Information for Potential Problematic Behavior
Depression
Suicidal Behavior
Parasuicidal Behavior and Self-Mutilation
Eating Disorders:
Anorexia Nervosa, Binge Eating Disorder, and
Bulimia
Violence and the
Verbally Aggressive Student
Alcohol and Other Drug Abuse
Poor Contact with Reality
Mania
Observer Responsibility and Intervention
It is important that everyone in the Park
University community, students, faculty and staff, share a sense of
responsibility for observing, identifying and reporting any type of behavior
that could potentially harm members of the Park University community.
Reasons for BIT Referral
-
Self-injurious behavior including but not limited to cutting, disordered
eating, alcohol/drug abuse
-
Suicidal
thoughts or actions
-
Erratic
behavior (including online activities) that disrupts the mission and/or
normal proceedings of University students, faculty, staff, or community.
Behaviors
include but are not limited to: weapons on
campus, significant inappropriate disruption to community, potential for
safety being compromised.
-
Involuntary
transportation to the hospital for alcohol and drug use/abuse.
The
Depressed Student
Depression and the
variety of ways in which it manifests itself is part of a natural emotional and
physical response to life’s ups and downs. With the busy and demanding life of
a college student, it is safe to assume that most students will experience
periods of reactive (or situational) depression in their college careers.
Major
depression, however,
is a “whole-body” concern, involving the body, mood, thoughts, and behavior. It
affects the way a person eats and sleeps, the way a person feels about him or
herself, and the way a person thinks about things.
Major
depression is not
a passing blue mood. It is not a sign of personal weakness or a condition that
can be wished or willed away. People with depression cannot merely pull
themselves together. Without treatment, symptoms can last for weeks, months or years.
Appropriate treatment, however, can help over 80% of those who suffer from
depression.
Symptoms
-
Persistent sad, anxious or
“empty” mood
-
Feelings of hopelessness,
pessimism
-
Feelings of guilt,
worthlessness, helplessness
-
Loss of interest or pleasure
in hobbies and activities that were once enjoyed, including sex and school
-
Insomnia, early morning
awakening or oversleeping
-
Appetite and/or weight loss
or overeating and weight gain
-
Decreased energy, fatigue,
being “slowed down”
-
Thoughts of death or suicide
attempts
-
Restlessness, irritability
-
Difficulty in concentrating,
remembering, making decisions—may effect completion of assignments
-
Persistent physical symptoms
that do not respond to treatment, such as headaches, digestive disorders,
and chronic pain
-
Inconsistent class
attendance
-
Decline in personal hygiene
For additional information:
http://www.nimh.nih.gov/health/publications/depression-a-treatable-illness.shtml
The Suicidal Student
Take It
Seriously
-
Seventy-five percent of all suicides give some warning of their intentions
to a friend or family member.
-
All
suicide threats and attempts must be taken seriously.
If you
have been contacted directly by a student who is threatening suicide, it is
important to act as quickly as possible by making sure they get immediate
intervention. This might involve calling 911 if you are with them or the
police if you not with them and concerned about their safety and well-being.
The incident needs to be reported to the Behavioral Intervention Team for
appropriate follow-up.
Warning Signs of Suicide
Suicide can be prevented. While
some suicides occur without any outward warning, most people who are suicidal do
give warnings. Prevent the suicide of loved ones by learning to recognize the
signs of someone at risk, taking those signs seriously and knowing how to
respond to them.
Warning signs include:
-
Observable signs of
serious depression:
Unrelenting low mood
Pessimism
Hopelessness
Desperation
Anxiety, psychic pain and inner tension
Withdrawal
Sleep problems
-
Increased alcohol
and/or other drug use
-
Recent impulsiveness
and taking unnecessary risks
-
Threatening suicide
or expressing a strong wish to die
-
Making a plan:
Giving away prized possessions
Sudden or impulsive purchase of a firearm
Obtaining other means of killing oneself such as poisons or medications
-
Unexpected rage or
anger
The emotional crises that
usually precede suicide are often recognizable and treatable. Although most
depressed people are not suicidal, most suicidal people are depressed. Serious
depression can be manifested in obvious sadness, but often it is rather
expressed as a loss of pleasure or withdrawal from activities that had been
enjoyable. One can help prevent suicide through early recognition and treatment
of depression and other psychiatric illnesses.
http://www.afsp.org/index.cfm?page_id=0519EC1A-D73A-8D90-7D2E9E2456182D66
Parasuicidal Behavior and
Self-Mutilation
There are behaviors that are
somewhat less serious in nature but still need to be addressed by a referral to
the Behavioral Intervention Team. These behaviors include self-mutilation such
as cutting behavior and risk-taking behavior. While these behaviors may not be
immediately life-threatening, these behaviors have the potential to escalate
into more serious life-threatening situations. These behaviors are reflective
of underlying psychological issues that need to be addressed.
Parasuicide:
An
apparent attempt at suicide, commonly called a suicidal gesture, in which the
aim is not death. A sub-lethal drug overdose or wrist cutting are examples.
Previous parasuicide is a predictor of suicide. The increased risk of
subsequent suicide persists without decline for at least two decades.
http://www.medterms.com/script/main/art.asp?articlekey=21820
Self-mutilation is a serious
public health problem, yet there is very little empirical evidence showing that
treatments can reduce this maladaptive behavior. Self-mutilation is defined
here as intentional and acute physical self-injury without intent to die, which
includes various methods such as cutting and burning. In contrast, only a
minority of individuals attempt suicide (i.e., intend to die) by cutting or
burning (e.g., Wexler, Weissman, & Kasl, 1978), and suicide attempts are much
more likely to be medically severe (Brown & Linehan, 1996). Despite these
differences between self-mutilation and suicide attempts, many individuals
who self-mutilate also attempt suicide or wish to die. It has been estimated
that about half of individuals who self-mutilate also attempt suicide (e.g.,
Hillbrand et al, 1994).
Collectively, this group of suicidal and nonsuicidal self-injury will be
referred to as
parasuicide
(Kreitman, 1977).
Eating Disorders:
Anorexia Nervosa, Binge Eating Disorder, and
Bulimia
It is critical to identify and refer someone with an eating disorder to the BIT
because for many people it is life-threatening or can result in serious health
issues.
In the United States, as many as 10 million females and 1 million males are
fighting a life and death battle with an eating disorder such as
anorexia or bulimia. Millions more are struggling with binge eating disorder (Crowther
et al., 1992; Fairburn et al., 1993; Gordon, 1990; Hoek, 1995; Shisslak et al.,
1995).
Eating disorders arise from a variety of physical, emotional, social, and
familial issues, all of which need to be addressed for effective prevention and
treatment.
Terms and
definitions:
Anorexia Nervosa
Anorexia Nervosa is a serious, potentially life-threatening eating disorder
characterized by self-starvation and excessive weight loss. There are
four primary symptoms:
-
Resistance to maintaining
body weight at or above a minimally normal weight for age and height.
-
Intense fear of weight gain
or being “fat” even though underweight.
-
Disturbance in the
experience of body weight or shape, undue influence of weight or shape on
self-evaluation, or denial of the seriousness of low body weight.
-
Loss of menstrual periods
in girls and women post-puberty.
Eating disorders experts have
found that prompt intensive treatment significantly improves the chances of
recovery. Therefore, it is important to be aware of some of the warning signs
of anorexia nervosa.
Warning Signs of Anorexia
Nervosa:
-
Dramatic weight loss
-
Preoccupation with weight,
food, calories, fat grams, and dieting
-
Refusal to eat certain
foods, progressing to restrictions against whole categories of food (e.g.
no carbohydrates, etc.)
-
Frequent comments about
feeling “fat” or overweight despite weight loss
-
Anxiety about gaining
weight or being “fat”
-
Denial of hunger
-
Development of food rituals
(e.g. eating foods in certain orders, excessive chewing, rearranging
food on a plate)
-
Consistent excuses to avoid
mealtimes or situations involving food
-
Excessive, rigid exercise
regimen--despite weather, fatigue, illness, or injury--the need to “burn
off” calories taken in
-
Withdrawal from usual
friends and activities
-
In general, behaviors
and attitudes indicating that weight loss, dieting, and control of food are
becoming primary concerns
Anorexia nervosa involves
self-starvation. The body is denied the essential nutrients it needs to
function normally, so it is forced to slow down all of its processes to conserve
energy. This “slowing down” can have serious medical consequences.
Health Consequences of Anorexia
Nervosa:
-
Abnormally slow heart
rate and low blood pressure, which mean that the heart muscle is changing. The
risk for heart failure rises as heart rate and blood pressure levels sink lower
and lower
-
Reduction of bone density (osteoporosis), which results in dry, brittle
bones
-
Muscle loss and weakness
-
Severe dehydration, which can result in kidney failure
-
Fainting, fatigue, and overall weakness
-
Dry hair and skin, hair loss is common
-
Growth of a downy layer
of hair called lanugo all over the body, including the face, in an effort to
keep the body warm
Statistics About Anorexia
Nervosa:
-
Approximately 90-95% of
anorexia nervosa sufferers are girls and women (American Psychiatric
Association, 1994)
-
Between 0.5-1% of American women suffer from anorexia nervosa
-
Anorexia nervosa is one of the most common psychiatric diagnoses in young
women (Hsu, 1996)
-
Between 5-20% of
individuals struggling with anorexia nervosa will die.
The probabilities of death
increases within that range depending on the length of the condition (Zerbe,
1995)
-
Anorexia nervosa has one of the highest death rates of any mental health
condition
-
Anorexia nervosa typically appears in early to mid-adolescence
I Information from:
http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=41142
Binge Eating
Disorder
Binge Eating Disorder (BED) is a type of eating disorder not otherwise specified
and is characterized by recurrent binge eating without the regular use of
compensatory measures to counter the binge eating. It
is characterized by:
-
Frequent episodes of
eating large quantities of food in short periods of time
-
Feeling out of control over eating behavior
-
Feeling ashamed or disgusted by the behavior
-
There are also several behavioral indicators of BED including eating when
not hungry and eating in secret
Health Consequences of Binge
Eating Disorder:
The health risks of BED are most commonly those associated with clinical
obesity. Some of the potential health consequences of binge eating disorder
include:
-
High blood pressure
-
High cholesterol levels
-
Heart disease
-
Diabetes mellitus
-
Gallbladder disease
About Binge Eating Disorder:
-
The prevalence of BED is
estimated to be approximately 1-5% of the general population.
-
Binge eating disorder
affects women slightly more often than men--estimates indicate that about 60% of
people struggling with binge eating disorder are female, 40% are male (NIH,
1993).
-
People who struggle with
binge eating disorder can be of normal or heavier than average weight.
-
BED is often associated
with symptoms of depression.
Information from:
http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=41140
Bulimia Nervosa
Bulimia Nervosa is a serious, potentially life-threatening eating disorder
characterized by a cycle of bingeing and compensatory behaviors such as
self-induced vomiting designed to undo or compensate for the effects of binge
eating. It
has three primary symptoms:
-
Regular intake of large
amounts of food accompanied by a sense of loss of control over eating behavior.
-
Regular use of
inappropriate compensatory behaviors such as self-induced vomiting, laxative or
diuretic abuse, fasting, and/or obsessive or compulsive exercise.
-
Extreme concern with
body weight and shape.
Eating disorder specialists
believe that the chance for recovery increases the earlier bulimia nervosa is
detected. Therefore, it is important to be aware of some of the warning signs
of bulimia nervosa.
Warning Signs of Bulimia
Nervosa:
-
Evidence of
binge-eating, including disappearance of large amounts of food in short periods
of time or the existence of wrappers and containers indicating the consumption
of large amounts of food.
-
Evidence of purging
behaviors, including frequent trips to the bathroom after meals, signs and/or
smells of vomiting, presence of wrappers or packages of laxatives or diuretics.
-
Excessive, rigid
exercise regimen--despite weather, fatigue, illness, or injury--the need to
“burn off” calories taken in.
-
Unusual swelling of the
cheeks or jaw area.
-
Calluses on the back of
the hands and knuckles from self-induced vomiting.
-
Discoloration or
staining of the teeth.
-
Creation of complex
lifestyle schedules or rituals to make time for binge-and-purge sessions.
-
Withdrawal from usual
friends and activities.
-
In general, behaviors
and attitudes indicating that weight loss, dieting, and control of food are
becoming primary concerns.
Bulimia nervosa can be
extremely harmful to the body. The recurrent binge-and-purge cycles can impact
the entire digestive system and purge behaviors can lead to electrolyte and
chemical imbalances in the body that affect the heart and other major organ
functions.
Health Consequences of Bulimia
Nervosa:
-
Electrolyte imbalances
that can lead to irregular heartbeats and possibly heart failure and death.
Electrolyte imbalance is caused by dehydration and loss of potassium and sodium
from the body as a result of purging behaviors.
-
Inflammation and
possible rupture of the esophagus from frequent vomiting.
-
Inflammation and
possible rupture of the esophagus from frequent vomiting.
-
Tooth decay and staining
from stomach acids released during frequent vomiting.
-
Chronic irregular bowel
movements and constipation as a result of laxative abuse.
-
Gastric rupture is an
uncommon but possible side effect of binge eating.
About Bulimia Nervosa:
-
Bulimia nervosa affects 1-2% of adolescent and young adult women.
-
Approximately 80% of
bulimia nervosa patients are female (Gidwani, 1997).
-
People struggling with
bulimia nervosa will often appear to be of average body weight.
-
Many people struggling
with bulimia nervosa recognize that their behaviors are unusual and perhaps
dangerous to their health.
-
Bulimia nervosa is
frequently associated with symptoms of depression and changes in social
adjustment.
Information from:
http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=41141
For additional
information:
http://www.nimh.nih.gov/health/publications/eating-disorders/what-are-eating-disorders.shtml
Violence and the
Verbally Aggressive Student
SIGNS
The most accurate predictor
of violent behavior is past violent behavior. If an individual has a
history of such behavior, she/he is more likely than someone with no history
to engage in it again. If you have no prior information, it is necessary
for you to be attentive to current behavior.
SYMPTOMS
Frequently, assaultive
behavior is predicted on the basis of observing hostile, suspicious, and
agitated behavior. In the absence of the above symptoms, the presence of
hyper-vigilance (i.e. looking around a lot), extreme dependency, or
delusions and hallucinations may be causal factors. Other signs and
symptoms that may indicate a loss of control are fearfulness or anger.
Verbal communication may be loud and pressured.
Please Note:
While the information below is focused on middle and high school
students, much of the information can still be applicable to the
college-age student.
Characteristics of Youth Who Have Caused School-related Violent Deaths
The
National School Safety Center offers the following checklist derived from
tracking school-associated violent deaths in the United States from July
1992 to the present. Follow this link to the School Associated Violent
Deaths Report. http://www.schoolsafety.us/School-Associated-Violent-Deaths-p-6.html
After studying common characteristics of youngsters who have caused such
deaths, NSSC has identified the following behaviors, which could indicate a
youth’s potential for harming him/herself or others.
Accounts of these tragic incidents repeatedly indicate that in most cases,
a troubled youth has demonstrated or has talked to others about problems
with bullying and feelings of isolation, anger, depression and frustration.
While there is no foolproof system for identifying potentially dangerous
students who may harm themselves and/or others, this checklist provides a
starting point.
These
characteristics should serve to alert faculty, staff, and friends to address
needs of troubled students through referrals to the Behavioral Intervention
Team (BIT).
http://www.park.edu/studentlife/bit/ Further, such
behavior should also provide an early warning signal that safe school plans
and crisis prevention/intervention procedures must be in place to protect
the health and safety of all school students and staff members so that
schools remain safe havens for learning.
-
Has a history of
tantrums and uncontrollable angry outbursts.
-
Characteristically resorts to name calling, cursing or abusive language.
-
Habitually makes violent threats when angry.
-
Has
previously brought a weapon to school.
-
Has
a background of serious disciplinary problems at school and in the
community.
-
Has
a background of drug, alcohol or other substance abuse or dependency.
-
Is
on the fringe of his/her peer group with few or no close friends.
-
Is
preoccupied with weapons, explosives or other incendiary devices.
-
Has
previously been truant, suspended or expelled from school.
-
Displays cruelty to animals.
-
Has
little or no supervision and support from parents or a caring adult.
-
Has
witnessed or been a victim of abuse or neglect in the home.
-
Has
been bullied and/or bullies or intimidates peers or younger children.
-
Tends to blame others for difficulties and problems s/he causes
her/himself.
-
Consistently prefers TV shows, movies or music expressing violent themes
and acts.
-
Prefers reading materials dealing with violent themes, rituals and
abuse.
-
Reflects anger, frustration and the dark side of life in school essays
or writing projects.
-
Is
involved with a gang or an antisocial group on the fringe of peer
acceptance.
-
Is
often depressed and/or has significant mood swings.
-
Has
threatened or attempted suicide.
Developed by the National
School Safety Center © 1998
PERMISSION TO REPRINT FOR PROFESSIONAL PURPOSE AS LONG AS CREDIT IS GIVEN TO
NSSC.
Assessing
Potentially Violent Students. ERIC Digest.
Although student school shootings of students
have recently gained significant national attention, more routine forms of
student violence (e.g., homicide, rape, aggravated assault, etc.) continue
to plague our nation's schools and streets. These less sensational but
equally harmful violent behaviors warrant appropriate response.
While one
or a few of these indicators does not necessarily identify or predict
violent behavior, it is important to recognize high-risk factors which
correspond to potentially violent students and a referral made to the BIT so
the behavior can be evaluated and action taken, if deemed necessary.
Past Violent Behaviors or Aggressive History:
Students who have been violent in the past or have demonstrated aggressive
behaviors towards others are at greater risk of repeating such behaviors.
Thus, these students are noted as being at greater risk for future violent
behaviors. Unless provided with support and counseling, a youth who has a
history of aggressive or violent behavior is likely to repeat those
behaviors (Elliot,
Huizinga, & Moise, 1986). Aggressive and violent acts may be
directed toward other individuals, be expressed in cruelty to animals, or
include fire setting. Youth who show an early pattern of antisocial
behavior frequently and across multiple settings are particularly at risk
for future aggressive and antisocial behavior (Gardner
et al., 1996;
Menzies & Webster, 1995;
Walker et al., 1990;
Walker, Stieber, Ramsey, & O'Neill, 1990;
Walker & Sylwester, 1991).
Similarly, youth who engage in overt behaviors such as bullying, generalized
aggression and defiance, and covert behaviors such as stealing, vandalism,
lying, cheating, and fire setting also are at risk for more serious
aggressive behavior (Walker
et al., 1990;
Walker, Steiber, Ramsey, et.al., 1990;
Walker & Sylwester, 1991). Research
suggests that age of onset may be a key factor in interpreting early warning
signs. For example, children who engage in aggression and drug abuse at an
early age (before age 12) are more likely to show violence later on than are
children who begin such behavior at an older age (Gardner
et al., 1996;
Menzies & Webster, 1995;
Walker et al., 1990;
Walker, Steiber, Ramsey et al., 1990;
Walker & Sylwester, 1991
Violent Drawings or Writings:
Violent students often indicate their intentions
before acting violently via drawings or writings. Violent poems, letters to
friends, or letters to the intended victim are clear indications of violent
potential. Hence, further assessment is warranted whenever a student uses
age inappropriate violent drawings or writings. However, an
overrepresentation of violence in writings and drawings that is directed at
specific individuals (family members, peers, other adults) consistently over
time may signal emotional problems and the potential for violence (Berman
& Jobes, 1991). Because there is a real danger in misdiagnosing
such a sign, it is important to seek the guidance of a qualified
professional – such as a school psychologist, counselor, or other mental
health specialist – to determine its meaning.
Threats of Violence Toward Others:
Any threat of violence toward others should be immediately assessed and
appropriate intervention actions should be taken to insure safety. Direct
threats such as, "I'm going to kill him" as well as veiled threats such as,
"Something big is going to happen to you after school" clearly are
inappropriate and warrant immediate assessment and intervention. Threats
should be assessed for: (a) lethality, (b) the degree to which a violent
plan exists, and (c) the student's ability to secure the indicated weapon or
harm instrument (e.g., poison, automobile). Any threat indicated by a
student which is realistic, well-planned, and highly lethal should be
considered viable. Idle threats are a common response to frustration.
Alternatively, one of the most reliable indicators that a youth is likely to
commit a dangerous act toward self or others is a detailed and specific
threat to use violence (Keller
& Tapasak, 1997;
Loeber, 1990). Recent incidents
across the country clearly indicate that threats to commit violence against
oneself or others should be taken very seriously. Steps must be taken to
understand the nature of these threats and to prevent them from being
carried out.
Animal Torturing:
There exists a high correlation between students
who torture animals and violence. Students who regularly torture animals or
intentionally inflict harm upon animals should be assessed for violent
ideation towards others.
Recent Relationship Break:
Students who have recently experienced a
relationship break (e.g., being jilted by a girlfriend or best friend) have
an increased likelihood of being violent.
Isolation:
The vast majority of students who isolate themselves from peers or who
appear friendless typically are not violent. However, one high-risk factor
which has been strongly correlated with violent behaviors towards school
peers is isolation. For this reason, students isolating themselves or
reporting feelings of being isolated from others should be considered at
greater risk.
Teased or Perceptions of Being Teased, Harassed,
or "Picked On": Violent students
often have a hypersensitivity toward criticism. These students report
perceptions of being teased, harassed or being picked on by those they were
violent toward. Therefore, students indicating feelings that they are
being teased, harassed, or "picked on" should be assessed to determine
whether or not they either intend to harm or fantasize about harming
others.
Uncontrolled anger:
Everyone gets angry; anger is a natural emotion.
However, anger that is expressed frequently and intensely in response to
minor irritants may signal potential violent behavior toward self or others
(Rothbart,
Posner, & Hershey, 1995;
Walker et al., 1995).
Being a
victim of violence: Children who are
victims of violence, including physical or sexual abuse, in the community,
at school, or at home are sometimes at risk themselves of becoming violent
toward themselves or others (Browne
& Finkelhor, 1986).
Social Withdrawal:
Withdrawal from peers and familial supports can
indicate the student is experiencing any of a number of concerns (e.g.,
depression, helplessness) which warrant assessment and intervention. When
combined with other risk factors, social withdrawal may signal potential
violence toward others.
Inappropriate Use or Access to Firearms:
Students who inappropriately use firearms by shooting at people, homes, or
vehicles, or have improper, unsupervised firearm access have a clear
potential to harm others and act violently. No student should be allowed to
posses a gun or weapon on school property or at school-related functions
(e.g., dances, sporting events, etc.). Given the general impulsiveness of
students and the dangers of immediate access to lethal weapons, this factor
is one of the most important which should be assessed.
Substance Abuse:
Although substance abuse does not cause students
to be violent, students under the influence of psychoactive substances often
fail to think logically and experience increased impulsivity. Thus, there
exists a strong correlation between substance abuse and violent behaviors.
Familial Stressors:
Familial stressors can engender feelings of
frustration, anger, and hopelessness among students as well as adults.
Noted by Peers as Being "Different":
On many occasions after student violence, peers
and others will note that the perpetrating student was labeled as being
"different" from peers or being associated with some group. Hence, students
frequently labeled by peers as being "weird", "strange", "geeky", etc. may
be at increased risk for violent behaviors.
Excessive feelings of rejection:
In the process of growing up, and in the course
of adolescent development, many young people experience emotionally painful
rejection. Children who are troubled often are isolated from their mentally
healthy peers. Their responses to rejection will depend on many background
factors. Without support, they may be at risk of expressing their emotional
distress in negative ways, including violence (Coie,
Dodge, & Kupersmidt, 1990,
Rubin, Hymel, Lemare, & Rowden, 1989).
Some aggressive children who are rejected by non-aggressive peers seek out
aggressive friends who, in turn, reinforce their violent tendencies.
Feelings of being picked on and persecuted: The
youth who feels constantly picked on, teased, bullied, singled out for
ridicule, and humiliated at home or at school may initially withdraw
socially (Saarni,
1990). If not given adequate support in addressing these
feelings, some children may vent them in inappropriate ways, including
possible aggression or violence (Floyd,
1985;
Greenbaum, 1988).
Intolerance for differences and prejudicial
attitudes: Everyone has likes
and dislikes. However, an intense prejudice toward others based on racial,
ethnic, religious, language, gender, sexual orientation, ability, and
physical appearance – when coupled with other factors – may lead to violent
assaults against those who are perceived to be different (Prothrew-Stith,
1987). Membership in hate groups or the willingness to victimize
individuals with disabilities or health problems also should be treated as
early warning signs.
Low School Interest:
The genesis of this risk factor could come from
any of a multitude of reasons which by themselves may not evoke violent
behaviors. However, in combination with other possible violence related
risk factors noted within this scale, students presenting with low school
interest may have an inability to perform as well as they desire to and may
feel frustrated by such inability. Additionally, these students may
perceive themselves as belittled by those performing more favorably. Thus,
when challenged to increase performance or when feeling harassed by those
performing at higher levels, these students may become violent. For these
reasons, this factor has been included.
Reference:
ERIC Identifier: ED435894
Publication Date: 1999-00-00
Author: Juhnke, Gerald A. - Charkow, Wendy B. - Jordan, Joe -
Curtis, Russell C. - Liles, Robin G. - Gmutza, Brian M. - Adams, Jennifer
R.
Source: ERIC Clearinghouse on Counseling and Student Services
Greensboro NC.
Reference: Dwyer, K., Osher, D., Warger, C.,
Bear, G., Haynes, N., Knoff, H., Kingery, P., Sheras, P., Skiba, R.,
Skinner, L., & Stockton, B. (1998). Early warning, timely response: A
guide to safe schools: The referenced edition. Washington, DC:
American Institutes for Research.
Alcohol and Other Drug Abuse
Alcohol abuse on college
campuses is a serious problem and can even involve those who do not drink.
The costs are staggering in terms of academic failure, vandalism, sexual
assault, and other consequences. If you are concerned about a person’s
abuse of alcohol or other drugs, it is important to make a referral to the
Behavioral Intervention Team so the problem can be evaluated and an
appropriate intervention determined. Keep in mind that this may help the
person you are concerned about be more successful in school, possibly stay
in school or most importantly, stay alive.
SIGNS AND SYMPTOMS
Alcoholism,
also known as alcohol dependence, is a disease that includes the following
four symptoms:
-
Craving
- A strong need, or urge, to drink.
-
Loss of control
- Not being able to stop drinking once drinking has begun.
-
Physical dependence
- Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety
after stopping drinking.
-
Tolerance
- The need to drink greater amounts of alcohol to get "high."
Warning Signals of Alcohol
and Other Drug Abuse
There are many signs of
alcohol and other drug use, abuse, and addiction. None of these signs alone
are conclusive proof of alcohol or other drug problems. Other conditions
could be responsible for unusual behavior, such as an illness or reaction to
a legally prescribed drug. Any one or a combination of these could be cause
for alarm and could signal problems in general, as well as a substance abuse
problem:
-
Impairment of Mental
Alertness
Lack of concentration, short-term memory loss, confusion, and
inability to follow directions.
-
Impairment of Mood
Depression, extreme or unpredictable moods swing, flat or unresponsive
behavior, hyperactivity, loss of interest in one’s work/school results,
nervousness, and volatility.
-
Impairment of Motor
Behavior
Hand tremors, loss of balance, loss of coordination, staggering,
inability to work normally, slurred speech, and passing out from alcohol
or other drug use.
-
Impairment of
Interpersonal Relationships
Detachment from or drastic change in social relationships, becoming a
loner or becoming secretive, attempt to avoid friends or co-workers,
loss of interest in appearance, change of friends, extreme change in
interests, tendency to lose temper, being argumentative, or borrowing
money and not repaying.
-
Violation of University
Rules, Impairment of Academic and Work Performance
Inability to perform work assignments at usual level of competence;
missed deadlines; missed appointments, classes, or meetings; increased
absenteeism or lateness; frequent trips from assigned or expected work
area; accidents in the lab; complaining or feeling ill as an excuse for
poor performance; coming to class, practice, or work intoxicated/high;
legal or judicial problems associated with alcohol or other drug use;
not scheduling morning classes, neglected school or work obligations for
two or more days in a row. (Some individuals with substance abuse
problems are still able to perform at a high academic level.)
Student may not actually be
“under the influence” during class, but be using at night or on the
weekends.
Sobering
Statistics
Information above from:
http://www.factsontap.org/
According
to the Core Institute, an organization that surveys college drinking
practices, 300,000 of today's college students will eventually die of
alcohol-related causes such as drunk driving accidents, cirrhosis of the
liver, various cancers and heart disease.
159,000 of today's
first-year college students will drop out of school next year for alcohol-
or other drug-related reasons. The average student spends about $900 on
alcohol each year. Do you want to know how much cash the average student
drops on his or her books? About $450.
Almost one-third of college
students admit to having missed at least one class because of their alcohol
or drug use, and nearly one-quarter of students report bombing a test or
project because of the aftereffects of drinking or doing drugs.
One night of heavy drinking
can impair your ability to think abstractly for up to 30 days, limiting your
ability to relate textbook reading to what your professor says, or to think
through a football play.
Information above from: http://www.factsontap.org/
A
Snapshot of Annual High-Risk College Drinking Consequences
Information above from: http://www.collegedrinkingprevention.gov/StatsSummaries/snapshot.aspx
-
Death: 1,700 college students between the ages of 18
and 24 die each year from alcohol-related unintentional injuries,
including motor vehicle crashes (Hingson
et al., 2005).
-
Injury: 599,000 students between the ages of 18 and 24
are unintentionally injured under the influence of alcohol (Hingson
et al., 2005).
-
Assault: More than 696,000 students between the ages of
18 and 24 are assaulted by another student who has been drinking (Hingson
et al., 2005).
-
Sexual Abuse: More than 97,000 students between the
ages of 18 and 24 are victims of alcohol-related sexual assault or date
rape (Hingson
et al., 2005).
-
Unsafe Sex: 400,000 students between the ages of 18 and
24 had unprotected sex and more than 100,000 students between the ages
of 18 and 24 report having been too intoxicated to know if they
consented to having sex (Hingson
et al., 2002).
-
Academic Problems: About 25 percent of college students
report academic consequences of their drinking including missing class,
falling behind, doing poorly on exams or papers, and receiving lower
grades overall (Engs
et al., 1996;
Presley et al., 1996a,
1996b;
Wechsler et al., 2002).
-
Health Problems/Suicide Attempts: More than 150,000
students develop an alcohol-related health problem (Hingson
et al., 2002) and between 1.2 and 1.5 percent of students indicate
that they tried to commit suicide within the past year due to drinking
or drug use (Presley
et al., 1998).
-
Drunk Driving: 2.1 million students between the ages of
18 and 24 drove under the influence of alcohol last year (Hingson
et al., 2002).
-
Vandalism: About 11 percent of college student drinkers
report that they have damaged property while under the influence of
alcohol (Wechsler
et al., 2002).
-
Property Damage: More than 25 percent of administrators
from schools with relatively low drinking levels and over 50 percent
from schools with high drinking levels say their campuses have a
"moderate" or "major" problem with alcohol-related property damage (Wechsler
et al., 1995).
-
Police Involvement: About 5 percent of 4-year college
students are involved with the police or campus security as a result of
their drinking (Wechsler
et al., 2002) and an estimated 110,000 students between the ages of
18 and 24 are arrested for an alcohol-related violation such as public
drunkenness or driving under the influence (Hingson
et al., 2002).
-
Alcohol Abuse and Dependence: 31 percent of college
students met criteria for a diagnosis of alcohol abuse and 6 percent for
a diagnosis of alcohol dependence in the past 12 months, according to
questionnaire-based self-reports about their drinking (Knight
et al., 2002).
Information above from:
http://www.collegedrinkingprevention.gov/StatsSummaries/snapshot.aspx
The Student in Poor
Contact with Reality
SIGNS
These students have
difficulty distinguishing “fantasy” from reality. Their thinking is
typically illogical, confused, or irrational (e.g., speech patterns that
jump from one topic to another with no meaningful connection); their
emotional responses may be incongruent or inappropriate and their behavior
may be bizarre and disturbing.
SYMPTOMS
The student may experience
hallucinations, often auditory, and may report hearing voices (e.g., someone
is/will harm or control them). While this student may elicit alarm or
fear from others, they generally are not dangerous or violent. However,
there are some situations in which they can become violent (e.g.,
experiencing “command” hallucinations). These hallucinations are telling
them what to do, such as “you must destroy that evil person.”
The student may also be
experiencing delusions—false ideas about what is taking place or who one
is. A delusion is a belief that is clearly false and that indicates an
abnormality in the affected person's content of thought. The false belief
is not accounted for by the person's cultural or religious background or his
or her level of intelligence. The key feature of a delusion is the degree
to which the person is convinced that the belief is true. A person with a
delusion will hold firmly to the belief regardless of evidence to the
contrary. Delusions can be difficult to distinguish from overvalued ideas,
which are unreasonable ideas that a person holds, but the affected person
has at least some level of doubt as to its truthfulness. A person with a
delusion is absolutely convinced that the delusion is real.
Information from:
http://www.minddisorders.com/Br-Del/Delusions.html
If you cannot make sense of
their conversation, it is important to report your observations and concerns
to the Behavioral Intervention Team so the problem can be evaluated and
addressed.
The Manic Student
SIGNS
These students are characterized
by having persistently lofty or irritable moods.
Different from the normal ups and downs that everyone goes through, these
symptoms are severe. They can result in damaged relationships, poor job or
school performance, and even suicide.
SYMPTOMS
-
They often see themselves in a grand light,
sometimes believing that they are famous or that the work they are doing is
awe-inspiring.
-
They often are overly talkative, with rushed
speech and racing thoughts.
-
Typically, their high energy interferes with
their sleep.
-
They can be very irritable and overly involved
in pleasurable activities, such as sex or spending money.
Generally, these students are
not dangerous, but caution should be taken, especially if alcohol or if other
drugs are involved. If they try to put their rapid thoughts and words into
action, they may place themselves in unsafe situations.
Signs and symptoms of
mania (or a manic episode) include:
-
Increased energy, activity, and restlessness
-
Excessively “high,” overly good, euphoric mood
-
Extreme
irritability
-
Racing
thoughts and talking very fast, jumping from one idea to another
-
Distractibility, can’t concentrate well
-
Little
sleep needed
-
Unrealistic beliefs in one’s abilities and powers
-
Poor
judgment
-
Spending sprees
-
A
lasting period of behavior that is different from usual
-
Increased sexual drive
-
Abuse
of drugs, particularly cocaine, alcohol, and sleeping medications
-
Provocative, intrusive, or aggressive behavior
-
Denial
that anything is wrong
Information from: http://www.nimh.nih.gov/health/publications/bipolar-disorder/symptoms.shtml
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