Question

Discuss disorders characterized by inattentiveness and disruptive behaviors. Include prevalence, causes, and treatment.

Answer 1

Discuss disorders characterized by inattentiveness and disruptive behaviors. Include prevalence, causes, and treatment.

answer:

The disorders characterized by inattentiveness and disruptive behaviors. Include

inattentiveness disorder like .Attention deficit hypersensitivity disorder-inattention type.

The other causes of inattention include neurological damages and mental disorders,brain damage and fetal alcohol syndrome,ODD,depression,drug and substance abuse,sleep deprivation and sleep apnea syndromes(7-9%),learning disabilities and congenital disorders with stunted neurological development.

2.Disruptive behaviour disorders include disorders like disruptive behaviour disorder not otherwise specified,oppositional defiant disorder,ODD,conduct disorder CD and minor disorders like kleptomania and pyromania.

The main disorders characterized by inattentiveness and disruptive behaviors. Including the  prevalence, causes, and treatment are discussed below

Inattentive attention-deficit hyperactivity disorder(ADHD):

Presentation,signs and symptoms:Attention deficit hyperactivity disorder can have 3 different types of symptoms hyperactivity ,impulsivity and inattentiveness.In the inattentive type,the child is inattentive and has learning delays.This is generally associated with poor educational outcomes.

Prevelance:

Attention deficit hyperactivity disorder:10-15% percent of the population

(males more than females,tends to persist in adulthood,inattentive type constitutes 20-30% of the total cases)

Diagnosis by psychiatric evaluation of the child by an experienced child psychiatrist or pediatrician and involves use of diagnostic and assessment tools.

Causes

genetic factors:family history of ADHD or mental disorder in parents or siblings.

developmental factors :caused by maternal use of alcohol,drugs and smoking .low birth weight and birth injury,prematurity,exposure to toxins during pregnancy.

environmental factors:exposure to lead or other toxins in early childhood

Treatment:Cognitive behaviour therapy

parental management techniques skill training

group therapy and family therapy

teachers training and special education skills

removal of the environmental causes where identified.

pharmacotherapy with stimulant drugs like dexedrine and ritalin.

Disruptive behaviour disorders: The findings of aggressiveness,irritability and violence is common among children and sometimes continues after adolescence in these kind of behaviors

The spectrum:The disruptive behaviour disorder  Includes disruptive behaviour {not otherwise specified),oppositional defiant disorder ODD and conduct disorder CD,intermittent explosive disorder(episodic behaviour of aggressiveness with destruction of property)kleptomania(generally begins in adolescence and more often seen in females ,pyromania(setting fires as an expression of internal disturbance).

Prevalence is about is 6%-12% in the general population.The prevalence rates for ODD is around 6-8% and for conduct disorder is higher around 12-14%

.About 25-30% of the children affected by ADHD have ODD or conduct disorder.

kleptomania and pyromania are rare disorders and less than 1% of the population is  affected by it:

Presentation:The children with this behaviour are generally irritable ,disobedient and physically hyperactive and tend to get violent easily and are involved in fights They may be throwing arguments ,tantrums causing it difficult for the parents and the teachers to manage the children and defy rules and authority. The social interaction of these children is mostly that of a violent nature. This creates functional disability in the child while he/she is growing and hence parents seek medical attention The child has  an inherent tendency to break the rules and often project his mistakes on others and blame them for it The parents often have to seek attention due to disciplinary issues at home at the day care centres or at school.

Causes

genetic factors:parents who are diagnosed with mental disorders like schizophrenia or substance abuse or personality disorders.

developmental causes like  low birth weight and brain injury during birth.

environmental factors :Parental loss, parental separation, divorce amongst the parents ,improper foster care ,sexual abuse, physical abuse, neglect,extreme poverty,witnesses to domestic violence, children born to parents with the substance abuse

psychological factors: 30 to 50% of the children with attention deficit hyperactivity disorder have an oppositional defiant disorder.

Diagnosis by psychiatric evaluation of the child by an experienced child psychiatrist or pediatrician using history,examination and assessment and diagnostic tools.

Treatment of destructive behaviour includes

removal of the causative  environmental factors if any ,

parent counselling and training for anger and behaviour management technique,

cognitive behaviour therapy,

Anger Management therapy,behavioural training,

positive reinforcement therapy and conditioning therapy.

Pharmacotherapy for intermittent explosive disorder.