Categories
Personality Disorders

A Guide to Cluster C Personality Types

Personality is defined by the set of traits or characteristics that shape an individual’s identity. This extends to the way an individual thinks, feels, and behaves. A person’s personality is a collection of their own unique experiences and inherited traits. A diagnosis of a personality disorder typically occurs when an individual’s personality begins to deviate significantly from the norm and turn into an unhealthy pattern of functioning. Personality disorders are usually organized into these three clusters: Cluster A, Cluster B, and Cluster C. Cluster A personality disorders are typically defined as eccentric and abnormal thinking. Some examples of disorders that fall into this category are paranoid personality disorder and schizoid personality disorder. Cluster B personality disorders are associated with dramatic and emotional behavior. This cluster encompasses diagnoses like antisocial personality disorder and narcissistic personality disorder. Cluster C personality disorders are established by anxious and fearful behaviors. Disorders that fall into this category typically range from behaviors like clinginess to avoidance of people. 

The three major types of Cluster C personality disorders are Avoidant personality disorder, Dependent personality disorder, and Obsessive-compulsive personality disorder. Avoidant personality disorder is defined as a group of conditions that mainly include nervousness and fear. People with Avoidant personality disorder tend to be hypersensitive to judgement by others and have a fear of rejection. It is hypothesized that this disorder develops because there is a genetic basis along with a prevalence of shyness during childhood. People with Dependent personality disorder usually have a profound need for people close to them whether it is emotionally or physically motivated. Those with Dependent personality disorder tend to avoid a sense of personal responsibility, have trouble being alone, and are often indecisive. Causes of this personality disorder are thought to be attributed to abusive relationships, childhood trauma, or certain familial traits or environments. Obsessive-compulsive personality disorder is explained by a chronic state of anxiety with a cycle of unwanted obsessions and compulsions. This personality disorder is believed to be caused by dramatic changes in one’s life, low levels of serotonin, overactivity in the brain etc. 

The majority of the time, Cluster C personality disorders go unnoticed because the actions associated with them will seem natural or normal to those who have these disorders. A diagnosis of a Cluster C personality disorder will include a physical exam, a psychiatric assessment, and a review of disorder criteria by a mental health professional or a doctor. This will then be referred to another specialist who will oversee treatment and confirm the diagnosis.  The most common way to treat a Cluster C personality disorder is by psychotherapy or medication. Psychotherapy entails working with a mental health professional and working through an individual’s thoughts and emotions. Social skill training may also occur individually or in a group setting. Medications that are prescribed to people with personality disorders typically are antidepressants, mood stabilizers, antipsychotic medications, and anti-anxiety medications. 

The personality disorders that are categorized in Cluster C have many overlapping symptoms. People with a personality disorder should be treated mindfully and supported throughout their diagnosis. 

 

References

Avoidant personality disorder: Symptoms, causes & treatments. Cleveland Clinic. (n.d.). Retrieved October 30, 2021, from https://my.clevelandclinic.org/health/diseases/9761-avoidant-personality-disorder.

Dependent personality disorder: Definition, symptoms, treatment. Cleveland Clinic. (n.d.). Retrieved October 30, 2021, from https://my.clevelandclinic.org/health/diseases/9783-dependent-personality-disorder.

Mayo Foundation for Medical Education and Research. (2016, September 23). Personality disorders. Mayo Clinic. Retrieved October 30, 2021, from https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463.

Obsessive compulsive disorder (OCD): Symptoms & treatment. Cleveland Clinic. (n.d.). Retrieved October 30, 2021, from https://my.clevelandclinic.org/health/diseases/9490-obsessive-compulsive-disorder.

Osborn, C. O. K. (2018, August 18). Cluster C personality disorders: Types, traits, treatment, support. Healthline. Retrieved October 30, 2021, from https://www.healthline.com/health/cluster-c-personality-disorders#how-to-help.

WebMD. (n.d.). Cluster C disorders: What they are and how to treat them. WebMD. Retrieved October 30, 2021, from https://www.webmd.com/mental-health/what-are-cluster-c-personality-disorders.

Categories
Attention-Deficit/Hyperactivity Disorder

Clinical Presentation of ADHD in Women

Attention-deficit/hyperactivity disorder, commonly referred to as ADHD, is classified as a neurodevelopmental disorder in which symptoms often manifest in childhood and can persist throughout adulthood. As the name suggests, individuals with ADHD may have difficulty concentrating on tasks, paying attention to others or their surroundings, or regulating impulsive behaviors. ADHD is divided into three subtypes: inattentive, hyperactive/impulsive, or combined type. Inattentive type ADHD is characterized when an individual predominantly displays inobservant behaviors or distractibility relating towards a task. This may include having a difficult time focusing on lectures or classroom discussions, forgetting daily tasks, or having difficulty following details in a conversation. In the hyperactive/impulsive type, one predominantly displays symptoms associated with erratic or restless behaviors such as difficulty engaging in leisure activities, appearing to need constant movement, or inability to wait for their turns in social functions or activities. In combined type ADHD, one presents symptoms of both inattentiveness and hyperactivity (American Psychiatric Association, 2021). 

ADHD is mostly diagnosed in early childhood, school-aged children with boys more commonly being the recipients of the diagnosis in contrast to girls,12.9% compared to 5.6% respectively (Centers for Disease Control and Prevention, 2020). While the prevalence of ADHD may appear more apparent in boys than girls, research shows that this gap in diagnosis is not necessarily the result of boys being more susceptible to ADHD, but rather, it may be due to girls being misdiagnosed or undiagnosed for ADHD in their younger years. 

Physicians Quinn and Madhoo, who specialize in ADHD treatment, conducted a review of varying clinical presentation of ADHD in women in contrast to men to analyze the differing factors in the recognition of a diagnosis and treatment options. In their review, they examined 41 ADHD articles, on Pubmed, over the span of the years 2002 to 2012 to identify the relevance of ADHD in women. Results signified that women and girls with ADHD to prominently display inattentive behaviors rather than hyperactive or impulsive symptoms. Internalizing symptoms, such as distractibility or inability to remain focused on a task, are more likely to be overlooked by teachers and parents in comparison to externalizing symptoms, which are associated with more disruptive behaviors as markers for ADHD diagnosis (Quinn & Madhoo, 2014). With public perception of ADHD heavily focused on the presentation of hyperactivity or impulsivity, behavioral symptoms relating to inattention are widely neglected in individuals who may present a different set of ADHD symptoms but are equally impacted by the condition. Typically, there is a greater emphasis on noticing disruptive or loud behaviors as common symptoms of ADHD; however, most do not realize individuals with inattentive or varying levels of combined type ADHD may have their symptoms go unnoticed and untreated for a great length of time. This inevitably would exacerbate negative behaviors that can disrupt the daily lives of individuals with these subtypes of ADHD. Quinn and Madhoo additionally noted that women and girls with ADHD are more likely to develop secondary presentations of anxiety and depression in association with their ADHD symptoms. Females with ADHD are more likely to exhibit lower self-esteem than males with ADHD. This negative self-perception is correlated with impaired peer and family relationships which is evident as females with ADHD are more likely to exhibit inattentive behavior which may make it difficult for them to focus on conversation building with others (Quinn & Madhoo, 2014). Overlooking an ADHD diagnosis in childhood can directly correlate with further exacerbation of symptoms related to depression and anxiety which travel to adulthood in women.  In this manner, it is seen how ADHD symptoms in women may be misdiagnosed even in adulthood for the coexistence of anxiety and depression. 

ADHD symptoms of all subtypes need to have greater recognition, so more individuals with ADHD can be included in the conversation for proper treatment and diagnosis. Because most diagnoses of ADHD happen in childhood years, it would be very beneficial to have additional instruction given to teachers, caregivers, and family members of the manifestation of ADHD behavioral markers that commonly go unnoticed. Additionally, with growing awareness of how clinical presentations of ADHD may be different in various groups, there should be a greater research focus on obtaining ADHD data on underrepresented populations. With proper diagnoses, more individuals with ADHD will be able to seek out proper medications and therapies to help them better understand their condition.

 

References

Image Citation: (Open Learn, 2021)

American Psychiatric Association. (2021). What is ADHD? https://www.psychiatry.org/patients-families/adhd/what-is-adhd

Centers for Disease Control and Prevention. (2020, November 16). Data and statistics about ADHD. https://www.cdc.gov/ncbddd/adhd/data.html

Open Learn. (2021, February 3). Understanding ADHD [Animated Photograph of a Young Girl with ADHD.]. The Open University. https://www.open.edu/openlearn/health-sports-psychology/understanding-adhd/content-section-0?active-tab=description-tab

Quinn, P. O., & Madhoo, M. (2014). A review of attention-deficit/Hyperactivity disorder in women and girls. The Primary Care Companion For CNS Disorders, 16(3). https://doi.org/10.4088/PCC.13r01596

Categories
Neurocognitive Disorders

Auditory Processing Disorder

“What?” “Huh?” “Sorry, can you repeat that again?” These are questions that may feel all too familiar for people with Auditory Processing Disorder (APD). Auditory Processing Disorder, also referred to as Central Auditory Processing Disorder (CAPD), is a condition that principally affects an individual’s ability to to understand speech. Though Auditory Processing Disorder can co-occur with hearing loss, Auditory Processing Disorder is not equivalent to hearing loss, and many people with Auditory Processing Disorder are hearing-abled. Auditory Processing Disorder is a result of issues in the processing of auditory signals in the brain rather than issues in the reception or transmission of signals which can be seen in hearing loss (Healthline 2020).

There are several different subtypes of Auditory Processing Disorder that can influence both speech processing and speech production. Auditory Sensitivity, also known as tolerance fading memory, individuals have an intolerance to background noises (Gemm Learning n.d., ACENTA n.d.). This can result in extreme difficulty understanding in noisy areas as well as impaired memory when listening to instructions. This can often lead to others perceiving those with Auditory Processing Disorder as ignoring or not paying attention to them, or missing important pieces of instruction (Gemm Learning n.d., ACENTA n.d.). In the Auditory Integration subtype, which is seen in most cases of Auditory Processing Disorder, though knowing phonetics individuals may experience difficulty reading and writing and may often need clarification (Gemm Learning n.d., ACENTA n.d.). Issues with the perception of tone and mood may be a challenge for those with the prosodic subtype of Auditory Processing Disorder (Gemm Learning n.d., ACENTA n.d.). In the Decoding subtype, phonetics may be confusing and similar sounding words can often be mistaken for one another. This subtype can additionally influence grammar and spelling (Gemm Learning n.d., ACENTA n.d.). Lastly, in the Organization subtype, the sequencing of words can prove to be difficult to understand (Gemm Learning n.d., ACENTA n.d.). In any of the subtypes, impediment of the ability to complete tasks and assignments are notable consequences of auditory processing impairments.

Auditory Processing Disorder is considered a relatively rare disorder with an estimated prevalence of 3-4% within the general population (Nationwide Children’s Hospital, n.d.). Despite its rarity, Auditory Processing Disorder has an observed high comorbidity in those who have also been diagnosed with neurodivergent orders like Attention Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorders (ASD) and Dyslexia. Amongst children tested for learning disabilities, 25% have been estimated to have Auditory Processing Disorder and Dyslexia co-occur (Auditory Processing Center n.d.). ASD has an estimated 9% co-occurrence in children with auditory processing disorder (Palaniyappan et al. 2016) while up 50% of those diagnosed with ADHD may also have Auditory Processing Disorder (Scherer 2021). However, there has been some controversy over the comorbidity of Auditory Processing Disorder and neurodivergent disorders due to the common overlap of symptoms and unknown status exact prevalence within the general population of “true” Auditory Processing Disorder only adds to the difficulty in estimates.

For individuals with Auditory Processing Disorder, daily life may seem incredibly difficult and it may feel like there is a broken link between them and the world. Their inability to understand others, and the inability for others to understand them, can create what feels like persistent plight and disconnect. However, awareness of Auditory Processing Disorder has been increasing and alleviation of symptoms fortunately may be achieved through various methods, including auditory training and compensatory training to enhance skills that can aid in Auditory Processing Disorder Management (Healthline 2020).

 

Resources

APD, Dyslexia or Both?. Auditory Processing Center. (n.d.). https://www.auditorycenter.com/what-is-auditory-processing-disorder/apd-dyslexia-or-both/

Auditory Processing: Auditory Processing Disorder Defined. Arkansas Center for Ear Nose Throat, Allergy and Hearing (ACENTA). (n.d.). https://acenta.com/auditory-processing/

Auditory Processing Disorder. Nationwide Children’s Hospital. (n.d.). https://www.nationwidechildrens.org/conditions/auditory-processing-disorder

Palaniyappan, V., Aisha S. and Swathi C. (2016). Central Auditory Processing Disorder: A Comorbid Condition. Otolaryngology. 1:5-9.

Scherer, P. (2021). “Could Your Child Have Auditory Processing Disorder”. ADDitude.

Types of Auditory Processing Disorder. Gemm Learning. (n.d.). https://www.gemmlearning.com/can-help/central-auditory-processing-disorder/info/types-of-apd/

What is Auditory Processing Disorder (APD). Healthline. (2020). https://www.healthline.com/health/auditory-processing-disorder

Categories
Uncategorized

Student Support: How It Relates to Everyday Life

The importance of a support system has long been understood, with many of the relationships and experiences we undergo informing our outlook on life and the way we interact with the world. In times of great difficulty, these are the people we lean on, the individuals who get us through rough patches, and make us feel loved and cared for in the process. The effects of this support system are especially helpful for those with mental illness. In fact, studies have shown that the presence of proper support improves anxiety or management of illness. Meanwhile, the absence of those who provide support results in increased anxiety, which ties into other factors as well.

Conceptually, this makes sense. As stated above, support during a difficult time makes the experience more manageable, if not easier. In the context of mental health, the individual is aware that their support system understands what they are going through and are ready to lend support when needed or asked for. Just the knowledge that this is an option, that you have that possibility, can decrease stress related to mental health in certain aspects. Rather than focusing on how others might be affected by your situation and how difficult or burdensome you are, you can focus on the problem at hand, fully aware that you have the support of those who matter.

One excellent example of this was done in relation to academics, where parental support of children was examined in the context of there being a potential connection between various academic stressors and the presence of anxiety (Leung et al, 2009). Split into different focus groups, students were polled on the various types of support they received from their parents, ranging from information, such as aid given when doing homework, to emotional, with students being able to go to their parents at times of difficulty, to time spent together. They were asked questions related to 28 anxiety items from a list, in which higher scores from this list indicated higher levels of anxiety (Leung et al, 2009). When further analyzed, the various support variables had a negative correlation with student anxiety, and that maternal support was found in higher levels than paternal support was, keeping in line with previous findings on this topic.

However, the effectiveness of parental support in lessening the effects of academic stress and reducing the rate of academic anxiety is not just due to the reassurance of love and care. It is also tied to culture, and the idea of what your parents’ support means. In Hong Kong, filial piety is a large part of societal norms and the parent-child relationship is heavily influenced by Confucian ideology (Leung et al, 2009). For the students in the experiment to know that their academic achievements didn’t necessarily equate to how good of a child they were, or for the parents to understand that a child’s progress isn’t a reflection of how they were raised, that is a large weight off of their back in terms of societal expectations and the chains that bind them. With the time put into this relationship and their support made clear, anxiety due to academics decreased, allowing both students and parents to focus on what was truly important to them. The same thought process can be applied to other aspects of life, allowing individuals to prioritize what truly matters and do so with those they care about by their side.

 

Reference

Leung, G. S. M., Yeung, K. C., & Wong, D. F. K. (2009). Academic Stressors and Anxiety in Children: The Role of Paternal Support. Journal of Child and Family Studies, 19(1), 90–100. https://doi.org/10.1007/s10826-009-9288-4

Categories
Neurodegenerative Disorders

The Mediterranean Diet and Age-related Neurodegenerative Disease

The Mediterranean diet is often credited as the ideal model of healthy eating. Multiple studies have proven its effectiveness in preventing a wide array of maladies, including diabetes mellitus, obesity, hypertension, cardiovascular disease, and cognitive disease (Aridi, 2020). Until recently, there was little evidence suggesting that this diet  protects against neurodegenerative disease, but with advances in technology, preliminary research has indicated this may be the case (ScienceDaily, 2021). As we age, we become more susceptible to developing neurodegenerative disorders, which are progressive diseases that impede the functioning of the central nervous system. While they do have a strong genetic component, they are also known to be triggered by environmental factors, such as exposure to certain toxins or viruses (NCI Dictionary). Although many of these factors are out of our control, we are able to decide what we are consuming.

The Mediterranean diet first got attention in the mid-twentieth century when studies confirmed  a significantly decreased amount of cardiovascular disease among Greek and Italian populations as compared to the rest of the world. It is believed that this can be attributed to the variety of fresh plant-based foods they consume, with most meals consisting primarily of vegetables, legumes, and whole grains. Processed foods with synthetic trans fats are substituted for lean meat and olive oil, which contains healthier unsaturated fats. Fish is often consumed as a good source of omega-3-fatty acids and is eaten in place of red meat.  Fresh fruit is also eaten as a substitute for desserts that are high in sugar and fat (Mayo Foundation, 2021).

Inhabitants of the small Greek island of Ikaria adhere the most strictly to this diet, except they eat significantly less meat and fish, replacing them with more vegetables which contain many more antioxidants. Such areas of the world where life expectancy is strikingly higher than in others are referred to as “blue zones,” and Ikaria certainly meets the qualifications, with people living eight to ten years longer than the average American. While the strong social culture of the island and the general active lifestyle there contributes to the overall health of the inhabitants, there is reason to believe their diets also play a key role. In addition to eating healthy, Ikarians drink herbal tea daily, which they make using freshly grown herbs. While they are also excellent sources of antioxidants, they are mild diuretics as well, working to lower blood pressure. This is actually directly related to neurodegenerative disease. According to Johns Hopkins research published in the Journal Neurology, the regular use of diuretics decreased the risk of Alzheimer’s by seventy-five percent, partially accounting for the fact that Ikarians over 85 have less than 10 percent chance of developing Alzheimer’s (Kotifani, 2020).

In Alzheimers and dementia, there is an accumulation of beta amyloid protein in the brain, forming clumps and causing neuronal cell death. The brain will also shrink in volume in a process called atrophy, thus manifesting as symptoms of memory loss, confusion, and disorientation. The German Center for Neurodegenerative Diseases has conducted studies following individuals’ diets over time and investigating the link between Mediterranean-like diets and protection against these physical changes in the brain in some healthy individuals and others that were identified as having a higher risk for these diseases. Magnetic resonance imaging was used to assess differences in brain volume and neuropsychological tests assessed the subjects’ memory and general cognitive abilities. Biomarker levels for beta-amyloid proteins in the cerebrospinal fluid of subjects were also measured. Subjects that more strictly adhered to the Mediterranean diet had consistently less beta-amyloid plaque deposits and performed better on memory tests. Their brains also showed less signs of atrophy and greater brain volume in the hippocampus, a brain structure essential to learning and memory. However, the underlying biological mechanisms at play are still poorly understood and are the focus of new research and longitudinal studies (ScienceDaily, 2021).

One factor contributing to the exceptionally low incidence of neurodegenerative disease in Ikaria and the results observed in atrophy studies is that consuming fresh foods means there are no neurotoxins. The US Food and Drug Administration permits the use of around 3,000 food additives, including some known neurotoxins like aspartame, diacetyl, monosodium glutamate (MSG), and aluminum. These target the central nervous system to reduce neuron functioning and elicit premature cell death. They are associated with a plethora of conditions, ranging from dementia and Alzheimers to anxiety, depression, headaches, and brain fog. Opting for fresh vegetables as opposed to processed food provides natural protection against these issues. However, mercury is a naturally-occurring neurotoxin that’s found in fish, which may contribute to why Ikarians, who avoid consuming too much of it, live even longer and have an even lower incidence of dementia and alzheimers than their other mediterranean counterparts (Alban).

Today, it is important to be aware of the dangers of consuming diets rich in processed foods, especially in the United States where this practice has grown to be so commonplace.  Unfortunately, the health and safety of consumers often takes a backseat to the monetary gain of large companies that have put a price-tag on the public’s health.  As more studies are conducted on the link between the Mediterranean diet and protection against neurodegenerative disease, it is advisable to steer clear of packaged foods with flashy labels, as they are designed by marketers to distract from the preservatives and high fat and sugar content. While it may seem difficult to live like Ikarians and consume what we perceive to be strict diets, they think their habits are just the norm. Thus, Americans should aim to emulate this lifestyle to thereby limit our risk of neurodegenerative disease to the extent that we can.  

 

References

Alban, P. (n.d.). 5 neurotoxins found in popular foods. Be Brain Fit. https://bebrainfit.com/neurotoxins-foods/. 

Aridi, Y. S., Walker, J. L., Roura, E., & Wright, O. R. L. (2020, April 28). Adherence to the Mediterranean diet and chronic disease in Australia: National Nutrition and    physical activity survey analysis. Nutrients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7281974/. 

Kotifani, A. (2020, June 3). A Greek island’s ancient secret to avoiding Alzheimer’s. Blue Zones. https://www.bluezones.com/2018/11/a-greek-islands-ancient-secret-to-avoiding-alzheimers/. 

Mayo Foundation for Medical Education and Research. (2021, July 23). Mediterranean diet for heart health. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801. 

NCI Dictionary of Cancer terms. National Cancer Institute. (n.d.)., https://www.cancer.gov/publications/dictionaries/cancer-terms/def/neurodegenerative-disorder. 

ScienceDaily. (2021, May 6). Alzheimer’s study: A Mediterranean diet might protect against memory loss and dementia. ScienceDaily. from https://www.sciencedaily.com/releases/2021/05/210506105355.htm.

Categories
Obsessive Compulsive Disorder Tic Disorders

Relations Between Tic Disorders and Obsessive-Compulsive Disorders

Unwanted urges and obsessions are burdensome because it likely interferes with daily life. These undesirable thoughts are associated with a lot of anxiety and distress over a specific event or action. Obsessive-Compulsive Disorder (OCD) is identified as intrusive and unwanted obsessions coupled with a compulsion or a sudden involuntary behavior. A tic disorder may often be characterized by motor or vocal. A vocal tic is when a person with the disorder will whistle, grunt, or repeat certain words. A motor tic is often exhibited through twitching, blinking, or nose scrunching. Obsessive-Compulsive Disorder and tic disorder can coexist, and the behaviors of each disorder can often overlap. 

There is a certain subtype of Obsessive-Compulsive Disorder, where many will identify as Tourettic Obsessive-Compulsive Disorder. This subtype is defined as extreme physical or psychological discomfort followed by a behavior that is carried out to relieve the discomfort. The difference between a tic and a behavior from Obsessive-Compulsive Disorder is very slight but can be correctly categorized by the intent. A tic can be characterized as a repetitive behavior that has no specific motive. Whereas a behavior from Obsessive-Compulsive Disorder is purposeful, and performed because it is believed to provide relief from discomfort. These distinctions are important especially in a clinical setting. It has been observed that when individuals with both these disorders seek treatment, they respond better when the treatment is catered to them rather than being treated for just one or the other. 

In a study led by Christine Conelea, it was proposed that children with tics in the Pediatric OCD Treatment Study II varied from those without tics. Therefore it is assumed that these children’s treatment responsiveness would differ because of a tic disorder. Youth between ages 7-17 with a primary diagnosis of Obsessive-Compulsive Disorder were included in this study. They were then divided into groups based on whether or not they had tics along with OCD or if they only had OCD without the presence of tics. This study used treatments like medication management, medication management plus instructions in cognitive behavioral therapy(CBT), or medication management plus full cognitive behavioral therapy. Throughout the treatment process people with tics terminated treatment early more often than people without tics did, however this was not reflective of how they responded to certain treatments. People with OCD and comorbid tics will benefit from cognitive behavioral therapy from someone with expertise in OCD and tic disorders. Tics are hypothesized to be facilitated by the feeling of relief when performing the behavior that alleviates discomfort. CBT aims to reduce the frequency of tics through exposure by purposely evoking more discomfort when that behavior is performed. 

The coexistence of both tic disorder and Obsessive-Compulsive Disorder does not suggest a higher degree of severity or a more intense expression of symptoms. Conelea’s study found that when comparing individuals with tic-related Obsessive Compulsive Disorder and individuals with only Obsessive-Compulsive Disorder, there was no significant difference in treatment responsiveness. Conelea’s study brings caution to making assumptions about people living with these disorders. 

 

References

Conelea, C. A., Walther, M. R., Freeman, J. B., Garcia, A. M., Sapyta, J., Khanna, M., & Franklin, M. (2014, December). Tic-related obsessive-compulsive disorder (OCD): Phenomenology and treatment outcome in the pediatric OCD treatment study II. Journal of the American Academy of Child and Adolescent Psychiatry. Retrieved October 16, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4254546/.

Marla Deibler, P. D. (2020, October 12). What is “just right” OCD and tic-like compulsions? Verywell Mind. Retrieved October 16, 2021, from https://www.verywellmind.com/just-right-ocd-2510668. 

Obsessive-compulsive disorder and TIC disorders. Duke Health. (n.d.). Retrieved October 16, 2021, from https://www.dukehealth.org/treatments/child-psychiatry/ocd-and-tic-disorders.

Tics, Tourette syndrome, and OCD. HealthyChildren.org. (n.d.). Retrieved October 16, 2021, from https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Tics-Tourette-Syndrome-and-OCD.aspx.

Categories
Autism Spectrum Disorder

Art and Music Therapies for Individuals with Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is classified as a neurological and developmental condition characterized by behavioral difficulties in areas of social interaction and communication. Individuals with ASD may display patterns of repetitive behaviors or restricted interests which can conflict with their proficiency to use verbal or non-verbal gestures, interpret their own and others’ emotions, or adjust to new environments and scenarios (American Psychiatric Association, 2021). As a result, individuals with ASD may be hindered from successfully communicating their thoughts and wishes to others. Children and adults with ASD experience different degrees of impairment with respect to the severity, number, or presentation of their symptoms. Early intervention, focused on different forms of training and therapy, have been shown to improve functionality of social and speech skills which can help individuals to better understand social situations. While most individuals with ASD opt for common forms of intervention such as applied behavior analysis and occupational and speech therapy, non-traditional programs such as art and music therapy have been seen to be very effective in increasing social adaptation and communication skills (Centers for Disease Control and Prevention, 2019). 

Art therapy is emerging as a new tool to successfully mitigate some symptoms of ASD by promoting a stimulating outlet to help individuals use artwork and media to explore their emotions while developing self-awareness skills to better acclimate to new surroundings (The Carmen B. Pingree Autism Center of Learning, 2021). Art therapy is a creative process which is facilitated by an art therapist who is a licensed, master-level clinician with expertise on how to integrate sensory and symbolic art modes into improvement of cognitive and emotional function (American Art Therapy Association, 2017). As individuals with ASD may experience difficulty expressing themselves verbally, art therapy provides a non-verbal outlet where one may develop and enhance their ability to express themselves in a less restrictive environment. As art therapy tends to be individualized, one may choose what materials, mediums, and colors they want to use to form their own visual work. In this manner, those with ASD are able to integrate abstract thinking and their emotions into their art to reveal their perspective and creative expression. Art therapists can cater their exercises to seeing which materials are most preferable or popular to their patient so they can be most comfortable in their own learning environment (Van Lith et al., 2017, p. 78-84). The preference in choosing different materials can help individuals with ASD increase their tolerance to experience new stimuli. Art strategies, such as sand art or playdough sculptures, are forms of different sensory materials which can help individuals to be more desensitized to new textures and smells. While participating in this creative play, individuals can be more comfortable with various stimuli which will inevitably improve their interaction to similar situations in their daily life. Here, art therapy is able to enhance visual and spatial skills in individuals to allow them greater behavioral regulation (The Carmen B. Pingree Autism Center of Learning, 2021).      

Similar to art therapy, music therapy is an intervention, facilitated by an accredited therapist, that focuses on instrument play, musical improvisation, and various musical activities to foster social and communicative skills. Music therapy helps to provide a predictable structure to sessions that may help to better accommodate individuals with ASD for their learning environment. Because of heavy sensory engagement, music based therapy sessions can help one to be accustomed to different social environments and increase the likelihood of positive engagement in daily activities. Additionally, music therapies can often be presented in group activities which can encourage individuals with ASD to collaborate with others and increase their interaction. As ASD may make it difficult for individuals to understand others’ expressions and emotions, these group activities can help their social skills and communication (American Music Therapy Association, 2015).

Through efforts to expand therapy and intervention practices, one can see how there are options for individuals with ASD to learn new social and communicative skills in a manner most comfortable to them. Interventions such as art and music therapy provide innovative learning styles where an individual with ASD can foster abilities to be confident and secure in themselves in their own environment.   

 

References

American Art Therapy Association. (2017). Becoming an art therapist. https://arttherapy.org/becoming-art-therapist/

American Music Therapy Association. (2015). Fact sheet: music therapy and autism spectrum disorder (ASD). https://www.musictherapy.org/assets/1/7/Fact_Sheet_ASD_and_MT__8-26-15.pdf

American Psychiatric Association. (2021, August). What is autism spectrum disorder? https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder

The Carmen B. Pingree Autism Center of Learning. (2021, May 25). Art therapy activities for autism. https://carmenbpingree.com/blog/art-therapy-activities-for-autism/

Centers for Disease Control and Prevention. (2019, September 23). Treatment and Intervention Services for Autism Spectrum Disorder. https://www.cdc.gov/ncbddd/autism/treatment.html

Van Lith, T., Stallings, J. W., & Harris, C. E. (2017). Discovering good practice for art therapy with children who have autism spectrum disorder: The results of a small scale survey. The Arts in Psychotherapy, 54, 78-84. https://doi.org/10.1016/j.aip.2017.01.002

Categories
Schizophrenia

Child & Adolescent Schizophrenia

Though schizophrenia is more commonly seen among adults, it can also be present in children and young adults. It must be noted, though, that the only difference between childhood schizophrenia and adult schizophrenia is that the former shows up earlier in a person’s life than the latter does. Early onset schizophrenia comes on before a person is eighteen years old, and is rarely seen in someone before they are thirteen years old. Most schizophrenia symptoms fall under three kinds: Behavior, Emotions, and Thinking.

Behavioral symptoms may include a person having difficulty sleeping, isolating oneself from those closest to them, being violent, and not having the incentive to do daily tasks such as showering or doing school work. Emotional symptoms can include being depressed, being suspicious of other people, and not showing any emotions. Thinking symptoms may include believing fiction to actually be reality and not being able to think logically. These are some symptoms, but as one gets older and the disorder progressives, the symptoms can get relatively worse. 

Worsening symptoms of schizophrenia can be the onset of hallucinations, the start of misinterpretations of social behaviors, and being scatterbrained. Hallucinations involve a person seeing things or hearing voices that are actually not real. These tricks of the mind can seem very real to the person experiencing them. A person with schizophrenia may experience hallucinations which cause them to misjudge how others feel about them. This perception a person with schizophrenia can have about those around them is one of the most common symptoms. Another symptom is a person becoming absentminded which can include not being able to concentrate or fidgeting around a lot. While all these symptoms can be very overwhelming to go through, and schizophrenia is chronic, it is very treatable (Mayo Clinic Staff, 2021).

The first step in childhood schizophrenia being treated is going to a psychiatrist. From there they can help with an official diagnosis and then begin to make a treatment plan. One option is for a patient to go on a low dose of an antipsychotic drug. This can help with any hallucinations one may be experiencing. Another alternative is going to therapy to help talk out what one is feeling. This therapy can be great for a child because they can get a better understanding of schizophrenia and how it affects them. Children with schizophrenia can also go to different classes or training to help them feel more comfortable. The classes can be on subjects like learning how to build healthy relationships in connection to their schizophrenia. And if symptoms get extremely severe, a child can be hospitalized to get the special care they need to feel better (Schizophrenia, 2021). 

While schizophrenia, especially among children, can be very difficult, it is very treatable, especially when families make some of the accommodations mentioned. People can acknowledge and work through their schizophrenia symptoms.

 

Resources

Mayo Clinic Staff. “Childhood Schizophrenia.” Mayo Clinic, 19 May 2021, https://www.mayoclinic.org/diseases-conditions/childhood-schizophrenia/symptoms-causes/syc-20354483.

“Schizophrenia .” Boston’s Children Hospital, 2021, https://www.childrenshospital.org/conditions-and-treatments/conditions/s/schizophrenia/diagnosis-and-treatments.

Categories
Attention-Deficit/Hyperactivity Disorder

Emotional Dysregulation in ADHD

Emotional dysregulation, defined as “emotional response that is poorly regulated and does not fall within the traditionally accepted range of emotional reaction” (Webmd 2021), is a common symptom among a wide range of mental disorders including Attention Deficit/Hyperactive Disorder (ADHD). Emotional dysregulation for many with ADHD may not just feel like a constant struggle with oneself but can additionally feel like a constant battle with those around them. Its misunderstood nature frequently ends up causing conflict in the lives of those with it, and often results in the further exacerbation of other existing ADHD symptoms.

Emotional dysregulation is a relatively common symptom of ADHD with prevalence among adults ranging from 30-70% in adults and 25-25% in children (Rüfenacht et al. 2019). It is associated with impaired activity of the amygdala and cingulate gyrus of the limbic system in the brain,both of which are involved in emotion and pain regulation. In one study, activity of cingulate activity was found to be lower in study participants with ADHD in comparison to those without ADHD (Webmd 2011). Other studies have found amygdala hyperactivity in participants with ADHD (Shaw et al. 2014). Additionally, weaker connections between the cerebral cortex – which is notably involved in the perception of external stimuli and decision making – and the amygdala are associated with those with ADHD (Nigg 2021). This can cause emotional reactions that are disproportionate to the stimuli/cause.

In emotional dysregulation, emotional reactivity can manifest in a variety of ways. This may include intense levels of anger (or rage), high anxiety levels, dissociating, and even suicidal thoughts (Webmd n.d.). Those with ADHD and emotional dysregulation may have a much lower frustration tolerance and higher reactivity to situational stressors. At the opposite end of the spectrum, reactivity can include over-excitement, joy, or passion. At either end, people observing these reactions may seem frightening or distressing and can lead to the degradation of relationships. Outsiders looking in may understand neither the emotional reaction nor the degree of it and this type of misunderstanding could influence the perception of the person with ADHD emotional dysregulation. They can consequently (and incorrectly) see them as volatile, inflexible to change and overly sensitive as personality traits rather than a result of an ADHD symptom.

Emotional dysregulation in ADHD is not just misunderstood among the public and the people in the lives of those affected by it, it is also misunderstood by medical and mental health professionals. Emotional dysregulation is a common symptom among multiple unrelated disorders, including Bipolar Disorder, Borderline Personality Disorder, Post Traumatic Stress Disorder, and Autism Spectrum Disorders. Its commonality among mood disorders and personality disorders makes it easy for ADHD to be mistaken as a mood or personality disorder (Marangoni 2018). That is not to say that mood and personality disorders cannot occur in individuals with ADHD, in fact bipolar disorder and personality disorders have a comorbidity rate upwards of 47.1% and 50% respectively (Katzman 2017). However, the overlap of symptom criteria makes distinguishing ADHD from other disorders difficult. This is an unfortunate source of misdiagnosis that can lead to additional complications and difficulties.

Despite the disruptions that emotional dysregulation may cause, it is treatable. Before treatment can be recommended and/or administered it is important to recognize and address emotional dysregulation as a symptom. Many stimulant medications have been found to be effective in treating emotional dysregulation in ADHD, as have cognitive and behavioral psychotherapies (Shaw et al. 2014). It is additionally crucial that thorough and holistic examination of individuals occur by mental health and medical professionals.

 

Resources

Katzman, M. A., Bilkey, T. S., Chokka, P. R., Fallu, A., & Klassen, L. J. (2017). Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC psychiatry, 17(1), 302.

Marangoni, C. (2018). ADHD, Bipolar Disorder, or Borderline Personality Disorder. Psychiatric Times, 35(10)

Nigg, J. (2021). “How ADHD Amplifies Emotions”. ADDitude.

Rüfenacht, E., Euler, S., Prada, P. et al. (2019). Emotion dysregulation in adults suffering from attention deficit hyperactivity disorder (ADHD), a comparison with borderline personality disorder (BPD). Borderline Personality Disorder Emotional Dysregulation, 6.

Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in attention deficit hyperactivity disorder. The American journal of psychiatry, 171(3), 276–293.

Study: Many With ADHD Can’t Control Emotions. Web M.D. (2011). https://www.webmd.com/add-adhd/news/20110506/study-many-with-adhd-cant-control-emotions

What is Emotional Dysregulation? Web M.D. (2021). https://www.webmd.com/mental-health/what-is-emotional-dysregulation

Categories
Eating Disorders

When A Bit Too Much Is An Issue

While some mental illnesses may present themselves independently under certain  scenarios, it’s important to acknowledge that some are interconnected as the side effects of one illness result in symptoms of another. The overlapping of various mental illnesses can especially be seen in the connection between anxiety and eating disorders, whether that be bulimia, anorexia, or other forms of disordered eating.

Before we begin to break down this web, we have to define anxiety, at least in the context of this situation. Many studies conducted have used the cognitive approach to anxiety, which is the thought that anxiety is the designation of specific stimuli as an excessive threat,  no matter how small or innocent it may seem (Pallister & Waller, 2007). Consequently, a bias against the stimuli is formed, evoking negative thoughts and fear from the individual. In order to deal with the effects of this bias, people may utilize different strategies of coping mechanisms. 

When it comes to generalized anxiety disorder, simple procrastination of tasks, overthinking, and organizing every little detail are one of the many mechanisms demonstrated. In terms of disordered eating, however, overeating or undereating is also a very common tactic. One study of 271 subjects found that 71% of individuals with an eating disorder had a comorbidity, a presence of two or more diseases at the same time, with anxiety (Godart et al., 2006). Another study found that the percentage of comorbidity was 64%, supporting the fact that there is an evident relationship between anxiety and eating disorders  (Godart et al., 2006).

Using food to relieve stress from stressful situations isn’t just seen in people with mental illnesses. Comfort eating, or emotional eating, is common within the general population too. The most common scenarios that come to mind are stuffing yourself with junk food after a bad breakup, or increasing your sugar or caffeine intake to pull all nighters (Pells, 2019). With that frame of reference in mind, it’s easy to see how food can be a diversion from the problems being faced, and how it might offer a brief respite from the tension and stress of dealing with it all.

However, the act of associating eating with stress relief would have more consequences than usual for those with a comorbidity for anxiety and disordered eating. The presence of these illnesses would mean that the stressor is most likely to affect the individual at a stable, frequent basis, which could encourage coping behaviors such as comfort eating. However, the dependence on these behaviors can eventually cause a continuous cycle of more harm than good without the realization or acknowledgement of it. Just like the consequences of any other mental illness, these behaviors need to be acknowledged and treated with the help of a professional who can validate the individual’s progress and guide them towards healing.

 

References

Godart, N., Berthoz, S., Perdereau, F., & Jeammet, P. (2006). Comorbidity of anxiety with eating disorders and OCD. The American Journal of Psychiatry, 163(2), 326; author reply 327–326; author reply 329. https://doi.org/10.1176/appi.ajp.163.2.327

Pallister, E., & Waller, G. (2008). Anxiety in the eating disorders: Understanding the overlap. Clinical Psychology Review, 28(3), 366–386. https://doi.org/10.1016/j.cpr.2007.07.001

Pells, J. (2019, April 16). Anxiety and overeating – What’s the overlap? Eating Disorder Hope. https://www.eatingdisorderhope.com/treatment-for-eating-disorders/co-occurring- dual-diagnosis/anxiety/anxiety-overeating-whats-the-overlap