Eating Disorders

Eating Disorders Among Child Beauty Queens

Little girls are often lost in their own little worlds, playing princesses and slaying their own dragons, with their shiny armors and glittery tiaras. They don’t need Halloween to roll around in order to dress up and shine, for every day is Halloween when you’re having fun impersonating your favorite heroes. However, there is a strict divide between little girls who wear their costumes in the comfort of their own surroundings and little girls who are sparkled and shined for beauty pageants. Not only are girls from the latter group exposed to a completely different lifestyle with constant hair, makeup checks, and camera attention, but they’re also more vulnerable to developing eating disorders and body dissatisfaction.

A Huff Post article presents interesting data regarding the prominence of body dissatisfaction in young girls. First of all, it states that eating disorders are becoming prominent in “children as young as 6 years old,” and that 10-year-olds are now going on diets. Additionally, it states that 50% of girls in the 11-16 age group have considered undergoing cosmetic surgery.   

Given these striking statistics on young girls, it wouldn’t be completely wrong to assume that children who participate in beauty pageant experience some levels of anxiety and concern regarding their appearances. A 2005 study conducted by Anna L. Wonderlich from the University of Minnesota and fellow researchers Diann M. Ackard and Judith B. Henderson sought to examine the correlation between “adult disordered eating, body dissatisfaction, depression, and self-esteem.” The study used data collected from 22 women: 11 of whom had participated in a beauty pageant during their childhood and 11 who hadn’t. While results for the two groups didn’t vary wildly in terms of bulimic tendencies, body perception, depression, or self-esteem issues, participants who had partaken in childhood beauty pageants expressed greater body dissatisfaction.

Another perspective taken on this issue is the hypersexualization of young girls by beauty pageants and shows like Toddlers and Tiaras and their contribution to the development of eating disorders. In a CNN article, Melissa Henson (director of Grassroots Education and Advocacy at the Parents Television Council) accuses the show Toddlers and Tiaras of sexualizing young contestants and argues that it leads to eating disorders, depression, self-esteem issues, and decreased aspirations for STEM fields.

In our current society, children are exposed to a plethora of information through social networks and media sources. While it is important to ensure that younger generations are knowledgeable and aware, exposure to social expectations on beauty and sexuality can often be detrimental to their perception of themselves and the world around them. As a result, child beauty pageants have the potential to pose a great threat, which may stay with them for decades to come, to their young contestants.


Henson, M. (2011, September 13). ‘Toddlers and Tiaras’ and sexualizing 3-year-olds. CNN. Retrieved October 1, 2018, from

L Wonderlich, Anna & Ackard, Diann & B Henderson, Judith. (2005). Childhood Beauty Pageant Contestants: Associations with Adult Disordered Eating and Mental Health. Eating disorders. 13. 291-301. 10.1080/10640260590932896.  

Perry, C. (2011, August 2). Sexualization of Young Children Linked to Eating Disorder Development. Huff Post. Retrieved September 30, 2018, from


The Media’s Portrayal of Parental Addictions

Parents dealing with drug addictions is the latest trend in media and news outlets coverage. It seems like every time you turn on the news, a recently surfaced video of drug-addicted parents dealing with their addictions while taking care of their children is running. News outlets are sure to portray these parents as harmful, negligent, and selfish. While sensationalism is rampant, there are compassionate ways to portray parents dealing with addiction. A video of fourteen-year-old Tori Brinkman showed how traumatizing and difficult having a parent with an addiction can be (Snow, 2017).

It can be hard to portray a parent’s suffering from an addiction as anything but dysfunctional, however, Eileen Fragiacomo (2017) portrays a different picture from what is typically seen on the news. Eileen was the daughter of a drug-addicted mother, Helen, who had Eileen picking up drugs for her by the age of nine years old. In her article, Eileen describes her fear of how her mother would behave and the drugs she would have taken when Eileen got home from school. Helen was similar to the news portrayals of drug-addicted parents; she was negligent towards Eileen and placed her daughter in reckless and dangerous situations to fulfill her addiction’s needs. When she was a child, Eileen explains her feeling at fault for her mother’s behavior, assuming that a lack of love is what leads her mother to disappear for multiple days at a time. It is obvious why the children of drug-addicted parents can be so emotionally and mentally distraught when growing up in a home that promotes such negative feelings and situations.

When Eileen describes her mother in these ways, she also thanks her mother for what she has learned from her. Eileen says that her mother was “…funny, wildly creative and wonderful… when she was sober. But she was a drug-addicted recluse – and had been since before [Eileen] was born. [Eileen] simply didn’t know her any other way” (2017). It is hard to look at the good when growing up in such a tough situation, but Eileen explains the good that was in her mother to remind readers that her mother was still a person, nonetheless. This is one thing that the media and news constantly forget to add. Angie, Eileen’s guardian, and grandmother taught her granddaughter that Helen was simply sick and once she had recovered, things would go back to normal, promoting a positive hope in Eileen. Angie made sure to teach Eileen that her mother was not a bad person for having an addiction. After her mother’s death, Eileen has come to the realization that because of her mother, she is now a kinder and stronger person, and understands what unconditional love for someone is now after living her life with a drug addicted parent (2017).

Thus, we come to a conclusion that prompts us to wonder: are the news and media covering parents suffering from drug addiction correctly? Eileen writes about her mother without judgment and remembers that her mother was a person like everyone else. When compared to the news outlets painting these parents as selfish, negligent and harmful, we must ask: is this a story that would inspire parents to get help for themselves and their children or continue their addictions from fear of being judged as such? It is unfair for parents wanting to get help for their addictions, but who are afraid to get help due to people considering them a selfish parent or a negligent parent.


Fragiacomo, E., (2017, October 10). “Surviving My Mother’s Drug Addiction.” Retrieved from

Snow, K., (2017, October 9). The Nightly News with Lester Holt. New York, NY: NBC News Retrieved from

Eating Disorders

A Peek at Pica

Caregivers of infants and toddlers are often heard shouting the words, “Don’t put that in your mouth!” In the time frame between birth and the age of eighteen months, children explore their surroundings by putting things in their mouth. While seemingly harmless and innocent at first, this behavior turns into pica, a life-threatening eating disorder which is when non-food items are consumed on a regular basis by individuals older than 2 years old.

Pica is prevalent among 10-32% of children who are 1-6 years of age, and the type of non-food substances often differs by age. According to an Everyday Health article, “youngsters will eat paint, plaster, string, hair, and cloth. Older children consume anything from animal droppings, sand, and insects to leaves, pebbles, and cigarette butts” (Stewart, 2010).

Teens and adults with developmental disabilities or mental illnesses such as schizophrenia and obsessive-compulsive disorder (OCD) are often vulnerable to pica. The most commonly consumed substances are soil or clay, but individuals may also eat “lead, laundry starch, plastic, pencil erasers, ice, fingernails, paper, coal, chalk, wood, plaster, light bulbs, needles, string, and wire” (Stewart, 2010). Additionally, pica may occur during the first trimester of pregnancy (Stewart, 2010).

The leading causes of pica are reported to be iron-deficiency anemia, malnutrition, and nutrition deficiency, as well as pregnancy. Pica is also caused by a craving for a specific texture.  In cases of anemia, malnutrition, and nutrition deficiency, treatment consists of referrals for vitamins and medication. Another treatment option is operant conditioning, in which individuals are given rewards for consuming proper food and punished for consuming non-food items (Rogge, 2016). While there is no official test that determines whether or not an individual has pica, testing for ingested toxins, anemia, lead poisoning, and intestinal blockages are recommended. Furthermore, the prevalence of pica may be determined by a thorough assessment of an individual’s clinical history (Pica, n.d.).

The cure rate for pica is vague. In certain cases involving children, pica may vanish with age. With individuals with developmental disabilities and mental disorders, pica may persist long into adulthood and may be reduced through the application of the aforementioned treatments. A common barrier to determining the prevalence and treatment of pica is the stigma and shame that individuals battling pica may encounter.

Most of us have experienced a craving for a “strange,” non-food item at some point in our lives. Perhaps our caregivers have childhood tales about us eating dirt or putting inedible substances in our mouths. While non-food cravings are often associated with very young children, they are also prevalent among teenagers and adults who are affected by pica. As with other disorders, the existing stigma about pica as well as its life-threatening nature, calls for a greater social awareness about this eating disorder.


“Pica,” (n.d.). National Eating Disorders Association. Retrieved April 9, 2018, from

Rogge, T. (2016, February 21). Pica. Medline Plus. Retrieved April 9, 2018, from

Stewart, K. (2010, May 10). Pica: The Eating Disorder That’s Not About Food. Everyday Health. Retrieved April 9, 2018, from

Post Traumatic Stress Disorder

Childhood Trauma: A Case of Children and PTSD

Childhood. A time full of innocence, playfulness, and hyperactivity. When thinking of their childhood, one might fondly reminisce about a family BBQ or a summer spent in the park with other energetic little rugrats. However, not every person will remember their childhood nostalgically. Many people who have undergone traumatic experiences in their childhood are still negatively affected by those events today.

People may develop PTSD if they have experienced events that have caused them or someone else pain and distress. This can include instances of sexual, emotional, or physical abuse, as well as disasters, and war. Child protection services receive nearly three million reports each year, involving approximately five million children. Three to ten million children witness family violence and 30% of reported cases have evidence of abuse (National Center for Veterans Affairs). Children may not experience flashbacks or memory issues in the way that adults with PTSD do. They may also display signs of PTSD in the way they play such as reenacting the incident (National Center for PTSD, 2007).

Children who have experienced traumatic events can also develop signs of depression, anxiety, and PTSD. They are also more likely to engage in substance use, aggressive behavior, and have difficulty paying attention. As a result, these children are more likely to perform poorly in school, engage in high-risk behavior, and have run-ins with the juvenile justice or social welfare system (Stewart et. al, 2017). These events may increase a person’s sensitivity to emotional conflict and make it more difficult to process and regulate emotions. PTSD can also create a tendency to avoid negative emotional expression (Chung et. al, 2017). If untreated, these symptoms and illnesses can continue into adulthood.

Hope Hill was diagnosed with PTSD at the age of 14 but, despite her early diagnosis, felt that she was isolated from receiving help for her PTSD. Usually, people with PTSD resulting from childhood trauma are not diagnosed until they reach adulthood. She lamented “I was given medications that worked for adults with PTSD. They worked, but no one talked to me about how being diagnosed as a child would affect me. Because there was no place for me. Doctors wrote notes in charts but didn’t explain them to me…There was no support group for kids like me. So, I taught myself the tricks of the trade. I constantly looked up things about PTSD and how to manage it. Since I didn’t know anyone who’d fought this disorder I cobbled together all the coping mechanisms I could find. I didn’t care where they came from, only that they worked.” (Hope et. al, 2017)

Providing early support to those who suffer from PTSD can make a world of a difference. We must work harder to provide them with sufficient care and treatment. While childhood is often associated with naivety, it’s important to recognize that they, like adults, can also experience trauma and developmental illnesses.


PTSD: National Center for PTSD. (2007, January 01).

Chung, M. )., & Chen, Z. ). (2017). Child Abuse and Psychiatric Co-morbidity Among Chinese Adolescents: Emotional Processing as Mediator and PTSD from Past Trauma as Moderator. Child Psychiatry And Human Development, 48(4), 610-618. doi:10.1007/s10578-016-0687-7

Hill, H., Stirling, A., Killmer, C., Bloemendaal, C., Speas, J., & Kee, A. (2017, March 25). I Was Diagnosed With PTSD at 14, but There Was No Place for Me.

Stewart, R. )., Ebesutani, C. )., Drescher, C. )., & Young, J. ). (2017). The Child PTSD Symptom Scale: An Investigation of Its Psychometric Properties. Journal Of Interpersonal Violence, 32(15), 2237-2256. doi:10.1177/0886260515596536


Could Technology Be Making Our Children More Depressed?

My childhood days were mostly spent outdoors at the park. I would run around with the other kids, tumble in the dirt, and adventure around our made-up kingdom; aka the playground. However, over the years, the way I spend my leisure time has changed. This is in part due to the rapid advancement of technology. From cells phones to laptops, it is right in our hands, occupying our attention while simplifying our work.

Technology also provides leisure for our children. Tablets have become quite a popular gadget among our kids. Their lightweight and large screens allow children to hold a whole new world of internet and apps at their fingertips. Furthermore, devices such as chromebooks are being integrated into schools as part of classroom teaching methods. However, how much time should children spend in front of a bright screen? And what effects does it have on them?

The American Academy of Pediatrics believes that the time in front of a screen should be limited, with children under the age of two receiving no screen time at all. The recommended time is no more than about two hours a day. However, a study conducted at the University of Washington found that about 66% of children under the age of five exceed that limitation by spending an average of about four hours a day. Overall, research has found that the increased use of technology has led to an increase of ill-being, even when accounting for a poor diet and low physical activity.

Physiologically, the increase in electronic usage has been linked to an increase in body mass index. Being overweight has been correlated with depression, especially in females, with increased weight leading to unhappiness with appearance or bullying. Additional negative impacts of excessive screen use during childhood include an association with lower cardiorespiratory fitness and raised serum cholesterol by their mid-twenties. A longitudinal study observed individuals, aged 10-15 years old, who watched a screen for more than four hours a day. The researchers found that they were five times more likely to smoke. Another New Zealand study also demonstrated that increased television usage was related to increased cigarette smoking during adulthood.

According to a study done in Australia, increased electronic usage has been linked to not only physical health issues, such as increased obesity and poor sleeping habits but also maladaptive mental and social health. Children adhering to these trends have found to be more isolated and suffer depression or depressive symptoms. They were also found to experience problems in attention, learning, and behavior. Additionally, these individuals suffering from attention and concentration problems also had reduced creative imagination and creative play. Another longitudinal study followed families during their first year of implementing the internet. Within that first year, the children experienced increased loneliness and a decrease in mood.

Overall, our children’s utilization of technology is inevitable. Electronic devices provide education as well as leisure for our children. However, too much screen time can have negative impacts on their physiological and psychological well being. These adverse effects can lead to disruptions in child development and mental health. Thus, limiting the use of it is vital. Instead, children should be taken outdoors more often where they can enjoy their natural environments and be exposed to more Vitamin D. They may also seek physical activity, fresh air, and perhaps explore an imaginative kingdom of their own.


Hancox RJ, Milne BJ, Poulton R. Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study. Lancet. 2004;364(9430):257-262.

Jasienska, G., Ziomkiewicz, A., Górkiewicz, M., & Pająk, A. (2005). Body mass, depressive symptoms and menopausal status: An examination of the “Jolly Fat” hypothesis. Women’s Health Issues, 15145-151. doi:10.1016/j.whi.2005.02.002

Kraut R, Patterson M, Lundmark V, Kiesler S, Mukopadhyay T, Scherlis W. Internet paradox: a social technology that reduces social involvement and psychological well-being? Am Psych. 1998;53(9):10171031.

Martin, K (2011) Electronic overload: The impact of excessive screen use on child and adolescent health and wellbeing. Perth, Western Australia: Department of Sport and Recreation

Rosen, L. D., Lim, A. F., Felt, J., Carrier, L. M., Cheever, N. A., Lara-Ruiz, J. M., … Rokkum, J. (2014). Media and technology use predicts ill-being among children, preteens and teenagers independent of the negative health impacts of exercise and eating habits. Computers in Human Behavior, 35, 364–375.

Autism Spectrum Disorder

Tablet Games: A Possible Future Diagnostic Technique for ASD

Diagnostic techniques for Autism Spectrum Disorder (ASD) often fall short of perfect because they rely on observation of behavioral and developmental progress by a physician (Screening and Diagnosis).  This subjectivity leads to a large population of undiagnosed individuals.  A study was recently conducted which aims to provide an effective supplemental tool in diagnosing and tracking the progress of therapy in ASD in children by Kołakowska, Landowska, Anzulewicz, and Sobota.  

Automatic Recognition of Therapy Progress Among Children with Autism studied the behavioral data of individual users while engaging in tablet games that monitored user activity through features such as touch screen sensors, accelerometer trackers, and a gyroscope that is able to record behavioral characteristics continuously. These features track the behavioral data of the user, which are incredibly accurate at predicting ASD in children at an early age, as well as track the progress of their therapy.  When the study was replicated, the authors found that this technique can be used to “identify children with autism with up to 93% accuracy.” Early diagnosis is crucial for the individual’s future development.  This research is important because it offers unique insights in the form of quantifiable data of behavioral characteristics of ASD, thereby eliminating some human error that may result in traditional diagnostic and progress checks alone.

Tablet games are useful for therapy progress because they focus on, “particular issues by teaching specific skills–e.g. expressing needs, learning certain behaviors, improving verbal communication, answering questions, interacting with other people in typical situations, recognizing and expressing emotions.” The detection of eye movement while engaging in a tablet game is a feature of this therapy.  The software records eye movements of the individual during gaming in order to capture the individual’s behaviors. Data collected from changes or lack thereof in eye movement can help the interpretation of other factors, such as motor deficiencies, making diagnosis more precise and evidence-based  The software can track motor deficiencies in individuals and record “the way a particular movement is prepared, in the velocity, acceleration, and jerks while specific types of arm movements are performed, or in different distributions of grip force over time”.  The data collected can then be used as a supplemental tool by the diagnostician.

Another advantage that tablet game platforms offer to diagnostic practices is that it provides data through a stress-free platform, not typically seen in traditional settings such as a questionnaire in a clinical interview. The DSM-5 illustrates the “insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior” often seen in individuals with ASD. Tablet games utilize this tendency through computer technology, which provides a “predictable framework” in which children with ASD are often comfortable with.  

 A unique aspect of the tablet game approach is that it provides a wealth of raw data that eliminates some human error seen in visual analysis of behavior alone. Though further research should be done to reassure the effectiveness of these tablet programs, experts should consider working this technique into their diagnostic practices in order to add evidence to their diagnosis and assure that they are being as accurate as possible.  


Kołakowska, Agata, et al. “Automatic Recognition of Therapy Progress among Children with Autism.” Nature News, Nature Publishing Group, 24 Oct. 2017,

“Neurodevelopmental Disorders.” Neurodevelopmental Disorders | Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association Publishing, 2013,

Eating Disorders

Addressing the Eclairs in the Room

Eating disorders among children are becoming a rising issue on both sides of the weight spectrum. According to data collected by the Centers for Disease Control and Prevention, the rate of obesity in children in the 2-19 year age range was 18.5% in 2016. This is a 4.6% increase from 2000 when the CDC reported the obesity rate as 13.9%. On the other hand, the Agency for Healthcare Research and Quality reports that hospitalizations for eating disorders such as anorexia and bulimia rose by 119% between 1999 and 2006. One way in which this issue can be addressed is through improved parent-child communication about healthy eating and positive body image.

A 2012 study shows that while there is an insufficient amount of data to make direct conclusions about the parental influence on childhood weight gain, parents are a contributing factor to childhood weight gain. Parents provide the primary environment for their children and shape their eating habits and diet (Tzou and Chu 2012).

Given their influence on childhood eating habits, parents must actively promote healthy eating and exercise among their children. Additionally, they must be sensitive and positive when verbally addressing weight-related issues. Dr. Sandra Hassink, the director of the American Academy of Pediatrics Institute for Healthy Childhood Weight, breaks down childhood into three phases: elementary, middle school, and high school. Parents are taught specific reaction strategies to efficiently help children form healthy eating habits in each of these phases.

In the elementary age, Hassink discusses the importance of actions and observations. In other words, this is considered to be a time when children observe and copy their parents. Being such, parents are taught more to practice “eating a good variety, right-sized portions, eating healthy food and not junk food, all of that gets observed.”

Hassink identifies middle school-aged children as being highly sensitive due to the numerous changes brought about by puberty. As a result, she advises parents to establish a safe, judgment-free environment, where children are encouraged to be accepting of their body types, rather than feeling the need to be compared to others or obsess over their weight. “Body image: pre-teens and teenagers,” an article posted on the Australian parenting website, Raising Children, discusses the importance for parents to teach their children about positive self-image and it also states that children with negative body image may lead to anxiety, stress, and social withdrawal.

Hassink encourages parents of children who fall in the high-school phase to be informational, by discussing family history, proper diets, and exercise schedules. In any case, parents are encouraged to promote optimism and self-confidence in children, as opposed to excessively controlling their diets and having them obsess over calories.

As shown by behaviorist, Albert Bandura, children often imitate the behavior of those around them, which is why it is important for parents to be sensitive and model healthy eating behavior and positive body image. This can be achieved by emphasizing nutrition and exercise over calories, weight, and other numeric factors.


Harb, C. (2012, August 22). Child eating disorders on the rise. Retrieved October 30, 2017, from

Raising Children, (2017, February 2). “Body image: pre-teens and teenagers.” Retrieved November 5, 2016, from

The State of Obesity. The State of Childhood Obesity, (n.d.). Retrieved October 30, 2017, from

Tzou, I. and Chu, N. (2012) Parental influence on childhood obesity: A review. Health, 4, 1464-1470. doi: 10.4236/health.2012.412A211.

Wallace, C. (2016, September 12). How to Talk to Kids About their Weight. Retrieved October 30, 2017, from

Eating Disorders

Eating Disorders Are Taking a Bite Out of Children

December 9, 2015. While many of us were counting the days until winter vacation, British teenager,  Pippa ‘Pip’ McManus was counting her last breaths, before jumping in front of a train, ending her three-year battle with anorexia (Scapens & Abbit, 2017). She was 15 years old.

Pip’s struggles with anorexia began when she was just 12. According to her mother, Pip was initially obsessed with looking at herself in the mirror and asking if she looked fat. While her parents initially overlooked this behavior, Pip’s preoccupation with her diet and exercise, followed by her drastic weight loss eventually pushed them to admit her to the Priory Hospital Altrincham, which specializes in the treatment of mental disorders. Despite receiving professional help, Pip’s condition only worsened over time and she eventually succumbed to her disorder. Around the time of her death, Pippa weighed 55 pounds (“Priory’s care plan for anorexic teen Pippa McManus “inadequate,’” 2017).

Although we often associate eating disorders with women in their late teens and twenties, a study conducted by the Agency for Healthcare Research and Quality revealed that “hospitalizations for eating disorders in children under 12 increased by 119% between 1999 and 2006” (Harb, 2012). In a 2012 CNN article by Cindy Harb, psychologist Dina Zeckhausen links the rise in childhood eating disorders to the increased focus on obesity and diets.

Additionally, Zeckhausen states that children who are vulnerable to eating disorders often display a shared set of traits including: “high anxiety, perfectionism and obsessive-compulsive tendencies” (2012). Zeckhausen also states that children with troubled home and/or school lives are most likely to develop an eating disorder because they see food as one of the only aspects of life under their control. Zeckhausen’s statement is further explained by a University of Rochester Medical Center article on anorexia, which notes that individuals with eating disorders view calorie-control as a way of reducing stress, anxiety and helps in attaining a sense of control and accomplishment through visible weight loss (University of Rochester Medical Center [URMC], n.d.).

In response to childhood eating disorders, numerous incentives have emerged across the globe. For instance, Australian Federal Health Minister, Greg Hunt, recently enforced a policy requiring teachers, school counselors, and coaches to receive training in detecting signs of eating disorders. Additionally, he increased funding for the Ed Hope national helpline and the Butterfly Foundation, both of which are dedicated to helping individuals overcome their eating disorders (Brennan, 2017).

Similarly, many schools throughout the United States have sought to help students through in-school counseling as well as awareness and prevention programs (Olivero, 2015). Additionally, in a 2015 U.S. News article, Magaly Olivero provides suggestions for possible in-school initiatives, including: educating school staff on signs of eating disorders and broadening health curriculums and anti-bullying campaigns to address body-image issues and eating disorders.

The increase in childhood eating disorders depicts the importance of raising awareness on body-image issues among not only adults, but also children, as the future of the world’s youth is dependent upon it.


Anorexia Nervosa. (n.d.). Retrieved September 25, 2017, from

Brennan, R. (2017, September 18). First National Policy for Treatment of Eating Disorders Announced. Retrieved September 19, 2017, from

Harb, C. (2012, August 22). Child eating disorders on the rise. Retrieved September 18, 2017, from

Olivero, M. (2015, February 23). Tackling Eating Disorders With School-Based Initiatives. Retrieved September 25, 2017, from

Priory’s care plan for anorexic teen Pippa McManus ‘inadequate’. (2017, May 2). Retrieved September 24, 2017, from

Scapens, A., & Abbit, B. (2017, May 3). The devastating last words of a teenager whose discharge from the Priory ‘was not done well enough’. Retrieved September 18, 2017, from

Bipolar Disorder

“Do you have open ears?”

Mental illness in a broad sense is a more abstract genre of illnesses in many cases, specifically with Bipolar Disorder, which makes it important to listen to individuals expressing themselves rather than relying on observation. Expressing one’s self may be challenging for the average adult, imagine how difficult it can be for children and teenagers. For this reason and many others, “the diagnosis of bipolar disorder (BD) in youth is confusing and controversial.” Some people might note that children go through mood swings all the time, however, “bipolar symptoms are more powerful than” the normal ups and downs children may go through because “the mood swings are more extreme and are accompanied by changes in sleep, energy level, and the ability to think clearly.” With the fine line still blurred, Youngstrom, Birmaher & Findling reveal some evidence as well as critiques regarding the phenomenology, the science behind the phenomena, and validity of pediatric bipolar disorder.

Youngstrom et al. finds it difficult to make concrete conclusions from various symptoms said to be associated with pediatric bipolar disorder. With analysis, they saw that “many of these [symptoms] are behaviors that, although strongly associated with pediatric BD, are not specific to the disorder, and thus often occur in the context of other conditions” (Youngstrom, Birmaher & Findling, 2008). Due to this observation, physicians are recommended to question whether symptoms are confirming the diagnosis of pediatric bipolar disorder or suggesting other disorders.

In the recent decades, advances have been made to validate the diagnosis of bipolar disorder in children and adolescents. Youths who are diagnosed usually “show considerable impairment, a strong familial association with mood disorder (and BD in particular), and morphological features and neuroaffective functioning that are consistent with findings in adults with BD, all of which are suggestive of continuity between the pediatric and adult diagnoses” (Youngstrom, Birmaher & Findling, 2008). However, notable areas of disagreement within the phenomenology of pediatric bipolar disorder are the concrete definition of elated mood in contrasts with irritable mood as well as if one of the major sources of consult, the Diagnostic and Statistical Manual (DSM-V), that identifies the most relevant and accurate categories for bipolar disorder. Nevertheless, future research perspectives including twin and adoptive studies should shed more light on pediatric bipolar disorder.

The child psychiatrist perspective also reveals more about the illness, starting with the idea that pediatric bipolar disorder might be an epidemic in the United States because the diagnosis has increased 40-fold in the past decade. In 1996, bipolar disorder was the least frequent diagnosis for children, and we saw that in 2004, it was the most frequent diagnosis for children admitted to psychiatric inpatient centers (Stebbins & Corcoran, 2016). After collecting data from four inpatient and outpatient clinics, both public and private, Stebbins and Corcoran saw several themes when the data was analyzed. The first was that pediatric bipolar disorder is overdiagnosed. The second step, as you may guess, is to ask ourselves why is this so? The data supports that “there is a lack of clarity in the diagnosis” (Stebbins & Corcoran, 2016) and that “medical professionals not trained in psychiatry were assessing and diagnosing children” (Stebbins & Corcoran, 2016). Another theme supported by the data is that the environment in which the child lives has a greater impact than biological risk factors. Children under chronic stress, trauma and or abuse were greatly influenced by their environment.      

Although Stebbins and Corcoran’s study is preliminary and additional investigations are needed for many pediatric mood disorders, we were able to understand the downfalls of the diagnosis of pediatric bipolar disorder as well as the merit through Younstrom et al. What we should keep in mind is the effects, a diagnosis of bipolar disorder in adolescents is in terms of the medication prescribed and quality of life. Therefore, directions for future perspectives include solidifying the diagnostic criteria, increasing psychiatric training, and placing more significance on environmental influences and how it can be mediated for the benefit of the child.          


Lee, T. (2016). Pediatric bipolar disorder. Pediatric Annals, 45(10), e362-e366. doi:10.3928/19382359-20160920-01

NIH. (2015). Bipolar Disorder in Children and Teens. Retrieved January 23, 2017, from

Stebbins, M. B., & Corcoran, J. (2016). Pediatric bipolar disorder: The child psychiatrist perspective. Child & Adolescent Social Work Journal, 33(2), 115-122.

Youngstrom, E. A., Birmaher, B., & Findling, R. L. (2008). Pediatric bipolar disorder: Validity, phenomenology, and recommendations for diagnosis. Bipolar Disorders, 10(1 PART 2), 194-214.

Obsessive Compulsive Disorder

The Kids Aren’t Alright

Children: curious, rambunctious, and innocent. As a child your mind is filled with strange thoughts: believing your parents are aliens, your pet can talk, or there are monsters in your closet. Additional to these thoughts, you probably had a few interesting habits: arranging your food by color, leaving your toys around your parent’s workspace, or avoiding cracks on the street. As you age, you grow out of these thoughts and quirks, reaching the conclusion they’re irrational. But what if you couldn’t? What if these thoughts of monsters felt so real that you couldn’t sleep? What if you wanted to step on that crack but you couldn’t because you were afraid it would make that monster angry? For children with obsessive-compulsive disorder, this may be their reality.

Obsessive-compulsive disorder (OCD) is described by the DSM-5 as the presence of time consuming and irrational obsessions and compulsions (American Psychiatric Association, 2013). Almost half a million children in the United States suffer from OCD. Approximately 25% of those with OCD  developed it before age 14, with 25% of male cases occurring before the age of 10.

Unlike adults, children with OCD may not realize their obsessions and compulsions are excessive or view their symptoms as a disorder which can be treated. A result of their limited vocabulary, it may be difficult for them to communicate the purpose of their compulsions (Kulkarni and Sudarshan, 2015). Children are also more likely to involve other people, usually their parents, as part of their ritual; they have their parent confirm their obsessions and acts are logical or may request their family member’s assistance completing the ritual (American Psychiatric Association, 2013). Parents are confused by their child’s behavior and may perceive it as them being “bratty.” When they are unable to engage their parents in their ritual to dispel their worries, they can become anxious, withdrawn, irritable, or angry.

Routines and rituals are a part of everyday life for a child. They’ll say goodnight before sleeping, follow their class schedule, or eat lunch at a particular time. These repetitive acts help organize a child’s day and are considered normal. Following routines also help children socialize, develop hobbies, or generate stress management tools (Boileau, 2011). However, actions and thoughts stemming from OCD are time consuming and make daily life stressful for children. When in a school environment, children with OCD tend to find it difficult to make friends or take part in extracurriculars because of the amount of time consumed by their compulsions (Strauss, 2016). The Anxiety and Depression Association of America describes how OCD affects children academically:

“Students with OCD may appear to be daydreaming, distracted, disinterested, or even lazy. They may seem unfocused and unable to concentrate. But they are really very busy focusing on their nagging urges or confusing, stressful, and sometimes terrifying OCD thoughts and images. They may also be focused on completing rituals, either overtly or covertly, to relieve their distress.”

Early detection of OCD is crucial to recovery. There are various treatment options available for those with OCD, including support groups and therapy. The International OCD Foundation and the Anxiety and Depression Association of America provide resources, such as help finding the nearest therapy group, opportunities to be involved in the foundation and spread awareness of OCD, and information for family members to educate themselves.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Boileau, B. (2011). A review of obsessive-compulsive disorder in children and adolescents. Dialogues in Clinical Neuroscience, 13(4), 401–411.

Dotson, A. (2016, November 03). Tuesday Q&A: Ethan S. Smith. Retrieved February 26, 2017, from

Kulkarni, H., & Sudarshan, C. Y. (2015). Obsessive Compulsive Disorder in a 4-Year-Old Child. Indian Journal of Psychological Medicine, 37(2), 230–232.

Strauss, V. (2016, October 11). What obsessive-compulsive disorder does to a young mind when it grows unchecked.