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Disruptive Behavioral Disorders

Disruptive Behavioral Disorders. Fatima AlHaidar Professor, Child & Adolescent Psychiatrist KSU. Oppositional Defiant Disorder. Definition:. Enduring pattern of negativistic, hostile, and defiant behaviors in the absence of serious violations of social norms or of the rights of others.

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Disruptive Behavioral Disorders

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  1. Disruptive Behavioral Disorders Fatima AlHaidar Professor, Child & Adolescent Psychiatrist KSU

  2. Oppositional Defiant Disorder

  3. Definition: Enduring pattern of negativistic, hostile, and defiant behaviors in the absence of serious violations of social norms or of the rights of others.

  4. Epidemiology: Developmentally normal in early childhood and adolescence ( establish autonomy, identity, & inner standards and control ) Prevalence of 2-16 % Boys ≥ Girls

  5. Etiology: Temperamental predisposition Psychological theories … …unresolved conflicts …learned behavior Parental factors Social factors Environmental factors

  6. Clinical features: Temper outbursts Active refusal to comply with rules Deliberately annoy others Blame others for their mistakes Present at home Cause distress to others Interpersonal difficulties Poor school performance

  7. Assessment: Nature & severity Situation & circumstances Who are around ? Parental personality and skills Parent- child relationship. Charts

  8. Management: Parental counseling Behavioral modification programs Cognitive behavioral approach Family therapy

  9. Outcome: Better prognosis if associated with clear stress 2/3 continues to have the diagnosis during school years Many children with ODD develop CD in adolescence

  10. Conduct Disorder

  11. Definition: Enduring set of behaviors, characterized by aggression and violation of the rights of others.

  12. Epidemiology: Prevalence of 10% Boys : girls 4-12 : 1 Parents with antisocial personality and alcoholism Socioeconomic factors

  13. Etiology: Parental factors Sociocultural factors Child abuse & maltreatment CNS dysfunction & damage Temperament

  14. Clinical features: Aggression to people & animals Destruction of property & stealing Deceitfulness or theft Serious violations of rules Persistent lying Fire setting Sexual behavior Frequent truancy Tobacco smoking & other substance abuse History of deprivation Family disharmony

  15. Comorbidity: ADHD Depression Learning disorders

  16. Assessment: Nature & severity Circumstances Family

  17. Management: Cognitive behavioral therapy Problem-solving skills training Parent management training Family therapy Medication Community-based centers Residential placement Court reports

  18. Outcome: Varies with the nature and extent of antisocial behavior Poor with parental criminality Associate with antisocial personality, substance abuse, & mood disorders Better prognosis with mild form, absence of comrbidity and normal intelligence

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