CONDUCT

DISORDER
PRESENTED BY:
AIRA FAEED
ARMIN SAMI
FATIMA ZAHRA
INTRODUCTION
“a chronic, age-inappropriate pattern of behavior that

violates the rights of others and breaks major social

rules” (American Psychiatric Association, 2013)

Persistent disruptive and violent behavior, posing
difficulties in rule adherence
Understanding the age of onset and the developmental
context
Marked differences while displaying symptoms based on
a. Severity
b. frequency
c. social relationships
 LITERATURE REVIEW
P R E VA L E N C E
• average lifetime prevalence of 2 to
10%
• general average of 4%, with an
approximately 4:1 male-to-female
ratio
 SUBTYPES
CHILDHOOD ADULT
ONSET ONSET UNSPECIFIED

01 02 03
 CAUSES
01 02 03 04
G ENETIC BIOLOGICA L SO CIO- PSYCHO SOCIAL
PRED ISPOSITION MARKERS: FAMILIAL FACTORS:
• Familial substance abuse. RISK S: • Poor school
• Low dopamine response.
• DNA methylation • Strict parenting. performance.
• High testosterone levels.
defects. • Childhood • Bullying and remarks.
• Abnormal frontal
• Moderate heritability maltreatment. • Low IQ, no support.
a c t i v i t y.
noted. • Family substance
abuse.
 SYMPTOM
S
• Aggression,
property destruction. • Linked to anxiety,
• Deceit, lying, theft. depression.
• Breaches of laws. • Narcissism,
• Physical aggression.
. aggression, decreased
• Rule violations.
self-esteem.
• Severe impact on life.

OVERVIEW CRITERIA CU- TRAITS IMPACT DSM-5 METHODS

• No concrete tests.
• Three months minimum. • Infant empathy development. • Behavioral observation.
• Persistent symptom for six months. • Impaired emotional • Sometimes brain scan.
• Severe interference required. processing.
• Compromised semantic
empathy
COMORBIDITIE
S
01
Comorbid Psychiatric Issues:
Learning disabilities.
ADHD, Explosive Disorder.
Oppositional Defiant Disorder

02
Intellectual Factors:
Low IQ students.
Academic struggles.
Potential cause.
 Psychotherapy
Psychosocial
Intervention
Parental Training
Non-Pharmaceutical Focus
TREATEMENT
APPROACHES Cognitive and
Family Therapy

Multidimensional
Treatment Foster Care

Atypical antipsychotics.
Pharmaceutical Psychostimulants
Anticonvulsants
CASE STUDIES
CASE STUDIES
Case Study Overview:
16-year-old girl at risk of school exclusion due to behavioral
issues.
Root causes: Ineffective parenting techniques of parents and
the teenager's own anger.
Intervention Strategies:
• Counseling and Improved Parenting:
• Successful control achieved through counseling and
better parenting techniques.
Treatment Methods for Conduct Disorder:
• Cognitive Behavioral Therapy (CBT):
Identifying and changing unfavorable thought patterns and
behaviors.
Development of coping strategies, critical thinking skills, and
anger management.
• Parent-Child Interaction Therapy (PTIC):
Short-term, planned intervention to strengthen parent-child
bonds.
Teaching parents to encourage positive actions, effective
communication, and discipline.
Parental Involvement:
• Encourage active, enthusiastic, and supportive
parental role.
• Improved teen behavior through increased
parental engagement.
Teacher-Parent Communication:
• Establish consistent framework for managing
behavior at home and school.
• Encourage communication between educators
and parents.
Regular Monitoring and Follow-Ups:
• Schedule routine follow-up meetings to assess
progress.
• Address any emerging issues promptly
Intervention and Improvement:
• Counseling and improved parenting techniques.
• Understanding the underlying reasons for socially
unacceptable behavior.
Management Strategies:
• Family therapy, behavior modification, and
pharmacotherapy.
• Multidisciplinary approach involving family therapist,
psychologist, social worker, counselor, and teachers.
Parental Learning and Positive Outcomes:
• Education on overcontrolling and permissive parenting.
• Immediate rewards for positive behaviors, consequences for
negative ones.
• Significant improvement in social interactions, reduced
outing times, and regular school attendance.
Raj, Age 14
Clinical Presentation:
• Hesitation and idleness during clinic visit.
• Behavioral issues reported by father, including aggression,
incomplete schoolwork, and disturbance in class.
Root Causes:
• Mother's hypothyroidism, hormonal treatment for conception,
and medications during pregnancy.
• Infections and vaccinations identified as triggers.
Treatment Approaches:
Homeopathy Treatment:
• Personalized medications based on mental health, family
history, and general characteristics.
• Addressing imbalances for emotional stability and
improvement.
Individual Therapy (Counseling):
Identifying and changing harmful thought patterns and actions.
Correcting false beliefs and promoting positive conduct.
Social Skill Training:
Enhancing peer and authority figure interactions.
Acquisition of acceptable social skills for improved
connections.
Medication Consideration:
Consultation with a psychiatrist for comprehensive evaluation.
Medication considered in certain cases, especially with co-
occurring disorders.
5-Year-Old with Violent Behavior
Clinical Presentation:
• Violent and impulsive behavior from age 2.
• Challenging behavior, including attempts to harm infant sibling.
Treatment Strategies:
Applied Behavior Analysis (ABA):
Positive reinforcement to encourage desired behaviors and discourage
problematic ones.
Breaking down behaviors into smaller parts.
Play-Based Therapy:
Utilizing play activities for Cognitive Behavioral Therapy (CBT).
Helping child understand and regulate emotions and behaviors.
Psychoeducation:
Informing family about conduct disorder, its causes, and management
techniques.
Collaboration with School:
Coordination with teachers for consistency in expectations and
interventions.
Medical Assessment:
Complete examination, including developmental and neurological
assessment.
Treatment Strategies and Results:
•CBT, family and school intervention, psychoeducation.
•Antipsychotics for violent behaviors, ongoing
improvement with medication.
•Recognition of consequences and improved mental state
post-treatment.
13-Year-Old Master X
Clinical Presentation:
History of intimidating, bullying, and violent behavior.
Involvement in destructive actions, substance use, and
sexual misconduct.
Diagnostic Methodology:
Formal and informal interviews with Master X.
Longitudinal approach for tracking behavior over
time.
Treatment Approaches:
Psychotherapy:
Cognitive-behavioral therapy for problem-solving,
anger management, and impulse control.
Family therapy to improve family interactions and
communication.
Parent Management Training (PMT):
Teaching parents positive influence strategies.
.
Pharmacotherapy:
Prescription of stimulants, antidepressants, lithium,
and anticonvulsants.
Nursing Priorities and Discharge Goals:
Providing a safe environment and promoting
development strategies.
Goals for coping skills, impulse control, and family
involvement.
16.5-Year-Old with Severe Behaviors
1.Clinical Presentation:
1.Severe violence, self-injurious, impulsive behaviors, and fire starting.
2.Treatment Methods:
1.Mode Deactivation Therapy (MDT):
1.Effective in reducing problematic behaviors.
2.Focus on cognitive-behavioral therapy with mode analysis.
2.Dialectical Behavior Therapy (DBT):
1.Four main areas of focus: emotion regulation, mindfulness, distress
tolerance, and interpersonal effectiveness.
2.Techniques for acceptance, distraction, observation, describing, and
participating
Successful Treatment with MDT:
• More effective than Cognitive Behavior Therapy and Social Skills
Training.
• MDT case conceptualization for investigating underlying worries.
MDT Components and Fear Assessment:
• Identifying avoidance behaviors linked to anxieties.
• Proactive fear assessment for understanding worries hindering therapy.
Results and Core Beliefs:
• Improvement in emotional state.
• Core beliefs associated with personality disorders identified.
• MDT case conceptualization aids in providing a functional treatment
plan
 1.Subjectivity in Diagnosis:
1.Lack of standardized tools.
L I M I TAT I O N S 2.Diagnosis based on subjectivity.
2.Parental Reporting Bias:
3.Limited Psychosocial Assessment:
1.Focus on parenting and anger.
2.Neglect of peer and school factors.
4.Absent Voice of the Patient (NH):
01 5.Continuity of Care Strategies:
1.Mentioned but not detailed.
2.Strategies for relapse prevention
unclear.
1.Subjective Reporting:
1.Father's perspective only.
2.Parental bias potential.
2.Homeopathic Treatment Impact:
1.Improved behavior reported.
2.Lack of control group.
3.Limited Psychosocial Factors:
1.Insufficient information. 02
2.Lack of standardized measures.
 1.Reliance on Parents' Observations:
• Child unable to self-report.
L I M I TAT I O N S • Diagnosis complexity in children.
2.Shift in Diagnosis:
• ADHD to Conduct Disorder.
03 • Reasons for the shift unclear.

1.Limited Background Information:.

2.Professional perspective focus.
3.Patient-Centeredness Absence:
4.Comorbid Mental Health
Conditions: 04
• Not discussed.
5.Treatment Approach Details:
1.Sole Reliance on Mode • Lack of intervention details.
Deactivation Therapy (MDT): • No follow-up information.
2.Long-Term Effectiveness and
Comparison:
• MDT effectiveness details
05 absent.
• No comparison with other
approaches.
 RECOMMENDATIONS
DEVELOPMENTAL DIAGNOSIS TREATEMENT AND
PATHWAYS PREVENTION
• Explore Individual • Enhance Age Recognition • Emphasize Timely Interventions
• Adopt Dimensional Approach • Understand Precursors Deeply
Pathways • Integrate Callous-Unemotional • Target Multiple Risk Factors
• Investigate Risk Traits • Prioritize Personalized Approaches
Factors • Use Comprehensive Assessment • Address Nature vs Nurture
• Identify Cognitive • Employ Multiple Sources • Refine Interventions for
Characteristics • Focus on Longitudinal Research Comorbidity
• Focus on Individualization
• Improve Treatment Research
THANK YOU