This information is taken from Mental Health and Growing Up, Third Edition Factsheets for parents, teachers and young people. Published by Royal College of Psychiatrists. London.

Behaviour problems and Conduct Disorder

Behavioural problems can occur in children of all ages. Very often they start in early life. Toddlers and young children may refuse to do as they are asked by adults, in spite of being asked many times. They can be rude, swear and have tantrums. Hitting and kicking of other people is common. So is breaking or spoiling things that matter to others.

Children with a conduct disorder may get involved in more violent physical fights, and may steal or lie, without any sign of remorse or guilt when they are found out. They refuse to follow rules and may start to break the law. They may start to stay out all night and truant from school during the day. Teenagers with conduct disorder may also take risks with their health and safety by taking illegal drugs or having unprotected sexual intercourse.

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Worries and anxieties

Fears and phobias

Very young children often develop fears and phobias. These usually happen in particular situations, such as going to nursery or settling down at night, and can result from the fear of separation from parents or familiar adults. Sometimes, the anxieties are set off by particular things such as dogs, spiders or snakes. Fears like this are very common in early childhood, but with some encouragement and support, most children learn to overcome their anxiety.

General anxiety

Some youngsters feel anxious most of the time for no apparent reason. It may be part of their temperament, or it may be part of a pattern of behaviour that is shared with other members of the family. If the anxiety becomes very severe, it can interfere with the child's ability to go to school, to concentrate and learn, and to be confident with others.

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ADHD

Children with ADHD/hyperkinetic disorder:

• are restless, fidgety and overactive
• continuously chatter and interrupt people
• are easily distracted and do not finish things
• are inattentive and cannot concentrate on tasks
• are impulsive, suddenly doing things without thinking first
• have difficulty waiting their turn in games, in conversation or in a queue

This type of behaviour is common in most children. It becomes a problem when these characteristics are exaggerated, compared to other children of the same age, and when the behaviour affects the child's social and school life. Often the signs will have been obvious since the child was a toddler.

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Parenting

Parenting is an important part of loving and caring for your child. Good parenting is about providing a warm, secure home life, helping your child to learn the rules of life (e.g. how to share, respecting others, etc.) and to develop good self-esteem. You may have to stop them from doing things they shouldn't be doing, but it is just as important to encourage them to do the things you do want them to do.

Rules are an important part of everyday life. They make it possible for us to get along with one another. If children do not learn how to behave, they will find it difficult to get on, both with grown-ups and with other children. They will find it hard to learn at school, will misbehave and will probably become unhappy and frustrated.

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Autism

Autism and Asperger syndrome are developmental disorders that are due to abnormalities in the way the brain develops and works.

Autism shows itself in the first 3 years of life. Asperger syndrome is a less well-defined condition and may not be recognised until after a child starts school.

Children with Autism or Asperger syndrome prefer familiar routine and tend to resist change, which they find difficult and unpleasant. They may also have unusual interests, such as in maps or electronic gadgets. They may be very sensitive to tastes, smells and sounds. They may also have odd body movements such as hand-flapping or finger-twiddling.

Any attempt to stop these activities and interests can cause furious protest and distress. When upset, these children may have tantrums, be hyperactive or injure themselves. Some children have special talents or gifts for drawing, music or calculation.

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Eating Disorder

A lot of young people, many of whom are not overweight in the first place, want to be thinner. They often try to lose weight by dieting or skipping meals. For some, worries about weight becomes an obsession. This can turn into a serious eating disorder.

• Someone with anorexia nervosa worries all the time about being fat (even if they are skinny) and eats very little. They lose a lot of weight and their periods stop.
• Someone with bulimia nervosa also worries a lot about weight. They alternate between eating next to nothing, and then having binges when they gorge themselves. They vomit or take laxatives to control their weight.

Both of these eating disorders are more common in girls, but do occur in boys.

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Obsessive Compulsive Disorder

Some people have thoughts or ideas that come into their mind even when they do not want them to (for example 'I must count to twenty or something bad will happen'). These thoughts often feel silly or unpleasant and are called obsessions. Compulsions are things that people feel they have to do, even when they do not want to (for example repeatedly checking that the light is switched off). Often people try to stop themselves from doing these things, but feel frustrated or worried unless they can finish them. Problems with obsessions and compulsions can cause distress and worry, and can begin to affect young people at school, with their friends, and in their families.

Many children have mild obsessions and compulsions at some time, for example having to organise their toys in a special way, or saying good night a certain number of times. This is normal. It may be the result of anxiety due to stress or change.

If you are worried that a child's behaviour is the beginnings of obsessive compulsive disorder, you need to ask yourself the following questions:

• Do the compulsions upset the child?
• Do they interfere with the child's everyday life (e.g. school, friends, etc.)?

If the answer to these questions is 'yes', it may be that the young person has obsessive compulsive disorder, sometimes called OCD for short. If this is the case, you should seek professional advice.

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Psychosis

The term 'psychosis' is used to describe when a person loses touch with reality. Teenagers often worry that they may be 'going mad' when they are feeling stressed, confused or very upset. In fact, feelings like these are very rarely a sign of mental illness. They can often get a lot better if you talk them through with someone you trust.

'Psychosis' is much more serious and affects people of all ages, but becomes increasingly common as you reach young adulthood.

When a young person has a 'psychotic breakdown', not due to drug use, it can be difficult to know what the long-term effects will be, and a definite diagnosis may not be possible.

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Stress

Everyone feels stressed at times. You may feel under pressure, worried, tense, upset, sad, angry - or maybe a mixture of uncomfortable feelings. There are many ordinary situations that can make you feel stressed. For example, your school work may pile up, preparing for exams may seem as if it's taking forever, you may be being teased or bullied at school, or having problems with teachers. At home you may be arguing with parents, brothers or sisters, or close friends.

Stress can be even worse if your family is breaking up, someone close to you is ill or dies, or if you are being physically or sexually abused.

When a young person has a 'psychotic breakdown', not due to drug use, it can be difficult to know what the long-term effects will be, and a definite diagnosis may not be possible.

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