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This chapter will provide a review of best practices for school safety to prevent school shootings. Recommendations for prevention strategies and programming, crisis response, threat assessment, and dealing with the aftermath on individual and community levels will be discussed in detail. National and state prevention efforts and resources will be presented. Personal perspectives from relevant individuals will be shared.

This chapter discusses the relationship between attention-deficit/hyperactivity disorder (ADHD) and trauma in adolescents. Trauma is conceptualized as a frightening, violent, or dangerous event that poses a threat to an individual’s bodily integrity or life. Exposure to traumatic events can impact adolescent development, contributing to emotional distress and difficulties with regulation; adolescents who have been exposed to trauma may exhibit symptoms that are classically seen in youth with ADHD. It is important, therefore, to arrive at an accurate diagnostic impression of adolescents who are presenting with inattention and regulation difficulties. Clinicians are advised to evaluate for the potential contribution of trauma when diagnosing ADHD in adolescents. Arriving at a clear diagnostic understanding of an adolescent’s presenting concerns has significant implications for the treatment of these youth. Adolescents with trauma histories who present with symptoms of ADHD require multifaceted interventions which target their emotional functioning as well as behavioral presentation.

A first important notion is the realization that students’ social and emotional functioning has a long tradition in education. Good working attitudes and good behavior have always been important areas on which students were monitored. In didactic analysis, taxonomies of educational objectives were designed for the affective, next to the cognitive domain. What has changed is that the reservation with which the non-cognitive domains used to be treated, because of privacy concerns and fear of indoctrination, seems to have disappeared and is being replaced by very deliberate attempts to stimulate social-emotional learning and promote social emotional outcomes, even beyond the school context.

Treatment of Attention-Deficit Hyperactivity Disorder (ADHD) may need to occur prior to addressing symptoms of anxiety for children with co-occurring disorders, especially if ADHD symptoms are interfering with functioning at school and at home. Treating executive functions deficits, so that the child can complete course work, is an example of intervening to treat ADHD symptoms. Interventions that address ADHD symptoms so the child can focus or pay attention, and therefore learn anxiety management strategies, may improve behavioral functioning. Treating anxiety through education, graded exposure, and teaching anxiety management strategies (e.g., relaxation) may reduce worries and improve emotional functioning. Reducing occurrence of risky behaviors (related to ADHD) and improving emotional regulation also may be essential interventions. Involving parents in treatment to help the child pay attention and learn strategies was a hallmark of many interventions. It is not yet clear whether having ADHD and anxiety results in further deficits in functioning compared to having ADHD alone, and further research is needed in this area.

The ability to perceive emotional facial expressions is an important building block for many aspects of social and emotional functioning. Not surprisingly, this ability emerges early in life, with development continuing through adolescence. We begin this chapter by briefly reviewing current theoretical models of face emotion processing in adults, with a particular emphasis on the neural bases of this ability. We then present an overview of the developmental literature, from birth to late childhood. A secondary focus pertains to atypical patterns of development, in particular, in children with autism and children with an anxiety disorder. In particular, we review the early development and neural basis of attentional biases to fearful or threatening facial emotions, in typical development and as they relate to individual risk profiles for anxiety disorders. Finally, we highlight recent advances in the understanding of the perceived valence of facial expressions in development and the variations of emotional facial expressions perception across different human cultures.

Each chapter of the Brain at Risk has explored different ways in which the brain is vulnerable for disease and/or various disorders, including ones that are acquired. Some of the latest research is presented in an informative way describing risk and mitigating factors that influence the expression and course of some of the more common major medical and environmental factors that alter behavior, emotional functioning, and cognition. Emphasis throughout each chapter is on a summation of the latest research on some of the most common major neuropsychological and neuropsychiatric disorders, highlighting the current understanding of each disease or disorder. Some general recommendations for improving outcome associated with some conditions are offered.

Early adverse rearing environments, in which children experience varying degrees of neglect, deprive the developing brain from experience-expectant caregiving mechanisms that facilitate the development of neural and physiological systems underlying emotional functioning. Caregiver neglect also denies children important social interactions needed to acquire behavioral skills that support emotional competence. Although further work in this area is still needed, our knowledge regarding the association between early deprivation and children’s emotional development has grown considerably in the last decade. In this chapter, we first discuss animal models that support developmental theories underscoring the importance of the caregiver–infant relationship for emotional development. We then acknowledge how varying degrees of neglect may be differentially associated with subsequent emotional outcomes. Finally, we review empirical work in this area from a developmental perspective by addressing how early neglect may impact the development of biological and behavioral mechanisms that underlie emotional functioning across multiple developmental periods.

Within the field of psychology, assessment is the process of evaluating individuals’ thinking, learning, behavior, and emotional functioning through the use of assessment tools and behavioral observations. This chapter will review information necessary for understanding the assessment process to aid in making appropriate referrals and consuming assessment reports. It will include a review of the types of assessments that a psychiatrist may encounter, principles behind standardized assessment and norm-referenced measures, how scores for tests are calculated and interpreted, typical procedures for an assessment, and information/issues to consider when consuming an assessment report. With this background knowledge in assessment, readers should be better equipped to read and interpret assessment reports and use those reports to inform treatment and consultation with patients and their families.

Torture can have significant long-term ramifications for the psychological and physical health of survivors. Here, we review the current neurobiological literature that suggests torture may have specific effects on the structure and functioning of the brain, perceptual and emotional functioning, and autonomic and neuroendocrinergic responses. We discuss these findings in the context of current neural models of PTSD, complex PTSD and the dissociative PTSD subtype. We also suggest that furthering the understanding of the neural impact of torture can only be achieved by conducting research that targets key disruptions characteristic to the interpersonal, prolonged and uncontrollable nature of torture trauma itself. Such research focusing on specific mechanisms underpinning the psychological effects of torture is critical to informing targeted treatments to alleviate suffering and promote recovery amongst survivors.

This chapter reviews assessment strategies for medical, psychological, and educational functioning for persons with intellectual disabilities. This includes a review of background information important to diagnostic assessment including (a) medical history, (b) family and home life, (c) educational history, (d) developmental history, (e) behavioural/mental health, and (f) employment/community. A review of indirect (i.e. rating scales and interviews) and direct assessment (i.e. behavioural observations) techniques is discussed. Finally, psychoeducational assessment is discussed to assist individualized educational plan teams in determining if a child requires and is eligible for special education assistance. Specific psychoeducational assessment practices are reviewed including (a) behavioural and assessment techniques, (b) cognitive assessment strategies, and (c) the evaluation of adaptive behaviour, language, basic psychological processes, academic achievement, and social/emotional functioning.

This chapter describes some salient physiological and psychological influences on multicultural and nonverbal assessment. Obviously, examinees who require nonverbal assessment, those from culturally diverse settings and those with emotional problems and/or language deficits, may behave in ways that are different from mainstream examinees and those who present no language-related problems. Examiners who are sensitive to these differences, to the psychological impact of the testing environment, and the impact of biology on test behavior will be more successful in reducing construct-irrelevant variance in test scores and in obtaining more accurate estimates of intellectual, educational, and emotional functioning. In particular, examiners should determine whether the examinee’s physiological condition is optimal for testing; one particularly salient consideration is the extent to which medications have been administered to examinees before testing, and the dosage level; this information should be included in the psychoeducational report. In addition, if an examiner suspects that an examinee is under the influence of illicit drugs the session should be terminated until the examinee is drug free. Examiners who are aware of the conditions under which tests are administered, who can relate the impact of these influences to the success or failure of the child in the testing session, and who can extrapolate the impact of these influences to the school and home will be more successful in accurately describing performance levels and potential of the examinee, and ultimately in helping teachers and parents help children.

Assessment of patients’ pain-related physical and emotional functioning is one of the most important measures in pain evaluation, and are two of the four key domains recommended by IMMPACT for interpreting the significance of treatment outcomes in clinical trials.