Disruptive Behavioral Disorders

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