Dan Ariely has a research study “How we view people with medical labels?”
Think for example about a parent who is told that their kid has ADHD – would this parent blame themselves less than if they were told that their kid is an active difficult kid? I think the answer is yes, and maybe this is one of the reasons that we as a society seem to be obsessed with diagnostic labels (other reasons include incentives for psychologists, medical companies etc).
(Image above from the Los Angeles Times article “Child bipolar diagnosis is a poor fit for many.”
Tara Parker-Pope has a post at the NYT titled “Attention Disorders Can Take a Toll on Marriage.” Here is an excerpt:
Does your husband or wife constantly forget chores and lose track of the calendar? Do you sometimes feel that instead of living with a spouse, you’re raising another child?
Your marriage may be suffering from attention deficit hyperactivity disorder.
An A.D.H.D. marriage? It may sound like a punch line, but the idea that attention problems can take a toll on adult relationships is getting more attention from mental health experts. In a marriage, the common symptoms of the disorder — distraction, disorganization, forgetfulness — can easily be misinterpreted as laziness, selfishness, and a lack of love and concern.
As the diagnostic process defining mental disorders evolves so does the complexity embedded in competing theories of the mind and what it means to be human. How the mind works and what soul entails remain in large part a mystery to us. We can’t escape what we don’t know as we struggle to find out who in fact has a psychiatric diagnosis and why. Add to the challenge of discovering why we suffer and when we cross a diagnostic threshold into pathology the fact that we live in a market economy where treatment is linked to dollars. So we have competing agendas, forces, egos, legitimate and perceived fears and anxiety, the literal and financial survival of individuals and industries at play here. Read more…
A central theme running through this blog is how we name and then treat people using psychiatric diagnoses. The diagnostic process of labeling someone with a mental illness is complex and many times fraught with peril for the person being diagnosed, his or her family and friends, and those who are trying to treat the disturbance. Add to this already difficult process the fact that the names of mental illnesses are now a part of our national lexicon, used by professionals and layperson alike. We can hear people without licensed backgrounds and/or training in the mental health field use the labels bipolar, autistic, ADHD, antisocial, sociopath, schizophrenic and psychotic for people they view as disordered and/or disturbed. The diagnostic power of these names and the criteria associated with them are diminished if we place them on people who don’t in reality have psychiatric disorders. We also have to ask, are psychiatric diagnoses a uniquely American phenomenon? The NYT has an excellent article that has garnered some buzz titled “The Americanization of Mental Illness,” which tackles the question of if the United States has been spreading the gospel of our brand of mental illness to people and places they don’t belong? Here is an excerpt:
In any given era, those who minister to the mentally ill — doctors or shamans or priests — inadvertently help to select which symptoms will be recognized as legitimate. Because the troubled mind has been influenced by healers of diverse religious and scientific persuasions, the forms of madness from one place and time often look remarkably different from the forms of madness in another.
That is until recently.
For more than a generation now, we in the West have aggressively spread our modern knowledge of mental illness around the world. We have done this in the name of science, believing that our approaches reveal the biological basis of psychic suffering and dispel prescientific myths and harmful stigma. There is now good evidence to suggest that in the process of teaching the rest of the world to think like us, we’ve been exporting our Western “symptom repertoire” as well. That is, we’ve been changing not only the treatments but also the expression of mental illness in other cultures. Indeed, a handful of mental-health disorders — depression, post-traumatic stress disorder and anorexia among them — now appear to be spreading across cultures with the speed of contagious diseases. These symptom clusters are becoming the lingua franca of human suffering, replacing indigenous forms of mental illness.
(Read Somatosphere’s commenary on this article and our post “Diagnostic Voices of Community: Global Mental Health.” See Alex Trochut’s artwork here.)
The Washington Post has an excellent article titled “Study may show whether neurofeedback helps people with ADHD and other disorders,” which talks about the high costs, potential benefits, and controversy surrounding the use of neurofeedback, specifically for psychiatric disorders like ADHD. The article identifies a government funded study currently being conducted by the the National Institute of Mental Health (NIMH) to test if in fact the use of neurofeedback can help those who suffer from this type of diagnoses and is worth the cost, which should be published in the Summer of 2010. Here are a couple of excerpts from the article:
Ohio State University child psychiatrist L. Eugene Arnold, the NIMH project’s director, says the institute agreed to fund the study as a result of new interest by the influential national advocacy group Children and Adults with Attention Deficit/Hyperactivity Disorder. CHADD receives about one-third of its revenues from pharmaceutical firms and historically has vigorously supported medication as a first-line treatment for ADHD. Yet in recent years the group has grown more willing to consider nondrug therapies.
“A lot of CHADD’s members wanted to know about neurofeedback,” says Arnold, who is on the group’s advisory board. “The claims looked pretty good, but there wasn’t enough data to make the recommendation.”
and:
Undergoing neurofeedback demands an extraordinary commitment of time and money. A typical therapist will recommend at least 40 half-hour sessions to treat ADHD and charge as much as $100 per session. Practitioners also commonly require a diagnostic “brain map” at the start of treatment, adding as much as $900. And — with so many questions about neurofeedback still unanswered by mainstream research — none of this is normally covered by insurance. (Some plans, including Kaiser Permanente, do cover biofeedback for stress relief.)
(EEG generated image above found here.)
We want to post a research study released back in September 2009 that generated some buzz by Dave E. Marcotte and Sara Markowitz titled “A Cure for Crime? Psycho-Pharmaceuticals and Crime Trends.” There is a lot to consider in this research practically, morally, ethically, and from public policy and clinical treatment perspectives. It makes sense that treating certain psychiatric disorders with psycho-pharmaceuticals can have a relationship to crime trends. What the implications are for a drug-oriented approach to addressing crime is up for debate. This post is one in a series that is meant to help people see how our perceptions of continuously rising crime rates match with reality. Here is an excerpt of the abstract:
In this paper we consider possible links between the advent and diffusion of a number of new psychiatric pharmaceutical therapies and crime rates. We describe recent trends in crime and review the evidence showing mental illness as a clear risk factor both for criminal behavior and victimization. We then briefly summarize the development of a number of new pharmaceutical therapies for the treatment of mental illness which diffused during the “great American crime decline.” We examine limited international data, as well as more detailed American data to assess the relationship between crime rates and rates of prescriptions of the main categories of psychotropic drugs, while controlling for other factors which may explain trends in crime rates. We find that increases in prescriptions for psychiatric drugs in general are associated with decreases in violent crime, with the largest impacts associated with new generation antidepressants and stimulants used to treat ADHD. Our estimates imply that about 8.5 percent of the recent crime drop was due to expanded mental health treatment.
Our increasing need to diagnose and label children and adolescents with psychiatric disorders should cause us pause. ADHD, bipolar disorder, and depression are three diagnoses you hear so often being given to children and teens. Then there is always the more immediate concern of suicide. We have talked about how child and adolescent developmental stages and behaviors need to be better clarified to help clinicians, parents and educators understand who a child and teenager is and why he or she may be thinking, feeling, and behaving, a certain way. Understanding how infants, toddlers, children, pre-teens, and adolescents behave and view themselves, others, and the world around them helps us distinguish who is in fact acting their age and who may have deeper, more problematic, issues to contend with and treat. The question we always want to ask when investigating the circumstances involving children and adolescents is who and/or what are they reacting and/or responding to? Read more…
In previous posts we looked at how we are distracted as a culture and the challenges and misconceptions associated with multitasking and stimulants. To continue exploring this theme of distraction, concentration/focus and the idea of multitasking as a measure of our success NPR has a post titled “Think You’re Multitasking? Think Again.” Here is an excerpt:
Don’t believe the multitasking hype, scientists say. New research shows that we humans aren’t as good as we think we are at doing several things at once. But it also highlights a human skill that gave us an evolutionary edge.
As technology allows people to do more tasks at the same time, the myth that we can multitask has never been stronger. But researchers say it’s still a myth — and they have the data to prove it.
Humans, they say, don’t do lots of things simultaneously. Instead, we switch our attention from task to task extremely quickly.
(See Jeff Soto’s artwork here.)
Sphere has an article by David Knowles titled “Medical Marijuana Prescribed to Kids with ADHD.” Here is an excerpt:
In California, the state with the nation’s most permissive medical marijuana law, several doctors say that some children with attention deficit hyperacitivty disorder, or ADHD, are being treated with marijuana — a fact that has sparked a heated debate.
Reliable figures on the use of marijuana to treat ADHD are hard to come by, as reported by The New York Times. Though California says it has issued more than 36,000 medical marijuana cards since 2004, the state does not compile statistics on prescriptions for specific conditions, such as ADHD. And many doctors and patients are reluctant to talk about it. Still, experts say such prescriptions are becoming more common as the number of pot dispensaries and doctors prescribing marijuana continues to grow.
And not everyone is happy about it.
“Let me count the ways in which prescribing marijuana for teens with ADHD is a bad idea,” said Stephen Hinshaw, professor of psychology at the University of California at Berkeley. Marijuana, Hinshaw said, is a “cognitive disorganizer” that produces roughly the same effect in users as those associated with ADHD.
