Magazine article Science News

Hyperactivity: The Family Factor: Researchers Are Looking at the Controversial Diagnosis and Treatment of Childhood Hyperactivity through a Familial Lens

Magazine article Science News

Hyperactivity: The Family Factor: Researchers Are Looking at the Controversial Diagnosis and Treatment of Childhood Hyperactivity through a Familial Lens

Article excerpt

Hyperactivity: The Family Factor

Methylphenidate hydrochloride, a stimulant drug better known as Ritalin, is back on the hot seat. Although physicians have used it since the 1950s to treat children and adults with attention-deficit hyperactivity disorder (ADD), often referred to simply as hyperactivity, there have been recurring concerns that the drug is prescribed too freely for all sorts of behavior problems.

Last November, for example, a Georgia mother filed suit against a public school district, charging that school-instigated methylphenidate treatment had made her son violent and suicidal. Her suit also contends the definition of attention-defict hyperactivity disorder drawn up by the American psychiatric Association is overly broad and invites misuse of the drug.

Psychiatrists generally agree that methylphenidate often has a role, along with psychological and behavior modification approaches, in the treatment of ADD. But uncertainties over who benefits most from which treatment will persist, says psychiatrist Peter S. Jensen of Eisenhower Army Medical Center in Fort Gordon, Ga., until investigators address a much-neglected influence on the child with ADD: his or her family.

Research at an ADD clinic for children of military personnel indicates that the disorder often reflects a younster's depression or anxiety, Jensen reported at the American Psychiatric Association's recent annual meeting in Montreal. He and his colleagues also find ADD is associated with an increased number of stressful events affecting a childhs family and the presence of psychiatric symptoms in parents.

"These children's attention problems are merely one of a number of significant problems affecting them and their parents," he says.

Jensen's preliminary findings point to several important family factors involved in attention-deficit hyperactivity, notes psychiatrist Mina K. Dulcan of Emory University in Atlanta, but they also emphasize the need for more rigorous comparisons of the home life of children with and without ADD.

Jensen and his co-workers compared 68 military offspring with ADD to 200 children without psychiatric diagnoses seen by military physicians. The average age of the youngsters was 9-1/2 years.

ADD children reported significantly more symptoms of depression and anxiety than the comparison group. Parent reports confirmed that more than half of the hyperactive subjects suffered from a mental disorder involving depression, anxiety or both.

In addition, says Jensen, parents of ADD children reported elevated levels of depression and anxiety as well as experiencing more stressful events, such as marital difficulties, divorce and hospitalization, in the previous year.

Drawing conclusions about the causes and effects of childhood ADD from results such as these is a tricky businesS, Jensen acknowledges. Children's symptoms may result from their parents' difficulties, or the parents' symptoms may be due to the stress and frustration of dealing with a hyperactive child. Another possibility is that a common genetic factor contributes to both adult and child psychiatric problems.

But the overriding theme of the findings, in Jensen's view, is that ADD is often only one of a number of psychiatric problems affecting many ADD children and their parents. …

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