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CONDUCT DISORDER - CONDUCT DISORDER DSM-IV 312.XX Conduct...

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CONDUCT DISORDER DSM-IV 312.XX Conduct disorder 312.81 Childhood-onset type 312.82 Adolescent-onset type Conduct disorder is most distinguishable by the degree of repetitive and persistent violation of the  basic rights of others. Common antisocial behaviors acted out in the home and school setting include  physical aggression toward people and animals, destruction of property, lying, and theft. There is a total  disregard for age-appropriate social norms as the child purposely engages in criminals acts, truancy from  school, and breaking curfew. The  DSM-IV  criteria rates the level of severity as  mild, moderate, to severe.  The greater the level of delinquency and frequency in early childhood, the greater the risk for chronic  offending into adulthood. Other prognostic factors leading to the continuation of the disorder include age of  onset and the variation in problem behaviors displayed in multiple settings. Co-morbid diagnoses often  associated with this condition are hyperactivity, depression, and chemical abuse and dependence. ETIOLOGICAL THEORIES Psychodynamics According to psychoanalytical theory, these children are fixated in the separation-individuation  phase of development. The mother figure projects her view of the child’s needs as an unrealistic demand on  her. The child cannot solidify attachment with the maternal object and compensates for the mother’s  narcissistic need for gratification by  overidealizing  the image of the mother. The child fails to build up  identification and differentiation between self and others to support sufficient superego development. The  id behavior is prominent. Biological Temperamental abnormalities have been observed in infants at birth in terms of excitability, attention  span, and adaptability. Heredity influences such traits as the tendency to seek risks and obey authority. One  possibility is the biological influence of heightened arousal in the CNS and abnormally high levels of  testosterone,   leading   to   aggression.   Differences   in   the   lack   of   sufficient   serotonin   transmission   is  evidenced. Current research suggests that negative experiences in infancy cause biological and neurological damage to  the brain tissue. When persistent stress results in an internal perception of a constant state of danger, the “ fight-or- flight ” hormones  (adrenaline  and cortisol) are released,  reaching  dangerously  high levels that can  cause  neurological impairment. These damaged brain cells react in unusual ways to the stimuli, possibly resulting in  epileptic seizures or depression.
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