Chapter 22: Oppositional Defiant Disorder and Conduct Disorder

Question 1

Oppositional Defiant Disorder (ODD) and Conduct Disorder

Answer 1

• multifactorial and complex etiologies

- antisocial behavior

Question 2

Signs + Symptoms: ODD

Answer 2

• frequent temper tantrums
• excessive arguing with adults
• often questioning rules
• active defiance and refusal to comply with adult requests and rules
• deliberate attempts to annoy or upset people
• blaming others for his or her mistakes or misbehavior
• often being touchy or easily annoyed by others
• frequent anger and resentment
• mean and hateful talking when upset
• spiteful attitude and revenge seeking

Question 3

Signs and Symptoms: Conduct Disorder

Answer 3

• breaking rules without obvious reason
• cruel or aggressive behavior toward people or animals (e.g. bullying, fighting, using dangerous weapons, forcing sexual activity, and stealing)
• failure to attend school
• heavy drinking and/or heavy illicit drug use
• intentionally setting fires
• lying to get a favor or avoid things they have to do
• vandalizing or destroying property

Question 4

Diagnosis

Answer 4

using the behavioral criteria presented
-many who meet the criteria for OFF or CD often have comorbid mental health problems and may also function poorly in interpersonal relationships with peers and caregivers

Question 5

Prevention

Answer 5

-early assessment; self-report scales, child interview, parent interview, physical assessment, observation of child-parent interaction and thorough family assessment (e.g. history of exposure to violence in the family and community)

Question 6

Working with Children with ODD or CD

Answer 6

nurse to be aware and manage personal feelings that may be aroused by the patient and family

• nurse can educate about the family-based prevention and intervention programs
• nurses must be mindful of the stress that these disorders have on the whole family; may be exhausting for parents to cope with the defiant behaviors; sibling may be put at risk simply spending time with the misbehaved child
• respite care (short-term care) can give the family a “rest” from the child who has the disorder
• encourage family to learn coping skills and take care of personal needs as well as the child’s

Question 7

Nursing Care

Answer 7

-can be prescribed medications from a number of categories:
>stimulants for ADHD symptoms, antipsychotics for behavior regulation, mood stabilizers for regulation of high and low mood presentations, and anti-anxiety agents

Question 8

Education/Discharge

Answer 8

• educating family about medications; action, potential side effects, and any additional important info
• community resources available for respite
• importance of psychotherapy