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Conduct disorder (Pattersons Coercion Hypothesis: the process of…

- - - - When the coercion model was applied to intervention studies, it was found that interventions targeting coercive parenting practices prevented escalation of CPs and other problem behaviors (e.g., emotional problems, substance use) one would expect among high-risk youths (Dishion, et al. 1992) and families undergoing divorce and remarriage (Forgatch & Patterson, 2010).
        
        Another study involving the same sample focused more intensively on the families with children who displayed clinically elevated oppositional behavior at age 2 and on changes in coercion dynamics as a function of the FCU (Smith, et al. 2013). Coercion involves emotionally driven interaction dynamics that are often attributable to overlearned patterns of behavior and therefore difficult to control and regulate. Changing these parenting dynamics requires more direct feedback and training. Video feedback has been found to reduce caregivers' coercive behaviors with their young children during the preschool years (Smith et al., 2013). We found that the inclusion of video feedback procedures during the age 2 FCU, which consists of showing caregivers brief videotaped clips of desirable interactions with their children (i.e., the FCU's ecological assessment) to reinforce positive parenting practices, reduced caregivers' negative schemas of their child. .
        
        This in turn was found to be an intervening variable in reducing coercive parenting behaviors 3 years later (age 5). This finding is consistent with a complementary study finding that more negative caregiver relational schemas about the child predict a less steep decline in observed coercive interactions during early childhood (Smith, et al. 2014). As such, interventions ought to target the underlying parental beliefs and schemas that govern and maintain coercive patterns of responding to and interacting with their child
        
        'Family Check Up' FCU is a second-generation intervention grounded in the Parent Management Training–Oregon Model (PMTO; Forgatch & Patterson, 2010)
- - - - Impulsiveness is the most crucial personality dimension that predicts antisocial behaviour.54 Unfortunately, there are a bewildering number of constructs referring to a poor ability to control behaviour. These include impulsiveness, hyperactivity, restlessness, clumsiness, not considering consequences before acting, a poor ability to plan ahead, short time horizons, low self-control, sensation seeking, risk taking, and a poor ability to delay gratification.
        
        Meta-analyses show that both ADHD and impulsiveness
        are strongly associated with delinquency (Pratt et al. 2002)
        Many studies show that hyperactivity or ADHD predicts CD
        and delinquency. In the Developmental Trends Study in the
        United States, ADHD predicted ODD, which, in turn, predicted
        CD.
        
        White et al. 1994 The most extensive research on different measures of impulsiveness was carried out in the Pittsburgh Youth Study.60 The measures that were most strongly related to self-reported delinquency at ages 10 and 13 years were teacher-rated impulsiveness (for example, acts without thinking), self-reported impulsiveness, self-reported under-control (for example, unable to delay gratification),
  - - - Good parenting involves
        • Encouraging desirable behaviour and
        strengths
        • Sensitivity to child’s needs
        • Setting firm limits consistently and calmly
        • Transmission of values, sub-culture and
        selection of environments
        (Pettit et al., 2003)
    - - The use of consequences to modify the
        occurrence and form of behaviour
        
        Reinforcement – a consequence that causes a behaviour to occur with greater frequency
        
        Punishment – a consequence that causes behaviour to occur less frequently
        
        Extinction – the lack of any consequence following a behaviour
      - Inadvertant positive reinforcement
        
        Parental Command --> Child refuses and becomes upset --> parent comforts
      - Inadvertant negative reinforcement
        
        Teacher asks class to do sums --> Student picks fight --> Student sent out of the room
    - - There seems to be significant intergenerational
        transmission of aggressive and violent behaviour from parents
        to children, as Widom (1983) found in a longitudinal survey of
        abused children in Indianapolis. The extensive review by
        Malinosky-Rummell and Hansen (1994) confirms that being physically abused as a child predicts later violent and nonviolent
        offending.
  - - - Costello et al. (2003) --> Natural experiment . Town before and after casino opened. Opening of casino = provided income and moved families out of poverty. Before casino opened = more children suffered symptoms of CD. After = significant drop in people who moved class.
- - - - 12 Episode Parenting Programme
        
        56 parents (2-8 yrs) randomly assigned to watching the television series or to waitlist control group.
        
        TV group reported significantly lower levels of disruptive child behavior and higher levels of parenting competence.
        
        Prior to intervention approx. 42.9% of the children in the TV group had significant disruptive behavior. This reduced to 14.3% following intervention.
        
        High level of consumer acceptability was reported by the TV group.
        
        All post-intervention effects were maintained at 6-month follow-up
      - BUT A significant proportion of children do not respond to parent training For those who do respond, there are often significant behaviour problems remaining
        
        Interventions work better for:
        – Younger children
        – Less severe CPs
        – More functinal families
- - - - Some evidence that ODD is a developmental
        precursor for CD (e.g. Hill, 2002).
        • In particular the ‘headstrong’ aspects of ODD
        are related to CD (e.g. Stringaris and
        Goodman, 2009)
        • The prevalence of ODD and CD is variably
        related to age, gender, socio-economic status,
        neighbourhood, and degree of urbanisation,
        but overall prevalence of ODD is 3.2% and of
        CD 2%
        
        .The significance of ODD in youth is apparent in its high prevalence and its particularly strong association with a widerange of adult psychiatric illness (Nock, et al. 2007), conduct disorder (CD) and antisociality (Burke, et al. 2005)
        
        Stringaris and Goodman, 2009 Looked at 3 dimensions of ODD
        
        The three dimensions of oppositionality wereassociated with somewhat different manifestationsof conduct disorder. The head-strong dimension being the main predictor of non-aggressive symptoms - instead, status violations – not surprising given that taking no notice of rules is one of the headstrong items. To a lesser extent, the Headstrong dimension was also associated with non-aggressive offences. The Hurtful dimension was strongly associated with teacher and parent ratings of the child as callous or cold-blooded – suggesting that the link between the Hurtful dimension and both non-aggressive and aggressive offences may reflect callous and premeditated behaviour. By contrast, the link between the Irritable dimension and both aggressive symptoms and status violations may reflect reactive behaviours triggered by anger.