[acb-hsp] "Shy" or a Person with a Mental Disorder?

[peter altschul]

'Shy' Children At Risk Of Being Diagnosed With Mental Disorder

Children who are merely shy or sad are at risk of being diagnosed 
with mental disorders and given powerful drugs, experts warn.

By Martin Beckford, Health Correspondent The Telegraph September 
14, 2011

Psychologists say that new guidelines being developed in America 
will lead more young people seeing their common problems regarded 
as illnesses that must be treated, rather than just being given 
support.  They fear that pupils who are quiet at school could be 
diagnosed with "social anxiety disorder" while those who become 
withdrawn after suffering a bereavement are classified as having 
a "depressive disorder".  Children who just talk back to adults 
or lose their temper regularly could be diagnosed with 
"oppositional defiant disorder".  As a result, those found to 
have these increasingly broad mental disorders could be 
prescribed powerful medication such as Prozac or Ritalin to 
control or alter their behaviour.

Now the pressure is increasing for a national review of the use 
of such drugs on schoolchildren as well as more research into 
their long-term effects, following a vote at the TUC Congress on 
Wednesday.  Kate Fallon, general secretary of the Association of 
Educational Psychologists, told delegates: "Behaviours develop 
over a long period of time, often with a range of complex causes; 
we can't `cure' the behaviours we don't like with a quick fix of 
medicine.  They usually require careful management by all the 
adults around the child.

"In 2013 we're expecting new criteria for the definition of 
mental illness to be adopted here in the UK.  These criteria will 
lead to many more children being diagnosed as mentally ill, based 
on reports of their behaviours.

"A shy child could be diagnosed with social anxiety; a sad or 
temporarily withdrawn child could be diagnosed with depression.

"These are conditions which are also likely to be treated with 
medication -- and under these circumstances, Congress, we will be 
putting potent drugs into children with little or no 
understanding of what it will lead to.

"In a society that wants quick results using drugs to improve 
behaviour is very tempting.  But there can be other ways of 
improving children's behaviour which typically involve time and 
energy from people."

Research has found that children under the age of six are being 
prescribed the drug Ritalin for attention deficit hyperactivity 
disorder, prompting calls for the Department of Health to 
investigate the scale of the problem and the potential long-term 
damage it may be causing.

Recent figures show 650,000 children aged between eight and 13 
are on the pscyhotropic drug, up from just 9,000 two decades ago, 
while others are taking Prozac for depression or anxiety.  Fears 
are growing that the number of children diagnosed with mental 
disorders and prescribed drugs will increase still further after 
2013, when a new "bible" of the psychiatric profession is 
published.

Known as DSM-5, the book widens the diagnostic criteria for many 
supposed conditions including social anxiety disorder, better 
known as shyness, and will likely be adopted by the health 
authorities in Britain after appearing first in the US.  The 
proposed new definition for social anxiety disorder states that 
it is marked by "fear or anxiety about one or more social 
situations in which the person is exposed to possible scrutiny by 
others.  Examples include social interactions (e.g., having a 
conversation), being observed (e.g., eating or drinking), or 
performing in front of others (e.g., giving a speech)".  In 
children this fear could be expressed by "crying, tantrums, 
freezing, clinging, shrinking or refusal to speak in social 
situations".

Young people will be deemed as having oppositional defiant 
disorder if they display symptoms including losing their temper, 
arguing with adults, deliberately annoying people or being 
"spiteful or vindictive at least twice within the past six 
months" to people other than their brothers or sisters.

The British Psychological Society has also raised concerns about 
the proposed revisions to the DSM.  It does not dispute that some 
children have emotional and behavioural problems but says that 
patients and the public are "negatively affected" by the 
continued "medicalisation" of natural and normal responses to 
their experiences, and that classifying such problems as 
"illnesses" ignores their wider causes.

Prof Peter Kinderman, chairman of the society's Division of 
Clinical Psychology, said: "We're not certain that a diagnosis 
and a medical response is the best way to help these kids.

"Absolutely understand and help, not necessarily diagnose and 
treat."