morbid borderline cognitive abilities

ANS: C REF: p.170 DIF: Moderate COG: Factual

23. Which of the following is true regarding the relationship between conduct problems and self-esteem?

a. Low self-esteem is a primary cause of antisocial behavior.

b. There is no relationship between conduct problems and self-esteem.

c. Conduct problems are related to an inflated, unstable, or tentative self-esteem.

d. The relationship between conduct problems and self-esteem only applies to children with callous and unemotional traits.

ANS: C REF: p.170 DIF: Easy COG: Factual

24. The single most powerful predictor of conduct problems in adolescence is:

a. early antisocial behavior

b. the combination of early antisocial behavior and involvement with deviant peers

c. the combination of early antisocial behavior and poor parenting

d. the combination of poor parenting and involvement with deviant peers

ANS: BREF: p.170-171DIF: ModerateCOG: Factual

25. The tendency to attribute negative intent to others, especially when the actual intentions of the other child are unclear, is referred to as:

a. trait confluence

b. hostile attribution bias

c. reactive aggression

d. none of these

ANS: B REF: p.171 DIF: Moderate COG: Factual

26. General family disturbances include:

a. marital discord and family instability

b. excessive use of harsh discipline

c. lack of supervision

d. all of the above

ANS: A REF: p.171-173 DIF: Easy COG: Factual

27. The siblings of children referred for conduct problems:

a. usually display as much negative behavior as their referred sibling(s)

b. usually display normative rates of negative behavior

c. usually display less negative behavior than their referred siblings

d. usually only engage in negative behavior when the referred sibling is present

ANS: A REF: p.173 DIF: Moderate COG: Factual

28. Children with co-morbid ______________ usually display more severe behavioral, academic, and social impairments.

a. depression

b. ADHD

c. anxiety

d. mental retardation

ANS: B REF: p.174 DIF: Easy COG: Factual

29. Children with conduct problems generally show _______ anxiety than those without conduct problems, and children with a callous-unemotional interpersonal style show _________ anxiety.

a. more, less

b. less, more

c. less, less

d. more, more

ANS: A REF: p.175 DIF: Moderate COG: Factual

30. The lifetime prevalence rate for CD is about:

a. 6%

b. 8%

c. 10%

d. 15%

ANS: B REF: p.175 DIF: Easy COG: Factual

31. The lifetime prevalence rate for ODD is about:

a. 2%

b. 6%

c. 12%

d. 18%

ANS: C REF: p.175 DIF: Moderate COG: Factual

32. The prevalence of ODD is _____________ the prevalence of CD.

a. less than

b. equal to

c. more than

d. less stable from decade to decade than

ANS: CREF: p.175DIF: ModerateCOG: Factual

33. An early symptom of CD in girls is often:

a. aggression

b. lying

c. theft

d. sexual misbehaviors

ANS: D REF: p.176 DIF: Easy COG: Factual

34. Compared to boys’ aggression, girls’ aggression tends to involve more:

a. confrontation

b. overtly aggressive acts

c. relationally aggressive acts

d. externalizing behaviors

ANS: C REF: p.176 DIF: Easy COG: Factual

35. A factor that predicts increased delinquency among girls who attend mixed-gender schools is:

a. early onset of menarche

b. aggressive behavior

c. anxiety

d. depression

ANS: A REF: p.177 DIF: Moderate COG: Factual

36. The earliest signs of antisocial behavior may be:

a. parental overactivity

b. difficult temperament as an infant

c. ODD in toddlerhood

d. rejection by peers in elementary school

ANS: B REF: p.178 DIF: Moderate COG: Factual

37. In comparison to children on the adolescent-limited path to antisocial behavior, those on the life-course-persistent path:

a. display more consistency in their behavior across situations

b. are more violent

c. are more likely to drop out of school

d. all of these

ANS: D REF: p.180 DIF: Easy COG: Factual

38. In comparison to youth on the life-course-persistent path, those on the adolescent-limited path:

a. display more extreme antisocial activity

b. are more likely to drop out of school

c. are often being influenced by situational factors, such as their peers

d. have weaker family ties

ANS: C REF: p.179 DIF: Easy COG: Factual

39. By their late twenties, ___________ former delinquents have desisted from offending.

a. very few

b. about a quarter of

c. about half of

d. most

ANS: D REF: p.181 DIF: Easy COG: Factual

40 The general relationship between childhood conduct problems and adult outcomes depends in part on:

a. gender

b. type and severity of conduct problems

c. cultural background

d. all of these

ANS: BREF: p.181DIF: EasyCOG: Factual

41. Which of the following is NOT a consistent finding for the genetic contribution to antisocial behavior?

a. Genetic contributions to overt behaviors are stronger than those for covert behaviors.

b. Heritability accounts for less than 10% of the variance in antisocial behavior.

c. Genetics is more strongly implicated for the life-course-persistent pattern than for the adolescent-limited pattern of antisocial behavior.

d. Genetic evidence for antisocial behavior is supported by both twin and adoption studies.

ANS: B REF: p.182 DIF: Moderate COG: Factual

42. Joshua is considered to have a low-active MAOA genotype. He is likely to:

a. have difficulty concentrating

b. act more aggressively

c. be more sexually active

d. lie frequently

ANS: B REF: p.183 DIF: Moderate COG: Factual

43. A child with antisocial behavior has:

a. an overactive BAS and an overactive BIS

b. an underactive BAS and an underactive BIS

c. an underactive BAS and an overactive BIS

d. an overactive BAS and an underactive BIS

ANS: D REF: p.183 DIF: Moderate COG: Factual

44. Neurobiological factors (e.g., low arousal and autonomic reactivity) play a more central role for:

a. late onset CD

b. early onset CD

c. adult criminality

d. CD accompanied by anxiety

ANS: B REF: p.183-184 DIF: Easy COG: Factual

45. What neurobiological factor has been linked to conduct problems?

a. Birth complications

b. Closed head injuries

c. Exposure to lead

d. All of the above

ANS: D REF: p.184 DIF: Easy COG: Factual

46. ____________ refers to the concept that the child’s behavior is both influenced by and influences the behavior of others.

a. Coercion

b. Attachment

c. Reciprocal influence

d. Influential factor

ANS: C REF: p.186 DIF: Easy COG: Factual

47. Ineffective parenting has been found to be related to conduct problems in:

a. all children

b. all children with conduct disorder

c. children with conduct disorder who also display significant callous-emotional traits

d. children with conduct disorder who also display high anxiety

ANS: C REF: p.187 DIF: Moderate COG: Factual

48. Unemployment, low SES, and multiple family transitions are related specifically to:

a. early onset CD

b. late onset CD

c. criminality

d. ODD

ANS: A REF: p.188 DIF: Moderate COG: Factual

49. Fathers of children with conduct disorder often display:

a. histrionic personality and depression

b. antisocial personality disorder and substance abuse

c. antisocial personality disorder

d. antisocial personality disorder, substance abuse, and criminality

ANS: D REF: p.188 DIF: Easy COG: Factual

50. Mothers of children with conduct disorder often display:

a. histrionic personality and depression

b. antisocial personality and depression

c. substance abuse and depression

d. schizophrenia and substance abuse

ANS: A REF: p.188 DIF: Moderate COG: Factual

51. According to the social-selection hypothesis:

a. people change or adapt to the environment in which they live

b. children with conduct disorder choose to be friends with other children with conduct problems

c. people who move into different neighborhoods differ before they arrive, and those who remain differ from those who leave

d. neighborhoods “embrace” those who are similar to the majority of the individuals already living in the neighborhood and actively reject those who are not

ANS: C REF: p.189 DIF: Moderate COG: Factual

52. In high-risk neighborhoods, _______________ can protect against the development of antisocial behavior.

a. increased police surveillance

b. removing children and placing them in foster homes in low-risk neighborhoods

c. a positive school experience

d. imposing curfews

ANS: C REF: p.189 DIF: Easy COG: Factual

53. The finding that externalizing problems are more frequent among minority-status children in the U.S. is likely related to:

a. differing socialization practices

b. genetic differences

c. problems related to low SES

d. all of these

ANS: C REF: p.191 DIF: Easy COG: Factual

54. Which of the following is NOT a characteristic of parent-management training for conduct problems?

a. intensive and direct intervention of the therapist with the child

b. teaching contingency management techniques

c. monitoring of progress

d. enhancement of supervision

ANS: A REF: p.193 DIF: Moderate COG: Factual

55.  Which of the following is NOT a characteristic of cognitive problem-solving skills training (PSST) for conduct problems?

a. teaching parents contingency management techniques

b. identification of self-statements

c. alteration of the child’s attributions regarding other children’s motivations

d. all of these are characteristic of PSST

ANS: AREF: p. 194DIF: ModerateCOG: Factual

56. Elizabeth’s parents, teachers, and probation officer met to discuss treatment strategies for Elizabeth’s aggressive and criminal behavior. What treatment modality is this?

a. Family Therapy

b. Community Intervention

c. Social Skills Training

d. Mulitsystemic Treatment

ANS: D REF: p.195 DIF: Moderate COG: Factual

57. What treatment components were used to achieve Fast Track goals?

a. academic tutoring

b. home visits

c. cognitive –behavioral training

d. all of the above

ANS: DREF: p.196DIF: EasyCOG: Factual

58. The overall results of Fast Track intervention indicate:

a. a reduction in conduct problems and increase in social competence and family relations

b. a reduction in classroom disruptive behaviors

c. an improvement in academic performance

d. an improved relationship with the student and teacher

ANS: A REF: p.196 DIF: Moderate COG: Factual

59. Which of these was NOT a finding of the FAST Track program?

a. moderate improvements in peer relations and academic performance by the end of Grade 1

b. decreases in conduct problems by the end of Grade 1

c. by the end of Grade 3 more children in the intervention group than in the control group were free of serious conduct problems

d. all outcomes at the end of Grade 1 were maintained at the end of Grade 3

ANS: D REF: p.196 DIF: Moderate COG: Factual

60. MST has been found to reduce long-term rates of criminal behavior for periods as long as ___ years.

a. two

b. three

c. four

d. five

ANS: D REF: p.195 DIF: Moderate COG: Factual

Short Answer/Essay Questions:

1. Define conduct problems from the legal, psychological, psychiatric, and public health perspectives.

2. Crossing the covert-overt and destructive-nondestructive dimensions of conduct problems yields four quadrants of antisocial behavior.  Describe behaviors in each of these quadrants.

3. Distinguish between childhood-onset versus adolescent-onset conduct disorder.

4. What role do cognitive deficits and/or distortions play in conduct problems?

5. What lines of reasoning suggest that ADHD and CD are separate disorders?

6. What are some of the gender differences in antisocial behavior, and what are some reasons behind these differences?

7. Explain the general progression of CD.

8. Distinguish between life-course persistent and adolescent-limited pathways to antisocial behavior.

9. What are some of the findings regarding genetic influences on the development of antisocial behavior?

10. Explain what the behavioral activation and behavioral inhibition systems are, and describe the role they play in conduct problems.

11. Crick and Dodge (1994) and Dodge and Pettit (2003) have presented a social-cognitive model to account for the behavior of socially aggressive boys.  As outlined by their model, discuss the steps in the thinking and behavior of aggressive children in social situations.

12. Create a scenario between a mother and child that illustrates Patterson’s coercion theory.

13. What role do neighborhoods and schools play in antisocial behavior?

14. How does the media influence aggression in children?

15. Discuss some of the limitations of parent-management training programs in treating conduct problems.

16. Explain Multisystemic Therapy (MST), and provide evidence that supports this approach.

17. What behaviors are likely to be exhibited by a child who has been maltreated and who also has a low-active monoamine oxidase-A (MAOA)?

Questions and Issues for Discussion:

1. Consider the teenagers in Littleton, Colorado who killed their classmates at school.  At what age should children be held responsible for their delinquent acts?  At what age should they be tried as adults or even face the death penalty? What factors should be taken into consideration in answering these questions? (See Horowitz, M. A. (2000).  Kids who kill: A critique of how the American legal system deals with juveniles who commit homicide. Law and Contemporary Problems for a thorough discussion of this issue (article is available on InfoTrac).)

2. If one aspect of abnormality is maladaptiveness, and if children with conduct disorder are aggressive as a way of adapting to their hostile world, should we really consider conduct disorder as a psychological disorder?  Should conduct disorder be punished or treated?

3. In recent years, questions have been raised as to whether parents should be liable/responsible for their children’s misbehavior.  Do students believe “parental responsibility” laws may help to reduce juvenile delinquency?  What might be some of the negative ramifications of imposing such laws?  (See Tyler, J. E., & Segady, T. W.  (2000). Parental liability laws: Rational, theory, and effectiveness.  The Social Science Journal, 37, p. 79 for a thorough discussion of this issue (article is available on InfoTrac).)

4. Are teens getting a bad rap these days?  It seems as if the media is constantly giving us stories about teen violence and crime.  Are today’s teens truly worse than in past years?  (See Cannon, A. & Kliener, C. (April 17, 2000). Teens get real. U.S. News and World Report, 128, p. 46, for an article that argues that today’s generation of teens are among “the best we’ve had” (article is available on InfoTrac).)

5. In past years, “boot camps” for youth offenders were viewed as a promising way to deal with youth violence and crime.  Despite their public appeal, boot camps have not been effective at reducing recidivism rates.  What might be some of the reasons for their failure?  (For a brief discussion of this topic see West, W.  (April 3, 2000).  Civilian boot camps lack intended kick.  Insight on the News, 16, p. 48 (article is available on InfoTrac).)

6. Bullying is one of the most serious problems facing schools today.  How can we understand bullying behavior?  How should we deal with bullying?  Are “zero-tolerance” policies justified, or do they go too far?  Have views about bullying changed in recent years? (For a brief discussion of this topic see Manning, M., & Lee, W.  (January 1, 2003).  Challenges and suggestions for safe schools.  The Clearing House (article is available on InfoTrac).)

7. How might family dynamics contribute to conduct problems in children? Is there a way to predict which children are more likely to develop antisocial behaviors on the basis of family factors? If so, how could this information be used in terms of prevention or early intervention?  (For a brief discussion of this topic see Van As, N. M. C.  (June 22, 2003).  Family predictors of antisocial behavior in adolescents.  Family Process (article is available on InfoTrac).)

8. Recent research indicates that early intervention is effective, and in some opinions, necessary in preventing aggression in children and adolescents. In some cases, intervention is recommended even at the pre-school level. Is it appropriate to begin thinking about preschoolers as “aggressive” and “requiring treatment”? How effective are interventions in preventing future aggression in children? (For a brief discussion of this topic see Grace, M.  (April 1, 2003).  Childreach: Violence prevention in pre-school settings.  Journal of Child and Adolescent Psychiatric Nursing (article is available on InfoTrac).)

9. Residing and attending school in a high-risk, low-income neighborhood has been found to be associated with adolescent delinquent behavior. What characteristics of these neighborhoods and schools are most likely to contribute to conduct problems? Can community contexts alone cause delinquent behavior? Can positive influences in other areas, such as the family, prevent these behaviors? (For a brief discussion of this topic see Toohey, S. M.  (January 1, 2003).  Community contexts of human welfares. Annual Review of Psychology (article is available on InfoTrac)).

10. Consider the Multisystemic approach to treating conduct disorders. What types of treatment does a multisystemic approach involve? Based on your understanding of the causes of conduct disorder, do you believe a multisystemic approach is necessary for successful treatment? Is this a treatment that works well in theory, but may be difficult to actually implement in society today? Discuss why you believe a multisystemic approach is realistic or unrealistic to implement. (For a brief discussion of this topic see Borduin, C. M.  (March 1, 1999). Multisystemic Treatment of criminality and violence in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry (article is available on InfoTrac).)

11. Now that studies suggest some gene-environment related interaction in regards to aggression, what are the implications for psychiatric treatment, as well as, punishment for harmful behaviors?

12. Discuss ways in which a child can be engaged and supported while also being held responsible and accountable for their actions, when participating in a multisystemic treatment model. How can the team of caretakers and providers be sure to not alienate the child, while coming up with a solid and safe treatment plan?

13. Discuss the interplay between callous-unemotional traits and narcissism and how people who display these behaviors can be both alluring and dangerous.

14. Bullying has become a significant social problem that unfortunately, at times, has led young people to commit suicide. Bullying has become even more prevalent with the advancement of technology and the internet. In what ways can responsible adults at home and at school try to reduce these destructive behaviors and protect the innocent victims?

Website Suggestions:

http://www.conductdisorders.com/   This site is oriented toward adolescents with conduct problems.  Offers information, personal stories, articles, and links.

http://www.bullying.co.uk/   A site for children, parents, and teachers wanting information and advice about bullying.

http://www.kidzworld.com/site/p488.htm A site for kids telling them what bullying is about and some anti-bullying tactics.

http://www.ncjrs.gov/App/Topics/Topic.aspx?Topicid=122 A listing of all on-line publications on juvenile crime and violence from the National Criminal Justice Reference Service.

http://www.athealth.com/consumer/issues/early_warning.html   The U.S. Department of Education and Department of Justice prepared this report, entitled “Early Warning, Timely Response: A Guide to Safe Schools”. Topics the guide covers include characteristics of safe schools, early warning signs, intervention for troubled children, development of a prevention and crisis response plan, and responding to crises.

http://www.cdc.gov/ncipc/dvp/bestpractices.htm#Download   “Best Practices of Youth Violence Prevention: A Sourcebook for Community Action,” a document prepared by the Center for Disease Control and Prevention, describes strategies for implementing interventions to prevent youth violence.  (Adobe Acrobat is needed to view or print this document.)

http://www.klis.com/chandler/pamphlet/oddcd/oddcdpamphlet.htm  A pamphlet with information about ODD and CD and includes strategies for helping and coping with children with CD/ODD.

http://www.violentkids.com  A site written by a forensic psychologist who works with violent children. Includes articles and facts, as well as letters written towards kids and teens that feel rejected by their peers. Provides information for parents and teachers dealing with violent juveniles.

Video Suggestions:

Violence (October 20, 2000, segment #01).  ABC News- 20/20.  (length unavailable; $29.95 purchase price)

Examines whether violence on TV, movies, and in video and computer games make children more violent. Presents findings on violent images and TV helped convince Congress to pass a law requiring the V-chip in all new TVs.

Secret Shame: Bullied to Death (1996).  Films for the Humanities and Sciences.  (28 minutes; $129 purchase price)

The tragic story of a 13-year-old who was bullied to the extent that he committed suicide. Focuses on how bullying is a growing social problem and how it has long-term psychological effects on its victims.

A & E Investigative Reports:  Bullied to Death (production date unavailable).  A&E Television.  (50 minutes; $19.95 purchase price)

Investigates the effects of bullying and how children often react destructively, either by turning the rage inward or by retaliating with lethal violence against their tormenters. Interviews bullied children and their tormentors and includes a visit to a school pioneering an anti-bullying program that focuses on this pervasive form of child abuse.

A & E Investigative Reports: Juvies (production date unavailable).  A&E Television.  (100 minutes; $29.95 purchase price)

Goes inside Maryland’s Cheltenham Youth Facility, and what emerges is a moving portrait of the Juvenile Justice System as told through the eyes of four troubled youths. Shows the harsh and unforgiving world of juvenile prisons.

Understanding the Defiant Child (1997).  Guilford Publications.  (34 minutes; $95 purchase price)

Narrated by Russell A. Barkley, this program discusses degrees of noncompliance and defiance, prevalence of defiant behavior and ODD, reasons for concern, aspects of the parent-child interaction, and causes of delinquent behavior.  Real life scenes of family interactions are included.

Managing the Defiant Child:  A Guide to Parent Training (1997).  Guilford Publications.  (34 minutes; $95 purchase price)

Narrated by Russell A. Barkley, this program covers principles underlying management methods for defiance, ten steps in a parent training program for defiance in children, and specific methods for managing the defiant child.

Kids Behind Bars (1999).  Films for the Humanities and Sciences.  (29 minutes; $89.95 purchase price)

Examines the trend in the U.S. toward trying juveniles as adults for their crimes, and experts discuss efforts towards understanding some children’s violent behavior.

Frontline: The Killer at Thurston High (production date unavailable).  PBS.  (90 minutes; $49.95 purchase price)

An in-depth examination of a school shooter reveals the intimate, inside story of how Kip Kinkel, a “shy and likable teenager” from a solid middle-class family, became a killer.

Young, Armed, and Dangerous  (1998).  Films for the Humanities and Sciences.  (58 minutes; $89.95 purchase price)

Investigates treatments for young offenders by focusing on social, economic, and psychological causes of violence. Looks at a resocialization program and another progressive program as ways of confronting violence.

It’s Not Okay: Speaking Out Against Youth Violence (2000). Films for the Humanities and Sciences. (40 minutes, $99.95 purchase price).

High school students, teachers, and mental health professionals offer their opinion on violence and its impact, and call for social change.

Brother of Mine: Youth Violence and Society (1993). Films for the Humanities and Sciences. (50 minutes, $149.95)

Examines why children are more violent at home, at school, and on the streets. Interviews reveal that violence is an everyday occurrence, and observes proactive school-based programs.

Preventing School Violence (2001). Films for the Humanities and Sciences. (29 minutes, $129.95 purchase price)

Examines violence among children and teens, and psychologist Daniel Goleman presents his theories on improving the school environment.

Harm’s Way: The Lessons of Youth Violence (1998). Films for the Humanities and Sciences. (47 minutes, $149.95 purchase price)

Young offenders and their families tell their stories and experts in the field offer possible answers to why there is increasingly frequent accounts of youth violence.

Kids and Drugs (production date unavailable) Films for the Humanities and Sciences. (28 minutes, $89.95 purchase price)

Presents stories of five teenagers battling drug abuse. Includes expert opinions on denial, warning signs, and family stress.