1. CONDUCT
DISORDER
MR. JAYESH PATIDAR
www.drjayeshpatidar.blogspot.com

2. CONCEPT…
 Aggressive behavior is the hallmark of conduct disorder.
 A child with this disorder fights, bullies, intimidates, &
assaults others physically or sexually.
 Typically, he has poor relationship with peers & adults. He
violates other’s rights & society’s rules.
 A child with conduct disorder rarely perform at the level
predicted IQ or age. His behavior interferes with his
school or work performance. He may be expelled from
school & have problems with the law.
 If the child is removed from the home, he may have
difficulty staying in an adoptive or foster family or a group
home, further complicating his development.
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3. EPIDEMIOLOGY
 Among children ages 9 to 17, the prevalence of
conduct disorder is approximately 1% to 4%.
Although the disorder occurs in both males &
females. It’s more common in males.
 Conduct disorder has an onset before age 18.
children with early onset (before age 10) are
predominately male, have a worse prognosis, &
are more likely to develop antisocial personality
disorder as adults. In fact, 25% to 50% of highly
antisocial children become antisocial adults.
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4. CONSEQUENCES…
Besides adult antisocial personality disorder, a
child with conduct disorder is at high risk for:
 Sexually transmitted diseases
 Rape
 Teenage pregnancy
 Injuries
 Substance abuse
 Depression
 Suicidal thoughts, suicide attempts & suicide
itself.
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5. CAUSES
 The cause of conduct disorder isn’t fully known.
 Studies of twins & adopted children suggest the disorder
has both biological (including genetic) & psychosocial
components.
Social Risks factors:
Various social factors may predispose a child
to conduct disorder. All of these factors can lead to
attachment to the patients or family unit - & eventually, to
lack of regard for societal rules. They include:
 Early maternal rejection
 Separation from parents, with no adequate alternative
caregiver available.
 Early institutionalization
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6. COUNT…
 Family neglect, abuse, or violence
 Frequent verbal abuse from parents, teachers, or other
authority figures.
 Parental psychiatric illness, substance abuse, or marital
discord
 Large family size, crowding, & poverty.
 Other Risk Factors:
 Certain physical factors & other conditions also increase
the risk of conduct disorder. These include:
 Neurological damage caused by low birth weight or birth
complications
 Under arousal of the autonomic nervous system
 Learning impairments
 Insensitivity to physical pain & punishment.
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7. SIGNS AND SYMPTOMS
 Fighting with family members & peers.
 Speaking to others in a nasty manner
 Being cruel to animals
 Vandalizing or destroying property
 Cheating in school
 Skipping classes
 Smoking cigarettes
 Using drugs or alcohol
 Stealing or shoplifting
 Engaging in precocious sexual activity
 Abusing others sexually.
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8. DIAGNOSIS
 Complete team approach - including medical &
psychiatric evaluation, feedback from parents, a
school consultant’s recommendations, a case
manager’s plan & a probation officer’s report,
important because antisocial behaviors tend to
be underreported.
 Educational assessment to determine if there are
cognitive deficits, learning disabilities, or
problems in intellectual functioning.
 A neurological examination if there’s a history of
head trauma or seizures.
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9. TREATMENT MODALITIES
 The treatment is difficult. The most common mode of
management is placement in a corrective institution.
Behavioral, educational & psychotherapeutic
measures are employed for changing the behavior.
 Drug treatment may be indicated in the presence of
epilepsy (anticonvulsants), hyperactivity (stimulant
medication), impulse control disorder & episodic
aggressive behavior (lithium, carbamazepine) &
psychotic symptoms (antipsychotics).
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10. COUNT…
 Parental instruction to teach how to deal with
the child’s demand
 May need to learn to reinforce appropriate
behaviors & to use harsh punishment for
inappropriate behavior behaviors
 Should be encouraged to find ways to bond
more strongly with child.
 Juvenile justice system, if needed, to provide
structured rules & a means for monitoring &
controlling the child’s behavior.
www.drjayeshpatidar.blogspot.in

11. NURSING INTERVENTION
 Work to establish a trusting relationship with the
child. Be sure to convey that you accept him.
 Provide clear behavioral guidelines, including
consequences for disruptive & manipulative
behavior.
 Talk to him about making acceptable choices.
 Teach him effective problem-solving skills, & have
him demonstrate them in return.
 Help him identify personal needs & best strategies
for meeting them.
 Identify abusive communication, such as
threats, sarcasm, & disparaging comments.
Encourage the child to stop using them.
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12. COUNT…
 Teach him how to express anger appropriately through
constructive methods to release negative feelings &
frustrations.
 Monitor him for anger as well as signs that he’s
internalizing anger, as shown by depression or suicidal
ideation.
 Work on helping the child accept responsibility for
behavior rather than blaming others, becoming
defensive, & waiting revenge.
 Teach him effective coping skills & social skills.
 Use role-playing so he can practice ways of handling
stress & gain skill & confidence in managing difficult
situation.
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13. THANK
YOU
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