Saturday, January 10, 2015

Childhood ‘Disorder‘ Inspires Questions

Published by the American Psychiatric Associat...
Published by the American Psychiatric Association, the DSM-IV-TR provides a common language and standard criteria for the classification of mental disorders. (Photo credit: Wikipedia)
BY ALAN SCHWARZ


With millions of children having received a diagnosis of attention deficit hyperactivity disorders, there is concern that the condition is over-treated with prescription medications.

Yet now some figures in mental health are claiming to have identified a new disorder that could vastly expand the ranks of young people treated for attention problems. Called sluggish cognitive tempo, the condition is said to be characterized by lethargy, daydreaming and slow mental processing.

Experts pushing for more research into sluggish cognitive tempo say it is gaining momentum toward recognition as a legitimate disorder – and, as such, a candidate for pharmacological treatment.

The Journal of Abnormal Child Psychology devoted 136 pages of its January issue to papers describing the illness, with the lead paper claiming the question of its existence “seems to be laid to rest as of this issue.” The psychologist Russell Barkley of the Medical University of South Carolina has claimed in research papers and lectures that sluggish cognitive tempo “has become new attention disorder.”

Keith Mc Burnett, a professor of psychiatry at the University of California, San Francisco, said: “When you start talking about things like daydreaming, mind-wandering, those types of behaviors, someone who has a son or daughter who does this excessively says, ‘I know about this from my own experience.’ They know what you’re talking about.”

Yet some experts, including Dr. McBurnett, say there is no consensus on the new disorder’s symptoms, let alone scientific validity. They warn that the concept’s promotion without vastly more scientific rigor could expose children to unwarranted diagnoses and prescription medications.

“We’re seeing a fad in evolution: Just as A.D.H.D. has been the diagnosis du jour for 15 years or so, this is the beginning of another,” said Dr. Allen Frances of Duke University in North Carolina. “This is a public health experiment on millions of kids.”

Though the concept of sluggish cognitive tempo, or S.C.T., has been researched since the 1980s, it has not been recognized in the Diagnostic and Statistical Manual of Mental Disorders, used by the American Psychiatric Association.

Steve S. Lee, an associate professor of Psychology at the University of California, Los Angeles, said he was conflicted over the psychology journal’s emphasis on sluggish cognitive tempo. He expressed concern that A.D.H.D. had already grown to encompass too many children with common youthful behavior, or whose problems are derived from inadequate sleep, a different learning disability or other sources.

About two-thirds of children with an A.D.H.D. diagnosis take medication that quells impulsiveness and inattention but carries risks for insomnia, appetite suppression and, for teenagers and adults, abuse.

“The scientist part of me says we need to pursue knowledge, but we know that people will start saying their kids have it, and doctors will start diagnosing it and prescribing for it long before we know whether it’s real,” Dr. Lee said. “A.D.H.D. has become a public health, societal question, and it’s a fair question to ask of S.C.T. We better pump the brakes more diligently.”


Taken from TODAY Saturday Edition, April 26, 2014

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