Transcript Chapter 028

Chapter 21
Impulse Control Disorders
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.
Oppositional Defiant Disorder
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Angry and irritable mood
Defiant and vindictive behavior
Experience
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Social difficulties
Conflicts with authority figures
Academic problems
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Intermittent Explosive Disorder
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Inability to control aggressive impulses
Adults 18 years or older
Leads to problems with
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Interpersonal relationships
 Occupational difficulties
 Criminal difficulties
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Conduct Disorder
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Behavior is usually abnormally aggressive
Rights of others are violated and societal norms
or rules are disregarded
Complications
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Academic failure, school suspensions and dropouts,
juvenile delinquency, drug and alcohol abuse, and
juvenile court involvement
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Conduct Disorder (Cont.)
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Childhood-onset conduct disorder
Adolescent-onset conduct disorder
Two problems
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Pyromania
Kleptomania
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Conduct Disorder (Cont.)
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Epidemiology
Comorbidity
Etiology
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Biologic factors
 Psychological factors
 Environmental factors
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Application of the Nursing Process
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Assessment
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Suicide risk
 Assessment tools
 Self assessment
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Diagnosis (Table 21-2)
Outcomes identification (Table 21-3)
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Nursing Process (Cont.)
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Implementation
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Psychosocial interventions
Pharmacological interventions
Health teaching and health promotion
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Nursing Process (Cont.)
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Advanced practice interventions
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Cognitive-behavioral therapy (CBT)
 Psychodynamic psychotherapy
 Dialectical behavioral therapy (DBT)
 Parent-child interaction therapy (PCIT)
 Parent management training (PMT)
 Multisystemic therapy (MST)
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Nursing Process (Cont.)
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Teamwork and safety
Seclusion and restraint
Evaluation
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Audience Response Questions
1. An adolescent with oppositional defiant
disorder says, “My therapist doesn’t understand
me. I want to see someone else.” Should this
client have the option to change therapists?
A. Yes
B. No
C. Not sure
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.
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Audience Response Questions
2. An adolescent with a conduct disorder is taken to the
principal’s office after assaulting and injuring another
student. Which comment is this adolescent most likely
to make?
A. “I lost my temper, but it will not happen again.”
B. “I’m sorry and embarrassed that this happened.”
C. “I failed my math test, and guess I was just having a
bad day.”
D. “So what if that kid was hurt? I should have beaten
him more.”
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