Lesson 6: EMOTIONAL-BEHAVIORAL DISORDER

Individuals with Disability Education Act (IDEA) defines emotional disturbance as a condition
exhibiting one or more of the following characteristics over a long period of time and to a marked
degree that adversely affects a child’s educational performance:

a. an inability to learn that cannot be explained by intellectual, sensory, or health factors.

b. an inability to build or maintain satisfactory interpersonal relationships with peers and

teachers.

c. inappropriate types of behavior or feelings under normal circumstances.

d. a general pervasive mood of unhappiness or depression.

e. a tendency to develop physical symptoms or fears associated with personal or school

problems.

Most Common Specific Emotional Disturbances.

ANXIETY

Anxiety is a normal emotion. It’s your brain’s way of reacting to stress and alerting you of potential
danger ahead. Everyone feels anxious now and then. For example, you may worry when faced with a
problem at work, before taking a test, or before making an important decision. Occasional anxiety is
fine but anxiety disorders are different. They’re a group of mental illnesses that cause constant and
overwhelming anxiety and fear. The excessive anxiety can make you avoid work, school, family get-
togethers, and other social situations that might trigger or worsen your symptoms.

TYPES OF ANXIETY ORDERS

1. Generalized anxiety disorder. You feel excessive, unrealistic worry and tension with little or no
reason.
2. Panic disorder. You feel sudden, intense fear that brings on a panic attack. During a panic attack
you may break out in a sweat, have chest pain, and have a pounding heartbeat (palpitations).
Sometimes you may feel like you’re choking or having a heart attack.
3. Social anxiety disorder. Also called social phobia, this is when you feel overwhelming worry and
self-consciousness about everyday social situations. You obsessively worry about others judging
you or being embarrassed or ridiculed.
4. Specific phobias. You feel intense fear of a specific object or situation, such as heights or flying.
The fear goes beyond what’s appropriate and may cause you to avoid ordinary situations.
5. Agoraphobia. You have an intense fear of being in a place where it seems hard to escape or get
help if an emergency occurs. For example, you may panic or feel anxious when on an airplane,
public transportation, or standing in line with a crowd.
6. Separation anxiety. Little kids aren’t the only ones who feel scared or anxious when a loved one
leaves. Anyone can get separation anxiety disorder. If you do, you’ll feel very anxious or fearful
 when a person you’re close with leaves your sight. You’ll always worry that something bad may
happen to your loved one.
7. Selective mutism. This is a type of social anxiety in which young kids who talk normally with
their family don’t speak in public, like at school.
8. Medication-induced anxiety disorder. Use of certain medications or illegal drugs, or withdrawal
from certain drugs, can trigger some symptoms of anxiety disorder

Anxiety Disorder Symptoms

The main symptom of anxiety disorders is excessive fear or worry. Anxiety disorders can also make it
hard to breathe, sleep, stay still, and concentrate. Your specific symptoms depend on the type of anxiety
disorder you have.
Common symptoms are: Panic, fear, and uneasiness
 Feelings of panic, doom, or danger
 Sleep problems
 Not being able to stay calm and still
 Cold, sweaty, numb, or tingling hands or feet
 Shortness of breath
 Breathing faster and more quickly than normal (hyperventilation)
 Heart palpitations
 Dry mouth
 Nausea
 Tense muscles
 Dizziness
 Thinking about a problem over and over again and unable to stop (rumination)
 Inability to concentrate
 Intensely or obsessively avoiding feared objects or places

BIPOLAR

Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme
mood swings that include emotional highs (mania or hypomania) and lows (depression). When you
become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When
your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of
energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior
and the ability to think clearly.

Types and Symptoms

There are several types of bipolar and related disorders. They may include mania or hypomania and
depression. Symptoms can cause unpredictable changes in mood and behavior, resulting in significant
distress and difficulty in life.

Bipolar I disorder. You've had at least one manic episode that may be preceded or followed by
hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality
(psychosis).
Bipolar II disorder. You've had at least one major depressive episode and at least one hypomanic
episode, but you've never had a manic episode.

Cyclothymic disorder. You've had at least two years — or one year in children and teenagers — of many
periods of hypomania symptoms and periods of depressive symptoms (though less severe than major
depression).

Other types. These include, for example, bipolar and related disorders induced by certain drugs or
alcohol or due to a medical condition, such as Cushing's disease, multiple sclerosis or stroke.

CONDUCT DISORDER

Conduct disorder is a serious behavioral and emotional disorder that can occur in children and teens. A
child with this disorder may display a pattern of disruptive and violent behavior and have problems
following rules.

It is common for children and teens to have behavior-related problems at some time during their
development. However, the behavior is considered to be a conduct disorder when it is long-lasting and
when it violates the rights of others, goes against accepted norms of behavior and disrupts the child's
or family's everyday life.

Symptoms of Conduct Disorder

Symptoms of conduct disorder vary depending on the age of the child and whether the disorder is mild,
moderate, or severe. In general, symptoms of conduct disorder fall into four general categories:

Aggressive behavior: These are behaviors that threaten or cause physical harm and may include
fighting, bullying, being cruel to others or animals, using weapons, and forcing another into sexual
activity.

Destructive behavior: This involves intentional destruction of property such as arson (deliberate fire-
setting) and vandalism (harming another person's property).

Deceitful behavior: This may include repeated lying, shoplifting, or breaking into homes or cars in order
to steal.

Violation of rules: This involves going against accepted rules of society or engaging in behavior that is
not appropriate for the person's age. These behaviors may include running away, skipping school,
playing pranks, or being sexually active at a very young age.

In addition, many children with conduct disorder are irritable, have low self-esteem, and tend to
throw frequent temper tantrums. Some may abuse drugs and alcohol. Children with conduct disorder
 often are unable to appreciate how their behavior can hurt others and generally have little guilt or
remorse about hurting others.

EATING DISORDERS

Eating disorders are serious conditions related to persistent eating behaviors that negatively impact
your health, your emotions and your ability to function in important areas of life. The most common
eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.

Most eating disorders involve focusing too much on your weight, body shape and food, leading to
dangerous eating behaviors. These behaviors can significantly impact your body's ability to get
appropriate nutrition. Eating disorders can harm the heart, digestive system, bones, and teeth and
mouth, and lead to other diseases.

Types of Eating Disorders

1. Anorexia (an-o-REK-see-uh) nervosa — often simply called anorexia — is a potentially life-threatening

eating disorder characterized by an abnormally low body weight, intense fear of gaining weight, and
a distorted perception of weight or shape. People with anorexia use extreme efforts to control their
weight and shape, which often significantly interferes with their health and life activities. When you
have anorexia, you excessively limit calories or use other methods to lose weight, such as excessive
exercise, using laxatives or diet aids, or vomiting after eating. Efforts to reduce your weight, even
when underweight, can cause severe health problems, sometimes to the point of deadly self-
starvation.
2. Bulimia (boo-LEE-me-uh) nervosa — commonly called bulimia — is a serious, potentially life-
threatening eating disorder. When you have bulimia, you have episodes of bingeing and purging that
involve feeling a lack of control over your eating. Many people with bulimia also restrict their eating
during the day, which often leads to more binge eating and purging. During these episodes, you
typically eat a large amount of food in a short time, and then try to rid yourself of the extra calories in
an unhealthy way. Because of guilt, shame and an intense fear of weight gain from overeating, you
may force vomiting or you may exercise too much or use other methods, such as laxatives, to get rid of
the calories.
3. Binge-eating disorder - When you have binge-eating disorder, you regularly eat too much food (binge)
and feel a lack of control over your eating. You may eat quickly or eat more food than intended, even
when you're not hungry, and you may continue eating even long after you're uncomfortably full.
After a binge, you may feel guilty, disgusted or ashamed by your behavior and the amount of food
eaten. But you don't try to compensate for this behavior with excessive exercise or purging, as
someone with bulimia or anorexia might. Embarrassment can lead to eating alone to hide your
bingeing.
Red Flags of Eating Disorders

· Skipping meals or making excuses for not eating

· Adopting an overly restrictive vegetarian diet

· Excessive focus on healthy eating

· Making own meals rather than eating what the family eats

· Withdrawing from normal social activities

· Persistent worry or complaining about being fat and talk of losing weight

· Frequent checking in the mirror for perceived flaws

· Repeatedly eating large amounts of sweets or high-fat foods

· Use of dietary supplements, laxatives or herbal products for weight loss

· Excessive exercise

· Calluses on the knuckles from inducing vomiting

· Problems with loss of tooth enamel that may be a sign of repeated vomiting

· Leaving during meals to use the toilet

· Eating much more food in a meal or snack than is considered normal

· Expressing depression, disgust, shame or guilt about eating habits

· Eating in secret

OBSESSIVE-COMPULSIVE DISORDER

Obsessive-compulsive disorder (OCD) features a pattern of unwanted thoughts and fears (obsessions)
that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere
with daily activities and cause significant distress. You may try to ignore or stop your obsessions, but
that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to
try to ease your stress. Despite efforts to ignore or get rid of bothersome thoughts or urges, they keep
coming back. This leads to more ritualistic behavior — the vicious cycle of OCD.

Symptoms

Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it's also possible
to have only obsession symptoms or only compulsion symptoms. You may or may not realize that your
obsessions and compulsions are excessive or unreasonable, but they take up a great deal of time and
interfere with your daily routine and social, school or work functioning.

1.Obsessive symptoms

OCD obsessions are repeated, persistent and unwanted thoughts, urges or images that are intrusive and
cause distress or anxiety. You might try to ignore them or get rid of them by performing a compulsive
behavior or ritual. These obsessions typically intrude when you're trying to think of or do other things.

Obsessions often have themes to them, such as:

· Fear of contamination or dirt

· Doubting and having difficulty tolerating uncertainty

· Needing things orderly and symmetrical

· Aggressive or horrific thoughts about losing control and harming yourself or others

· Unwanted thoughts, including aggression, or sexual or religious subjects

2.Compulsion symptoms

OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors
or mental acts are meant to reduce anxiety related to your obsessions or prevent something bad from
happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary
relief from anxiety. You may make up rules or rituals to follow that help control your anxiety when
you're having obsessive thoughts. These compulsions are excessive and often are not realistically related
to the problem they're intended to fix.

Examples of compulsion signs and symptoms include:

· Hand-washing until your skin becomes raw

· Checking doors repeatedly to make sure they're locked

· Checking the stove repeatedly to make sure it's off

· Counting in certain patterns

· Silently repeating a prayer, word or phrase

· Arranging your canned goods to face the same way

 SCHIZOPHRENIA

Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia
may result in some combination of hallucinations, delusions, and extremely disordered thinking and
behavior that impairs daily functioning, and can be disabling.

Symptoms

1. Delusions. These are false beliefs that are not based in reality. For example, you think that you're
being harmed or harassed; certain gestures or comments are directed at you; you have exceptional
ability or fame; another person is in love with you; or a major catastrophe is about to occur. Delusions
occur in most people with schizophrenia.
2. Hallucinations. These usually involve seeing or hearing things that don't exist. Yet for the person with
schizophrenia, they have the full force and impact of a normal experience. Hallucinations can be in any
of the senses, but hearing voices is the most common hallucination.
3. Disorganized thinking (speech). Disorganized thinking is inferred from disorganized speech. Effective
communication can be impaired, and answers to questions may be partially or completely unrelated.
Rarely, speech may include putting together meaningless words that can't be understood, sometimes
known as word salad.
4. Extremely disorganized or abnormal motor behavior. This may show in a number of ways, from
childlike silliness to unpredictable agitation. Behavior isn't focused on a goal, so it's hard to do tasks.
Behavior can include resistance to instructions, inappropriate or bizarre posture, a complete lack of
response, or useless and excessive movement.
5. Negative symptoms. This refers to reduced or lack of ability to function normally. For example, the
person may neglect personal hygiene or appear to lack emotion (doesn't make eye contact, doesn't
change facial expressions or speaks in a monotone). Also, the person may lose interest in everyday
activities, socially withdraw or lack the ability to experience pleasure.

Complications

Left untreated, schizophrenia can result in severe problems that affect every area of life. Complications
that schizophrenia may cause or be associated with include:

· Suicide, suicide attempts and thoughts of suicide · Anxiety disorders and obsessive-compulsive disorder (OCD)

· Depression · Abuse of alcohol or other drugs, including nicotine

· Inability to work or attend school · Financial problems and homelessness

· Social isolation

· Health and medical problems

· Being victimized

· Aggressive behavior, although it's uncommon