it's always been YOU....

My world stops turning since the day I met you
Your eyes, your lips, your smile, your laugh,
I keep on staring at your face
Because all I want to see is you.

Your scent is all over my place,
In the kitchen, sala, dining area, in my room
It stops my mind and calm my nerves
Because all I want to think is you.

My eyes are  fixed to no one but you,
My tears only falls to no one but you,
My heart gave in to no one but you,
Because all I want is to love you.

Every time I see you, I keep on asking,
"What beauty do you possess that no other ladies have?"
I looked into the mirror, smiled and answered myself,
"Because she's the only beauty that my heart see!"

All I thought everything is fine and happy,
All I thought I am close in saying I love you,
But I was hurt when you're with a guy,
Because you are blind not to feel my love for you.

My world stops turning when I lose you,
My heart stopped on beating and beating,
My tears started to fell on the ground,
Because all I wanted is you.

My mind sets to find another woman,
But every time I stare at them,
Your image keeps on flushing in my mind,
Because its always been you I love.

I've never experience so much pain,
But all the time I see you with him,
Staring at him like his the only guy exist,
Your smile doesn't leave your gorgeous lips.

Loving you is the most painful, but
It is the greatest thing that happened to me.
I was just an hopeless and unlucky guy,
Who chooses to love his one and only best friend!

CONDUCT DISORDER

CONDUCT DISORDER

          Conduct disorder is a persistent antisocial behavior of children and adolescents that significantly impairs their ability to function in the social, academic, or occupational areas. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. They display behavior that violates the basic rights of others or societal norms and rules.

            Conduct disorders are divided into three types which includes the following:

A.   Group Type

-          Is when conduct problems occur usually in the context of group activities with peers

B.    Solitary Aggressive Type

-          Is predominantly aggressive behavior towards peers and adults

C.  Undifferentiated Type

-          Is for children or adolescents who demonstrate mixed features of the conduct disorders

Persons with conduct disorders have little empathy for others; they have low self-esteem, poor frustration tolerance, and temper outbursts. Conduct disorder is often associated with early onset of sexual behavior, drinking, smoking, use of illegal substances, and other reckless or risky behaviors. These disorder occurs three times more often in boys than girls, and as many as 30% to 50% of these children are diagnosed with antisocial personality disorder as adults.

Diagnostic criteria for 312.8 Conduct Disorder

Conduct disorder is a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past 6 months: 

A.   Aggression to people and animals 

1.        often bullies, threatens, or intimidates others 

2.        often initiates physical fights 

3.        has used a weapon that can cause serious physical harm to others (e.g., abat, brick, broken bottle, knife, gun) 

4.        has been physically cruel to people 

5.        has been physically cruel to animals 

6.        has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery) 

7.        has forced someone into sexual activity 

B.     Destruction of property 

8.        has deliberately engaged in fire setting with the intention of causing serious damage 

9.        has deliberately destroyed others' property (other than by fire setting)

C.    Deceitfulness or theft

10.   has broken into someone else's house, building, or car 

11.   often lies to obtain goods or favors or to avoid obligations (i.e., "cons" others) 

12.   has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery) 

D.    Serious violations of rules 

13.   often stays out at night despite parental prohibitions, beginning before age 13 years 

14.   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) 

15.   is often truant from school, beginning before age 13 years 

ONSET AND CLINICAL COURSE

            Two subtypes of conduct disorder are based on age of onset.

A.   Childhood-Onset Type

It involves symptoms that occur before age 10 years, including physical aggression toward others and disturbed peer relationships. These children are more likely to have persistent conduct disorder and to develop antisocial personality disorder as adults.

B.    Adolescent-Onset Type

It is defined by the absence of any conduct disorder behaviors until after the age of 10 years. These adolescents are less likely to be aggressive, and they have more normal peer relationships. They are less likely to persistent conduct disorder or antisocial personality disorder as an adult (DSM-IV-TR, 2000). Persons with the adolescent-onset type and few or milder problems can achieve adequate social relationships and academic or occupational success as adults.

           

Conduct disorder clinical signs and symptoms can be classified according to degree of severity.

I.     According to severity (DSM-IV-TR, 2000)

a.   Mild

-          The person has a few conduct problems that cause relatively minor harm to others, such as lying, truancy, or staying out late without permission.

b.   Moderate

-          The number of conduct problems increases, as does the amount of harm to others, such as vandalism.

c.   Severe

-          Many conduct problems are present, and there is considerable harm to others, such as forced sex, cruelty to animals, used of a weapon, burglary, or robbery.

The course of conduct disorder is variable. Only about 40% of persons with conduct disorder go on to develop antisocial personality disorder, but even those who do not may lead troubled lives, difficulty with interpersonal relationships, unhealthy lifestyles, and an inability to support themselves (Steiner, 2000).

ETIOLOGY

            It is generally accepted that genetic vulnerability, environmental adversity, and factors such as poor coping interact to cause the disorder.

            Risk Factors includes

·         Poor parenting

·         Low academic achievement

·         Poor peer relationships

·         Low self-esteem

Protective Factors include

·         Resilience

·         Family support

·         Positive peer relationships

·         Good health

There is a genetic risk for conduct disorder, although no specific gene marker has been identified. The disorder is more common in children who have a sibling with conduct disorder or a parent with antisocial personality disorder, substance abuse, mood disorders, schizophrenia, or ADHD.

A lack of reactivity of the autonomic nervous system has been found in children with conduct disorder, similar to adults with antisocial personality disorder. This abnormality may cause more aggression in social relationships as a result of decrease in normal avoidance or social inhibitions.

Poor family functioning, marital discord, poor parenting and a family history of substance abuse and psychiatric problems are all associated with the development of conduct disorder. Child abuse is an especially significant risk factor. The specific parenting patterns that are considered ineffective are inconsistent responses by parents to the child’s demands, and giving in to demands as the child’s behavior escalates. Exposure to violence in the media and in the community is a contributing factor for the child who is at risk in other areas. Socioeconomic disadvantages such as inadequate housing, crowded conditions, and poverty also increase the likelihood of conduct disorder in the at-risk child.

Academic underachievement, learning disabilities, hyperactivity, and problems with attention span are all associated with conduct disorder. Children with conduct disorder have difficulty functioning in social situations. They lack the abilities to respond appropriately to others or to negotiate conflict, and they lose their ability to restrain themselves when emotionally stressed. They are often accepted only by persons who have similar problems.

TREATMENT

            A wide variety of treatments have been used for conduct disorder with only modest effectiveness. Early is more effective, and prevention is more effective than treatment. Dramatic interventions such as “boot camp” or incarceration have not proven effective and may even worsen the situation. Treatment must gear toward the client’s developmental age; no one type of treatment is suitable for all ages.

Preschool programs such as Head Start result lower rates of delinquent behavior and conduct disorder through use parental education about normal growth and development, stimulation for the child, and support of parents during crises.

School-age children with conduct disorder

-          The child, the family, and school environment are the focus of treatment.

-          Parenting education, social skills training to improve peer relationships, and attempts to improve academic performance and increase the child’s ability to comply with demands from authority figures are included.

-          Family Therapy is considered essential for children in this age group.

-          Behavioral Therapy and Psychotherapy are usually necessary to help the child appropriately express and control anger.

Adolescents

-          Individual Therapy is often used as a treatment for this age group because they rely less on their parents and move on peers.

-          Many clients in this age group have some involvement with the legal system as a result of criminal behavior, and they may have restrictions on their freedom as a result.

-          The most promising treatment approach includes keeping the client in his or her environment. Conflict resolution, anger management, and teaching of social skills are frequently included in the treatment plan.

Psychophamarcotherapy

·         Antipsychotic

-          If the client present a clear damage to others.

·         Lithium or other Mood Stabilizer

-          Carbamazepine (Tegretol) or Valproic Acid (Depakote)

-          May be given to clients with labile mood.

NURSING MANAGEMENT

            Providing interventions with a client diagnosed with conduct disorder can also be quite challenging. The following nursing interventions incorporate the suggestions of boys with the diagnosis of conduct disorder and living in reform school:

1.      Establish trust by being honest.

2.      Maintain control by setting limits for manipulative, acting-out behavior.

3.      Be consistent with limit-setting.

4.      Respect’s the client’s age and maintain and adult-child or adult-adult relationship, whichever is appropriate.

5.      Establish realistic observations. Discuss such expectations with the client and encourage verbalization of feelings.

Nursing interventions for client with conduct disorder mainly focuses on maintaining safety and helping the child or adolescent develop internal limits, problem-solving skills, and self-responsibility for acts of antisocial behavior, which may include violent physical harm, theft, fire setting, assault, and callous or manipulative behavior.

Young client with conduct disorder often have underlying medical problems; therefore nursing interventions may include treatment for a medical condition such as epilepsy or a closed head injury.

Merry Christmas!

December 25, a date that each and everyone of us gathers and celebrates the birth of the One and Only Savior, JESUS CHRIST!

Every time this day comes around the corner, all people get their feet on the ground and bounce to their homes to celebrate this one of the most unforgettable event in their lives. We, as Filipinos and even other races believes that this is a celebration of close family ties as well as a happy memory to children because Santa Claus is also coming to town! Every day counts before Christmas for the families to prepare and welcome the birth of Jesus Christ.

This day is a celebration of families all over the world. Another good thing to do is to help and make all the people jump in happiness most especially the kids because of the blessings that they receive. Helping the people who suffered from great devastation of human life such as calamities will complete their happiness during Christmas day. Sufferings may be a part of our lives and that's the reason why we, who were given so much blessings and doesn't face great heartache because of losing loved ones, will give them much greater happiness and joy and this will make them stronger and fight until to their last breath.

This is also a day of forgiveness. We sinned, we make mistakes towards other people. We commit great sin that hurts other person's feelings. Thus, this time, if not a wrong time, we forgive each other because this is how we welcome him, Jesus Christ. Welcoming him with no sin, no mistake, no guilt, no cries, no sorrow will totally make his Father great.

So to everyone who are reading my blog, think of this, we celebrate Christmas every year on the day of December 25 but we face it with great despair and sorrow, then what is the point of why we celebrate it? So we need to celebrate this special day with a smile, heartwarming joy and endless love for Jesus Christ to be happy because he knows that each and everyone of us, individuals, families and communities celebrate his special day with the greatest and biggest smile of all!

MERRY CHRISTMAS TO EVERYONE!