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Conduct Disorder, Conduct Disorder, Aggression, and Aggression, and Violence Violence
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Conduct Disorder, Aggression, and Violence. April 20, 1999….

Dec 16, 2015

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Page 1: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Conduct Disorder, Conduct Disorder, Aggression, and Aggression, and

ViolenceViolence

Page 2: Conduct Disorder, Aggression, and Violence. April 20, 1999….

April 20, 1999….April 20, 1999….

Page 3: Conduct Disorder, Aggression, and Violence. April 20, 1999….
Page 4: Conduct Disorder, Aggression, and Violence. April 20, 1999….
Page 5: Conduct Disorder, Aggression, and Violence. April 20, 1999….
Page 6: Conduct Disorder, Aggression, and Violence. April 20, 1999….
Page 7: Conduct Disorder, Aggression, and Violence. 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.

Page 8: Conduct Disorder, Aggression, and Violence. April 20, 1999….

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

Two Students Shot Outside D.C. SchoolThe Associated Press Wednesday, April 5, 2006

Public Schools spokeswoman Roxanne Evans said that a 19-year-old male student was shot in the back around 9:15 a.m. E

DT, and that he was being treated for serious injuries.

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.

Page 9: Conduct Disorder, Aggression, and Violence. April 20, 1999….

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

Page 10: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Violence Every DayViolence Every Day Between 1985 and 1991, annual homicide rates Between 1985 and 1991, annual homicide rates

among males 15-19 years old almost tripled (from 13 among males 15-19 years old almost tripled (from 13 to 33 per 100,000).to 33 per 100,000).

In 2002, 5,219 young people 15-24 years old were In 2002, 5,219 young people 15-24 years old were victims of homicide. victims of homicide. 4,317 were by firearm (=83% of homicides).4,317 were by firearm (=83% of homicides). That translates to 14 youth homicide victims per That translates to 14 youth homicide victims per

day in the U.S. (12 by firearm).day in the U.S. (12 by firearm). In Iraq since the invasion, we have averaged ~2 In Iraq since the invasion, we have averaged ~2

U.S. servicemen killed per day. U.S. servicemen killed per day.

Page 11: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Homicide in Black Male YouthsHomicide in Black Male Youths Homicide is the second leading cause of death for Homicide is the second leading cause of death for

persons 15-24 years of age, and is the leading cause persons 15-24 years of age, and is the leading cause of death for African-American youths in this ageof death for African-American youths in this age group.group.

Rates of homicide/100,000 (2002) age 15-24:Rates of homicide/100,000 (2002) age 15-24: White males: 11White males: 11 Latino males: 30Latino males: 30 Black males: 83 (1 of every 1,200 murdered/year)Black males: 83 (1 of every 1,200 murdered/year)

By contrast, motor vehicle accident deaths:By contrast, motor vehicle accident deaths: White males: 41/100,000White males: 41/100,000 Black males: 30/100,000Black males: 30/100,000

Page 12: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Carrying a weapon or gun, past Carrying a weapon or gun, past 30 days (h.s. students)30 days (h.s. students)

0

5

10

15

20

25

30

%

Females Males

White

Black

Hispanic

Page 13: Conduct Disorder, Aggression, and Violence. April 20, 1999….

H.S. students carrying a gun, H.S. students carrying a gun, past 30 dayspast 30 days

0

2

4

6

8

10

12

%

Females Males

White

Black

Hispanic

Page 14: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Threatened or Injured With a Weapon Threatened or Injured With a Weapon on School Property, Past Year, 2003on School Property, Past Year, 2003

0

2

4

6

8

10

12

14

16

%

Females Males

Whites

Blacks

Hispanics

Page 15: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Property Stolen or Intentionally Property Stolen or Intentionally Damaged at School, Past Year, 2003Damaged at School, Past Year, 2003

0

5

10

15

20

25

30

35

40

%

Females Males

Whites

Blacks

Hispanics

Page 16: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Homicides in U.S. Schools 1992/3-Homicides in U.S. Schools 1992/3-2002/3 (per 100,000)2002/3 (per 100,000)

Page 17: Conduct Disorder, Aggression, and Violence. April 20, 1999….

A Few DefinitionsA Few Definitions

Antisocial BehaviorAntisocial Behavior

Conduct DisorderConduct Disorder

Juvenile DelinquencyJuvenile Delinquency

Page 18: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Conduct Disorder (DSM-IV)Conduct Disorder (DSM-IV)

Aggression to people and animalsAggression to people and animals Bullies, intimidatesBullies, intimidates Often initiates physical fightsOften initiates physical fights Used a weapon than could physically harmUsed a weapon than could physically harm Physically cruel to people, or animalsPhysically cruel to people, or animals Stolen while confronting victimStolen while confronting victim Forced someone into sexual activityForced someone into sexual activity

continued...continued...

Page 19: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Conduct Disorder ContinuedConduct Disorder Continued Destruction of PropertyDestruction of Property

Fire setting with intent to cause damageFire setting with intent to cause damage Deliberately destroy others’ propertyDeliberately destroy others’ property

Deceitfulness or theftDeceitfulness or theft Broken into house, building, carBroken into house, building, car Often lies to obtain desired goalOften lies to obtain desired goal Stealing without confrontationStealing without confrontation

Serious rule violationsSerious rule violations Often stays out past curfewOften stays out past curfew Run away from home overnight >= 2xRun away from home overnight >= 2x Often truant at schoolOften truant at school

Page 20: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Course of Antisocial SymptomsCourse of Antisocial SymptomsCourse of Antisocial SymptomsCourse of Antisocial Symptoms

31% of antisocial teens later qualify as 31% of antisocial teens later qualify as adults for diagnosis adults for diagnosis (Antisocial (Antisocial Personality)Personality)

94% later have employment problems94% later have employment problems Multiple moving traffic violations (72%)Multiple moving traffic violations (72%) Severe marital difficulties (67%)Severe marital difficulties (67%) Fewer than 20% show good social Fewer than 20% show good social

functioning as adultsfunctioning as adults

Page 21: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Why Do Youth Become Why Do Youth Become Antisocial? Antisocial?

Page 22: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Characteristics Beginning in Characteristics Beginning in ChildhoodChildhood

Characteristics Beginning in Characteristics Beginning in ChildhoodChildhood

Impulsivity Impulsivity (and ADHD diagnosis)(and ADHD diagnosis) IrritabilityIrritability InattentionInattention Peer rejection in middle childhoodPeer rejection in middle childhood Poor relationships with teachersPoor relationships with teachers Academic deficienciesAcademic deficiencies Affiliation with deviant peer group in Affiliation with deviant peer group in

childhoodchildhood

Page 23: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Neuropsychological DeficitsNeuropsychological DeficitsNeuropsychological DeficitsNeuropsychological Deficits

Deficiencies in:Deficiencies in: Attention modulationAttention modulation Self control and impulsivitySelf control and impulsivity Verbal skillsVerbal skills MemoryMemory IQIQ Visual-motor integrationVisual-motor integration

Deficits worse among those with Deficits worse among those with chronic antisocial problems, beginning chronic antisocial problems, beginning in childhoodin childhood

Page 24: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Biological DeficitsBiological DeficitsBiological DeficitsBiological Deficits

Low levels of serotonin metabolite 5-Low levels of serotonin metabolite 5-hydroxyinadolacetic acid acid (5-HIAA) in hydroxyinadolacetic acid acid (5-HIAA) in spinal fluidspinal fluid

Under-responsive to electrodermal Under-responsive to electrodermal stimulation, an index of processes stimulation, an index of processes involving anxiety and inhibitioninvolving anxiety and inhibition

Page 25: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Social Cognitive DeficitsSocial Cognitive DeficitsSocial Cognitive DeficitsSocial Cognitive Deficits

Inaccurate interpretations of peers’ Inaccurate interpretations of peers’ intentions--biased towards assuming intentions--biased towards assuming hostile intent in othershostile intent in others

Misjudging aggression as means to Misjudging aggression as means to positive outcomespositive outcomes

Deficient problem-solving skillsDeficient problem-solving skills

Page 26: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Family Coercion ProcessFamily Coercion ProcessFamily Coercion ProcessFamily Coercion Process

Gerald R. Patterson, John B. ReidGerald R. Patterson, John B. Reid Involves maternal irritability, child Involves maternal irritability, child

provocationprovocation Negative reciprocity ends with parent Negative reciprocity ends with parent

backing downbacking down Negative reinforcement of aggressive Negative reinforcement of aggressive

behavior resultsbehavior results

Page 27: Conduct Disorder, Aggression, and Violence. April 20, 1999….

Other Social FactorsOther Social FactorsOther Social FactorsOther Social Factors

Experiencing or witnessing violence within Experiencing or witnessing violence within the familythe family

Viewing violence on TV and filmsViewing violence on TV and films Access to firearmsAccess to firearms Poverty, economic inequality, Poverty, economic inequality,

discriminationdiscrimination

Page 28: Conduct Disorder, Aggression, and Violence. April 20, 1999….

TreatmentTreatmentTreatmentTreatment

Not reimbursable by both insurance plansNot reimbursable by both insurance plans Parent management training (Patterson Parent management training (Patterson

and Forgatch)and Forgatch) FAST Track programFAST Track program

Page 29: Conduct Disorder, Aggression, and Violence. April 20, 1999….

PreventionPreventionPreventionPrevention

Parent training at early age (when children Parent training at early age (when children are preschoolers)are preschoolers)

Teaching emotion regulation, conflict Teaching emotion regulation, conflict resolution in schoolsresolution in schools

Reducing availability of weaponsReducing availability of weapons Addressing discrimination, economic Addressing discrimination, economic

disparitydisparity Reduction of violence in media--not Reduction of violence in media--not

glorifying itglorifying it