Teen Use of ADHD Meds Up Sharply

By Nancy Walsh

ADHD-drugsThe use of stimulant medications among children with attention deficit hyperactivity disorder (ADHD) continues to rise, particularly among adolescents, a nationally representative survey showed.

In 2008, these medications were used by 3.5% (95% CI 3.0 to 4.1) of children ages 18 and younger compared with 2.4% (95% CI 1.8 to 2.9) in 1996, according to Samuel H. Zuvekas, PhD, of the Agency for Healthcare Research and Quality in Rockville, Md., and Benedetto Vitiello, MD, of the National Institute of Mental Health in Bethesda, Md.

But among those ages 13 to 18, the rate of use increased by 6.5% annually, rising from 2.3% (95% CI 1.5 to 3.1) in 1996 and reaching 5% (95% CI 3.9 to 6.1) by 2008 (P<0.001), the researchers reported online in the American Journal of Psychiatry.

Full story at Med Page Today

Secondhand Smoke Tied To ADHD And Learning Disabilities In Children

By Medical News Today

Children exposed to secondhand smoke in the home appear to be at 50% higher risk of neurobehavioural disorders such as ADHD/ADD and learning disabilities compared to unexposed children according to an analysis led by the Harvard School of Public Health (HSPH) that was published in the journal Pediatrics this week. The analysts suggest if such a link were found to be causal, then secondhand smoke in the home is responsible for over quarter of a million children across the US developing ADHD and other neurobehavioural disorders.

For their research, Hillel Alpert, a research scientist for the Tobacco Control Research and Training Program at the HSPH in Boston, Massachusetts, and colleagues, examined data from the 2007 National Survey on Children’s Health. The telephone survey took place between April 2007 and July 2008.

Full story at Medical News Today

Is It ADHD, OCD or Both?

By Stephanie Sarkis, Ph.D.

Many people ask me what the difference is between attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). Both ADHD and OCD seem to be highly heritable: if you have it, it’s likely that at least one of your parents also has it. When you have ADHD, one of the issues is that your brain has a low level of a chemical called dopamine. When you have OCD, one of the issues is that your brain has too much of a chemical called serotonin. Sometimes people have both ADHD and OCD. This means that you have the inattention and/or hyperactivity of ADHD, along with the compulsions and/or obsessions of OCD.

Sometimes people with ADHD tend to have what look like compulsive tendencies. This is because we’ve learned to overcompensate for difficulties that we’ve experienced with distraction, disorganization and inattention. For example, when I shut the trunk of my car, I look to make sure my keys are in my hand. I also check that the stove is turned off after I’ve been using it and about to leave the house. I don’t do those things because I have a compulsion; I have tendency to misplace my keys, so I want to make sure that I know that they’re with me and in my hand before I shut the trunk of the car, and I check the oven because I’ve left it on before when I was at home. So there are some things that people with ADHD do to compensate for having problems with attention, focusing and forgetfulness.

Full story at Huffington Post

Link Between Childhood ADHD and Substance Abuse Risk Supported by Long-Term Study Data

By ScienceDaily

Analysis of data from two long-term studies of the impact of attention-deficit hyperactivity disorder (ADHD) on the development of psychiatric disorders in young adults confirms that ADHD alone significantly increases the risk of cigarette smoking and substance abuse in both boys and girls.

“Our study, which is one of the largest set of longitudinal studies of this issue to date, supports the association between ADHD and substance abuse found in several earlier studies and shows that the increased risk cannot be accounted for by co-existing factors such as other psychiatric disorders or family history of substance abuse,” says Timothy Wilens, MD, of the MGH Pediatric Psychopharmacology Unit, who led the study. “Overall, study participants diagnosed with ADHD had a one and a half times greater risk of developing substance abuse than did control participants.”

Full story at ScienceDaily

Unlikely Bedfellows: Neuroscience and Family Therapy

by Marilyn Wedge, Ph.D.

  Many parents come into my office already having a diagnosis for their child firmly planted in their heads. “My son has ADHD” is a refrain I hear all too frequently. Equally often, I hear a mother say: “I was reading an article in a magazine on childhood depression, and my daughter has all the signs. I think she’s clinically depressed.”

     In our society, diagnosing mental disorders in children has become an acceptable, even fashionable, way of categorizing sad or angry or inattentive kids. If we pause for a moment and ask ourselves why parents so readily embrace these diagnoses for their youngsters, one answer immediately jumps to mind. A diagnosis of mental illness shifts responsibility for a child’s troubling behavior away from parents. Parents cannot be blamed for their child’s ADHD or clinical depression or oppositional defiant disorder any more than they can be blamed for their child’s diabetes or asthma or any other medical condition. Biological psychiatry has banished all trace of Freudian parent-blaming.

Because we are a pill-taking society, it is socially acceptable to give a child a pill to ease her suffering: a pill for school problems, a pill for sadness or moodiness, even a pill for temper tantrums. In an effort not to blame parents, we see these difficulties as problems inside our children’s biological make-ups, rather than the result of the child’s social environment. It’s nature at fault, not nurture. It’s the wiring of the kid’s brain gone askew or a “chemical imbalance” (although the exact chemicals involved in these maladies still remain a mystery). Even a child as young as three years old can be diagnosed with a serious mental illness.

     This biological point of view, so prominent in the past three decades, now seems to be at odds with the latest advances in neuroscience; for neuroscientists are telling us that we must look to nurture as well as nature to understand a child’s difficulties. The wiring of a child’s brain, neuroscientists argue, is structured in large part by the child’s nurturing environment. If a child’s family environment is disrespectful or stressful, this factor actually impacts the neural wiring of the child’s brain. In a fascinating article in the January 5, 2011 issue of the Huffington Post, neuroscientist Dr. Douglas Fields tells us that environmental stress is actually a “neurotoxin”, especially during the development of the brain of a child. Our brains, argues Fields, are not fully formed at birth, but are actually products of “the environment in which we are nurtured during the first two decades of life.” And research shows that harsh words in the parenting environment are as toxic to the brain of a child as harsh blows. If I understand Fields correctly, this means that the child’s social environment can create a biological condition in the child’s brain. Although the child’s problem did not begin as biological, it can become biological.

     But just as a stressful, toxic environment can etch the eminently plastic and shapeable brain of the child, so a positive change in the parenting environment can create healthy changes in the child. If parents change their behavior to become more respectful, their child’s brain can change accordingly. This does not mean that we need to go back to blaming parents. It only means that we must educate and instruct parents as to how to create the nurturing environment that will produce a healthy brain in their child.

     All of this neuroscience becomes especially relevant to the family therapist, who must strike a delicate balance between changing a stressful family situation without placing blame on parents. In practice, this is not as difficult as it sounds. Every family therapist is aware that in order to help a child, the therapist must have a good relationship with the parents, while at the same time changing parental behaviors that are toxic and cause the child to feel unhappy or misbehave.

     A few weeks ago, I met for the first time with a twelve-year-old boy named Howie (not his real name) and his parents Belinda and Victor. Howie had been refusing to go to school for several months. He was recently diagnosed with ADHD–which has become a catch-all diagnosis for any kind of school problem–and was taking stimulant medication. After two months, the medication still was not helping. Howie still refused to go to school. A half hour conversation with Howie’s parents revealed a significant problem in his family environment: Howie and his father had come to blows one day, after Howie refused to do his homework. In daily power struggles, Victor often yelled at Howie to get him to do his chores around the house or do his homework. The parents also argued about how to discipline Howie. These stressors in Howie’s environment seemed to be a much more significant factor in his refusal to go to school than any purported biological condition. Healing the relationship with his father, I believed, would help Howie more than any bottle of pills.

     Without heaping blame or shame on Victor, who already felt terrible about hitting and yelling at his son, I suggested some strategies to heal the relationship. I earnestly told Victor that every parent “loses it” occasionally, and the important thing was to apologize to Howie. Victor apologized right there in the session. In a session with the parents alone later in the week, I asked Victor to tell Howie two good things about himself every day, and to take Howie out for an enjoyable activity on the weekend. Victor readily agreed to this. I also told Belinda and Victor that together we could figure out an agreement about discipline that would work for both of them. After meeting with the parents for three sessions and having them make changes at home, Howie began going to school.

     If children’s brains are continuously developing in response to the parenting environment, labeling a child with a purportedly biological “mental disorder” and giving him pills doesn’t make any sense. When the child’s social environment changes to become more respectful and thus less toxic to his brain, the child’s mental structure will change accordingly. The recent theories of brain plasticity mean that damage from the nurturing environment–as long as it has not been severe and chronic-can be reversed with the help of the correct family interventions. Family therapists have known this for years. Now neuroscientists are providing us with a scientific underpinning for just how this occurs.

Web Source: http://www.psychologytoday.com/blog/suffer-the-children/201101/unlikely-bedfellows-neuroscience-and-family-therapy