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NVR & Conduct Disorder

NVR & Conduct Disorder

Diane Purper-Ouakil, professor of child and adolescent psychiatry at the university hospital of Montpellier, France, and Nathalie Franc, child and adolescent psychiatrist at the Unit of Child and Adolescnt Psychiatry- Saint Eloi Hospital (MPEA1), present their NVR work with families of "Tyranical Children" - In our clinical practice we sometimes meet families in which the child has taken over the power and controls his parents, creating a reversed family hierarchy. This situation is generally installed progressively with a child manifesting increasing disruptive behavior in the family context, such as verbal and physical aggressivity, threatening behavior and rages. Contrary to children and adolescents with typical conduct disorder, this severe externalized behavior is not present in contexts outside the family. However, these youngsters often show co-occurrent psychiatric disorders such as anxiety disorders and attention deficit/hyperactivity disorder. The family dynamics is generally characterized by an extreme accomodation of parents and an overcautious educative style. We also find an overrepresentation of somatic diseases in the child or parents weakened by age or handicap. These children typically resist change and engagement in classical therapeutic management. We have adapted a NVR-based group format for these parents with severely tyrannic children. This program consists of 13 thematic sessions of 90 minutes each. The present talk will outline clinical characterisics of children and adolescents with conduct disorder confined to family context, the different topics covered by the program and describe results of our pilot study showing improvements in parental self-efficacy and parental attitudes.

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