attention deficit and disruptive behavior disorders2
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ATTENTION DEFICIT ANDDISRUPTIVE BEHAVIOR
DISORDERS
By: Kristine Charisse V. Tanedo
BSN3 MSU-IIT
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CONDUCT DISORDER
-characterized by persistent antisocialbehavior in children and adolescentsthat significantly impairs their ability to
function in social, academic, oroccupational areas
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Symptoms clustered in 4 areas:
Aggression to people and animals
Destruction of property
Deceitfulness and theft
Serious violation of rules
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CONDUCT DISORDER
-People with conduct disorder have littleempathy for others
-have low self-esteem -poor frustration tolerance -temper outbursts -Conduct disorder is associated with early onset
of sexual behavior, drinking, smoking, use ofillegal substances and other reckless or risky
behaviors -occurs more often in boys than in girls -30-50% are diagnosed with antisocial
personality disorder as adults
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ONSET AND CLINICAL COURSE
Two subtypes: (based on age of onset)
1.Childhood-onset type -involves symptoms before 10 years of age
including physical aggression toward othersand disturbed peer relationships
-more likely to have persistent conduct disorder
and to develop antisocial personality disorderas adults
2. Adolescent-onset type
-no behaviors of conduct disorder untilafter 10 years of age -less likely to be aggressive and have more
normal peer relationships -less likely to have persistent conduct disorder or
antisocial personality disorder as adults
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D/O:
Mild some conduct problems that causerelatively minor harm to others
Lying, truancy, staying out late withoutpermission
Moderate number of conduct problemsincreases as does the amount of harm toothers
Vandalism and theft
Severe many conduct problems withconsiderable harm to others
Forced sex, cruelty to animals, use ofweapon, burglary, robbery
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SYMPTOMS:
Aggression to people and animals
Bullies, threatens or intimidates others Physical fights
Use of weapons
Forced sexual activity Cruelty to people or animals
Destruction of property
Fire setting Vandalism
Deliberate property destruction
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SYMPTOMS:
Deceitfulness and theft Lying Shoplifting
Breaking into house, building, or care Cons other to avoid responsibility Serious violation of rules Stays out overnight without parental consent Runs away from home overnightTruancy form school
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ETIOLOGY
Genetic vulnerabilityThere is a genetic risk for conduct
disorder although no specific genemarker has been identified.
More common in children who have asibling with conduct disorder or aparent with antisocial personalitydisorder, substance abuse, mood
disorder schizophrenia or ADHD
Factors such as poor coping interact tocause the disorder
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Risk factors:
Poor parenting
Low academic achievement
Poor peer relationships
Low self-esteem
Protective factors include resilience,family support, positive peer
relationships and good health Child abuse
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CULTURAL CONSIDERATIONS
-in high-crime areas aggressive behaviormay be protective and not necessarilyindicative of conduct disorder.
-in immigrants from war-ravagedcountries, aggressive behavior mayhave been necessary for survival sothey should not be diagnosed withconduct disorder.
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TREATMENT
Early intervention is more effective
Prevention is more effective thantreatment
Treatment is geared toward the clientsdevelopmental age no treatment issuitable for all ages
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TREATMENT
Preschool :
-preschool programs such as HeadStart
-lower the tendency of delinquentbehaviors and conduct disorder byparental education about normal growthand development, stimulation for thechild and parental support during crisis
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TREATMENT
School-age:
-FOCUS: chikd, family, schoolenvironment
-parental education -social skills training (helps improve
academic performance and peer
relationships) -family therapy is also essential
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TREATMENT
Adolescents: -individual therapy since adolescence
rely less on parents and more on theirpeers
-issues of drug and alcohol abuse is a
major concern, thus treatment plan mustaddress to this -MOST PROMISING TREATMENT APPROACH:
keeping the client in his environment withfamily and individual therapy
-conflict resolution -anger management -teaching social skills
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MEDICATIONS:
-have little effect
-but may be in conjunction with treatment forspecific symptoms such as:
a. client who presents a threat or danger toothers will be prescribed with ANTIPSYCHOTICmedications
b. client with labile mood is given LITHIUM orCARBAMAZEPINE(TEGRETOL) another moodstabilizer or VALPORIC ACED (DEPAKOTE)
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INTERVENTIONS:
Improving coping skills and self-esteem.Show acceptance of the person, not
necessarily the behavior
Encourage the client to keep a diaryTeach and practice problem-solving skills
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INTERVENTIONS:
Promoting social interactionTeach age-appropriate skills.
Role-model and practice social skills.
Provide positive feedback for acceptablebehavior.
Provide family education.
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