Self destructive behaviour

1. Self destructive behaviour Sub Outcomes: 2)Explain substance misuse and list types of substances to include smoking and drugs 3)Name eating disorders and explain how to recognize them 4)Discuss suicide and self-harm

2. Substance abuse also known as drug abuse, : taking a psychoactive drug or performance enhancing drug for a non-therapeutic or non-medical effect. • Alcohol • Smoking • Drugs- e.g. Cannabis • Inhalants – paint, glue, petrol.

3. 1) alcohol • Starts in adolescence • 40-50% of 14 yr. olds drink in UK • increases to 70 % by 17 yrs. in UK • 40 % of them binge drink. • Bingeing for enjoyment and to be sociable

4. 2) smoking • 1% at 11 yrs. And increases to 26 % of girls and 21 % of boys at age 15 in UK. • Girls overtook boys from mid 1980’s

5. 3) drugs- cannabis • Most common in western world • Starts at 16-17 yrs. and 30- 50% report abuse • 10 % report regular use and 3 % daily use.

6. 4) inhalants • 5 % of adolescents use paint , glue and petrol. • Readily available • Purchase and possession is not illegal. • when vaporized and inhaled , paint , glue and petrol rapidly result in intoxication and euphoria.

7. Specific signs of substance misuse • Intravenous drug habit- pupil constriction, puncture marks, old scars • Inhalants misuse- paint stains on clothing and skin, chemical smell on breath • Withdrawal effects- agitation, tremor tachycardia

8. Assessing dependence • Dependence is likely when the young person experiences • Difficulty controlling use of substance despite negative consequences • Tolerance to the substance , needing increasing amounts • Withdrawal symptoms when not using the substance.

9. Treatment options • Counseling- cognitive behavior therapy • Drug withdrawal or detoxication • Pharmacotherapy • Rehabilitation through outpatient program Harm reduction strategies to minimize harm • Monitor medical issues : HIV screening • Mental health concerns

10. rehabilitation • Setting realistic expectations • Positive reinforcement • Remind the adolescent of previous success • Reintegration • Integration into education and employment, and other healthier options such as sport ., activities and hobbies

11. What are Eating Disorders? • While more common among girls, eating disorders can affect boys, too. • They're so common in the U.S. that 1 or 2 out of every 100 kids will struggle with one, most commonly • Obesity. • Anorexia • Bulimia

12. Obesity • Excessive amount of body fat- BMI> 30 Women with > 30-35% body fat Men with > 25% body fat • Fat cells grow in number and size • The number of fat cells increase especially during childhood/puberty • Obesity occurs when fat cells increase in number, size, or both • The number offat cells do not decrease with weight loss

13. Fat Cell Development During growth, fat cells increase in number. When energy intake exceeds expenditure, fat cells increase in size. When fat cells have enlarged and energy intake continues to exceed energy expenditure, fat cells increase in number again. With fat loss, the size of the fat cells shrinks, but not the number. Fat cells are capable of increasing their size by 20-fold and their number by several thousand fold.

14. Health Risks of Obesity • Cardiovascular disease • Type 2 Diabetes • Hypertension • Some cancers(colon, Pancreas, gallbladder, breast cancer) • Gallbladder disease • Osteoarthritis

16. Is this the future?

17. What is Anorexia? • People with anorexia have an extreme fear of weight gain and a distorted view of their body size and shape. As a result, they strive to maintain a very low body weight. • dieting, fasting, or excessive exercise.

18. Causes Media has a huge impact on the way we look • E.g. pictures of skinny models • The media is always commenting on how people look. • All of this has a negative impact on the way we look and the way we perceive our bodies.

19. Anorexia A very successful male model recovered from anorexia

21. What is Bulimia? Definition: An eating disorder involving overeating and forcing oneself to vomit.

23. treatment 1) Assess through a physical examination 2) Establish weight monitoring 3) Discuss psychiatric risk 4) Provide information to the family Admission to hospital if • rapid weight loss • Risk of suicide • Physical compromise (dehydration, low blood pressure)

24. Self harm • Deliberate self harm ranges from behaviours with no suicidal intent to suicide • 7-14% of adolescents attempt self harm. And 20- 45 % have suicidal thoughts.

25. Other causes/ reasons • To : • Die • Escape from anguish • Change behaviour of others • Escape a situation • Show desperation • Get back at others • Gain relief from tension • Seek help

26. prevention • Identify people at risk • Suicidal ideation • Depressed adolescents • Interpersonal crisis • Previous self harm • Isolated and depressed people • Suicide note or suspicious behaviour • Talk of death

27. Class activity • Stormy adolescence scan ( pdf) • Questions for the scan ( word)

28. treatment 1.Individual: • Problem solving • Cognitive behaviour therapy • Treatment of psychiatric disorder • Treatment of drug abuse • Anger management 2.Family therapy ( assess family support) 3.Group therapy 4.Environmental changes- temporary accommodation