Psychiatrist in-dubai

CONDUCT DISORDER

Psychiatrist In Dubai

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OVERT AGGRESSION

How is Overt Conduct Disorder Identified and Treated?






CONDUCT DISORDERCharacterized by persistent

antisocial behavior that violates: The rights of others Age-appropriate social norms

Includes: Aggression to people and animals Destruction of property Deceitfulness and theft Violation of rules Powered by

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STUDENTS WITH CONDUCT DISORDER

Differ from peers inRate of noxious behaviorsPersistence of such conduct

beyond age at which most children have adopted less aggressive behaviors






HOW DO THESE STUDENTS DO IN SCHOOL? Teachers see these students as:

UninterestedUnenthusiasticCareless

Students with Conduct Disorder have:Poor interpersonal relationsRejected by their peersPoor social skills

Students with Conduct Disorder are most likely to be:Left behind in gradesShow lower achievement levelsEnd school sooner than same-age peers

THE VILE WEED: STAGES IN THE COERCION MODEL

CONDUCT DISORDER CASE STUDY Tony is 13 and has conduct disorder and depression. He is living with his Uncle and Aunt who have basically raised him since birth. Occasionally his mom comes by, but not on a regular basis. The father is unknown. Tony’s Uncle and Aunt adopted him. They are the head of a “team” which cares for Tony. This includes respite foster parent’s two weekends a month, Tony’s other Uncle one weekend a month, and his grandparents or his adopted parents the other weekend. At the moment, Tony is doing well. After the last sentencing, they were able to get better cooperation from their probation officer and a more workable probation agreement. Tony is supervised more than his adopted parent’s four year old. Last year he was hospitalized after he cut his wrist when he was caught drinking. Tony is now part of a group at school who are putting together a house. For once he is doing really well, expect when he tried to steal an electric saw. But Tony’s parents had warned the school to watch for this, and they did, and they caught him. The punishment? No electric guitar for four days. Every week or so while Tony is at school, his parents go through all his stuff. They have told Tony they will do this. Tony now thinks it is mean and unfair. On the other hand, their have been no knives in the house for a month now. His parents call it “room service”.

CONDUCT DISORDERIs often comorbid with other disorders

Is one of the most prevalent psychopathological disorders

Affects:6 – 16% of males2 – 9% of females1.3 to 3.8 million children have

conduct disorder

CONDUCT DISORDERMales exhibit:

Fighting Stealing Vandalism

Overly aggressive Females exhibit:

Lying Truancy Running away Substance abuse Prostitution

Less aggressivePowered by





CONDUCT DISORDERMay be classified by age of onset

Earlier onset usually predicts more serious impairment






THE CAUSAL WHEEL

CLASSIFIED AS: Mild (resulting in only minor harm to others) Moderate Severe (causing considerable harm to others) Undersocialized (violent behavior) Socialized (more covert antisocial acts)

Versatile (both overt and covert forms of antisocial conduct)






CONDUCT DISORDERSubtypes

Overt AggressionCovert AntisocialVersatile






CAUSES OF AGGRESSIONLearned through:

ModelingReinforcementIneffective punishment

Risk can be increased through these factors: Personal Family School Peer Cultural

PREVENTING AGGRESSION

Consequences that deter aggression

Instruction in nonaggressive responses

Early interventionRestriction of tools of aggressionCorrection of living conditionsMore effective school options

ASSESSING AGGRESSION

Behavior rating scales, ANDDirect observationMust include:

Evaluation of a variety of domainsProsocial skillsSocial deficitsFunctional assessment of behavior

INTERVENTIONS FOR AGGRESSION

Interventions based on social learning Most reliable Include strategies such as:

RulesTeacher praisePositive reinforcementVerbal feedbackStimulus changeContingency contractsModeling and reinforcement

USES AND MISUSES OF PUNISHMENT Punishment should:

Be reserved for serious misbehaviorBe instituted in ongoing behavioral

management and instructional programsBe used only by people who are warm

and loving toward the individualBe administered matter-of-factly, without

anger, threats, or moralizingBe fair, consistent, and immediateBe of reasonable intensityInvolve response costBe related to the misbehaviorBe discontinued if it is not quickly

apparent that it is effectiveHave written guidelines for using specific

punishment procedures

BEHAVIOR CYCLE AND PRECORRECTION

1) Calm: Behaving in ways that are expected and appropriate

2) Trigger: First stage in moving towards a major blowup

3) Agitation: Overall behavior in unfocused and off task

4) Acceleration: Student engages the teacher in a coercive struggle

5) Peak: Student’s behavior is out of control6) De-escalation: Student is beginning to

disengage from the struggle and is in a confused state

7) Recovery: Eager for busy work and a semblance of ordinary glasswork

THE ACTING OUT CYCLE

SCHOOL-WIDE DISCIPLINE School-wide discipline plans must:

Focus on earlier phases in the acting out cycle Focus efforts on positive attention to appropriate

behavior Provide clear expectations and monitoring of student

behavior Provide staff communication and support Provide consistent consequences






COVERT AGGRESSION

How is Covert Conduct Disorder Identified and Treated?






DEFINITION Covert Antisocial Behavior includes: Untrustworthiness and manipulation of others; Running away; and Concealment of one’s acts.

“Masculine” Antisocial Behaviors Vandalism, fighting, and stealing.

“Feminine” Antisocial Behaviors Lying, running away, and substance abuse.

Behaviors Clustered Together for Males and Females Truancy, expulsion, underachievement, and discipline





CASUAL FACTORS AND PREVENTION





ASSESSMENTCovert behaviors are difficult to observe

Involves: Long periods of observation Self reports

CHILD ABUSE AND ANIMAL ABUSE•New Jersey Study - 53 families met criteria for child abuse or neglect. 60% had confirmed instances of cruelty to animals; in families referred for physical abuse, 88% had instances of animal abuse: 2/3 by fathers; 1/3 by children.•1980 study in England: Of 23 families with history of animal abuse, 83% had children at risk for abuse or neglect.•Pennsylvania study corroborated that behavior patterns toward children and pets are similar.

ABUSED CHILDREN ABUSE ANIMALS

In one study, 4.7% of “normal” children acknowledged animal abuse, compared to

13% who were sexually abused

24.5% who were physically abused 34% who were both physically and sexually abused

Children who witness violence are at greater risk of becoming abusers or victims• 26% to 32% of children in abusive families cruel to animals

RESPONSES Primary Prevention

Humane education

Secondary Prevention Programs for at-risk children

Tertiary Prevention The AniCare Model of Treatment for Animal Abuse AniCare Child






PROGRAMS—PAIRING AT-RISK CHILDREN AND FAMILIES WITH ANIMALS IN NEED

•“Forget Me Not Farm,” collaboration of Humane Society of Sonoma County, the San Francisco Child Abuse Council, and the YWCA of Sonoma County, which includes the Women’s Emergency Shelter and a therapeutic child care services program. Teaching gentleness with gardens and animals to children from violent homes and communities.

–

SAFE HAVEN FOR PETS PROGRAMS

Various arrangements, depending on local

community

• Local vets provide shelter and medical care

• Fostering

• Negotiating extra kennel space off-site






ANICARE CHILD

Practical, concrete tools for assessment, prevention, and intervention

Designed for all professionals working with children--counselors, teachers, social service workers, probation department officials, clergy

Focuses on empathy development and self management skills

Includes case studies, projective materials, and individual and group exercises

THE ANICARE MODEL OF TREATMENT FOR ANIMAL ABUSE

Stresses accountability and empathy development

Cognitive-behavioral Active therapist, directly addresses problem Pre- and Post-Treatment Questionnaires Ten AniCare Exercises, with homework

Becoming the Victim Fostering Flexibility Learning to Nurture Establishing Intergenerational

AccountabilityPowered by




RESPONDING TO STEALING Define stealing Parents decide when theft has occurred Parents apply consequences Every instance of stealing receives

consequences Parents “keep eyes open” and ask questions Consequences involve specified interval of

work or period of restriction No positive reinforcement for periods of non-

stealing Program remains in effect for at least 6 months

RESPONDING TO LYING Careful monitoring of verbal and written products Providing reinforcement for honest behavior Punishing occurrences of lying Determining if child can differentiate truth from

non-truth Avoiding getting caught up in arguments about

the veracity of statements






FIRESETTINGChildren may be more likely to set fires if:They do not understand the danger of fireThey do not have the necessary social skills

to obtain gratification in other waysThey engage in other antisocial behaviorsThey are motivated by anger and revenge






VANDALISMAppears to be a reaction to aversive environments:Vague rulesPunitive disciplineRigid punishmentSchool curriculum not matched with

student needsLittle recognition for appropriate

behavior or achievement Powered bywww.saiwebtech.co.in




RESPONDING TO TRUANCY Social Learning Principles

Attendance is praisedSystems where attendance earns

rewardsSchool work that is interestingConnecting school and homeStopping harassment by peersDecreasing fun outside of school

during school hours Powered bywww.saiwebtech.co.in




PROBLEM BEHAVIORS OF ADOLESCENCE

How are problem behaviors identified and treated in adolescence?





JUVENILE DELINQUENCY

Delinquent actsIndex crimesStatus offenses






TYPES OF DELINQUENTS

Those who commit a few delinquent acts vs. repeat offenders

Age at first offensePrognosis is worse for juveniles who

offend before the age of 12






CAUSES OF DELINQUENCYHistory of child abuseHyperactivity and impulsivityLow intelligence and achievementLax parental supervisionFamily history of criminalityPoverty and large family sizeAntisocial behavior or conduct disorder

CAUSES OF DELINQUENCY

RESPONDING TO DELINQUENCY

FamiliesIntervention is extremely difficult

Juvenile Courts and CorrectionHarsher punishments seem

counterproductiveSchooling

Typical punishment is usually ineffective Powered by




STREET GANGSThe typical gang member has:

A notable set of personal deficiencies

A notable tendency toward defiance

A greater-than-normal desire for status, identity, and companionship

A boring, uninvolved lifestylePowered by


SUBSTANCE ABUSE Usually episodic for most adolescents Alcohol and tobacco are the largest problems Important Terms

Intoxication Symptoms of a toxic amount of substance in the blood stream

Tolerance Physiological adoption to a substance so that an increasing

amount is required to produce the same effectsAddiction

Compulsive use of a substance and that obtaining and using the substance has become a central concern and pattern of behavior

Dependence The need to continue using a substance to avoid physical or

emotional discomfort or bothWithdrawal

Physical or emotional discomfort associated with a period of abstinence

PREVENTING SUBSTANCE ABUSEMust be designed for the individual case

School based interventions must:Require clear school policiesRequire systematic efforts to provide

informationProvide referral to other agenciesInvolve families and peers

PREVENTING SUBSTANCE ABUSE – CON’T

Skills for students to learn:Resist peer pressureChange attitudes, values, and behavioral

norms related to substance useRecognize and resist adult influences

toward substance useUse problem-solving strategies such as

self-control, stress management, and appropriate assertiveness

Set goals and improve self-esteemCommunicate more effectively

SEVEN POSSIBLE SYMPTOMS OF DRUG INVOLVEMENT

1) Change in school or work attendance or performance

2) Alteration of personal appearance3) Mood swings or attitude changes4) Withdrawal from responsibilities / family contacts5) Association with drug-using peers6) Unusual patterns of behavior7) Defensive attitude concerning drugs



EARLY SEXUAL ACTIVITY

Increases:Risk of pregnancySexually transmitted diseasesPsychological and health

problemsCurrent school based interventions may be ineffective Powered by


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