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The Difference in Accommodations and Modifications

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The Difference in Accommodations and Modifications

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Journal of Infant, Child, and Adolescent Psychotherapy

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Journal of Infant, Child, and Adolescent Psychotherapy

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Bridging the Divide Between Psychodynamic and Behavioral Approaches for Children with Oppositional Defiant Disorder

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(2018). Bridging the Divide Between Psychodynamic and Behavioral Approaches for Children with Oppositional Defiant Disorder. Journal of Infant, Child, and Adolescent Psychotherapy: Vol. 17, Special Issue: Psychotherapy Integration: Challenges and New Pathways, pp. 364-377.

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Child Mind Institute | Transforming Children’s Lives.

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The Child Mind Institute is an independent nonprofit dedicated to transforming the lives of children struggling with mental health and learning disorders.

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Conduct disorder is a repetitive and persistent pattern of behavior in children and adolescents in which the rights of others or basic social rules are violated. The child or adolescent usually exhibits these behavior patterns in a variety of settings-at home, at school, and in social situations-and they cause significant impairment in his or her social, academic, and family functioning.

What are the signs and symptoms of Conduct Disorder?

Behaviors characteristic of conduct disorder include:

Aggressive behavior that causes or threatens harm to other people or animals, such as bullying or intimidating others, often initiating physical fights, or being physically cruel to animals.

Non-aggressive conduct that causes property loss or damage, such as fire-setting or the deliberate destruction of others' property.

Deceitfulness or theft, such as breaking into someone's house or car, or lying or "conning" others.

Serious rule violations, such as staying out at night when prohibited, running away from home overnight, or often being truant from school.

Many youth with conduct disorder may have trouble feeling and expressing empathy or remorse and reading social cues. These youth often misinterpret the actions of others as being hostile or aggressive and respond by escalating the situation into conflict. Conduct disorder may also be associated with other difficulties such as substance use, risk-taking behavior, school problems, and physical injury from accidents or fights.

How common is Conduct Disorder?

Conduct disorder is more common among boys than girls, with studies indicating that the rate among boys in the general population ranges from 6% to 16% while the rate among girls ranges from 2% to 9%. Conduct disorder can have its onset early, before age 10, or in adolescence. Children who display early-onset conduct disorder are at greater risk for persistent difficulties, however, and they are also more likely to have troubled peer relationships and academic problems. Among both boys and girls, conduct disorder is one of the disorders most frequently diagnosed in mental health settings.

What does the research say about Conduct Disorder?

Recent research on Conduct Disorder has been very promising. For example, research has shown that most children and adolescents with conduct disorder do not grow up to have behavioral problems or problems with the law as adults; most of these youth do well as adults, both socially and occupationally. Researchers are also gaining a better understanding of the causes of conduct disorder, as well as aggressive behavior more generally. Conduct disorder has both genetic and environmental components. That is, although the disorder is more common among the children of adults who themselves exhibited conduct problems when they were young, there are many other factors which researchers believe contribute to the development of the disorder. For example, youth with conduct disorder appear to have deficits in processing social information or social cues, and some may have been rejected by peers as young children.

Despite early reports that treatment for this disorder is ineffective, several recent reviews of the literature have identified promising approaches treating children and adolescents with conduct disorder. The most successful approaches intervene as early as possible, are structured and intensive, and address the multiple contexts in which children exhibit problem behavior, including the family, school, and community. Examples of effective treatment approaches include functional family therapy, multi-systemic therapy, and cognitive behavioral approaches which focus on building skills such as anger management. Pharmacological intervention alone is not sufficient for the treatment of conduct disorder.

Conduct disorder tends to co-occur with a number of other emotional and behavioral disorders of childhood, particularly Attention Deficit Hyperactivity Disorder (ADHD)and Mood Disorders (such as depression). Co-occurring conduct disorder and substance abuse problems must be treated in an integrated, holistic fashion.
Why are assessment and treatment important?

Assessment and diagnosis of conduct disorder-or any emotional or behavioral disorder of childhood-should be done by a mental health professional, preferably one who is trained in children's mental health. Any diagnosis must be made in consultation with the child's family. The assessment process should include observation of the child, discussion with the child and family, the use of standardized instruments or structured diagnostic interviews, and history-taking ,including a complete medical and family / social history. When assessing and diagnosing any childhood emotional or behavioral disorder, the mental health professional should consider the social and economic context in which a child's behavior occurs.

Accurate assessment and appropriate, individualized treatment will assure that all children are equipped to navigate the developmental milestones of childhood and adolescence and make a successful adaptation to adulthood. Treatment must be provided in the least restrictive setting possible.
What can I do if I'm concerned about a child?

Learn more about conduct disorder, including recent research on effective treatment approaches. Contact NMHA for additional resources on conduct disorder or other emotional or behavioral disorders of childhood.

Consult with a mental health professional, preferably one who is trained in children's mental health.

Explore the treatment options available. Treatment must be individualized to meet the needs of each child and should be family-centered and developmentally and culturally appropriate.

Find a family support group or organization in your community.

Sources
American Academy of Child and Adolescent Psychiatry. (1997). Practice parameters for the assessment and treatment of children and adolescents with conduct disorder. Journal of the

American Academy of Child and Adolescent Psychiatry, 36 (supplement); 122S-139S.

American Psychiatric Association. (1994). Diagnostic and Statistic Manual of Mental Disorders (4th edition). Washington, DC: American Psychiatric Association.
This Fact Sheet is one in a series of Fact Sheets that Mental Health America has produced on major childhood emotional and behavioral disorders, including bipolar disorder, depression, and anxiety disorders. This Fact Sheet is intended to generally inform the reader about this disorder and is not intended to be a substitute for proper assessment by a trained mental health professional.

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What is Conduct Disorder? Conduct disorder is a repetitive and persistent pattern of behavior in children and adolescents in which the rights of others or basic social rules are violated. The child or adolescent usually exhibits these behavior patterns in a variety of settings-at home, at school, and in social situations-and they cause significant impairment in his or her social, academic, and family functioning.

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Home of the School Mental Health Referral Pathways Toolkit.

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Home of the School Mental Health Referral Pathways Toolkit.

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https://blackboard.angelo.edu/webapps/blackboard/execute/displayLearningUnit?course_id=_58585_1&content_id=_2103082_1

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SAMHSA - The Substance Abuse Mental Health Services Administration

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SAMHSA - Substance Abuse and Mental Health Services Administration

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SAMHSA.gov, Substance Abuse and Mental Health Services Administration

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Anorexia Nervousa

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Anorexia nervosa is an eating disorder characterized by weight loss (or lack of appropriate weight gain in growing children); difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, distorted body image. People with anorexia generally restrict the number of calories and the types of food they eat. Some people with the disorder also exercise compulsively, purge via vomiting and laxatives, and/or binge eat.

Anorexia can affect people of all ages, genders, sexual orientations, races, and ethnicities. Historians and psychologists have found evidence of people displaying symptoms of anorexia for hundreds or thousands of years.

Although the disorder most frequently begins during adolescence, an increasing number of children and older adults are also being diagnosed with anorexia. You cannot tell if a person is struggling with anorexia by looking at them. A person does not need to be emaciated or underweight to be struggling. Studies have found that larger-bodied individuals can also have anorexia, although they may be less likely to be diagnosed due to cultural prejudice against fat and obesity.

DIAGNOSTIC CRITERIA

To be diagnosed with anorexia nervosa according to the DSM-5, the following criteria must be met:

1. Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.

2. Intense fear of gaining weight or becoming fat, even though underweight.

3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

Even if all the DSM-5 criteria for anorexia are not met, a serious eating disorder can still be present. Atypical anorexia includes those individuals who meet the criteria for anorexia but who are not underweight despite significant weight loss. Research studies have not found a difference in the medical and psychological impacts of anorexia and atypical anorexia.

WARNING SIGNS & SYMPTOMS OF ANOREXIA NERVOSA
Emotional and behavioral

Dramatic weight loss

Dresses in layers to hide weight loss or stay warm

Is preoccupied with weight, food, calories, fat grams, and dieting

Refuses to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)

Makes frequent comments about feeling "fat" or overweight despite weight loss

Complains of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy

Denies feeling hungry

Develops food rituals (e.g., eating foods in certain orders, excessive chewing, rearranging food on a plate)

Cooks meals for others without eating

Consistently makes excuses to avoid mealtimes or situations involving food

Expresses a need to "burn off" calories taken in

Maintains an excessive, rigid exercise regimen - despite weather, fatigue, illness, or injury

Withdraws from usual friends and activities and becomes more isolated, withdrawn, and secretive

Seems concerned about eating in public

Has limited social spontaneity

Resists or is unable to maintain a body weight appropriate for their age, height, and build

Has intense fear of weight gain or being "fat," even though underweight

Has disturbed experience of body weight or shape, undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight

Postpuberty female loses menstrual period

Feels ineffective

Has strong need for control

Shows inflexible thinking

Has overly restrained initiative and emotional expression

Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)

Difficulties concentrating

Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)

Dizziness

Fainting/syncope

Feeling cold all the time

Sleep problems

Menstrual irregularities-amenorrhea, irregular periods or only having a period while on hormonal contraceptives (this is not considered a "true" period)

Cuts and calluses across the top of finger joints (a result of inducing vomiting)

Dental problems, such as enamel erosion, cavities, and tooth sensitivity

Dry skin

Dry and brittle nails

Swelling around area of salivary glands

Fine hair on body (lanugo)

Thinning of hair on head, dry and brittle hair

Cavities, or discoloration of teeth, from vomiting

Muscle weakness

Yellow skin (in context of eating large amounts of carrots)

Cold, mottled hands and feet or swelling of feet

Poor wound healing

Impaired immune functioning

HEALTH CONSEQUENCES OF ANOREXIA NERVOSA

In anorexia nervosa's cycle of self-starvation, the body is denied the essential nutrients it needs to function normally. Thus, the body is forced to slow down all of its processes to conserve energy, resulting in serious medical consequences.

The body is generally resilient at coping with the stress of eating disordered behaviors, and laboratory tests can generally appear perfect even as someone is at high risk of death. Electrolyte imbalances can kill without warning; so can cardiac arrest. Therefore, it's incredibly important to understand the many ways that eating disorders affect the body.

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Anorexia nervosa is an eating disorder characterized by weight loss (or lack of appropriate weight gain in growing children); difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, distorted body image. People with anorexia generally restrict the number of calories and the types of food they eat.

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Anxiety disorder

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Oppositional Defiance Disorder
http://www.kellybear.com/TeacherArticles/TeacherTip68.html

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This is a tv show about a detective that suffers from OCD.  To learn more about OCD, visit
https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml