Priya Mary, Mammen (2011) Family factors associated with conduct disorders in Children and Adolescents. Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION : Conduct disorder is a disorder initially diagnosed in childhood or adolescence and refers to a persistent pattern of antisocial behavior in which the individual repeatedly breaks social rules and carries out aggressive acts that upset other people. Antisocial behavior is a common problem in the course of development of children. Although conduct disorder has been widely studied, it still consumes much of the resources of mental health, juvenile justice and the special education system. DSM-IV mentions conduct disorder as one of the most frequently diagnosed conditions in outpatient and inpatient mental health facilities for children 1 DSM- IV specifies for conduct disorder, criteria which includes symptoms from the following areas: aggression against people or animals, property destruction, lying or theft and serious rule violation. It defines conduct disorder as a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated 2. About a third of those affected have antisocial personality disorder in adult life and a further third experience other personality, psychiatric and psychosocial problems. The prevalence of conduct disorders varies from 6-20% in studies across different cultures and settings 3, 4. In the evolution of conduct disorders different risk factors are implicated which includes “child biological factors,” “child functional factors,” and “psychosocial factors” 5. Even though the number of studies discussing the evolution of conduct disorders and factors associated with it are numerous, there is a lack of information on risk factors associated with conduct disorder in our Indian population. In this study we aim to delineate the family factors like parenting style, parental separation, parental psychopathology, family type and family functioning associated with conduct disorders. AIMS AND OBJECTIVES : To study the family factors associated with conduct disorder in a clinic-based population. To study the family factors in children and adolescents diagnosed with conduct disorder, in comparison with a group of children without conduct disorder, but with other psychiatric disorders. The following null hypothesis was postulated: There is no significant difference between children and adolescents with conduct disorder and those without conduct disorder, with respect to family factors. MATERIALS AND METHODS : The participants were recruited from the outpatient department of the Child and Adolescent Psychiatry Unit, Department of Psychiatry, Christian Medical College. This is a tertiary care centre, providing services to children and adolescents with various mental health needs, from different parts of the country and neighboring regions. The Child and Adolescent Psychiatry unit of the Department has two divisions, one for children with emotional as well as behavioral disorders and the other one for children with developmental disorders. The multidisciplinary treating team makes the clinical diagnosis based on the ICD-10 clinical diagnostic system. Inclusion criteria: 1. Children and adolescents between 5 - 18yrs. 2. Diagnosed to have conduct disorder based on the ICD-10 clinical diagnostic criteria at initial presentation. 3. Conduct disorder with or without comorbid psychiatric disorders 4. Conversant in English, Tamil or Hindi. RESULTS : The acceptability of the study data for a parametric analysis was initially assessed and found to be favourable as depicted in Table 1. 164 children and adolescents were enrolled for the study between January 2010 and October 2010. As diagnostic data was missing for 5 participants, only 159 participants were considered for further analysis. Table 2 shows the participant characteristics of the total sample. The sample consisted of children and adolescents between the ages of 5 to 18 years with a mean age of 11.61 years (SD 3.5). Approximately three fourth of the participants were male (74.2%). The majority had completed at least a primary or high school education (91.2%). Participants were predominantly Hindus and hailed from a upper middle socioeconomic background. There was a slightly larger representation from urban areas (56.6%). The majority was from Tamil Nadu and West Bengal (79.3 %), therefore spoke Tamil and Bengali respectively. All the participants included whose mother tongue was Bengali, were also conversant in Hindi. There were 63 participants with conduct disorder which accounted for 30.6% of the total disorders seen. Among children with conduct disorder, 33.3% had conduct disorder in the family context, 15.9% had socialized conduct disorder and oppositional defiant disorder was seen in 50.85%.The majority (40%) of other diagnosis present in the total sample included mild mental retardation and ADHD. ‘Other’ disorders included nonspecific behaviour problems and enuresis. CONCLUSION : In conclusion, while this study failed to find a significant association of family factors with conduct disorder when a multivariate analysis was done, male gender and more number of comorbidities had a significant association with conduct disorder.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Family Factors Associated ; Conduct Disorders ; Children ; Adolescents. |
| Subjects: | MEDICAL > Psychiatry |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Aug 2017 00:56 |
| Last Modified: | 16 Aug 2017 12:04 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1886 |
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