Maternal Depression, Violence at Home May Raise Child's ADHD Risk

By Denise Mann

HealthDay Reporter

THURSDAY, Feb. 7 (HealthDay News) -- Preschoolers whose parents report depression and intimate partner violence may be more likely to develop attention-deficit/hyperactivity disorder (ADHD) by the age of 6, new research suggests.

And young children with depressed moms may be more likely to receive prescription drugs to treat behavioral and mental health issues down the road.

"Our study indicates that preschoolers who are diagnosed with ADHD are more likely to have been exposed to both intimate partner violence and parental depression within the first three years of life than their peers not exposed to either risk factor," said study author Dr. Nerissa Bauer, an assistant professor of pediatrics at Indiana University School of Medicine, in Indianapolis.

"There has been increasing awareness that certain psychosocial risk factors can impact the behavioral presentation of children at very young ages," she said. Still, not all children who are exposed to maternal depression and intimate partner violence will develop ADHD, she noted.

"There are other factors that can be associated with a child's higher likelihood of being diagnosed with ADHD, including a family history of ADHD," Bauer explained.

ADHD symptoms can include impulsiveness, hyperactivity and difficulty focusing. Kids with ADHD may have difficulty in school, holding down jobs and sustaining relationships. They are also at greater risk for alcohol or substance abuse, depression and anxiety disorders. Treatment typically involves medication and behavioral modifications.

"Pediatricians and family practitioners know to routinely screen for the presence of these psychosocial risk factors because of the potential negative effects on the child," Bauer said. "Families who experience intimate partner violence will need help, not only to make sure the victims stay safe from physical harm, but there [are] also psychological effects."

The study, which appeared online Feb. 4 in the journal JAMA Pediatrics, included more than 2,400 children who were 3 years old. Parents who brought them to four different pediatric community clinics filled out questionnaires regarding their personal history of depression and domestic violence while in the pediatricians' waiting room.

Fifty-eight caregivers reported a history of intimate partner violence and depression before their child turned 3. In addition, 69 reported a history of intimate partner violence and 704 had symptoms of depression during this time frame. Close to 66 percent of the parents reported neither depression nor intimate partner violence. Children who were exposed to intimate partner violence and/or parental depression were four times more likely to be diagnosed with ADHD by the age of 6.

What's more, 2.9 percent of kids whose parents reported depression received prescription drugs to treat behavioral and mental health issues, compared with 1.6 percent of children whose parents did not report a history of depression. Medications included those that treat anxiety, depression and sleep problems.

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Asperger's and Violence: Experts Weigh In

Dec. 19, 2012 -- Reports that Newtown shooter Adam Lanza had Asperger’s syndrome, a highly functioning form of autism, have led some to wonder whether that diagnosis could have played a role in the mass shooting, which killed 20 children and six adults at a Connecticut elementary school last week.

As with many cases such as this, the answer is complex. While experts are clear that Asperger's doesn’t make a person more likely to commit a violent crime, some say it may affect the way a crime is carried out.

Advocates for people with autism are more direct.

“Autism did not cause this crime,” says Peter Bell, MBA, executive vice president for programs and services at the nonprofit group Autism Speaks.

Bell, who also has a son with autism, says it’s important to understand that the condition is a developmental disorder that arises early in life. Children and adults with autism spectrum disorders struggle to communicate with others. They may feel socially isolated and have trouble feeling like part of a group. They may also have repetitive or restrictive behaviors, like rocking or shaking their hands.

“There’s absolutely nothing in that definition that talks about violence or committing aggressive acts,” Bell says.

Indeed, psychologists and psychiatrists agree that people with autism or Asperger’s are not more likely to commit violent crimes than members of the general population, but they say in very rare cases, it can happen.

In those isolated instances, forensic psychiatrists tell WebMD, a diagnosis of Asperger’s or autism may help explain some aspects of seemingly unfathomable acts.

“I think it does matter. I think that’s probably part of making sense of this horrible thing that happened. I think that’s part of the equation,” says Marc Hillbrand, PhD, a clinical psychologist at Yale University in New Haven, Conn.

Hillbrand has studied the psychology of mass shootings, but he had no direct knowledge of Adam Lanza’s medical history.

“What’s so unusual about this individual, if indeed he has Asperger’s, is the use of weapons. There are a few cases of people with high-functioning autism who have committed violent crimes using weapons, but it’s a very small number of people,” he says.

Marianne Kristiansson, PhD, professor of forensic psychiatry at Karolinska Institute in Stockholm, Sweden, has published one of the few studies looking at the characteristics of a small number of violent offenders who also had autism.

She said when she heard about the Connecticut shooting, her first thought was that the shooter might have had Asperger’s.

“That was just my diagnosis,” Kristiansson says. “This offender behavior that he has presented is quite typical of a subject with ... autistic traits.”

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Teen Dating Violence Linked to Substance Abuse, Depression

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WebMD Health News Reviewed byBrunilda Nazario, MD

Dec. 10, 2012 -- Teens in abusive relationships may be more likely to develop emotional problems and substance abuse issues as they age, a new study suggests.

The study included more than 5,600 12- to 18-year-olds who had been in one or more relationships with someone of the opposite sex back in 1996. Of these, about a third said they had experienced teen dating violence, including emotional and physical abuse.

Participants were asked if they had ever been called names, insulted, or treated disrespectfully by their partner. They were also asked if they had been threatened with violence, pushed, shoved, or had something thrown at them.

Five years later, those who answered yes to any of these questions were more likely to engage in unhealthy behaviors. Specifically, girls who reported experiencing dating violence as teens were more likely to binge drink, have symptoms of depression, smoke, and think about killing themselves as young adults, compared with girls who were in healthier relationships.

By contrast, boys who reported dating violence during their teen years were more likely to be antisocial, think about suicide, and use marijuana as young adults than boys who did not report any dating violence or abuse.

Males and females who were in physically abusive relationships as teens were also two to three times more likely to be in violent relationships at ages 18 to 25, the study shows.

The findings appear in Pediatrics.

What Is a Healthy Teen Dating Relationship?

“Children and teens need to know what it means to be in a healthy dating relationship,” says researcher Deinera Exner-Cortens of Cornell University in Ithaca, N.Y. “Parents, teachers, and health care providers all have a role to play in encouraging healthy relationships and modeling respect, trust, and open communication.”

In other words, it’s "do as I say and do as I do" when teaching kids what a healthy relationship looks like, she says.

It’s not just dating violence that sets children up for health and emotional problems, says Metee Comkornruecha, MD, an adolescent medicine specialist at Miami Children's Hospital in Florida. “When children are exposed to any sort of violence or insult, unfortunately it does affect their psyche,” he says. “The study shows how important it is for pediatricians to screen for teen dating violence and prevent and/or treat these negative health outcomes.”

What do these kids look like?

“They may be isolated from their parents or peers and may not do the things they used to enjoy because their partner is keeping them from going out with friends,” he says. “When it comes time to go out on dates, they don't seem as happy as they used to be.”

View Article Sources

SOURCES:

Deinera Exner-Cortens, Cornell University, Ithaca, N.Y.

Metee Comkornruecha, MD, adolescent medicine specialist, Miami Children's Hospital, Miami, Fla.

Exber-Corens, D. Pediatrics, 2012, study received ahead of print.

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