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by Carlie Hoffman The purposes of naming are to help categorize the world in which we live and to aid in grouping similar things together. However, who decides which name is the correct one? Is a child who often cannot pay attention to his classwork “absent-minded,” or experiencing attention deficit hyperactivity disorder? Is a person whose moods often swing from one extreme to the other simply “moody,” or living with bipolar disorder? Naming a lived experience a “mental illness” has the ability to change the social realities of those who receive the diagnosis, altering not only self-perception, but also influencing the perceptions and triggering the biases of others— often in a detrimental manner. So, who has the power to determine how such a label is assigned, and what happens if someone is given the wrong one? The power affiliated with naming has caused the diagnosis of mental disorders to be fraught with controversy. Mental illnesses are defined by the Diagnostic and Statistical Ma...

As I have written before , researchers at the Marcus Autism Center are working with eye tracking technologies to identify Autism Spectrum Disorder (ASD) in young children and infants. As Katie Strong described in this blog pos t, a recent article in Nature , titled “Attention to eyes is present but in decline in 2-6-month-old infants later diagnosed with autism,”[1] presented the Marcus team’s most recent findings related to the early identification of ASD traits. They argue that, although there are many different ‘autisms’ with many likely causal pathways, the developmental pathway to ASD is similar. This work is an effort to capture this pathway by focusing on differences in early looking patterns. In this article, they “propose that in infants later diagnosed with ASD, preferential attention to others’ eyes might be diminished from birth onwards”(p. 427). After a brief refresher on the article’s findings and background, I will provide a deeper discussion on the neuroethical concern...

Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders in the world. Its main symptoms consist of inattention (be easily distracted, miss details, and frequently switch from one activity to another or have difficulty organizing and completing a task or learning something new or trouble completing homework assignments), hyperactivity and impulsiveness (fidget and squirm in their seats or talk nonstop or be very impatient) 1 . These symptoms emerge mainly before seven-year old and approximately 75% of those children are male 2,3 . Two criteria are currently used to diagnose ADHD, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) and International Classification of Diseases, 10th edition (ICD-10). American psychiatrists follow the DSM-IV, which describes two primary categories of behavioral symptoms: inattention and impulsivity-hyperactivity; and three subtypes of ADHD: inattentive type, hyperactive-impulsive typ...

Over the past decade or so, there has been an alarming growth in the number of ADHD diagnoses, and, which is more disturbing, the prescription of stimulants for children with this condition. Concurrent with these increases has been a growing concern in the general public about the legitimacy of ADHD as a real disease and the repercussions and ethical issues of giving kids psychotropic drugs. A hundred years back, this was not a problem. Kids would come to class, be disruptive, not listen, misbehave… and get a whopping smack in the hand or bum with some kind of discipline ruler or other blunt object. The teacher found this behavior to be typical of kids, the parents shook their heads wondering “where did we go wrong?” and life went on. Today, however, there have been striking advances in science that have given us some insight into the factors that contribute to ADHD, tools for recognizing the symptoms of this disease, and yet others for treating it. Or so it seems. Do we indeed ...

There are many ethical concerns that are raised by the treatment of children with psychotropic drugs. This is especially relevant with the use of stimulants to treat ADHD because of the large number of children receiving stimulant medication. In 2008, 3.5% of children under 18 in the United States received stimulant medication. This was even higher in school age children and adolescents, with 5.1% of 6-12 year olds and 4.9% of 13-18 year olds receiving stimulant treatment. This data indicates that an estimated 2.8 million children received stimulant medication for the treatment of ADHD in 2008 1 . Are stimulants overused? ( Source ) The safety of stimulant medications in children is a large concern because there have not been many longitudinal studies on the effects of stimulant usage, especially for children beginning stimulant usage at a young age. There has been some evidence of serious side effects, including cardiovascular risk, growth suppression, and development or early onset ...

By Guest Contributor Racheal Borgman, MA   DSM IV-TR via Wikipedia.org The rhetorical component of illness is an important extension to the issues raised in last month’s post on the DSM . As Anjana Kallarackal pointed out, there are concerns aplenty when it comes to the DSM and how the committee goes about its categorizing work. But I was especially interested by the very first response to the post, by David Nicholson : "I wonder if it would be useful to try to put a number to the "negative consequences" of a given addiction… If we could decide how damaging some addiction was, maybe that would tell us how much to medicalize it as well. Insurance companies could decide that they'd cover cognitive behavioral therapy for internet addiction, but nothing beyond that." It’s an incredibly tempting solution. But then there’s the pesky rhetorical component of illness that must be contended with. For instance, how do we: know that an illness is an illness? know that a p...

That title sounds like the prequel to a William Burroughs novel. I wish I'd come up with it myself, but I'm actually plagiarizing almost word for word from Dr. Steven Hyman, Director of the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard. Last week, Emory awarded Dr. Hyman this year's Neuroscience and Ethics Award. Dr. Hyman spoke on "Addiction as a Window on Volitional Control", which shouldn't be surprising, given his molecular and genetic studies of the dopaminergic system. Earlier in the day, Dr. Hyman stopped by the Emory Center for Ethics to have lunch with faculty and students from several schools and programs. He held forth on the state of translational neuropsychiatric research for an hour and a half, while the rest of us prevented him from eating by constantly barraging him with questions. I have a feeling I'm not the only one who found what he had to say both thought-provoking and provocative. He liberally spice...