A recent study published by the Journal of the American Medical Association highlights some extremely alarming current trends. This 15 year study, which recorded emergency room visits from 66 hospitals around the country has found that the number of teenage girls admitted for nonfatal self-harm has risen since 2008. Curiously, before 2008 rates were stable, so it is important to examine why this rise is taking place. Although suicide rates are on the rise for both boys and girls in the US, the rise in self-harming behaviours is limited to girls.
Self-harming behaviours including cutting, poisoning and overdosing on drugs are strong indicators of suicidal intentions or co-occurring mental illness such as anxiety or depression. Amongst the self-harming behaviours recorded, ingesting pills or poison was the most common method.
Self-harming is more common than many people may be aware. Prevalence rates are estimated to lie around the 10% mark and is not limited to young people.
It is also worth noting that the data discussed as part of this study involves admissions to emergency rooms only. It does not include injuries that were treated in doctors’ offices or that were never treated at all. As a result, the worrying findings highlighted by this study may not even reflect the full scope of the problem.
Why is This Happening?
One theory which has been put forward by researchers is that teens are spending too much time on their smartphones. It has been found that teens who spend five hours a day or more on their smartphone are 71% more likely to be at risk of suicide than those who spend an hour or less.
Although smartphone use may not be the actual cause of self-harm, it may put already vulnerable teenagers at further risk as it leads to increased social isolation (spending time alone scrolling through social media) and detracting from healthier behaviours such as exercise.
A more sinister reason that smartphone use may have a role to play in the rise of self-harm amongst girls is the growing online culture where teenagers encourage each other to self-harm and share photos and videos of the practice.
Social media may be normalising a behaviour that is extremely dangerous. It would be remiss to attribute all the blame to social media platforms, but it is certainly likely to be a factor, and with numbers rising it may be pertinent for parents and educators to speak openly to teenagers about self-harming behaviour.
Signs of Self-Harming
It can be hard to tell if someone has been self-harming, but often family members or friends will have a sense that something is not right. If you are worried someone you know may be self-harming then look out for any of the following signs:
Why Do People Self-Harm?
Self-harm is an extremely complicated behaviour which may be rooted in a myriad of issues. Often the individual who is self-harming may be experience emotional issues for which they require an outlet. It would be impossible to list all the possibilities but the following are some of the more common causes:
Social Problems: This encapsulates all the interpersonal difficulties an individual may be having. This could be being bullied at school, difficulties with co-workers or coming to terms with their sexuality.
Psychological problems: There is a link between self-harming and borderline personality disorder. Sometimes, those who self-harm have heard voices telling them to do so or have been disassociating (losing touch with their surroundings).
Trauma: Individuals who self-harm may often (but not always) have a history of trauma. This could be a bereavement, a history of physical or sexual abuse or any incidence which causes a high level of distress.
These issues, whether alone or combined, can lead to a build-up of negative emotions such as anger or self-hatred. The individual will often feel like they cannot speak openly of these feelings or turn for help, and so self-harm becomes an alternative method through which to express this.
What Can You Do if You Suspect That Your Child or Someone You Know is Self-Harming?
It is important not to respond in a negative manner to suspected self-harm. Don’t react in anger or disgust, or minimize the behaviour as “attention seeking”.
Ask what is going on in their life generally, and try to ascertain whether there is anything which may make him/her want to self-harm. Let them know that you are there to listen or to give any help that they may need right now.
Although it is difficult, it does not help to “confiscate” any tools that are being used to self-harm without prior agreement. The individual will find a way around this, ultimately eroding the trust you are trying to build.
It’s also important to express to them that this is a worry for you and something which needs a plan of action.
The first point of contact will often be your GP who can put you in touch with the relevant services. Schools may also have a child protection officer, or someone qualified who you may speak to.
Treatments include individual, group and family treatments and the family often have an important role to play in recovery.
The following resources may be helpful when a family member or friend is self-harming.
It is also important to remember to look after yourself when dealing with a loved one who is self-harming. This will ultimately be distressing for you too and make sure to speak to someone you trust or seek help when needed.
Mercado, M. C., Holland, K., Leemis, R. W., Stone, D. M., & Wang, J. (2017). Trends in Emergency Department Visits for Nonfatal Self-inflicted Injuries Among Youth Aged 10 to 24 Years in the United States, 2001-2015. Jama, 318(19), 1931-1933.
NHS Choices. (2015, June 04). Self-harm. Retrieved December 07, 2017, from https://www.nhs.uk/conditions/self-harm/
Attention Deficit Hyperactivity Disorder (ADHD) is one of the world’s most common childhood disorders, with an estimated prevalence of 5.29%. It is also a highly misunderstood neurodevelopmental condition.
Whilst many associate it with hyperactivity and overmedication, particularly in young boys, ADHD encompasses a wide range of symptoms. ADHD is also being increasingly diagnosed in adults and girls.
ADHD is diagnosed three times more frequently in boys than girls. Not long ago, however, this figure was closer to 10 to 1. Although the margins are narrowing, by adulthood the level of diagnoses across the sexes is roughly the same - so to what can we attribute the lower rates identified in childhood?
One potential explanation is that the symptoms observed in girls and boys can be quite different. Boys tend to exhibit the more “obvious” signs of ADHD such as hyperactivity and conduct disorder, whereas the difficulties experienced by girls tend to be attentional such as daydreaming in class.
For this reason, ADHD in girls may not be as obvious in an educational setting and therefore fall under the radar.
The hyperactive symptoms more commonly displayed by boys are more likely to be problematic in the home or classroom, and may therefore more quickly draw the attention of teachers, special needs officers etc.
Girls on the other hand, tend to experience the difficulties of ADHD in a more internal manner. It has also been argued that as girls are socialised by society to behave in a more reserved manner that they are better than boys at covering up symptoms.
There is also limited public knowledge in terms of the different ways ADHD may express itself among the sexes.
So in what ways may ADHD look different in girls than boys?
An interesting paper by Rucklidge (2010) explored gender differences in ADHD. In a review of previous studies, she found a number of differences in a variety of areas.
This is potentially the most widely recognised symptom of ADHD and is the main symptom that boys tend to exhibit more than their female counterparts. Children with ADHD may find it difficult to sit still and may also exhibit impulsivity for example non- stop talking, making inappropriate comments and being impatient.
Although many children may be high-energy, in order to meet the clinical criteria for these facet of ADHD the hyperactivity and impulsivity demonstrated must be impacting the child’s life and have been doing so for six months or more.
Inattentive ADHD is that which leads to trouble focusing and being easily distracted. Children with ADHD are daydreamers who get bored easily. Whilst this could easily be said of many children, in the case of those with inattentive ADHD this leads to trouble completing schoolwork and avoiding tasks requiring focus. Children with ADHD may also be highly disorganised with messy rooms.
Again, whilst many of these are common childhood traits, those with ADHD will suffer both at home and at school due to the severity of these symptoms.
Girls display attentional ADHD more so than boys.
Tactile Defensiveness (TD) refers to both behaviours and emotional responses which are out of proportion to tactile (relating to sense of touch) stimuli. Children with TD may be overwhelmed by sensory overload and in extreme cases may find everyday activities such as having hair brushed or eating cold food intolerable.
TD is commonly associated with ADHD and is exhibited more frequently by females.
Social and Psychological Functioning:
Studies have also found some marked differences in these areas between girls and boys. Boys have been found to be more aggressive, particularly with peers. Interestingly, it has been found that girls suffer from lower self-esteem and demonstrate poorer coping strategies than boys.
This could be due to the more internalised nature of female ADHD but could also be the result of later diagnosis.
Effects of late diagnosis
Early identification and intervention are obviously important in terms of determining future outcomes. Children who receive support at home and at school are much more likely to manage their condition into the future.
Unfortunately, at present ADHD tends to be diagnosed later in girls than in boys. Until recently, the American Psychiatric Association diagnosis manual specified 7 as the cut- off age for symptoms to be evident. Although this has recently been increased to 12, it is quite possible that the narrow age- range previously provided prevented some diagnoses from being made.
Some studies estimate that as many as 50- 75 percent of girls with ADHD are not diagnosed.
Studies have found that both men and women diagnosed as adults struggle in a wide array of domains and have lower self- esteem, poorer coping strategies and higher levels of depression. In addition adults identified with ADHD later in life tend to have negative attributions about themselves.
The lack of a diagnosis may lead individuals to having their difficulties attributed to laziness or lack of ability both by themselves and others.
As of yet however, no study has compared those diagnosed during adulthood with those diagnosed during childhood.
So what should you look out for in order to spot the signs of ADHD in girls?
The following signs may indicate that ADHD is going unnoticed:
If this sounds familiar it may be worth speaking to a GP or therapist in order to further investigate the basis of these problems. Given the lack of awareness regarding girls with ADHD, and the detrimental impact of later diagnosis, it is important not to let girls with ADHD continue to fall under the radar.
By Dr. Syras Derksen
Hamed, A. M., Kauer, A. J., & Stevens, H. E. (2015). Why the diagnosis of attention deficit hyperactivity disorder matters. Frontiers in psychiatry , 6 .
Rucklidge, J. J. (2010). Gender differences in attention-deficit/hyperactivity disorder. Psychiatric Clinics of North America , 33 (2), 357-373.
“I hated high school. I don’t trust anybody who looks back on the years from 14 to 18 with any enjoyment. If you liked being a teenager, there’s something wrong with you.” ― Stephen King
The teenage years are tumultuous to say the least. It can be easy to forget how miserable and self- doubting the teenage self can be, as a wave of drastic change and hormones sweeps over your developing mind and body. With this uncertainty comes a predictable amount of moodiness, fluctuations in confidence, and conflict with parents.
Sometimes however, these common teenage symptoms go beyond what is normal for this life stage. When depression manifests itself in teenagers it can often be attributed to hormones etc. when it is in fact a real and pervasive psychological problem. Conversely, some parents may mistake their teens natural growing-up stage for depression when it is completely harmless.
An Underestimated Problem
The important thing to note is that undetected depression in the early years can have lifelong consequences. The average age of depression onset in lifelong sufferers is 14 years old, so those that experience lifelong depressive episodes will most likely start as teens.
The Association for Young People’s Health report that the number of young people aged 15- 16 with depression has almost doubled between the 1980s and now. They also estimate that 1 in 10 young people suffer from a diagnosable mental health disorder. These are statistics that are replicable in most developed countries around the world.
Untreated depression in the early years can lead to eating disorders, academic difficulties, and substance abuse. There is no shame in seeking the help of mental health experts and, in fact, early positive experiences with these services can set your child up for a lifetime of positive mental health.
So how do you tell when your teenager is suffering from depression and needs a little help? Listed below are some common signs of teenage depression. Although many of these occur during the teenage years, the presence of most or all of them over the space of several weeks indicates your teen may have depression.
Please bear in mind that this list is not exhaustive, but merely a guide to identifying when your teen may have a problem. In order to be diagnosed the help of a trained mental health professional is required.
Signs to Look Out For
Mood: This is one of the hardest ones to disentangle, but if your child is consistently sad, cranky, and irritable then you may need to explore why this is so pervasive. This, combined with a belief that life is meaningless is a warning sign for depression.
Appetite: If your teen is eating a lot more or a lot less than usual and has experienced significant weight loss/ gain then this may be a depressive symptom. It is common for weight to fluctuate during adolescence but if this is combined with several of the other symptoms listed here then it may be a warning sign.
Loss of interest: Sometimes teens move away from things they used to enjoy as children. This is perfectly normal, but if your teen completely withdraws from things they truly love such as a particular sport, instrument or even friends then this is not to be ignored. A loss of interest in enjoyable pursuits is particularly worrying as the lack of activity and fun will only exacerbate any pre-existing depression.
Sleep: An excessive amount of sleep is not normal, nor are highly irregular sleeping patterns. Parents should look out for ongoing fatigue and/ or exhaustion.
Physical complaints: If your child regularly reports headaches, nausea and other without any seeming explanation or cause then this may be a sign of deeper issues.
School performance: A sudden worsening in school performance, frequent absences and seeming disinterest in school life may hint at depression.
Difficulty concentrating: Difficulty concentrating at home and at school should be taken note if. Your child may seem restless or agitated and be unable to relax.
Tearfulness: Teens who become easily tearful or cry frequently may be experiencing deeper unhappiness.
What to Do if You Think Your Child May Have Depression?
Again, this list should not be used to diagnose your child but should merely be used as a guide if you already have concerns. Most of these behaviours will be evident at some stage or another throughout the teenage years. If however, these behaviours are ongoing and pervasive then you should consider your options.
Parents of depressed teenagers should do their best to listen to their teenagers concerns. Try to schedule some time to really listen to how they are feeling. Do not judge or lecture as tempting as this can be. Statements such as “when I was a teen” or “you’ll grow out of it” are not helpful.
Structure and self- care are extremely important when it comes to alleviating depression. Encourage your child to get enough sleep and make sure they are getting the nutrients they need. Simple things like these can make a difference.
Whether as a teenager or an adult it is vital to talk through your depression. There are many mental health experts who are trained to work with depressed teens. Most schools have a counsellor or psychologist and there are a range of valuable community services.
Don’t feel as though “fixing” depression is your parenting duty. If you suspect that your teen is depressed, get in touch with these services and ensure that the correct support they need is obtained.
Sometimes the best example to set is that it is okay to ask for help!
By Dr. Syras Derksen
Machoian, L. (2006). The disappearing girl: Learning the language of teenage depression. Penguin.
Mental Health Foundation (2006). Truth hurts: report of the National Inquiry into self-harm among young people. London: Mental Health Foundation
Oster, G. D., & Montgomery, S. S. (1995). Helping your depressed teenager: A guide for parents and caregivers. John Wiley.
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.
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.
Parenting is arguably one of the toughest jobs in the world. Raising kids is no joke. It can be exhausting. It can test a parent’s patience, and it may not get easier as the kids grow up.
Different ages pose different challenges for parents. Some even think they won’t be able to survive their kids’ teen years. They may get some moments to give a sigh of relief and breathe a little easier when the kids are asleep or at school, but there is always something to do and things to think about.
The stress, anxiety and difficulties that come with having children is what mindful parenting wants to address. Like other methods of parenting, it also believes that whatever parents do — from disciplining to spending time with them— can somehow influence what these kids would grow up into.
Mindful Parenting Defined
As defined by Kabat-Zinn (2003), mindfulness is “the awareness that emerges through paying attention, on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment.” The very concepts and practices governing this belief are extended into the model of mindful parenting.
Children, whether they are still toddlers, tweens or full-blown teens, can set off a wide range of emotions in parents. When the stress becomes too much, the parents may often become aware of unresolved issues in the past or may burst into anger that their reactions to situations may become inappropriate. Additionally, they tend to be preoccupied with the past that has already happened and a future that hasn’t happened yet, adding more anxiety and stress on top of everything else that they do in the present.
In mindful parenting, parents are encouraged to step back from a tense situation, double check their emotion and take a deep breath before reacting. Theoretically, this will help them be calmer and more rational in dealing with difficult situations with their teenagers.
Mindful Parenting and Risky Behaviours Among Adolescents
A recent study (Turpyn, C. & Chaplin, T., 2016) investigated if mindful parenting can mitigate risk behaviors in adolescence. The authors wanted to know if parent emotional expression can have a “potential mechanism in the relationship between low mindful parenting and adolescent risk behaviors.
To find out, they asked 157 12–14-year-old adolescents, 49 of which were females, and their primary caregivers (99 % are women) to participate in an emotionally arousing conflict interaction. Negative, positive and shared parent-youth positive emotions were then coded. They also did an assessment regarding the use of prohibited drugs and other substances and sexual behaviors through self-report, interviews and physical toxicology screen tests.
Results revealed that mindful parenting can cause the parents to have less negative emotion and generate more positive emotion between them and their children in the given conflict-driven situations. Additionally, this method of parenting is shown to have an indirect effect on adolescents’ substance use. The researchers noted, though, that there is a lack of correlations between how parents express their emotions and adolescent sexual behaviors.
The Five Dimensions of Mindful Parenting
1. Active Listening and Full Attention
Awareness is one of the most important facets of mindfulness. In mindful parenting, active listening plays a vital role. Full attention should be given to the child while listening to what he or she has to say. Duncan, L., Coatsworth, J. & Greenberg, M. (2009) explained that combining “listening with a quality of focused attention and awareness... goes beyond simply hearing words that are said.”
This becomes the more important when children reach their adolescent period. Parents can no longer physically monitor them as they go on their daily lives. They can only gather information through their kids’ friends and other people they interact with most of the time. Arguably, the only way for parents to perceive the thoughts and feelings of their adult children is to bring full attention to how they act inside their homes and their answers to questions they throw at them. Moreover, when parents have time to “hang out” with their adolescents more often and be truly “present” on those moments, they may be able to promote self-disclosure (Smetana, JG., et. al., 2006).
2. Acceptance of the Child and Self Without Judgment
Parents are encouraged to see their child as a human being separate from themselves and that he or she is a unique individual with his or her own aspirations, desires, attributes and values. To recognize this, they should be mindful of their own expectations as to how their child should be and aware of how these expectations can affect their relationship with the child. This also means that they should accept the challenges and situations that come with becoming parents.
There will be inevitable moments of imperfections and committing mistakes that the child will witness. Parents should not shield their children of these realities. Instead, they should be conveyed in ways that are appropriate to their children’s development.
3. Emotional Awareness
Mindful parenting encourages parents to keep their emotions in check most of the time and to be fully aware of their teen kids’ emotions as well. Strong emotions can have a powerful influence on igniting undesirable behaviors, but when parents are able to channel more positive emotions even in stressful situations, they tend to become more able in making conscious choices and give more calm and rational responses.
4. Self Regulation
Self-regulation means taking a pause before responding to something a teenager has done. This way, parents can exercise better parenting practices. This is where “count to 10 before you react” belief comes to play.
5. Kindness and Compassion
Having a compassion for one’s adolescent children means fulfilling that desire of meeting their appropriate and realistic needs and comforting them when they’re distressed. Mindful parenting also emphasizes kindness and compassion for oneself as a parent by accepting the fact that you cannot always be perfect.
Kabat-Zinn, J. (2003). Mindfulness-Based Interventions in Context: Past, Present, and Future. Clinical Psychology: Science and Practice, 10: 144–156. doi:10.1093/clipsy/bpg016
Turpyn, C. & Chaplin, T. (2016). Mindful Parenting and Parents’ Emotion Expression: Effects on Adolescent Risk Behaviors. Mindfulness, 7 :246–254. DOI 10.1007/s12671-015-0440-5
Duncan, L. G., Coatsworth, J. D., & Greenberg, M. T. (2009). A Model of Mindful Parenting: Implications for Parent–Child Relationships and Prevention Research. Clinical Child and Family Psychology Review, 12(3): 255–270. http://doi.org/10.1007/s10567-009-0046-3
Smetana, J. G., Metzger, A., Gettman, D. C., & Campione-Barr, N., (2006). Disclosure and Secrecy in Adolescent-Parent Relationships. Child Development, 77: 201–217. doi:10.1111/j.1467-8624.2006.00865.x
As children move into adolescence, it starts to become real to parents that this once small and helpless baby is soon going to be an independent adult. Many parents may worry about the attitude and disrespect they see in their teen – will they be able to hold a job? Will they be responsible enough to pay their bills?
The questions that come to the minds of parents likely reflect their own values; have they been able to instill values in their teenager? Friends and peers play more of a role in the influence of an adolescent, and some parents may worry that the values with which their teen has grown up are completely lost.
For better or for worse, the values of parents do not always become the values of their children as they reach adolescence and adulthood. There are a number of factors that may influence how likely it is that a teenager will value the same things that their parents do.
Research by Knafo and Schwartz (2012) examined several aspects of the parent-teen relationship and how that impacted the similarity in values. They define values as overarching goals that “serve as guiding principles for behavior, for justifying actions and for evaluating people and events.” The study included 547 families of a teen aged 15-19. Parents were asked to complete a questionnaire about their own values, and also to rate how they would like their teen to respond. Teenagers completed the same questionnaire about their own values and also asked how they think their parents would like them to respond. In addition to the questionnaire about values, teens were also asked to examine their relationship with their parents.
Three Relationship Factors
Knafo and Schwartz were curious about three specific areas within the parent-teen relationship. First, how much the teen identified with their parent; that is, do they see their parent as a role model, do they aspire to be like their parent?
Second, they looked at how teens perceived their parents’ warmth and responsiveness; do they feel their parent is affectionate and sensitive toward them?
Finally, does the teenager view their parent’s words as consistent with their actions?
All Three Are Important
The results of the study found correlations between how much teens look up to their parents (seeing their parents as a role model) and how similar their values were to their parents’.
Importantly, both of these things also correlated with how warm and responsive teens judged their parents to be; that is, the adolescents who felt their parents were affectionate and involved in their lives were more likely to want to emulate their parents and accept their values.
And, not surprisingly, when teens felt that what parents said matched up with actions, they were more likely to accept their values.
It's About Your Relationship
While we want teens to be able to have their own opinions and to discover what they believe for themselves, we also hope that they will accept many of the principles that we have tried to teach them. This study tells us that our relationship with teens is essential in how they accept those principles and values.
Being warm and responsive might involve things like telling your teen that you love them, involving them in making decisions, and providing opportunities for them to talk and be listened to. As well, teens are very perceptive of hypocrisy, so if we expect them to abide by certain rules and values, we have to be able to show them that we also live by those rules.
By Kristi MacDonald
Knafo, A., & Schwartz, S. (2012). Relational identification with parents, parenting, and parent–child value similarity among adolescents. Family Science, 3(1), 13-21. doi:10.1080/19424620.2011.707794