EMOTIONAL BEHAVIOR DISORDERS AUGUSTA PAYEUR ERIN BRADFORD BEHAVIORAL

EMOTIONAL & BEHAVIOR DISORDERS AUGUSTA PAYEUR ERIN BRADFORD

BEHAVIORAL DISORDER • Also known as disruptive behavioral disorders • Are the most common reasons that parents are told to take their kids for mental health assessments and treatment

WHAT IS AN EMOTIONAL & BEHAVIORAL DISORDER? • An emotional and behavioral disorder is an emotional disability is: • An inability to build/maintain interpersonal relationships with others • An inability to learn which cannot be adequately explained by intellectual, sensory or health factors • Consistent or chronic inappropriate type of behavior or feelings under normal conditions • Displayed pervasive mood of unhappiness or depression • Displayed tendency to develop physical symptoms, pains or unreasonable fears associated with personal or school problems

CHARACTERISTICS • Hyperactivity • short attention span • impulsiveness • Aggression or self injurious behavior • acting out fighting • Withdrawal • not interacting socially with others • excessive fear or anxiety • Immaturity • inappropriate crying • temper tantrums • poor coping skills • Learning difficulties • academically performing below grade level

CAUSES Biological, family and school related factors are some causes of behavioral disorders Some biological causes may include: • Physical illness or disability • Malnutrition • Brain damage • Hereditary factors Other factors related to an individual’s home life may contribute to behaviors associated with a behavioral disorder: • Divorce or other emotional upset at home • Coercion from parents • Unhealthy or inconsistent discipline style • Poor attitude toward education or schooling

EMOTIONAL SYMPTOMS OF BEHAVIORAL DISORDERS • Some of the emotional symptoms of behavioral disorders include: • Easily getting annoyed or nervous • Often appearing angry • Putting blame on others • Refusing to follow rules or questioning authority • Arguing and throwing temper tantrums • Having difficulty in handling frustration

PHYSICAL SYMPTOMS OF BEHAVIORAL DISORDERS Behavioral disorder will have mostly emotional symptoms. However there are some physical symptoms such as a fever, rash, or headache being absent.

WHAT ARE SOME TYPES OF BEHAVIORAL DISORDERS? • Anxiety disorders • Bipolar disorder • Dissociative disorders • Obsessive Compulsive disorder • Bi polar Disorder • Attention Deficit Hyperactivity Disorder (ADHD) • Eating disorders • Autism

ANXIETY DISORDER • Often cause children to feel distressed, uneasy, even frightened for no apparent reason. • Some common anxiety disorders are panic disorders characterized by episodes of intense fear that occur without warning or provocation.

EXAMPLES OF ANXIETY DISORDERS • Post traumatic stress disorder • A disorder that develops in some people who have experienced a shocking, scary, or dangerous event. • Obsessive compulsive disorder • Are compulsive, repeated behaviors or thoughts that seem like they are impossible to stop. • Generalized anxiety disorder • A persistent and excessive worry about a number of different things • Panic disorder • Recurring panic attacks, causing a series of intense episodes of extreme anxiety

BI-POLAR DISORDER • Also known as manic depressive illness is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day to day tasks. • There are four types of bipolar disorder; they all involve clear changes in mood, energy, and activity levels. • These moods range from periods of extremely elevated, and energized behavior known as manic episodes to very sad, or hopeless periods known as depressive episodes. • The less severe manic periods are known as hypomanic episodes.

THE FOUR TYPES OF BIPOLAR • Bipolar I Disorder • Defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features such as having depression and manic symptoms at the same time are also possible. • Bipolar II Disorder • Defined by a pattern of depressive episodes and hypomanic episodes, but not the full blown manic episodes described above.

THE FOUR TYPES OF BIPOLAR • Cyclothymic Disorder also called cyclothymia • Defined by numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least 2 years in adults and 1 year in children and adolescents. However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode. • Other Specified and Unspecified Bipolar and Related Disorders • defined by bipolar disorder symptoms that do not match the three categories listed above.

MANIC EPISODE VS DEPRESSIVE EPISODE • • • Feel very “up, ” “high, ” or elated Have a lot of energy Have increased activity levels Feel “jumpy” or “wired” Have trouble sleeping Become more active than usual Talk really fast about a lot of different things Be agitated, irritable, or “touchy” Feel like their thoughts are going very fast Think they can do a lot of things at once Do risky things, like spend a lot of money or have reckless sex • Feel very sad, down, empty, or hopeless • Have very little energy • Have decreased activity levels • Have trouble sleeping, they may sleep too little or too much • Feel like they can’t enjoy anything • Feel worried and empty • Have trouble concentrating • Forget things a lot • Eat too much or too little • Feel tired or “slowed down” • Think about death or suicide

EATING DISORDERS • Any of a range of psychological disorders characterized by abnormal or disturbed eating habits. Obsessions with food, body weight, and shape may also signal an eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder.

ANOREXIA NERVOSA • A psychological and possibly life threatening eating disorder defined by an extremely low body weight relative to stature, extreme and needless weight loss, illogical fear of weight gain, and distorted perception of self image and body.

BULIMIA NERVOSA • An emotional disorder involving distortion of body image and an obsessive desire to lose weight, in which bouts of extreme overeating are followed by depression and self induced vomiting, purging, or fasting.

BINGE EATING DISORDER • An eating disorder characterized by recurrent episodes of eating large quantities of food often very quickly and to the point of discomfort; a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and not regularly using unhealthy compensatory measures to counter the binge eating. • Binge eating disorder is a severe, life threatening and treatable eating disorder.

OBSESSIVE-COMPULSIVE DISORDER OCD • Is a common, chronic and long lasting disorder in which a person has uncontrollable, reoccurring thoughts, obsessions, and behaviors, compulsions, that he or she feels the urge to repeat over and over. • Approximately 1 to 3 percent of individuals will experience some form of OCD during their lives.

OBSESSIVECOMPULSIVE DISORDER • Obsessions are repeated thoughts, urges, or mental images that cause anxiety. • Fear of germs or contamination • Unwanted forbidden or taboo thoughts involving sex, religion, and harm • Aggressive thoughts towards others or self • Having things symmetrical or in a perfect order • Compulsions are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought. • Excessive cleaning and/or handwashing • Ordering and arranging things in a particular, precise way • Repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off • Compulsive counting

ATTENTION-DEFICIT HYPERACTIVITY DISORDER ADHD • Is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity impulsivity that interferes with functioning or development • Affects between 3 and 7 percent of the population; it causes considerable difficulty in paying attention and can lead to discipline problems at work or school

KEY BEHAVIORS OF ADHD • Inattention • A person wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; and these problems are not due to defiance or lack of comprehension. • Hyperactivity • A person seems to move about constantly, including in situations in which it is not appropriate; or excessively fidgets, taps, or talks. In adults, it may be extreme restlessness or wearing others out with constant activity. • Impulsivity • A person makes hasty actions that occur in the moment without first thinking about them and that may have high potential for harm; or a desire for immediate rewards or inability to delay gratification. An impulsive person may be socially intrusive and excessively interrupt others or make important decisions without considering the long term consequences.

AUTISM • Autism spectrum disorder (ASD) refers to a group of complex neurodevelopment disorders characterized by repetitive and characteristic patterns of behavior and difficulties with social communication and interaction. The symptoms are present from early childhood and affect daily functioning. • Typically interferes with social and occupational function by making it difficult for afflicted individuals to form relationships with other human beings. Twin studies suggest that a genetic influence is at work in causing the condition.

THERAPIES FOR BEHAVIORAL DISORDERS • In the absence of a for sure cure for these complex issues, treatment will be confined to management of the more disruptive symptoms they manifest. Fortunately, there now exist many therapies for behavioral disorders that seem to be delivering results researchers and mental health practitioners could only have dreamed of just 30 or 40 years ago.

COGNITIVE BEHAVIORAL THERAPY TREATMENT • Formerly known as talk therapy, cognitive behavioral therapy treatment (CBT) is by far the most commonly used mechanism for managing the symptoms of behavioral disorders. • CBT is usually administered in hour long sessions by a single therapist who will engage the patient on a deep level. • The therapy places its focus on helping the patient to overcome the effects of negative thoughts and feelings through a heightened awareness of internal states and a more thorough understanding of the relevant issues. • Patients are taught strategies for learning how to cope with destructive impulses and actions, as well as mechanisms for coping with the social and emotional baggage that comes with being so afflicted. • The sessions are generally limited in scope and duration, as they are intended to be a short term intervention that’s included in a larger spectrum of other treatments.

OTHERAPEUTIC TREATMENTS • Otherapeutic methods will typically be incorporated into a comprehensive plan for treatment of behavior issues. • In addition to CBT, traditional psychotherapy may be attempted. • Also popular for the treatment of behavioral disorders, especially addiction, is one or another variant of group therapy, in which two or more patients interact with one or more therapists and each other. • One of the benefits of this approach is that it reduces the feeling that they are completely alone in the world. • Another benefit is to encourage patients to come out of their shells and begin to form relationships with other patients with whom they can usually empathize. • This will be seen as an especially desirable outcome for the treatment of autistic spectrum disorder.

RESIDENTIAL INPATIENT BEHAVIOR DISORDER TREATMENT CENTERS • The residential inpatient behavior disorder treatment centers can be a difficult and time consuming business. • In any reasonably populous area, you can expect to find a plethora of residential care centers offering services to people with behavior issues. • Many of these are able to offer the kind of care that individuals with behavior issues need to manage, if not partially recover from, the effects that the disorder has had on their lives. • The typical residential care facility will take in a patient who has been referred by a physician or therapist for some set period of time such as 30, 60 or 90 days and begin an intensive regimen of inpatient care in the safe, controlled environment of the center.

THE BENEFITS OF RESIDENTIAL BEHAVIORAL TREATMENT • Among the benefits of residential behavioral treatment in an inpatient facility or other clinical setting is the ability to manage serious disturbances in peace, without extraneous influences and under almost totally controlled conditions. • The individuals who seek treatment in a residential care program may be assured that while they are at the most vulnerable stage of their recovery, they will be fully taken care of by a staff of dedicated professionals. • Meals, medications and therapy sessions, as well as any unrelated medical issues, will be wholly looked after in such a place, minimizing the risk that a serious behavior problem will lead to harm for the patient or those around them

LUXURY BEHAVIORAL DISORDER FACILITIES • For patients who would benefit from getting away from a largely sterile clinical treatment environment, an entire class of treatment centers exists to render care in a setting that seems closer to that of a spa or resort than a medical center. • These luxury behavioral disorder facilities are generally privately owned and operated, though they will typically hold some form of accreditation and submit to state inspections. • For many patients, they present a viable alternative to the sometimes upsetting environment of a more traditional facility, while at the same time maintaining a constant level of care to rival other modes of inpatient care.

EXECUTIVE BEHAVIORAL DISORDER PROGRAMS • Executive behavioral disorder programs are of a different kind. • These programs are intended to efficiently treat those patients who are likely to suffer more from a protracted stay in an inpatient clinic than they would from a short stay, followed by a rapid return to their home, job and family.

OUTPATIENT BEHAVIORAL REHAB AND TREATMENT PROGRAMS • For those who cannot or do not wish to reside even temporarily at an inpatient treatment center, outpatient behavioral rehab and treatment programs present a viable hands off approach to care. • Such facilities come in a wide variety of configurations and might be as simple as a neighborhood clinic that will dispense medication and assist the patient in taking it to a full scale adult daycare center that differs from inpatient care only in sleeping arrangements. •

BEHAVIOR THERAPY FOR CHILDREN • Cognitive therapy involves minimizing anxiety, learning alternative ideas and learning that feelings and moods alter behavior. • It helps the child to identify their inner thoughts and replace bad thoughts with positive productive thoughts. • Applied behavior analysis analyzes behavior and teaches the child different ways to respond to situations in a positive way. • It also rewards positive behavior and punishes negative behavior.

BEHAVIOR THERAPY FOR CHILDREN • Play therapy is exactly that for younger children it allows them to act out their issues through role playing or they can interact with common issues dolls and sensory objects. • Children with behavioral issues need to have some type of therapy that allows them to express themselves without consequences and then slowly build up their level of trust with the counselor. • Once this is done the child can begin to learn the reasons for their behavior and what the trigger points are and how to deal with those issues once they arise.

HISTORY • These next couple slide are how behavioral and emotional health issues where looked in the past. They were considered mental illnesses.

CAUSES OF MENTAL ILLNESSES • There have been three general theories of the etiology, or causes, of mental illness: supernatural, somatogenic, and psychogenic.

SUPERNATURAL CAUSES • Supernatural theories say that you develop a mental illness by demonic possession. • Another way you can develop mental illnesses is by displeasing the Gods, and paying for your sins. • The eclipses of the moon or the gravitation of the planet were other ways you could acquire a mental illness.

SOMATOGENIC THEORIES: • Somatogenic, or physical, theories were when you had a genetic imbalance that has been passed down to you, or you have had a brain injury resulting in brain damage.

PSYCHOGENIC THEORIES: • Psychogenic, or mental, theories are decided by the amount or severity of a traumatic experience in your life. • It can also be defined by he amount of adaptation to your surroundings you are able to accomplish.

TREPHINATION: • This method was one of the earliest to be used to cure mental illnesses. It was the process of drilling or scrapping a hole into the patients heads in order to… • A. ) released trapped spirits • B. ) cure epilepsy • C. ) cure mental illnesses in general. • Depending on the illness, occasionally this treatment would work, because they would get lucky enough to drill in the area of the brain of which causes the mental illness to be prevalent.

INSANE ASYLUMS: MEDIEVAL ERA • Before they were called Insane Asylums, they were called Lunatic Asylums. • In 872 Ahmad ibn Tulun built a hospital in Cairo that provided care to the insane, which included music therapy. • In Europe, people were held in a variety of different places. Roy Porter says that some of the insane were looked after in monasteries. Roy Porter was a historian who focused in on the history of Medicine.

ASYLUMS: • In the beginning of the 16 th century, asylums, or hospitals, were places where criminals, homeless, and the mentally ill were housed. • The living quarters were usually filthy, and the inmates were typically chained to the walls. • The public used to be able to pay a small fee to come in and see the inmates, as if it were a zoo and they were the animals in their cages.

IMPORTANT PEOPLE: • One important person who changed the way that an asylum was run was an Italian physician named Vincenzo Chiarughi in 1785. He removed the chains of his patients and encouraged good hygiene and occupational training. • The other was a more well known French physician Philippe Pinel and former patient Jean Paptise Pussin. They also decided in 1793 and 1795 that they were going to unshackle their patients and encourage hygiene and allow them to move freely around the grounds.

PUBLIC LUNATIC ASYLUMS • Colonial Williamsburg was the first public Lunatic Asylum, and the first patient was admitted on October 12 th, 1773.

REFERENCES • Kidsmentalhealth. Org • Nimh. nih. gov • Psychguides. com • Georgiadepartmentofeducation. org • Wikiapedia. com