Paraphilias & Childhood Disorders

paraphilias

sexual arousal from fantasies, behaviors, or urges involving nonhuman objects, the suffering of self or others, and/or nonconsenting persons####exhibitionism

-worried about person being injured####sexual sadism

sexual arousal is associated with *inflicting* pain or humiliation####voyeurism

-peeping tom####-use nondirective approach for taking sexual history

-convey warmth, openness, honesty, and objectivity

-do not let personal feelings or thoughts interfere with acceptance of client

-remain nonjudgmental

-listen in matter-of-fact manner w/o overreactiing

What is our role in paraphilias?####oppositional defiance

-child does not view themselves as the problem

-typically begins around *8 yrs of age* but no later than adolescence

-precedes conduct disorder####-frequent temper tantrums & excessive arguing

-active defiance & refusal to comply w/ rules

-deliberate attempts to annoy and are easily annoyed by others

-blame other for mistakes & behaviors

-frequent anger & resentment and have mean, hateful talking when upset

-often seek revenge

What are s/s of oppositional defiance?####-provide structure

-establish reward/consequence system: get everyone involved to enforce this

-provide opportunities for success

-give feedback and on what are good and bad behaviors

-unconditionally accept child

-educate parents & child on stress management

How do we work with children with oppositional defiance?####conduct disorders

-physical aggression is common

-childhood onset: prior to age 10

-adolescent onset: absent before age 10####-physical aggression in violation of rights of others; have poor frustration tolerance

-manifests in all aspects of life

-stealing, lying, truancy; early tobacco, ETOH, or sex behaviors

-portray "tough guy" image

-low academic achievement and ADHD manifestations are very common

What are s/s of conduct disorder?####intellectual disability

-diagnosed w/ IQ testing & functioning skills####-sit up, crawl, and walk later than others

-learn to talk later and have trouble speaking

-difficulty remembering things

-don't understand how to pay for things and have trouble solving problems & thinking logically

-have trouble understanding social rules and seeing consequences of actions

What are s/s of intellectual disabilities?####*KEEP THEM SAFE*

-teach basic safety and create safe environment

-provide simple concrete examples

-encourage independence

-maintain consistency and learn/teach systemic habit training

-anticipate and fulfill client's needs

-establish appropriate behavior modification

What is our role as the nurse when caring for intellectually disabled?####