Psychiatrist in-dubai
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Transcript of Psychiatrist in-dubai
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CONDUCT DISORDER
Psychiatrist in Dubai
www.psychiatryservices4u.com
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Conduct Disorder
Objectives
Know what Conduct Disorder is
Why it’s important
Significant facts regarding this disorder
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Conduct Disorder
Children and adolescents with this disorder
have great difficulty following rules and
behaving in a socially acceptable way. They
are often viewed by other children, adults and
social agencies as "bad" or delinquent, rather
than mentally ill.
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DSM IV Categories
Within the DSM IV, Conduct Disorder is placed in the category of Attention-Deficit and Disruptive Behavior Disorders.
This category is defined in the DSM IV as a set of externalizing negative behaviors that co-occur during childhood
Oppositional Defiant Disorder (ODD), is defined as "a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures".
Attention-Deficit/Hyperactivity Disorder (ADHD), is defined as a “Persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and is more severe than is typically observed in individuals at comparable level of development.”
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Conduct Disorder
Definition: The essential features of Conduct Disorder (CD) involve “a
repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated”, resulting in a clinically significant impairment in functioning.
This includes aggressive behaviors,
behaviors that result in property loss or damage,
deceitfulness or theft,
other serious rule violations (e.g., running away from home, truancy).
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DSM IV Conduct Disorder Criteria
For 12 months or more has repeatedly violated rules, age-appropriate societal norms or the rights of others.
Shown by 3 or more of the following, with at least one of the following occurring in the past 6 months:
Aggression against people or animals
Frequent bullying or threatening Often starts fights Used a weapon that could cause serious injury Physical cruelty to people Physical cruelty to animals Theft with confrontation Forced sex upon someone
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DSM IV Conduct Disorder Criteria
Property destruction Deliberately set fires to cause serious damage
Deliberately destroyed the property of others (except fire-setting)
Lying or theft Broke into building, car or house belonging to someone else
Frequently lied or broke promises for gain or to avoid obligations ("conning")
Stole valuables without confrontation (burglary, forgery, shoplifting)
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DSM IV Conduct Disorder Criteria
Serious rule violation
Beginning by age twelve, frequently stayed out at night against parents' wishes
Runaway from parents overnight twice or more (once if for an extended period)
Frequent truancy before age 13
These symptoms cause clinically important job, school or social impairment.
If older than age 18, the patient does not meet criteria for Antisocial Personality Disorder.
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DSM IV Conduct Disorder Criteria
Childhood-Onset Type: at least one problem with
conduct before age 10 Adolescent-Onset Type: no problems with
conduct before age 10 Note. Age of onset subtypes have been supported using trajectory analyses
in longitudinal cohorts by finding that those with childhood-onset type typically continue to meet criteria up to their late 20’s (Mofitt, 2007)
Severity: Mild (both are required):
There are few problems with conduct more than are needed to make the diagnosis, and Problems cause little harm to others.
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DSM IV Conduct Disorder Criteria
Severity: (cont.) Moderate. Number and effect of conduct problems
is between Mild and Severe Severe. Many more conduct symptoms than are
needed to make the diagnosis, or Symptoms cause other people considerable harm.
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Distinctions between Disorders
Diagnosis of ODD and CD have tested and proven differences
Subjecting gathered data to multidimensional scaling techniques resulted in some significant findings which has helped narrow the focus of study regarding behaviors associated with CD
oppositional defiant and aggressive characteristics were located on one end of the dimension (overt symptoms).
Substance use and other non-aggressive conduct disorder symptoms were located on the other (covert symptoms).
Behavior directed towards property or persons in a destructive way was located on one of the dimension (destructive behavior).
Behavior on the opposite end were non-destructive such as substance abuse, status offenses (non-destructive behavior).
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Distinctions between Disorders
These findings provide general support for the distinction between oppositional defiant and conduct disorder.
They also suggest that conduct problems may be more meaningfully grouped into four, rather than two, general categories.
These include
overt & nondestructive behaviors reflecting symptoms of ODD
overt & destructive symptoms of aggression
covert & destructive behaviors, such as lying and stealing
covert & nondestructive behaviors such as truancy and running away from home (status offenses)
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Four Dimensions of Conduct Disordered
Behavior
OVERT/DESTRUCTIVE (Aggressive Behaviors)
Fights
Bullies
Assault
Spiteful
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Four Dimensions of Conduct Disordered
Behavior
OVERT/NONDESTRUCTIVE
(Oppositional Features)
Annoys
Defies
Stubborn
Angry
COVERT/DESTRUCTIVE COVERT/NONDESTRUCTIVE
(Property Violations) (Status Offenses)
Cruel to Animals Runaway
Vandalism Truancy
Steals Substance Use
Fire setting Breaks Rules