Trastornos de Conducta

TRASTORNOS DE
CONDUCTA
LESLY ROJAS MEZA, MR2 DE PSIQUIATRÍA DEL HRDT

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DEFINICIÓN
TRASTORNO OPOSICIONISTA
DESAFIANTE
El trastorno de oposición desafiante (TND) es un tipo de trastorno de

conducta disruptiva infantil que involucra principalmente problemas
con el autocontrol de las emociones y las conductas. Se caracteriza
por un patrón persistente de estado de ánimo enojado o irritable,
comportamiento discutidor o desafiante o venganza hacia los demás.
EPIDEMIOLOGÍA
 Prevalencia: 2 - 11 %.
 Aparece a partir de los 3 años, los síntomas permanecen
relativamente estables entre las edades de 5 y 10 años. Se
cree que disminuyen después.
 Es más común en varones que en mujeres: 1,4: 1, la
distribución por sexos se iguala en la adolescencia.
 Ocurre principalmente en los grupos socioeconómicos
bajos.
ETIOLOGÍA
• Heredabilidad: 50%
GENÉTICOS • Existe una superposición genética con el trastorno de conducta (EC).
corteza prefrontal, la
NEUROANATÓMICOS
amígdala y la ínsula
• Niveles bajos de cortisol y elevados

HORMONALES
de testosterona
• función alterada de neurotransmisores en los sistemas

NEUROTRASMISORES
serotoninérgico, noradrenérgico y dopaminérgico
• Apego inseguro: Ansioso – evitativo.
PSICOSOCIALES • Dinámica familiar: Estilos coercitivos, falta de supervisión o negligencia,
AMBIENTALES aplicación de medidas disciplinarias incoscistentes y el maltrato.
• Tabaquismo y desnutrición materna.
DIAGNÓSTICO
CRITERIOS DIAGNÓSTICOS DSM-5
ÁNIMO IRRITABLE O ENOJO
Your Picture Here 1. Perder la calma facilmente.
2. Molestarse con Facilidad.
3. Mostrarse enojad o resentido frecuentemente.
CONDUCTA ARGUMENTATIVA, DESAFIANTE O TERQUEDAD.
4. Discutir con figuras de autoridad
5. Desafiar activamente o rehusarse a seguir indicaciones
6. Molestar a otros deliberadamente
7. Culpar a otros de errores comentidos o del mal comportamiento
VENGANZA/HIRIENTE
8. Ser recoroso o vengativo por lo menos en 2 ocasiones durante los
últimos 6 meses.
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COMORBILIDADES
TRASTORNO DE DEFICIT DE
ATENCIÓN E HIPERACTIVIDAD
• Relación bidereccional
• 40% TDAH  TND
• 70 – 80% TND  TDAH
• Pronóstico desfavorable: Manifestación
de altos niveles de agresividad y pobre
desempeño académico.
TRASTORNO DE CONDUCTA
TRASTORNOS DE ANSIEDAD Y
DEPRESIVOS
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Trastornos de Conducta

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TRASTORNOS DE

LESLY ROJAS MEZA, MR2 DE PSIQUIATRÍA DEL HRDT

El trastorno de oposición desafiante (TND) es un tipo de trastorno de

• Niveles bajos de cortisol y elevados

• función alterada de neurotransmisores en los sistemas

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