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Often bullies threatens or intimidates others

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Often bullies, threatens or intimidates others, initiates fights, used a weapon tothreaten or harm, physically cruel to others and animals, has stolen, has forcedsexual activity, truancy or school drop outOften affects boys more than girlsIn girls = promiscuity, truancy, drug abuse, prostitution, runaways, high riskbehaviors, smoking, drinkingMay exhibit lack of remorse or guilt, lack of empathyDisturbed peer relationships, may have ODD in childhood, ADHDFirst seen in middle childhood to middle adolescence – before age 16 (after age18 = antisocial PD) -- earlier onset predicts a worse prognosis and increased riskfor criminal behavioroRisk factorsParental rejection and neglectInconsistent child-rearing practicesHarsh disciplineLarge family sizeFrequent changes of caregiversParental criminality
Sexual abuseLack of supervisionEarly institutional livingDelinquent peer groupExposure to violence in neighborhoodAntisocial family traitsoInterventionsTx often in outpatient settingProtect from harmIncrease patient ability to trust and use interpersonal skillsIncrease ability to control impulses, tolerate frustration, control moodIncrease use of cognitive skills (memory, concentration, test reality, solveproblems)Expose to positive role models, behavior modification modelFoster development of self esteemMay need medsProvide support, education, and guidance for parentsFamily therapy, group therapy, behavior modification, play therapy, CBT,psychodrama, art therapyoMedsTreat underlying issue like depression, ADHD, ODD, etcOppositional Defiant DOsigns and symptoms, nursing diagnoses, outcomes, interventionsoOppositional Defiant Disorder = problems with self-control of emotions and behavioroOppositional = argumentative, resistant, don’t want to do what people tell them to dooDo not get in trouble with the lawoSx present at home or in multiple settingsoSx occur during preschool years – often precedes conduct disorder but not necessarilyoDSM5 = Pattern of angry/irritable mood, argumentative/defiant behavior lasting at least 6months plus four or more of the symptoms belowAngry/irritable mood, loses temper, easily annoyed, resentfulArgumentative/defiant behavior with authority figures, with adults, defies orrefuses to comply with requests from authority figures, with rules, blamesothers for his/her mistakes or behaviorVindictiveness = has spiteful or vindictive (ie revenge seeking)
ooNursing diagnosesRisk for school problems, impulse control problems, substance use, anxietyoInterventionsPsychosocial interventions = parent training, group therapy, and angermanagement and cognitive-behavioral therapyPharmacological treatmentDepression, Bipolar and Schizophrenia in childrensigns and symptoms, nursing diagnoses,outcomes, interventions, medsoDepressionSymptoms like adults - sadness and loss of pleasureWhat differs is how these symptoms are displayed -- a very young childmay cry, a school-age child might withdraw, and a teenager may

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Term
Fall
Professor
CHOONG-MINKANG
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