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National Institute of Mental Health (NIMH)

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Does your child go through extreme changes in mood and behavior? Does your child get much more excited or much more irritable than other kids? Do you notice that your child goes through cycles of extreme highs and lows in mood and energy levels more often than other children? Do these mood changes affect how your child acts at school or home?

Some children and teens with these symptoms may have bipolar disorder, a mental illness that causes unusual shifts in mood, energy, activity levels, and day-to-day functioning. With treatment, children and teens with bipolar disorder can improve over time.

What is bipolar disorder?

Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental illness that causes people to experience noticeable, sometimes extreme, changes in mood and behavior. It is a common misperception that children cannot have bipolar disorder. Although most people are diagnosed with bipolar disorder in adolescence or adulthood, the symptoms can appear earlier in childhood.

Bipolar disorder is not the same as the typical ups and downs every child goes through. The mood changes in bipolar disorder are more extreme, often unprovoked, and accompanied by changes in sleep, energy level, and the ability to think clearly.

Children with bipolar disorder sometimes feel very happy or "up" and are much more energetic and active than usual. This is called a manic episode. Children with bipolar disorder sometimes feel very sad or "down" and are much less active than usual. This is called a depressive episode. Bipolar disorder is often episodic, but it usually lasts a lifetime.

Bipolar disorder symptoms can make it hard to perform well in school or get along with friends and family members. Some children and teens with bipolar disorder may try to hurt themselves or attempt suicide. Early diagnosis and treatment can lead to better functioning and well-being over the long term.

Signs and symptoms of bipolar disorder may overlap with symptoms of other disorders that are common in young people, such as attention-deficit/hyperactivity disorder (ADHD), conduct problems, major depression, and anxiety disorders.

Diagnosing bipolar disorder can be complicated and requires a careful and thorough evaluation by a trained, experienced mental health professional.

With treatment, children and teens with bipolar disorder can manage their symptoms and lead full, active lives.

What causes bipolar disorder?

The exact causes of bipolar disorder are unknown, but several factors may contribute to the illness.

For example, researchers are beginning to uncover genetic factors linked to bipolar disorder and other mental illnesses. Research shows that a person's chances of having bipolar disorder are higher if they have a close family member with the illness, which may be because they have the same genetic variations. However, just because one family member has bipolar disorder does not mean other family members will have it. Many genes are involved in the disorder, and no single gene causes it.

Research also suggests that people with a genetic risk of having bipolar disorder may be more likely to develop the disorder after experiencing trauma or other stressful life events.

Some research studies have found differences in brain structure and function between people with bipolar disorder and people without it. Researchers are examining these differences to learn more about possible causes and effective treatments.

What are the symptoms of bipolar disorder?

Mood episodes in bipolar disorder include intense emotions and significant changes in sleep habits, activity levels, thoughts, or behaviors. Children and teens with bipolar disorder may have manic episodes, depressive episodes, or "mixed" episodes. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that often last for several days or weeks. During an episode, symptoms occur every day and last for most of the day.

These mood and activity changes are very different from the child's usual behavior and the behavior of healthy children and teens.

Children and teens having a manic episode may:

Show intense happiness or silliness for long periods of time.

Have a very short temper or seem extremely irritable.

Talk fast about a lot of different things.

Have trouble sleeping but do not feel tired.

Have trouble staying focused and experience racing thoughts.

Seem overly interested or involved in pleasurable but risky activities.

Do risky or reckless things that show poor judgment.

Have an inflated sense of ability, knowledge, and power.

Children and teens having a depressive episode may:

Feel frequent and unprovoked sadness.

Show increased irritability, anger, or hostility.

Complain a lot about physical pain, such as stomachaches and headaches.

Start sleeping a lot more.

Have difficulty concentrating.

Feel hopeless and worthless.

Have difficulty communicating or maintaining relationships.

Eat too much or too little.

Have low energy and no interest in activities they usually enjoy.

Think about death or have thoughts of suicide.

Can children and teens with bipolar disorder have other problems?

Young people with bipolar disorder can have several problems at the same time. For example, they may also be at risk of misusing alcohol or drugs. Sometimes extreme behaviors go along with mood episodes. During manic episodes, young people with bipolar disorder may take extreme risks that they wouldn't usually take or that could cause them harm or injury. During depressive episodes, some young people with bipolar disorder may think about running away from home or have thoughts of suicide.

If your child shows signs of suicidal thinking, take these signs seriously and call your child's health care provider.
If your child is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988 or chat at 988lifeline.org . This service is confidential, free, and available 24 hours a day, 7 days a week.

How is bipolar disorder diagnosed?

A health care provider will ask questions about your child's mood, sleeping patterns, energy levels, and behavior. There are no blood tests or brain scans that can diagnose bipolar disorder. However, the health care provider may use tests to determine if something other than bipolar disorder is causing your child's symptoms. Health care providers may need to know about medical conditions in the family, such as depression or substance use.

Other disorders-such as ADHD, disruptive mood dysregulation disorder, oppositional defiant disorder, conduct disorder, and anxiety disorders-have symptoms like those of bipolar disorder. It can be challenging to distinguish bipolar disorder from depression that occurs without mania, referred to as "major depression." A health care provider who specializes in working with children and teens can carefully evaluate your child's symptoms to provide an accurate diagnosis.

How is bipolar disorder treated?

Children and teens can work with their health care provider to develop a treatment plan to help them manage their symptoms and improve their quality of life. It is important to follow the treatment plan, even when your child is not currently experiencing a mood episode. Steady, dependable treatment works better than treatment that starts and stops.

Several types of medication can help treat symptoms of bipolar disorder. Children respond to medications in different ways. They may need to try different types of medication to find the one that works best for them. Some children may need more than one type of medication because their symptoms are complex. Health care providers usually try to prescribe the fewest number of medications and the smallest doses possible to help treat a child's symptoms. Always tell your child's health care provider about any medication side effects. Do not stop giving your child a prescribed medication without speaking to a health care provider. Stopping medication suddenly can be dangerous and can make symptoms worse.

Different kinds of psychosocial therapy can also help children and their families manage the symptoms of bipolar disorder. Therapies based on scientific research-including cognitive behavioral approaches and family-focused therapy-can provide support, education, and guidance to youth and their families. These therapies teach skills that can help people manage bipolar disorder, including skills for maintaining routines, enhancing emotion regulation, and improving social interactions.

What can children and teens expect from treatment?

With treatment, daily functioning and well-being can improve over time. Treatment is more effective when health care providers, caregivers, and young people work together.

Sometimes a child's symptoms may change or disappear and then come back. When this happens, your child's health care provider may recommend changes to the treatment plan. Treatment can take time but sticking with the treatment plan can help young people manage their symptoms and reduce the likelihood of future episodes.

Your child's health care provider may recommend keeping a daily life chart or mood chart to track your child's moods, behaviors, and sleep patterns. This may make it easier to track the illness and see whether treatment is working.

How can I help my child or teen?

Help begins with an accurate diagnosis and treatment. Talk to your child's health care provider about any symptoms you notice.

If your child has bipolar disorder, here are some basic things you can do:

Be patient.

Encourage your child to talk, and listen to your child carefully.

Pay attention to your child's moods, and be alert to any major changes.

Understand triggers and learn strategies for managing intense emotions and irritability.

Help your child have fun.

Remember that treatment takes time: Sticking with the treatment plan can help your child get better and stay better.

Help your child understand that treatment can make life better.

How does bipolar disorder affect caregivers and families?

Caring for a child or teenager with bipolar disorder can be stressful for parents and families. Coping with a child's mood episodes and other symptoms-such as short tempers and risky behaviors-can challenge any caregiver.

It is important that caregivers take care of themselves, too. Find someone you can talk to or consult your health care provider about support groups. Finding support and strategies for managing stress can help you and your child.

Where do I go for help?

If you're unsure of where to get help, your doctor, pediatrician, or other family health care provider is a good place to start. A health care provider can refer you to a qualified mental health professional, such as a psychiatrist or psychologist, who has experience treating bipolar disorder and can evaluate your child's symptoms.

Learn more about getting help on the NIMH website. The Substance Abuse and Mental Health Services Administration has an online treatment locator to help you find mental health services in your area.

What should I know about clinical trials?

NIMH supports a wide range of research, including clinical trials that look at new ways to prevent, detect, or treat diseases and conditions-including bipolar disorder. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. Learn more about  participating in clinical trials.

Reprints

The information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

For More Information

MedlinePlus (National Library of Medicine) ( En español )

ClinicalTrials.gov ( En español )

NIH Publication No. 23-MH-8081
Revised 2023

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Information about bipolar disorder in children and teens including causes, signs and symptoms, diagnosis, treatment options, and how to help a child or teen who has bipolar disorder.

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Counseling Movies: Films That Illustrate Mental Health

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Counseling Movies: Films That Illustrate Mental Health

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Counseling Movies: Films that Illustrate Mental Health - Unseen Footprints

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Are you a counselor or studying to be one? Here are some counseling movies to check out that illustrate issues in mental health and how counselors are perceived in our society!

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Schizophrenia spectrum and other psychotic disorders is the category of mental health conditions in which psychosis is the primary symptom. Psychosis involves hallucinations (sensory experiences that are not real) and/or delusions (persistent false beliefs that are not based in reality).

While all people who have schizophrenia spectrum disorder experience psychosis, psychosis is a symptom for other conditions as well.

In the previous edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), there were distinct subtypes of schizophrenia, a central condition in this category.

In the current edition (DSM-5), these different types of schizophrenia were removed in favor of a broader definition of schizophrenia.

What Is Schizophrenia?

Schizophrenia is a complex and long-term mental illness that affects a person's ability to think clearly, determine reality, manage emotions, relate with others, and function well cognitively.

The symptoms of schizophrenia fall into three main categories.

Positive Symptoms (Psychotic Symptoms)

Positive symptoms reflect things that are present that should not be, namely:

Hallucinations: Seeing, hearing, smelling, tasting, or feeling (through touch) things that are not there

Delusions: False beliefs that don't change even when the person is presented with evidence that they are false. This can present as extreme paranoia or irrational fears.

Thought disorder: Unusual thinking or disorganized speech

Negative Symptoms

Negative symptoms, on the other hand, are characteristics that should be present but are not. These might include:

Loss of motivation

Disinterest or lack of enjoyment in daily life

Social withdrawal and reduced speaking

Difficulty showing emotions

Difficulty planning, beginning, and sustaining activities

Displaying a "flat affect" (difficulty expressing emotions using facial expression or voice tone)

Cognitive Symptoms

These include problems with attention, concentration, and memory, such as:

Problems with processing information to make decisions

Difficulty using information immediately after learning it

Difficulty focusing or paying attention

A healthcare provider or mental health expert will evaluate these symptoms to help inform a diagnosis of schizophrenia or another psychotic disorder.

The DSM-5 is a reference book published by the American Psychiatric Association. It is considered the standard in the diagnosis of mental health conditions, outlining criteria that must be met for a diagnosis of a specific condition.

A diagnosis of schizophrenia is typically made after the first episode of psychosis. Under the criteria found in the DSM-5, a person must persistently have two or more of the following symptoms (at least one being in the top three) to receive a diagnosis:

Decreased level of functioning in the areas of work, interpersonal relationships, or self-care must also be present.

Diagnosing Schizophrenia With Other Factors

Spectrum of Schizophrenia Disorders

Schizophrenia is just one of several conditions that fall under the spectrum of psychotic disorders. These conditions share similar symptoms but are classified differently based on certain factors, such as the length of the psychotic symptoms and the presence of mood disorder characteristics.

Other psychotic disorders include:

Schizophreniform disorder: A person exhibits the defining symptoms of schizophrenia, but the condition lasts less than six months. Can develop into schizophrenia if the symptoms reach the six-month mark.

Schizoaffective disorder: Has features of schizophrenia and features of a mood disorder (either major depressive disorder or bipolar disorder), including psychosis, depression, and mania. The person must experience psychosis for at least two weeks when they are not having a depressive or manic episode. Depressive or manic episode symptoms are present over half of the duration of the condition.

Delusional disorder: The person has experienced at least one delusion for at least one month but has never met the criteria for schizophrenia. Functional impairment is due to the delusion only and not experienced outside of it.

Brief psychotic disorder: An episode of psychotic behavior with a sudden onset lasting less than a month, followed by complete remission. Another psychotic episode in the future is possible.

Associated Conditions

Some conditions commonly occur alongside schizophrenia and/or share symptoms that can make diagnosis more difficult.

These can include:

Some studies have demonstrated that individuals with schizophrenia spectrum disorders have higher autistic characteristics than those without schizophrenia spectrum disorders, but lower autistic characteristics than individuals with autism.

DSM-5 Updates

Before the DSM-5 was published in 2013, schizophrenia was officially recognized as having five distinct subtypes.

In practice, the symptoms of these subtypes were not felt to be reliable or consistently valid. The American Psychiatric Association decided that having these distinct subtypes with specific criteria hindered diagnosis.

When the DSM-5 was published, these subtypes were removed as part of the official diagnosis of schizophrenia.

Some mental health professionals still use these subtypes to gain nuanced understanding of how schizophrenia can present, which can help with creating treatment plans that are tailored to the individual.

DSM-IV Subtypes

Before the diagnostic criteria for schizophrenia changed, the DSM-IV recognized the following subtypes:

Paranoid: Primarily involves positive symptoms, especially delusions and auditory hallucinations. It does not typically involve disorganized speech, disorganized or catatonic behavior, or a flat or inappropriate affect.

Disorganized: Involves disorganized speech, disorganized behavior, and a flat or inappropriate affect. It does not meet the criteria for the catatonic subtype.

Catatonic: Meets the criteria for a diagnosis of schizophrenia and also exhibits symptoms of catatonia. Catatonia influences both speech and behavior, including excessive or decreased movement.

Undifferentiated: Has symptoms that fit with a diagnosis of schizophrenia but does not meet the full criteria for a particular subtype.

Residual: Does not currently display prominent delusions, hallucinations, disorganized speech, or highly disorganized or catatonic behavior. Exhibits negative symptoms and/or two or more diagnostic symptoms of schizophrenia, but in a milder form.

Managing Schizophrenia Spectrum Disorders

Schizophrenia is typically treated as a team effort among the individual, their friends and family, medical professionals, mental health experts, and community supporters.

In addition to formal treatment involving medication and therapies, there are ways to make living with schizophrenia more manageable.

Lifestyle practices a person with schizophrenia can adopt include:

Eating a healthy, balanced diet

Getting regular exercise

Getting plenty of sleep, with a healthy sleep routine

Stopping or quitting smoking, drinking alcohol, and other substance use

Spending time with family and friends

Doing mindfulness and relaxation exercises and techniques

Engaging in healthy activities they enjoy that help reduce daily stress

Friends and family can help a loved one with schizophrenia by:

Helping them to find and start treatment

Encouraging them to stay in treatment

Being respectful, supportive, and kind while setting and enforcing boundaries, including not tolerating dangerous or inappropriate behavior

Looking for local or online support groups that can be helpful for the individual and their loved ones

Schizophrenia Misconceptions

There are many misconceptions about schizophrenia. Some common, long-held ones include:

Schizophrenia means someone has multiple personalities/a split personality.

A "split personality" is an element of a rare condition called dissociative identity disorder, which is a condition entirely separate from schizophrenia.

People with schizophrenia are violent and dangerous.

While some people with schizophrenia can exhibit aggression, it is not always the case, and it is actually rare for a person with schizophrenia to be violent. They are more likely to be the victim of violence than to be dangerous to others.

People with schizophrenia must be hospitalized/can't function independently/can't hold down a job.

Schizophrenia is usually treated on an outpatient basis, unless there is a need for an acute hospital stay.

With treatment, many people with schizophrenia can lead fairly normal lives, including being employed.

In some cases, people with schizophrenia need to use disability services in addition to or instead of working.

A Word From Verywell

The definition and classification of schizophrenia has changed and evolved over the years. Coupled with the existence of many conditions that share similar characteristics as schizophrenia, getting an accurate diagnosis can be difficult.

Taking note of your symptoms, or the symptoms of your loved one, and the factors that influence them can help a healthcare provider understand more clearly what is going on and provide the best treatment possible.

If you or a loved one is experiencing signs of schizophrenia, even if all the criteria for schizophrenia are not met, meet with a healthcare provider to discuss next steps.

Frequently Asked Questions

Is schizophrenia diagnosed on a spectrum?

Schizophrenia is just one of several conditions that fall under the spectrum of psychotic disorders.

While there is one set of criteria for the diagnosis of schizophrenia, the severity of symptoms can vary both by individual and over time in the same individual. Sometimes symptoms can be mild.

Someone who has some symptoms of schizophrenia but doesn't meet the criteria for a diagnosis may be experiencing a different psychotic disorder that is similar to schizophrenia.

Can someone with schizophrenia have multiple mental illnesses?

It is common for people with one mental illness to have other mental illnesses at the same time. This is also true of schizophrenia. A person with schizophrenia may also have a depressive disorder such as major depression, an anxiety disorder, PTSD, or other comorbid (coexisting) conditions.

What can I do to help someone with schizophrenia?

Some ways to help someone with schizophrenia include:

Helping them to find resources for treatment and support

Encouraging them to stay in treatment

Being supportive, but enforcing healthy boundaries

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Schizophrenia spectrum and other psychotic disorders is the category of mental health conditions in which psychosis is the primary symptom. Psychosis involves hallucinations (sensory experiences that are not real) and/or delusions (persistent false beliefs that are not based in reality). While all people who have schizophrenia spectrum disorder experience psychosis, psychosis is a symptom for other conditions as well.

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Strategies for Children with Behavioral Disorders

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Strategies for Children with Behavioral Disorders

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Behavioral disorders also known as conduct disorders are one of the most common forms of disability among children and young adults and is the most frequently cited reason for referral to mental health services. The appearance of behavioral disorders is increasing dramatically in our K-12 classrooms. As a result, their presence severely constrains the ability of the school systems to educate students effectively. The prevalence of behavioral problems among children and young adults is substantial. Many surveys indicate that behavioral disorders vary among young adults, ranging from 2 and 6 percent among K-12 students. This percentage translates into 1.3 to 3.8 million cases of behavioral disorders among the school and pre-college population.

Behavior disorders have also been referred to in a variety of different terminologies, including but not limited to:

1. Emotional and Behavior Disorders (EBD)

2. Emotional Conflict (EC)

3. Serious Emotional Disturbance (SED)

Behavioral disorders become apparent when the student displays a repetitive and impact persistent pattern of behavior that results in the significant disruption of other students. Such disturbances may cause significant impairments in academic, social, and or occupational functioning. Among the characteristics of a behavioral disorder among children and adolescents are:

General Strategies

Multidisciplinary educational teams, including parents, must design programs to meet the individual behavioral and academic needs of identified SED students. Most students can benefit from supportive treatments provided in general education programs. For others, at least temporary placements in special education classrooms, schools, or institutional programs may be appropriate.

Special education programs usually attempt to provide a structured environment where students experience a high degree of success; rules and routines are predictable; and students are consistently rewarded for appropriate behavior. Behavior management techniques, such as positive reinforcement, token economies, contracting, and time-out, which rely on direct measurement and monitoring of behavioral change, are commonly used in SED programs. The assessment and systematic teaching of social skills through modeling, discussion, and rehearsal are frequently used to help students increase control over their behavior and improve their relations with others. In addition, supportive therapies involving music, art, exercise, and relaxation techniques, as well as affective education, individual, and group counseling are sometimes employed to improve self-understanding, self-esteem, and self-control. The following are strategies that may be effective with students with EBD:

Teacher Presentation

Laboratory

Group Interaction and Discussion

1. Acknowledge the contributions of the student with an emotional disorder.

2. Call for responses and participation commensurate with the student's socialization skills.

3. As the student's comfort level rises and when a safe topic is available, encourage the student to be a group spokesperson.

4. Along with the student, devise a contingency plan in which inappropriate forms of response are replaced by appropriate ones.

5. Gradually increase the challenges in the student's participation in group exercises while providing increased positive reinforcement.

6. Help the student to feel as though he or she has something worthwhile to contribute to the discussion.

7. Some students may experience considerable strain in social adjustment in a group context. It may be necessary to work gradually toward group activities. One can devise a strategy of progressing from spectatorship to one-to-one instruction and eventually to small group discussion.

8. Should monitor carefully to ensure that the nondisabled students do not dominate the discussion or detract in any way from the successful performance of the student with the behavioral disorder.

Reading

1. It is necessary to target specific pro-social behaviors for appropriate instruction and assessment to occur such as:

1. Taking turns, working with partner, following directions.

2. Reading in group or with others.

3. Increasing positive relationships by means of awards when they read appropriately.

4. Demonstrating appropriate reading

2. Instructional strategies involving self-control, self-reinforcement, self-monitoring, self-management, problem solving, cognitive behavior modification, and metacognitive skills should be focused on teaching students reading skills

Research

1. Review and discuss with the student the steps involved in a research activity. Think about which step(s) may be difficult for the specific functional limitations of the student and jointly devise accommodations for that student.

2. Use appropriate laboratory and field strategies.

3. Depending on the site of the research check the previous two sections.

4. Show clear examples of what the students should expect as an outcome of their research.

Field Experiences

1. Use appropriate general strategies.

2. Consider alternate activities/exercises that can be utilized with less difficulty for the student, but has the same or similar learning objectives.

3. In field activities acknowledge the contributions and assistance of the student with an emotional disorder.

4. Help the student to feel as though he or she has something worthwhile to contribute to the field trip.

5. Use a buddy system.

6. Gradually increase the challenges in the student's participation in field exercises while providing increased positive reinforcement.

7. Group participation in field activities is highly desirable because it enhances social contacts.

8. Make the student with the behavioral disorder become one of the field trip leader of an activity which can often reduce their disorder.

9. Special efforts should be made to get students with behavioral disorders to interact with other students.

10. You should encourage students to practice field skills during their free hours.

11. Every effort should be made to arouse the interest of such students in activities, so they will learn to perform the activities with success and pleasure with appropriate behaviors.

Testing

1. Be sensitive to the student's reactions to the various aspects of assessment.

2. For each student, accumulate in his or her portfolio several examples of work (quizzes, assignments, projects) that demonstrate knowledge of the subject matter or the unit of study.

3. Make special arrangements for the student with an emotional disorder according to what their special needs are and that they do not compromise the integrity of the testing situation.

4. Stay on top of student progress through informal assessment, don't wait until it's too late to discover that there is a problem.

5. Provide private room/smaller group setting/alternative test site (with proctor present); alternatively screens to block out distractions.

Organizations

Council for Exceptional Children-Council for Children with Behavior Disorders (CCBD)
The Council for Children with Behavioral Disorders (CCBD) is dedicated to supporting the professional development and enhancing the expertise of those who work on behalf of children with challenging behavior and their families. It is a division of the Council for Exceptional Children (CEC).

CCBD Foundation
The CCBD Foundation was founded in 1997 by the Council for Children with Behavioral Disorders (CCBD), to support its mission of improving the education of children and youth with emotional or behavioral disorders (EBD).

Resources

Council for Exceptional Children (Behavior Disorders/Emotional Disturbance)
The Council for Exceptional Children (CEC) page on EBD. The Council for Exceptional Children (CEC) is the largest international professional organization dedicated to improving the educational success of individuals with disabilities and/or gifts and talents.

BehaviorDisorder.org
The site offers information on behavior disorders, conduct disorders, and other behavior problems.

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Behavioral disorders also known as conduct disorders are one of the most common forms of disability among children and young adults and is the most frequently cited reason for referral to mental health services. The appearance of behavioral disorders is increasing dramatically in our K-12 classrooms. As a result, their presence severely constrains the ability of the school systems to educate students effectively.

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UNSTUCK: an OCD kids movie Official Trailer

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UNSTUCK: an OCD kids movie Official Trailer

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https://www.ocdkidsmovie.com/

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UNSTUCK: an OCD kids movie Official Trailer

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Kids, teens and adults with Obsessive Compulsive Disorder (OCD) are looking for help. They need help handling the symptoms, harmful obsessions, intrusive thoughts and constant rituals.

To uncover what OCD is, and what it isn’t UNSTUCK: an OCD kids movie focuses on a different group of OCD experts: kids. 

By documenting six unique stories, UNSTUCK shows the complexity of this mental health disorder that affects 1 in 200 kids. Most importantly, it allows these resilient kids and teenagers to share how they faced their fears and regained control over their lives. 

Watch instanstly: http://ocdkidsmovie.com/familypurchase
Educational Purchase: https://www.newday.com/film/unstuck-ocd-kids-movie

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ASCA Student Standards: Mindsets & Behaviors forStudent Success

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ASCA Student Standards: Mindsets & Behaviors forStudent Success

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Centers for Disease Control and Prevention. (2022). What Is Children’s Mental Health?

https://www.cdc.gov/childrensmentalhealth/basics.html

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Centers for Disease Control and Prevention

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Being mentally healthy during childhood means reaching developmental and emotional milestones and learning healthy social skills and how to cope when there are problems. Mentally healthy children have a positive quality of life and can function well at home, in school, and in their communities.

Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, which cause distress and problems getting through the day. Many children occasionally experience fears and worries or display disruptive behaviors. If symptoms are serious and persistent and interfere with school, home, or play activities, the child may be diagnosed with a mental disorder.

Mental health is not simply the absence of a mental disorder. Children who don't have a mental disorder might differ in how well they are doing, and children who have the same diagnosed mental disorder might differ in their strengths and weaknesses in how they are developing and coping, and in their quality of life. Mental health as a continuum and the identification of specific mental disorders are both ways to understand how well children are doing.

What are common childhood mental disorders?

Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety (fears or worries), and behavior disorders.

Learn more about childhood mental disorders, symptoms, and treatment.

Other childhood disorders and concerns that affect how children learn, behave, or handle their emotions can include learning and developmental disabilities, autism, and risk factors like substance use and self-harm.

Read more about related conditions.

What are the symptoms of childhood mental disorders?

Symptoms of mental disorders change over time as a child grows, and may include difficulties with how a child plays, learns, speaks, and acts, or how the child handles their emotions. Symptoms often start in early childhood, although some disorders may develop during the teenage years. The diagnosis is often made in the school years and sometimes earlier; however, some children with a mental disorder may not be recognized or diagnosed as having one.

Can childhood mental disorders be treated?

Childhood mental disorders can be treated and managed. There are many treatment options based on the best and most current medical evidence. Parents and doctors should work closely with everyone involved in the child's treatment-teachers, coaches, therapists, and other family members. Taking advantage of all the resources available will help parents, health professionals, and educators guide the child towards success. Early diagnosis and appropriate services for children and their families can make a difference in the lives of children with mental disorders.

Get help finding treatment

If you have concerns about a child, you can use these resources to help you find a healthcare provider familiar with treatment options.

Who is affected?

Childhood mental disorders affect many children and families. Boys and girls of all ages and ethnic/racial backgrounds and living in all regions of the United States experience mental disorders. Based on the National Research Council and Institute of Medicine report, which gathered findings from previous studies, it is estimated that in 2007, 13-20% of children living in the United States (up to 1 out of 5 children) experienced a mental disorder in a given year, costing individuals, families, and society an estimated $247 billion per year.

What is the impact of mental disorders in children?

Mental health is important to overall health. Mental disorders are chronic health conditions-conditions that last a long time and often don't go away completely-that can continue through the lifespan. Without early diagnosis and treatment, children with mental disorders can have problems at home, in school, and in forming friendships. Mental disorders can also interfere with a child's healthy development, causing problems that can continue into adulthood.

Public health includes mental health

Supporting children's mental health also includes making sure children meet developmental milestones, understanding what to do when there is a concern, supporting positive parenting strategies, and improving access to care.

CDC works with partner agencies to better understand mental health and mental disorders and the impact they have on children.
Read more about research on children's mental health.
What you can do

Parents: You know your child best. Talk to your child's healthcare professional if you have concerns about the way your child behaves at home, in school, or with friends.

Youth: It is just as important to take care of your mental health as it is to take care of your physical health. If you are angry, worried or sad, don't be afraid to talk about your feelings and reach out to a trusted friend or adult.

Healthcare professionals: Early diagnosis and appropriate treatment based on updated guidelines are very important. There are resources available to help diagnose and treat children's mental disorders.

Teachers/school administrators: Early identification is important so that children can get the help they need. Work with families and healthcare professionals if you have concerns about the mental health of a child in your school.

Resources

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Learn more about mental health, mental disorders, treatments, prevention, and public health research on children's mental health.

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Managing behavior referrals often fall under the realm of school counseling. However, most school counseling programs have few, if any, behavior management components. Don't worry, we've got you covered! Confident Counselor authors are ready to share their best practices for managing behavior referrals. Heather will cover the details we need to know first when presented with a behavior. Carla has some tips for clarifying the problem with the teacher. Finally, Robyn has some solid advice on how to engage the parents.

Hey there! I'm Heather from The Helpful Counselor Blog & Counseling Resources . Over the past two decades, I've worked as a therapist, school counselor, and special education teacher for students with emotional impairments. I pride myself on my ability to develop rapport and engage the tougher "hard to help" students. There's just something about watching them grow into their full potential!

Has a teacher ever referred a student to you for being disruptive but you were unsure about how to help? Sometimes, uncertainty can leave counselors feeling less than the helpful superstar they are.

The term "disruptive behavior" is extremely broad. It can mean anything that interrupts the classroom. Sometimes teachers will give you a broad description like a student is "angry". But unless we know the details, we won't be able to pinpoint . In order to help, we need to what's behind their anger clarify the problem.

Description of disruptive behaviors.

When does it occur (e.g., time of day, day of the week, subject)?

When did the behavior first begin?

How frequently does the behavior occur?

How long the behavior lasts?

What happened right before the disruptive behavior?

Gathering all of these details will help you narrow down the behavior AND the cause of the disruptive behavior.

Example: A student is extremely argumentative and off-task for most of the day every Friday. Upon speaking with the student, we learn he started visiting his father over the weekend. Although it's not 100% conclusive, there could be a connection and it certainly warrants further exploration!

Another Example: A student talks to the student around him whenever the teacher uses the overhead projector. While speaking with the student, they admit that they can't read what's being projected. The words are blurry. The two examples both contained disruptive behavior, but one of them might be helped with a pair of glasses while the other student may need counseling to learn some coping or anger management skills to help process the changes in his home life.

Hello, I'm Carla Christian, the DIY Counselor. I am a wife to Bill, Mom to three daughters, and Nanna to four grands with one on the way. Spending time with family and advocating for my profession are two things that I am very passionate about. My twenty plus years of experience as an educator have enabled me to create resources for teachers and school counselors. I especially enjoy developing no prep lessons for middle level school counselors

Sometimes it seems my colleagues are saying, "Here, fix this!" When this happens, it is difficult to know how to support the teacher and help the student right at that moment. How does one handle these impromptu encounters? I have found that consultation and collaboration are essential in managing behavioral referrals and helping teachers manage disruptive behaviors in the classroom.

Strategies for those spur of the moment behavior referral conversations

Ask the teacher specific questions: "Where are you in your discipline plan with this student?" "Have you contacted the parent?" "What are the most disruptive behaviors?" The answers provide a starting point to determine how to proceed. (Our school has a uniform discipline plan that teachers are to follow. Parent contact is the first step.) If there has been no parent contact, the teacher should inform the parents of student behavior. After there has been parent contact, consult with the teacher and move to the next step.

Request the teacher fill out a referral form. (This form documents all that the teacher has done prior to the referral and is vital in determining a plan of action.)

Observe the student in different settings. (include classroom, cafeteria, hallway, gym)

Meet with the teacher to discuss information from the referral and observations.

Work with the teacher to develop strategies for addressing student behavior, including behavior goals, behavior tracking charts, positive rewards, seating arrangement, classroom management, etc.

After a designated time, evaluate strategies to determine effectiveness.

If there is no improvement in student behavior, follow-up may include a conference with the parent, referral to a counselor for individual counseling, conference with admin, or a functional behavior assessment and behavior intervention plan.

Hello, I am Robyn from the TPT store Mental Fills. I am a Licensed Clinical Social Worker in California with close to 20 years of experience in the field of Mental Health. I have worked with a broad range of children, teens, and adults in inpatient psychiatric hospitals, residential treatment facilities, and outpatient mental health clinics providing individual and group therapy. Currently, I work full-time in The Department of Mental Health at a military hospital and part-time in private practice. Although I specialize in evidenced based treatment for anxiety, depression, and interpersonal relationships, it is my experience as a parent of a child with special needs in elementary school that has inspired both my TPT resources and my tips on engaging parents of disruptive children.

Reach out to parents early on to share your interest and good intentions of working together. After speaking to a parent in person or over the phone, an online partnership might be a good next step. To promote parent reception and eliminate defensiveness, consider scheduled weekly or biweekly emails:

Review specific goal(s). Keep the email focused on the specific goal that is being worked on. This will help eliminate child blame and focus on strategies that are working or need tweaking. For example, instead of "I am emailing you about David's anger problem," try "I am emailing you today regarding our goal of anger management."

Use language that demonstrates partnership, such as "us, we, our, let's." Although this may show a looseness of boundaries, we want parents to understand we are equally invested in their child's goals and progress; and this avoids blaming statements. A helpful example of positive language is, " work on helping David with coping skills this week."

Invite parent expertise. A newbie mistake is assuming parents are at fault for their child's behaviors. Regularly ask the parent/s for their advice. Ask what has worked for their child before, what is working for the child at home, and what reasonable suggestions the school could try to help their child's behavior. This will not only provide strategies you may not have considered before but helps to improve the parent's feeling of value and connection.

Include positive behaviors and progress towards goals. Similar to children, parents need to feel encouraged and supported. Parents need to hear their children are moving in a positive direction and although there may be a temporary regression, reminders of the steps made forward are necessary to sustain hope. Although this may be a challenge, it will be a critical piece of gaining parent investment.

When sharing updates that include negative behaviors, avoid language that shows judgment or criticism. Simply state the facts. Instead of "David lost control again and rudely threw his pencil. He can't seem to control his anger," try, "David struggled with impulse control today and threw his pencil." Sticking to facts prevents emotional and finger-pointing responses.

Avoid reviewing the negative consequences to their child's behaviors, such as "the teacher and the classmates are tired of his behavior." This will only promote shame and resistance. Instead, focus on the positive consequences that include the both of you working together. For example, "I plan to review coping skills with David this week. I will send home a list of the skills he prefers to practice at home."

Offer help. Even the best of parents feel helpless and inadequate. Instead of imposing recommendations, when appropriate, gently offer solutions. For example, "If you are interested, I have found some useful tips that may work at home, I would be happy to email you." Other suggestions that help support the parent include collaborating with the student's outside therapist and providing updates as needed.

Lastly, although parents can have a negative influence at times, we do not want to take for granted the positive influences they have on your student's success. These emails may seem like a chore at first, but once you create a trusting connection with a parent, the fewer details need to be provided and most importantly, the alliance built aids in improved behaviors. Finally, when writing your email, always put yourself in the parent's shoes and ask yourself, what would I want to read if this was my child?

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Managing Referrals for Disruptive Behavior

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Managing behavior referrals often fall under the realm of school counseling. However, most school counseling programs have few, if any, behavior management components. Don't worry, we've got you covered! Confident Counselor authors are ready to share their best practices for managing behavior referrals.

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https://vocal.media/psyche/obsessive-compulsive-disorder-ocd

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How Do I Find Out If I Have Eating Disorder?

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Latest Updates In The Eating Disorder Field posted by EDReferral on EDReferral.com.

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From Dr. Tamar Chansky Creator of Worrywisekids.org

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Pospech & Prewitt Anxiety Education and Information

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Anxiety Education and Information Infographic

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Anxiety Education and Information Infographic

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Pospech & Prewitt Anxiety Education and Information (800 × 2000 px) (800 × 3000 px) (800 × 4000 px)

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Inside Higher Ed. (2017, March 29). Anxiety and depression are the primary concerns for students seeking. https://www.insidehighered.com/news/2017/03/29/anxiety-and-depression-are-primary-concerns-students-seeking-counseling-services

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Inside Higher Ed | Higher Education News, Events and Jobs

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More than half of the college students who visited their campus counseling centers during the 2015-16 academic year reported symptoms of anxiety, according to a survey by the Association for University and College Counseling Center Directors.

This marks the seventh year in a row that anxiety has been the top complaint among students seeking mental health services. This year, 51 percent of students who visited a counseling center reported having anxiety, followed by depression (41 percent), relationship concerns (34 percent) and suicidal ideation (20.5 percent). Many students reported experiencing multiple conditions at once.

Since 2009, when anxiety overtook depression as the No. 1 concern among college students, the number of students experiencing anxiety has steadily increased.

This survey was conducted between September 2015 and August 2016. In total, 529 counseling center directors representing that many institutions responded to the survey, with an even split between public and private institutions. The majority of respondents came from four-year colleges, but community colleges, professional schools and art schools were also included.

In an effort to reflect the makeup of their student bodies, counseling centers have diversified their clinical staff members. Of new hires, 62.2 percent are white, 15.3 percent black, 7.5 percent Latino and 10 percent Asian. This compares to current clinical staff, who are 70.9 percent white, 10.1 percent black, 7.3 percent Latino and 7.9 percent Asian.

"Student populations have become more diverse," said Micky Sharma, president of the AUCCCD and director of counseling and consultation services at Ohio State University. "Counseling services work to create a staff that represents their student bodies."

At Ohio State, for example, the counseling center now offers clinical services in nine different languages to meet the needs of their international students, who make up about 12 percent of the student body, Sharma said.

Regardless of race, ethnicity, gender or sexual orientation, "anyone could show up with anxiety or depression or a relationship issue," Sharma said. "A university counseling center is charged with providing help for everybody."

Another key finding in the survey is that 41.6 percent of counseling centers hired additional staff members in the last academic year, compared to about 26 percent in 2011 and 36 percent in 2016.

College counseling centers continue to grow to match the demands of their students, according to David Reetz, the lead researcher and coordinator for the 2016 survey and director of counseling and psychological services at the Rochester Institute of Technology.

"More students are seeking services because we continue to be more and more aware that a student's health and well-being have a lot to do with their success in their academic programs and the quality of their student life experience," Reetz said.

In fact, of the students surveyed, about 72 percent who used counseling services said it helped their academic performance in some way.

As more students continue to seek out mental health services and campus counseling centers try to keep up with new hires, the question of student wait times becomes key.

For the first time, this year's survey asked counseling center directors about average wait times for students based on the number of business days between when the appointment was scheduled and when it occurred.

The survey team found that, on average, students waited between six and eight business days for counseling services. However, as might be expected, institutions with a lower ratio of professional staff to students saw shorter wait times.

Reetz noted that the wait-time average is a "tricky number," given that some students opt to schedule their first appointment farther out to accommodate their own schedules.

"Students don't necessarily want to be seen right away," Reetz said, adding that, generally, "the more staff a center has, the shorter that wait time is between initial contact and first appointment."

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Anxiety and depression are the primary concerns for students seeking counseling services

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Survey of campus counseling centers finds increased demand for services, as well as additional positions and more diversity in hiring.

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Child Mind Institute | Transforming Children’s Lives.

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The Child Mind Institute is an independent nonprofit dedicated to transforming the lives of children struggling with mental health and learning disorders.

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Depression: More than Sadness Full Video (06:49)

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Depression: More than Sadness Full Video (06:49)

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Angelo State University - Library Online Resources

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Unauthorized use is prohibited; Usage may be subject to security testing and monitoring; Misuse is subject to criminal prosecution; No expectation of privacy except as otherwise provided by applicable privacy laws.

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What teachers should know about obsessive-compulsive disorder, and how to help students with OCD in class.

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What Is Schizophrenia Spectrum and Other Psychotic Disorders?

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What Is Schizophrenia Spectrum and Other Psychotic Disorders?

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What Is Schizophrenia Spectrum and Other Psychotic Disorders? | Hopeway

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Schizophrenia is a complicated illness that is often misunderstood. There are 5 types of schizophrenia based on predominant symptoms, 3 schizophrenia spectrum disorders, and 5 other psychotic disorders.

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When you have depression or anxiety, it is often pretty clear. You feel nervous or down and that misery is very much on your mind. But what does it mean to have a dysfunctional personality? This is a much more complicated question.

First, like so many terms in the field of psychology and psychiatry, the term personality is a complicated one. A useful working definition of personality is "the organized, developing, psychological systems within an individual". The question that follows from this definition is what are these systems and how are they organized? One useful scheme divides psychological systems up into three broad levels; 1) temperament; 2) characteristic adaptations; and 3) identity. Temperament refers to a person's general traits and dispositions, and five major classes of traits have been identified ( extraversion, neuroticism, agreeableness, conscientiousness and openness). Once someone reaches the age of 25 or so, their traits will generally stabilize. Characteristic adaptations refer to ways people characteristically adjust and respond to their environment. Recently, I have argued that there are five systems of adaptation, namely 1) the habit system; 2) the experiential system; 3) relational system; 4) defensive system and 5) justification system. The final layer of personality is your identity, which refers to the broad constellation of beliefs and values an individual has about herself, others and the world and how those are pulled together into a self-narrative that justifies their existence relative to others. Here is a quick diagram of the three levels, which exist in a biological and social context, as depicted.

So what makes a dysfunctional personality? First, let's consider what we mean by the word "functional". An individual is functional when they are able to effectively work toward realizing valued goal states, given the stressors and affordances they face.

Now, when clinicians are considering the functioning of one's personality, they are especially looking at two broad domains, that of identity and interpersonal relations. Thus, the question of what is a dysfunctional personality broadly comes down to questions of how does the individual function in these domains, especially when faced with stressors? There are specific things one can look for.

When examining identity, the following domains can be assessed: 1) The degree of integration and integrity in the self-concept, especially under stress or duress; and 2) the capacity for and quality of self-directedness. A healthy/ resilient (AKA functional) identity is characterized by a general degree of self-acceptance and compassion, the ability to have appropriate boundaries relative to significant others, the ability to tolerate a range of emotions while maintaining a consistent sense of self, the ability to self-reflect and accurately narrate one's experiences, and the capacity to recognize and experience different self-states but not become unglued, overly conflicted or dramatically inconsistent in response to the pressures of such different states. In addition, a functional identity is associated with the capacity to effectively set long term goals and live according to internalized standards that function as guides, but have a feeling of ownership of those standards and not be overly rigid or inflexible in relationship to them.

It follows, then, that an unhealthy/vulnerable (AKA dysfunctional) identity is associated with problems of esteem and acceptance, fragmentation, difficulty tolerating strong emotion, lack of harmony between feelings and self-concept, the presence of self-states that lead to erratic or contradictory actions, rigidity, and the inability to effectively self-direct in accordance with internalized goals and ethical standards.

When examining the functioning of individuals' relationships, the following domains can be assessed: 1) The degree of empathy and capacity for the complex, nuanced representation of others; and 2) The quality and intimacy of relationships with other people. An individual with a healthy or functional relationship system feels valued by important others, expresses attachment and compassion, and has a portfolio of strong, long term relationships with family, friends, and romantic partners. They can effectively cooperate and demonstrate the capacity to appreciate others experiences, are able to hold conflicting feelings (e.g., guilt or anger) without being overwhelmed, and are able to narrate how they are perceived by others and how their actions play a role in the social exchange.

In contrast, someone with dysfunctional relationships has significant trouble forming lasting, intimate relationships, has difficulty empathizing with others in complex and effective ways, often lacks insight into their own roles in conflict and the responses that they elicit, have difficulty trusting or having compassion for others, and generally feel devalued by important others.

There was a strong push for the DSM-5 to replace the current categorical system of different personality types (e.g., narcissistic, borderline, avoidant, etc.) with a more dimensional system that characterizes personality functioning much in the way described above. However, at the 11 th hour, the folks in charge of the DSM-5 decided to not go with the dimensional approach. Thus, the approach described above will not become as institutionalized as might have been the case. Nevertheless is important that the concept of personality functioning be spelled out, for both clinicians and lay people alike. It is also important to be aware that, as described above, functioning exists on a continuum and that, depending on the circumstances, other people, and stressors, can vary quite a bit. A person may be relatively functional in some contexts and quite dysfunctionl in others.

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When you have depression or anxiety, it is often pretty clear. You feel nervous or down and that misery is very much on your mind. But what does it mean to have a dysfunctional personality? This is a much more complicated question.

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Anxiety disorders - Symptoms and causes. (2018, May 4). Mayo Clinic.

https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-

causes/syc-20350961

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Overview

Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).

These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment.

Whatever form of anxiety you have, treatment can help.

Symptoms

Common anxiety signs and symptoms include:

Feeling nervous, restless or tense

Having a sense of impending danger, panic or doom

Having an increased heart rate

Breathing rapidly (hyperventilation)

Sweating

Trembling

Feeling weak or tired

Trouble concentrating or thinking about anything other than the present worry

Having trouble sleeping

Experiencing gastrointestinal (GI) problems

Having difficulty controlling worry

Having the urge to avoid things that trigger anxiety

Several types of anxiety disorders exist:

Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.

Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem.

Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events - even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.

Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they've occurred.

Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.

Separation anxiety disorder is a childhood disorder characterized by anxiety that's excessive for the child's developmental level and related to separation from parents or others who have parental roles.

Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.

Specific phobias are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.

Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.

Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don't meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.

When to see a doctor

See your doctor if:

You feel like you're worrying too much and it's interfering with your work, relationships or other parts of your life

Your fear, worry or anxiety is upsetting to you and difficult to control

You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety

You think your anxiety could be linked to a physical health problem

You have suicidal thoughts or behaviors - if this is the case, seek emergency treatment immediately

Your worries may not go away on their own, and they may get worse over time if you don't seek help. See your doctor or a mental health provider before your anxiety gets worse. It's easier to treat if you get help early.

Causes

The causes of anxiety disorders aren't fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor.

Medical causes

For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem.

Examples of medical problems that can be linked to anxiety include:

Heart disease

Diabetes

Thyroid problems, such as hyperthyroidism

Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma

Drug misuse or withdrawal

Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications

Chronic pain or irritable bowel syndrome

Rare tumors that produce certain fight-or-flight hormones

Sometimes anxiety can be a side effect of certain medications.

It's possible that your anxiety may be due to an underlying medical condition if:

You don't have any blood relatives (such as a parent or sibling) with an anxiety disorder

You didn't have an anxiety disorder as a child

You don't avoid certain things or situations because of anxiety

You have a sudden occurrence of anxiety that seems unrelated to life events and you didn't have a previous history of anxiety

Risk factors

These factors may increase your risk of developing an anxiety disorder:

Trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life. Adults who experience a traumatic event also can develop anxiety disorders.

Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future.

Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety - for example, a death in the family, work stress or ongoing worry about finances.

Personality. People with certain personality types are more prone to anxiety disorders than others are.

Other mental health disorders. People with other mental health disorders, such as depression, often also have an anxiety disorder.

Having blood relatives with an anxiety disorder. Anxiety disorders can run in families.

Drugs or alcohol. Drug or alcohol use or misuse or withdrawal can cause or worsen anxiety.

Complications

Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as:

Depression (which often occurs with an anxiety disorder) or other mental health disorders

Substance misuse

Trouble sleeping (insomnia)

Digestive or bowel problems

Headaches and chronic pain

Social isolation

Problems functioning at school or work

Poor quality of life

Suicide

Prevention

There's no way to predict for certain what will cause someone to develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you're anxious:

Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.

Stay active. Participate in activities that you enjoy and that make you feel good about yourself. Enjoy social interaction and caring relationships, which can lessen your worries.

Avoid alcohol or drug use. Alcohol and drug use can cause or worsen anxiety. If you're addicted to any of these substances, quitting can make you anxious. If you can't quit on your own, see your doctor or find a support group to help you.

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Learn the symptoms of this mental health condition, and ways to manage worry and fear that interfere with your daily activities.

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Teaching Students with Emotional Disturbances: 8 Tips forTeachers

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Teaching Students with Emotional Disturbances: 8 Tips forTeachers

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Eating & Eating Disorders - Child Mind Institute

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Resources on eating disorders and other eating challenges, including anorexia, bulimia, binge eating and picky eating.

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Home - ADDA - Attention Deficit Disorder Association: A website to connect, grow, and learn about ADHD

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Home - ADDA - Attention Deficit Disorder Association

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Empowering adults with adhd to live their best lives A Different Brain Requires a Different Approach Whether you're newly diagnosed, wondering if you have ADHD, or simply ready to take charge of your life - we're here to help. Have ...

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When parents start googling behavior issues, one phrase tends to jump out: oppositional defiant disorder (ODD). It's easy to see why. "The words 'oppositional' and 'defiant' show up in parents' vocabulary fairly frequently," says David Anderson, PhD, a clinical psychologist at the Child Mind Institute. "It's one of the more aptly named diagnoses that exists."

Whether your child has oppositional defiant disorder (or ODD) or not, learning about the disorder can be helpful. That's because the behavior management strategies used in treatment are evidence-based techniques that all parents will benefit from knowing.

What is Oppositional Defiant Disorder (ODD)?

It is normal for children to be oppositional and defiant at least some of the time. In fact, it's a sign of healthy development. So when does a child have oppositional defiant disorder? The diagnosis should not be given, for example, to a toddler who has just discovered that her new favorite word is "no."

ODD is typically diagnosed around early elementary school ages and stops being diagnosed around adolescence. Kids who have ODD have a well-established pattern of behavior problems. Symptoms include:

Being unusually angry and irritable

Frequently losing their temper

Being easily annoyed

Arguing with authority figures

Refusing to follow rules

Deliberately annoying people

Blaming others for mistakes

Being vindictive

All children can have these symptoms from time to time. What distinguishes ODD from normal oppositional behavior is how severe it is, and how long it has been going on for. A child with ODD will have had extreme behavior issues for at least six months.

Another hallmark of ODD is the toll it takes on family relationships. Regular daily frustrations - ignored commands, arguments, explosive outbursts - build up over time, and these negative interactions damage the parent-child bond and reinforce hostile patterns of behavior.

Parenting Under Fire

"Kids who have behavioral issues push parents towards the extremes," says Dr. Anderson. "They push parents to become permissive and they push parents to become hyper-coercive in the hope that a larger amount of control will get the kid to listen."

Neither of these extremes make for ideal parenting. It is never a parent's intention to reinforce bad behavior, and we often don't realize when we're doing it. Here are two common scenarios:

You tell your child to stop playing a game and get ready for bed. He ignores your first two requests. By the third time you ask, you're so mad that you yell.

You tell your child to stop playing a game and get ready for bed. He throws a tantrum because he wants to keep playing. You don't want him to be so worked up before bedtime, so you back down and say he can play for another ten minutes - but then he has to go to bed.

In the first scenario, your child learns that yelling is an acceptable way to get a message across. More subtly, he might also be learning that he can continue ignoring those first few requests - when you escalate the situation is when he knows you're serious.

In the second scenario, your child has learned that throwing a tantrum might give him something that he wants, so he'll be more likely to do it again in the future.

Both of these scenarios can set families up for future conflicts, and the more they are repeated the more they become familiar patterns of behavior that are harder to break out of. Your child doesn't have to have ODD for these scenarios to happen, but repeated negative interactions like these make diagnosing a behavior disorder much more likely.

And just like parents aren't necessarily to blame, neither are the kids, says Dr. Anderson. "Through no conscious effort of the child, he learns through hundreds of trials that this is a way to continue getting what he wants."

This also explains why kids who have ODD might act out more at home. Dr. Anderson notes, "Kids who have ODD are likely to be more oppositional with people they know well, partly because the pathways are so well worn. Whereas in a place like school, where a kid has less control in general over their environment, the types of behaviors that are common to ODD may not pay off as much."

ADHD and Other Risk Factors

There is a very high overlap in kids who have ADHD who are also diagnosed with ODD. Depending on the study, the overlap could be 30 to 50 percent of kids with ADHD also have ODD.

Dr. Anderson explains the connection like this: "Kids with ADHD are biologically loaded to be distractible, to be impulsive, to have difficulty staying in one place for a little while. So kids with ADHD start off doing things that parents perceive as off limits. And then when those kids get negative feedback they start to become even more negatively oriented towards adults." These repeated patterns of negative interactions can lead to developing ODD.

But another pathway into developing ODD has more to do with a child's temperament and might be apparent early on. Children who had a lot of difficulty soothing themselves as toddlers and continue to struggle with an age-appropriate ability to control their emotions in the face of disappointment or frustration can sometimes develop ODD. The adults in their environment might be more inclined to accommodate their demands in order to keep the family functioning as harmoniously as possible.

Kids who have experienced a lot of life stress and trauma are also more likely to develop ODD.

Why Treatment is Important

It's important to get treatment to improve the parent-child relationship, which is crucial to the health and happiness of the entire household. It is also important for your child's future. Some children will grow out of oppositional defiant disorder, but others will continue to have behavior issues, which could lead to peer rejection and difficulty forming healthy relationships, not to mention continued family discord.

They'll also be less likely to achieve their potential. If something doesn't go their way, they might think it's anyone's fault but theirs. Dr. Anderson says they might also "retreat to the places where they know they can get what they want. That might mean that they try even less, push even more on the people who are closest to them, who they actually care about the most, causing even more frayed relationships."

A small percentage of kids with ODD go on to develop something called conduct disorder, which is a more severe behavior disorder that includes criminal acts like stealing, setting fires and hurting people. Getting treatment sooner rather than later improves a child's trajectory.

What Treatment for ODD Looks Like

Parents play a key role in treatment for oppositional defiant disorder. This might be surprising, since children are the ones given the diagnosis, but in ODD the parent-child relationship needs to be repaired, which means both parties need to make changes to get back on track.

All programs have certain goals in common, like helping parents find the middle ground between being too authoritative and too permissive. A behavioral therapist helps parents learn how to train their child's behavior through setting clear expectations, praising kids when they follow through and using effective consequences when they don't. Parents also learn to use these strategies consistently - one reason why behavior management strategies sometimes don't work is because parents try different, conflicting techniques, or don't stick to one program long enough to see gains. Parents and children will also learn problem solving skills they can rely on when they run into issues.

Parent training programs might include sessions with parents and children working together, or just parents alone. Some different programs include:

Parent-Child Interaction Therapy (PCIT)

Parent Management Training (PMT)

Defiant Teens

Positive Parenting Program (Triple P)

The Incredible Years

Clinicians might also recommend social skills training to help improve your child's peer relationships or cognitive behavioral therapy if she is struggling with anxiety or depression.

There is no FDA-approved medication for ODD, but medications are sometimes used as an adjunct to behavioral therapy. Anti-psychotic medications like Abilify (aripiprazole) and Risperdal (risperidone), which have been shown to reduce aggression and irritability, are frequently used in cases where a child is at risk of being removed from the school or home. Stimulant medication may be used if a child has excessive impulsivity, including those who have an ADHD diagnosis. Antidepressants (SSRIs) may be helpful if a child has underlying depression or anxiety.

Regardless of the treatment plan your therapist recommends, parents will need to provide a lot of encouragement. "Make no mistake, kids do not often just suddenly wake up with the insight that they wish their behavior was better and then ask all the adults in their life how they can change," warns Dr. Anderson. "They'll stick with whatever behavior is working for them, even if it's not working that well."

But once the family dynamic begins to change, and kids (and parents) begin to feel more confident in their ability to get along, everyone will be a lot happier.

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What Is Oppositional Defiant Disorder (ODD)? - Child Mind Institute

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Learn about the symptoms of ODD and how treatment can improve the parent-child relationship and improve a child's behavior.

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Fact Sheet: Disruptive Behavior Disorders: Oppositional Defiant Disorder (ODD) & Conduct Disorder (CD)

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Fact Sheet: Disruptive Behavior Disorders: Oppositional Defiant Disorder (ODD) & Conduct Disorder (CD)

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Educating Parents on Feeding and Eating Disorders

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Educating Parents on Feeding and Eating Disorders

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Pospech & Prewitt_ Professional Presentation_ Educating Others on Feeding and Eating Disorders (1)

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Strategies for Learning and Teaching: Emotional Disturbance and/or Behavioral Problems

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Strategies for Learning and Teaching: Emotional Disturbance and/or Behavioral Problems

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Working to deliver a better special education service

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Child Mind Institute | Transforming Children’s Lives.

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The Child Mind Institute is an independent nonprofit dedicated to transforming the lives of children struggling with mental health and learning disorders.

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares.

Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry. These are called obsessions. To alleviate the anxiety caused by their obsessive thoughts, they perform repetitive, ritualized actions called compulsions. A child with OCD might need to line things up, touch things in a certain order when leaving the room or wash his hands repeatedly.

Obsessions Common in Kids With OCD

Contamination: Kids with this obsession are sometimes called "germaphobes." In schools, this plays out with kids worrying about other kids sneezing and coughing, touching things that might be dirty or getting sick in many different ways. This is the most common obsession seen in children.

Magical thinking: This is a kind of superstition, like "step on a crack, break your mother's back," taken to extremes. For example, kids might worry that their thoughts can cause someone to get hurt, or get sick. A child might think, "Unless my things are lined up in a certain way, mom will get in a car accident."

Catastrophizing: Some kids easily jump to the conclusion that something terrible has happened. For example, if her parents are five minutes late picking her up, a girl who is catastrophizing might tell herself that they've decided to abandon her.

Scrupulosity: This is when kids have obsessive worries about offending God or being blasphemous in some way.

What ifs: Kids may be plagued by a lot of different kinds of thoughts about bad things they could do. "What if I hurt someone? What if I stab someone? What if I kill someone?"

The "just right feeling": When OCD first develops, from about 6 to 9 years of age, kids may not know why they are doing something, but just that they need to do it until they get what we call the "just right feeling." So: "I'll line these things up until it just kind of feels right, and then I'll stop." And then over time - in the 9- to 12-year-old range - it evolves into magical thinking and becomes more superstitious in nature.

Behaviors You Might See in Students With OCD

Frequent requests to go to the bathroom: This could be to wash hands, if someone near the child was coughing or sneezing, or if she touched something that she perceives as contaminated. She could be washing items-pens, pencils, backpacks, books. It could also be an excuse to get out the classroom and just be away from everyone, and have some respite.

Constant reassurance-seeking: This takes the form of repetitive questions. "Are you sure that's the answer? Could you tell me again? Did you hear what I said?" Checking doors, windows, lockers, desks. Over and over and over again.

Getting stuck on tasks: Sometimes kids with OCD will need to finish something to completion, or understand it to completion, before they're able to move on. So if a child is working out what he did wrong on a math test, and the teacher says, "Now let's open the textbook and start a new chapter," he's not going to be able to shift gears.

Retracing: If a child leaves the classroom and worries that she left a pencil behind, she'll go back into the classroom and go to her desk and check. If she had a bad thought as she went through the doorway, she might have to "fix it" by going back through the doorway again saying a good word. If she had a bad thought when she went down a flight of stairs on the way to class, she might need to go back up that same stairway at the end of the period, even if it means being late to her next class.

Obsessive erasing: A child could be erasing a lot because the letters have to look perfect. Or he could have used a word that disturbs him. For example, if he has a fear of vomiting and he's written the word vomit, he might not be able to stand seeing that word, so he erases it. Kids start having erasers worn down to the metal. Teachers start to see holes in the paper. Words will be drawn over on the back of the page. A lot of different areas of writing become problematic.

Behaviors Often Confused With Another Disorder

Some behaviors associated with OCD are easy to confuse with ADHD, learning problems or being oppositional.

Distraction: If a child is busy thinking that if she doesn't turn the pen cap and count to four the right way then her mom is going to get sick, she's not going to be paying attention in class. And if her teacher calls on her to answer a question, her distraction might look like ADHD, but it isn't.

Slowness on exams, papers and tasks: Sometimes when kids take a long time, they're struggling with the perfectionism of needing to do things the right way. This could look like learning problems, or inattention, but it isn't.

Avoidance: Teachers might see a child who doesn't want to sit on the floor, or pick things up that touched the floor, or get his hands dirty in art class. He may avoid a lot of playground activities - kids with germ fears will view the playground the way some adults view the subway: it's gross. Why touch anything there?

Tapping and touching symmetrically: If a child sits down at her desk and she accidentally kicks the chair of the kid next to her with her right foot, she's going to have to then kick it with her left foot. That might look like somebody who's being oppositional, or somebody who's got too much energy, but actually it's OCD.

Complaints of anxiety and fatigue: There's one interesting theory that kids with OCD are smarter than other kids. And if you consider how much thinking they're doing, they're really using their brain more frequently than a lot of other kids are. But when that's coupled with a lot of anxiety, you can have a lot of fatigue. So it's common for kids with OCD to want to come home and take a nap after school.

How to Help Students With OCD

For children struggling with OCD, functioning in school can be complicated and very difficult. Here are some things you can do to help them, and the class as a whole, focus on learning:

Seating arrangement: If the school has noisy hallways, you might not want to have a child with OCD sit by the door. You might have her sit in the front, where she's less able to hear the noise and can stay more focused on her work. On the other hand, a child who has very observable symptoms, and doesn't want other kids to see her fidgeting with her hands, rocking or getting up a lot, might be better off closer to the door, toward the back of the room.

Extended time for tests and papers: If writing is a problem for a child who needs to find the perfect way to say something, he's going to need more time to finish those essay questions or papers.

Laptops for writing: If writing and rewriting/erasing is really problematic for a child, consider letting her use a laptop for taking notes, and having all assignments be typed instead of handwritten.

Private testing rooms: Research is quite clear that kids with OCD do better, are less overwhelmed and are more in control of their thoughts and their reactions if they're in a quiet place away from the other kids.

Skip reading out loud: Kids who feel they need to read perfectly may have to go back and reread sentences or whole paragraphs over and over to make sure they've got them right. So reading becomes a very laborious task, and reading in front of the class can become a nightmare. So if we know doing this is a problem for children, we can spare them.

Books on tape: If kids get so hung up reading that it takes forever, listening to the books can be a solution.

Break homework into chunks: If looking at a whole page of math makes kids feel overwhelmed and anxious - think of the potential for mistakes! - the problems can be broken up over four pages. It helps kids stay focused on doing the problems instead of worrying.

How to Minimize Behavioral Problems

Plan an escape route: Try working out a communication system so that if the student feels symptoms coming on, she can signal to you and leave the classroom, or go to a protected place in the classroom, without interrupting the class. It can prevent an embarrassing and disruptive blowup of symptoms in the classroom, and the other kids picking on or bullying her about it.

Be aware of triggering events: It's very important for teachers to know what kind of things might trigger the symptoms. Fatigue is a huge piece of OCD, and it can be exacerbated by medication. So it's important to know that if a child is drowsy in class, and maybe he's putting his head down, it's not because he's being oppositional or disrespectful, but because he's overwhelmed with fatigue.

Advance notice: Irritability and frustration are two of the longer-lasting things that kids with OCD are feeling on a daily basis. Changes in schedule can be very disruptive for a child with OCD, so it can be helpful for teachers to give advance notice of things. Kids who know what to expect are less likely to be thrown by the change.

Children with OCD are often teased and bullied because of their symptoms. Kids feel very uncomfortable about their rituals, knowing that they're being watched. It can be helpful to educate the whole class about what's going on, especially if a child is going to be in the same school for a number of years, and it can inspire a surprising amount of support from other children.

Peer understanding program: A peer understanding program includes a presentation in the classroom that explains (with the child participating) what OCD is. The child might say, "Listen, I have OCD. It's an anxiety disorder. It makes me think that my hands are dirty and I have to wash my hands a lot, so if you see me getting up and going to the sink to wash my hands, that's why." Psychologists can role-play with the teacher and child ahead of time, to anticipate questions his classmates might ask, and how to answer them.

A buddy system: A buddy is like a peer coach who sits next to the child and prompts him to keep up with note taking and staying on task. It can be great for the buddy, to foster a sense of confidence and pride and to be able to help someone in need, and great for fostering friendship.

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares. Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry.

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Credit: Julius-Maximilians-Universität Würzburg, JMU

An overactive molecular signal pathway in the brain region of the amygdala can lead to obsessive-compulsive disorder (OCD). A research team from Würzburg has established this connection.

Some people have an extreme fear of dirt or bacteria. As a result, they may develop a habit of compulsive washing and repeatedly cleaning their hands or body. They are trapped in a vicious circle, as the fear of new contamination returns quickly after washing. Sufferers see no way out. They are even incapable of changing their behaviour when the excessive washing has led to skin irritation or damage.

Around two percent of the general population suffer from some kind of obsessive-compulsive disorder (OCD) at least once in their life. The disorder is characterised by persistent intrusive thoughts which the sufferers try to compensate for by repetitive ritualized behaviour.

Like depression, eating disorders and other mental diseases, OCD is treated with antidepressants. However, the drugs are non-specific, that is they are not tailored to the respective disease. Therefore, scientists have been looking for new and better targeted therapies that have fewer side effects.
Missing protein triggers urge to wash
Professor Kai Schuh from the Institute of Physiology at the Julius-Maximilians-Universität (JMU) Würzburg (Germany) and his team explore the underlying causes of obsessive-compulsive disorder in collaboration with the JMU's Departments of Psychiatry and Neurology.

"We were able to show in mouse models that the absence of the protein SPRED2 alone can trigger an excessive grooming behaviour," Schuh says. He believes that this finding is crucial as no clear trigger for this type of disorder has been identified until now. Previous research pointed to multiple factors being responsible for developing OCD.

Occurring in all cells of the body, the protein SPRED2 is found in particularly high concentrations in regions of the brain, namely in the basal ganglia and the amygdala. Normally, the protein inhibits an important signal pathway of the cell, the so-called Ras/ERK-MAP kinase cascade. When it is missing, this signal pathway is more active than usual.
Hyperactive signal cascade in the brain
"It is primarily the brain-specific initiator of the signal pathway, the receptor tyrosine kinase TrkB, that is excessively active and causes the overshooting reaction of the downstream components", biologist Dr. Melanie Ullrich explains.

Administering an inhibitor to attenuate the overactive signal cascade in the animal model improves the obsessive-compulsive symptoms. Moreover, the JMU research team was able to treat the OCD with an antidepressant, similarly to standard therapy in humans. Their detailed results have been published in the journal Molecular Psychiatry.
New targets for therapies pinpointed
"Our study delivers a valuable new model that allows the disease mechanisms to be investigated and new therapy options for obsessive-compulsive disorders to be tested," Professor Schuh says.

The recently discovered link between OCDs and the Ras/ERK-MAP kinase cascade also opens up new targets for therapy. Drugs that inhibit this cascade are already available and some of them are approved for human treatment.

According to Melanie Ullrich, these are cancer drugs, as overactivation of the Ras/ERK-MAP kinase cascade is also a frequent trigger of cancer: "So we are wondering whether such drugs could also be effective in the treatment of obsessive-compulsive disorders and whether they are beneficial in terms of side effects."

More information: M Ullrich et al. OCD-like behavior is caused by dysfunction of thalamo-amygdala circuits and upregulated TrkB/ERK-MAPK signaling as a result of SPRED2 deficiency, Molecular Psychiatry (2017). DOI: 10.1038/mp.2016.232

Provided by Julius-Maximilians-Universität Würzburg

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An overactive molecular signal pathway in the brain region of the amygdala can lead to obsessive-compulsive disorder (OCD). A research team from Würzburg has established this connection. Some people have an extreme fear of dirt or bacteria. As a result, they may develop a habit of compulsive washing and repeatedly cleaning their hands or body.

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Suffering in Silence: Examining Obsessive Compulsive Behaviors in the School Setting

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Suffering in Silence: Examining Obsessive Compulsive Behaviors in the School Setting

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Definition

Students with emotional disorders are a very heterogeneous group with a wide range of issues that are unique to each individual. However, there are some key characteristics that are used to define this disability category, mostly relating to issues of personal identity and emotional well-being. An emotional disorder may be present if a student responds to a situation with an inappropriate behavior or emotion, and particularly, if this emotion is depression or long term unhappiness. Students with emotional disorders typically have a very difficult time maintaining personal relationships with others, and these personal problems lead to physical symptoms in time. If the student has difficulty learning, but there is no intellectual or sensory cause of this difficulty, then an emotional disorder may be to blame. This disability category does include some mental illnesses such as schizophrenia.

It should be noted that one or more of the previously mentioned characteristics has to be present for an extended period of time, and must have a negative impact on the student's academic performance before being considered an emotional disorder. Signs of an emotional disorder need to be taken seriously, as they can lead to physical aggression and self-injurious behavior. However, care must also be taken to recognize the difference between emotional disturbance and general teenage angst. There are as many causes of emotional disturbance in children as there are children in this category, but they can generally be divided into either biological causes, environmental causes, or a combination of the two.

Prevalence

The U.S. Department of Education reports 5,971,495 students receiving special education services in the 2003-2004 school year. Of that number, roughly 7.7%, or 461,055 students, received special education services based on a classification of emotional disturbance. However, within this group of 461,055 students, there was a definite disproportionally between gender, race and socioeconomic background. African-American students were far more likely to be diagnosed as emotionally disturbed than white students, reflecting possible race bias in this category. Research has pointed to a direct correlation between low income status and emotional disorders, but the exact reasons for this correlation are unknown.

Characteristics

Each student with an emotional disturbance will have characteristics that are unique to that individual. However, these students will all share deficits in three specific areas, namely emotional development, behavioral development, and cognitive development.

These students may have specific emotional characteristics/conditions such as anxiety disorder, mood disorder, oppositional defiant disorder, conduct disorder, and schizophrenia. Not addressing any one of these disorders with the appropriate support system could have potentially tragic results. Behavioral characteristics of an emotional disorder include externalizing behavior and conversely internalizing behavior. The former can result in problem behavior and physical aggression while the latter results in depression and anxiety. Finally, students with emotional disorders have a number of academic issues as well, and each year half of the students in this category drop out of school entirely.

One intriguing possible contributing factor to emotional disturbance can be found in deficits in communication. An estimated 71% of students with emotional disorders also have expressive and receptive language disorders that impact their ability to understand and communicate with peers and adults.

Impact on Learning

Students with emotional disorders can be found at every level of cognitive functioning, but the majority of these students tend to have low average intelligence. Most achieve below grade level in academic achievement, with the greatest deficits in both math and spelling. Many have a coexisting learning disability of some type. Students that exhibit externalizing behaviors are at the greatest risk for continued deficits in academic functioning. Students with emotional disorders are less likely to attend post-secondary school than students in many other disability categories. An effective educational program for students with emotional disorders will provide emotional and behavioral supports that foster the replacement of problem behaviors with more appropriate behaviors. Positive behavior support systems are one especially effective strategy to achieve this goal, as are the implementation of wraparound services.

Teaching Strategies

Wraparound planning is a collaborative process that has shown great promise in supporting students with emotional disorders, both in research and in more practical application. This planning process brings all of the involved service providers (i.e., adult rehabilitation services, mental health services, guidance counselor) and individuals together to create a natural support system that is founded on the strengths of the individual student and the community in which that student lives. The family is an integral part of this process, and the overall goal is to devise a program that will capitalize on the strengths and interests of the student while utilizing community resources for placement and intervention.

Generally, academic achievement and problem behaviors often go hand-in-hand for students with emotional disorders. To put this another way, the more difficulty they have with a classroom task, the more likely that maladaptive behavior will result. Supporting the academic performance of these students will thus have the added benefit of decreasing externalizing and internalizing behaviors. Best practices for students with emotional disorders are often best practices for all students. A strategy such as allowing students to choose between classroom tasks, for example, is an effective way to decrease problem behaviors in general. Consistent and specific praise is also a great technique to utilize with all students in the classroom, but can be particularly effective with students with emotional disorders.

It is very important to not make assumptions about any family of a child with an emotional disorder. Many emotional disorders have an organic cause, and the parents of the child may well be loving and supportive in every way. However, some of these students have indeed been abused in some fashion in their young lives, and this too can be a cause of emotional or behavioral issues. Trust can be a very large issue for these children. Forming a relationship with these students that is built on empathy, trust, and mutual respect can often be the solution to many problem behaviors, and can have a lasting impact of the emotional development of the child.

Assistive Technology

Some modification in instruction will be necessary to allow a student with an emotional disorder to demonstrate mastery in a number of academic areas, and most especially in the area of writing. Word processing software can be an excellent supplementary aid for these students, allowing them to edit and revise their work as they produce it. These programs can strengthen spelling skills and writing cohesion simply by making the writing process easier overall. Of particular benefit are word processing programs that read the text as it is typed, providing an additional audio cue for the student.

Organizations

There are a number of excellent organizations that can help support classroom instruction for students with emotional and behavioral disabilities. The information presented in this module is intended as just a very brief description of emotional disorder and its impact on learning. Much more in-depth information and instructional strategies can be accessed through the following organizations:

American Academy of Child and Adolescent Psychiatry

The AACAP (American Academy of Child and Adolescent Psychiatry) is the leading national professional medical association dedicated to treating and improving the quality of life for children, adolescents, and families affected by these disorders. Composed of over 7,500 child and adolescent psychiatrists and other interested physicians, its members actively research, evaluate, diagnose, and treat psychiatric disorders and pride themselves on giving direction to and responding quickly to new developments in addressing the health care needs of children and their families.

Public Information Office
3615 Wisconsin Ave., NW
Washington, DC 20016-3007

Web: www.aacap.org

Center on Positive Behavioral Interventions and Supports

The OSEP-funded National Technical Assistance Center on Positive Behavior and Intervention Supports was established to address the behavioral and discipline systems needed for successful learning and social development of students. The Center provides capacity-building information and technical support about behavioral systems to assist states and districts in the design of effective schools.

5262 University of Oregon
Eugene, OR 97403-5262

Email: pbis@oregon.uregon.edu
Web: www.pbis.org

Center for Disability and Development

Dept. of Educational Psychology
4225 Texas A&M University
College Station, TX 77843-4225

Council for Exceptional Children

The Council for Exceptional Children (CEC) is the largest international professional organization dedicated to improving educational outcomes for individuals with exceptionalities, students with disabilities, and/or the gifted. CEC advocates for appropriate governmental policies, sets professional standards, provides continual professional development, advocates for newly and historically underserved individuals with exceptionalities, and helps professionals obtain conditions and resources necessary for effective professional practice.

1110 North Glebe Road, Suite 300
Arlington, VA 22201-5704

Federation of Families for Children's Mental Health

This organization is dedicated exclusively to helping children with mental health needs and their families achieve a better quality of life. They provide leadership to develop and sustain a nationwide network of family-run organizations; focus the passion and cultural diversity of our membership to be a potent force for changing how systems respond to children with mental health needs and their families; help policy-makers, agencies, and providers become more effective in delivering services and supports that foster healthy emotional development for all children.

1101 King Street, Suite 420
Alexandria, VA 22314

Email: ffcmh@ffcmh.org
Web: www.ffcmh.org

National Alliance for the Mentally Ill (NAMI)

NAMI is the National Alliance on Mental Illness, the nation's largest grassroots organization for people with mental illness and their families. NAMI is dedicated to the eradication of mental illnesses and to the improvement of the quality of life for persons of all ages who are affected by mental illnesses. NAMI members and friends work to fulfill our mission by providing support, education, and advocacy.

Colonial Place Three
2107 Wilson Boulevard, Suite 300
Arlington, VA 22203-3754

Web: www.nami.org

Mental Health America

Mental Health America is dedicated to helping ALL people live mentally healthier lives. They work to fulfill this mission by education the public about ways to preserve and strengthen mental health; advocating for access to effective care; fostering innovation in research, practice, services and policy; and providing support to individuals and families.

2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22311

Web: www.nmha.org

National Mental Health Information Center

The National Mental Health Information Center was developed for users of mental health services and their families, the general public, policy makers, providers, and the media. They provide free information about mental health via a toll-free number, their website, and more than 600 publications.

P.O. Box 42557
Washington, DC 20015

Web: www.mentalhealth.org

References

Hunt, N., and Marshall, K. (2006). Exceptional children and youth. Boston, MA: Houghton Mifflin Company.

National Dissemination Center for Children with Disabilities (2004). Fact Sheet 5. Retrieved February 1, 2008 from www.nichcy.org/pubs/factshe/fs5txt.htm.

Turnbull, A., Turnbull, R. & Wehmeyer, M. L. (2007). Exceptional lives. Special education in today's schools. Upper Saddle River, NJ: Pearson Merrill Prentice Hall.

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Students with emotional disorders typically have a hard time maintaining relationships, and these personal problems may lead to physical symptoms in time.

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School Mental Health Referral Pathways Toolkit

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School Mental Health Referral Pathways Toolkit

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ASCA Ethical Standards for School Counselors 

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ASCA Ethical Standards for School Counselors 

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School Counselor Referral Processes and Procedures Guide

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School Counselor Referral Processes and Procedures Guide

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AddressingMental Health in School Crisis Prevention& Response 

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AddressingMental Health in School Crisis Prevention& Response 

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8 Ways School Counselors Can Support Defiant Students

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8 Ways School Counselors Can Support Defiant Students

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8 Ways School Counselors Can Support Defiant Students - Bright Futures Counseling

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Have you ever encountered a student who has more trouble than others when it comes to complying with class rules and following directions?

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Offering kids choices, safe spaces, and positive reinforcement can help teachers avoid problems-or manage them when they arise.

Elliott Golden / The iSpot

Most children will, at times, argue and test limits. Yet some kids are defiant and hostile to a degree that interferes with their daily lives-behavior that's sometimes diagnosed as Oppositional Defiant Disorder, or ODD, according to a story by WeAreTeachers.

"Students with ODD disrupt their own lives and often the lives of everyone nearby," write the report's authors. "[They] push the limits of defiance far beyond reason. Their problem behavior is much more extreme than that of their peers, and it happens much more often."

According to the American Academy of Child & Adolescent Psychiatry, kids with ODD exhibit "an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the child's day-to-day functioning," for six months or more. Symptoms like frequent temper tantrums, excessive arguing with adults, and mean and hateful speech when upset, are usually seen across multiple settings, but especially at home or school. While a direct cause remains unclear, "biological, psychological, and social factors may have a role," the academy notes. Up to 16 percent of children may have the disorder, and children with ADHD are especially prone.

Though a teacher's first reaction to ODD might be to react defensively, this can backfire and create a power struggle with the student, say experts. Instead, teachers who've worked with students with ODD recommend a set of strategies that will address challenging behavior, and help you start building relationships with hard-to-reach students.

"We all have the capacity to learn, change, and grow," writes special education teacher Nina Parrish. "When given the right tools and environment, students with problematic behavior can learn more productive strategies that will help them have positive and effective interactions with others."

1. Be Calm and Consistent: As a new teacher, Parrish says she quickly learned that reacting with anger when her students with ODD acted out made the behavior worse and students became "amused or encouraged by upsetting an adult." Instead, Parrish recommends trying to keep a positive tone to your voice, adopting neutral body language, and being "cautious about approaching the student or entering their personal space as this might escalate the situation."

Consistency with words and actions is also important when working with kids with ODD. Teacher Brandy T. tells WeAreTeachers she routinely uses the same set of "trigger words" so her students know she's serious. When students in her class begin to argue with her, "I simply say either, 'not now,' 'later,' or 'fix the issue.'" When her students hear 'fix the issue,' for example, she says that's the signal to "go to their chill-out space if they need to calm down."

2. Reinforce Positive Behavior: For all kids, but especially children with ODD, it's important to "switch your focus from recognizing negative behavior to seeking out demonstrations of positive behavior," writes Parrish. She sends home positive notes when students show behavior improvements, even if they're small gains.

Additionally, consider offering students the opportunity to earn certain privileges, suggests WeAreTeachers, rather than "taking those privileges away as punishment." For example, give kids the opportunity to earn rewards-like a bit of iPad time or lunch with a teacher.

3. Find Out What's Going On: Behaviors, notes Parrish, help students "obtain something desirable, or escape something undesirable." She suggests thinking about behavior as feedback, or a way of communicating, an approach that's "helped me work more effectively as a teacher with students who display problem behaviors." Figuring out factors that contribute to students with ODD acting out can help you develop a plan for addressing their difficult behaviors in the classroom.

Sometimes, it's a matter of picking up on a student's signals that their emotions are building long before things reach a breaking point. When students who've experienced trauma are beginning to feel upset, they often show physical signs of their mounting distress: balling up fists, withdrawing from classroom interaction, or clenching their jaw, writes Micere Keels, an associate professor at the University of Chicago and a trauma-informed educator.

"Many educators tend to ignore students' increasing signs of agitation, hoping they'll eventually calm down. But when disregarded, these minor behaviors can quickly escalate," writes Keels, who also recommends identifying students' triggers, like touch or emotionally difficult anniversaries, to avoid situations entirely.

4. Create a Safe Reset Space: Kids with ODD "can learn to recognize when they're feeling overwhelmed and getting ready to challenge or defy," according to WeAreTeachers. "Giving them a safe space to calm down and rethink their choices can be beneficial."

At Fall-Hamilton Elementary, a trauma-informed school in Nashville, Tennessee, for example, every classroom has a nook-called a peace corner-with a comfortable seat, a timer, and items like stuffed animals, sensory squeeze toys, and simple drawing and writing supplies. It's a spot where kids can take a break and reset. The school also recognizes that teachers may need a time out too. Using a strategy called Tap-in/Tap-Out, teachers can ask a colleague via text message to briefly cover their class if they are about to lose their cool.

"A dysregulated adult cannot regulate a dysregulated child," says school principal Mathew Portell. "Use strategies that honor the student's emotions and need for space while also getting their systems to calm in a safe way."

5. Offer Choices: It's important to "affirm your students' autonomy by giving them choices," writes Keels, about best practices for de-escalation. When kids feel respected, "their sense of belonging and mood will often improve."

She recommends avoiding ultimatums like "You better sit back down or I'll send you to the office." Instead, clearly communicate expectations and limits so kids understand. You might say, "I see you're upset, but it's not OK to yell at me. You can either go get a drink of water and come back in five minutes, or sit in the reading chair and I will check in with you in five minutes," says Keels.

In the heat of the moment, it's important to avoid an argument, teacher Holli A. tells WeAreTeachers. "State your choices, then walk away," she says. "Give the student time to process and decide which choice to make. If they don't like the choices, don't engage. When they try to argue, repeat the choices, and walk away again. If the student still will not choose, they do not get to participate in their preferred activity."

6. Build Connections: Often, kids with ODD "are looking for a relationship with a teacher who can help them deal with problems on their own, instead of making them stand out in a negative way," according to WeAreTeachers. "Building a connection with them will help get to the root of the behavior."

Though teachers can feel the need to create boundaries with students, simply talking with them informally can build invaluable connections that influence their behavior in the classroom, says middle school math teacher Cicely Woodard.

Woodard says she intentionally makes herself approachable to students and tries to learn interesting details about them. "Some of my students tell me stories about their lives during the five minutes between classes," Woodard says. "I stop what I am doing, look them in the eyes, and listen."

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Offering kids choices, safe spaces, and positive reinforcement can help teachers avoid problems-or manage them when they arise.

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Five Research-Based Interventions for the Treatment of Oppositional Defiant Disorder in Children!

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Five Research-Based Interventions for the Treatment of Oppositional Defiant Disorder in Children!

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Five Research-Based Interventions for the Treatment of Oppositional Defiant Disorder in Children!

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Resources on children with autism, including symptoms, diagnosis, therapies to help kids develop skills, and parenting kids on the spectrum.

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School Support for Students with Autism Spectrum Disorder: A Guide for Parents

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School Support for Students with Autism Spectrum Disorder: A Guide for Parents

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1 in 68 children have Autism Spectrum Disorder (ASD), which is roughly 1 percent to 2 percent of students in the United States, according to a recent CDC report. Schools, in increasing numbers, are recruiting professionals to serve the academic, social, and emotional needs of students with autism.

Parents of a newly diagnosed child or a student transitioning to a new school should be aware of their educational rights and the rights of their child. The Individuals with Disabilities Education Improvement Act (IDEA) of 1975 specifies that students receive an education that supports their individual needs in the least restrictive learning environment. If your child is diagnosed with autism, he or she is entitled to special education services and early intervention services. The legislation also names parents as equal partners in the development of an individual education plan (IEP) for their child. IEPs involve professionals who work together to provide the best academic, behavioral, social, and emotional services for a student.

SLPs are licensed professionals who diagnose and treat communication problems and disorders. They work in the medical field, as well as in schools, helping students with autism improve language and literacy skills, as well as communication in social contexts. Depending on the child's abilities and needs, SLPs may use spoken language or sign language as well as AAC devices (augmentative and alternative communication), such as speech generating devices (SGD) to help a child integrate into his or her social environment.

Speech-language pathologists diagnose and treat
communication problems and disorders.

SLPs help families navigate special education services, which at times can feel overwhelming. To highlight the host of resources available, Speech@NYU created this reference list of the professionals and teachers who might interact with your child during the school day.

This list is not finite, as other professionals can also play a fundamental role in your child's development.

ABA therapists apply the principles of behavior theory aimed to help a child with autism develop in a range of areas. ABA therapists use behavior modification tools, such as reinforcement strategies, to support students in building communication skills, playing successfully with others, and increasing motor development.

OTs evaluate a child's functioning in daily activities, help customize interventions to improve social and academic functioning, and ultimately help a child meet his or her personal goals. OTs can help children with autism manage and integrate their sensory systems into school work, play, responsibilities at home, and other areas of interest.

Special Education Itinerant Teachers (SEITs) are certified special educators who are responsible for implementing a child's IEP both in the classroom and at home. The school or parents can hire a SEIT to work with the child on reducing bad habits, increasing positive coping skills, and rewarding social interactions.

A pediatric PT is a licensed medical professional who works with children to improve gross motor skills, physical strength, and mobility. In schools, pediatric PTs work with students of varying needs, including those with autism, to improve coordination, balance, and muscle tone.

School counselors are licensed professionals who work directly with students, families, and school staff to help students thrive emotionally, socially, and academically and prepare them for the future. School counselors use the wellness model, which focuses on identifying the strengths of a student with autism and integrating these strengths into the student's IEP. School counselors also play a role in educating the student body about student differences and debunking myths about disorders like autism.

School psychologists evaluate, monitor, and support the psychological needs of students in a school. They often administer assessments to evaluate a child's emotional, behavioral, and social functioning, as well as help generate appropriate interventions in the classroom and beyond to meet these needs.

Special education teachers may be the professionals that students with autism interact with the most during the school day. Depending on a child's IEP, they may work with students in classrooms during the entire school day or as additional support in certain subject areas. They assume an instructional role but also use a student's IEP and feedback from other professionals to promote good academic, social, and emotional functioning. Because they work with students on a daily basis, they can provide informed feedback to parents on how interventions used by other professions play out in the classroom and peer interactions.

If you're not sure whether your child needs specialized services, it may be a good idea to have a conversation with someone who could be a potential resource. You might start by reaching out to your school's guidance counselor, social worker, or assistant principal to get a fuller picture of how these professionals work together to assist your child in the school setting. Each student has a right to the best and least restrictive education possible, so it's important to explore your options and consider which professionals can best support your child on his or her academic journey.

Citation for this content: Speech@NYU, the online masters in speech pathology from NYU Steinhardt.

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School Support for Students with Autism Spectrum Disorder: A Guide for Parents

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1 in 68 children have Autism Spectrum Disorder (ASD), which is roughly 1 percent to 2 percent of students in the United States, according to a recent CDC report. Schools, in increasing numbers, are recruiting professionals to serve the academic, social, and emotional needs of students with autism.

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Childhood schizophrenia - Symptoms and causes

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Childhood schizophrenia - Symptoms and causes

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Childhood schizophrenia - Symptoms and causes

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This severe mental disorder in children involves hallucinations, delusions, and disordered thinking and behavior that can impair the ability to function.

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How Dysfunctional Behavior Affects Families

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How Dysfunctional Behavior Affects Families

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The term dysfunction is defined as "any impairment, disturbance, or deficiency in behavior" on the part of an individual person, between people in a relationship, or among family members. Dysfunction can manifest as poor communication, frequent conflict, emotional or physical abuse, and much more.

Dysfunctional relationships or situations often serve as motivation for people to seek help, often in the form of psychotherapy.

Examples of Dysfunctional Behavior

Examples of dysfunctional behavior within families can include situations such as when a family member, parent, or caregiver:

Engages in compulsive behavior such as gambling or overworking

Engages in emotionally, physically, or sexually abusive behavior

Misuses drugs or alcohol

Uses threats of violence

Allows children to drink alcohol or use drugs

Fails to provide children with emotional support

Relies on a child to provide emotional or financial support

Uses an authoritarian style of parenting in which there is no flexibility

Abuses or neglects children

Cannot provide basic needs such as food and shelter for children

Doesn't address or manage violence or inappropriate behavior

A parent or caregiver in a dysfunctional family might view their children or other family members as property or as things they can control, abuse, or use as an outlet for negative emotions.

Causes of Family Dysfunction

There are many potential causes of family dysfunction. Dysfunction is often the result of a parent or caregiver not getting the emotional support they need. As a result, they are unable or don't know how to provide their children with emotional support.

If a parent or caregiver is abusive, it's possible they themselves experienced abuse as a child-whether emotional, physical, or sexual. For instance, a child who is verbally abused may grow up confusing feelings like anger and love, so they may express themselves with yelling and aggression as an adult in their close relationships.

Mental Health Conditions

If a parent or caregiver experiences severe symptoms of a mental health disorder such as depression, bipolar disorder, post-traumatic stress disorder (PTSD), or a personality or mood disorder, and these symptoms are not appropriately treated, they may contribute to dysfunction within the family dynamic.

Someone with a mental health condition may find it difficult to perform daily tasks or support their family, especially if they aren't receiving adequate treatment or if they don't have a support system of loved ones to step in and help. A child's needs may go unmet and they may experience the added stress of seeing their parent struggle and not being able to help.

One study found that severe symptoms of mental health conditions like depression can often result in a parent treating a child harshly or disengaging from the relationship with their child.

Substance Use

Substance use disorder can also contribute to family dysfunction. If a member of the family misuses drugs or alcohol, all members of the family can experience stress as a result. Coping with addiction in the family may lead to other members of the family feeling neglected.

A parent or family member may also struggle with other types of addiction like overeating or gambling. If, for example, a family member is spending money on the object of their addiction and are unable to pay for basic needs like rent or food, it's likely that everyone in the family will feel stressed and insecure as a result.

Socioeconomic Status

Families who are at a socioeconomic disadvantage, or those who have low income, tend to experience additional stress levels, especially in single-parent households.

A parent or caregiver might struggle to provide food and shelter; they may also work long hours in harsh conditions. Some may have multiple children or family members to support financially. These burdens can contribute to family dysfunction, particularly if the parent is not receiving any support themselves.

Low-income communities generally have less access to mental health services, which can make it even more difficult for a parent or caregiver to get the support that they need. Unfortunately, they may end up taking their negative feelings out on their children or other family members.

The Effects of Dysfunction on Children

When dysfunctional patterns become the standard in a family, the detrimental effects on the children are significant and can be carried into their adult relationships. Some of the potentially damaging effects for children include:

One study found that people who endured stress during childhood as a result of a parent or caregiver's poor mental health experienced more stress into adulthood compared to people who weren't exposed to the same type of stress as children.

If a child's parents or caregivers don't provide them with adequate emotional support, they may grow up not knowing how to prioritize or express their needs or feeling that their needs are unimportant.

Children who've experienced familial dysfunction may even repeat patterns of abuse in their future relationships. They may unconsciously seek out partners who are abusive in similar ways as their parents or they themselves may abuse their partners or children.

Acknowledging dysfunction within your family, how it's affected you, and/or how you contribute to it is the first step in healing.

Getting Help for Family Dysfunction

If your family is experiencing dysfunction for any reason, there is help available. Outside of traditional therapy, there are accessible resources to help you and your family address dysfunctional patterns. Many communities have mental health centers that offer free information and counseling.

Family Therapy

Family therapy may be a good option for those experiencing the effects of dysfunction. Family therapy has been shown to be extremely effective in helping families learn new ways of communicating, solving problems, and supporting each other.

Family therapy sessions usually last 50 minutes to an hour and continue once a week for up to 12 weeks. Oftentimes, families will enter therapy looking to resolve a specific issue such as one family member's uncontrolled anger.

A therapist would work with your family as a unit to discuss how you're all communicating, how you can all respond to incidents of anger more effectively, and teach you how to set goals for productively handling future incidents.

If you have health insurance, check with your plan about coverage for mental and behavioral health services as well as providers that are in-network (which means that the provider is contracted with your insurance and your plan will likely cover more of the cost). If you don't have insurance, you can still research family therapists. Some therapists offer a sliding payment scale based on your income, so be sure to inquire about this prior to booking a session.

Individual Therapy

Whether your family seeks family therapy or not, online or in-person therapy can be a helpful option for anyone in the family. Individual therapy includes working one-on-one with a therapist who can address the underlying causes or effects of family dysfunction with the individual family member seeking help.

For example, if you have learned any negative beliefs as a result of family dysfunction, such as "I don't matter," or "My needs aren't important," a therapist who offers cognitive behavioral therapy (CBT) can work with you to reframe these beliefs into more positive ones. If you are contributing to dysfunction within your family, CBT can help you understand the roots behind your behavior and how to replace negative actions with healthy coping mechanisms.

Support Groups

There are also online or in-person support groups that may offer support for what you're going through in your family. Some support groups are tailored for people coping with specific mental health conditions as well as their friends and family members.

Self-Help Resources

There are also mental health apps, podcasts, and books that cover specific types of family dysfunction and offer practical advice for you and your family to start addressing maladaptive patterns.

Religious Counseling

If you are part of a religious group, you may seek advice from a religious leader as well. Some religious leaders may meet with your entire family and offer words of support and encouragement as you cope with dysfunctional patterns.

Get Advice From The Verywell Mind Podcast

A Word From Verywell

Whether you are coping with family dysfunction right now or you are dealing with the aftermath of a tumultuous childhood experience, remember that you are not alone. Therapy can be very effective in addressing the causes, effects, and trauma of family dysfunction, giving you or your family a roadmap for healing.

Be sure to prioritize your own physical and emotional safety. Family dysfunction may not change overnight, but you should do your best to ensure your own health and the health of your children as best you can.

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How Dysfunctional Behavior Affects Families

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The term dysfunction is defined as "any impairment, disturbance, or deficiency in behavior" on the part of an individual person, between people in a relationship, or among family members. Dysfunction can manifest as poor communication, frequent conflict, emotional or physical abuse, and much more.