Conduct disorder: a mounting concern among youngsters today

Health Care Comments Off

Conduct disorder: a mounting concern among youngsters today

Exposure to violence through various media can aggravate aggressive behavior

New Delhi, 13 November 2017: As per a recent study conducted on 519 boys in the juvenile justice system in the US, it was found that about 80% of them suffered from a conduct disorder. The recent incidence of a small boy killed in a reputed school in Delhi and the associated arrest of a 16-year-old points towards the increasing prevalence of conduct disorder in youngsters today. Studies show that people with conduct disorders are a threat to others and themselves. They are also thrice as likely to get anxiety disorders, depression, or indulge in substance abuse or alcohol dependence.

Conduct disorder refers to a mental health condition defined by behavior that violates the rights of others, or social norms. Teenagers have the tendency to take more risks than their adult counterparts. This is because of hormonal changes, poor impulse control, and also because seeking external stimulation is a biological need for them at that age.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “It is both shocking and sad to know that a 16-year-old boy was behind the killing of a young child. While the reason behind the crime was to avert examinations and a PTM, the situation also hints at a larger issue – that of an increased exposure to aggression through social media, television, video games, and even real life. Aggressive behavior is reinforced for a child at every point today, be it at home, school, or other areas. The message that is conveyed is violence and shouting can get things done faster and better. The fact that youngsters are in the prime of risk taking behavior adds fuel to the fire. This is a serious issue and a possible precursor to behavioral and mental problems that may develop in a person later in life. Violence in media today is a stimulus for physiological arousal, cruel thoughts, and aggressive behaviour. They trivialize violence and brutality, and make winning imperative to boost self-esteem. This makes youngsters go to any lengths to get what they want.”

Studies indicate that watching violent content reduces pro-social behaviour in children and young adults. Other situations such as stressful family, parents who fight constantly, and other such issues can make them more hostile and socially alienated.

Adding further, Dr Aggarwal, said, “While external cannot be curtailed entirely, what can be done is managing the situation at home. Parents need to serve as positive role models for children. Increasing number of nuclear families are reducing the interaction children have with their peers. Demanding jobs, the need to see their only child happy, and other factors make them fulfil all demands of their children. Vigilance is the key. Parents need to understand that their kids need their time. They should understand what is bothering their child. Ensuring these can help children grow into emotionally secure human beings.”

Here are some tips to prevent aggressive behavior in children.

  • Set limits and be firm and consistent about them.
  • Act when you notice the very first signs of aggressive behavior.
  • Encourage your child to express their feelings and talk about them.
  • Avoid encouraging aggression as a sign of toughness, especially in boys.
  • Control your own temper. And remember that hitting the child will only serve as a bad example.

Findings of DAWN trial may influence treatment of stroke

Health Care, Medicine Comments Off

Results of the DAWN trial published in the New England Journal of Medicine shows that clot removal up to 24 hours after stroke led to significantly reduced disability for properly selected patients. The international multi center DAWN trial randomized 206 patients of acute stroke who arrived at the hospital within six to 24 hours to either standard medical therapy alone or to endovascular clot removal therapy plus standard care. It is currently recommended that clot removal should be done only within 6 hours of stroke onset of stroke. Patients were selected for the trial based on brain imaging diffusion weighted MRI or perfusion CT to assess the extent of irreversible brain damage plus clinical criteria to help decide if thrombectomy would help the patient even if he she arrives after 6 hours but within 24 hours rather than just using the 6 hour window as the cut off. Almost 50 of patients with stroke due to occlusion of the intracranial internal carotid artery or proximal middle cerebral artery and who had a mismatch between the severity of the clinical deficit and the infarct volume who underwent clot removal reported significant decrease in disability at 90 days post treatment. On the other hand only 13.1 patients who received medical treatment showed such reduction in disability. Decrease in disability means more independence in activities of daily life. Mortality and other safety end points were similar between the two groups. Time is brain . The trial abides by this and re emphasizes the importance of reaching the hospital as early as possible after the onset of stroke. The findings of the trial though may influence management of some selected patients who present to the hospital late outside the 6 hour window period. Patients with a clinical deficit that is disproportionately severe relative to the infarct volume may benefit from late thrombectomy. The DAWN trial is published online November 11 2017 in the New England Journal of Medicine.