発達障害（ASD /ADHD）の人が攻撃的なのはなぜ？ #精神医学 #発達障害 #ASD #ADHD

*Hairstyle is different because I went to the hair salon 01:52 What is aggression? 04:27 Why is it said to be common in people with developmental disorders? 10:16 Common comorbidities 13:08 Treatment Today, I will talk about "aggression in developmental disorders (ASD/ADHD)". ASD (Autism Spectrum Disorder) is a group of disorders formerly known as Asperger's, and has characteristics such as difficulty understanding other people's feelings, strong obsessions, difficulty with multitasking, and sensory hypersensitivity. ADHD (Attention Deficit Hyperactivity Disorder) has characteristics such as inattention, hyperactivity, impulsivity, and forgetfulness. These are two separate disorders, but many people have elements of both. It is common for people to have elements of the other disorder even if they do not meet the diagnostic criteria, such as being diagnosed with ASD but being inattentive, or being diagnosed with ADHD but being obsessive, or being unable to multitask, so I will talk about them together as "developmental disorders". Humans evolved from monkeys, so everyone has aggression. You and I have it too. Everyone has that tendency to bite a cat when they're cornered. However, clinically, aggression in people with developmental disorders is more likely to be a problem than in the general population. ■What is aggression? We will use a psychoanalytic model to explain what aggression is. For example, when stress is added to your life due to relationship problems or workload, it is absorbed into you and you feel "I don't like it." Good pattern: You solve the problem by interpreting what you have swallowed, such as "I'm irritated because I'm still feeling something that person said to me," "I'm so overwhelmed by the amount of work," and "I'm binge eating." Bad pattern: The moment you swallow something you don't like, you can't hold it in and you spit it out, saying "I don't like it, it's someone else's fault!" You spit it out and attack or bully someone. Or, instead of taking it out on others, they may take it out on themselves and harm themselves, drink too much alcohol, or binge and purge. Both are forms of aggression. When you hear the word "aggression," you probably think of aggression against others, but self-harm is also a form of aggression. ■ Why is it said to be common in people with developmental disorders? Data shows that there is a high rate of comorbidity with conduct disorder and antisocial personality disorder. ・ High stress in the first place People with developmental disorders have a hard time living, so they are stressed to begin with. ・ Difficulty verbalizing Many people find it difficult to identify why they are having trouble, and their problems and their feelings are separated. Therefore, they cannot digest it all. In addition, they have problems with impulsivity and tend to spit it out immediately, which makes them more likely to split. For these reasons, it is clinically believed that people with developmental disorders are more likely to become aggressive. ■ Drug treatment Drug treatment can sometimes be effective for impulsivity. There are three medications for adult ADHD: Concerta, Strattera, and Intuniv. For aggression and impulsivity, Intuniv (guanfacine) is probably used. A small amount of an antipsychotic (drug that blocks dopamine) such as risperidone may also be added. Risperidone can also be effective for the sensory hypersensitivity of ASD. ■ Not understanding other people's feelings (your own/other people's) They cannot intuitively understand how their current feelings are connected to their problems (stress). "Not understanding other people's feelings" means not only not understanding other people's feelings, but also their own feelings. Because they don't understand other people's feelings, they end up hurting others. Because they don't understand their own feelings, they hurt themselves to confirm their own feelings and pain. It is necessary to provide psychological education on each of these things one by one. We talk about things like, "Right now, you're having trouble with this, aren't you?" and "You're irritated because you were hurt by this." In response to this, the patient may say, "I only work about 40 hours of overtime a month, so I'm being spoiled," but everyone feels differently. Some may say that 40 hours is too much, that they should forgive themselves more, or that they should have more confidence in themselves. ■Abuse and environmental issues Abuse and environmental issues are also involved. People with developmental disorders are more likely to have problems such as abuse or poverty than normal people. There are also cases where a child's developmental disorder is caused by a genetic problem such as a parent with a developmental disorder, neglect, alcohol or drug addiction, or poverty due to a parent's developmental disorder. For example, if a child grows up with a father who drinks a lot of alcohol and is quick to hi...