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Child-Maltreatment-Research-L (CMRL) List Serve

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Welcome to the database of past Child-Maltreatment-Research-L (CMRL) list serve messages (10,000+). The table below contains all past CMRL messages (text only, no attachments) from Nov. 20, 1996 - September 14, 2018 and is updated quarterly.

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Message ID: 8799
Date: 2011-01-30

Author:Rosemary Caolo

Subject:RE: Misdiagnosis of ADHD in Abused Children

Hello all- Having worked in the field of child welfare and in community mental health and private practice with victims of physical/sexual abuse I could not agree more. My dissertation was a case study of a client and the ramifications of ongoing CSA. I am currently teaching theory and practice to graduate social work students (many who currently work in child welfare and foster care) and would be interested in the name of the Handbook of PTSD you reference. I have multiple texts on trauma and PTSD but am always looking for worthwhile material. Thanks so much for your help- Rosemary Caolo, PhD, LCSW -----Original Message----- From: bounce-7824398-11755120@list.cornell.edu [mailto:bounce-7824398-11755120@list.cornell.edu] On Behalf Of cecox Sent: Saturday, January 29, 2011 7:21 PM To: Child Maltreatment Researchers Subject: Re: Misdiagnosis of ADHD in Abused Children Maybe in theory. For most practitioners a diagnosis of PTSD or more accurately, Traumatic Sress Syndrome (ongoing, chronic exposure), would not occur to them. They see the most obvious symptoms and go straight to ADHD because it is such a popular diagnosis and they are so highly influenced by the pharmaceutical industry. If you ask them if it could be PTSD instead, they would probably argue against it because they are also influenced by the traditional diagnostic criteria for PTSD being EVENT-based and including "threatened death or serious injury, or a threat to physical integrity". Living in a home with adults behaving in a threatening or disturbing and unpredictable manner on a daily basis can produce the same symptoms but is commonly not considered. Also there is a prejudice that the symptoms would present as primarily psychological, e.g., depression and anxiety, not so much cognitive, physiological and behavioral symptoms. The glucocorticoids released in distressing situations exert effects on neurotransmitter/neuroendicrine functioning (the hypothalamus-pituitary axis, amygdala, hippocampus), impair the functioning of the prefrontal cortex, affect behavior, learning and memory. Stimulants can seem to help with symptoms of depression and inability to concentrate in PTSD, however the prescribing of them is misguided because they are hard on the adrenal glands which can have long term affects on the ability of the adrenal glands to produce normal levels of cortisol and also chemically alter brain and endocrine function in a way that can lead to permanent problems. Especially in childhood when the brain is still developing. There needs to be greater awareness of the possibility of PTSD in children, even in apparently "normal" families, and also education about natural ways to address the symptoms rather than using drugs. All conscientious pediatricians and people working with children and victims of family violence should take it upon themselves to read the Handbook of PTSD and related literature to familiarize themselves with underlying physiological processes involved in PTSD. Then they will be more likely to recognize it and treat it effectively. Those are very good questions that you raise Carrie. Unfortunately you will probably not find much in the way of research and get a lot of these "uh- let's not go there" type of responses. Christine Cox On Wed, 5 Jan 2011 19:07:52 -0500, "Dr. Bruce Borkosky, Psy.D PA" wrote: > Any diagnosis of ADHD must have ruled out all other possible causes of the > behaviors. > Bruce Borkosky > > On Mon, Jan 3, 2011 at 1:02 PM, Carrie Ellis > wrote: > >> I am looking for studies on the misdiagnosis of ADHD in abused children. >> Particularly, the diagnosis of ADHD when the true diagnosis should be >> PTSD. >> Also, the consequences of prescribing stimulants to children who have >> been >> misdiagnosed. >> >> Any ideas are greatly appreciated! >> >> Carrie Ellis >> Policy Research Intern >> TexProtects >> >> No virus found in this incoming message. Checked by AVG - www.avg.com Version: 9.0.872 / Virus Database: 271.1.1/3412 - Release Date: 01/30/11 02:34:00

Hello all- Having worked in the field of child welfare and in community mental health and private practice with victims of physical/sexual abuse I could not agree more. My dissertation was a case study of a client and the ramifications of ongoing CSA. I am currently teaching theory and practice to graduate social work students (many who currently work in child welfare and foster care) and would be interested in the name of the Handbook of PTSD you reference. I have multiple texts on trauma and PTSD but am always looking for worthwhile material. Thanks so much for your help- Rosemary Caolo, PhD, LCSW -----Original Message----- From: bounce-7824398-11755120list.cornell.edu [mailto:bounce-7824398-11755120list.cornell.edu] On Behalf Of cecox Sent: Saturday, January 29, 2011 7:21 PM To: Child Maltreatment Researchers Subject: Re: Misdiagnosis of ADHD in Abused Children Maybe in theory. For most practitioners a diagnosis of PTSD or more accurately, Traumatic Sress Syndrome (ongoing, chronic exposure), would not occur to them. They see the most obvious symptoms and go straight to ADHD because it is such a popular diagnosis and they are so highly influenced by the pharmaceutical industry. If you ask them if it could be PTSD instead, they would probably argue against it because they are also influenced by the traditional diagnostic criteria for PTSD being EVENT-based and including "threatened death or serious injury, or a threat to physical integrity". Living in a home with adults behaving in a threatening or disturbing and unpredictable manner on a daily basis can produce the same symptoms but is commonly not considered. Also there is a prejudice that the symptoms would present as primarily psychological, e.g., depression and anxiety, not so much cognitive, physiological and behavioral symptoms. The glucocorticoids released in distressing situations exert effects on neurotransmitter/neuroendicrine functioning (the hypothalamus-pituitary axis, amygdala, hippocampus), impair the functioning of the prefrontal cortex, affect behavior, learning and memory. Stimulants can seem to help with symptoms of depression and inability to concentrate in PTSD, however the prescribing of them is misguided because they are hard on the adrenal glands which can have long term affects on the ability of the adrenal glands to produce normal levels of cortisol and also chemically alter brain and endocrine function in a way that can lead to permanent problems. Especially in childhood when the brain is still developing. There needs to be greater awareness of the possibility of PTSD in children, even in apparently "normal" families, and also education about natural ways to address the symptoms rather than using drugs. All conscientious pediatricians and people working with children and victims of family violence should take it upon themselves to read the Handbook of PTSD and related literature to familiarize themselves with underlying physiological processes involved in PTSD. Then they will be more likely to recognize it and treat it effectively. Those are very good questions that you raise Carrie. Unfortunately you will probably not find much in the way of research and get a lot of these "uh- let's not go there" type of responses. Christine Cox On Wed, 5 Jan 2011 19:07:52 -0500, "Dr. Bruce Borkosky, Psy.D PA" wrote: > Any diagnosis of ADHD must have ruled out all other possible causes of the > behaviors. > Bruce Borkosky > > On Mon, Jan 3, 2011 at 1:02 PM, Carrie Ellis > wrote: > >> I am looking for studies on the misdiagnosis of ADHD in abused children. >> Particularly, the diagnosis of ADHD when the true diagnosis should be >> PTSD. >> Also, the consequences of prescribing stimulants to children who have >> been >> misdiagnosed. >> >> Any ideas are greatly appreciated! >> >> Carrie Ellis >> Policy Research Intern >> TexProtects >> >> No virus found in this incoming message. Checked by AVG - www.avg.com Version: 9.0.872 / Virus Database: 271.1.1/3412 - Release Date: 01/30/11 02:34:00