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Too many psychiatric diagnoses for children: an epidemic of labels

"Allen Frances, professor of child psychiatry at Duke University and chair of the DSM IV(Diagnostic and Statistical Manual of Mental Disorders) task force hit the nail on the head in a recent commentary "Why So Many Epidemics of Childhood Mental Disorders?" in the Journal of Developmental and Behavioral Pediatrics. Because he makes his argument so clearly and persuasively (and the full article is only available toΒ those who subscribe to the journal) I will quote it at length....

"This paper hypothesises that the population of children receiving a clinical diagnosis of ADHD is aetiologically heterogeneous: that within this population, there is a group for whom the development of ADHD is largely genetically driven, and another who have a 'phenocopy' of ADHD as a result of very adverse early childhood experiences, with the prevalence of this phenocopy being heavily skewed towards populations living with poverty and violence. A third group will have a high genetic risk and have been exposed to violence....

"The key phrase here is "aetiologically heterogeneous." Psychiatric labels, be it "ADHD" "bipolar disorder" or "autism," are artificial constructs that provide a false sense of simplicity...."

http://claudiamgoldmd.blogspot.co.uk/2013/06/too-many-psychiatric-diagnoses-for.html

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Later this year, I'll post a story about the approach taken by CPS in San Diego -- intervening early so that children don't have to be tortured for months or years before the community intervenes, helping the parent become a better parent and helping the child heal and not further traumatizing either one.

As you put it so well, Patti, our traditional practices have society acting as an enabler. A lot of people are developing systems to change that.

Well said, Patti. Certainly understanding that you are not to blame for the horrible adversity you experienced is key. Positioning the responsibility where it belongs is necessary for healing. And then what?....especially if a parent clings to their denial because of their own fear and anger, long buried because of their own upbringing?

With parents whose children have grown into adults it's definitely too late to influence their children's upbringing. And it remains to us who have been severely traumatized to heal, and do something useful with this knowledge. But what about young parents who haven't resolved their own issues, which is leading them to pass on their trauma to their children?

Research is showing that with many parents, talking about their own ACE scores often opens the door to looking at their own parenting through a different lens. I know cases where mothers have indeed looked the other way when their children were being sexually abused, because it dropped them right back into their own traumatic childhood experiences. Turns out that they were dissociating -- a normal PTSD response to unresolved trauma.

And if this happens, then the community has to step in and help, because no amount of finger-pointing and blame will shift that person. She's just not equipped to protect her children or to provide them with modeling of healthy relationships -- she needs counseling and skills that she never developed.

Here are some stories that address some of your points:

Public health clinic adds childhood trauma to smoking, alcohol, HIV screening

When a parent says, "I don't like my kid", what then?

Digging deeper to prevent another Newtown, CT, massacre

Unfortunately, bad parenting comes from bad parenting. As the ACE Study shows, many parents (perhaps most parents, by now) just don't have the skills or modeling necessary to raise healthy kids. They need help, and without the shame and blame that raise defenses so that they won't accept help. And our culture has to move from shame and blame to recognizing that the best approach is to offer assistance, not reproach. It's a difficult thing to do, though, especially if you're still angry about your own childhood trauma. I know; I've been there. Β 

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