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Conduct Disorder, Aggression, and Violence
Conduct Disorder, Aggression, and Violence
Overview of Session
Scope of the problem Definitions Reasons for antisocial and violent
behavior Treatment and Prevention
Washington, DC. Thursday, February 10, 2000
'JUST TOTALLY SENSELESS'; TWO WILSON 'JUST TOTALLY SENSELESS'; TWO WILSON HIGH SENIORS SHOT DOWN AFTER HIGH SENIORS SHOT DOWN AFTER LEAVING GAME LEAVING GAME
Manassas, Va., March 26, 2000 – Prince William County police say three teens from Stonewall Jackson Middle School were caught with instructions and materials to build bombs.
SANTEE, Calif., March 6 -- San Diego County sheriff's investigators said today that 15-year-old Charles "Andy" Williams took a .22-caliber long-barrel revolver from his father's locked collection of weapons, brought as many as 40 rounds of ammunition to his high school in his backpack and fired 30 of them during the shooting rampage in which the boy allegedly killed two schoolmates and injured 13 others.
Washington Post, March 7, 2001
In the nearly two years since the massacre at Columbine High School, officials at Santana High School developed elaborate security plans for the campus. There were phones in every classroom. Security guards patrolled the hallways with two-way radios. And a sheriff's deputy was assigned to visit the campus each day.
But even with that elaborate security net, school officials could not avert Monday's shooting rampage at the suburban San Diego school because friends of accused gunman Charles "Andy" Williams -- and the one adult who heard Williams's plans -- did not turn him in.
For Schools, a Calculus of Rights and Safety
April 20, 1999….
…and Every Day...Trauma room specialists stand helplessly as the mother and brother of a teenager killed in a drive-by shooting collapse in grief on the hospital floor. The family was allowed to see the boy's body, which lies in a nearby room, just moments after the emergency room team failed to revive him.
Gun Ownership in USGun Ownership in US
Violence Every Day
Between 1985 and 1991, annual homicide rates among males 15-19 years old almost tripled (from 13 to 33 per 100,000).
In 1997, 6,083 young people 15-24 years old were victims of homicide. – That translates to 17 youth homicide victims per
day. Homicide is the second leading cause of death for
persons 15-24 years of age, and is the leading cause of death for African-American youths in this age group.
Violence Every Day (ctd…)Violence Every Day (ctd…)
In each year since 1988, more than 80 percent of homicide victims 15-19 years of age were killed with a firearm. In 1996, 85 percent of homicide victims 15-19 years of age were killed with a firearm
Carrying a weapon or gun, past 30 days (h.s. students)
0
5
10
15
20
25
30
35
%
Females Males
White
Black
Hispanic
H.S. students carrying a gun, past 30 days
0
2
4
6
8
10
12
14
16
18
%
Females Males
White
Black
Hispanic
Carrying a Weapon on School Property, Past 30 Days
0
2
4
6
8
10
12
14
16
%
Females Males
White
Black
Hispanic
Missed School Because Felt Unsafe: Past 30 days
0
1
2
3
4
5
6
7
8
%
Females Males
Whites
Blacks
Hispanics
Property Stolen or Intentionally Damaged at School, Past Year
0
5
10
15
20
25
30
35
40
%
Females Males
Whites
Blacks
Hispanics
A Few Additional Points
Rates of all violent behavior decrease from 9th grade to 12th grade
Rates of violent behavior very high in Washington, D.C.
Definitions & Diagnostic Criteria
Antisocial Behavior
Conduct Disorder
Juvenile Delinquency
Conduct Disorder (DSM-IV)
Aggression to people and animals– Often bullies, intimidates– Often initiates physical fights– Used a weapon than could physically harm– Has been physically cruel to people– Has been physically cruel to animals– Has stolen while confronting victim– Has forced someone into sexual activitycontinued...
Conduct Disorder Continued
Destruction of Property– Deliberate fire setting with intent to cause damage– Deliberately destroy others’ property
Deceitfulness or theft– Broken into house, building, car– Often lies to obtain desired goal (e.g., “cons”)– Stealing without confrontation (e.g., shoplift)
Serious rule violations– Often stays out past curfew– Run away from home overnight >= 2x– Often truant at school, beginning before age 13
Two Trajectories of Antisocial Behavior: 1. Early Starters
Two Trajectories of Antisocial Behavior: 1. Early Starters
Antisocial tendencies as small children Antisocial behavior at ages 9, 10 predicts
length of arrest record in adolescence, and arrest at those ages predicts adult arrests
Training with deviant peers, beginning late childhood/early adulthood
Big jump in frequency and intensity of antisocial behavior in early adolescence, which later tapers off
Highest risk of persistence in adulthood
Two Trajectories of Antisocial Behavior: 2: Late Starters
Two Trajectories of Antisocial Behavior: 2: Late Starters
Those whose first antisocial acts occur in adolescence are likely to have a less chronic course, and less likely to continue to commit antisocial acts after adolescence
Course of Antisocial Symptoms From Adolescence to AdulthoodCourse of Antisocial Symptoms From Adolescence to Adulthood
High stability r’s from childhood through adolescence
31% of antisocial teens qualify as adults for diagnosis (Antisocial Personality)
94% had employment problems as adults 85% violence as adults Multiple moving traffic violations (72%) Severe marital difficulties (67%) Fewer than 20% show good social functioning
as adults
Is Conduct Disorder A Mental Disorder?
Richters and Cicchetti Article: – Concept of Harmful Dysfunction:
A condition is a disorder if and only if:
- It causes harm, or deprivation of benefit, to the person (as judged by one’s culture)
AND
The condition results from the inability of some internal mechanism to perform its natural function, from an evolutionary perspective
Why Do Youth Become Antisocial?
Why Do Youth Become Antisocial?
Risk Factors Beginning in Childhood
Risk Factors Beginning in Childhood
Impulsivity (and ADHD diagnosis)
Irritability
Inattention
Academic deficiencies/school failure
Neuropsychological DeficitsNeuropsychological Deficits Deficiencies in:
– Attention modulation– Self control and impulsivity– Verbal skills– Memory– IQ– Visual-motor integration
Deficits worse among those with chronic antisocial problems that begin in childhood
Biological DeficitsBiological Deficits
Low levels of serotonin metabolite 5-hydroxyinadolacetic acid acid (5-HIAA) in spinal fluid, low norepinephrine, low 5-HT (hydroxytryptamine); all part of Gray’s behavior facilitation system
Under-responsive to electrodermal stimulation, low resting heart rate
‘Difficult’ temperament in first year of life
Interpersonal Functions of Aggression/AngerInterpersonal Functions of Aggression/Anger
Dominance/Power
Remove threat to self or self-concept
Attachment: expression of separation distress
Protection of loved one
Unifying force – achieve common goal
Peer relationships: Social AggressionPeer relationships: Social Aggression
During Childhood, aggression is physical
Girls: develop social aggression ages 10-11– Proportion of female conflicts involving social aggression
rises from 14% in 4th grade, to 56% in 10th grade.
Boys: Use little social aggression even in adolescence.– Severity of aggression increases in adolescence, boys
stronger and more often use weapons
Peer rejectionPeer rejection
Peer rejection in middle childhood has been linked to externalizing problems in childhood, as well as adolescence
Rejected/aggressive boys tend to persist in aggression when other aggressive kids stop
Males who are rejected and aggressive in middle childhood are more likely to show high levels or increasing in antisocial behavior across adolescence
Adolescent Peer GroupsAdolescent Peer Groups
Reduction (vs. childhood) in social constraints
Increased access to firearms Confrontation,aggression are the norm Affiliation with deviant peer group in
childhood Aggression fuels aggression in other
members of group
Social Cognitive DeficitsSocial Cognitive Deficits
Encoding cues: tendency to attend to hostile features
Inaccurate interpretations of peers’ intentions--biased towards assuming hostile intent in others (Dodge)
Response generation Response evaluation EnactmentQuestion: Are these deficits in capacity or in
production?
Family ProcessFamily Process
Family Coercion Model: (GR Patterson)– Involves parental irritability, child provocation– Negative reciprocity ends with parent backing
down– Negative reinforcement of aggressive behavior
results
Poor monitoring Poor parenting (inconsistent, harsh) Parents do not prevent escalation of
aggression with peers
Other Social FactorsOther Social Factors
Experiencing or witnessing violence within the family, including being physically abused
Viewing violence on TV and films Access to firearms Poverty, economic inequality,
discrimination
TreatmentTreatment
Not reimbursable by insurance plans Parent management training (Patterson
and Forgatch) Focus on deviant peers at early
adolescence FAST Track program
PreventionPrevention
Parent training at early age (when children are preschoolers). Reduce violence in home.
Teaching emotion regulation, conflict resolution in schools
Target children with antisocial behaviors by age 9 or 10
Reduce availability of weapons Address social context (discrimination, economic
disparity) Reduction of violence in media