The document discusses conduct disorder, which affects 1-4% of children and is characterized by antisocial behavior that impairs functioning. It defines conduct disorder as a repetitive pattern of violating others' rights or social norms. Causes include biological and psychosocial factors like genetics, family environment, and peer associations. Diagnosis requires at least 3 behaviors like aggression, property destruction, deceit, or rule violations in the past year. Treatments include family therapy, social skills training, cognitive behavioral therapy, and sometimes medication. Schools can provide specialized programming, parent training, and social emotional learning.

1. PREPARED BY
MRS. DIVYA PANCHOLI
ASSISTANT PROFESSOR, SSRCN, VAPI
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2. INTRODUCTION
• Conduct disorder is characterized by persistent
antisocial behavior in children and adolescents
that significantly impairs their ability to
function in social, academic, or occupational
areas.
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3. DEFINITION
A repetitive and persistent pattern of
behavior in which the basic rights of others
or major age-appropriate social norms or
rules are violated.
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4. INCIDENCE
• Conduct disorder affects 1 to 4 percent of 9-
to 17-year-olds.
• More common in boys than in girls.
• More common in cities than in rural areas.
• The rate among boys in the general
population ranges from 6% to 16% while the
rate among girls ranges from 2% to 9%.
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5. TYPE
• Onset prior to age 10.
• Usually boys displays physical aggression,
and have disturbed peer relationships.
• May have oppositional defiant disorder
and likely to develop antisocial personality
disorder in adulthood.
Childhood
onset type
• Absence of any characteristic symptoms
prior to age 10.
• Less likely to display aggressive behaviors
and tend to have normal peer
relationships.
• Less likely to have persistent conduct
disorder or develop antisocial personality
disorder.
Adolescent
onset type
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6. ETIOLOGY
• Biological influences
–Genetics
–temperament
–Biochemical factors
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7. • Psychosocial influences
– Parental rejection
– Inconsistent management with harsh discipline
– Frequent shifting of parental figures
– Large family size
– Absent father
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8. CONTI..
– Parents with antisocial personality disorder or
alcohol dependence
– Marital conflict & divorce in parents
– Associations with delinquent subgroups
– Inadequate communication pattern within family
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9. Mrs. Divya Pancholi 9

10. • Aggression to people
and animals
• Bullies, threatens, or
intimidates others
• Physical fights
• Use of weapons
• Deliberate
property destruction
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11. • Forced sexual activity
• Cruelty to people or
animals
• Fire setting
• Vandalism
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12. • Deceitfulness and theft
• Lying
• Shoplifting
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13. • Breaking into house,
building, or car
• Cons others to avoid
responsibility
• Serious violation of
rules
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14. • Stays out overnight
without parental
consent
• Runs away from home
overnight
• Truancy from school
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15. The diagnostic criteria for Conduct Disorder (DSM-5)
• A. repetitive and persistent pattern of behavior in
which the basic rights of others or major age-
appropriate societal norms or rules are violated, as
manifested by the presence of three (or more) of
the following criteria in the past 12 months, with at
least one criterion present in the past 6 months.
– Aggression to people and animals
– Destruction of property
– Deceitfulness or theft
– Serious violations of rulesMrs. Divya Pancholi 15

16. CONTI..
1. Aggression to people and animals
a. Often bullies, threatens, or intimidates others.
b. Often initiates physical fights.
c. Has used a weapon that can cause serious physical harm
to others (e.g., a bat, brick, broken bottle, knife, gun)
d. Has been physically cruel to people.
e. Has been physically cruel to animals.
f. Has stolen while confronting a victim (e.g., mugging,
purse snatching, extortion, armed robbery).
g. Has forced someone into sexual activity.
2. Destruction of property
a. Has deliberately engaged in fire setting with the intention
of causing serious damage.
b. Has deliberately destroyed others’ property (other than
by fire setting). Mrs. Divya Pancholi 16

17. 3. Deceitfulness or theft
a. Has broken into someone else’s house, building, or car.
b. Often lies to obtain goods or favours or to avoid obligations (i.e.,
“cons” others).
c. Has stolen items of nontrivial value without confronting a victim (e.g.,
shoplifting, but without breaking and entering; forgery).
4. Serious violations of rules
a. Often stays out at night despite parental prohibitions, beginning
before age 13 years.
b. Has run away from home overnight at least twice while living in
parental or parental surrogate home (or once without returning for a
lengthy period).
c. Is often truant from school, beginning before age 13 years.
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18. CONTI..
B. The disturbance in behaviour causes clinically
significant impairment in social, academic, or
occupational functioning.
C. If the individual is age 18 years or older,
criteria are not met for antisocial personality
disorder.
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19. NURSING DIAGNOSIS
• Risk for violence related to peer
rejection and dysfunctional family
dynamics.
• Impaired social interaction related to
impaired peer relations leading to
inappropriate social behavior.
• Defensive coping related to low self
esteem and dysfunctional family
system.
• Low self esteem related to
unsatisfactory parent/child
relationship.
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20. PHARMACOLOGICAL
INTERVENTIONS
• Commonly used when comorbidity exists (ADHD,
mood disorders)
• Used in combination with other treatments
• Treats specific symptoms:
• Stimulants (aggression)
• Anti-convulsants (rage and temper outbursts)
• Lithium (aggression)
• Clonidine (over-arousal)
• Neuroleptics and Atypical Antipsychotics (severe CD)Mrs. Divya Pancholi 20

21. TREATMENT
 Limit Television
 Limit all media use to no more than
1 to 2 hours per day.
 Monitor their children's use of the
media.
 Co view television with their
children.
 Eliminate or reduce video and
Computer games
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22. CONTI…………
School-Based Treatment
Programs
A safe community
Family Therapy
Social Skills Training
Cognitive-Behavioral
Therapy
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23. INTERVENTIONS FOR CONDUCT DISORDER
• Decreasing violence and
increasing compliance with
treatment
• Protect others from client’s
aggression and manipulation.
• Set limits for unacceptable
behavior.
• Provide consistency with
client’s treatment plan.
• Use behavioral contracts.
• Institute time-out.
• Provide a routine schedule of
daily activities.
• Improving coping skills and self-
esteem
• Show acceptance of the person,
not necessarily the behavior.
• Encourage the client to keep a
diary.
• Teach and practice problem-
solving skills.
• Promoting social interaction
• Teach age-appropriate social
skills.
• Role-model and practice social
skills.
• Provide positive feedback for
acceptable behavior.
• Providing client and family
educationMrs. Divya Pancholi 23

24. CLIENT/FAMILY TEACHING
FOR CONDUCT DISORDER
• Teach parents social and problem-solving skills
when needed.
• Encourage parents to seek treatment for their
own problems.
• Help parents to identify age-appropriate activities
and expectations.
• Assist parents with direct, clear communication.
• Help parents to avoid “rescuing” the client.
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25. Different Types
of Treatment
School-Based Intervention Strategies
• Specialized Programming: Classroom Level
• Specialized Programming: Comprehensive
Strategies
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26. CONTI…
• Interventions to Promote Prosocial Skills
• Parent Management Training
• Contingency Management Programs
• Cognitive Problem-Solving Skills Training
• Functional Family Therapy
• Group Therapy
• Psychopharmacologic Interventions
• Multidimensional Interventions
• Multisystemic Therapy
• Families and Schools Together (FAST TRACK)
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27. WHAT SCHOOLS CAN DO
• With a 504 plan or a behavioral plan, accommodations
can be made for students with CD
• Specialized Programming: Classroom Level
• Create a structured, predictable environment
• Instruction should be consistent and methodical
• Sufficiently staffed environment
• Material should be presented in:
– Consistent manner
– Systematic instructional routines
– Cumulative manner
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28. SPECIALIZED PROGRAMMING:
COMPREHENSIVE STRATEGIES
Student-Focused Approaches
• Teachers and mental health professionals address mental
• and social processes that affect behavior
• Examples of interventions: modeling, role-play,
immediate
• positive reinforcement of target behaviors
Parent-Focused Approaches
• Parents can recognize influences at home that are
affecting
• the child’s behaviors
• Examples of interventions: coaching, prompting,
• feedback, graduated homework assignments
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29. School-Focused Approaches
• Through instruction, teachers need to create a
balance in the classroom between the needs of
specific children and the rest of the classroom
• Examples of interventions: smooth transitions,
being consistent and direct with praise and
redirection, clear classroom rules stated first day
of class and emphasize throughout the year,
social skills curriculum, teamwork curriculum
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30. Parent Management Training
• Parents are trained to use specific procedures in
the home:
1. Improve parent-child interactions
warmth and responsiveness
2. Promote pro-social behaviors
• reinforcement of desirable behaviors
3. Discourage negative behaviors
structured home environment
clear rules and expectations
consistent discipline
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31. CONTI…
• Functional Family Therapy
• Focus on making changes within the family system
• Improve communication skills and family interactions
• Cognitive Problem-Solving Skills Training
• Focus on improving child’s social skills using problem-
solving techniques
• Self-statements
• Multiple solutions
• Understanding others’ perspectives
• Group Therapy
• Focus on development of interpersonal skills
• Interaction with positive peer role models
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32. You can refer following link also
• https://youtu.be/XH46Nm1QOcg
• https://www.youtube.com/watch?v=gVILmwjL
EAA
• https://www.youtube.com/watch?v=EUCIKfNI
NYU
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33. Mrs. Divya Pancholi 33