Thursday, April 17, 2014
Inquirer Daily News

Psychology

POSTED: Tuesday, March 11, 2014, 5:30 AM
(iStockphoto)

A 20-year-old college student talked to me about recent suicides on college campuses: “When a suicide happens to someone your own age, it is so sad that it doesn’t feel real. Even if you don’t know the person, you may have mutual friends on Facebook. The person may look happy on Facebook and then you are shocked to see ‘R.I.P.’  messages."

Young people everywhere are upset about suicides among their peers. As parents, we are worried when suicide touches the lives of our children. Here are some observations about suicide among young people, and some suggestions as to how parents can help reduce the risk factors and offer emotional support.

Suicide rates for 18- to 24-year-olds, both students and non-students, come from the National Violent Death Reporting System.  The 2001 data was collected from four states (CT, ME, UT, WI) and two counties (Allegheny PA, San Francisco CA) and is derived from 181 suicide victims.  Most of the suicide victims were male (88%), white (89%) and non-students (80%).  According to the data, college students actually had a lower risk of suicide than people their age who were not in school. Use of firearms (51%) or suffocation or hanging (37%) were the most common methods. Students were less likely to use firearms than non-students.

POSTED: Tuesday, March 4, 2014, 4:00 AM
Teenage girls are sexually assaulted with alarming frequency and many will go on to develop post traumatic stress disorder (PTSD). (iStockphoto)

Teenage girls are sexually assaulted with alarming frequency and many will go on to develop post traumatic stress disorder (PTSD).  If left untreated, PTSD can make life hell for the sufferer for years after the original trauma, and increase the likelihood of other problems – most common are anxiety, depression, substance abuse, and self-destructive behaviors. 

But what treatment is appropriate – not to mention effective – for PTSD in girls who have been sexually abused?  A very important study, recently conducted right here in Philadelphia, points to a type of cognitive-behavioral therapy (CBT) known as prolonged exposure (PE). 

Typically, sufferers of PTSD go to great – and understandable – effort to avoid memories or reminders of the traumatic event. Even if the individual with PTSD attends therapy for relief, they will often avoid bringing up the trauma. Many well-meaning therapists, fearful of increasing their patients’ distress, will allow the avoidance.

POSTED: Tuesday, December 3, 2013, 5:30 AM

A significant part of my work as a cognitive-behavioral therapist specializing in anxiety and related disorders is providing families with recommendations for good resources. “Good resources,” in these cases, are usually books and websites that offer general, up-to-date information on the disorder for which I am treating the child, as well as sound suggestions for at-home interventions (i.e., parent manuals).  Of course I provide such psychoeducation in session, but I like parents to be able to hear the information more than once, from more than one source, and for it to be accessible to them outside of the therapy hour.

What I do not want is for families to garner information or recommendations for treatments from “unsafe” sources – that is, sources that provide information that is not scientifically supported or has been directly contradicted by science.  In fact, I explicitly warn families about this, because there is so much misinformation on the web. During initial sessions, when giving my families handouts printed with what I think are the best and safest sources of information on their child’s disorder and treatment for that disorder, I typically say: “Please DO NOT put the name of your child’s diagnosis into Google search and hit ‘return.’ You will receive millions of hits, many of them from untrustworthy sources having something to sell, and you will feel even more overwhelmed than you already do.  Instead, start with these I am recommending – you can always read more later.”

I've given my recommendations for resources on obsessive-compulsive disorder, for children who have difficulty with pill swallowing, tic disorders and school refusal. What follows are my current recommendations for good resources on trichotillomania and other habit disorders.

POSTED: Monday, November 25, 2013, 9:42 AM
(iStockphoto)

A significant part of my work as a cognitive-behavioral therapist specializing in anxiety and related disorders is providing families with recommendations for good resources. “Good resources,” in these cases, are usually books and websites that offer general, up-to-date information on the disorder for which I am treating the child, as well as sound suggestions for at-home interventions (i.e., parent manuals).  Of course I provide such psychoeducation in session, but I like parents to be able to hear the information more than once, from more than one source, and for it to be accessible to them outside of the therapy hour.

What I do not want is for families to garner information or recommendations for treatments from “unsafe” sources – that is, sources that provide information that is not scientifically supported or has been directly contradicted by science.  In fact, I explicitly warn families about this, because there is so much misinformation on the web. During initial sessions, when giving my families handouts printed with what I think are the best and safest sources of information on their child’s disorder and treatment for that disorder, I typically say: “Please DO NOT put the name of your child’s diagnosis into Google search and hit ‘return.’ You will receive millions of hits, many of them from untrustworthy sources having something to sell, and you will feel even more overwhelmed than you already do.  Instead, start with these I am recommending – you can always read more later.”

I've given my recommendations for resources on obsessive-compulsive disorder,for children who have difficulty with pill swallowing, and tic disorders. What follows are my current recommendations for good resources on school refusal.

POSTED: Monday, September 16, 2013, 12:00 AM
(iStockphoto)

Bullying is a risk factor for poor psychological health.  Dozens of research studies have already established that bullied children are at greater risk than their non-bullied peers for anxiety, depression, and suicide ideation, as well as compromised school achievement.  What is not as well-known is that bullying also affects physical health as well.

Bullied children are at least twice as likely as non peer-victimized children to experience with psychosomatic problems such as headaches, stomachaches, vomiting, dizziness, poor appetite, skin problems, sleeping problems, and bed-wetting, according to a study published online today in Pediatrics.

The study complements another published earlier this year in the same journal showing that psychosomatic abdominal pain in children predicts increased rates of anxiety and depression in teens and young adults.

POSTED: Wednesday, September 11, 2013, 6:00 AM
(iStockphoto)

A significant part of my work as a cognitive-behavioral therapist specializing in anxiety and related disorders is providing families with recommendations for good resources. “Good resources,” in these cases, are usually books and websites that offer general, up-to-date information on the disorder for which I am treating the child, as well as sound suggestions for at-home interventions (i.e., parent manuals).  Of course I provide such psychoeducation in session, but I like parents to be able to hear the information more than once, from more than one source, and for it to be accessible to them outside of the therapy hour.

What I do not want is for families to garner information or recommendations for treatments from “unsafe” sources – that is, sources that provide information that is not scientifically supported or has been directly contradicted by science.  In fact, I explicitly warn families about this, because there is so much misinformation on the web. During initial sessions, when giving my families handouts printed with what I think are the best and safest sources of information on their child’s disorder and treatment for that disorder, I typically say: “Please DO NOT put the name of your child’s diagnosis into Google search and hit ‘return.’ You will receive millions of hits, many of them from untrustworthy sources having something to sell, and you will feel even more overwhelmed than you already do.  Instead, start with these I am recommending – you can always read more later.”

I've given my recommendations for resources on obsessive-compulsive disorder, and for children who have difficulty with pill swallowing. What follows are my current recommendations for good resources on tics.

I recently gave my recommendations for resources on obsessive-compulsive disorder. What follows are my current recommendations for good resources for children who have difficulty with pill swallowing
Read more at http://www.philly.com/philly/blogs/healthy_kids/How-can-I-help-my-child-swallow-pills.html#I1sPmuLFsaKopRgd.99
I recently gave my recommendations for resources on obsessive-compulsive disorder. What follows are my current recommendations for good resources for children who have difficulty with pill swallowing
Read more at http://www.philly.com/philly/blogs/healthy_kids/How-can-I-help-my-child-swallow-pills.html#I1sPmuLFsaKopRgd.99
POSTED: Monday, August 12, 2013, 9:51 AM
Children who experience unexplainable ab pain are more likely to develop anxiety disorders as adults. (istockphoto)

Abdominal pain in childhood with no determined physical cause predicts much higher rates of anxiety and depression in adolescence and early adult years, according to a study published online today in Pediatrics.  

It’s been estimated that anywhere from 8 to 25 percent of school-aged children experience recurring abdominal pain. Many of these patients have no evidence of a physical cause of the pain, and therefore have medically unexplained or “functional” abdominal pain.

This large, well run study followed over 300 patients with abdominal pain and a matched control group of about 150 patients from childhood into adulthood. The researchers from Vanderbilt University found of the adults who had abdominal pain as children, 51 percent had an anxiety disorder during their lifetime (and 30 percent had a current diagnosis), compared with 20 percent of adults in a control group who had an anxiety disorder in their lifetime. Forty percent of adults who had abdominal pain as children had depression during their lifetime, compared to 16 percent of adults in the control group.

POSTED: Thursday, July 25, 2013, 9:21 AM
(iStockphoto)

A recent study in Pediatrics found that African American and Hispanic children are less likely to be diagnosed and treated for Attention Deficit Hyperactivity Disorder than white children. It was a very well designed, carefully measured study based on a representative sample of over 15,000 children being followed in a longitudinal study. The problem is these now 20-year-olds, were all born in 1993 and the measurement was of how many were diagnosed between their kindergarten year of 1998 and eighth grade in 2003.  It is a great snapshot, but an old snapshot.

We’ve now seen diagnostic rates for ADHD rise dramatically in the past 10 years (a 53 percent increase), and the Centers for Disease Control and Prevention estimates that over 11 percent of children are now diagnosed with ADHD. This includes nearly one in five high school age boys who have been diagnosed over the course of their lives by a professional.  

It also appears that race or ethnicity no longer predicts how likely a child will be diagnosed with ADHD. Children from low income families who have Medicaid insurance are more likely to be diagnosed, as are children of single mothers. Poverty is now the strongest predictor. The CDC says that the differences between racial and ethnic groups are diminishing. The leadings states for ADHD diagnosis? Alabama, North Carolina, Mississippi.  The lowest numbers are in Wyoming and Utah. 

About this blog
The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Christopher C. Chang, M.D., Ph.D Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Mario Cruz, M.D St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Lauren Falini Bariatric exercise physiologist, Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, RD Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D. Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Flaura Koplin Winston, MD, PhD Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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