AGGRESSION Mental Health Psychiatry.pptx

Mental Health and Psychiatry

1. AGGRESSION Compiled by; The BBB MR N. NALISHUWA MISS G. SIANGA MR. N. MUKENA

2. DEFINITION Aggression refers to behaviour that is intended to cause harm or pain( Lyttle . J 1986)

3. CHARACTERISTICS OR AGGRESSIVE BEHAVIOUR Aggressive behavior can either be verbal or non verbal

4. RISK FACTORS SITUATIONAL FACTORS
Heightened physiological arousal: Vigorous exercises ,exposure to provocative films enhances overt aggression. Sexual arousal: Exposure to photos of attractive nude , aggression is reduced. Aggression is enhanced by the exposure to films of couples engaged in various sex acts.

5. ENVIRONMENTAL FACTORS Air pollution: Exposure to noxious orders ,such as those produced by chemical plants and other industries ,may increase personal irritability and therefore aggression , although this effect appears to be truly up to a point. If the odors in question are truly foul , aggression appears to decrease –perhaps because escaping from the unpleasant environment becomes a dominant goal for those involved.

6. SOCIAL FACTORS Frustration: The single most potent means of inciting human beings to aggression is frustration. Widespread acceptance of this view stems from John Dollard’s frustration, aggression hypothesis. This hypothesis indicated that frustration always leads to a formof aggression and that aggression always stem from frustration.

7. GENETIC FACTORS Twin studies : concordance rate for monozygotic twins exceed the rates for dizygotic twins Pedigree studies: the persons with family histories of mental disorders are more susceptible to mental disorder and engage in more aggressive behaviour than those without such histories. Those with low IQ scores appear to have frequency of delinquency and aggression than those with normal IQ scores. Chromosomal influences: XYY syndrome contributes to aggressive behaviour . The person with this syndrome are tall, belowaverage intelligence and likely to be apprehend and in prison for engaging in criminal behaviour .

8. NEUROPHYSIOLOGICAL DISORDERS ➢Epilepsy of temporal lobe and frontal lobe origin results in episodic aggression and violent behaviour . Tumours in the brain ,particularly in the areas of the limbic system and the temporal lobe ,trauma to the brain ,resulting in cerebral changes and the disease such as encephalitis have been implicated in the predisposition to aggression and violent behaviour .

9. CONT… 1-Aggressive people may invade the personal space of others 2-They may speak loudly and with greater emphasis 3-They usually maintain eye contact over a prolonged period of time so that the other person experiences it as an intrusive (something that disturbs your mood or life in a way that you do not like

10. CONT… 4.Gestures may be emphatic and often seem threatening. (For example they may point their finger, shake their fists, stamp their feet or make slashing motion with their hands) . 5.Posture is erect and often aggressive people lean forward slightly towards the other person. The overall impression is one of power and dominance.

11. TYPES OF AGGRESSION 1- Instrumental aggression   - aggression aimed at obtaining an object, privilege or space with no deliberate intent to harm another person 2-Hostile aggression - Aggression intended to harm another person, such as hitting, kicking, or threatening to beat up someone.

12. CONT… 3- Relational aggression A form of hostile aggression that does damage to another's peer relationships, as in social exclusion or rumour spreading.  

13. MOYER CLASSIFICATION Moyer (1968) presented an early and influential classification of seven different forms of aggression, from a biological and evolutionary point of view.

14. CONT.. 1-Predatory aggression : Attack on prey by a predator. 2- Inter-male aggression : Competition between males of the same species over access to resources such as females, dominance, status, etc.

15. CONT… 3-Fear-induced-aggression : Aggression associated with attempts to flee from a threat. 4 -Irritable aggression : Aggression induced by frustration and directed against an available target.

16. CONT… 5- Territorial aggression : Defence of a fixed area against intruders, typically conflicts. 6- Maternal aggression : A female's aggression to protect her offspring from a threat. Paternal aggression also exists.

17. CONT… 7- Instrumental aggression : Aggression directed towards obtaining some goal, considered to be a learned response to a situation.

18. MANAGEMENT Management is approached in 3 ways; 1-use of medication. 2-Restrain. 3-Seclusion.

19. USE OF MEDICATION The psychiatrist will do a mental state examination on the patient in the psychiatric unit and immediately commence the patient on drugs after taking ; full history from the relatives and doing a-full physical examination (head to toe)to detect what could not have been detected by the physician on the general wards.

20. Nursing care Nursing care is directed towards safe guarding the patient and fellow patients, to impose limits on the patients behaviour and to promote the development of more appropriate behavioural pattern.

21. NSG CARE CONT… - Despite displays of aggressive behaviour, the patient is vulnerable. - There is often a risk of exhaution,mulnutrition and injury occurring during episodes of aggressive behaviour.

22. 1-Enviroment The aggressive patient lacks internal control so external controls should be imposed by the nurse if escalation of potentially harmful behaviour is to be avoided.

23. RESTRAIN -These are conditions that are put in place to limit the patient from causing any harm, such as holding him to prevent him from causing injury, and releasing him only when he is calm.

24. SECLUSION -all patients who are a threat to others are put in a special room alone away from the other patients as a form of punishment so that the bad behaviour is not sustained and also to protect them from injuring themselves and others.

25. 2-POSITION -Nurse them in any position in which they are comfortable. Do not restrain to the extent of causing more harm to the patient. --Excessive restrain may provoke hostility, resentment and retaliatory excess in behaviour.

26. 3-REST -The aggressive patient may be too restless to sleep. -There is danger of exhaustion and debilitation if adequate sleep is not ensured as the aggressive patient will ignore fatigue signals from his body and will continue to push himself beyond safe limits.

27. REST CONT… -His aggressiveness is also likely to disturb the rest of fellow patients. -Avoid noise to allow this patient to rest

28. 4-OBSERVATIONS -observation of temperature, pulse respirations and blood pressure -Observe the patients nutritional status -assess the mental state for any improvement. -Observe for side effects of the drugs.

29. 5-PSYCHOLOGICAL CARE -Psychological care is given to the relatives to allay anxiety. -As soon as the patient stabilises, explain the condition to allay anxiety and gain patients co-operation.

30. 7-EXERCISES -The patient should only be allowed to exercise when the condition stabilises. -In the acute phase ,he needs enough rest because a lot of energy is consumed in aggression.

31. 8-NUTRITION -A normal diet which is well balanced is given to promote good nutritional state. -Avoid any foodstuffs that contain caffeine such as coffee to prevent the patient from being alert , because we want him to rest.

32. 10 MEDICATION -Ensure that the patient takes the drugs as prescribed to enhance recovery.

33. 11 ADVICE -The patients relatives will be advised to be very understanding and to offer support to the patient. -Advise the patient to avoid any substances that can destabilise the mind, such as alcohol to prevent reoccurrence of aggression.

34. ADV CONT… -Advice the patient also to avoid smoking to prevent him from having another episode of aggressive behaviour. -On discharge advice the patient and relatives to keep review dates so that follow up is not missed to monitor patients recovery at home.

35. THE END TOGETHER WE CAN! (NO HEALTH WITHOUT MENTAL HEALTH)