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Most Treated Disorders in Children and Adolescents

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Adjustment Disorder

Adjustment Disorder is defined as an emotional behavioral reaction to an identifiable stressful event or change in a person’s life. The event or change is considered to be maladaptive or somehow not an expected healthy response to the event or change. Symptoms generally lessen as the stress diminishes or as the person adapts to the stress. Approximately 5 percent to 20 percent of the individuals in outpatient mental health treatment have a principal diagnosis of adjustment disorder.

Effective treatments for adjustment disorders include psychotherapy, family therapy, and possible medication if symptoms are severe.

Anxiety Disorders

Anxiety disorders cause individuals to feel excessively frightened, distressed and uneasy during situations in which most others would not experience these symptoms. Left untreated, these disorders can dramatically reduce productivity and significantly diminish an individual’s quality of life. Anxiety disorders in children can lead to poor school attendance, low self-esteem, deficient interpersonal skills, alcohol abuse, and adjustment difficulty.
Anxiety disorders are the most common mental illnesses in America. They affect as many as one in 10 young people. Often these disorders are difficult to recognize. And, many individuals that suffer from them are either too ashamed to seek help, or they fail to realize that these disorders can be treated effectively.

The most common anxiety disorders include:

Panic Disorder

Characterized by panic attacks. This disorder results in sudden feelings of terror that strike repeatedly and without warning. Physical symptoms include chest pain, heart palpations, shortness of breath, dizziness, abdominal discomfort, feelings of unreality, and fear of dying. Children and adolescents with this disorder may experience unrealistic worry, self-consciousness, and tension.

Obsessive-Compulsive Disorder (OCD)

Characterized by repeated, intrusive and unwanted thoughts or obsessions and/or rituals that seem impossible to control. Adolescents may be aware that their symptoms don’t make sense and are excessive, but younger children may be distressed only when they are prevented from carrying out their compulsive habits. Compulsive behaviors often include counting, arranging and rearranging objects, and excessive hand washing.

Posttraumatic Stress Disorder (PTSD)

Persistent symptoms of this disorder occur after experiencing a trauma such as abuse, natural disasters orextreme violence. Symptoms include nightmares; flashbacks; the numbing of emotions; depression; feeling angry, irritable and distracted; and being easily startled.


Consist of a disabling and irrational fear of something that actually poses little or no danger. The fear leads to avoidance of objects or situations and can cause extreme feelings of terror, dread and panic, which can substantially restrict one’s life. “Specific” phobias center on particular objects (e.g. animals) or situations (e.g. heights or enclosed places). Common symptoms for children and adolescents with “social” phobias are hypersensitive to criticism, difficulty being assertive and low self-esteem.

Generalized Anxiety Disorder

Chronic, exaggerated worry about everyday, routine life events and activities that lasts at least six months

Children and adolescents with this disorder usually anticipate the worse and often complain of fatigue, tension, headaches, and nausea.

Separation Anxiety Disorder

Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached

This disorder is evidenced by three or more of the following:

  • Recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated
  • Persistent and excessive worry about losing or about possible harm to major attachment figures
  • Persistent and excessive worry that an untoward event will lead to separation from major attachment figure (e.g. getting lost or kidnapped)
  • Persistently and excessively fearful or reluctant to be alone or without major attachment figures at home or without significant adults in other settings
  • Persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home
  • Repeated nightmares involving the theme of separation
  • Repeated complaints of physical symptoms such as headaches, stomach aches, nausea, or vomiting when separation from major attachment figures occurs or is anticipated
  • The duration of the disturbance is at least four weeks
  • The onset is before the age of 18 years
  • The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning
  • The disturbance does not occur excessively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder with Agoraphobia

Although studies suggest that children and adolescents are more likely to have an anxiety disorder if their caregivers have anxiety disorders, it has not been shown whether biology or environment plays the greater role in the development of these disorders. High levels of anxiety or excessive shyness in children aged six to eight years may be indicators or a developing anxiety disorder.
Scientists at the National Institute of Mental Health (NIMH) and elsewhere have recently found that some cases of OCD occur following infection or exposure to streptococcus bacteria. More research is being done to pinpoint who is at greatest risk, but this is another reason to treat strep throats seriously and promptly.

Effective treatments for anxiety disorders include medication, specific forms of psychotherapy also known as behavioral therapy or cognitive-behavioral therapy, family therapy, or a combination of these. Cognitive-behavioral treatment involves the young person’s learning to deal with his or her fears by modifying the way he or she thinks and behaves by practicing new behaviors.

Ultimately, parents and caregivers should learn to be understanding and patient when dealing with children with anxiety disorders. Specific plans of care can often be developed and the child or adolescent should be involved in the decision-making process whenever possible.

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is one of the most common behavioral disorders among children. Between 3 percent and 5 percent of all children may suffer from this condition. It is characterized by a persistent pattern of inattention and/or hyper activity and/or impulsivity that occurs in academic, occupational or social settings. It is best defined as a condition where an individual’s attention span is dramatically less than what is expected for an individual of that age.

Although ADHD is usually diagnosed in childhood, it is not a disorder limited to children and it often persists into adolescence and adulthood. Frequently, it is not diagnosed until later years.

According to the NIMH, ADHD is characterized by three major categories.

  • Inattention People who are inattentive have a hard time keeping their minds on any one thing and may get bored with a task after only a few minutes. They may give effortless, automatic attention to activities and things they enjoy, but focusing deliberately on organizing and completing a task or learning something new is difficult.
  • Hyperactivity— People who are hyperactive, always seem to be moving. Hyperactive teens and adults may feel restless throughout the day whenever long periods of attention are required or they move from one activity to another all at once.
  • Impulsivity— People that are overly impulsive, seem unable to reduce their immediate reactions to a circumstance or be able to think completely through before acting on a situation.

What causes ADHD? ADHD is not caused by dysfunctional parenting, and those with ADHD do not merely lack intelligence or discipline. There are several potential causes but none proven. Since parental support seems to lesson the affects of ADHD, parental involvement is encouraged. Style of parenting does not seem to have an impact on the condition itself.

Strong scientific evidence supports the conclusion that ADHD us a biologically based disorder. Biological studies suggest that children with ADHD may have lower levels of the neurotransmitter dopamine in critical regions of the brain, which may account for many of the signs and symptoms of ADHD. Brain imaging studies have shown that brain metabolism is lower in individuals with ADHD than in normal controls. More important, these studies show significantly lower metabolic activity in the regions of the brain that control attention, social judgment and movement. There is strong evidence that ADHD has a genetic basis in some cases. Scientific studies have not verified dietary factors as a main cause of ADHD. Environmental factors might have an influence on the development of ADHD. These include cigarette, alcohol or drug use during pregnancy. Each of these substances may damage the baby’s developing brain and may be responsible for some conditions related to ADHD. The most proven treatments are medication and behavioral therapy.

Medication Stimulants are the most widely used drugs for treating attention-deficient/hyperactivity disorder. Medications such as s Ritalin, Cylert, and Dexedrine have been successful in treating the symptoms associated with ADHD. However, there is a great deal of debate about the long-term effect of the medication. Every person reacts to the treatment differently, so it is important to work closely and communicate openly with the physician. Some common side effects of stimulant medications include weight loss, decreased appetite, trouble sleeping, and in children, a temporary slowness of growth. However, these reactions can often be controlled with dosage adjustments. Medication has proven effective in the short-term treatment of more than 76 percent of individuals, but specialists must monitored in this area (e.g. a child psychiatrist).

Treatment strategies such as rewarding positive behavior changes and communicating clear expectations of those with ADHD have also proven effective. Additionally, it is extremely important for family members and teachers or employers to remain patient and understanding.

Children with ADHD can also benefit from caregivers paying close attention to their progress, adapting classroom environments to accommodate their needs and using positive reinforcement. Formal educational testing and an evaluation for speech and language disorders should be preformed. Where appropriate, parents should work with the school for special classroom accommodations for the child.

Approximately 25 percent of children with ADHD (mostly younger children and boys) also experience anxiety and depression. At least 25 percent of children with ADHD suffer from some type of communication or learning disability. There is also a correlation with Tourette’s syndrome. Research is also beginning to show that ADHD-like symptoms are sometimes actually manifestations of childhood-onset bipolar disorder.

Eating Disorders

Eating disorders are characterized by severe disturbances in eating behavior. Anorexia Nervosa is characterized by a refusal to maintain a minimally normal body weight. Bulimia Nervosa is characterized by repeated episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics, and other medications; fasting; or excessive exercise. In both disorders, individuals may have a disturbance in the perception of body shape, image or weight.

Oppositional Defiant Disorder

Oppositional Defiant Disorder (ODD) is a behavior disorder, usually diagnosed in childhood, which is characterized by uncooperative, defiant, negativistic, irritable, and annoying behaviors towards parents, peers, teachers, and other authority figures. Children and adolescents with ODD are more distressing or irritable to others than they are distressed or troubled themselves. Almost 50 percent of all children with Attention-Deficit/Hyperactivity Disorder (especially boys) tend also to have ODD, characterized by negative, hostile, and defiant behaviors. ODD is reported to affect 2 percent to 16 percent of children and adolescents in the general population and is more common in boys than girls.

Clinically Significant Symptoms of ODD include at least four of the following:

  • Often loses temper
  • Often argues with adults
  • Often actively defies or refuses to comply with adults’ requests
  • Often deliberately annoys people
  • Often blames others for his/her mistakes or misbehavior
  • Is often touchy or easily annoyed by others
  • Is often angry or resentful
  • Is often spiteful or vindictive

The disturbances must cause significant impairment in social, academic or occupational functioning. Age of onset typically occurs before the age of 8 and not usually later than adolescence. The pattern of behavior must last for at least six months and not be associated in stages in which oppositional behavior does occur (Peak time is between 18 and 24 months of age or the “terrible twos”).
Treatment for ODD includes individual therapy with the child and counseling or training with the parents in child management skills.


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