Knowledge Bank
National PBS Knowledge Bank
We have grouped our knoweldge bank into different diagnoses. Click on the orange “+” to open and read some general information on each diagnosis. At thebottom of each section, there is a link which will take you to our research centre. Our research centre houses all the latest research articles that we have dissected.
What is it?
Acquired brain injury (ABI) refers to any type of brain damage that occurs after birth. It can include damage sustained by infection, disease, lack of oxygen or a blow to the head. Brain injury can occur through:- sudden onset – caused by trauma, infection, lack of oxygen (for example, during near drowning or suicide attempts), strokes or drug use episodes
- insidious onset – from prolonged alcohol or substance abuse, tumours or degenerative neurological diseases.
How this affects behaviour
The long-term effects of brain injury are difficult to predict and are different for every individual. Symptoms range from mild to severe depending on personal circumstances. It is common for many people with ABI to experience increased fatigue (mental and physical) and some slowing down in how fast they can process information, plan and solve problems. They may experience changes to their behaviour and personality, physical and sensory abilities, or thinking and learning. Aggressive behaviour is common.Treatment/Interventions
A range of tests, including x-rays and CT brain scans, can help pinpoint the exact areas of damage. In some cases, surgery may be needed. Recovery depends on the extent and location of the brain damage, the age and general health of the person, the speed of first aid received and the quality of treatment. Caring for someone who has had a brain injury may bond a family closer together. It can also mean enormous burdens for the family, which may tear it apart. It will help if family members:- have good information about the effects of ABI
- appreciate the difficulties that might be encountered
- understand that recovery is a slow process.
Read our latest research summaries on ABI’s here
What is it?
Anxiety disorders are a group of mental health problems. They include generalised anxiety disorders, social phobias, specific phobias (for example, agoraphobia and claustrophobia), and panic disorders. Depression is often related to anxiety disorders. It’s important to note that not all anxiety is a disorder. Anxiety is deemed a disorder when the individual experiences excessive, frequent and irrational anxiety that interferes with their daily lives.How this affects behaviour
The main features of an anxiety disorder are fears or thoughts that are chronic (constant) and distressing and that interfere with daily living. Other symptoms of an anxiety disorder may include:- Panic or anxiety attacks or a fear of these attacks
- Physical anxiety reactions – for example trembling, sweating, faintness, rapid heartbeat, difficulties breathing or nausea
- Avoidance behaviour – a person may go to extreme lengths to avoid a situation that they think could bring on anxiety or panic.
Treatment/Interventions
Recovery from an anxiety disorder is possible with the right treatment and support. Effective treatments for anxiety disorders may include:- Cognitive behavioural therapy – aims to change patterns of thinking, beliefs and behaviours that may trigger anxiety.
- Exposure therapy – involves gradually exposing a person to situations that trigger anxiety using a fear hierarchy: this is called systematic desensitisation.
- Anxiety management and relaxation techniques – for example deep muscle relaxation, meditation, breathing exercises and counselling.
- Medication – this may include antidepressants and benzodiazepines.
Read our latest recsearch summaries on Anxiety here
What is it?
Attention deficit hyperactivity disorder (ADHD) is a condition that affects an individual’s behaviour and learning. Individuals with ADHD often have difficulty concentrating (are easily distracted), and are impulsive and overactive. ADHD is not the child’s or the parents’ fault.How this affects behaviour
Individuals with ADHD experience difficulties with:- inattention – having difficulty concentrating, forgetting instructions, moving from one task to another without completing anything
- impulsivity – such as talking over the top of others, having a ‘short fuse’, being accident prone
- overactivity – constant restlessness and fidgeting
- emotional regulation
- social navigation
- sleep – see Insomnia below
Treatment/Interventions
There are a number of ways to help reduce ADHD symptoms. These include:- medication – ADHD medications are most commonly stimulant medications. They can reduce hyperactivity and impulsivity and improve the individual’s ability to focus, work, and learn
- psychotherapies – such as behaviour therapy and cognitive behaviour therapy
- counselling – for the individual and other family members.
- parenting skills training that helps them learn how to encourage and reward positive behaviours in their child
- learning some stress management techniques
- Autism
- OCD
- ODD
Read our latest research summaries on ADHD’s here
How this affects behaviour
There is a range of behaviours commonly linked with autism. These may include:- challenges with communicating and interacting with others
- repetitive and different behaviours, moving their bodies in different ways
- strong interest in one topic or subject
- unusual reactions to what they see, hear, smell, touch or taste
- preferences for routines and disliking change.
Treatment/Interventions
There are no “cures” for autism, but therapies and other treatment considerations can help people feel better or alleviate their symptoms. Many treatment approaches involve therapies such as:- behavioral therapy
- play therapy
- occupational therapy
- physical therapy
- speech therapy
Alternative treatments
Alternative treatments for managing autism may include:- high-dose vitamins
- chelation therapy, which involves flushing metals from the body
- hyperbaric oxygen therapy
- melatonin to address sleep issues
- ADHD
- OCD
- ODD
- ID
Read our latest research summaries on Autism here
- feeling extremely euphoric (‘high’) or energetic
- going without sleep
- strong interest in one topic or subject
- thinking and speaking quickly
- reckless behaviour, such as overspending
- participating in unsafe sexual activity
- aggression
- irritability
- grandiose, unrealistic plans
- withdrawal from people and activities
- feelings of sadness and hopelessness
- lack of appetite and weight loss
- feeling anxious or guilty without reason
- difficulty concentrating
- suicidal thoughts and behaviour.
- mood-stabilising medications
- antidepressant medications
- anti-psychotic medications
- psychological therapies
- hospitalisation – for appropriate treatment during acute episodes
- education – to help people understand and manage their condition and be more self-sufficient
- community support programs – to provide rehabilitation, accommodation and employment support
- self-help groups for emotional support and understanding.
Read our latest research summaries on Bipolar Disorder here
What is it?
Borderline personality disorder (BPD) is a type of psychiatric condition. People with BPD experience distressing emotional states, difficulty relating to other people and self-destructive behaviour.
About 1–4% of the population will develop BPD at some time in their lives. Women are more likely than men to develop BPD.
People with BPD have difficulty relating to other people and the world around them.
The causes of BPD are unclear, but may involve a combination of:
- biological factors – for example, structural and functional changes in the brain
- genetic factors – for example, where a close family member, such as a parent or sibling, also lives with BPD
- environmental factors – for example, the person may have experienced trauma or loss. Traumatic experiences in early life are common in people living with BPD
How this affects behaviour
Difficulties that people with BPD may experience include:
- idealising or devaluing other people
- constant, overwhelming emotional pain
- impulsive or self-destructive behaviours – such as spending sprees or engaging in unsafe sex or substance abuse
- intense outbursts of anger.
Treatment/Interventions
Currently, the most effective treatments for BPD are:
- psychotherapy – a mental health professional talks with the person about their symptoms, and they discuss ways to cope with them
- psychosocial rehabilitation – helping people with BPD learn social skills
- medication – this may help reduce associated symptoms such as depression.
Common dual-diagnoses
BPD often occurs with:
- mood disorders (for example, bipolar disorder and depression)
- eating disorders
- alcohol or drug abuse.
It is essential that each of these disorders is recognised and treated separately
References:
Borderline personality disorder, SANE Australia
Borderline personality disorder, 2017, National Institute of Mental Health
Read our latest research summaries on Borderline Personality Disorder here
What is it?
Cerebral palsy describes a range of disabilities associated with movement and posture.
There are four main types of cerebral palsy:
- Spastic cerebral palsy – this is the most common type of cerebral palsy. Spasticity means stiffness or tightness of muscles, which is most obvious when the person tries to move.
- Athetoid cerebral palsy – athetosis means uncontrolled movements, which often lead to erratic movements.
- Ataxic cerebral palsy – this is the least common type of cerebral palsy. Ataxia means a lack of balance and coordination. It often presents as unsteady, shaky movements called tremors.
- Mixed type cerebral palsy – may involve a combination of types of cerebral palsy.
Cerebral palsy is not a disease, it is a condition. Cerebral palsy is not contagious. It is also not hereditary. It is usually the result of changes in, or injury to, the developing brain before or during birth, or sometimes in early childhood. It is usually the result of a diminished blood supply and lack of oxygen to areas of the brain, causing damage to brain cells.
How this affects behaviour
Where speech is affected, the person with a disability will understand what is said to them, but may find it difficult to respond. Many people with cerebral palsy are unable to walk or need assistance to walk. Cerebral palsy may also lead to reduced control of facial muscles, which can result in uncontrolled facial expressions or drooling.
Treatment/Interventions
Practical aids – such as communication boards and electronic devices that provide written or spoken words – help to get a message across.
Wheelchairs allow mobility – however, people can still be restricted by inaccessibility to trams, buses, shops and services.
Many people with cerebral palsy can and do live independent lives in the community, and most people with cerebral palsy have the potential to participate in the same activities as others – in business, education, recreation, marriage or raising children.
References:
Cerebral Palsy, Better Health Channel
What is it?
Dementia is a broad term used to describe the symptoms of a large group of illnesses that affect the brain and cause a progressive decline in a person’s functioning. It is not one specific disease. Dementia symptoms include memory loss, confusion, and personality and behavioural changes. These symptoms interfere with the person’s social and working life.
Common types of Dementia
- Alzheimer’s Disease
- Vascular Dementia
- Frontotemporal Dementia
- Younger-onset Dementia
- Dementia caused by Huntington’s disease
Dementia is more common in people over 65, but it is not a normal part of ageing. A number of different illnesses can result in dementia and each has its own features. In most cases, the reason people develop these conditions is not known.
How this affects behaviour
In the early stages of dementia, a person may still show some insight into their changes. As a result, they may experience anger, resentment, depression, emotional lability (constant changing emotions), withdrawal, or loss of self-confidence. These early changes tend to become less prominent as the disease progresses and progressive loss of insight. However, some individuals will remain aware of their difficulties for a long time.
Treatment/Interventions
Treatment varies from person to person, and depends on the type of Dementia. Read our latest research summaries on Dementia here to learn more about different treatment options.
References:
What is dementia?, 2012, Alzheimer’s Australia.
What is it?
Depression is a mental illness that may be mild or severe. Types include major depressive disorder, bipolar disorder, dysthymic and cyclothymic disorders, postnatal depression and seasonal affective disorder.
We’ve all felt sad before, we all have low days. Depression however is much more severe. Depression is a serious condition that has an impact on both physical and mental health.
How this affects behaviour
Depression affects how people think, feel and act. Depression makes it more difficult to manage from day to day and interferes with study, work and relationships. A person may be depressed if for more than two weeks they have felt sad, down or miserable most of the time. Participants with depression have also lost interest or pleasure in most of their usual activities.
Emotions caused by depression
A person with depression may feel:
- sad
- miserable
- unhappy
- irritable
- overwhelmed
- guilty
- frustrated
- lacking in confidence
- indecisive
- unable to concentrate
- disappointed
Behaviour caused by depression
- withdraw from close family and friends
- stop going out
- stop their usual enjoyable activities
- not get things done at work or school
- rely on alcohol and sedatives.
Physical symptoms of depression
- being tired all the time
- feeling sick and ‘run down’
- frequent headaches, stomach or muscle pains
- a churning gut
- sleep problems
- loss or change of appetite
- significant weight loss or gain.
Treatment/Interventions
Different types of depression require different treatment. Mild symptoms may be relieved by:
- learning about the condition
- lifestyle changes (such as regular physical exercise)
- psychological therapy provided by a mental health professional.
There are several different types of psychological treatments including:
- cognitive behaviour therapy (CBT)
- interpersonal therapy (IPT)
- behaviour therapy
- mindfulness-based cognitive therapy (MBCT).
For moderate to more severe depression, medical treatments are likely to be required, in combination with these other treatments.
If you are experiencing severe symptoms listed above, please seek help at either beyondblue (1300 224 636) or Lifeline (13 11 14).
References:
Depression, Black Dog Institute, Australia.
Depression: signs and symptoms, beyondblue.
Depression, The Australian Psychological Society.
What is it?
Eating disorders are serious mental illnesses. They can affect people of all age groups, genders, backgrounds and cultures. The number of people with eating disorders is increasing. We understand more about eating disorders now than ever before. Yet, many people live with these disorders for a long time without a clinical diagnosis or treatment. Eating disorders are estimated to affect almost one million Australians.
The most common risk factors for the onset of an eating disorder are:
- body dissatisfaction
- dieting
- depression
The main types of eating disorder include:
- anorexia – characterised by restricted eating, weight loss, and fear of gaining weight
- bulimia – periods of binge eating (often in secret), followed by attempts to compensate with excessive exercise, vomiting, or periods of strict dieting. Binge eating is often accompanied by feelings of shame and being ‘out of control’
- binge eating disorder – characterised by recurrent periods of binge eating. Binge eating can include:
- eating much more than usual
- eating until uncomfortably full
- eating large amounts when not feeling hungry.
Feelings of guilt, disgust and depression can follow binge eating episodes. Binge eating does not involve compensatory behaviours, such as for bulimia.
How this affects behaviour
There are some warning signs that are common to people with eating disorders. These may include:
- weight loss, weight gain or weight fluctuation – usually due to dieting, but sometimes from an illness or stressful situation
- preoccupation with body appearance or weight
- sensitivity to cold
- faintness, dizziness and fatigue
- increased mood changes and irritability
- social withdrawal
- anxiety or depression
- inability to think rationally or concentrate
- increased interest in preparing food for others
- obsessive rituals, such as only drinking out of a certain cup
- eating in secret
- wearing baggy clothes or changes in clothing style
- excessive or fluctuating exercise patterns
- avoidance of social situations involving food
- frequent excuses not to eat
- disappearance of large amounts of food from the refrigerator or pantry
- trips to the bathroom after meals
- constant and excessive dieting
Treatment/Interventions
Many different forms of therapy are available. It is important to remember that different approaches work for different people. Finding the right approach and early intervention maximises prospects of recovery. Professional help and support from others is important.
Because eating disorders affect people physically and mentally, a range of health professionals might be involved in treatment, including:
- psychiatrists
- psychologists
- GPs
- dietitians
- social workers
- nurses
- dentists
References:
Eating disorders explained, Eating Disorders Victoria
What is it?
Epilepsy is a common condition of the brain in which a person tends to have recurrent unprovoked seizures. Seizures can involve loss of consciousness, a range of unusual movements, odd feelings and sensations, or changed behaviours.
The cause of epilepsy varies by the age, and is not always known. In fact, up to half of people with epilepsy don’t know the cause of their condition.
However, known causes can include:
- brain injury
- stroke
- brain infection
- structural abnormalities of the brain
- genetic factors.
How this affects behaviour
Some people may have episodes where they ‘go blank’ for a few seconds. Others remain fully conscious during a seizure and can describe their experience. For many, consciousness is affected, and they may be briefly confused during and after the seizure.
A seizure may involve both sides of the brain (generalised onset seizure) or a small part of the brain (focal onset seizure). Sometimes seizures may evolve and start as one type and progress into another.
Treatment/Interventions
Medication is the main type of treatment for epilepsy with up to 70% of people gaining seizure control with the right medication. However, medication is not prescribed for everyone who has a seizure, it depends on the risk of that person having further seizures.
For some people, medication is not an ideal solution for seizure control. Sometimes epilepsy is caused by an area of abnormal brain tissue. In this instance, surgery might be the best solution. The most common surgical intervention is Vagus nerve stimulation (VNS).
Some people may need to trial more than one medication before they obtain seizure control.
References:
Fisher RS, Acevedo C, Arzimanoglou A, et al. 2014. A practical clinical definition of epilepsy. Epilepsia, vol. 55, no. 4, pp. 475–482
Treatment, Epilepsy Action Australia.
Vagus nerve stimulation (VNS), Epilepsy Action Australia.
What is it?
Fragile X syndrome is a genetic disorder caused by a change to one of the genes on the X chromosome. It is the most common inherited cause of intellectual disability. Fragile X syndrome is also linked to features of autism spectrum disorder.
Developmental Profile
- Moderate to severe ID – average IQ <55< /li>
- Weakness in: short-term and working memory, auditory and sequential processing, abstract thinking and mathematical thinking.
- Strength in: receptive vocab, visual memory, simultaneous processing and imitation.
- Girls are generally less severely affected.
- Individuals are more talkative, more intelligible, have higher expressive language skills and are stronger in phonological memory than those with Down Syndrome or Autism.
Co-diagnoses
- On average, 75% of individuals with FXS have attention problems<55< /li>
- On average, 65% of individuals with FSX have anxiety
- On average, 35% of individuals with FSX have autism
- On average, 20% of individuals with FSX have epilepsy
- On average, 40% of individuals with FSX are treated for Behaviours of Concern
- On average, 79% of individuals (males) with FSX report self-injury, mainly in biting of hands and fingers
Medical Profile
- FXS individuals normally have long narrow faces, prominent eats, hypermobility of joints, hypotonia and flat feet. Scoliosis is less common. Shorter height is common.<55< /li>
- Sleep is a real issue with FXS: 85% of individuals have trouble either getting to sleep or have frequent night awakenings.
- 31% of individuals with FXS are obese
- FXS individuals have enlarged hippocampus, amygdala and thalamus
- The blink rate in FXS is much higher than in other individuals, which is correlated with behaviours of concern and physiological arousal
Treatment/Interventions
- Reducing anxiety and sensory issues may reduce Behaviours of Concern. Positive reinforcement has shown to be the best intervention method. Negative reinforcement and Punishment does not work.
- A combined effort from Allied Health Services work best. Given the high rates of ID and comorbidities, FXS participants require a high level of specialised needs from Speech Paths, Occupational Therapists and Behaviour Specialists.
- Most FXS patients are on medication. The main medication is for behaviour management to reduce Behaviours of Concern. Risperidone is used the most, with positive effects on aggressive behaviours.
What is it?
Insomnia is a symptom, not a disease. It means being concerned with how much you sleep or how well you sleep. This may be caused by difficulties in either falling or staying asleep. Self-reported sleeping problems, dissatisfaction with sleep quality and daytime tiredness are the only defining characteristics of insomnia. It is an individual perception of sleep. Long-term chronic insomnia needs professional support from a sleep disorder clinic.
How this affects behaviour
It has been shown that insomnia and broader sleep problems in participants result in daytime consequences.
These include: fatigue, memory consolidation problems, irritability and aggressive behaviour. Those with more severe problems have more frequent and severe behaviours of concern.
Treatment/Interventions
Insomnia that has persisted for years needs professional support and a lot of patience. It might take some time to re-establish normal sleeping patterns.
Some of the techniques used by a sleep disorder clinic might include:
- a sleep diary, to help pinpoint the pattern of insomnia
- a program of mild sleep deprivation
- medication to help set up a new sleeping routine
- exposure to bright light in the
References:
Sleep – Insomnia, Better Health VIC
What is it?
Intellectual disability involves problems with general mental abilities that affect functioning in two areas:
- intellectual functioning (such as learning, problem solving, judgement)
- adaptive functioning (activities of daily life such as communication and independent living)/li>
How this affects behaviour
Three areas of adaptive functioning are affected in participants with ID:
- Conceptual – language, reading, writing, math, reasoning, knowledge, memory
- Social – empathy, social judgment, communication skills, the ability follow rules and the ability to make and keep friendships
- Practical – independence in areas such as personal care, job responsibilities, managing money, recreation and organizing school and work tasks
Treatment/Interventions
Intellectual disability is a life-long condition. However, early and ongoing intervention may improve functioning and enable the person to thrive throughout their lifetime. It may also be influenced by underlying medical or genetic conditions and co-occurring conditions.
Services for people with intellectual disabilities and their families provide support to allow full inclusion in the community. Many different types of supports and services can help, such as:
- Early intervention (infants and toddlers)
- Special education
- Family support (for example, respite care)
- Transition services
- Vocational programs
- Day programs
- Housing options
- Case management
Common dual-diagnoses
- Attention-deficit/hyperactivity disorder
- Autism spectrum disorder
- Social communication disorder
- Specific learning disorder
References:
American Association on Intellectual and Developmental Disabilities
The Arc: for People with Intellectual and Developmental Disabilities
Read our latest research summaries on Intellectual Disabilities (ID) here
What is it?
Global development delay is used when a child takes longer to reach certain developmental milestones in multiple skill areas than other children at the same age. This can include skills like learning to walk and talk, gross and fine motor skills, and interacting with others socially.
How this affects behaviour
Global Developmental Delay may show these symptoms:
How a child looks after them self:
- showering, bathing, dressing, eating, toileting, grooming, sleeping.
How a child understands and uses language:
- being understood by other people by using gestures, pictures, words and sentences to communicate
- understanding what other people say and communicate.
How a child thinks, learns and problem solves:
- understanding and remembering information
- learning new things and using new skills
- planning, making decisions and completing tasks
- developing pretend play skills and play interests
- emotional development and social awareness.
How a child uses their body to move:
- moving around the home (sitting, crawling, walking)
- moving to perform everyday routines
- manipulating objects and using hands
- moving about in the community.
Evidence for developmental delay can come from those who know a child well including family, carers, health professionals, allied health professionals and educators.
Treatment/Interventions
Treatments for global developmental delays vary according to the delay observed in specific areas of skill development. The treatment plan may include physical or occupational therapy for help in motor skill delays and speech-language therapy for help with speech delays, and the like. Even when it’s not clear what’s causing the delay, early detection and intervention is important in helping kids develop skills.
Common dual-diagnoses
- Fragile X Syndrome
References:
Global Developmental Delay, NDIS
All You Need To Know About GDD, Mom’s Belief
Read our latest research summaries on Global Developmental Delay here
What is it?
Korsakoff syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1). Korsakoff syndrome is most commonly caused by alcohol misuse, but certain other conditions also can cause the syndrome.
Korsakoff syndrome is often — but not always — preceded by an episode of Wernicke encephalopathy, which is an acute brain reaction to severe lack of thiamine.
How this affects behaviour
Korsakoff syndrome causes problems learning new information, inability to remember recent events and long-term memory gaps. Memory difficulties may be strikingly severe while other thinking and social skills are relatively unaffected.
Those with Korsakoff syndrome may “confabulate,” or make up, information they can’t remember. They are not “lying” but may actually believe their invented explanations. Scientists don’t yet understand the mechanism by which Korsakoff syndrome may cause confabulation. The person may also see or hear things that are not there (hallucinations).
Treatment/Interventions
Heavy drinkers and others at risk of thiamine deficiency take oral supplements of thiamine and other vitamins under their doctor’s supervision. Thiamine can also be injected for more severe cases.
For those who develop Korsakoff syndrome, extended treatment with oral thiamine, other vitamins and magnesium may increase chances of symptom improvement. If there is no improvement, consideration should be given to treatment of comorbid deficiencies and medical conditions, and the need for long-term residential care or supportive accommodation.
References:
Korsakoff Syndrome, Alzheimer’s Association
Read our latest research summaries on Korsakoff’s Syndrome here
What is it?
Obsessive compulsive disorder (OCD) is an anxiety disorder that usually begins in late childhood or early adolescence. People with OCD experience recurrent and persistent thoughts, images or impulses that are intrusive and unwanted (obsessions). They also perform repetitive and ritualistic actions that are excessive, time-consuming and distressing (compulsions). People with OCD are usually aware of the irrational and excessive nature of their obsessions and compulsions. However, they feel unable to control their obsessions or resist their compulsions.
How this affects behaviour
Common obsessions include:
- fear of contamination from germs, dirt, poisons, and other physical and environmental substances
- fear of harm from illness, accidents or death that may occur to oneself or to others. This may include an excessive sense of responsibility for preventing this harm
- intrusive thoughts and images about sex, violence, accidents and other issues
- excessive concern with symmetry, exactness and orderliness
- excessive concerns about illness, religious issues or morality
- needing to know and remember things.
Common compulsions include:
- excessive hand washing, showering and tooth brushing
- excessive cleaning and washing of house, household items, food, car and other areas
- excessive checking of locks, electrical and gas appliances, and other things associated with safety
- repeating routine activities and actions such as reading, writing, walking, picking up something or opening a door
- applying rigid rules and patterns to the placement of objects, furniture, books, clothes and other items
- touching, tapping or moving in a particular way or a certain number of times
- needing to constantly ask questions or confess to seek reassurance
- mentally repeating words or numbers a certain number of times, or concentrating on ‘good’ or ‘safe’ numbers
- replacing a ‘bad thought’ with a ‘good thought’.
Treatment/Interventions
- Treatment for OCD can include:
psychological treatments such as cognitive behaviour therapy - anxiety management techniques
- support groups and education
- medications.Psychological treatment such as cognitive behaviour therapy can improve symptoms, and this improvement is often maintained in the long term.
Common dual-diagnoses
- Autism
- ADHD
- ODD
References:
Obsessive Compulsive Disorder (OCD), Anxiety Recovery Centre Victoria.
What is it?
Oppositional defiant disorder (ODD) is a childhood behavioural problem characterised by constant disobedience and hostility. Around one in 10 children under the age of 12 years are thought to have ODD, with boys outnumbering girls by two to one.
ODD is one of a group of behavioural disorders known collectively as disruptive behaviour disorders, which include conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD).
How this affects behaviour
ODD behaviours usually surface when the child is at primary school, but the disorder can be found in children as young as three years of age.
A participant with ODD may:
- Become easily angered, annoyed or irritated
- Have frequent temper tantrums
- Argue frequently with adults, particularly the most familiar adults in their lives such as parents
- Refuse to obey rules
- Seem to deliberately try to annoy or aggravate others
- Have low self-esteem
- Have a low frustration threshold
- Seek to blame others for any accidents or bad behaviour.
Treatment/Interventions
Treatment options for ODD may include:
- Parental training – to help the parents better manage and interact with their child, including behavioural techniques that reinforce good behaviour and discourage bad behaviour. This is the primary form of treatment and the most effective. Social support is increased if the parents are trained in groups with other parents who have children with ODD
- Functional family therapy – to teach all family members to communicate and problem-solve more effectively
- Consistency of care – all carers of the child (including parents, grandparents, teachers, child care workers and so on) need to be consistent in the way they behave towards and manage the child.
References:
Sattler, JM & Hodge, RD 2006, Assessment of Children: Behavioural, Social, and clinical foundations (5th edition). Jerome M. Sattler, San Diego.
What is it?
PTLS is a genetic disorder characterized by the presence of an extra copy of a tiny portion of chromosome 17. People with this duplication often have some degree of developmental delay (primarily speech delay), low muscle tone, poor feeding, and failure to thrive during infancy. In addition, many individuals display some behaviors commonly associated with autism spectrum disorders. Some people with PTLS have a heart defect. While most cases of PTLS occur sporadically, in rare cases, it may be inherited.
How this affects behaviour
The symptoms and severity of PTLS vary from person to person. In some cases, the features are subtle, and the diagnosis may be delayed. Symptoms of PTLS may include:
- Congenital heart defects (present at birth) or heart problems that develop with age
- Low muscle tone (hypotonia) beginning in infancy
- Poor feeding beginning in infancy
- Failure to thrive beginning in infancy
- Developmental delay of motor and verbal milestones
- Intellectual disability
- Behavioral difficulties such as attention problems, hyperactivity, or withdrawal
- Features of autism spectrum disorder
- Neuropsychiatric disorders (such as bipolar disorder or anxiety disorder)
- Sleep apnea, which often is not apparent but found during sleep studies
Other signs and symptoms of Potocki-Lupski syndrome can include vision and hearing problems, dental and skeletal abnormalities, and abnormal kidney development and function. Many affected individuals have problems with sleep, including short pauses in breathing during sleep (sleep apnea) and trouble falling asleep and staying asleep.
Treatment/Interventions
Depending on the age and presenting problems of the individual with PTLS, a multidisciplinary evaluation involving healthcare providers from the following specialties is often necessary: audiology, cardiology, dental, developmental pediatrics, endocrinology, feeding, gastroenterology, general pediatrics, clinical genetics, ophthalmology, orthopedics, otolaryngology, physical medicine and rehabilitation, psychiatry, sleep medicine, speech pathology, and urology.
References:
Potocki-Lupski Syndrome, MedlinePlus
Potocki-Lupski Syndrome, GARD
Potocki L, Neira-Fresneda J, Yuan B. Potocki-Lupski Syndrome. 2017 Aug 24. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK447920/
What is it?
How this affects behaviour
Children with Prader-Willi syndrome are delayed in all aspects of development, reaching developmental milestones – such as sitting, crawling and walking – later than other children. The average IQ of a child with Prader-Willi syndrome is around 70, but the degree of intellectual disability will differ for each child. By five years of age, a feature of Prader-Willi syndrome is excessive appetite, which can lead to obesity if not carefully managed.
Children with Prader-Willi syndrome are prone to a range of associated health and behavioural problems as they get older. Some of these problems may include:
- obsessive and compulsive behaviours, such as picking at the skin
- eye problems, such as short-sightedness
- short stature, often due to growth hormone deficiency
- delayed onset of puberty
- scoliosis (sideways curves in the spine)
- kyphosis (exaggerated hump in the spine)
- delayed or absent menstrual periods in girls
- abnormally small penis in boys
- type 2 diabetes
- osteoporosis (weakened bones that are prone to fracturing)
- teeth problems, including soft enamel and tooth grinding
- sleep apnoea (breathing stops for a period of time during sleep)
- problems with short-term memory
- temper tantrums.
Treatment/Interventions
There is no cure for Prader-Willi syndrome and it cannot be prevented. Treatment aims to ease some of the associated problems. Depending on the needs of the person, some of the treatment options may include:
- strict supervision of diet (there are no medical means of curbing appetite)
- plenty of physical activity to help maintain the child’s body weight within the normal range
- growth hormone treatment to overcome the hormone deficiency that contributes to the child’s short stature
- hormone therapy to increase muscle mass
- hormone therapy to boost inadequate sex hormone levels
- medication to help control any obsessive and compulsive behaviours
- orthopaedic treatment for scoliosis or kyphosis
- appropriate prescription eye glasses
- specialist care from a range of healthcare professionals.
What is it?
Post-traumatic stress disorder (PTSD) is a set of reactions that can develop in people who have experienced or witnessed a traumatic event that threatens their life or safety (or others around them). This could be a car or other serious accident, physical or sexual assault, war-related events or torture, or a natural disaster such as bushfire or flood.
How this affects behaviour
A person with PTSD has four main types of difficulties:
- Re-living the traumatic event through unwanted and recurring memories, flashbacks or vivid nightmares. There may be intense emotional or physical reactions when reminded of the event including sweating, heart palpitations or panic.
- Avoiding reminders of the event, such as thoughts, feelings, people, places, activities or situations that bring back memories of the event.
- Negative changes in feelings and thoughts, such as feeling angry, afraid, guilty, flat or numb, developing beliefs such as “I’m bad” or “The world’s unsafe”, and feeling cut off from others.
- Being overly alert or ‘wound up’ indicated by sleeping difficulties, irritability, lack of concentration, becoming easily startled and constantly being on the lookout for signs of danger.
Treatment/Interventions
Effective treatments are available. Most involve psychological treatment such as counselling, but medication can also be helpful. Generally, it’s best to start with psychological treatment rather than use medication as the first and only solution to the problem.
The cornerstone of treatment for PTSD involves confronting the traumatic memory and working through thoughts and beliefs associated with the experience. Trauma-focussed treatments can:
- reduce PTSD symptoms
- lessen anxiety and depression
- improve a person’s quality of life
- be effective for people who have experienced prolonged or repeated traumatic events, but treatment may be required for a longer period.
Alternative treatments are now at the forefront of current research too. Participants have found that a holistic approach to PTSD treatment including these activities help reduce symptoms:
- Yoga
- Eye Movement Desensitization and Reprocessing (EMDR)
- Neurofeedback
- Communal Rhythms and Theatre
References:
Van der Kolk, B. (2014). The body keeps the score: Mind, brain and body in the transformation of trauma. Penguin UK.
Australian Guidelines for the Treatment of Acute Stress Disorder and Posttraumatic Stress Disorder, 2013, Australian Centre for Posttraumatic Mental Health. More information here .
What is it?
Schizophrenia is a complex brain disorder, which affects about one in a 100 or between 150,000 and 200,000 Australians. The illness is characterised by disruptions to thinking and emotions, and a distorted perception of reality. It usually begins in late adolescence or early adulthood and does not spare any race, culture, class or sex.
How this affects behaviour
Symptoms include:
- Hallucinations
- Delusions
- Thought disorder
- Social withdrawal
- Lack of motivation
- ‘Blunted’ emotions
- Inappropriate responses
- Impaired thinking and memory
- Lack of insight.
Not all people affected by schizophrenia have all these symptoms. Some symptoms appear only for short periods or ‘episodes’.
While these psychotic symptoms are more alarming, other symptoms reinforce the alienation of people with schizophrenia. They are often unable to participate in normal social events or conversations, and lack sufficient motivation for simple activities like bathing or cooking. In addition, sufferers lack the insight to recognise how their inappropriate behaviour appears to others.
Treatment/Interventions
Medication, hospital care and rehabilitation are the best forms of treatment. Admission to hospital is only necessary during crises; normal living can resume once symptoms subside. Effective antipsychotic medications enable many people with schizophrenia to lead full and productive lives.
Antipsychotic drugs help stabilise some symptoms, but do not cure the disease and are frequently associated with side effects. Most people need to stay on medication to prevent relapse
References:
Schizophrenia. Better Health VIC
