Posts tagged ‘Mental disorder’

May 29, 2013

Quick Links – The ‘science’ of psychiatry

by Grace

Up to 20% of American children suffer from mental disorders, but the accuracy of reporting is questionable.

Scientists at the U.S. Centers for Disease Control and Prevention found that 13% to 20% of American children age 3 to 17 experience mental disorders each year, and that rates have been increasing.

A ‘hodgepodge’ of counting methods

The study also showed there are no standard ways of counting afflictions, but a hodgepodge including parental reports or reports directly from children. Some disorders, such as bipolar disease and anxiety disorders, weren’t included in the overall rates for lack of data. The disorders that were included span a wide range, including hyperactivity and severe autism.

Statistical experts are skeptical of the reported numbers.  Data collection is inconsistent, with random phone surveys of parents yielding higher results than other methods.  Families with health insurance report higher rates, and regional differences raise suspicion about different approaches in diagnosis.  Double counting children with multiple disorders leads to inflated rates.

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French children have much lower rates of diagnosed ADHD.

In the United States, at least 9% of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications. In France, the percentage of kids diagnosed and medicated for ADHD is less than .5%. How come the epidemic of ADHD—which has become firmly established in the United States—has almost completely passed over children in France?

Different approaches to diagnosis and treatment

 In the United States, child psychiatrists consider ADHD to be a biological disorder with biological causes. The preferred treatment is also biological–psycho stimulant medications such as Ritalin and Adderall….

French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational causes. Instead of treating children’s focusing and behavioral problems withdrugs, French doctors prefer . . . to treat the underlying social context problem with psychotherapy or family counseling…

Different parenting styles

And then, of course, there are the vastly different philosophies of child-rearing in the United States and France. These divergent philosophies could account for why French children are generally better-behaved than their American counterparts….

From the time their children are born, French parents provide them with a firm cadre—the word means “frame” or “structure.” Children are not allowed, for example, to snack whenever they want. …

… French parents have a different philosophy of discipline. Consistently enforced limits, in the French view, make children feel safe and secure. Clear limits, they believe, actually make a child feel happier and safer … French parents believe that hearing the word “no” rescues children from the “tyranny of their own desires.” And spanking, when used judiciously, is not considered child abuse in France.

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Psychiatry:  diagnosis is not scientific, but political and bureaucratic

In an interview with The Atlantic, Gary Greenberg, a practicing psychotherapist and author of The Book of Woe: The Making of the DSM-5 and the Unmaking of Psychiatrysays no one can define “mental illness”.

What is the difference between a disorder and distress that is a normal occurrence in our lives?

That distinction is made by a clinician, whether it’s a family doctor or a psychiatrist or whoever. But nobody knows exactly how to make that determination. There are no established thresholds. Even if you could imagine how that would work, it would have to be a subjective analysis of the extent to which the person’s functioning is impaired. How are you going to measure that? Doctors are supposed to measure “clinical significance.” What’s that? For many people, the fact that someone shows up in their office is clinical significance. I’m not going to say that’s wrong, but it’s not scientific. And there’s a conflict of interest — if I don’t determine clinical significance, I don’t get paid.

Is a child autistic or just awkward?  Special education services and insurance coverage are controlled by committee decisions on what is to be included in the DSM.

… You can’t just ask for special services for a student who is awkward. You have to get special services for a student with autism. In court, mental illnesses come from the DSM. If you want insurance to pay for your therapy, you have to be diagnosed with a mental illness….

Arbitrary?
Homosexuality was declassified as a DSM disorder in 1973.  And I’m sure I’m not the only one who has considered that Oppositional Defiant Disorder (ODD), characterized by “negativistic, defiant, disobedient, and hostile behavior toward authority figures that persist for at least six months“, is a particularly arbitrary disorder.

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December 25, 2012

‘What Families Can Do When a Child May Have a Mental Illness’

by Grace

From the National Alliance on Mental Illness (NAMI):

If you are worried about your child’s mental health, follow your instincts. Unexplained changes in a child’s behavior and/or mood may be the early warning signs of a mental health condition and should never be ignored.

There are many different types of mental illness, and it isn’t easy to simplify the range of challenges children face. One way to begin to get a handle on this question is to get an evaluation of your child or teen by a licensed mental health professional.  Because all children and youth are unique and the local mental health services, insurance coverage and school services vary a great deal from community to community, it is a challenge to find the right kind of help for your child.

Like many others, my family has had to deal with this issue.  You can read more about different types of mental illness and what steps parents can take to help their children at the NAMI website.


Have a joyful and peaceful Christmas.

 

Related:

January 12, 2012

Are college students with psychological problems over-indulged?

by Grace

Increased incidents of  psychological problems among college students have caused colleges to become more accommodating, but some wonder if all this is just another sign of  a coddled generation.

Colleges say they’re seeing more students on campus with psychiatric illnesses. About 11.6% of college students were diagnosed or treated for anxiety in the last year, and 10.7% were diagnosed or treated for depression, according to a survey of more than 100,000 students at 129 schools conducted by the American College Health Association. Many mental illnesses, particularly depression, bipolar disorder and schizophrenia, emerge during late adolescence.

Psychiatric disorders like depression and anxiety can have serious academic consequences because they affect concentration, sleep and cognitive processing, say mental health professionals.

Institutions are required to comply with the American for Disabilities Act, but it can get complicated.

Schools say they can’t require faculty to adjust deadlines or attendance policies. And in some courses, like science labs and speech classes, participation is critical, but schools can push instructors to compromise with students.

Even with increased accommodations, psychological conditions are often not viewed as charitably as physical ones.  Is it really an anxiety disorder, or simply a frail temperament overwhelmed by hard work and tough deadlines?  And does a school’s forgiving attitude adequately prepare graduates for a competitive work environment?

“There’s the danger that we take too much care and when they hit the real world that same kind of support isn’t there,” says David Cozzens, dean of students and associate vice president of student affairs at the University of Wyoming in Laramie.

This harsh tone was typical among the 250 comments to this story:

I am so sickened by this article I don’t even know where to begin…….what a bunch of coddled whiners this generation is…….if these students cannot make deadlines because their “karma” is upset ot they are having a bad day caused by the pressure of deadlines and exams…then they should be allowed to fail…as they will in the real world whjere they will not be coddled or catered to….there will be nobody to ‘understand’ just somebody in line to take their job and they will be fired…deservedly…this is not high school…you are in college to perform…under all sorts of pressures….performance requires that you deliver the goods when asked to do so…not on your own timetable…those who can will advance…those who do not will fail…and oh by the way…when allowed an extra 10 days to complete her report where is the fairness to the other students who busted their you know what to be on time? If she is that mentally oppressed and cannot play by the rules then she should simply not be there.

Ouch!  It’s a tough world, even if official attitudes seem more humane  than before.  Parents and students dealing with psychological problems should become fully informed about individual school policies.

Some formal accommodations, like additional test time, are fairly standard across universities and apply to students with physical and learning disabilities, too. But, schools diverge widely on formal accommodations for flexibility with assignment deadlines, class attendance and participation. Some schools leave it up to individual instructors. Others intervene more directly on students’ behalf.

Some more tough talk from college professors over at College Misery

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