Tag: teen defiance

Categories
Parenting Articles

Rebellious Teens

Rebellious and Defiant Teens

One of the most difficult parenting situations that come up around the world is that of rebellious and defiant teens. It is true that most teenagers rebel to some degree. They are testing their limits, and learning to be individuals. It is only natural to rebel a little bit in order to develop a sense of self. However, asserting individuality and testing the boundaries is a different proposition from outright rebellion and defiance.

Rebellious and defiant teens have a disdain for authority, and show little desire to work with parents, teachers and others. They repeatedly cross the line, and may show outright disrespect, flouting rules constantly, or ignoring your strictures. Dealing with rebellious and defiant teens is difficult, and you can only do your best. Here are some ideas for trying to deal with rebellious and defiant teens:

Do what you can to enforce boundaries

It is important to show your rebellious teenager that there are still rules. This means doing your best to enforce consequences. No, you probably can’t stop him or her from sneaking out the window at night. However, you can take away computer privileges or video games. You can also remove car privileges and make it clear that if your child wants to benefit from the extra, “fun” things you have as a family, he or she needs to be a functioning and respectful part of the family. Try these teen behavior contracts.

Try to avoid big fights

This can be difficult, but you need to try to avoid big fights. Part of the reason that defiant and rebellious teens act out is to get a reaction from you. One of the best things you can do is react calmly. Explain that the poor decision that a teenager has made is resulting in a specific consequence (try to choose consequences that you can actually enforce), and that he or she can earn back your trust.

Big fights over a teenager’s hair or clothes will only put you in a losing position. Calmly state that you do’t approve of something your teen is wearing, saying, or listening to, and leave it at that. If the behavior is offensive, you can enforce consequences.

Be available to talk

Try to be available to talk. Listen to your teenager. If he or she comes to you with a problem, or confesses something he or she did, hold your tongue until he or she is done. While it may be difficult, try to avoid making judging statements. If your teen wants advice, give to him or her candidly and calmly. If he or she is admitting wrong-doing, calmly point out that there is a consequence attached to all such actions, and that it will be enforced. Try to help your teen, or just listen on occasion.

Be clear in your unconditional love

It is difficult, but when dealing with rebellious and defiant teens, you need to be clear about your unconditional love for your teenager. Make sure that you are clear that it is the behavior you do not approve of. Also, do your best to avoid comparisons between your troubled teenager and others. These comparisons will most likely only provoke more efforts to rebel as teens feel unloved.

Continue to invite your troubled teenager to family activities, and express a desire for your child to join the table at meal times. Be sure that you continue to provide the basics of life: Shelter, food and clothing. However, you do need to make it clear that you will not tolerate violence in your home, and that your teen should not endanger anyone else in the family.

Programs for rebellious and defiant teens

If your teenager has become so unmanageable that he or she is engaged in illegal activities, or becoming violent, you might have to look into programs for your teenager. Make it clear that you love your teen, and you want to help him or her, but you can’t have destructive behavior in your home. Programs for rebellious teens can help your teenager learn techniques to manage his or her anger issues and problems. In these cases, your teen might still have problems when he or she gets back from the program, but they might be more manageable.

It can be difficult to know what to do if you have a troubled teenager. You should do what you can to re-establish a good relationship with your teenager, and show that you are concerned and loving. In the end, though, all you can do is try your best, since rebellious and defiant teens make their own decisions.

Categories
Mental Health

Conduct Disorders

Why Conduct Disorder Is Difficult to Understand

The two primary guides to diagnosing disorders, both of which are used in the diagnosis of Conduct Disorder are the Diagnostic and Statistics Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10).

In some cases, the two guides have a similar analysis of disorders and how they relate to each other. In the case of conduct disorder, however, the two views are different, complicating understanding.

The DSM-IV-TR View of Conduct Disorder

The DSM-IV-TR lists Conduct Disorder as a subcategory of “Attention-deficit and disruptive behavior disorders,” along with Oppositional Defiant Disorder, Attention-Deficit Hyperactivity Disorder, and Disruptive Behavior Disorder NOS (Not Otherwise Specified). There are three specific subcategories of Conduct Disorder, distinguished by the time of onset: in childhood, during adolescence, or unspecified.

Diagnosing Conduct Disorder using the DSM-IV-TR criteria, which should only be done by qualified mental health professionals. If the person is 18 or older, a diagnosis of Conduct Disorder cannot be given unless the criteria for Antisocial Personality Disorder are not met.

The descriptions make it clear that this is a more serious disorder than Oppositional Defiant Disorder. For a diagnosis, the person must demonstrate a pattern of behavior that has included three or more symptoms of those listed below for at least the past 12 months and shown at least one in the past 6 months:

• Aggression towards people and animals

  • frequently bullies, threatens, or intimidates
  • frequently initiates physical altercations
  • has employed a weapon capable of causing serious physical harm
  • has shown physical cruelty to people
  • has shown physical cruelty to animals
  • has confronted and stolen something from a victim
  • has forced sexual activity on someone

• Property destruction

  • has set at least one fire meaning to cause notable damage
  • has purposely destroyed property in some other way

• Deceit or theft

  • has forcibly entered someone else’s house or car without permission
  • frequently lies, conning others
  • has stolen items without a confrontation

• Serious rule violations

  • has frequently broken the house rules and stayed out at night, since before age 13
  • at least twice has stayed away from home overnight without permission or once for an extended period
  • has frequently been truant from school, since before age 13. 

In addition, these behavior disturbances must:

• result in “clinically significant impairment” in either academic, social, or occupational functioning;

If Childhood-Onset type is diagnosed, at least one characteristic must have manifested prior to age 10, whereas is Adolescent-Onset is diagnosed, there must be an absence of manifestation of any of the behaviors prior to age 10. The severity can be designated as mild, moderate, or severe.

ICD-10 View of Conduct Disorder

ICD-10 takes a different approach to Conduct Disorder than the DSM-IV-TR. It includes Conduct Disorder under the category “Behavioral and emotional disorders with onset usually occurring in childhood and adolescence” and designates six subcategories, which are:

• Conduct disorder confined to the family context

• Unsocialized conduct disorder

• Socialized conduct disorder

• Oppositional Defiant Disorder (ODD)

• Other conduct disorders

• Conduct disorder unspecified.

So ODD is a subset of Conduct disorder in the ICD-10 analysis, but not in the DMS-IV-TR analysis, and the category of Conduct Disorder is subdivided in a completely different way, based not on age of onset, but on other specifics of how it manifests.

Diagnosis of any of the ICD-10 subgroups requires that a child first meet the criteria for Conduct disorders generally. This means that the pattern of disruptive behavior–which may be dissocial, aggressive, or defiant—must both be repetitive and persistent, notably beyond outside age-appropriate expectations, and last for six months or longer. If a different psychiatric diagnosis explains the symptoms, that diagnosis should be used.

The further criteria that separate the subcategories are:

• Conduct disorder confined to the family context occurs only or almost only in the home and with members of the family or household.

• Unsocialized conduct disorder is marked by serious abnormalities in relationships between the child and other children.

• Socialized conduct disorder is diagnosed when a person gets along well with peers, and is generally characterized by delinquent activities as a group, or gang, as well as truancy.

• Oppositional Defiant Disorder is usually diagnosed in younger children and the behaviors demonstrated are better characterized as disobedient, defiant, and disruptive rather than delinquent, dissocial, or aggressive.

Understanding a Diagnosis of Conduct Disorder

If you or someone you know has a child who has received a diagnosis of conduct this order, you can use the information in this article to ask questions and find out more. Which type of conduct disorder has been diagnosed and according to which definition? Which criteria were met to support the diagnosis?

Sources

http://www.surgeongeneral.gov/library/mentalhealth/
chapter3/sec6.html#disruptive

http://apps.who.int/classifications/apps/icd/icd10online/?gf90.htm+f913

http://www.surgeongeneral.gov/library/mentalhealth/
chapter3/sec6.html

Categories
Troubled Teen Issues

Behavior Problems

Not everything that can happen will happen. This is a good thing to keep in mind when considering the range of issues that can afflict adolescents. It is also important to remember that because of chemical and hormonal imbalances, the difficulties of creating an identity, the sensitivities of adolescents, and the tensions between being cool to peers and respectful to parents, all teens are likely to—at least occasionally—behave in a way that their parents deem unacceptable.

But here, we’re not discussing a child who occasionally swears, breaks curfew, takes more ice cream than you said he or she could, or argues heatedly for more time with the family car. This article focuses on and provides an overview of the more concerning behavior problems that can afflict a teen.

What Is a Behavior Problem?

Although some people may casually lump all issues when teens act in a problematic way as “behavior problems,” it is actually useful to distinguish behavior problems from other types of issues. For example, a mental health issue may lead to problematic behaviors, but a mood disorder, like bipolar disorder, is not a “behavior problem” per se.

In addition, what appears to be a behavior problem may be caused by a different type of underlying issue—for example, substance abuse that arises out of an attempt to deal with a major depression. If this is the case, treating the behavior in isolation from its root cause will not be successful: the substance abuse and depression need to be addressed in tandem.

The role of an apparent behavior problem in signaling other issues may be more evident in a teen than in an adult. For example, an adult who can’t afford to lose his or her job may have the maturity, experience, and self-preservation instincts to hide his or her feelings about some practice or situation that seems entirely unfair in the workplace. A teen faced with the same situation or practice at school or at work and not having the same level of maturity may manifest his or her contempt or righteous indignation by his or her behavior, whether words or actions or facial expressions.

In addition, some types of problem seem to defy clear categorization. When one person does physical harm to another person or property, is it even without some other type of mental health issue? It’s difficult to say. Even the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) groups “Mental and behavioral disorders” as a group. For these reasons, the list below does not attempt to be complete or to sort out all the issues of what is a behavior problem and what would be better classified in another way.

Some Behavior Problems that May Afflict Adolescents and Require Expert Help

• Teenagers are curious, and they may try substances that are illegal period or illegal for them to use at their age. If there is no other underlying cause, then substance abuse is a behavior problem.

• There are several behavior problems that the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision) classifies under the heading Attention-deficit and disruptive behavior disorders. These include the following:

  • Attention-Deficit Hyperactivity Disorder (AD/HD), which has four subtypes
  • Conduct Disorder, which has three subtypes
  • Oppositional Defiant Disorder
  • Disruptive Behavior Disorder Not Otherwise Specified (NOS)

• The DSM-IV-TR also includes Antisocial behavior with two subtypes

• The ICD-10 classifies a group of “Behavioral syndromes,” that lists eating disorders—including anorexia nervosa, bulimia nervosa, overeating, and vomiting—are often linked to adolescence.

• The ICD-10 also lists “Behavioral and emotional disorders with onset usually occurring in childhood and adolescence.” The ones most closely tied to behavior include:

  • Hyperkinetic disorders, of which Attention-deficit hyperactivity disorder is a subgroup
  • Conduct disorders, which in the ICD-10 includes Oppositional defiant disorder