Adolescence is a scary age for parents. At no other age do kids change more rapidly, in all aspects of their lives. Some of these changes can be summarized as follows:
But over and above each of these different realms, the change that can be most difficult for parents to handle is how adolescents develop emotionally.
The emotional life of a teenager or pre-teen adolescent is often characterized by dramatic emotional highs and lows, with what can feel like a constant fluctuation. Sometimes the seeming paradoxes can be too much for parents to handle: Adolescents crave the freedom and independence to make their own decisions, and can become angry and frustrated when they feel controlled. Yet at the same time, they also crave approval and validation, and can become hurt and resentful when they feel abandoned.
Meanwhile, in most cases, the dominant desire of parents is simply to see their child safe, healthy, and (if at all possible!) happy. While most parents want to give their adolescent children the independence they crave, parents also want to ensure that they are making the right decisions.
New Research Helps Identify Teens at Risk
In essence, one of the main tensions that parents of adolescent children face is between allowing their child to experiment and discover the world independently, while constantly fearing that this experimentation could end up leading to serious dangers like unprotected sexual activity or substance abuse.
Psychology researchers have stepped into this admittedly difficult situation and identified some patterns that parents can watch out for in their adolescent children.
Research performed by Dr. Patricia Conrod, of the University of Montreal, supports the idea that the majority of adolescents who experiment with drugs and alcohol do not become addicted, and among those who do, a test on four different personality traits can identify around 90% of those who had the highest risk.
One 2013 study published in the Journal of the American Medical Association – Psychiatry included over two thousand secondary school students in more than a dozen British schools, randomly selected to either participate in a preventative program or not.
Using the knowledge gained from the personality testing, the researchers were able to reduce binge drinking among high-risk students by 43%, which in turn had a whole suite of positive after-effects on the other students in the schools.
The work performed by Dr. Conrod in validating the personality assessment techniques and demonstrating its effectiveness in actual trial programs has since been replicated by other experimenters. It serves as a valuable contribution to our general understanding of how substance abuse, mental illness, and other issues can develop at the adolescent level.
Four Traits for Parents to Watch For
Over and above this general contribution, the practical takeaway for parents of the research above is that it identifies four character traits that can potentially serve as indicators for the future development of substance abuse or mental illness. A desire for experimentation and independence are completely normal: an abnormal presence of any of these four traits might not be. The four traits that parents should be aware of in their adolescent children are as follows:
Sensation-seeking means a constant search for feelings or experiences that elicit strong emotions, e.g. a “rush.” Individuals high on this trait are willing to take serious risks in order to feel something new and intense. While sensation-seeking is not necessarily comorbid with any given mental illness, it does increase the likelihood that individuals will seek out experiences with drugs.
Impulsiveness differs from sensation-seeking in that it is less about the end goal and more about the process. An impulsive decision need not have serious consequences, necessarily, but it is nonetheless marked by a lack of awareness for the consequences of an action. Impulsiveness has often been found to be comorbid with a diagnosis of Attention Deficit Hyperactivity Disorder.
Anxiety sensitivity refers to an unusual and maladaptive awareness of the physical signs of anxiety. For example, an individual with anxiety sensitivity might become hyper-aware of the experience of shortness of breath or increased heart rate associated with feelings of anxiety, which in turn worsens the experience. Anxiety sensitivity is often linked to a later diagnosis of a panic disorder.
Hopelessness is defined generally as a feeling that things are bad, that they will not improve in the future, and that the individual is to blame for this turn of events. It is often linked to helplessness, a feeling of low self-esteem or incompetence, or a more general feeling of meaninglessness. It can potentially serve as a precursor to a diagnosis of major depression.
It’s very important to keep this research in perspective. The purpose of the research was to develop a means of objectively assessing the potential risk that adolescents will develop substance abuse or mental health issues using rigorous psychological assessment techniques. Parents should not conflate this with the idea that a subjective judgment that any of these four traits is present should signal immediate danger.
To jump to this conclusion would be exactly contrary to the overall goal of the research, which is to support the idea that unless certain underlying personality traits are present, there is little risk that the experimentation that characterizes normal adolescent behavior will result in any dangerous or harmful long-term consequences.
Most parents are neither psychology researchers nor clinicians, and should make sure not to allow their own healthy fear for the safety of their children to spill over into the realm of clinical diagnoses. A myriad of other factors over and above personality are also responsible for the development of substance abuse issues or mental illness.
For many adolescents, simply having parents who love and care enough about them to worry puts them at much lower levels of risk already.
By Dr. Syras Derksen
Castellanos‐Ryan, N., O'Leary‐Barrett, M., Sully, L., & Conrod, P. (2013). Sensitivity and specificity of a brief personality screening instrument in predicting future substance use, emotional, and behavioral problems: 18‐month predictive validity of the substance use risk profile scale. Alcoholism: Clinical and Experimental Research, 37(s1), E281-E290.
Conrod, P. J., O’Leary-Barrett, M., Newton, N., Topper, L., Castellanos-Ryan, N., Mackie, C., & Girard, A. (2013). Effectiveness of a selective, personality-targeted prevention program for adolescent alcohol use and misuse: a cluster randomized controlled trial. JAMA psychiatry, 70(3), 334-342.
Jurk, S., Kuitunen‐Paul, S., Kroemer, N. B., Artiges, E., Banaschewski, T., Bokde, A. L., ... & Frouin, V. (2015). Personality and substance use: psychometric evaluation and validation of the Substance Use Risk Profile Scale (SURPS) in English, Irish, French, and German adolescents. Alcoholism: Clinical and Experimental Research, 39(11), 2234-2248.
Woicik, P. A., Stewart, S. H., Pihl, R. O., & Conrod, P. J. (2009). The substance use risk profile scale: A scale measuring traits linked to reinforcement-specific substance use profiles. Addictive behaviors, 34(12), 1042-1055.
Never before has technology been so important in the lives of teenagers. For the current generation, Instagram and other social platforms are ubiquitous and an integral part of their social lives. For many, social media presence is an important part of self-identity and a way to interact with and expand upon one’s social network.
For parents, the use of social media can be completely baffling. Not only must you get to grips with the wide range available (think Facebook, YikYak, Snapchat) but you also must contend with fears surrounding its use and how to place limits on what your child has access to.
Many also harbour concerns about the sheer amount of time spent on social media. With smartphones widespread and easy to use discreetly it is impossible to know how much time is actually being spent on such sites. Anonymous studies hint at very high use amongst adolescents. In one study, conducted using a large sample in Ontario; 36% of students reported using social media for 2-4 hours daily, whilst 11% placed their usage at a staggering 4 hours plus. This has vastly overtaken other forms of technology such as watching television or playing videogames.
Research on Social Media and Mental Health
So what does current research tell us about social media, and what implications can it have for mental health? Quite simply, should we be worried? Judging by some recent studies the answer may unfortunately be yes.
Studies are consistently linking social media use with poorer mental health outcomes. For example, high social media use may make adolescents three times more likely to develop depression (Lin et al., 2016). Another study, which focused primarily on Facebook, explored whether Facebook influenced subjective well-being over time.
This novel study measured subjective wellbeing by texting the young participants five times per day for two-weeks. It assessed how the subjects felt throughout the day and how generally satisfied they are with their lives. Facebook negatively affected both these measures. The more people had used Facebook at a certain time, the worse they felt. It is often argued that Facebook can provide a sense of social support, however, the researchers did not find that their findings were moderated by the size of social network, supportiveness or perceived positive effects.
Social media feeds what sociologists call “relative deprivation” . This refers to the dissatisfaction individuals feel when they compare their lives to others. More often than not, we fixate on what we are lacking compared to others. This leads to a sense of inferiority and unhappiness. Of particular relevance to today’s generations is the ability to compare our lives not only to those around us, but to the rich and famous. When young people compare themselves to airbrushed and unattainable lifestyles, it is no wonder they feel deprived and dissatisfied.
Social media may also prevent teenagers from engaging in behaviour that is beneficial to their mental health. Studies are increasingly noting a link between lack of sleep and social media use (O’Keefe & Clarke- Pearson, 2011). The light of a smartphone screen disrupts adolescent’s brain activity, making it difficult for them to “switch off” when they go to sleep. Teenagers can also find it hard to relax and out their phones away, as they may be afraid of missing out on something new in their feed.
It is common sense that spending more time on smartphones may also detract from physical exercise. More time spent on technology can mean a more sedentary lifestyle as teenagers become increasingly dependent on social media . The opposite, however, can also be true. Sites such as Instagram are filled with fitness and health tips. Whilst many of these are intended to promote healthier lifestyles they can also promote negative body image. Pages encouraging the development of muscle mass can convince both people of both genders that they need to up their fitness game and change body type. Similarly, images depicting consistently slim models can encourage unhealthy diets and lower self-esteem.
Social Media and Eating
The rise in eating disorders has been well documented throughout the past couple of decades, and it has also been cemented by psychological research. As early as 1997, Harrison and Cantor predicted a rise in eating disorders due to media consumption. Whilst this media consumption referred to television and print, media is even more ubiquitous now in the form of social media. Subsequently, researchers have found consistent links between body image, social media and eating disorders (Derren & Beresin 2006).
Social Media and Anxiety
Anxiety may also be linked to social media use. Feeling left out actually activates the amygdala, which is the brain – centre for all of our most basic requirements. A sense of being outside of one’s social circle activates the amygdala. In an attempt to avoid this we can increase our efforts to avoid missing out by compulsively checking social media. This creates a cycle of anxiety.
Social media use is not an entirely bad thing and in fact, can have some really positive uses. However, the research available to us at the moment does indicate that teenagers should not be spending an excessive amount of time on social media. Try speaking to your teen about their usage, and maybe discuss a phone free time in the home (maybe over dinner). Whilst you cannot prevent access to media, you can help your child create boundaries.
By Dr. Syras Derksen
Derenne, J. L., & Beresin, E. V. (2006). Body image, media, and eating disorders. Academic psychiatry, 30(3), 257-261.
Harrison, K., & Cantor, J. (1997). The relationship between media consumption and eating disorders. Journal of communication, 47(1), 40-67.
Kross, E., Verduyn, P., Demiralp, E., Park, J., Lee, D. S., Lin, N., ... & Ybarra, O. (2013). Facebook use predicts declines in subjective well-being in young adults. PloS one, 8(8), e69841.
O'Keeffe, G. S., & Clarke-Pearson, K. (2011). The impact of social media on childre
Sidani, J. E., Shensa, A., Radovic, A., Miller, E., Colditz, J. B., Hoffman, B. L., ... & Primack, B. A. (2016). Association between social media use and depression among US young adults. Depression and anxiety, 33(4), 323-331.
Romantic relationships are a fundamental part of life, and healthy, loving relationships can lead to some of the greatest joys available in the human experience.
Recent scholarship utilizing a conceptual framework called Self-Determination Theory has identified several core components of successful romantic relationships. Here we will examine the theory and some of its contributions to our understanding of romantic relationships.
What Is Self-Determination Theory?
Self-determination theory is a fundamental theory of human behavior that serves to organize the different tendencies and needs of human beings in order to explain the motivation for their behavior and the personalities they develop. It is a theoretical framework which is useful for exploring and explaining certain human experiences.
The fundamental concept of Self-Determination Theory, as is apparent by the name, is the idea that human beings, when they are operating as a true self, are performing actions that are self-motivated and self-determined. This is to say that an individual’s behavior is not so much determined by their surroundings, their context, or the external influences acting upon them, but rather by their own conscious ability to choose what is best and to act upon their desires.
This theory is in contrast to other theoretical frameworks, such as several frameworks that fall under the heading “Behaviorism,” which maintain that human behavior contains almost no element of true agency, and that individual actions are determined – in part or in full – by influences that are outside of the individual’s control.
Self-Determination Theory posits that three processes are responsible for a human being’s ability to act: first, there is present a mindful, reflective awareness of what the individual needs and what tendencies they desire to act upon. Second, an acknowledgment that the environment of the individual is sufficient to support the actions that it intends to take. And third, that the actions of an individual are enfolded, by various degrees, into that individual’s personality: That the individual “owns” their actions, so to speak.
Recent research utilizing a framework of Self-Determination Theory reviewed what the theory has to say on the topic of romantic relationships.
What Self-Determination Theory Says about Romantic Relationships
In a 2015 study entitled “Self-Determination Theory and Romantic Relationship Processes,” published in the journal Personality and Social Psychology Review, the authors took a close look at past research involving Self-Determination Theory and romantic relationships, and attempted to synthesize the findings and present patterns found in the literature.
For the purposes of the study, the authors took an interest in how a true self acts in a romantic relationship, and what consequences there are to those actions. By true self, the authors referred to the self as defined by Self-Determination Theory, namely a self that has been fully internalized, fully adopted, and fully endorsed by an individual as part of their identity.
Thus, a true self in relationships is one who fully endorses one’s own involvement in a relationship, and does not blame that involvement on any other external factors such as manipulation, coercion, guilt, or lack of knowledge. The researchers were interested in examining the patterns of romantic relationships when the individuals involved are truly, wholly committed at the level of their identity.
The first useful takeaway that becomes immediately apparent from this conceptual framework is the simple idea that not all actions are performed by a true self. A very powerful feeling of awakening can arise inside a relationship when one or both parties realize that they are not truly acting according to their own needs or according to the interests of their true self, but rather simply preserving and going through the motions of what they believe they must do, or what role has been thrust upon them.
A second major takeaway of considering romantic relationships using the framework of Self-Determination Theory is the idea that the more one invests one’s identity in one’s activities, the more satisfying and fulfilling they become. This includes relationships. When the true self is acting in a relationship, there is a resounding sense of affirmation: The individual is in the relationship because they want to be, and because it is important to them. This authenticity spills over into a host of other relational benefits, including partners feeling affirmed and becoming more honest and aware of the other’s needs.
One final takeaway we will mention here among the many cited in the article is the Self-Determination Theory perspective on goals. There is a big difference in romantic relationships on the function of goals, depending on whether the individual adopts more of a victim mentality or if they act as a true self. Research has demonstrated that people who are able to pursue their own intrinsic goals autonomously inside a relationship have greater overall well-being. When both partners in a relationship are aware of what they want and can verbalize those desires so as to actively pursue them together, growth takes place and mutual satisfaction often follows.
Why This Theory Matters
In the end, Self-Determination Theory is just that – a theory. A “theory,” in the scientific sense of the word, defines a coherent and cohesive set of concepts and ideas that together form a framework of hypotheses. These hypotheses have dual value: to provide a working explanation of the phenomena of the world around us, as well as to generate specific questions that can be tested.
With this conception of Self-Determination Theory, it is apparent why there is value in considering romantic relationships from this perspective. If, using this theory, an individual is able to consider what their romantic relationships would look like if they were acting as a true self, according to the theory, they have the opportunity to learn a lot about who they are, what they want, what their relationships are like, and any number of other questions.
This is not to say that Self-Determination Theory is “true,” necessarily. Competing theories that more highly emphasize the role of the environment and of the situation in motivating human action also contain an element of truth.
Nonetheless, by interacting with these various different theories and understanding what they say about human action, an individual has the opportunity to develop their self-understanding. And with more self-understanding, particularly in the realm of intimacy and romantic awareness, comes a greater ability to experience the great joys that life has to offer.
For more information, feel free to read the above-mentioned research article, to check out any number of books on Self-Determination Theory, or to consult with a psychologist or trained mental health professional with experience in this theory.
Knee, C. R., Hadden, B. W., Porter, B., & Rodriguez, L. M. (2013). Self-Determination Theory and Romantic Relationship Processes. Personality and Social Psychology Review, 17(4), 307-324.
Can love alone bring dating couples into the realms of married life?
While love can play a role in keeping a relationship glued together, there are other factors that make up a healthy and happy marriage. After all, marriage is no longer just about planning surprises, bringing roses and going on a date as often as you feel like it. It involves piles of laundry to put in the washing machine, loads of dishes to wash, dirty floors to clean and big decisions to make.
So, before saying “I do,” a couple must know whether or not they are compatible enough to live together for the rest of their lives. One way to do this is to assess what type of relationship they do have.
A new study (Ogolsky, B., Surra, C. & Monk, J. , 2015) has found four types of relationship pattern that can determine whether or not couples will end up getting married. Unlike previous research that looked into the individual aspects of a romantic relationship, this study conducted by researchers from the University of Illinois took the relationships of their participants as a whole.
376 unmarried couples who are in their mid-20s participated in the nine-month long research. Over the course of the research, the participants assessed how committed they were to tying the knots with their current romantic partner and why they would want to marry. Additionally, the researchers interviewed them about the reasons behind the change-of-mind regarding the commitment to get married in the future. Results showed four categories of relationship.
The “Dramatic Couples”
27-30% Ended Their Relationship During the Study
The characteristics of this group were ups and downs in commitment. These couples often thought about their relationship in negative terms. These couples would often have separate friends and acquaintances that would not interact. Finally, they were often less interdependent than the other couples.
Dramatic couples face a lot of challenges in their relationship that their commitment changes so wildly. This makes them the most vulnerable to breaking up among all types. Lead author Ogolsky said that they would make decisions based on the negative events or discouraging things that are happening in their relationship. Moreover, these couples tend to spend less time together because of their intense desire of hanging on to their individuality, choosing friends and family over their partners.
The “Conflict-Ridden Couples”
14-20% Ended Their Relationship During the Study
As can be guessed from the title, these couples were high in conflict. Like the dramatic couples, the commitment in these couples would also fluctuate, however they did not fluctuate as much.
This type of relationship may be exhausting for both partners. Couples are the either both ends of the spectrum in any given situation. They tend to have drops in their long-term commitment in the middle of a misunderstanding or argument without breaking up. However, they are super-passionate when everything is well between them.
Ogolsky noted (Picklesimer, P., 2016), “These couples operate in a tension between conflict that pushes them apart and passionate attraction that pulls them back together. This kind of love may not be sustainable in the long term—you’d go crazy if you had 30 to 50 years of mind-bending passion.”
He clarified, though, that conflict-driven partners may switch to another type of relationship in the future.
The “Socially-Involved Couples”
7-21% Ended Their Relationship During the Study
These couples were very concerned about their social network and their involvement in this social network. They did not have as many downturns in their commitment to the relationship as the dramatic or conflict couples.
The socially-involved couples feel stability in their relationship. They share the same group of friends and tend to rely on them when it comes to decisions regarding how they committed they are with each other. Having mutual social network is a big deal for this type of couples; it makes them feel closer to each other and get their relationship stronger than ever. The question remains, though: do they want to base their relationship based on other people’s opinions? For some, such may be crossing the line of friendship.
The “Partner-Focused Couples”
12-15% Ended Their Relationship During the Study
These couples were more interdependent and felt that their partner was more important when understanding why they were committed to the relationship. These couples weren’t as socially focused.
In the study, the findings showed that partner-focused relationships have the highest chance of lasting longer having more happy times. The couples in this category very much care about the relationship and the individual who makes it possible for the relationship itself to exist. They are very much involved in each other’s lives and are so involved with each other. Whatever happens in their relationship — whether good or bad — they use this to further strengthen and deepen their commitment. When they have to make choices that could affect their relationship, they spend time examining these choices and are very careful and thoughtful of their decisions.
The limiting factor of the study, is that the researchers were not able to see what happens of the relationship after nine months. Though, dramatic couples are most likely to break up within that time frame.
Ogolsky explained that these categories can help couples be more aware of the different ways of making commitment-related decisions and their effect on the relationship. Will their pattern propel the commitment forward or push the couple further apart from each other? Knowing this can help couples to determine what their relationship pattern is and then make decisions about whether they would like to either work to change that pattern or move on to another relationship.
By Dr. Syras Derksen,
Ogolsky, B. G., Surra, C. A. & Monk, J. K. (2016). Pathways of Commitment to Wed: The Development and Dissolution of Romantic Relationships. Journal of Marriage and Family, 78: 293–310. doi: 10.1111/jomf.12260
Picklesimer, P. (2016, February 9). Daters move toward (or away from) marriage in four different ways—where do you fit?. College of Agricultural, Consumer and Environmental Science, University of Illinois. Retrieved from http://news.aces.illinois.edu/news/daters-move-toward-or-away-marriage-four-different-ways%E2%80%94where-do-you-fit
It is old news that dysfunctional or insecure relationships in childhood may lead to difficulties down the line. Whilst this has long been known, a recent study has shed further light on the reasons for this, and the specific effects poor attachments may have.
Attachments are the relationships we have with caregivers from an early age. In general, attachment styles may be divided into four categories: secure, anxious-preoccupied, dismissive-avoidant and fearful-avoidant. The type of attachment style we develop is directly linked to the quality of care we receive. For example, a neglectful parent may contribute to their child’s dismissive- avoidant attachment style (Cassidy, 1999).
Insecure attachment styles have been linked to range of adult mental health issues. These range from anxiety and depression to relationship issues and even health problems. Obviously attachment styles are an important research area, but why does the human brain react so negatively to poor parenting?
The study, published in Frontiers in Human Neuroscience, found that insecure childhood attachments can negatively influence our ability to deal with stress as adults (Leyh, 2016). We are all aware that there is huge variability in how individuals deal with stress. This is evident in any office in the world! Some people remain calm and proactive in the face of adversity, whilst some crumble and become extremely negative.
One of the reasons for this, according to Dr. Rainer Leyh and his team, is that our negative childhood experiences and attachment styles stay with us throughout adulthood, and rear their heads when we are faced with a stressful or anxiety provoking scenario.
In this report on the study, Dr Christine Heinsich gives the example of a car approaching a traffic light. For the driver, when they are in a neutral state, following the signal is easy and may even come automatically. For an emotional driver however, following the signal is much more difficult. They may stop late or fail to stop altogether, driving straight through the light.
What moderates our ability to stay calm under emotional strain? For those of us that had emotionally attentive parents or caregivers it can be a lot easier. The key term is “emotional regulation”. Emotional Regulation is our ability to control our emotions, and our reactions and subsequent behaviours in response to them. Attachment styles have been directly linked to emotional regulation.
In the aforementioned study, adults were recruited who had a wide range of childhood parental/ caregiver experiences. Participants were asked to perform a task which involved identifying a target letter from a series of flashing letters. The task was conducted in different conditions, some which evoked a positive emotional response, some which evoked a negative response and others which evoked neutral. The participants’ brain activity was recorded using a type of brain scanning called “EEG”.
Subjects with insecure childhood attachments had significantly more trouble performing under the negative conditions than those with secure childhood attachments. Another interesting finding was that those with insecure attachments also exhibited lower brain activity under negative conditions when attempting to identify the target letter.
The poorer the task performance, the poorer the strategies for emotional regulation. One theory put forth by the researchers, is that the more effort you have to exert on inhibiting your emotion, the less resources you have to perform on the task. Therefore, negative childhood experiences may make all those day- to- day struggles we encounter just that little bit more difficult.
Were there any potential limitations to this study? It could be argued that as the target letters were unrelated to the emotional cures, it is difficult to generalise them to everyday life. Future studies will have to find a way to make the testing environment more realistic.
Despite this, it does see clear that poor relationships with our caregivers can have long- lasting consequences.
How do I know if I have difficulties with attachment and/ or emotional regulation?
It can be difficult to know whether any of this applies to you. You may have difficulties with emotional regulation if:
Implications for relationships
Those who are negatively attached may bring these issues and insecurities into relationships. Attachment style can have massive connotations, particularly for romantic relationships, and it is important to be aware of how it can affect you.
It is easy to see the connection between a turbulent relationship, and the findings of the study we have just discussed. Being resilient and calm when faced with stressful situations, arguments and all that comes with a relationship, is often central to its success. For those with poor emotional regulation, this can be difficult.
What can you do about insecure attachment?
New research is increasingly shedding light on how our past experiences can shape our present and future. It is fascinating what we area learning, but also important to stress that your past does not necessarily dictate your future, and we all have the ability to change long- learned behaviours.
By Dr. Syras Derksen,
Cassidy, J. (1999). Handbook of attachment: Theory, research, and clinical applications. Rough Guides.
Leyh, R., Heinisch, C., Kungl, M. T., & Spangler, G. (2016). Attachment representation moderates the influence of emotional context on information processing. Frontiers in Human Neuroscience, 10, 278.
For many of us, the word “assessment” conjures up negative associations.
In reality, though, the fact of the matter is that even though from the outside psychological assessments might prompt a fear of judgment or an image of subjective evaluation, the exact opposite is true: Psychological professionals use assessments to gather objective information in order to find the best way to help an individual grow.
Let’s take a closer look at what psychological assessments entail, common biases to note, and the best way for you to think about psychological assessment.
What Is Psychological Assessment?
The notion of psychological assessment defines an individualized, holistic information-gathering process. It’s not something that can be summarized in a single sentence: there are as many different ways to perform a psychological assessment as there are individuals.
Although there is diversity in how assessments are performed, there is a general method that is consistent across different realms of psychology and different types of disorders. This method involves integrating the results of a variety of different psychological tests in order to create a balanced, objective view of the psychological profile of an individual
Multiple Sources of Information
A psychological professional generally integrates multiple sources of information when coming to a conclusion. This will generally include observation of the person (e.g., interview), historical information (e.g., grades), and the results from multiple tests hopefully done by multiple people. For example, when diagnosing Attention-deficit/Hyperactivity Disorder (ADHD) our clinic will gather information from teachers, parents, and the child. We would rule out various learning difficulties and emotional/behavioural challenges.
Is the Issue A Disorder?
Tests are norm-referenced, which means that an individual’s performance is compared against the average performance of a group of people. For example, a height measurement is a kind of test – it provides a single, discrete measurement of a physical characteristic (not a psychological characteristic). But an individual’s height is only meaningful if it is compared to others; for instance, a child’s height compared to the norms for his or her age group. This can let you know if there is an issue with the child’s growth.
Finding Important Factors that are Hard to Observe
It may be clear that a person is having difficulty managing life. However, the real issues may be harder to see. They may be difficult to see because the person is hiding it, or because they are just not aware. Children, for example, often benefit from psychological assessments because they don’t know how to describe the issues they are facing.
It’s not just children who may not be aware of their issues. For example, a client may be consuming a large amount of alcohol, which is causing anger and relationship problems. This alcohol problem is more obvious and is the issue that attracts the attention of family and friends. A psychological assessment my show that this the alcohol use is an issue, but it may also show that their level of anxiety is very high. This combination of issues may suggest that the individual is using the alcohol to manage their anxiety difficulties. A recommendation of therapy or using an anti-anxiety medication may be the result of this type of assessment. Treating the anxiety may then help the person to stop the alcohol abuse.
Multiple Tests to Rule out Other Potential Issues
Psychological assessments aren’t there to just measure one symptom. The tests chosen are also there to ensure that other issues may not be causing the problem. For example, in an ADHD diagnosis, it is important to know that the observed attention problem is not a symptom of a different disorders.
In the case of ADHD, the primary pharmacological treatment is a stimulant. However, bipolar can look like hyperacitvity and a stimulant medication can make bipolar worse. Psychological assessments are there to make an accurate diagnosis to avoid making mistakes that can lead to months or years of extra pain and confusion.
Tests Can only Be Used With Certain Groups
It’s important when interpreting the results of an individual test to notice the assumptions that the test makes about its subject population. Every individual is different, and it’s dangerous to oversimplify these differences by measuring the averages of a group of people.
Psychological tests are generally meant for specific populations. When these rules are broken, the results may not be accurate. For example, a test that was developed with North American’s may not be accurate with people who grew up in India. Although psychologists sometimes break these rules because no better test is available, clinical judgement is important in interpreting the results.
How to Approach Psychological Assessment
One helpful way to think about psychological assessment is to approach as you would a trip to the doctor’s office.
In both cases, whether it’s a medical professional running a blood test to check for signs of a physical illness, or a psychological professional performing a mental health evaluation to check for signs of a psychological disorder, the basic idea is the same. A professional with the patient’s best interest at heart is simply gathering information in order to inform themselves as to the best next steps.
This comparison also illustrates how one should prepare for the assessment: You wouldn’t study for a blood test. When you go to the doctor, the goal isn’t to present yourself as perfectly healthy and to ignore the physical ailments that are bothering you. How would that help?
Instead, the goal should be to open up lines of honest communication between you and the professional devoted to your care and well-being. With both medical and psychological assessments, you want to be as completely honest as possible, even if you feel afraid or embarrassed. The individual trained to help you is on your team, and will help as best they can.
In conclusion, psychological assessments are an information-gathering process performed by psychological professionals in a number of different contexts. While the process is open to some amount of human bias, if approached like a medical examination, the process of psychological assessment can be a helpful part of psychological care for individuals in all situations.
By Dr. Syras Derksen,
Eabon, M. F., and Abrahamson, D. (2016). Understanding psychological testing and assessment. American Psychological Association. Retrieved from www.apa.org.
We all know individuals who are of a more melancholy disposition than others. In A. A. Milne’s popular set of children’s stories, the friends of Winnie-the-Pooh include both Tigger – the bouncing, happy tiger; and Eeyore – the somber, plodding donkey. Even from a young age, we all understand that it is completely acceptable for individuals to have their own unique dispositions and levels of emotional valence.
However, when a friend or loved one’s general tendency towards being blue seems to worsen, and perhaps begins to impair day-to-day functioning, it is exceptionally difficult to assess the seriousness and potential danger of the situation. In particular, it can be hard to know when a period of melancholy crosses the line into untreated major depression.
Depression Can Be Misdiagnosed
A recent study published in the JAMA Internal Medicine journal by the American Medical Association indicated that in the United States, a large proportion of individuals seeking attention for depression-related symptoms are misdiagnosed. The study surveyed over 46,000 US adults aged 18 or older in 2012-2013.
Using an established scale to measure depressive symptoms, the study established that around 8.4% of the participants in the sample had depression. However, only 28.7% of those individuals had received treatment. Meanwhile, of those who were undergoing treatment for depression (either psychotherapy or antidepressant medication), only 29.9% screened positive for symptoms of major depression.
This means that there are some serious challenges associated with the correct identification of depression, and diagnosis and treatment is not necessarily always straightforward.
In an effort to widen the scope of research into the prevalence of depression misdiagnosis, another study conducted a meta-analysis of 118 different studies assessing the accuracy of depression diagnoses. The final analysis contained data from more than 50,000 patients across 41 different studies, in countries including the United States, Canada, and various European countries, among others.
In the end, the study suggested that for every 100 cases of potential depression seen by a primary care physician, 15 cases are false positives (treatment was prescribed when there was no real depression), 10 cases are missed (treatment is not prescribed when there is real depression), and 10 cases are correctly identified (treatment is provided for real, identified depression).
One reason for this pattern of diagnosis is the difficulty in ascertaining the difference between depression and psychological distress. The AMA study described in the previous section measured the difference between depression and serious psychological distress, and found that among adults who were undergoing treatment for major depression, 29.9% had depression and 21.8% had serious psychological distress.
In addition, factors such as age, culture, and available medical resources can impact diagnoses. In general, the studies concluded that developing a relationship with a mental health care professional and undergoing multiple diagnostic visits over a longer period of time can substantially increase diagnostic accuracy.
Signs to Look For
To address the complexity of depression diagnosis, there are several mnemonics that have been developed in an effort to make the symptoms of depression more memorable. The mnemonic below, published by Blenkiron, 2006, lists 10 symptoms of depression aligning with the 10 letters of the word. Here we present the list and supplement each item with a brief description.
As was apparent from the list above, each symptom presented must recur in an individual for a period of multiple days before it should be considered a possible indicator for major depression. Generally speaking, until multiple of the symptoms above are present much of the time for a sustained period lasting around two weeks, there should not be major cause for concern.
However, anyone with any concern over the mental health or safety of a friend or loved one should consult with a mental health professional. Individuals who fear for anyone’s immediate safety should contact emergency services.
By Dr. Syras Derksen,
Blenkiron, P. (2006). A mnemonic for depression. BMJ: British Medical Journal, 332(7540), 551.
Mitchell, A. J., Vaze, A., & Rao, S. (2009). Clinical diagnosis of depression in primary care: a meta-analysis. The Lancet, 374(9690), 609-619.
Olfson, M., Blanco, C., & Marcus, S. C. (2016). Treatment of Adult Depression in the United States. JAMA Internal Medicine, 176(10), 1482.
In our increasingly digital age, addiction to internet use is growing in prevalence, and has recently received more and more attention from medical and scientific researchers. Nowhere is the problem more alarming than with adolescents, who have the greatest access to internet-based technologies, and also have the most at stake developmentally.
Some rather sensationalized news sources have even referred to the rise of internet addiction as a new “electric heroin,” citing the research demonstrating how internet use and serious substance abuse demonstrate similarities in their symptomologies and in the way that they stimulate the reward pathways of the brain.
While the danger and addictive potential of heroin use makes the comparison a little strained, excessive internet use is nonetheless a condition that merits serious attention.
The History Of Internet Addiction
The possibility for addictive behavior related to internet use was first proposed in 1995. The term was initially used in jest, because at the time the rarity of personal computers and the unlikelihood of any individual developing an addiction to internet use made the idea ridiculous.
In the ensuing years, however, the explosion of internet technologies rapidly made internet addiction a reality. By 1998 a diagnostic tool known as the Internet Addiction Tool (IAT) was developed by Dr. Kimberly Young in order to assess whether an individual’s internet use was pathological.
The assessment was based on the criteria for pathological gambling listed in the DSM-IV (the American Psychological Association’s diagnostic manual for mental disorders). This was based on the logic that despite the fact that internet addiction had not yet been recognized by the psychological establishment as a real disorder, the symptoms it presented were similar enough to gambling addiction that the two could be diagnosed in a comparable fashion. When the DSM-V was released in 2013, pathological gambling was updated to a condition now called “gambling disorder,” but problem internet use was once again left out.
Notwithstanding, psychological and medical researchers across the world have begun devoting major resources towards studying the effects of internet use, especially on school age populations ranging from ages 5-22. This field of research has been especially active in Asian countries such as China, Japan, Korea, and Taiwan; countries in which the vast majority of the population have access to the internet and incidence of internet addiction is especially high. Recent studies have found that an estimated 19.8% of adolescents in Taiwan and 20% of adolescents in Korea screened positive for either internet addiction or excessive internet use.
The Diverse Manifestations of Excessive Internet Use
Internet Addiction has been grossly understudied, and additional research is required to establish prevalence rates in European and North American countries. The various diagnostic tools currently available are often times outdated, and assess patterns of internet use that are no longer relevant. Future research is needed to validate measuring tools that more accurately reflect the actual patterns of internet use in today’s adolescents.
In the 1990s, the internet functions available to the average user were so limited that one of the only possible types of pathological use was compulsively checking websites, in a pattern that closely mirrored compulsive gambling. However, today’s adolescents use the internet for so many different things that, depending on their pattern of use, the internet can either enable or catalyze a host of different disordered patterns of thinking.
For example, online gaming can be associated with the impulsivity often marked in cases of Attention Deficit Hyperactivity Disorder (ADHD). Adolescents with a bent towards narcissistic personality disorder might gravitate towards excessive self-promotion on networking outlets like Twitter, Facebook, or Instagram. The constant stream of world news and cultural information present on social media websites can enable a crippling fear of missing out (or “FOMO”) that might co-occur with an anxiety disorder. And the internet also provides opportunities for the destructive cyber-bullying perpetuated by over-aggressive adolescents.
Of course it is impossible to determine if the disordered or problematic patterns of thinking listed above are caused by internet use or if the internet use simply enables preexisting pathological tendencies to manifest. It is also possible that there is a reciprocal relationship, with excessive internet use both fostering and enabling the expression of negative behavior patterns.
Diagnosis and Understanding
While this diversity of the symptomology of internet addiction makes it difficult to issue blanket statements, the important thing is to have the discernment to distinguish between frequent internet use and the excessive patterns of use that can lead to addiction.
Internet use should not be judged to be excessive until several of the following criteria are met (among others): impaired psychological well-being; worsened academic performance; physical abnormalities including back pain, eye strain or carpal tunnel syndrome; severely decreased family and peer interactions; and finally the traditional markers of addiction, including increased tolerance, signs of withdrawal after lack of use, disregard for consequences, and difficulty controlling behavior.
While discussions of internet addiction can often alarm parents who may believe that their child spends too much time online, it’s important not to jump to conclusions nor to inhibit overall internet use wholesale. Internet use is not per se harmful or inhibiting; in fact, there is a mountain of evidence that adolescents with regular internet access generally have higher test scores, a greater motivation to learn, greater access to health information, and a general feeling of empowerment compared to adolescents without internet access.
As was noted above, there are many diverse uses for internet technologies, and each has the potential to enable various different disordered patterns of thinking. What is required in such a complex situation is a sensitivity to the overall developmental context of an adolescent’s physical, emotional, and social situation.
While internet addiction has recently been given increasing attention by mental health professionals and should be taken seriously, parents of adolescents should not jump to conclusions. Using the criteria listed above, in addition to outside research and, if necessary, consultation with a certified health professional, parents of adolescents can be more secure in their ability to discern between the excessive internet use that marks internet addiction and the frequent internet use that marks 21st century adolescence.
By Dr. Syras Derksen,
Guan, S. S. A., & Subrahmanyam, K. (2009). Youth Internet Use: Risks and opportunities. Current Opinion in Psychiatry, 22(4), 351-356.
Ong, S. H., & Tan, Y. R. (2014). Internet Addiction in Young People. Annals of Academy of Medicine, Singapore, 43(7), 378-382.
Tao, R., Huang, X., Wang, J., Zhang, H., Zhang, Y., & Li, M. (2010). Proposed Diagnostic Criteria for Internet Addiction. Addiction, 105(3), 556-564.
Wallace, P. (2014). Internet Addiction Disorder and Youth. EMBO Reports, 15(1), 12-16.
For as long as most of can remember, the Canadian Paediatric Society (CPS) and American Academy of Pediatrics (AAP), among others, have held strict guidelines about kids and screen time: Little or no screen-based activities for children under two, and only one to two hours of television for older children.
But to reflect the new realities of digital media and the many forms it takes, the AAP recently revised its guidelines to relax its hard-and-fast rules and acknowledge that time on a device might now be as important as how they are using that device.
For instance, an article in the Wall Street Journal points out that sitting down to read a book with your child on an e-reader isn’t all that different than reading a hard copy. You’re still having a high-quality, interactive experience. That’s a huge improvement over parking your toddler in front of a cartoon and calling it educational.
In the right context—such as using video chat to stay in touch with an out-of-town relative—digital media can be an adequate or even equal alternative to activities we normally consider to be developmentally healthy.
Small Children Shouldn’t Be Left Alone With Technology
Children are naturally curious about what your device can do, so one danger is that you sit them down for a video chat with your sister, walk away and find they’ve navigated away from the video chat into dangerous territory.
Dangerous territory doesn’t have to mean a pornographic website. For a child old enough to read, just opening your email could raise questions about a seemingly tense exchange between you and your spouse, or a note from his or her teacher not intended for their eyes. We sometimes forget how much information is available on our devices. So remember that smartphones, computers and tablets are tools, not toys, and require supervision.
As kids get older, you’ll give them more freedom to explore, and it will likely become impossible to keep them from using the Internet outside of your presence. But for now, take advantage of the control you do have to make sure that Internet access is never unsupervised.
Not Recommended as a Pacifier
So often, we see a child grow bored, irritable or on the verge of a tantrum, only to watch a parent hand over their smartphone to calm the child. You might have even done this yourself—after all, it usually works, doesn’t it? But I don’t recommend it.
While no one wants to deal with an angry, screaming toddler—especially in public—these can be teachable moments both for you and your child. Practice taking deep breaths and talking with your child about why he’s upset and how he can express his emotions more constructively.
Be A Good Digital Role Model
“Limit your own media use,” the AAP recommends in its newsletter, AAP News, adding that “attentive parenting requires face time away from screens.” Kids naturally mimic the behaviour of the adults around them, and spending all your time glued to a tablet or smart phone is no different. If you’re repeatedly checking email during dinner, kids will pick up on that, so make sure that if the rule is “no phones at dinner,” it applies to adults at the table, too. Even at other times—including when you’re working—make a point of modelling healthy behaviour by taking breaks from the computer to go outside, stretch your legs or just have face-to-face conversations with people.
No doubt you have even more concerns and questions about older children and the Internet, from cyber bullying to privacy and safety. Those are topics for another day, but remember that if you lay the groundwork by setting healthy boundaries early on, continuing the dialogue will be easier as they get older.
Shapiro, J. The American Academy Of Pediatrics Just Changed Their Guidelines On Kids And Screen Time. (2015, Sept.). Forbes. Retrieved from
Reddy, S. Pediatricians Rethink Screen Time Policy for Children. (2015, Oct.). The Wall Street Journal. Retrieved from (http://www.wsj.com/articles/pediatricians-rethink-screen-time-policy-for-children-1444671636)
Parenting doesn't cause Attention deficit hyperactivity disorder (ADHD), but it does appear to have an impact on the symptoms. ADHD is a common and often controversial condition that affects about 5% of all children. Associated symptoms include distractibility, impulsivity and disruptive behaviour. ADHD is linked with negative outcomes (dropping out of school, criminality, antisocial behavior, etc.) and a multitude of challenges to mental health, like mood and sleep disorders.
What is ADHD?
ADHD is a neurodevelopmental disorder, meaning that it is associated with functional impairments in some brain networks (currently thought to include those related to the neurotransmitters dopamine and norepinephrine).
Motivation is known to be impacted by ADHD as well. Recent research suggests that children may not react the same way to positive and negative experiences. For example, when the social rules change from recess to the classroom - they aren't able to adjust their behaviour.
The cause of ADHD has been linked to both genetic and environmental influences, but no definite causal factors have been uncovered. There is no biological test for ADHD, so diagnosis relies on observation and psychological testing often performed by child psychologists. Attention problems are a part of a number of mental health disorders, so diagnosis often involves ruling out other conditions. Adults can also be diagnosed with ADHD.
Impact of Parental Style
Evidence suggests that some parenting styles can sustain or even worsen the symptoms associated with ADHD. The characteristics of one’s parenting can vary on a wide range of scales, like aggression, consistency and emotional expression. Recently a group of researchers studied more than 500 children (388 with ADHD) over a period spanning the ages of 7-13. They tracked symptoms related to ADHD, as well as parental characteristics related to emotions (use of criticism, expression and over-involvement) to determine if there were significant associations between the two groups.
ADHD symptoms were found to be significantly associated with parental criticism. Symptoms of ADHD usually decrease with age, but these improvements were inhibited when consistently high rates of parental criticism were present. These findings are alarming because many of the behaviors associated with ADHD can cause frustration for parents (as well as the child). When children show symptoms of ADHD it can be a very natural and almost reflexive response for parents to respond with criticism.
ADHD is a difficult condition for those experiencing it as well as their family, but it is important that parents be aware of the effect that their own behaviors can have on its development. Criticism can be especially damaging when it is emotionally charged and persistent. Other characteristics of some parental styles, like inconsistent discipline and inadequate supervision, have also been found to be associated with poor outcomes for children with ADHD (Ullsperger, Nigg and Nikolas, 2016).
One thing seems to be clear, many parents will likely need support to prevent natural responses to ADHD symptoms. Parental frustration can cause criticism as well as other behaviours that only make the symptoms worse. It is also important to not that this research is not talking about the occasional parental slip. It is amazing how children are open to repairing relationships with parents if parents are willing to take steps to repair and improve the relationship. Although difficult, parents who work on managing emotional responses can help create a more positive family dynamic over the long-run.
By: Dr. Syras Derksen
Alsop, B., Furukawa, E., Sowerby, P., Jensen, S., Moffat, C., & Tripp, G. (2016). Behavioral sensitivity to changing reinforcement contingencies in attention‐deficit hyperactivity disorder. Journal of Child Psychology and Psychiatry.
Musser, E. D., Karalunas, S. L., Dieckmann, N., Peris, T. S., & Nigg, J. T. (2016). Attention- deficit/hyperactivity disorder developmental trajectories related to parental expressed emotion. Journal of Abnormal Psychology, 125(2), 182.
Ullsperger, J. M., Nigg, J. T., & Nikolas, M. A. (2016). Does child temperament play a role in the association between parenting practices and child attention deficit/hyperactivity disorder? Journal of Abnormal Child Psychology, 44(1), 167-178.