RE: severity of abuse -Reply

["Lisa Amaya-Jackson" <laj@xxxxxxxxxxxxxx>]

I really think this will be where the money's at-or will be  "at "  in the future.  Siegel's work-largely influenced by Allan Shore and attachment research   poignantly pulls together conceptually the biology of interpersonal experiences.  It is still somewhat armchair psychiatry-though he cites numerous lab studies and clinical experiences that support his framework for how disrupted attachments and traumas can affect neurophysiological  development.-lisa a-j 

Lisa Amaya-Jackson, MD, MPH
Asst. Professor in Psychiatry & Behavioral Sciences, Duke Univ. Medical Center
Director, Trauma Evaluation, Research, & Treatment Program
Center for Child & Family Health, NC
(Collaboration of University of N.C., Duke University, & N.C. Central University)
3518 Westgate Dr., Suite 100, Durham, NC 27707
919-419-3474x405  FAX: 919-419-9353   Email: LAJ@xxxxxxxx



-----Original Message-----
From:	Scott Cangelosi [SMTP:Cangelosi@xxxxxxxxxxxxxxxxxx]
Sent:	Thursday, May 25, 2000 9:07 AM
To:	Child Maltreatment Researchers
Subject:	Re: severity of abuse -Reply

Your latest input to the discussion of ADHD etiology is intriguing!
I am wondering if the research accounts for the premise that early childhood attachment experiences can influence the actual development of the brain?  Siegel writes, "'Developmental overpruning' refers to the toxic effect of overwhelming stress on the young brain:  The release of stress hormones leads to excessive death of neurons in the crucial pathways involving the neocortex and limbic system-the areas responsible for emotional regulation...The fact is that neither genetics nor environmental theories have led to a fundamental understanding of the etiologies of the vast majority of psychiatric disorders.  If we have learned anything from recent studies, it is that a delicate interplay exists between nature and nurture."
I have taken this to mean that the mere presence of differences in the brain functioning of control subjects as opposed to ADHD subjects does not rule out that environmental factors may cause (or at least interact with biological vulnerabilities to cause) psychiatric disorders.

>>> jcrowley@xxxxxxxx 05/24/00 12:25pm >>>
D
> What an interesting question;  Are children that are abused more likely to
> have  a diagnosis of ADHD or are they more likely to be abused because
> they have ADHD?
> 

Yes to both.  

I've been researching the links between ADHD and delinquent 
behavior with a colleague.  So far, it's just a literature review, but we 
have a few observations relevant to this discussion.

Most of the people doing research on ADHD per se have concluded 
that its origins are biological, involving at least two brain structures, 
the basal ganglia and the frontal lobes.  These structures affect what 
are called the executive functions of the brain--those skills 
associated with planning and carrying out a complex course of 
actions.  For most children, ADHD seems to be organic rather than 
a reaction to parenting.  This finding is both frustrating and relieving 
for parents of ADHD children.

Terrie Moffitt in some of her early longitudinal work noted that the 
children who continued committing delinquent acts after most of 
their age-mates had stopped were characterized by a combination 
of ADHD and poor parenting.  The parenting practices are those 
associated with oppositional defiant disorder and with conduct 
disorder--e.g., parenting that alternates between being uninvolved 
and being harsh and demanding.  Children who show the types of 
hyperactivity and inattentiveness associated with ADHD seem to be 
at risk of this type of parenting.  It may be that some parents who 
would be adequate for an easy going child may be unable to meet 
the demands of children with special needs--ADHD, developmental 
delays, etc.

Finally, Bruce Perry's work on the neurological impacts of abuse 
shows differences in brain organization which could produce 
behaviors that are associated with ADHD, among them 
hypervigilance and attention to threat cues which distract children 
from attending to other aspects of the classroom.  

So--the sum of these observations suggests that:
 1.  Trauma can produce behaviors that look like ADHD.
 2.  ADHD children are at risk of being abused by their parents.
 3.  The combination of ADHD and abuse is a formula for social 
disaster.  If an ADHD child has been in a home that is inadequate, 
the foster parents will have a greater challenge than if they were 
dealing with either just ADHD or just abuse.  The effects seem to be 
interactive, not merely additive.

BTW--My co-author and I have wondered if there would be a 
publishing outlet for this work.  Any suggestions?

Jody Crowley



Joan (Jody) Crowley
Assistant Professor
Department of Criminal Justice
New Mexico State University
Box 30001, Dept 3487
Las Cruces, NM 88003-0001
505-646-5376

                                 

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