Category: Self-Control

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When Discipline Worsens Performance in Competitive Sports

00Child Development, Coaching, Featured news, Parenting, Self-Control, Sport and Competition, Trauma May, 17

Source: Petr Magera on flickr, Creative Commons

On December 19, 2015, former National Hockey League (NHL) player Patrick O’Sullivan revealed shocking details of sports-related childhood abuse. In a blog article on The Players Tribune, he disclosed that his father began abusing him at 5 years old when he got his first pair of hockey skates.

At the age of 10, it worsened:

“It would start as soon as we got in the car, and sometimes right out in the parking lot.”

He reveals that his father would put out cigarettes on his skin, choke him, and throw objects at him. At times, he endured whippings with a jump rope or an electrical cord.

“As twisted and insane as it sounds, in his mind, the abuse was justified. It was all going to make me a better hockey player—and eventually get me to the NHL.”

The more goals Patrick scored, the more the abuse intensified.

Patrick’s father assumed that these harsh disciplinary practices would enhance his abilities and success, but experts say otherwise. The scars of childhood abuse have a lasting negative impact.

John O’Sullivan (no relation to Patrick), a former soccer player, coach, and founder of the Changing the Game Project, says this parenting behaviour burdens the child, hindering performance.

In an article on the Changing the Game Project website, John writes:

“If a child believes that a parent’s love is tied to the expectation of winning, and he does not win, he may believe that he is less loved or valued. This creates anxiety and inhibits performance.”

Childhood maltreatment leads to decreased mental and physical health, even decades after the abuse. Rutgers sociology professor Kristen Springer and colleagues reported that, in their population based survey, physical symptoms and illnesses, like hypertension and cardiac problems, were present in those who experienced childhood abuse years earlier. And childhood maltreatment is also associated with increased anxiety, anger, and depression—symptoms that can be heavily detrimental to an athlete’s performance.

Some studies also show that early childhood maltreatment, such as the abuse endured by Patrick, shape aspects of socio-emotional development in adolescence and adulthood. A study conducted by Pan Chen and colleagues at the University of Chicago supported the relationship between childhood abuse and aggressive behaviour in adulthood. The researchers note that early trauma may increase impulsive behaviour and lashing out in abuse survivors.

But some, like Patrick, seek help. He says in an interview with ESPN, “…I have put the money and time into my own health.”

He acknowledges that not everyone has the opportunity to find the help they need—especially as an athlete:

“Players don’t feel like they can say anything because it’s a huge red flag. You say you need to see a psychologist and you’ll get a call from your agent saying he spoke to the General Manager of the team and wants to know what your ‘problem’ is.”

In addition to how isolating the experience of abuse can be for professional athletes and adults, Patrick emphasizes how helpless and frightening it can be for a child. He describes his own feelings of disempowerment, at the age of ten: “I just tried to survive. Each morning, I’d wake up and think: Here we go again. Just get through it.”

It didn’t help that others turned a blind eye. Patrick says that parents and coaches would catch a glimpse of the abuse, but no one stepped in. Bystanders may feel hesitant to intervene, out of fear of being wrong. But he counters, “If you are wrong, that’s the absolute best case scenario.” He hopes his story will raise awareness about childhood abuse in young athletes.

As for parents, soccer coach John O’Sullivan says that empowerment may be key to promoting competitive success, instead of harsh discipline and criticism. “The best players play with freedom, they play without fear and they are not afraid of making errors, they can play up to their potential,” he says in an interview with Kids in The House.

He shares that “I love watching you play” are the best five words you can say to a child after a game. “Because when you tell your kids, after a game, that ‘I love watching you play’, what you do is you free them from the burden of being responsible for your happiness as a parent”.

–Khadija Bint Misbah, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Divorce an Unreliable Predictor of Aggressiveness

00Anger, Child Development, Divorce, Emotion Regulation, Family Dynamics, Featured news, Parenting, Self-Control August, 16

by Afifa Mahboob, Contributing Writer, The Trauma and Mental Health Report

“Tomorrow is the day of retribution, the day in which I will have my retribution against humanity, against all of you.”

Elliot Rodger spoke these words in a video he recorded before stabbing and shooting fellow students at the University of California, Santa Barbara (UCSB) in May 2014. After killing six and injuring 14 others, Rodger took his own life.

In a 140-page manifesto called “My Twisted World,” Rodger explained that he was seeking revenge for being a virgin at 22 years of age. Tormented by loneliness and rejection, he detailed many painful experiences that helped push him over the edge. In a final video, he threatened the life of every female student in UCSB’s most popular sorority house and anyone else he saw on the streets of Isla Vista.

Rodger sent this manifesto to his parents and therapist before the killing spree, blaming them for his sexual frustrations. His father, Peter Rodger, later explained that his son began dealing with mental health problems at a young age, following his parents’ divorce. In an interview with Barbara Walters on ABC’s 20/20, Rodger’s father spoke about Elliot’s fear of interaction with other children in high school:

“He felt the inability to get along with them. And this is when we realized that he had a real fear of other human beings, of other kids his age.”

Stories like those of Elliot Rodger lead us to seek explanations. We try to understand how something like this can occur. In the 20/20 interview, one explanation advanced was the idea that Rodger’s life changed when his parents divorced.

Source: Yuliya Evstratenko/Shutterstock

The idea of divorce being profoundly damaging to children offers a compelling explanation when it is otherwise difficult to understand certain individual actions. Research shows that children who experience divorce at a young age may develop separation anxiety and dependency. When they do not receive equal attention from both parents, they may become sensitized to rejection and react strongly to this same type of rejection in social situations. Over time, they may develop lower self-esteem and negative expectations regarding intimate relationships.

But even among this small fraction of children, severe aggression is rare. In fact, most children of divorce are able to cope relatively successfully with their situation and go on to develop close relationships, experiencing few behavioral problems. Yet it remains common to view divorce as being destructive for children.

Janine Bernard of Purdue University and Sally Nesbitt of the Counseling and Psychological Services Center in Texas both found no significant differences in levels of anger, aggression, and passive-aggressiveness between children of divorced or disrupted families and children of intact families. In their two-part study, they found that while all children are affected by the quality of their parents’ relationship, environmental and sociocultural factors are just as important in determining individuals’ temperament. Similarly, internal levels of maturity, personal coping styles, and other relationships can and often do counterbalance the negative impacts of divorce.

Bernard and Nesbitt note:

“For generations couples have been disillusioned by the marriage myth, which promised life happily ever after. The more recent divorce myth is equally dogmatic and suggests that divorce has inordinate powers to hurt people regardless of the mental health and maturity of the adults and children involved.”

People with such views tend to expect children from divorced families to become socially isolated and develop behavioral problems. Bernard and Nesbitt explain that this is a common hypothesis among researchers conducting divorce studies. The bias may impact their judgment and cause stilted reporting of results, with more focus on a child’s negative behavior and less on their positive qualities.

Eva Bennett on flickr

Source: Eva Bennett on flickr

Elliot Rodger is an example of one individual who was psychologically disturbed and viewed his parents as responsible for his suffering. But he is certainly not a typical example of a child of divorced parents.

His social isolation may have felt unbearable to him, and he and his family sought an explanation for his violent actions, just as we all do when we hear about tragic stories like this. But our best explanations can be misguided. Reliably predicting violent behavior is still difficult to do.

Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Book Review: The Marshmallow Test

00Behaviorism, Career, Child Development, Cognition, Emotion Regulation, Featured news, Self-Control June, 16

Source: Jørgen Schyberg on flickr

Walter Mischel, a psychologist best known for the Marshmallow Test, produced his first book at the age of 84.

The Marshmallow Test: Mastering Self-Control hit bookshelves in the fall of 2014, and became an instant media sensation. Part memoir and part scientific analysis of Mischel’s work on self-control, the book reviews research on the Marshmallow Test, which he first carried out at Stanford University, and which has since been replicated around the world.

The Marshmallow Test is a way of assessing children’s capacity for delaying gratification and resisting temptation. Children are placed in a room by themselves and given one marshmallow. An experimenter explains that if the child waits 15 minutes, they will receive a total of two marshmallows to eat. If they don’t wait, they’ll receive only one. After the experimenter leaves the room, the child is observed through a one-way mirror or recorded. The longer a child is able to wait, the greater the ability to delay gratification.

Many videos of children taking the Marshmallow Test have been posted to YouTube, often showing amusing coping strategies children use to maintain restraint. The Marshmallow Test has been so widely popularized that even the Wall Street Journal referred to it in assessing a proposed budget by U.S. president Barack Obama.

In his book, Mischel looks at the correlation between outcome on the test at age 5 or 6 with social skills and academic performance later in life. Results show that children who are able to wait longer for two marshmallows have better social skills and higher academic test scores. The book provides several explanations for this phenomenon, including the possibility that the Marshmallow Test accesses characteristics, such as delay of gratification, that are related to developing positive social skills and performing well academically later on.

For those seeking a step-by-step guide to improve self-control and achieve higher grades, this is not the right book. Mischel discusses theoretical concepts and summarizes research. Although he integrates many personal narratives to add a human touch, the book is not meant as a guide to self-improvement.

With critical and thorough analysis, Mischel instead explains how genetic, environmental, and social factors can impact self-control. He emphasizes that self-control is not predetermined or universal across all areas of an individual’s life. Someone who shows a great deal of control in academia may struggle to show that same level of control when overcoming problem drinking.

Making the content more personal, Mischel often incorporates his own challenges with overcoming a nicotine addiction and how his research was often affected by observations of his own children.

Empowerment is another important issue discussed throughout the book. In one section, Mischel refers to his time as a trainee in a clinical psychology doctoral program, recalling how he watched his mentor, George Kelly, work with an extremely anxious woman. The woman had asked Dr. Kelly, “Am I falling apart?” to which he replied, “Would you like to?”

Using this case, Mischel shifts the focus from the Marshmallow Test and how it might predict future action to how perceived self-control can impact demonstrated self-control. This is an idea that Mischel calls the ‘The Engine of Success.’

The idea is that there are essential resources nurturing and cultivating self-control. Mischel explains this theory through the case of George, a student completing his bachelor degree on a full scholarship at Yale University.

At the age of nine, George was enrolled in a KIPP school, which is an American charter school. Mischel explains how such schools attempt to integrate self-control, self-discipline, brain development, and delay of self-gratification into their curriculum. He emphasizes the need for more schools like this.

Although the original Marshmallow Test predicts a specific type of self-control in later life, Mischel stresses that self-control is fluid. Taking control of any area of your life, he suggests, starts with asking the very question George Kelly asked his client: Would you like to?

– Genevieve Hayden, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Non-offending Pedophiles Suffer from Isolation

00Featured news, Law and Crime, Self-Control, Self-Help, Suicide, Therapy March, 16

Source: Simon Prades, Used with permission

The stigma of pedophilia and the fear of criminal consequences often prevent non-offending pedophiles from seeking help. Non-offenders who confess sexual urges toward children are usually turned away by professionals who are untrained or unwilling to help, leaving these adults or adolescents to struggle on their own.

The Diagnostic and Statistical Manual of Mental Disorders defines a pedophile as someone who has “recurrent, intense, sexually arousing fantasies, sexual urges, or behaviours involving sexual activity with a prepubescent child or children.” To be diagnosed with pedophilia, the person must experience these symptoms for at least six months, and feel serious distress from the sexual urges and fantasies.

As an under-researched population, it is hard to know the precise number of non-offending pedophiles. Michael Seto, Director of the University of Ottawa’s Forensic Research Unit, estimates that up to 9 percent of men have fantasized about having sex with a prepubescent child. It is now believed that approximately 1 to 5 percent of men identify as a pedophile.

Adam (name changed), a non-offending pedophile, first noticed his attraction toward young children when he was 11. In a Matter Magazine interview with award-winning journalist Luke Malone, he describes his adolescence as a period of agonizing self-hatred:

“I was passively suicidal for a long time […] A lot of it was, ‘I’m a monster’ for having viewed [child pornography], but also just for having these attractions.”

There is currently no system in place in Canada to treat those who are sexually attracted to children, but have not acted upon these urges. Mandatory reporting laws, which make professionals responsible for reporting suspicion of child abuse to Child Protective Services, often deter non-offending pedophiles from seeking treatment. In Ontario, this requirement exists under the Child and Family Services Act.

Elizabeth Letourneau, Director of the Moore Center for the Prevention of Child Sexual Abuse at Johns Hopkins University, is a leading force in prevention programming targeting non-offending pedophiles. In an interview with TIME Magazine, she describes her experiences working with this population.

“I’ve spoken to young men who were horrified to realize they were attracted to younger children in adolescence, and that they were not growing out of their attraction. They described appalling childhoods, living in self-imposed isolation for fear of being discovered and labeled a pedophile. Several expressed self-loathing. Many considered suicide. As adolescents, they wanted help controlling their sexual impulses, but had nowhere to turn for help.”

A U.S. researcher in the field of primary prevention, Letourneau calls for the development of a “culture of prevention” around pedophilia. She advocates for preventative therapy for both non-offenders and offenders alike:

“If they could have just turned to someone to talk about this, a professional who’s going to treat this objectively and see them as a person of worth, who’s going to know that they’re not bad kids, that they’re good kids but they have this aspect of them that they really need help controlling. That’s what they’re looking for and that’s what I hope we can provide.”

Many non-offending pedophiles like Adam desperately turn to the internet for social support. In his words:

“For a pedophile, there is almost no place to go and get information or any sort of help, I’m sure that there are pedophiles who kill themselves who will never reveal or admit to it, even in a suicide letter. I think there’s probably a lot more than people would realize.”

Adam now leads an informal online support group for pedophiles in their teens and early twenties who want help battling this issue. There are a total of nine members, between sixteen and twenty-two years of age. All members need to abide by two rules: no previous history of offending and complete abstinence from child pornography.

Other self-help resources exist online for non-offending pedophiles. Virtuous Pedophiles, the largest online pedophile support group in the U.S., currently has 318 members and operates under the simple belief that sex with children is wrong.

In Germany, prevention efforts are already in place. Thousands of self-identified pedophiles reach out to Prevention Project Dunkelfeld, a therapeutic program that targets non-offending males attracted to children. Germany does not have mandatory reporting laws, making it easier for non-offending pedophiles to seek treatment.

In accordance with recent research on pedophilia claiming a neurobiological basis to the disease, Klaus Beier, director of the German project, believes that, at the very least, a minor attraction to children is a fixed part of a pedophile’s identity.  Dunkelfeld operates within a harm reduction framework. Rather than trying to change behaviour, the program works to manage their clients’ attraction towards children. The project offers both weekly cognitive behaviour therapy sessions and libido-reducing medication.

Paradigm shifts towards relieving stigma and treating pedophilia as a disease are key to enacting real change. It is vital to differentiate between fantasy and behavior and to offer resources to those who want to manage their condition willingly.

– Lauren Goldberg, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Dysregulation: A New DSM Label for Childhood Rages

Dysregulation: A New DSM Label for Childhood Rages

00Anger, Child Development, Cognition, Featured news, Health, Parenting, Self-Control, Stress July, 15

Source: Mary Anne Enriquez/Flickr

With the many changes in the newest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), among the most significant has been the inclusion of Disruptive Mood Dysregulation Disorder (DMDD)—a direct response to the dramatic increase in the diagnosis of bipolar disorder in children and adolescents during the 1990s.

Diagnosing bipolar illness in children is considered elusive at best.  Characterized by extreme and distinct changes in mood, bipolar illness ranges from depressive symptoms to manic “highs.”  In younger populations, the shift between manic and depressive episodes is not so clear.

Children often experience abrupt mood swings, explosive and lengthy rages, impairment in judgment, impulsivity, and defiant behavior.  Such parent-reported symptoms became a popular basis for childhood bipolar disorder diagnoses.

In recent years, Ellen Leibenluft, a senior investigator at the National Institute of Mental Health and an associate professor at Georgetown University, developed the concept of “severe mood dysregulation” as distinct from bipolar disorder.  Her research highlights the difference between unusual intense rages, and the distinct mood swings in bipolar disorder.

Anchored in her research, the DSM-5 task force attempted to develop a new classification for a disorder that shared some characteristics with bipolar disorder but did not include the abrupt shifts in mood.  By doing so, the task force hopes the rate of diagnoses for bipolar disorder in children will decline.

The DSM-5 characterizes DMDD as severe recurrent temper outbursts that are “grossly out of proportion in intensity or duration” to the situation.  Temper outbursts occur at least 3 times per week and the mood between outbursts remains negative.  To separate DMDD from bipolar disorder, children must not experience manic symptoms such as feelings of grandiosity, and reduced need for sleep.

Differentiating between bipolar disorder symptoms and rages unrelated to mood swings may very well be a step in the right direction.

But some studies suggest that DMDD may not be all that distinct or useful as a diagnostic entity different from those already in use, such as oppositional defiant disorder or conduct disorder.  It may be that DMDD is not a condition of its own, but rather a primary symptom of a larger issue.  Irritability and rages may be an indication of a disorder already established in previous versions of the DSM.

Aside from diagnostic labels, taking social situations into account may lead to a sharper understanding of rages in children.

While the role of biology cannot be discounted in the development of mental disorders, childhood behavioral problems may be affected by social and economic circumstances. Financial hardships and other parental stresses have an effect on children’s mental well-being, and stress may be detrimental to the communication between the parent and child.

Along with biological conditions, the DSM task force should consider the impact of the child’s social experience.  Helena Hansen, assistant professor of psychiatry at the New York University School of Medicine, argues that the recent revisions in the DSM-5 have missed key social factors that trigger certain biological responses.  Her article, published in the journal Health Affair, emphasizes the importance of understanding how social and institutional circumstances influence the epidemiological distribution of disorders.

For example, differing temperaments can explain why some children appear to cope well with life stresses while others develop problem behaviors.  Lashing out in the form of rages and tantrums may be a natural response to intolerable anxiety and stress for some children.

As new terms for disorders are coined, such as DMDD, we need to ask if the development of another category is the best alternative.  Is substituting one label of childhood behavioral problems for another really our best option?

Due to the many possible causes for temper outbursts, giving the child a single label may not be all that helpful.  Instead, determining the core issues surrounding the rages may be more useful in providing the patient with an effective treatment plan.

Also, let’s keep in mind that mental disordersare simply constructs, not unique disease states.  They are developed to allow better understanding of a group of behavioral, emotional, and cognitive symptoms, and are regularly revised based on new research and changing cultural values.  While the DSM is useful for the purpose of understanding the challenges faced by patients, it should not be given “bible” status.

Along with mental health care providers, it is important for parents to get informed about DMDD, to ask questions, and to get involved in discussions when considering treatment options for their child.

– Khadija Bint Misbah, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Children Who Kill Are Often Victims Too

00Adolescence, Attachment, Caregiving, Child Development, Empathy, Ethics and Morality, Featured news, Law and Crime, Parenting, Psychiatry, Punishment, Self-Control, Therapy, Trauma March, 15

Source: torbakhopper/Flikr

In 1993, in Merseyside, England, Jon Venables and Robert Thompson were charged with the abduction and murder of 2-year-old James Bulger.  Bulger had been abducted from a shopping mall, repeatedly assaulted, and his body left to be run over by a train.  Both Venables and Thompson were 10 years old at the time.

The public and the media called for justice, seeking harsh punishment and life imprisonment for the murder of a child.  The boys were labeled as inherently evil and unrepentant for their crimes.

When there are crimes against children, it is common for the public to view the victims as innocent and the perpetrators as depraved monsters.  But what do we do when the accused are also children?

Instances of children (12 years of age and younger) who have killed other children are extremely rare.  In a study conducted by University of New Hampshire professors David Finkelhor and Richard Ormrod for the Office of Juvenile Justice and Delinquency Prevention (OJJDP), murders of children committed by those aged 11 and under accounted for less than 2 percent of all child murders in the US. Cases also tend to differ significantly, so conclusions can be difficult to make.  But there are some similarities that have emerged, telling us about the minds of child murderers.

Children who murder have often been severely abused or neglected and have experienced a tumultuous home life.  Psychologist Terry M. Levy, a proponent of corrective attachment therapy at the Evergreen Psychotherapy Centre, notes that children who have severe attachment problems (which often result from unreliable and ineffective caregiving) and a history of abuse may develop very aggressive behaviours.  They can also have trouble controlling emotions, which can lead to impulsive, violent outbursts directed at themselves or others.

Other similarities among child murderers include having a family member with a criminal record, suffering from a traumatic loss, a history of disruptive behaviour, witnessing or experiencing violence, and being rejected or abandoned by a parent.  Problems in the home can be particularly influential.  If a child witnesses or experiences violence, they are likely to repeat violence in other situations.

What a child understands at the time of the crime is of great importance to the justice system.  The minimum age of criminal responsibility (MACR) is the age at which children are deemed capable of committing a crime.  The MACR differs between jurisdictions, but allows any person at or above the set chronological age to be criminally charged, and receive criminal penalties, which can include life imprisonment.

Many courts consider criminal responsibility in terms of understanding.  So they may consider someone criminally responsible if, at the time of the crime, they understood the act was wrong, understood the difference between right and wrong or understood that their behaviour was a crime.  But this approach has been criticized as being too simplistic.  Criminal responsibility requires the understanding of various other factors, many of which children cannot appreciate.

Children may know that certain behaviours are ‘wrong’, but only as a result of what adults have taught them, and not because they fully understand the moral argument behind it.  Morality and the finality of death are abstract concepts, and according to theorists such as Swiss psychologist-philosopher Jean Piaget (whose theory of child development has seen much empirical support), most children under 12 are only able to reason and solve problems using ideas that can be represented concretely.  It is not until puberty that the ability to reason with abstract concepts (like thinking about hypothetical situations) develops.

Prepubescent children are also not fully emotionally developed, and less able to use self-control and appreciate the consequences of their actions.  This, in combination with the fact that many child murderers are impulsive, aggressive, and unable to deal with their emotions, suggests that when children kill, they are treating their victim as a target, as an outlet for violence.  Most victims are either much younger than or close to the same age as the perpetrators, which may suggest they were chosen because they could be overpowered easily.

Research to date suggests that child murderers don’t fully understand the severity or implications of their crimes.  And psychiatric assessments have shown intense psychological disturbance, making true appreciation of the crime even less likely.  Yet many children have been found criminally responsible and sentenced in adult courts.

Jon Venables, Robert Thompson, and Mary Bell received therapeutic intervention while incarcerated, and have since been released.  As far as the public knows, only Venables has reoffended.  However, Eric Smith (convicted of killing 4-year-old Derrick Robie) remains behind bars today, even though he was imprisoned at 13.

Critics of judicial leniency for children accused of murder often cite the refrain ”adult crime; adult time,” choosing to focus on the severity of the crime rather than the age and competency of the offender.  Make no mistake; the murders of these children were brutal, depraved acts that caused intense suffering for the victims, their families, and communities.

But in our zeal, in our outrage, do we dehumanize these children?  Children who—like their victims—can be victims too.

– Contributing Writer: Jennifer Parlee, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

Photo Credit:torbakhopper/Flikr

This article was originally published on Psychology Today

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Video Games Rated A for Addictive

00Addiction, Depression, Diet, Featured news, Health, Neuroscience, Optimism, Psychopharmacology, Self-Control, Sex, Sleep, Stress, Treatment December, 14

Picture if you will, flashing screens, loud noises, focused faces and a crowd gathered to watch high stakes games; games that end only when you run out of money.

This is not a casino. Those faces are staring at flashing computer screens in an arcade and the high stakes match is actually a video game.

Scenes like this make it possible to view video gaming as an addiction. Like a gambler endlessly playing slots, the video gamer can spend hours on the vice of choice.

Those who consider gaming as addictive highlight similarities between models of addiction and the behaviour of those who can’t seem to stop playing video games, despite the consequences 

What does it mean to be addicted to a video game? Addiction used to be a term reserved for drug use defined by physical dependency, uncontrollable craving, and increased consumption due to tolerance. Advances in neuroscience show that these drugs tap into the reward system of the brain resulting in a large release of the neurotransmitter dopamine. This is a system normally activated when basic reinforcers are applied, like food or sex. Drugs just do it better.

Gaetano Di Chiara and Assunta Imperato, researchers at the Institute of Experimental Pharmacology and Toxicology at the University of Cagliani, Italy, found that drugs can cause a release of up to ten times the amount of dopamine normally found in the brain’s reward system. This has led to a shift in how addictions are viewed. Any physical substance or behaviour that can “hijack” this dopamine reward system may be viewed as addictive.

When can you be sure that the system has been hijacked? Steve Grant, chief clinical neuroscientist at the National Institute of Drug Abuse, says it happens when there “is continued engagement in self-destructive behaviour despite adverse consequences.”

Video games seem to hijack this reward system very efficiently. Certainly Nick Yee, author of the Daedelus Project, thinks so. He explains, “[Video Games] employ well-known behavioral conditioning principles from psychology that reinforce repetitive actions through an elaborate system of scheduled rewards. In effect, the game rewards players to perform increasingly tedious tasks and seduces the player to ‘play’ industriously.” Researchers in the UK found biological evidence that playing video games and achieving these rewards results in the release of dopamine.

This same release of the neurotransmitter occurs during activities considered healthy, such as exercise or work. Since dopamine release is not bad per se, it is not necessarily a problem that video games do the same thing.

In her book, Reality is Broken: Why Games Make Us Better and How They Can Change the World, Jane McGonigal writes, “A game is an opportunity to focus our energy, with relentless optimism, at something we’re good at (or getting better at) and enjoy. In other words, game-play is the direct emotional opposite of depression.” Playing games can be an easy way to relieve stress and get that satisfaction that comes with dopamine release.

But it is concerning when this search for the dopamine kick becomes preferable to real life, when playing video games replaces activities like socializing with friends and family, exercising, or sleep. Nutrition may begin to suffer as the gamer picks fast-food over proper meals. School-work and job performance suffer as gaming turns into an escape from life. It becomes troubling when video games are used as the main way of coping.

Psychologist Richard Wood says just that in his article Problems with the Concept of Video Game “Addiction”: Some Case Study Examples. “It seems that video games can be used as a means of escape…If people cannot deal with their problems, and choose instead to immerse themselves in a game, then surely their gaming behaviour is actually a symptom rather than the specific cause of their problem.”

Regardless, there are some unable to stop despite the consequences. In rare cases it has actually caused death, through neglect of a child or physical exhaustion. Excessive video game playing may represent a way of coping with underlying issues. But it becomes its own problem when the impulse to play just can’t be denied.

Psychiatrist Kimberly Young, Director of the Center for Internet Addiction Recovery argues that “[gaming addiction is] a clinical impulse control disorder, an addiction in the same sense as compulsive gambling.” Her centre is one of many that are now found in the United States, Canada, the United Kingdom, and China.

These clinics treat those with gaming problems using an addiction model. They use detox, 12-step programs, abstinence training, and other methods common to addiction centres.

Notably, many people play well within healthy limits, and engage in the activity for diverse reasons. Stress relief, a way to spend time online with friends, or the enjoyment of an interactive storyline are all common reasons for playing. Whatever the reason for starting, when you can’t stop you have a problem. 

We are often critical of labels in mental health, for good reason; they can be misused. On the other hand, a label can sometimes be helpful. If we call it an addiction, then we recognize it as a problem worth solving.

– Contributing Writer: Bradley Kushner, The Trauma and Mental Health Report 

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report 

Copyright Robert T. Muller

Photo Credit: Ben Andreas Harding

This article was originally published on Psychology Today

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Dr. Mom and Dad

00ADHD, Anxiety, Attention, Child Development, Depression, Environment, Featured news, Health, Intelligence, Leadership, Motivation, Parenting, Psychiatry, Psychopharmacology, Self-Control, Sleep September, 14

We live in a world of self-diagnosis. With access to online medical databases like WebMD and kidshealth.org, it is easy to type symptoms into Google, find a diagnosis and present findings to the family physician.

Self-diagnosis may seem harmless, but it can become problematic when we diagnose ourselves or our children with more complicated conditions, behavioral disorders like Attention Deficit Hyperactivity Disorder (ADHD).

The over-diagnosis of ADHD and the over-prescription of medications like Ritalin, Adderall, and Vyvanse (to name a few) have been longstanding problems in the health care community. Clinical psychologists Silvia Schneider, Jurgen Margraf, and Katrin Bruchmuller, on faculty at the University of Bochum and the University of Basel found that mental health workers such as psychiatrists tend to diagnose based on “a rule of thumb.” That is, children and adolescents -often males- are diagnosed with ADHD based on criteria such as “motoric restlessness, lack of concentration and impulsiveness,” rather than adhering to more comprehensive diagnostic criteria.

Parentsmotivation to get help for their child’s problems along with free access to online information may play a role in the over-diagnosis of ADHD.

A study by Anne Walsh, a professor of Nursing at Queensland University of Technology found that close to 43% of parents diagnosed and 33% treated their children’s health using online information. Of concern, 18% of parents actually altered their child’s professional health management to correspond with online information. Considering the questionable quality of some online health information, these numbers are worrisome.

Furthermore, as primary caregivers can sometimes be persuaded, it is possible that parental conviction of the child’s diagnosis may play a role in physician decisions to treat. With basic diagnostic criteria for ADHD readily available online, some parents may be quick to self-diagnose their “restless and impulsive child.”

“It sometimes happens that parents come to me convinced that their child has ADHD [based on their own research] and in many circumstances they are correct,” says Dan Flanders, a pediatrician practicing in Toronto, Canada.

 According to Flanders, there are certain traits that make a child more likely to be misdiagnosed with ADHD. “Children who have learning disabilities, hearing impairment, or visual impairment may be mistaken as having ADHD because it is harder for them to focus if they can’t see the blackboard, hear their teacher or if they simply cannot read their homework.”

Flanders adds that gifted children, children with anxiety or depression, and children with sleep disorders are commonly misdiagnosed with attention disorders. “Gifted children learn the class objectives after the first 10 minutes of a class whereas their classmates need the whole hour. For the remaining 50 minutes of class these children get bored, fidgety, distracted, and disruptive. The treatment for these children is to enrich their learning environment so that they are kept engaged by the additional school materials.”

Children with anxiety and depression can be misdiagnosed with ADHD because there may be an interference with a child’s ability to learn, focus, eat, sleep, and interact with others. For children with sleep disorders, “one of the most common presentations of sleep disorders is hyperactivity and an inability to focus during the day. Fix the sleep problem and the ADHD symptoms go away.”

It is, however, important to note that these disorders are not mutually exclusive of each other. “A child can have a learning disability, anxiety, and independent ADHD all at the same time.” 

While it is often beneficial for parents to consult online databases for background information, Flanders warns against relying solely on information found online because the information may not be up-to-date and cannot replace a thorough psychological assessment.

Why, then, do parents resort to this quick fix of information?

Walsh reported that parents use online health information for a range of reasons including feeling rushed and receiving limited general lifestyle guidance from their doctors.

Flanders points out that the doctor’s approach should always be to review the data honestly and objectively with parents and then openly present the treatment options available to them.

“The most important part of ADHD treatment is making sure of the diagnosis. There are so many children who are started on medication inappropriately. Throwing medication at the problem is not the answer unless the diagnosis is well established and the differential diagnoses have been exhausted.”

– Contributing Writer: Jana Vigour, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today