Behavioral and Mood Disorders

Introduction Behavioral and emotional abnormalities are called when a child exhibits an emotion, personality, and social behavior that deviates from that age and seriously affects the child's own development and the learner's interference with others' lives. Children with behavioral and emotional abnormalities are divided into extroverted and introverted surnames. Extroverts are their non-stop activities, their attention is very short-lived, they are distracted and unable to learn, or they are aggressive, unable to obey authority, and have more aggressive behaviors. This type of child often destroys group order in a group. Introverted children often have deep fears, often feel anxious, insecure, unable to bear frustration or blows, and sometimes cry, depression or sadness, so that they can't learn normally. Such children are also classified into mild and moderate to severe due to different biased behavioral intensity. The extremes of this type are autism, schizophrenia, and the like.

Cause

1. Genetic factors: According to many survey data, tic disorder is related to genetic factors, and the twins have a higher prevalence rate. The first-degree relatives of children with tic disorder suffer from tic disorder. Tourette syndrome and other mental illnesses are more common than normal people. It is generally believed that the genetic pattern may be autosomal dominant or polygenic.

2, nerve serialization factors: through the study of neurotransmitters and behaviors and the mechanism of action of psychotropic drugs, suggesting that this disease is related to neurobiochemical metabolic changes, some scholars believe that this disease is due to striatal dopamine hyperactivity or post-synaptic dopamine receptor Caused by hypersensitivity; another scholar believes that tic disorder is associated with norepinephrine and serotonin dysfunction, or due to decreased gamma-aminobutyric acid (GABA) inhibition in the brain, resulting in tics. In addition, studies on endorphins in recent years have shown that the imbalance of various neurotransmitters such as dopamine, serotonin and gamma-aminobutyric acid in the central nervous system may be secondary to dysfunction of the endogenous opioid system, so it is considered Endorphin has an important influence on the pathogenesis of Tourette's syndrome. However, changes in neurobiochemistry have yet to be studied in depth.

3, organic factors; tic disorder may be related to perinatal damage (production injury, asphyxia, etc.). About 50% to 60% of children with Tourette's syndrome have abnormal EEG, mainly slow wave or spike wave, but no specific change. In a few cases, the head CT was abnormal. The nervous system soft signs are more common. Some people think that tics-slang syndrome, behavioral motor abnormalities are related to amygdala-striatum pathway disorder; involuntary vocalization may be related to cingulate gyrus and irregular brain stem discharge, so it is considered to be organic disease.

4. Psychosocial factors: Children may be induced or severely twitched by trauma, excessive tension and other effects. Some people think that some stress events during pregnancy and severe reaction in the first 3 months of pregnancy are risk factors for tic disorder in offspring; post-natal stress also increases the incidence of individuals with genetic susceptibility.

5, other factors: infectious diseases, taking drugs (such as taking central stimulants and antipsychotic drugs) may cause tic disorder.

an examination

Related inspection

Nervous system examination

1. Abnormal behavior of children is characterized by personality change, stubbornness, hyperactivity, impulsivity, social withdrawal, forced behavior, aggressive behavior (body and language) and even self-harm.

2. Behavioral and emotional abnormalities are one of the clinical manifestations of tic disorder in children. A tic disorder is a period of onset of childhood and adolescence. It is mainly characterized by involuntary, purposeless, repetitive, rapid, one-part or multi-site muscles, motor tics, and vocal tics. ), and can be accompanied by other behavioral symptoms, including inattention, hyperactivity, self-injury and obsessive-compulsive disorder. The cause of tic disorder is not understood, and the course of the disease is different. If it persists for a long time, it can become a chronic neuropsychiatric disorder.

3, the most common period of childhood is transient tic disorder, also known as tic disorder or habitual sputum, the prevalence rate is about 1% to 7%. More men than women, the majority of ages 5 to 7 years old. Foreign literature reports that the prevalence of Tourette syndrome (ie, Tourette's syndrome) is 0.1% to 0.5%. In recent years, there have been more cases of domestic reports, but there are fewer epidemiological surveys. Gao Qingyun (1984) investigated 17,727 children aged 8 to 12 years old and found 43 patients with Tourette's syndrome. The prevalence rate was 2.42. The city was higher than the rural areas, and there were significant differences between the environmentally polluted areas and the non-polluted areas.

5, the diagnostic criteria for tic disorder (transient tic disorder): 1 onset in childhood; 2 exercise tics, or vocal tics; 3 twitch can be restrained by will for a short time (minutes to hours); 4 the intensity of symptoms or The twitching site can be changed; 5 the disease period lasts at least 1 month but not more than 1 year; 6 excludes extrapyramidal systemic neuropathy and other causes of muscle spasm.

6, the diagnosis criteria of Tourette syndrome: 1 onset before the age of 21, most between 2 to 15 years old; 2 recurrent, involuntary, repetitive, rapid, purposeless twitch, affecting multiple groups of muscles; 3 kinds of twitching and one or more vocal tics, both at the same time but not necessarily at the same time; 4 can be restrained by the will for several minutes to several hours; 5 the intensity of symptoms in weeks or months There are changes; 6 twitches occur many times a day, almost every day. The course of disease is more than 1 year, and the symptoms are relieved for more than 2 months in the same year; 7 exclude small chorea, liver bean degeneration, epilepsy myoclonus, drug-induced involuntary movement and other extrapyramidal lesions .

7. Diagnostic criteria for chronic exercise or vocal dysfunction: (1) must meet the 1, 2, and 3 items listed in transient tic disorder; (2) muscle twitching or involuntary vocalization occurs multiple times a day, almost every day or Intermittent appearance. The intensity is generally unchanged. The disease period is more than 1 year.

Differential diagnosis

Differential diagnosis of behavioral and emotional abnormalities:

1. Obsessive-compulsive disorder (OCD), obsessive-compulsive disorder (OCD) is a kind of neurosis, an anxiety disorder. Patients with this disease are always plagued by a forced mind. The patient repeatedly has obsessive and compulsive behaviors in his life. The patient's self-awareness is intact, knowing that this is unnecessary, even painful, but unable to get rid of it.

2, emotional ups and downs: When your emotions or psychology easily rise and fall in a short period of time, then you may suffer from "emotional illness", which is a symptom of psychological unhealthy. Many people do not pay attention to emotional illness, and think it is only a kind of psychological fluctuation. However, if this time is not treated, it will lead to more serious mental illness and even damage to life safety.

3, children's behavior is secluded: children are lonely, afraid of seeing people, always unhappy, indifferent to everything, or temper to move, do not concentrate on things, insist on poor, we must pay attention. For such a situation, many parents think that it is a child's personality characteristics, do not care. In fact, these children have got "high-rise autism", which is a new kind of mental illness for children.

4. Aggressive behavior: Attacking behavior, also known as infringing behavior, usually refers to behaviors that intentionally harm the physical and mental health of others. Aggressive behavior is an integral part of the social development of children and adolescents, and is an individual developmental psychology, social psychology, criminal psychology. And other important topics related to scientific research. In recent years, with the increase of the crime rate of juveniles in the West, the issue of juvenile delinquency has attracted great attention from Western scholars. As an important feature of violent crimes, aggression has become a hot topic in Western psychology and is used as a prediction. The important content of adolescents' anti-social behaviors and violent crimes has attracted much attention. It is particularly worth noting that some scholars have focused on the cognitive characteristics of adolescents' aggressive behaviors, and have revealed the causes of violent crimes among juvenile offenders from a cognitive perspective. This is a major advancement in juvenile crime research, and it provides a psychological basis for rationally controlling adolescents' aggressive behavior and scientifically correcting their violent behavior. At present, China's research in this area is relatively weak. In order to learn from the relevant Western experience and strengthen the research on juvenile violent crimes, the author makes a brief introduction to the cognitive research on the aggression behavior of juveniles in the West based on relevant information. And ask your colleagues.

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