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Message ID: 8835
Date: 2011-03-28

Author:cecox

Subject:RE: Misdiagnosis of ADHD in Abused Children

Rosemary- I believe I was referring to Handbook of PTSD: Science and Practice Matthew J. Friedman MD PhD (Editor), Terence M. Keane PhD (Editor), Patricia A. Resick PhD (Editor) http://www.amazon.com/Handbook-PTSD-Matthew-Friedman-PhD/dp/1593854730 Christine On Sun, 30 Jan 2011 11:11:40 -0500, "Rosemary Caolo" wrote: > 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

Rosemary- I believe I was referring to Handbook of PTSD: Science and Practice Matthew J. Friedman MD PhD (Editor), Terence M. Keane PhD (Editor), Patricia A. Resick PhD (Editor) http://www.amazon.com/Handbook-PTSD-Matthew-Friedman-PhD/dp/1593854730 Christine On Sun, 30 Jan 2011 11:11:40 -0500, "Rosemary Caolo" wrote: > 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