F)+Treatment+of+Conduct+Disorder+and+Antisocial+Personality+Disorder

= **__Treatments of Conduct Disorder/Antisocial Personality Disorder__** =



__Lithium__

Lithium is similar to sodium and potassium. It is a positively charged particle which interferes with the uptake of chemical messages. It also affects the levels of serotonin and tryptophan in the brain, as well as increasing the levels of white blood cells in the body’s bone marrow.

A study conducted by Gabriele et al was conducted in 2009 on the effects of the drug Lithium on hospitalized children with severe conduct disorder. Gabriele et al used a sample of 60 children, both male and female (aged 8-17) over a course of 6-12 months. It was found that Lithium whether administered alone or with another atypical antipsychotic were shown to reduce aggressive behaviours in children with conduct disorder.

The side effects of Lithium were common but hardly severe (Gabriele, et al, 2009). Some side effects include
 * Tremors
 * Weight gain
 * Increased thirst and urination
 * Gastrointestinal problems

__Parent Management Training__

This is a treatment focused on how the parents interact with their child with conduct disorder. The parents or guardians meet with a therapist or trainer to learn how to encourage pro social behaviour and diminish deviant behaviour.

Parents should not be blamed for their child’s actions but they often inadvertently reinforce deviant behaviours in their children (Nathan & Gorman, 2002). Parents are taught to respond to deviant behaviours in consistent and predictable ways as well as rewarding positive social interactions. This treatment is based on the principles operant conditioning done by B.F. Skinner (1938). Skinner theorized that behaviours are formed through a series of antecedents and consequences.

Parent Management Training or PMT has shown visible improvements in the child’s behaviour according to parent and teacher reports, and these behaviours were maintained 1 to 3 years after treatment (Nathan & Gorman, 2002).

__Multisystemic Therapy__

This treatment is problem focused and action oriented. It focuses on several systems in the life of a child with conduct disorder (ie, family, peer relationships, schools, and neighbourhoods) and attempts to intervene to create positive changes.

Multisystemic therapy attempts to change embedded behaviours in the child’s life, i.e,
 * Family Life: attempt to reduce maritial conflict, increase communication, Parent Management Treatment, etc
 * Peers: Encourage involvement with prosocial peers, promote disengagement with deviant peers
 * Schools: educating teachers, etc

There is strong evidence in favour of Multisystemic therapy, supported by randomized and controlled clinical trials (Nathan & Gorman, 2002). It is shown to reduce deviant behaviours, and increase prosocial interactions, however, all systems must participate (Nathan & Gorman, 2002).

__Cognitive Problem Solving Skills Training__ This treatment focuses on generating different solutions to interpersonal problems and social situations. Empasis is put on develping interpersonal cognitive problem solving skills.

This treatment is broken down into five steps:
 * 1) How the child approaches social situations is noted. The child is then taught how to use a step by step approach to solve interpersonal problems
 * 2) What behaviours the child chooses is also noted. Prosocial behaviours are reinforced through modeling and reinforcement
 * 3) Structured tasks and activities are performed by the therapist (ie, games, activities, and stories). This is to show the child how to act and react
 * 4) The therapist models proper cognitive processes and attempts to help the child apply these to real life situations
 * 5) Attempting to combine all the child has learned. The therapist helps the child apply their new thought process to daily life through reinforcement of prosocial behaviours and punishment of antisocial behaviours.

Cognitive problem solving skills training has been proven effective in reducing aggressive behaviours and decreasing antisocial behaviours at home, at school, and in the community for up to one year through randomized trails (Nathan & Gorman, 2002).