HLTHAGE 2G03 Lecture Notes - Lecture 8: Refrigerator Mothers, Mental Health, Truancy

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2G03 July 18, 2016
Lecture 8: Mental Health Across the Lifespan
Introduction
- To some extent, our norms of behaviour are primarily based around behaviour
that is deemed as expected for middle-aged adults
- There are some specific differences when it comes to criteria for childhood (less
so for old age), but it’s tricky… these are periods of immense change
- Both children and older adults are described as facing unique challenges related to
mental health
- Some unique features about child and older adult mental health, e.g. emphasis on
3rd party reporting
Emergence of Childhood Mental Health
- Notions of childhood have not been stable
- Emergence of the Psyences helped transform “bad kids” into “problem children”
- Growth in psychoanalysis prompted increased interest in children and
relationships to family
- 1950s cult of the “ideal family” – emergence of “broken home” as threat to
wellbeing of children, family and society
oRefrigerator mothers, divorcees, widowers all cited as likely incubators of
poor mental health
oSchizophrenia and autism specifically blamed on refrigerator mothers
(cold, non-maternal mothers)
Emergence II
- Mental hygiene move prompted preventative care – school became surveillance
site
o1950s and 1960s: move to identify “pre-delinquent” children – those that
had minor behavioural issues that might be amplified later
oIncreasing usage of positions (counselors, occupational therapists) whose
sole job is to identify deviant children “in need of intervention”
oDistinction between ‘healthy’ and ‘unhealthy’ children hardened…
moving from a spectrum to a binary of normal/abnormal
Case Study: Conduct Disorder
- Since DSM-II (1968), linked to inconsistent parenting, parental mental health
problems, poverty, low educational achievement…
- Found in 2-16% of the US pediatric population
- “Repetitive and persistent pattern of dissocial, aggressive, or defiant conduct
- Signs: excessive levels of fighting, bullying, cruelty to people or animals,
destructiveness to property, fire setting, stealing, lying, being truant, running
away from home, temper tantrums, playing pranks, being sexually active at a
young age, disobedience
Explosion of Childhood Mental Disorder
- Since mid 1990s:
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oRates of ADHD have tripled
oRates of childhood depression 10x up
oAutism diagnoses up by 2000%
oChildhood B.D. rates increased by 4000%
- Childhood mental health redefined as absolutely critical period for intervention,
why?
oBiological explanations: neural plasticity, connections being forged within
brain
oPsychological explanations: learned behaviours, patterns, self-concept
formed
oSocial explanations: learn relationship with others, connected to
community
Explaining the Rise – Criteria
- Expanding criteria:
oADHD how includes daydreamers who do not display hyperactivity age
threshold increased to 12 years
oAutism originally emphasized communication issues, social struggles, and
intellectual deficits
Many children who wouldn’t have met original criteria for
diagnosis now do
oODD, antisocial and disruptive behaviours, resisting authority
Since introduced in DSM-III, criteria has loosened so greater
number of behaviours understood as symptoms
- Childification: new “childhood” symptoms created for disorders previously
associated only with adults
oB.D.: in adults, psychiatrists look for cycling in terms of moods that last
weeks or months… in children, expected that moods might change
multiple times in a single day
- Creation of new illness categories (DMDD)
Explaining the Rise – Family and Parenting Change
- Parents have gotten busier – behaviours that are irritating, disruptive, or demand
attention more likely to be understood as problematic
- Less blended families, fewer “parents” around. Increasing reliance on
professionals for child rearing advice
- Shifts in parenting styles  from authoritarian to emphasis on promotion of
individual rights of children
oGrowth of “me” culture
oPositive mental health qualities prevented from developing (autonomy,
independence, resilience)
oParenting out “the good reasons for feeling bad”
Explaining the Rise – Third Party Reporters
- Symptom reporting does not necessarily come from the child, but other people
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