PRESENTED BY Kshirabdhi Tanaya Tutor,SUM Nursing college S‘O’A DTU,Bbsr.

1. PRESENTED BY
Kshirabdhi Tanaya
Tutor,SUM Nursing
college
S‘O’A DTU,Bbsr.

2. CONDUCT DISORDERS
Conduct disorders are characterized by a persistent and
significant pattern of conduct in which the basic rights of
others are violated or rules of society are not followed.
The onset occurs much before 18 years of age. usually
even before puberty. The disorder is much more (about 5
to 10 times)common in boys

3. Epidemiology:-
•Conduct disorder is estimated to affect 51.1
million people globally as of 2013.
•The percentage of children affected by conduct
disorder is estimates to range from 1-10%

4. Etiology:-
1-Genetic factors:-
•Higher number of conduct disorders among
those whose family members are affected with
the disorder.
•Alcoholism and personality disorder in the father
is reported to be strongly associated with conduct
disorders.
•The impairment of the frontal lobe .

5. 2-Biochemical factors:-elevated plasma
levels of testosterone and aggressive
behaviors.
3-organic factors:-children with brain
damage and epilepsy are more prone to
conduct disorders.

6. 4-psychosocial factors:-
•Parental rejection
•Frequent shifting of parental figures
•Management with harsh discipline
•Large family size
•Absent father
•Parents with antisocial personality disorder
•Parental permissiveness
•Marital conflict and divorce in parents
•Inadequate /inappropriate communication
patterns in the family

7. Who is at risk for conduct disorder ?:-
Following factors may increase your child’s risk of
developing conduct disorder:-
•Being male
•Living in an urban environment
•Living in poverty
•Having family history
•Having parents abuse drugs or alcohol
•Having history of traumatic events
•Being abused or neglected

8. Types of conduct disorder:-
There are three types of conduct disorder .They are
categorized according to the age :-
1-childhood onset occurs when the signs of conduct
disorder appear before age 10.
2-Adoloscent onset occurs when the signs of conduct
disorder appear during the teenage years.
3-unspecified onset means the age at which conduct
disorder first occurs is unkown.

9. DIAGNOSTIC CRITERIA FOR CONDUCT DISORDER:-
A- 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 at least 3 of the following
15 criteria in the past 12 months from any of the
categories below , with at least one criterion present in
the past 6 months.

10. 1-Aggression to people and animals:-
•Often bullies, threaten or intimidates others.
•Often initiates physical fights.
•Has used a weapon that can cause serious
physical harm to others.
•Has been physically cruel to people/animals.
•Has stolen while confronting a victim.
•Has forced someone into sexual activity.

11. 2-Destruction of property:-
•Has deliberately engaged in fire setting with the intention
of causing serious damage.
•Has deliberately destroyed other’s property.
3-Deceitfulness or theft:-
•Has broken into someone else’s house, building or car.
•Often lies to obtain goods or favors or to avoid
obligations.
4-Serious violation of rules:-
•Often stays out at night despite parental prohibitions,
beginning before age 13 years.

12. •Has run away from home overnight at least twice
while living in parental home.
•Is often truant from school ,beginning before age
13 years.
B-The disturbane in behaviour causes clinically
significant impairment in school,academic or
occupational functioning.
C-If the individual is age 18 years or older,criteria
are not met for antisocial personality disorder.

13. Diagnosis:-
•Compete team approach including medical
and psychiatric evaluations,feedback from
parents,a case manager’s plan,a probation
officer’s report.
•Educational assessments to determine if
there are cognitive deficits ,learning
abilities or problems in intellectual
functioning.
•A neurological examination if there’s a
history of head trauma or seizures.

14. Treatment modalities:-
•Drug treatment may be indicated in the
presence of epilepsy,hyper
activity(stimulant medication like
amphetamines),psychotic
symptoms(antipsychotics).

15. Nursing Diagnosis:-
Risk for other directed violence related to peer
rejection,negative parental role models
,dysfunctional family dynamics as evidenced by
temperament,cruelty for others.
Goal:-Client will not harm others or other’s
property.

16. Nursing intervention:-
•Observe client’s behaviour frequently through
routine activities and interactions
•Redirect violent behaviour with physical outlets
for suppressed anger and frustration.
•Encourage client to express anger and act as a
role model for appropriate expression of anger.
•Ensure that a sufficient number of staff is
available to indicate a show of strength if
necessary.
•Administer tranquilizing medication,if ordered.

17. Nursing diagnosis:-
Impaired social interaction related to
negative parental role models;impaired peer
relations as evidenced by poor interpersonal
relationship.
Goal:-Client will be able to interact with staff
and peers using age appropriate ,acceptable
behaviours.

18. Nursing interventions:-
•Develop a trusting relationship with the
client.
•Discuss with client which behaviours are
and are not acceptable.
•Provide group situations for client.

19. Nursing diagnosis:-
Defensive coping related to low self esteem
and dysfunctional family system .
Goal:-Client will accept responsibility for
own behaviours and interact with others
without becoming defensive.

20. Nursing interventions:-
•Explain to client the correlation between
feelings of inadequacy.
•Provide immediate ,nonthreatening
feedback for unacceptable behaviours.
•Help identity situations that provoke
defensiveness.
•Provide immediate positive feedback for
acceptable behaviours.

21. THANK YOU