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Steelers HC Tomlin says "to deal" with unmasked dance in the locker room

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Tomlin HC concludes his statement on behavioral problems with the phrase "confront" that he often uses.

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Conduct disorder

Conduct disorder(Kouishogai, conduct disorder, CD) from DSM-5Behavioral disordersTranslated intoConduct disorderTranslated from, it features repetitive and persistent, antisocial, aggressive, and rebellious behavioral patterns.[1], Age-appropriateSocial norms,RuleIt is a state that deviates greatly from.These behavior patterns are oftenAntisocial behaviorと 呼 ば れ る[2]..Therefore, it must be more serious than normal childish mischief and adolescent rebellion.[1]..It also needs to last for at least 6 months[3][4]..This is in the judicial administrative contextdelinquencyIt contains many of the categories that have been discussed in the concept of.

Conduct disorder is often adultAntisocial personality disorderIt is a pre-stage of (ASPD), and if you are under the age of 18, you will not be diagnosed with ASPD.[5].


It is a type of psychiatric disorder.

communication skill

Aggression against humans and animals[6]
They often quarrel with people, threaten them, intimidate them, and treat animals cruelly.
Destruction of property[6]
Destruction of other people's property, arson, etc.
Lie and theft[6]
Repeatedly lie and steal.
Serious rule violation[6]
School holidays, runaway, etc.

However, such descriptive actions need to arise from personal problems (such as impoverished areas, immigrants from war-torn countries, etc.)[4]) In cases where it is environmentally or culturally commonplace, it may mean the need to adjust to a healthier environment.[7].



who OfICD-10 Mental and behavioral disordersIn F91 Conduct Disorder[8]..Provocative but no offensive behavior, no legal infringement such as theft,Oppositional defiant disorderDistinguished by (ODD)[9]..Developmental stages must be considered in the diagnosis, and tantrums in 3-year-olds and violence in 7-year-olds in normal developmental stages are not the basis for diagnosis.[6].Attention deficit/hyperactivity disorderAndMood disorder,Pervasive developmental disorderIt is necessary to make a differential diagnosis with[6].

Conduct disorder requires repetitive and persistent, and diagnosis is not recommended unless it persists for more than 6 months[3]..So a single antisocial episode is not the basis for a diagnosis[10].

F91 As a subclassification of conduct disorder, as a valid subclassification[11], F91.0 Home Localization, F91.1 Individual Behavior Type, F91.2 Group Behavior Type[12]..In addition, in the diagnostic criteria for ICD-10 research, it is said that the method of making serious harm such as serious injury or theft is a good index, and it is described from three aspects including hyperactivity and emotion. Is recommended to do[11].

American Psychiatric Association

American Psychiatric Associationby"Diagnostic and Statistical Manual for Mental IllnessThe diagnostic code in the 4th edition (DSM-IV) is 312.8.

In DSM-IV-TR[4], Ignoring social rules and human rights in Diagnostic Criteria A, in Diagnostic Criteria BCauses significant dysfunction, 18 years or older in diagnostic criteria CAntisocial personality disorderIt is necessary that it is not.The childhood-onset type is the onset before the age of 10, and the adolescent-onset type is after that.And if you are actually doing a lot of harm, such as using a weaponSevereIs diagnosed.

In DSM-5, the diagnosis name of conduct disorder is also listed.

Differential diagnosis

Delinquency is not serious,Does not cause significant clinically impaired functionThings do not apply[13]..If the behavior corresponds to the cultural standards of the child's environment, such as a confused family or being abused.Adjustment disorderIs[13]..Especially in children and adolescents, it can be a stress response to the family and the environment.[14][15],Initial diagnosis tends to be inappropriateShould be diagnosed carefully or should not be diagnosed[15]..The later the onset, the more transient the possibility and the possibility of other reasons need to be considered.[16].

Substance addiction,Substance dependenceShould also be excluded if it occurs in connection with[1][17], Behavior may disappear if coping with use[18]..Behavioral annoyance isAttention deficit/hyperactivity disorderBut it happens, but the severity of the problem is different[13][14].

If there is no legal infringementOppositional defiant disorderIs[13]..Conduct disorder andOppositional defiant onsetIs on the order of behavior, and if the child is growing up in a poor environment with a lot of stress in discrimination, it is considered better for the child to develop oppositional defiant syndrome.[19]..Serious but below diagnostic criteria, diagnostic code V71.02 is antisocial behavior in children and adolescents[7].

back ground

The following factors influence each other in a multifaceted and complex manner.

  • Personal factors
  • Family factors
  • Socio-cultural factors


There is evidence of a high risk of conducting disorders in classes with many children aged 3-7 years[20][21]..There is also evidence that early intervention can reduce the risk of developing conduct disorder.[20].. NICE recommends that emotional learning and problem-solving programs be implemented on a class-by-class basis, with less than 1 students per grade.[20].


The prevalence of conduct disorder is in the range of 1-10%[2]..It was 9% of Canada's 19-6.8 year old population (2011)[22]..However, in juvenile rehabilitation facilities, it is 23-87% according to the US Ministry of Justice.[23].

対 応

The most effective treatment for conduct disorders is the integration of the individual, school and home environment.For the familyPsychological educationI will provide a[1]..In addition, in treatment, attention should be paid to domestic conflicts such as marital conflicts and maternal depression.In treatment, we will focus on the potential to trigger many behavioral problems.

There are many treatments, but the most effective one(English edition (MST).UK National Institute of Medical Technology(NICE) practice guidelines recommend MST for patients aged 11-17 years[24].

In addition,Parent training Cognitive behavioral therapy,Life skills trainingYou can also consider the use of[1].

Multisystemic therapy

MST is a centralized and integrated treatment that emphasizes how individual behavioral problems apply in a broad context.In the system to which an individual is connected (home, school, neighbor's house), the existence of a pattern that enhances the antisocial behavior of the individual is found. MST is a psychotherapy that seeks to disconnect from individuals and families with the help of individuals and families.

3-4 weekly therapies for 3-5 months by trained professionals[25].

Drug intervention

Child and adolescent psychiatryDrug therapy should not be done without a specialist[1].

NICE is a conduct disorder orOppositional defiant disorderIt is said that continuous drug therapy should not be tried for children and adolescents who have[26].. NICE is a short-term intervention for serious aggressive behaviorRisperidoneHowever, it states that it must be carefully prescribed by specialists in compliance with clinical guidelines.[26].


  1. ^ a b c d e f World Health Organization 2010, BEH.
  2. ^ a b Hinshaw, SP, & Lee, SS (2003). Conduct and oppositional defiant disorders. In EJ Mash & RA Barkley (Eds.), Child psychopathology (pp. 144-198). New York: Guilford Press.
  3. ^ a b World Health Organization 2005, pp. 275-276.
  4. ^ a b c American Psychiatric Association 2004, p. Conduct disorder.
  5. ^ Brown, SA .; Gleghorn, A .; Schuckit, MA .; Myers, MG .; Mott, MA. (May 1996). “Conduct disorder among adolescent alcohol and drug abusers.”. J Stud Alcohol 57 (3): 314–24. two:10.15288 / jsa.1996.57.314. PMID 8709590. 
  6. ^ a b c d e f World Health Organization 2005, p. 276.
  7. ^ a b Allen Frances 2014, p. 31.
  8. ^ World Health Organization 2005, pp. 276, 279.
  9. ^ World Health Organization 2005, pp. 279-280.
  10. ^ World Health Organization 2005, p. 275.
  11. ^ a b World Health Organization 2008, p. 169.
  12. ^ World Health Organization 2005, pp. 275-278.
  13. ^ a b c d Allen Frances 2014, p. 30.
  14. ^ a b UK National Institute of Medical Technology 2013, Chapt. 1.3.5.
  15. ^ a b Allen Frances 2014, pp. 19, 22.
  16. ^ Allen Frances 2014, pp. 31-32.
  17. ^ UK National Institute of Medical Technology 2013, Chapt. 1.3.15.
  18. ^ Allen Frances 2014, pp. 30-31.
  19. ^ Allen Frances 2014, p. 32.
  20. ^ a b c UK National Institute of Medical Technology 2014, Chapt. 1.
  21. ^ UK National Institute of Medical Technology 2013, Chapt. 1.2.
  22. ^ The Life and Economic Impact of Major Mental Illnesses in Canada (Report). Mental Health Commission of Canada. (2013-02-09). http://www.mentalhealthcommission.ca/English/node/5024. 
  23. ^ US Department of Justice. (2006). Psychiatric disorders of youth in detention (NCJ 210331) Washington, DC: US ​​Government Printing Office.
  24. ^ UK National Institute of Medical Technology 2013, Chapt. 1.5.13.
  25. ^ UK National Institute of Medical Technology 2013, Chapt. 1.5.14.
  26. ^ a b UK National Institute of Medical Technology 2013, Chapt. 1.6.


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