Behavioural Problems in

children

Lifespan development
~Behavioral problems:
~Behavioural problems arise when a child does not
conform to societal norms and regulations, is
defiant, abusive, etc.

~It comes under the Disruptive, impulse-control,

and conduct disorders in DSM-V.

~And includes oppositional defiant disorder,

intermittent explosive disorder, conduct
disorder, antisocial personality disorder,
pyromania, kleptomania.
~Oppositional defiant disorder
~Behavioral noncompliance, also known as defiance
or disobedience, refers to those instances when a
child either actively or passively, but
purposefully, does not perform a behavior that
has been requested by a parent or other adult
authority figure.
The term defiance, described by Wenar, reads
“negativism for its own sake.”
 ~Introduction:
~Oppositional defiant disorder (ODD) is one of a
group of behavioral disorders called disruptive
behavior disorders (DBD). These disorders are called
this because children who have these disorders tend
to disrupt those around them. ODD is one of the more
common mental health disorders found in children and
adolescents.
 ~Symptoms of odd:
~Symptoms generally begin before a child is eight
years old. They include irritable mood, argumentative
and defiant behaviour, aggression,and vindictiveness,
that last longer than six months and cause significant
problems at home or school. They are of three main
types.

~Angry and irritable mood

~Vindictiveness

~Argumentative and defiant behaviour

~Diagnosis:
~For a child or adolescent to qualify for a
diagnosis of ODD, behaviors must cause
considerable distress for the family or interfere
significantly with academic or social
functioning. Interference might take the form of
preventing the child or adolescent from learning
at school or making friends, or placing him or
her in harmful situations.
~Epidemiology:
~There is a range of estimates for how many
children and adolescents have ODD. Evidence
suggests that between 1 and 16 percent of
children and adolescents have ODD. However, there
is not very much information on the prevalence of
ODD in preschool children, and estimates cannot
be made.
~Treatment:
• Parent-Management Training Programs and Family
Therapy
• Cognitive Problem-Solving Skills Training
• Social-Skills Programs and School-Based
Programs.
• Medication
~Prevention:
~There is research that shows that
early-intervention and school-based programs
along with individual therapy can help prevent
ODD.
~Conduct disorder:
~Conduct disorder (CD) is a mental disorder
diagnosed in childhood or adolescence that
presents itself through a repetitive and
persistent pattern of behavior in which the basic
rights of others or major age-appropriate norms
are violated.
~Signs or symptoms of CD:
1. Frequent refusal to obey parents or other authority
figures,Repeated truancy
2. Tendency to use drugs, including cigarettes and alcohol,
at a very early age,Lack of empathy for others.
3. Being aggressive to animals and other people or showing
sadistic behaviours including bullying and physical or
sexual abuse
4. Keenness to start physical fights,Using weapons in
physical fights
5. Frequent lying, A tendency to run away from home
6. Criminal behaviour such as stealing, deliberately lighting
fires, breaking into houses and vandalism, Suicidal
tendencies – although these are more rare.
~Types and subtypes of cd:
~Following 2 types can be mild, moderate or severe in form.

~Childhood-onset:Here, individuals are usually male, frequently

display physical aggression toward others, have disturbed peer
relationships, may have had oppositional defiant disorder during early
childhood, and usually have symptoms that meet full criteria for
conduct disorder prior to puberty. Many children with this subtype
also have concurrent attention-deficit/hyperactivity disorder (ADHD)
or other neurodevelopmental difficulties.

~Adolescent-onset: The children are less likely to display aggressive

behaviors and tend to have more normative peer relationships (although
they often display conduct problems in the company of others). These
individuals are less likely to have conduct disorder that persists
into adulthood. The ratio of males to females with conduct disorder is
more balanced for the adolescent-onset type than for the
childhood-onset type
~Epidemiology of CD:
~Current data indicates that the prevalence of
conduct disorder is 2–5% in children between 5–12
years and 5–9% in adolescents between 13–18 years
[5]. Most studies show that boys are more likely
to present with symptoms of conduct disorder than
girls
~Etiology of CD:
➔ TEMPERAMENTAL FACTORS:Temperamental risk factors include a difficult
undercontrolled infant temperament and lower-than-average intelligence,
particularly with regard to verbal IQ.
➔ GENETIC/ PHYSIOLOGICAL FACTORS:. The risk is increased in children with a
biological or adoptive parent or a sibling with conduct disorder. The
disorder also appears to be more common in children of biological parents
with severe alcohol use disorder, depressive and bipolar disorders, or
schizophrenia or biological parents who have a history of ADHD or conduct
disorder. Family history particularly characterizes individuals with the
childhood-onset subtype of conduct disorder.
➔ ENVIRONMENTAL FACTORS: Family-level risk factors include parental
rejection and neglect, inconsistent child-rearing practices, harsh
discipline, physical or sexual abuse, lack of supervision, early
institutional living, frequent changes of caregivers, large family size,
parental criminality, and certain kinds of familial psychopathology (e.g.,
substance-related disorders). Community-level risk factors include peer
rejection, association with a delinquent peer group, and neighborhood
exposure to violence. Both types of risk factors tend to be more common
and severe among individuals with the childhood-onset subtype of conduct
disorder.
~diagnosis:
~The essential feature of conduct disorder is a repetitive and persistent
pattern of behavior in which the basic rights of others or major
age-appropriate societal norms or rules are violated. These behaviors fall into
four main groupings: aggressive conduct that causes or threatens physical harm
to other people or animals; nonaggressive conduct that causes property loss or
damage; deceitfulness or theft; and serious violations of rules. Three or more
characteristic behaviors must have been present during the past 12 months, with
at least one behavior present in the past 6 months.
~Individuals with conduct disorder often initiate aggressive behavior and react
aggressively to others. They may display bullying, threatening, or intimidating
behavior (including bullying via messaging on Web-based social media); initiate
frequent physical fights; use a weapon that can cause serious physical harm
(e.g., a bat, brick, broken bottle, knife, gun); be physically cruel to people
(Criterion A4) or animals; steal while confronting a victim (e.g., mugging,
purse snatching, extortion, armed robbery); or force someone into sexual
activity.
~Individuals with conduct disorder may also frequently commit serious
violations of rules (e.g., school, parental, workplace). Children with conduct
disorder often have a pattern, beginning before age 13 years, of staying out
late at night despite parental prohibitions. Children may also show a pattern
of running away from home overnight.
~Treatment:
~Psychotherapy:Psychotherapy (a type of counseling) is aimed at
helping the child learn to express and control anger in more
appropriate ways. A type of therapy called cognitive-behavioral
therapy aims to reshape the child's thinking (cognition) to improve
problem solving skills,anger management, moral reasoning skills, and
impulse control. Family therapy may be used to help improve family
interactions and communication among family members. A specialized
therapy technique called parent management training (PMT) teaches
parents ways to positively alter their child's behavior in the home

~Medication: Although there is no medication formally approved to

treat conduct disorder, various drugs may be used (off label) to
treat some of its distressing symptoms (impulsivity, aggression,
dysregulated mood), as well as any other mental illnesses that may
be present, such as ADHD or major depression.
~Antisocial personality disorder :
~Antisocial personality disorder, like other
personality disorders, is a longstanding pattern of
behavior and experience that impairs functioning and
causes distress.

~By definition, antisocial personality disorder

(ASPD) is a deeply ingrained and rigid dysfunctional
thought process that focuses on social
irresponsibility with exploitive, delinquent, and
criminal behavior with no remorse.
Symptoms
1. Failure to conform to social norms concerning lawful
behaviors, such as performing acts that are grounds for
arrest.
2. Deceitfulness, repeated lying, use of aliases, or conning
others for pleasure or personal profit.
3. Impulsivity or failure to plan.
4. Irritability and aggressiveness, often with physical fights
or assaults.
5. Reckless disregard for the safety of self or others.
6. Consistent irresponsibility, failure to sustain consistent
work behavior, or honor monetary obligations.
7. Lack of remorse, being indifferent to or rationalizing having
hurt, mistreated, or stolen from another person.
 Etiology
Although the precise etiology is
unknown, both genetic and
environmental factors have been
found to play a role in the
development of ASPD.Various
studies in the past have shown
differing estimations of
heritability, ranging from 38%
to 69%. Environmental factors
that correlate to the
development of antisocial
personality disorder include
adverse childhood experiences
(both physical and sexual abuse,
as well as neglect) along with
childhood psychopathology.
Epidemiology
The estimated lifetime
prevalence of ASPD amongst the
general population falls within
1 to 4%.Due to the predicting
factor of the initial diagnosis
of conduct disorder before the
age of 15, this assumption can
be quite broad as CD does not
always get adequately
evaluated.Gender distribution
tends to be skewed towards
males, with 3 to 5 times more
likelihood of being diagnosed
with ASPD than females.
Treatment/management
~Although there has been a multitude of interventions
tested in the past, an appropriate algorithm fails to
exist today. Literature suggests early treatment
intervention with conduct disorder in children as the
least costly and most effective with treating ASPD.

~Insufficient evidence exists to support any psychological

intervention in adults with ASPD. No pharmacological
intervention has been shown to treat ASPD, but medications
are highly recommended to treat co-occurring conditions.
THANK YOU!
Project by:
Ananya Arenavaru
Arjun Upadhyay
Aruna Kashi
Arya Paliwal