Conduct Disorder Parent Guide

Introduction

Conduct disorder is classified among disorders of disruptive behavior which are often comorbid with other defiant disorders. Conduct disorder is characterized by a pattern of behaviors which demonstrate a violation of rights and aggression. It has a complex etiology which is as a result of the interaction of several psychosocial and biological factors. Biologically, a low level of p5-hydroxy indole acetic acid levels in CSF tends to correlate with violence and aggression among children and adolescents Conduct Disorder Parent Guide. A family which lacks structure and supervision with occasional conflicts between parents and siblings results to maladaptive behaviors. This paper discusses the Conduct disorder including its signs and symptoms, pathophysiology, diagnosis, and currently available treatment options.

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Signs and Symptoms

The signs and symptoms of conduct disorder vary with age and are highly dependent on whether the condition is moderate, mild or severe. The first sign is aggressive behavior which may result in physical harm. Aggressive behavior may be in the form of fighting, bullying, forced sexual activity and cruelty to animals or others. Children may also display destructive behavior where they intentionally destroy and vandalize property (Blair, Leibenluft & Pine, 2014). Other children may display deceitful behavior where they repeatedly lie, break into cars or homes to steal or even shoplift. The last sign is that of violating rules such that, a child frequently goes against societal accepted rules or even engage in behaviors which are not appropriate for the child’s age (Blair, Leibenluft & Pine, 2014). Key examples of such behaviors may include sexual activity at a very young age, running away and skipping school Conduct Disorder Parent Guide.

Pathophysiology

Behaviors which are a problematic result from a child’s temperamental characteristics and environmental influences that shape the child’s temperament. As young as 2 years, the signs of irritability, inattentiveness, impulsivity, and compliance can result in behavioral patterns which negatively influence conduct in later ages (Sadock, Sadock & Ruiz, 2014). Due to difficulties with a child’s temperament, even parents with good intentions get involved in a negative cycle and can even isolate themselves from communal and family support. As a child advances, those with problems in conduct progressively display aggression and impulsivity with peers since they lack the skills for socializing (Sadock, Sadock & Ruiz, 2014). By the time they reach adolescence, most of them experience anger episodes and resort to being aggressive rather than responses that are verbally mediated.

Diagnosis of Conduct Disorder

Based on the DSM-V criteria for diagnosing mental health disorders, conduct disorder is diagnosed among individuals with a positive history of habitually violating the rights of other people such that, he/she fails to confirm individual behaviors to social norms that are appropriate for age. Besides, an individual ought to have at least four of the signs and symptoms in the categories of being aggressive to animals and people, destroying property, theft and deceit and serious violation of rules (American Psychiatric Association, 2013). Some of the behaviors may include: using a weapon to harm others, frequent physical confrontations with others, aggressive behavior towards animals or others, destroying property with arson or other means, an incident of forcibly influencing another to engage in sex, engaging in economic crimes and running away from home at least twice(American Psychiatric Association, 2013). The behaviors should also have significant impairment on the physical, social and mental functioning of the individual who should either be an adolescent or a child. The child or adolescent may also have limited prosocial emotions such as lack of empathy, guilt or remorse, not concerned about his/her performance and a deficient effect.

Treatment Options

Treatment for conduct disorder aims at decreasing or eliminating behavioral problems in the short term while working towards the long-term goal of preventing the behavioral problems of children from worsening with time. Multiple modalities of treatment have proven to be highly effective in treatment especially the combination of psychotherapy with medications. The most effective psychotherapeutic approach is cognitive behavioral therapy (Sadock, Sadock & Ruiz, 2014). In this case, CBT is used in the context that behavioral which are not appropriate can be unlearned and replaced with pro-social ones which are more meaningful. This is done through a systematic manipulation of consequences and rewards which promote behaviors which are pro-social and discourage those that are antisocial. Majority of the parents with children who have conduct disorder tend to blame themselves for creating a number of problems in a child’s life(Sadock, Sadock & Ruiz, 2014). Therefore, Family therapy can also be used to improve the interactions and communication among family members by addressing family conflict. For instance, parent management training can be used to teach parents how to positively change the behavior of a child at home.

Medications that have proven to be effective in the management of conduct disorder aim at reducing a child’s distressing symptoms such as aggression, impulse and other underlying mental illnesses that may be in existence. Generally, atypical antipsychotics such as risperidone are indicated for the management of mood lability (Pringsheim et al., 2015). Clonidine, a beta blocker may also be used to control aggression and impulsivity. Anticonvulsants such as lithium have also proven to be effective in managing aggression and symptoms of mood disorders. Fluoxetine, which is a selective serotonin reuptake inhibitor, has proven to benefit patients with rigid, depressive aggressive behaviors (Pringsheim et al., 2015). Stimulants are also effective in managing aggressiveness and impulsivity but need close parental monitoring due to high street value and a high potential for abuse from peers.

References

.American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Blair, R. J. R., Leibenluft, E., & Pine, D. S. (2014). Conduct disorder and callous-unemotional traits in youth. New England Journal of Medicine, 371(23), 2207-2216.

Pringsheim, T., Hirsch, L., Gardner, D., & Gorman, D. A. (2015). The pharmacological management of oppositional behavior, conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder: a systematic review and meta-analysis. Part 1: psychostimulants, alpha-2 agonists, and atomoxetine. The Canadian Journal of Psychiatry, 60(2), 42-51.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer Conduct Disorder Parent Guide

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

•Standard 5E “Pharmacological, Biological and Integrative Therapies” (page 59)

•Chapter 3, “Contributions of the Sociocultural Sciences” (pp. 131–150)
•Chapter 31, “Child Psychiatry” (pp. 1152–1181, 1244–1253)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

•“Neurodevelopmental Disorders”
•“Intellectual Disabilities”
•“Communication Disorders”
•“Disruptive, Impulse-Control, and Conduct Disorders”
Note: You will access this book from the Walden Library databases.

Volkmar, F., Siegel, M., Woodbury-Smith, M., King, B., McCracken, J., & State, M. (2014). Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 53(2), 237–257. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00819-8/pdf Conduct Disorder Parent Guide

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication. Conduct Disorder Parent Guide

Review the following medications:

Irritability in autism

Attention-deficit/hyperactivity disorder

aripiprazole
risperidone

armodafinil
amphetamine (d)
amphetamine (d,l)
atomoxetine
bupropion
chlorpromazine (hyperactivity)
clonidine
guanfacine
haloperidol (hyperactivity)
lisdexamfetamine
methylphenidate (d)
methylphenidate (d,l)
modafinil
reboxetine

Note: Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”

Required Media

Laureate Education (Producer). (2017b). A young girl with difficulties in school [Multimedia file]. Baltimore, MD: Author. Conduct Disorder Parent Guide

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

•Chapter 51, “Autism Spectrum Disorder” (pp. 665–682)

Discussion: Parent Guide

Note: You and your group will use the wiki function to develop three Parent Guides (one in Week 3, one in Week 7, and one in Week 10). A wiki is a site that allows collaborative editing by all users. Each group will have its own place to communicate and collaborate on the assignments. Once your group has completed each assignment, one member should transfer the information to its final format and submit it through the group submission link in the Discussion. Do not delete the assignment from the wiki format, as your Instructor will review this area to determine each member’s participation.

Collaboration is essential to accurate diagnosis of the conditions under consideration in this week. For this week’s Discussion, you practice collaboration by working in a group on developing a “Parent Guide,” which will serve as a teaching tool for parents with children who have been diagnosed with a specific mental health disorder Conduct Disorder Parent Guide.

It is recommended that you make your project as attractive as possible and consider using the finished product as teaching tools for families that you will work with in your own practices.

Learning Objectives

Students will:
•Analyze signs and symptoms of neurodevelopmental disorders
•Analyze the pathophysiology of neurodevelopmental disorders
•Analyze diagnosis and treatment methods for neurodevelopmental disorders
•Evaluate Parent Guides Conduct Disorder Parent Guide

To Prepare for this Discussion:
•Your Instructor will assign you to a group and a disorder by Day 1 of Week 2.
•Review the resources concerning your assigned disorder.
•Review the Blackboard Help website concerning wikis.
•Use your group’s Discussion Board to design and develop the Parent Guide before posting to the group wiki. For further guidance, refer to the Accessing Group Discussions instructions below.

Using evidence-based research, design and develop a Parent Guide for your assigned disorder including:
•Signs and symptoms
•Pathophysiology
•How the disorder is diagnosed
•Treatment options

Provide a minimum of three academic references. Conduct Disorder Parent Guide