- 1 What is the Challenging Negativist Disorder
- 2 Beginning and Course of Challenging Negativist Disorder
- 3 Family Pattern Challenging Negativist Disorder
- 4 Differential Diagnosis Challenging Negativist Disorder
- 5 Treatment Challenging Negativist Disorder
What is the Challenging Negativist Disorder
It is a pattern of recurring and persistent behavior in which the orders of authority figures are challenged, checking again and again the established limits, ignoring orders, arguing, showing hostility towards peers or adults and deliberately bothering them or verbally assaulting them. It manifests itself invariably in the family context, being able to manifest itself or not, in other contexts such as school. It is shown with more evidence with well-known adults or partners.
In the school years there may be low self-esteem, emotional lability, poor tolerance to frustration, use of swear words, early use of alcohol, tobacco and illegal substances. Conflicts with parents, teachers and peers are frequent. Attention Deficit Hyperactivity Disorder is common. Learning disorders and communication disorders may also appear.
Between 2% and 16% according to the population studied and the evaluation methods. It is more common in men than in women until puberty but rates seem to equalize later.
Start and Course of Challenging Negativist Disorder
It manifests before 8 years usually and no later than the beginning of adolescence. Symptoms remain months or years and many of the cases are a history of Disocial Disorder.
Family Pattern Challenging Negativist Disorder
It is more frequent in families where at least 1 of the parents has suffered: mood disorders, Challenging Negativist Disorder, Disocial Disorder, Attention Deficit Hyperactivity Disorder, Antisocial Personality Disorder or Substance Use Disorder. Also in families where there are serious marital problems.
Differential Diagnosis Challenging Negativist Disorder
It is distinguished from Disocial Disorder by the severity of symptoms and is not diagnosed if it exists. It is usually associated with mood disorders and psychotic disorders of children and adolescents, so it is not diagnosed if it is done with them. It differs from the Attention Deficit Hyperactivity Disorder due to the lack of intentionality in not following orders and in that the challenge is not so frequent, although a double diagnosis of both disorders can be established. A careful observation allows not to confuse the syndrome with the Language Comprehension Disorder and the negativism or rebellion of some evolutionary stages.
Treatment Challenging Negativist Disorder
Structure and duration of treatment
The treatment is carried out over 20 sessions, over a period; Approximately 5 to 6 months. Each session lasts approximately 40 to 50 minutes and one session is held every week.
Components and characteristics of the treatment
- The therapist assumes the role of coach in the treatment, his role is active: and manager, he will tell stories planned in advance about his personal life to illustrate examples.
- Parents play a critical role in treatment, they come to learn exactly what the child is being taught. The therapist helps and models the parents in what and how to praise the child. Parents should serve as therapists in situations outside of sessions.
- The main components of the treatment are the following: Training in solving problems through self-instructions. Gradual approximation of the types of problems used, from neutral problems, to real problems in the child's life. Modeled by the therapist, problem solving. Contingencies of social reinforcement. Cost of response Feedback and labeling of errors (at the beginning of the treatment, the therapist offers information on the execution using the specific labeling, and subsequently uses the conceptual labeling). Self appraisal. Rewards Menu Representation of scenes (role-play) from session 7. Fade in three levels, from session 7. Live procedures.
- Establishment of rapport with the child. Explanation of the troubleshooting steps, program procedures, system and use of the tabs and rewards menu, response cost, and self-assessment.
- Teaching the steps of troubleshooting, and how self-instructions help not to act impulsively.
- The objectives of this session are to teach the child to follow instructions, and continue helping him to use the troubleshooting steps.
- "Connect 4" is used to teach the child how to apply what has been learned to a game situation, and to facilitate the therapist asking the child about his interpersonal problems, while suggesting how the steps could be used to solve the problem. .
- The application of the problem solution steps to the interpersonal problems of the child begins.
- Problematic interpersonal situations of a hypothetical nature are considered as a means to consider different solutions, and the consequences of each of them for the child and for others.
- Through the representation of scenes the lessons learned are applied to the solution of interpersonal problems. Each session focuses on a different category of social interaction.
- Reversal of papers, to estimate what was learned in the treatment Clarification of doubts. Final summary of what was discussed.
It is a pattern of recurring and persistent behavior in which the orders of the authority figures are challenged, checking again and again the established limits, ignoring orders, arguing, showing hostility towards peers or adults and deliberately bothering them or verbally assaulting them. It manifests itself invariably in the family context, being able to manifest itself or not, in other contexts such as school. It is shown with more evidence with well-known adults or partners.