Conduct disorders

PRESENTED BY
Kshirabdhi Tanaya
Tutor,SUM Nursing college
S‘O’A DTU,Bbsr.

1. CONDUCT DISORDER PRESENTED BY Kshirabdhi Tanaya Tutor,SUM Nursing college S‘O’A DTU,Bbsr .

2. CONDUCT DISORDERS Conduct disorders are characterized by a persistent and significant pattern of conduct in which the basic rights of others are violated or rules of society are not followed. The onset occurs much before 18 years of age. usually even before puberty. The disorder is much more (about 5 to 10 times)common in boys

3. Epidemiology:- Conduct disorder is estimated to affect 51.1 million people globally as of 2013. The percentage of children affected by conduct disorder is estimates to range from 1-10%

4. Etiology :- 1-Genetic factors :- Higher number of conduct disorders among those whose family members are affected with the disorder. Alcoholism and personality disorder in the father is reported to be strongly associated with conduct disorders. The impairment of the frontal lobe .

5. 2- Biochemical factors :-elevated plasma levels of testosterone and aggressive behaviors. 3- organic factors :-children with brain damage and epilepsy are more prone to conduct disorders.

6. 4- psychosocial factors :- Parental rejection Frequent shifting of parental figures Management with harsh discipline Large family size Absent father Parents with antisocial personality disorder Parental permissiveness Marital conflict and divorce in parents Inadequate /inappropriate communication patterns in the family

7. Who is at risk for conduct disorder ?:- Following factors may increase your child’s risk of developing conduct disorder:- Being male Living in an urban environment Living in poverty Having family history Having parents abuse drugs or alcohol Having history of traumatic events Being abused or neglected

8. Types of conduct disorder:- There are three types of conduct disorder .They are categorized according to the age :- 1-childhood onset occurs when the signs of conduct disorder appear before age 10. 2-Adoloscent onset occurs when the signs of conduct disorder appear during the teenage years. 3-unspecified onset means the age at which conduct disorder first occurs is unkown .

9. DIAGNOSTIC CRITERIA FOR CONDUCT DISORDER:- A- A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated ,as manifested by the presence of at least 3 of the following 15 criteria in the past 12 months from any of the categories below , with at least one criterion present in the past 6 months .

10. 1- Aggression to people and animals:- Often bullies, threaten or intimidates others. Often initiates physical fights. Has used a weapon that can cause serious physical harm to others. Has been physically cruel to people/animals. Has stolen while confronting a victim. Has forced someone into sexual activity.

11. 2-Destruction of property:- Has deliberately engaged in fire setting with the intention of causing serious damage. Has deliberately destroyed other’s property. 3-Deceitfulness or theft:- Has broken into someone else’s house, building or car. Often lies to obtain goods or favors or to avoid obligations. 4- Serious violation of rules :- Often stays out at night despite parental prohibitions, beginning before age 13 years.

12. Has run away from home overnight at least twice while living in parental home. Is often truant from school ,beginning before age 13 years. B -The disturbane in behaviour causes clinically significant impairment in school,academic or occupational functioning. C -If the individual is age 18 years or older,criteria are not met for antisocial personality disorder.

13. Diagnosis :- Compete team approach including medical and psychiatric evaluations,feedback from parents,a case manager’s plan,a probation officer’s report. Educational assessments to determine if there are cognitive deficits ,learning abilities or problems in intellectual functioning. A neurological examination if there’s a history of head trauma or seizures.

14. Treatment modalities :- Drug treatment may be indicated in the presence of epilepsy,hyper activity(stimulant medication like amphetamines ), psychotic symptoms(antipsychotics).

15. Nursing Diagnosis :- Risk for other directed violence related to peer rejection,negative parental role models ,dysfunctional family dynamics as evidenced by temperament,cruelty for others. Goal :-Client will not harm others or other’s property.

16. Nursing intervention :- Observe client’s behaviour frequently through routine activities and interactions Redirect violent behaviour with physical outlets for suppressed anger and frustration. Encourage client to express anger and act as a role model for appropriate expression of anger. Ensure that a sufficient number of staff is available to indicate a show of strength if necessary. Administer tranquilizing medication,if ordered.

17. Nursing diagnosis :- Impaired social interaction related to negative parental role models;impaired peer relations as evidenced by poor interpersonal relationship. Goal :-Client will be able to interact with staff and peers using age appropriate ,acceptable behaviours .

18. Nursing interventions :- Develop a trusting relationship with the client. Discuss with client which behaviours are and are not acceptable. Provide group situations for client.

19. Nursing diagnosis :- Defensive coping related to low self esteem and dysfunctional family system . Goal :-Client will accept responsibility for own behaviours and interact with others without becoming defensive.

20. Nursing interventions :- Explain to client the correlation between feelings of inadequacy. Provide immediate ,nonthreatening feedback for unacceptable behaviours . Help identity situations that provoke defensiveness. Provide immediate positive feedback for acceptable behaviours .

21. THANK YOU