Providing diagnostic services
Within this project We are interested in recruiting children and teenagers across the spectrum of disruptive behaviour – from children who almost never get in trouble in school or at home, to those who have been excluded from school or college or may have been in contact with the youth justice system for breaking the law.
Adolescents with severe aggression and antisocial behavior problems are oftentimes not adequately diagnosed. In order to comprehensively assess underlying causes and mechanisms of aggressive behavior as well as comorbid symptoms (anxiety, depression, substance abuse) improved access to child and adolescent psychiatry services is recommended. In order to prevent high risk children and adolescents from developing a chronic disease with subsequent impairment of their psychosocial functioning (e.g. school failure, unemployment, or a criminal career) access to a diagnostic assessment as early as possible is one of the most important recommendations.
Children and adolescents showing severe aggressive and antisocial behaviour symptoms (see symptom list below) should be referred from professional institutions (e. g. Child Protective Services, Juvenile Court, Youth Welfare Systems, Schools, etc.) to Child and Adolescent Psychiatric Departments for a comprehensive clinical examination. Meeting with a health care professional ensures to adequately asses mental and physical health, individual and familial risk factors and everyday life problems, to find out what the problem is, how severe it is and the most suitable treatments.
A referral is recommended if at least three of the below mentioned criteria are fulfilled (longer than 6 months) and the disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning:
- Often bullies, threatens, or intimidates others
- Often initiates physical fights
- Has used a weapon that can cause serious physical harm to others (e.g., abat, brick, broken bottle, knife, gun)
- Has been physically cruel to people
- Has been physically cruel to animals
- Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery)
- Has forced someone into sexual activity
- Has deliberately engaged in fire setting with the intention of causing serious damage
- Has deliberately destroyed others' property (other than by fire setting)
- Has broken into someone else's house, building, or car
- Often lies to obtain goods or favors or to avoid obligations (i.e., "cons" others)
- Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery)
- Often stays out at night despite parental prohibitions, beginning before age 13 years
- Has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period)
- Is often truant from school, beginning before age 13 years
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References
Conduct disorders in children and young people: NICE guideline.
http://www.nice.org.uk/guidance/cg158
