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Normal or not? When temper tantrums become a disorder

Angry kids who throw excessive, explosive tantrums now have their own disorder: disruptive mood dysregulation disorder. Whereas this new addition to the mental health dictionary, the DSM, has prompted protests that psychiatrists are turning a normal part of childhood into a mental disorder, proponents say it will address the skyrocketing rate of another diagnosis that is leading to the inappropriate use of powerful medications on children. The soaring diagnoses belong to pediatric cases of bipolar disorder. Between 1994-1995 and 2002-2003, the diagnosis of bipolar disorder in children grew by 40-fold, according to research published in 2007 in the journal Archives of General Psychiatry. [11 New Warning Signs Help Spot Mental Illness in Children] Many of these children exhibited a pattern not consistent with a bipolar diagnosis. Specifically, bipolar disorder involves episodes of mania, which can show up in children as irritability. However, many of the children diagnosed did not have clear-cut episodes of irritability, instead, they were constantly irritable. As a result, experts believe many children are being misdiagnosed. Bipolar disorder is often treated with medications that bring worrisome side effects that are worse in children, according to the advocacy group the National Alliance on Mental Illness. These include weight gain that brings increased risk of diabetes or heart problems later in life, movement abnormalities and other problems. When it came time to put together the new edition of the mental health manual, called the DSM-5, officials at the American Psychiatric Association, which publishes the manual, wanted to include a better-fitting diagnosis for kids with persistently angry, irritable dispositions, hence the addition of disruptive mood dysregulation disorder (DMDD). However, the addition is controversial. Allen Frances, who chaired the task force for the previous edition of DSM, charges that this new DMDD diagnosis “will exacerbate, not relieve, the already excessive and inappropriate use of medicationin young children.” The addition of DMDD could prove helpful, because it will enable researchers to study these symptoms in children who have previously been diagnosed with bipolar disorder, but who dont fit the profile for that disorder, said Robin Rosenberg, a clinical psychologist and co-author of the psychology textbook “Abnormal Psychology” (Worth Publishers, 2009). “The concern is that it will lower the threshold for diagnosing kids who are just having a hard time,” Rosenberg said. “There is a gain and there is a risk. If it becomes overly diagnosed, it will prevent us from figuring out what is going on with kids who really have this persistent problem with mood and behavior and, more importantly, needlessly put children on dangerous medications.” Tantrums and bad moods are normal parts of childhood. But to receive a DMDD diagnosis, a child must have rages that are “grossly out of proportion” three or more times per week, on average. The child's mood between outbursts must be “irritable or angry most of the day, nearly every day,” according to the DMDD criteria, which set a threshold of at least 12 months. Kids who might qualify for this new diagnosis may come to the attention of mental health professionals because they have serious behavioral trouble at school or their parents may be unable to control them at home, Rosenberg said. Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.source : http://www.foxnews.com/health/2013/06/17/normal-or-not-when-temper-tantrums-become-disorder/

Sibling bullying is under-recognized, study finds

Across the U.S., parents, educators, doctors and other experts have rallied to protect children from bullies. However, bullying by brothers and sisters is often chalked up to normal sibling behavior. Now a new study finds that sibling aggression, like peer aggression, causes mental distress, which can lead to anger, depression and anxiety in the child who is being targeted. The researchers found that 32 percent of the children and adolescents had experienced one type of sibling aggression during the previous year. Further, the study showed that regardless of whether the aggression was mild or severe, bullied kids had significantly worse mental health than children who were not bullied. “There is a natural emotional intensity to sibling relationships,” said lead author Corinna Jenkins Tucker, an associate professor of family studies at the University of New Hampshire. “There is a lot of love, but also the potential for a lot of conflicts.” More from LiveScience The researchers analyzed information from telephone interviews with nearly 3,600 adolescents ages 10 to 17, and with adult caregivers of children 9 and under. Each youngster had at least one sibling under 18 who was living at home. The data were obtained as part of The National Survey of Children's Exposure to Violence, which documents the incidence and prevalence of youngsters' exposure to violence. During the interviews, the researcher asked if the adolescent or child had been bullied by a sibling during the past year. As the researchers defined it, bullying included physical assault, property victimization (such as forcibly taking something a child was wearing, or destroying something belonging to the child), or psychological aggression (such as name-calling, or telling the child he or she wasn't wanted around). In addition, researchers asked the youngsters if they had experienced anger, depression or anxiety during the previous month. Eight percent of the children interviewd had experienced two or more types of sibling bullying duringthe previous year. Children who were even mildly physically assaulted by a sibling had greater mental distress than adolescents who were not assaulted. However, all the kids were similarly affected by the other types of sibling aggression. Tucker said that parents and other adults often downplay sibling aggression. As a result, it's “under-recognized and under-estimated,” she said. “Our work is showing that in some cases, the mental distress associated with sibling aggression is similar to what we see with peer aggression. It is something to be taken seriously.”  Mark E. Feinberg, a research professor at the Prevention Research Center at Penn State University, said “while our society has been working to eliminate bullying, it has not touched the relationship that is most violent — the sibling relationship.” The findings are “are not news to those of us who have been paying attention to sibling relationships,” but because the study involved a large, nationally representative sample, the findings should focusattention on sibling aggression, said Feinberg, who was not involved with the study. “The question then is, what do we do about it?” he said. “Nobody yet has the answer on how to deal with this problem.” According to Tucker, when parents notice bullying, they should step in. “It is an opportunity for parents to act as a mediator, and teach constructive conflict skills,” she said. Parenting programs, Tucker added, should include discussions about sibling bullying as well. “There is a big push now to stop aggression, particularly between peers, and we are suggesting that these programs include a focus on siblings,” she said. The study is published June 17 in the journal Pediatrics. Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.source : http://www.foxnews.com/health/2013/06/17/sibling-bullying-is-under-recognized-study-finds/