Psychiatry Research EG

Conduct disorder (CD) is one of the most difficult and intractable mental health problems in children and adolescents. CD involves a number of problematic behaviors, including oppositional and defiant behaviors and antisocial activities (e.g. lying, stealing, running away, physical violence, sexually coercive behaviors) [1]. In 2006, the National Mental Health Association reported that CD is more common among boys than girls, with studies indicating that the rate among boys in the general population ranges from 6 to 16%, whereas the rate among girls ranges from 2 to 9% [2]. It was reported by Kaplan et al. [3] that the prevalence of CD is 6–l6% in boys and 2–9% in girls younger than 18 years of age. In Egypt, El-Behary et al. [4] found that the total prevalence of CD among the adolescent students was 19.5% (ranging from 14 to 18 years old) in the secondary schools in Assiut City. Self-concept includes all ideas, perceptions, and feelings of one-self. It has a major impact on behavior as we creatively build up our self-concepts from our daily experiences, and can affect personal adjustment considerably, especially when it is inaccurate or inadequate [5]. A positive self-concept implies acceptance of one’s own strengths and weaknesses, and it enhances self-confidence in one’s social interaction. In contrast, a negative self-concept is reflected in feelings of worthlessness and lack of respect for oneself and one’s abilities [6].Individuals with CD may have less empathy for others, low self-concept, and little concern for their feelings. They may lack feelings of guilt or remorse. They may blame others for their own misdeeds. In addition, they may also have low frustration tolerance, irritability, temper problems, and recklessness. Early sexual behavior, drinking, smoking, and illicit substance abuse are also common [7]. Although patients with CD generally try to appear tough, their self-concept is low. They do not value themselves as individuals any more than they value other individuals. Their identity is related to the types of behavior they show, such as being cool if they have many sexual encounters or important if they steal expensive merchandise or are expelled from school [8]. Nursing interactions with patients with CD include establishing trust by being honest, maintaining control by setting limits for manipulative, acting-out behavior, being consistent with limit setting, respecting the patient’s age, and maintaining an adult–child or adult–adult relationship, whichever is appropriate [9].