This category of disorders represents one of the most frequent causes of consultation request in the centers of child neuropsychiatry, and is associated with school failure, stable, deviant behavior (impulsive and aggressive), and high risk of developing psychosocial negative. According to the DSM-5 (Manual of diagnostic and statistical of mental disorders – 5th and most recent edition) and the disruptive behavior disorders, impulse control and conduct are characterized by problems of self-control of emotions and behaviors.
Unlike other disorders that can lead to problems in emotional regulation and behaviour, this type of noise involves events violate the rights of others (e.g. aggression) and/or which place the individual in contrast with the authority or with the social rules.
These conditions are often referred to as the term disorders esternalizzantisince the discomfort is expressed through behaviors angry that impact on other people; this differentiates them from disorders internalizzanti (such as anxiety and depression), characterized by an inner experience of discomfort, which is direct toward itself and are unlikely to cause conflict with others.
Such disorders?
Oppositional defiant disorder
The PDO is characterized by a common pattern of hostile behaviors and provocativewith episodes of open challenge to the authority figures and aspects of anger and irritability.
The anger, the oppositività and provocation appear to be persistent, often acontestuali, and inappropriate with respect to the developmental age of the child.
These aspects of behavior are manifested in the interaction with different individuals from the brothers, they must persist for at least 6 months (as it is not an attitude humoral passenger), and should result in a significant impairment of the functioning of the child in social, family and school.
In the DSM 5 outlines three distinct types:
- Type “with humor angry/irritable” the child has frequent outbursts of anger, it is often irritable, sensitive and touchy, and gets annoyed easily by other people.
- Type “with behavior argumentative/defiant” the child frequently quarrels with adults and peers. Challenge actively, or refuses to follow the prompts and the rules given by their parents within the family, or by teachers within the school. Often disturbs deliberately others, and tends to charge them of their mistakes or their own behavior.
- Type “with behavior vengeful” the child puts in place many jokes and provocations with aspects vindictive.
The symptoms become more apparent in school age (6-8 years) and, in particular, in the relationship with adults and peers, the child knows well, which may not occur during the clinical evaluation.
In the family these issues, behavioral determine high levels of stress parental, with feelings of negativism with respect to the child and of the inadequacy of the skills to parenting. You are to create vicious circles dysfunctional in which the adult and the child entered the competition, and the relationship becomes more tense and confrontational.
At school, you may submit difficulties in learning, lack of motivation in the study, and school failure, with risk of early school leaving.
In the relationship with peers, these children are often rejected and isolated. This leads to a reduction of self-esteempromotes the experiences of insulation and the adhesion with deviant groups.
Intermittent explosive disorder
The intermittent explosive disorder is characterized by explosions of aggression of the impulse generated by the anger that arose quickly and uncontrollably. Occur in response to provocations of little importance, are disproportionate, not premeditate and in general short duration (under 30 minutes). They are characterized by an excess of anger, invective, discussions, or arguments, verbal, damage or destruction of objects, aggression and attack, even to animals and people. You can get to compromise the social and working life of the person and to have negative consequences from the point of view of financial and legal matters.
Occurs in late childhood and adolescence and has a high comorbidity with other disorders, in particular mood disorders, anxiety disorders, and substance use, although the onset of these conditions is typically next.
Disturbance of conduct
Disturbance of conduct means a pattern of behavior that is repetitive and persistent they are violated social norms (appropriate for age) and the fundamental rights of others, the consequences are very serious about the operation of the school or work and social. The aggressiveness is moved in different ways and at multiple levels. The person with disturbance of conduct presents a behavior of a bully, threatening, intimidating, causes quarrels and colluttazioni, steal, cause damage to things , animals or people with weapons, is violent and can get to commit crimes such as rape, assault and murder.
People with this disorder tend to minimize their conduct problems , to lie and to misrepresent the intentions of others ,considering them to be the most hostile and threatening and reacting with an aggression that they consider reasonable and justified. Can try lack of empathy and care for the feelings and welfare of others, not to have sense of guilt or remorse for your actions. The Disturbance of Conduct can also occur in pre-school age, but the first significant symptoms emerge, usually in the the period between childhood and adolescence . Can also be diagnosed in adulthood, but its symptoms emerge, typically before the age of 16. In most people, the disorder remits by adulthood; others develop mood disorders, anxiety disorders, disorders of impulse control (antisocial personality disorder), psychotic disorders, disorder, somatic symptoms and related disorders substance.
Pyromania
Its characteristic feature is thedeparture fire, voluntary and deliberate, repeated in several separate incidents. The Arsonists can be tense or excited emotionally before I give you something on fire, so how can they be delighted, gratified, or to be raised during the departure or immediately after. The Pyromaniac not sets fire to the money, to cover up a crime or for a different reason than the personal gratification of the act.
Kleptomania
His character is the inability to resist the impulse of steal something that you don't need real. The Kleptomaniac, prior to the theft, he feels the tension rise and test satisfaction and pleasure while it is being committed. Theft is not the result of anger or revenge, or anything that is not personal gratification.
This disorder is a pattern to the pervasive non-compliance and violation of the rights of others that begins in childhood or early adolescence and continues into adulthood. To make this diagnosis, the individual must be at least 18 years of age and have a history of some symptoms of the disturbance of conduct before the age of 15 years. Individuals with antisocial personality disorder are not able to conform to the social norms for the conduct, whether legal, are frequently dishonest and manipulative for profit or for personal pleasure (e.g., to obtain money, sex or power), and can make decisions under the impulse of the moment, without reflection, and without considering the consequences for themselves and for others. They tend to be irritable and aggressive, show a disregard reckless of own safety or that of others, they also tend to be often extremely irresponsible and show little remorse for the consequences of their actions.
As we intervene in the Center Tice?
Disorders oppositional defiant, intermittent explosive and conduct come to clinical attention, especially in childhood and adolescence, such as problems related to behavior (it is disobedient, is a bully, beating, stealing, etc..), should be carefully evaluated before being diagnosed as such and treated with individualized curricula that also involve the family. It is very difficult to ask for help with this type of problems because it tends to minimize, and do not consider them as such, but is it really useful to be able to intervene as soon as possible to ensure that no advance in more serious forms. Behind the aggression is there so much fear and fragility.
When a family member is suffering from one of these disorders, the life of thethe entire nucleus is put severely to the test and often, reactions, behaviors, and challenges not do anything else other than food vicious circles you automantengono. For this is fundamental the involvement of the entire family in the path. To tice we offer parent training aimed at improving the capacity of the educational management of the child and of the interactions within the family. The psychological counseling helps family members to develop the emotional impact and explores the how can better support them. Is provided information on the ways to communicate and to put limits effective and loving.
Have a student with difficulties in this area, it can be very difficult for the teacher and for the classmatesas problem behaviors involving the entire system, often becoming a factor in the impediment of a job pays with the group. For this TICE offers tell the class the difficulties of the pupilbecause everyone can understand and learn to tolerate the behaviour of the partner, creating awareness and culture through the use of appropriate words and correct.
Fundamental furthermore, the support, and sharing them withnsegnanti class and support, as well as educatorsto maximize the effectiveness of the intervention, psychoeducational, through the use of rules and strategies that create a consistent and continuous patterns of responses the environment can change the behavior.
The goals of the intervention for children and adolescents with disruptive behavior disorders and impulse control, and conduct are the reduction of the dysfunctional behaviorsthe expansion of the capacity of social adaptation the valorization of “strengths”, the prevention of failure and abandonment school and inserting in extra-curricular activities. For this in the centers TICE children and young people with these difficulties attending full paths, which include the training face to the effectiveness of the school, paths, psychomotor, in which the body becomes a vehicle and a tool to experience the control and the respect of the rules, and decrease impulsivity.
Through the cognitive-behavioral therapy it is possible to implement the ability of self-control and self-regulation of behavior, attention, planning and strategic management of the business.
The end of the pharmacological treatment is the control of symptoms and/or dysregulation behaviorally in order to implement the benefit of the treatments psicoeducativi (Bradley, 2004). For this the staff TICE collaborates and communicates with the neuropsychiatrists of the territory, in order to maximize the adhesion to the treatment of the patients, in order to obtain the maximum possible result.
The results of our actions are reflected in numerous scientific publications that you can see HERE.
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Our team recognizes the the healing power of being part of a group, and offers specific training on social skills, both at the individual and group level. In childhood and adolescence, the Centers TICE act as a sheltered environment in which to experiment with social skills, being frequented by many children, and kids that learn to communicate in a constructive and positive manner. Our classrooms are places in which to simultaneously develop skills, learning ability, but also ways of communicating and spending time with others in a healthy way.