#Everything listed is self diagnosed but almost everything is peer reviewed

[aidens-home]

Anxiety in childhood and adolescents

Anxiety appears to be the most common mental disorder in children of all ages and gender (Abe & Masui, 1981; Orvaschel & Weissman, 1986). Approximately 8-12% of children meet diagnostic criteria for a form of an anxiety disorder (Anderson et al., 1987; Costello, 1989)

In child psychopathology anxiety disorder also account for a number of various disorders such as separation anxiety disorder, overanxious disorder, avoidant disorder, social communication disorder, disruptive mood dysregulation disorder and generalised anxiety disorder (DlSM-V; American Psychiatric Association, 2013). Anxiety disorders in childhood and adolescents diagnosed almost in the same way as for adults and can be treated as well.

Pediatric anxiety disorders are linked to a range of negative consequences. Children with anxiety reported depression, low self-esteem and school performance, attention deficit and impairment in peer relations and overall social behaviour (Strauss, Frame & Forehand, 1987).

Starting with relationships with other children, anxious children are disliked by a majority of other children and are not preferred as playmates; that is, they are socially rejected by peers (Coie et al., 1982). Furthermore, anxious children usually have poor academic performance (Strauss, Frame & Forehand, 1987). However, a relation of child anxiety to poor school performance might be biased due to the fact that it is a teacher who evaluates pupils and their evaluation may be consciously or unconsciously dependent on teachers' ratings of anxiety. Further, 42% of children with anxiety are reported to have a problem with attention (Strauss, Frame & Forehand, 1987). A considerable number of anxious children might also be diagnosed with an attention deficit disorder without hyperactivity (ADDWO) since they have high rates of attention deficits without excessive motor activity. Finally, anxious children have higher levels of depression and lower self-esteem compared to nonanxious children (Strauss, Frame & Forehand, 1987).

Furthermore, if anxiety disorders are not treated in childhood, they may persist through adolescence and adulthood (Pfeffer et al., 1988; Keller et al., 1992). Having a separation anxiety disorder in childhood might continue in later life. So separation anxiety disorder in adolescent might be predicted by separation anxiety disorder in childhood (Bittner et al., 2007). Panic attacks might be predicted by overanxious disorder but more research should be done on that matter. Moreover, childhood overanxious disorder might predict overanxious disorder in the adolescent. Also, adolescent depression and conduct disorder is linked to the overanxious disorder. Childhood social phobia is related to ADHD,  adolescent social phobia and adolescent overanxious disorder.

Anxiety disorders in childhood not only can predict them in later life but also associated with other disorders in childhood. This is called comorbidity, that it, having more than one diagnosis at the same time. Indeed, there are high levels of comorbidity among various types of anxiety disorders and between anxiety disorders and other psychiatric disorders such as depression and alcohol use disorders (Kashani & Orvaschel, 1988; Lewinsohn et al., 1997).

To sum up, everything said above, children can be exposed to the very same mental health problems as adults, especially regarding anxiety disorders. Approximately every ten children are diagnosed or have one or another type of anxiety disorder. Anxiety in children should not be overlooked or regarded as something minor. They can be diagnosed. Even if a diagnosis of anxiety disorders is difficult but it is very much possible. Moreover, anxiety is treated and should be treated. If left untreated, anxiety disorders affect the children’s social life or even persist through later stages of life. Moreover, anxiety is very much associated with depression and other mental health problems. Hence, anxiety in children should be treated to not cause other negative consequence but also to make child life happier and better.

Stay safe and wear your mask,

your Aiden

Reference list:

Abe, K., & Masui, T. (1981). Age-sex trends of phobic and anxiety symptoms in adolescents. The British Journal of Psychiatry, 138(4), 297-302.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Anderson, J. C. (1987). Williams 5, McGee R. Silva PA: DSM-III disorders in preadolescent children: prevalence in a large sample from the general population. Arch Gen Psychiatry, 44, 69-76.

Bittner, A., Egger, H. L., Erkanli, A., Jane Costello, E., Foley, D. L., & Angold, A. (2007). What do childhood anxiety disorders predict?. Journal of Child Psychology and Psychiatry, 48(12), 1174-1183.

Coie, J. D., Dodge, K. A., & Coppotelli, H. (1982). Dimensions and types of social status: A cross-age perspective. Developmental psychology, 18(4), 557.

Costello, E. J. (1989). Child psychiatric disorders and their correlates: A primary care pediatric sample. Journal of the American Academy of Child & Adolescent Psychiatry, 28(6), 851-855.

Kashani, J. H., & Orvaschel, H. (1988). Anxiety disorders in mid-adolescence: a community sample. The American journal of psychiatry.

Keller, M. B., Lavori, P. W., Wunder, J., Beardslee, W. R., Schwartz, C. E., & Roth, J. (1992). Chronic course of anxiety disorders in children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 31(4), 595-599.

Lewinsohn, P. M., Zinbarg, R., Seeley, J. R., Lewinsohn, M., & Sack, W. H. (1997). Lifetime comorbidity among anxiety disorders and between anxiety disorders and other mental disorders in adolescents. Journal of Anxiety disorders, 11(4), 377-394.

Orvaschel, H., & Weissman, M. M. (1986). Epidemiology of anxiety disorders in children: A review. Anxiety disorders of childhood, 58-72.

Strauss, C. C., Frame, C. L., & Forehand, R. (1987). Psychosocial impairment associated with anxiety in children. Journal of clinical child psychology, 16(3), 235-239.

Pfeffer, C. R., Lipkins, R., Plutchik, R., & Mizruchi, M. (1988). Normal children at risk for suicidal behavior: A two-year follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry, 27(1), 34-41.

[avandelay20]

Good intro to how the people (and whether they are narcissists) we work with determine whether we can achieve working sans deadlines.

“What is an asshole though? In this context, it’s basically a narcissist, someone who consistently puts their own personal, short-sighted needs in front of the other humans around them and in front of the best interests of the organizations that they are a part of, which includes the employer that pays their salary or wage.

When I write about narcissists below, I’m referring to people with various shades of narcissistic personality disorder (NPD) or similar clusters of change-resistant personality features. Some people exhibit features of NPD without being diagnosable, a state which is referred to as “sub-clinical;” those features are still usually very destructive to relationships. 

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists the following symptoms:

Grandiosity with expectations of superior treatment from other people

Fixation on fantasies of power, success, intelligence, attractiveness, etc.

Self-perception of being unique, superior, and associated with high-status people and institutions

Need for continual admiration from others

Sense of entitlement to special treatment and to obedience from others

Exploitation of others to achieve personal gain

Unwillingness to empathize with the feelings, wishes, and needs of other people

Intense envy of others, and the belief that others are equally envious of them

Pompous and arrogant demeanor

People with NPD usually exhibit at least some of these symptoms in a way that is out-of-whack with their real-life qualities or accomplishments. Of course, it’s important not to read this list and start diagnosing yourself or others, but it’s good to be aware of this list in order to recognize when these kinds of behaviors seem to be appearing. There are many other terms related to NPD that come from different psychological schools attempting to categorize the phenomenon, such as malignant narcissist, oblivious narcissist, and covert narcissist, all of which hopefully speak for themselves.

All personality disorders are essentially characterized as being ego-syntonic, which means that the person with the disorder consistently perceives their dysfunctional behaviors as normal and acceptable, even if they also attempt to hide them from selected others (such as those with immediate power over them). This characteristic of personality disorders, especially NPD, make them very resistant to treatment. NPD is particularly heavily armored against change because the idea of needing to change is in itself an affront to the narcissist. The narcissist believes that everyone else needs to change, but not them.

Narcissists are highly effective at self-sabotage in the long-run simply because they cannot understand that what’s best for the group is usually also what’s best for themselves. Doing what’s best for the company is obviously the most effective long-term path to career success to someone who can peer just a little bit past their own fear, jealousy, anger, righteousness, and greed. The only kind of employee you need to instruct to “do what’s right for the company” is either severely disempowered (probably by a narcissist) or is a narcissist themselves. By definition, the narcissist will never do what’s right for the company unless it happens to coincide with their own short-sighted and selfish desires. The solution in either case is to locate the narcissist and terminate their employment.

And it’s pretty easy to root-out narcissists in an organization. For the individual contributor, a thorough review by peers is sufficient. Since NPD is characterized by dysfunctional relationships, the working peers of a narcissist will usually be able to convey the experience of chronic demoralization, upset, and manipulation that they have experienced at the hands of the narcissist. They usually want to get away from the narcissist, and often do so by leaving the company. This can result in great cost to both the company and the victim. I believe that this is partly the explanation for the somewhat surprising discovery by Google that the most significant predictor for the effectiveness of an employee is the quality of their personal relationships outside of work. Larry Page, one of the two founders of Google, told this to a friend of mine.“

[eurotoques]

Why Children Are Getting Fatter By The Minute

Kids give more meaning to life. Ask any parent about it and they will likely tell you the same thing. But raising one is a different story. There are a lot of hurdles parents face each day from the moment a child is born. Not only are parents expected to provide all the basic needs of their kids but as well as teach them on how to become wise, responsible, God-fearing, and compassionate adults someday. But how can kids do that in the near future if they are already struggling with their health (and body image) as early as now? Looks may not be everything but say that to a bullied pubertal child or teen and you’d likely receive glaring stares that paint a thousand words.

Weight is the biggest struggle of young kids these days perhaps because of the food they eat and the lifestyle they lead. Parents today are almost always harassed and exhausted so you can’t expect them to prepare healthy home-cooked meals when more often than not, both partners are out most of the day earning their keep. Aside from feeding their young children sweets, junks and processed food, kids also have access to tech gadgets to help them pass the time and not bother their tired parents at home. So eating + lounging around with a tablet/smart gadget with WiFi in hand = obesity. Hence, more and more kids are diagnosed as overweight and obese today than kids in the past.

Affiliated with Tokyo’s National Institutes of Biomedical Innovation, Health and Nutrition, the authors of the new study express concern about the number of Japanese children with weight problems: “approximately 10% and 8% of 12-year-old boys and girls, respectively, were overweight or obese in 2015.” Though these percentages are down a bit from what health officials saw in 2000, when they began addressing the problem, the authors of the new study still regard them as “substantial.”

Childhood obesity is hardly peculiar to Japan. The researchers see “Japan follow[ing] the global trends,” with “the prevalence of childhood overweight and obesity increas[ing worldwide] in the late 20th century,” pushing the number of preschool children who were overweight or obese in 2014 to approximately 41 million.

(Via: https://www.mercatornet.com/family_edge/view/why-only-children-are-at-higher-risk-of-obesity/20300)

Even adults find comfort in eating especially when they are stressed. It is not surprising to discover that kids are vulnerable to this too since it helps them cope with all the new things they encounter in life. Children’s preoccupation with technology leaves them too lazy to engage in more active outdoor activities that young kids their age should be doing. Yet even though we like pinching the chubby cheeks of a cute, fat child, the impact of obesity on the health and well-being of that child is not always a positive experience as it can put them at higher risk of certain medical conditions and even suffer from lower self-esteem from being bullied by their peers for their heavy weight.

Recent research reflects some of this range of aetiological factors that influence childhood obesity. Global perspectives from countries of study including Brazil, Australia, England, South Africa, China, and a review of the international literature cover topics frequently reported by the media, like the food environment, unhealthy food advertising policy, weight management interventions, and associations with gender and sleep. Lesser known research areas include the developmental origins of obesity, which examines how foetal conditions in utero can influence the amount of fat deposited on the body in childhood and adulthood. This field of research provides the kind of evidence used to justify a public health approach to obesity, with a focus on prevention in early life. Another important area of public health research, but again perhaps lesser known, is the roles of schools and parents, given the tendency for policy approaches to involve schools and communities in prevention.

(Via: https://blog.oup.com/2017/07/children-obesity-future/)

Society as a whole should be taught to change their perception regarding obesity and basically urge everyone to examine the way they live their lives and how parents also raise their children. If children aren’t taught about the value of health and healthy eating, they will carry their bad habits into adulthood and eventually do the same thing to their children. It will be an endless vicious cycle that we are starting to feel its menace now. The problem basically lies with the types of food we eat and how we live our lives when we are constantly glued to the screens of our smart gadgets day in and day out.

Despite this awareness, nothing much has changed and kids still get fed with fastfood and all things sweet and processed. But you can’t blame most parents since it is actually more expensive now to feed your family with healthy and organic food than junks especially if these parents are also struggling to make both ends meet. Indeed, it takes a village to raise a child. It is only with the concerted efforts of everyone that we can start making progress in addressing childhood obesity and saving young kids from a long list of health, emotional, and mental woes brought about by being overweight or obese from a young age.

The following post Why Children Are Getting Fatter By The Minute was initially published on https://www.euro-toques.org/

from https://www.euro-toques.org/2017/09/15/why-children-are-getting-fatter-by-the-minute/

[oselatra]

On bullshit

I am quoted in Leslie Peacock's article about doctors and medical marijuana. I do not disown any of the things I am quoted as saying, and I commend Peacock on her excellent research and writing. I've enjoyed reading her for at least two decades. But the slant of the article creates a misperception that I am (and many other doctors like me are) cruelly depriving suffering human beings of beneficial treatment. This is not correct.

Silly season

The "silly season" is almost here. This is the season in which some people talk and act crazy about themselves and public policy. It happens around every two years. Political candidates do everything in their power to win public office. In Arkansas, judicial candidates file as early as December of this year. Democrats and Republicans will start signing up as early as February 2018. Voting for primary elections starts in early May. When the primaries are finished, Arkansas's political government will basically be decided. There is only one viable political party now in Arkansas, the Republicans, and winners of the Republican primary contests will most likely proceed to public office. The general election in November 2018 will simply be a formality for our red state's constitutional officers and most of the legislature. Our governor, attorney general and representatives can plan their agendas now for the next two years.

The silly season is also made simpler by computer voting. Arkansas is quickly switching to the Schouptronic machines provided by the Danahar Control Corp. in Illinois. Paper trails are not available to the silly news media and software engineers will eventually be able to design voting results throughout our state. Maybe someday soon Arkansans will be able to phone text their choices for "Republican Idol." Virtual democracy and a one-party system take a lot of the silliness out of politics.

Gene Mason Jacksonville

On bullshit

I am quoted in Leslie Peacock's article about doctors and medical marijuana. I do not disown any of the things I am quoted as saying, and I commend Peacock on her excellent research and writing. I've enjoyed reading her for at least two decades. But the slant of the article creates a misperception that I am (and many other doctors like me are) cruelly depriving suffering human beings of beneficial treatment. This is not correct. The problem is that there is a lack of scientifically valid evidence that marijuana is helpful for any medical condition that I treat, such as PTSD. Peacock notes on the Psychiatric Associates of Arkansas Facebook page an article reviewing the evidence for using marijuana for PTSD and chronic pain. The article concludes there is no good evidence that marijuana is a beneficial treatment for either of these conditions. The article is published in the prestigious, peer-reviewed journal Annals of Internal Medicine and is summarized in a Reuter's clip. Peacock's article states that my office "voted" not to certify medical marijuana. Voting has nothing to do with this or with determining whether any medical treatment is appropriate. If doctors voted that apple juice cured colon cancer, it would not make it any more effective. I do not object to unusual treatments. If you look on the Facebook page there are also articles about using ketamine (the club drug "special K") as a treatment for depression and MDMA (the club drug "ecstasy") as a treatment for PTSD. If there is evidence a treatment is safe and alleviates human suffering or remediates human disease, then I am all over it. The "evidence" for medical marijuana is testimonial. While testimony is emotionally compelling, it carries no scientific weight. It is not hard to find examples of testimony to just about anything. Even the available testimonial data is not gathered in the systematic scientific way a medical sociologist might do. In my own area of psychiatry there is plenty of evidence that marijuana does harm. For instances it can provoke paranoia and psychosis in people who are predisposed. It can interfere with motivation and memory. I defer to other specialists regarding marijuana as a treatment for seizures, HIV, Alzheimer's disease, etc.

I know that the law only requires that a doctor certify that somebody has one of the listed conditions and does not require the doctor to certify that it is his or her professional opinion that marijuana helps the condition. Think about who this disclaimer lets off the hook: It is not the doctors who provide treatments to patients that are proven to be helpful to them. I will never in my capacity as a doctor advise a patient: "Take this; there is no evidence it works and I don't know whether it does more harm than good — but here you go."

In Peacock's article I am quoted using the word "baloney." I apologize for this word choice. I self-censored to be polite. The word I actually have in mind is "bullshit," in the sense described in the philosopher H.G. Frankfurt's definitive treatise "On Bullshit." Frankfurt argues bullshit is a valuable concept in analyzing human discourse. He states that the difference between bullshit and lying is that the liar is concerned with truth (and wants to obscure or misrepresent it), whereas the bullshitter does not care what the truth is — he is up to something else. For instance, I was out with a friend, and he ordered a bottle of wine and grinned and said "for my heart." I rolled my eyes. Why did he grin and why did I roll my eyes? Because both of us recognized his statement was bullshit. Notice that truth is irrelevant here; wine may or may not be good for his heart, but that is not why he was ordering a bottle of wine. He was ordering a bottle of wine because it is an intoxicating, euphoriant drug, and we both know it. When I say medical marijuana is bullshit, what I mean is that whether or not medical marijuana is helpful for any medical condition, people use it because it is an intoxicating, euphoriant drug. And we all know it. When someone says they use marijuana for their PTSD, they should grin and we should roll our eyes.

Arkansas voters can pass a law legalizing medical marijuana, but they cannot pass a law making marijuana an appropriate treatment for any illness any more than my partners and I can vote that marijuana is not an appropriate treatment for PTSD. The only thing that can establish the utility of marijuana as a treatment is a randomized blocks, placebo-controlled trial comparing marijuana with a plausible placebo and using objective measures and statistical analyses to sort out all the biases that human beings are prone to. In the case of medical marijuana, such evidence is conspicuously absent. Unless there is good scientific evidence, medicine should not be involved with this at all. Also, notice that I am not necessarily against revoking the laws prohibiting marijuana use. I think a good case can be made for repealing all of our vice laws — because their enforcement is too expensive, painful, and ineffective — and then mount public health information campaigns and presume that smart, good, well-informed people will choose to live healthy, happy, productive lives and cultivate good habits rather than bad habits, and they will judiciously use pharmaceuticals that are proven to be helpful to them. That is, we might do better if we treated all vices like we do nicotine use — develop public health and moral solutions rather than punitive, painful legal sanctions. And a debate about this would be honest and not bullshit.

I also worry about doctors monetizing human suffering. The U.S. medical system, which should be devoted to ameliorating disease and easing suffering, is already badly twisted by perverse economic incentives. Obviously, the most self-serving way for me to play the medical marijuana game would be to hand out a checklist with the qualifying diagnoses and their symptoms and have patients check off symptoms and attach a check for $250. I would then provide a signed certificate and a disclaimer that there is no good scientific evidence that marijuana helps any of these conditions. And I could do it all by mail or telemedicine. The patients would buy short-term happiness and I'd be rich. And we could both grin and roll our eyes.

Richard Owings

Psychiatric Associates of Arkansas Little Rock

From the web

In response to Leslie Peacock's Sept. 7 cover story on medical marijuana:

Is hydrocodone "baloney"? Is OxyContin "baloney"? Are fentanyl patches "baloney"? Are the addictions and long-lasting effects on patients' health of the three previous drugs mentioned just "baloney"? I have never met a marijuana addict. I have met plenty of hydrocodone addicts who are now so messed up that they are turning to heroine to ease their physical pain and sadly falling into deeper spirals of addiction.

Artificial Intelligence

Amen. I say give it awhile. After the storm of the early days turns into months and a year or so, the benefits will began to show and start outweighing the negative attitudes on the subjects. The doctors will truly see the good in using it and will begin to come around. You'll see.

Mike Hogan Sr.

Anything that might, I say even might, cut down on the opioid addiction in this country, which leads to heroin, I am all for. Since it is nonaddictive (not to be confused with habit or liking it a lot), I say it is worth a try. Many parts of the country are seeing enormous spikes in opioid addiction deaths in all age groups. No approach seems to be working. For that reason alone, I would be in favor of  legalization of marijuana.

Ark7788

On bullshit