Oppositional Defiant Disorder and Conduct Disorder in Childhood

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1 Oppositional Defiant Disorder and Conduct Disorder in Childhood Walter Matthys and John E. Lochman A John Wiley & Sons, Ltd., Publication

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3 Oppositional Defiant Disorder and Conduct Disorder in Childhood

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5 Oppositional Defiant Disorder and Conduct Disorder in Childhood Walter Matthys and John E. Lochman A John Wiley & Sons, Ltd., Publication

6 This edition first published John Wiley & Sons Ltd. Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley s global Scientific, Technical, and Medical business with Blackwell Publishing. Registered Office John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial Offices The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 9600 Garsington Road, Oxford, OX4 2DQ, UK 350 Main Street, Malden, MA , USA For details of our global editorial offices, for customer services, and for information about how to apply for permission to reuse the copyright material in this book please see our website at The right of the authors to be identified as the author of this work has been asserted in accordance with the Copyright, Designs and Patents Act All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Library of Congress Cataloging-in-Publication Data Matthys, Walter. Oppositional defiant disorder and conduct disorder in childhood / Walter Matthys and John E. Lochman. p. ; cm. Includes bibliographical references and index. ISBN (cloth) ISBN (pbk.) 1. Oppositional defiant disorder in children. 2. Conduct disorders in children. I. Lochman, John E. (John Edward) II. Title. [DNLM: 1. Attention Deficit and Disruptive Behavior Disorders. 2. Child. WS M443o 2010] RJ506.O66M dc A catalogue record for this book is available from the British Library. Set in Minion 10.5/13 pt by SNP Best-set Typesetter Ltd., Hong Kong Printed in Singapore by Fabulous Printers Pte Ltd

7 To Paula and Linda

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9 Contents About the authors Preface Foreword ix xi xiii 1. Behaviours and disorders 1 2. Developmental perspectives Basic issues on aetiology Individual characteristics Environmental characteristics Clinical assessment Intervention and intervention development Behavioural parent training Cognitive-behavioural therapy Pharmacotherapy Multicomponent intervention Factors that influence intervention delivery and outcomes 181 References 201 Index 253

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11 About the authors Walter Matthys, MD, PhD, is Professor of Aggression in Children at Utrecht University, The Netherlands. His clinical work as a child and adolescent psychiatrist is based at the Department of Child and Adolescent Psychiatry, University Medical Centre Utrecht. His research at the Rudolf Magnus Institute of Neuroscience focuses on the neurobiological and psychological characteristics of children and adolescents with aggressive behaviour and disruptive behaviour disorders, and on interventions to prevent and treat these disorders. John E. Lochman, PhD, ABPP, is Professor and Doddridge Saxon Chairholder in Clinical Psychology at the University of Alabama, where he also directs the Center for Prevention of Youth Behavior Problems. He has served as a Special Professor at Utrecht University. He is Editor - in - Chief of the Journal of Abnormal Child Psychology, serves on the Board of the Society for Prevention Research, and is President of the American Board for Clinical Child and Adolescent Psychology. His research interests encompass risk factors, social cognition and intervention and prevention with aggressive children.

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13 Pref a ce This book offers a brief but comprehensive overview of empirical knowledge and associated clinical information regarding oppositional defiant disorder (ODD) and conduct disorder (CD) in children aged 3 14 years. Since the amount of research in this subject is vast, we have avoided presenting an extended review of the literature of some areas while neglecting others. Instead, we have given priority to conciseness and clarity in the presentation of a broad array of topics. The book opens with an introductory chapter on relevant terms. We then present the developmental psychopathology perspective (Chapter 2 ). The section of the book on aetiology starts with a chapter on basic issues (Chapter 3 ) followed by two detailed chapters on individual and environmental characteristics (Chapters 4 and 5 ). We then describe the clinical assessment from a decision - making point of view (Chapter 6 ). The section on intervention opens with a chapter on general issues (Chapter 7 ), followed by chapters on behavioural parent training (Chapter 8 ), cognitive - behavioural therapy (Chapter 9 ), pharmacotherapy (Chapter 10 ) and multicomponent interventions (Chapter 11 ). Finally, issues relating to the delivery of intervention are discussed in Chapter 12. This synopsis is intended to be a guide for professionals and will be useful for students and researchers as well. Some information, for example on genetics, will serve as background information for clinicians and will be relevant for their accurate general understanding of the initiation, development and maintenance of the disorders. The background aetiological chapters can also help clinicians in understanding subsets of the children they see. Students and beginning researchers will find a quick overview of the whole field, while advanced researchers may find essential information on topics that are not their primary focus of interest and expertise. For decades, the research fields of ODD and CD (and aggressive and antisocial behaviour) on the one hand and attention deficit/hyperactivity disorder (ADHD) (and hyperactive, impulsive and inattentive behaviour) on the other have been split as if these two groups of disorder and problem behaviour are independent of each other. In fact, however, they often co - occur. The

14 xii Preface separation of research areas of ODD/CD and ADHD has hampered our understanding of these two groups of related disorders. Fortunately, the last decade has seen an integration of the research fields of these disorders. In this book, we have paid much attention to the relation between these disorders, with respect both to aetiology, assessment and treatment, and to neurobiological factors in ODD and CD, as information on this topic has grown rapidly over the last few years and is essential for an accurate understanding of these disorders. In reviewing the literature, we pay particular attention to recently published studies and meta - analyses, if available, without neglecting older, high - quality studies. The selection of studies, of course, reflects our own view on the subject. Likewise, we give personal comments on issues. We include our clinical and research experience in the chapters on clinical assessment and interventions. To make the book accessible, we have included a conclusion in the form of summary points at the end of each chapter. We would like to thank the publisher Wiley - Blackwell for the invitation to write the book and the many people associated with the publisher for their assistance: Carole Millett, Emma Hatfield, Holly Myers, Al Bertrand, Darren Reeds, Anne Bassett, Annie Rose, Carrie Walker and Helen Baxter. We would also like to thank Karen Shield for her assistance in manuscript delivery, and Martin Schmidt, Dennis Schutter, Louk Vanderschuren and Sarah Durston for their detailed comments on earlier drafts of the chapters. Walter Matthys John E. Lochman

15 Foreword The authors of this important book, Professors Walter Matthys and John E. Lochman, need little by way of introduction; they are known to a wide professional readership for their prolific empirical, clinical and theoretical studies of Disruptive Behavior Disorders (DBD) and other challenging behavior problems of childhood and adolescence. Certain children, as early as two or three years of age, drive their parents to despair by the intensity of their tantrums and aggressive outbursts, the intransigence of their defiance, and the wilfulness of their demands. During the school years teachers struggle to cope with their violation of classroom rules, and the disruption that results from (inter alia) their inattention, hyperactivity, bullying, and cheating. Many go on to an adolescence marked by violence, vandalism, theft, and other delinquent activities. These children, diagnosed early on as presenting Oppositional Defiant Disorder (ODD) and later Conduct Disorder (CD), cause much harm to society. As they grow up they enter, exit and almost invariably return, through the revolving doors of mental health, educational, social services, and justice departments. Carers and teachers endure ongoing distress and demoralisation, while the State is forced to raise vast sums of money for damage limitation and repairs, and the costs of assessment and treatment agencies. Clearly, the need to support families, teachers and workers from the social and mental health professions is urgent, and represents a compelling rationale for the book. The authors state that their aim is to write for professionals, students, and researchers, a concise guide to the aetiology and the assessment of ODD and CD, as well as to evidence - based interventions, and their short and long - term outcomes, Focusing on children aged 3 to 14 years, the book provides in twelve chapters, a overview of aetiology, assessment, prevention and treatment of ODD and CD, with particular attention given to recently published studies and meta - analyses. High quality studies from the past are not neglected. The introductory guides and final point-by-point summaries to each chapter, the provision of technical and conceptual definitions, plus comprehensive referencing, ensure that child and adolescent psychiatrists, clinical psychologists, and trainees, have access to a store of useful empirical

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