1. CONDUCT PROBLEMS
Pınar Özeren

2. Description
Conduct disorder is a psychiatric category to describe a pattern of repetitive behavior where the rights of others or the current social norms are violated. Symptoms include verbal and physical aggression, cruel behavior toward people and pets, destructive behavior, lying, truancy, vandalism, and stealing.

3. The Case: Ali, 32 years old Graduated from primary school Scrap dealer
Divorced for 1.5 years
Have 3 children staying with their mother
Heavy drinker and smoker since 10 years

4. Application Reason
He tried to throw himself from the Yenibosna Bridge when he was drunk then the police convinced him and brought him to the hospital.

5. Family History Father died when he was 10
Mother got into a deep mourn after her husband’s death
The oldest of 5 siblings
Took care of his siblings especially his youngest brother

6. Own History He was a problematic child at school
Escaped from school many times
Very low grades
His mother took him from school because of his lying and escaping behaviors.

7. Own history
Be in prison for 1.5 year at military service for insulting and using abusive language to his superior.
Be in prison for 3.5 years for full attempting to kill someone.
Attempted to commit suicide 1 year ago
Beating his wife heavily.

8. “I am going to cut her into peaces, she destroyed my life
“I am going to cut her into peaces, she destroyed my life. I am going to kill her, I have nothing to loose.”

9. Etiology Family characteristics Socio-cultural factors
Psychological factors
Neuro-biological factors

10. Family Characteristics
Low SES people
Fathers are away from the family
Mothers are depressive or have personality disorders
Chaotic family structure
Denial by the parents at an early age

11. Socio-cultural Factors
Society’s view towards low SES children
The approved behaviors are not a way to get a status

12. Psychological Factors
Lack of role models
Cannot develop consciousness and adopt social norms
Cannot tolerate the obstacles when forming mature relationships
Psychoanalytic view: lack of attachment at infancy

13. Neuro-biological Factors
Very low dopamine
High serotonin

14. DSM-IV Aggression towards people and animals
Abusive language, threatening
Physical violence
Using harmful weapons
Cruelty
Sexual abuse

15. DSM-IV Destroying property Dishonesty and robbery
Starting a fire consciously
Giving harm to someone's property consciously
Dishonesty and robbery
Constant lying
Stealing some things by facing the victim

16. DSM-IV Disruption of the rules
Not coming to the house without the permission of the parent (before age 13)
Not coming to the house at least 2 days (before age 13)
Escaping from school (before age 13)

17. DSM-IV
1) Beginning in Childhood
2) Beginning in Adolescence

18. Assessment
They do not feel discomfort from their behaviors and cannot communicate well.
There can be depression and anxiety in this disorder

19. Assessment (for Ali) Judgement problems Very slow talk Pessimism
Sleepless
Refuse to take medications
Very disordered and unclean

20. Prognosis
The prognoses of the conduct disorder beginning in adolescence is more positive than the beginning in childhood.
During the recovery of the symptoms depression occurs.

21. Treatment Medication Psychotherapy
Abnormal electrical activity in limbic system
Neurological medications for aggression and tantrum (for short term)
Litium for emotional and behavioral stability
Psychotherapy
Behavioral and cognitive therapy
Communication skills, problem solving, motive and anger controlling

22. “I am fine and feel good, I want to go out from here
“I am fine and feel good, I want to go out from here. I will try to compromise with my wife and see my children. But if she does not want to, I am going to go to Adapazarı and live there.”

23. THANK YOU