Behavioral effects Violence

Behavior. Some patients with PCP toxicity display inappropriate behavior. Behavioral effects include muteness, staring, violence, and agitation. Violent behavior occurred in 35 percent of people with PCP intoxication who were examined on the prison wards of the LAC/USC Medical Center (McCarron et al. 1981a). 

Use of anabolic steroids has been associated with a range of psychological and behavioral effects in case reports, such as hypomania, mania, aggression, violence, depression, and, after withdrawal, suicide. 

Initially, most prominent effect is elated mood, although depression may occur hypervigilance and anxiety that may progress to panic with high doses or chronic use, may see impairment of judgment, violence to others or self, paranoia or psychosis with delusions and hallucinations (hallucinations are generally tactile or auditory, rarely visual) an increase in motor activity is common compulsive or stereotyped behavior (e.g., skin picking) may be seen severe intoxication may result in a self-limited delirium... 

Flomicides have been committed under the influence of LSD and other drugs of this type, although these agents are not intrinsically likely to unleash violent behavior. Rather, the disinhibiting effects may remove constraints or violence already present in an individual. I have encountered instances of persons accused of homicide who claimed that the crime was perpetrated under the influence of hallucinogens. Unfortunately, it is not possible to substantiate such claims. Some, however, strain one s credulity and suggest that this type of plea of diminished responsibility is often misused. 

Because the symptoms are so disruptive to the family and to the child, conduct disorder is one of the most common reasons for referral to a pediatrician or child psychiatrist. In patients with MR, this disorder is seen less as organized, planned illicit activities and more as impulsive, unpredictable acts of violence or destruction. Such individuals may exhibit aggression toward caregivers, teachers, family members, or themselves, and they may be emotionally labile. If behavior therapy has not been effective, pharmacological treatment may be necessary. 

The extensive clinical use of triazolam has led to reports of serious central nervous system effects including behavioral disinhibition, delirium, aggression, and violence. While behavioral disinhibition may occur with sedative-hypnotic drugs, it does not appear to be more prevalent with triazolam than with other benzodiazepines. Disinhibitory reactions during benzodiazepine treatment are more clearly associated with the use of very high doses and the pretreatment level of patient hostility. 

In an attempt to modify the observed droplet behavior, a brief qualitative investigation was carried out with blends of SRC-II heavy distillate and pure heptane. The objective was to enhance droplet disruptive combustion as a means of reducing effective droplet size and hence soot formation. With these fuels visible droplet fragmentation was found to occur throughout the droplet stream. The fragmentation produced new droplets on different trajectories these in turn were terminated by small disruptions, as described above. Three blends were used 60/40, 80/20, and 90/10. Secondary atomization was observed for all three, although the violence of the activity was noticeably reduced as the heptane content of the blend became smaller. This secondary atomization was a completely different process than the... 

The following year, the British National Formulary, a joint publication of the British Medical Association and Royal Pharmaceutical Society of Great Britain (1991), listed suicidal ideation and violent behavior as fluoxetine side effects. Also in 1991,1 published Toxic Psychiatry, in which I observed for the first time that Prozac was producing a continuum of overstimulation that included akathisia, agitation, anxiety, insomnia, depression and mania, and, in the extreme, suicide and violence. I drew on previously sequestered FDA premarketing data on Prozac, the scientific literature, and my own clinical and forensic cases. 

The FDA provided a summary of 52 adverse psychiatric reactions reported over the prior year for Concerta and Ritalin, including cases of overstimulation (agitation and mania), depression, psychosis, aggression and violence, and suicidal behavior (FDA, 2006b). Notice the similarity to the dangerous effects that the FDA previously recognized as associated with the newer antidepressants. The similarity between stimulant and antidepressant adverse effects is probably due to the stimulating effects of the newer antidepressants. 

The negative effects of viewing violence includes making young people comfortable with violence, possibly rousing them to aggressive behavior, and making children fearful that they will be subject to violence. 

Four major and five minor clinical patterns of acute phencyclidine intoxication have been described in 1000 patients (7). Major patterns were acute brain syndrome (24.8%), toxic psychosis (16.6%), catatonic syndrome (11.7%), and coma (10.6%). Minor patterns included lethargy or stupor (3.8%) and combinations of bizarre behavior, violence, agitation, and euphoria in patients who were alert and oriented (32.5%). Patients with major patterns of toxicity usually required hospitalization and had most of the complications. Patients with minor patterns generally had mild intoxication and did not require hospitalization, except for treatment of injuries or autonomic effects of phencyclidine. There were various types of injuries in 16%, and aspiration pneumonia in 1.0%. There were 22 cases of rhabdomyolysis (2.2%), and three patients required dialysis for renal insufficiency. One patient who had been comatose died suddenly with a pulmonary embolism. 

Psychiatric Side Effects. Antipsychotic-induced akathisia, akinesia, and dysphoria may have unfortunate sequelae, resulting in what has been termed behavioral toxicity. Akathisia has resulted in impulsivity and in extreme cases, violence and suicide. Akinesia, characterized by diminished spontaneity, results in symptoms of apathy and withdrawal, often mistaken for the negative symptoms of schizophrenia these patients may actually appear depressed on formal evaluation. 

Smith Kline, the manufacturer of the SSRI, paroxetine, reported 44 aggressive events in 11,491 patients taking the drug. They warned that clinicians need to be aware of these possible effects, but stated that serious violence is rare. Some people with increased serotonin levels in the brain for a long period of time may develop problems in modulating anger, depression or impulsive behavior. 

The newly revised Chapter 13 addresses security issues in emergency departments, pediatric locations, infant care units, medication storage locations, cUnical labs, forensic patient treatments areas, and behavioral units. The chapter also addresses communications, data infrastructure, and security of medical/health records. Chapter 13 covers media relations, crowd control, employee practices, and security operations. Facilities must conduct a security vulnerability analysis and planning for the protection of people and resources beyond a disaster event. Security education should address customer relations, emergency procedures, use of force issues, importance of effective de-escalation of tense tactics, and restraint usage. The new code reqnires the development of policies, plans, and procedures to address hostage situations, bomb threats, workplace violence, disorderly conduct, and restraining order policies. 

The safety and security of organization personnel, patients, and visitors is of vital importance. Threats, threatening behavior, or acts of violence against personnel, patients, visitors, or contractors will not be tolerated. It is the policy of the organization to provide a safe environment in order to conduct the mission of the organization in the most effective manner possible. 

In order to promote intervention efforts aimed at prevention in a positive and inclusionary manner, rather than the traditional punitive and exclusionary manner (e.g., suspension, expulsion). Walker et al. (1996) revised the three-tiered model for use in schools in preventing violence and antisocial behavior patterns. Walker and his colleagues believed that in order to produce consistent, effective behavior changes, interventions needed to be comprehensive and target the entire population within and across all school settings, including the total student population as... 

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