I'm glad to see that trauma is being raised as a factor in childhood mental disorders, but trauma is an all encompassing term which leads people to immediately feel that a child has been beaten or scalded by the parents. Bert Hellinger expounds a more nuanced view. Trauma can be anxiety, guilt, nervousness, sorrow, that the parent manifests and the child picks up on. Where does the parent get these feelings? From his own parents, and so on through the generations. Parents often have more than one child, who grow up without mental illness. This means to me that the person with the mental illness is hyper-sensitive to other people's feelings (the parents) while other siblings aren't.

Fingerpointing at the parents is not helpful. Going to school is often the only "trauma" that will set off a breakdown in many ill children. My statement is based on personal experience and first person accounts (hearsay) - hardly scientific, lol.

That's not to say I take issue with his entire theory.

Yes!!!

Trauma and it's effects are so important to understand to take into account. It takes trust and time for the truth of trauma to come to the surface. We need to be careful not to medicate our children for behaviors and the resultant diagnoses that may stem from unrecognized trauma.

Thank you so much for this.

I don't know, for goodness sake, children are by definition immature, childish. Labeling childish behavior as mental illness is a crime against all of us. Meanwhile, if parents don't want to be responsible for the effects that parenting has on children, they should not have children.

I appreciate Rossa's comment that included that 'Trauma can be anxiety, guilt, nervousness, sorrow, that the parent manifests and the child picks up on. Where does the parent get these feelings? From his own parents, and so on through the generations. Parents often have more than one child, who grow up without mental illness. This means to me that the person with the mental illness is hyper-sensitive to other people's feelings (the parents) while other siblings aren't.'

It is important to understand different temperaments and take those into account when treating someone. At that point the professional must decide is it the child or the family that needs a lifetime of medication. or is it the community that needs the prescription... or perhaps it is the society that needs the medication.

I imagine that would be interesting... medicating an entire society.

Always nice to see a voice of reason in what is currently a muddled forest of DSM bio-psych reductionist, faulty thinking.

Most parents I've encountered who have chosen to drug their young kids for issues like pediatric bipolar or ADHD - cling to the bio-psych explanation with an almost religious fervor. Why? Because the alternative explanation -- bad parenting, bad social environment, child abuse issues, bad schooling, bullying, trauma -- is simply too much responsibility to bear. No one wants to admit that their kid's behavioral problems may be linked to something they did (or did not do) as a parent. Moreover, no parent wants to truly face the realities and questions that necessarily come with feeding your child a steady diet of powerful psychotropic cocktails, good intentions notwithstanding.

Bravo to Dr. Edmund Levin for suggesting what seems to be beyond obvious: that environmental factors and trauma may be the elephant in the room when it comes to childhood behavioral issues.

@ nvam 7:37 From my anecdotal experience, I have to say the exact opposite. My teachers at school gave me the acceptance, approval and encouragement that my mother never had the ability or willingness to give. To this day, I stand in awe of these absolutely awesome, nurturing people.

There seems to be a lack of awareness of the overriding damage to childrens brains that the childrens vaccine schedule has done. The recent study by A.Wakefield et al shows that brain damage occurs in the birth dose of the HEP B vaccine--
http://www.ageofautism.com/2009/09/blockbuster-primate-study-shows-significant-harm-from-one-birth-dose-of-a-mercurycontaining-vaccine.html#more.
This is but one vaccine from a myriad offered by the pediatric establishment over the last couple of decades. No wonder they are having problems.

Many commenting assume the blame is on parents.
What I thought immediately was chemical (toxic, allergies) trauma setting off survival mechanisms such as the fight or flight mechanism. Naturally these traumatic responses were meant for short term physical trauma such as an auto accident. Chemically induced trauma could set off unhealthy long term results such as hydrocephalus.
I agree with Angela.....trauma such as from the side effects of vaccines as the Wakefield HEP B study reveals makes more sense considering the number of developmental trauma disorders.
Also it sounds like these children are alternatively treated bio medically vs. family intervention from the article: "It seems reasonable to attribute the clinical improvement of these children to diminished efforts to control thinking, affect, and behavior by pharmacologic interventions, while simultaneously increasing the amount and quality of analytically informed treatment."

I am hesitant to link childhood vaccines with childhood schizophrenia. The incidence of schizophrenia is the general population remains stable over time and cultures. As far as I am aware, it is not growing, as is the case with autism. 1 - 2 % of any given population has been true for schizophrenia as long as people started keeping track of these kinds of things.

Reading Dr. Levin's study, clearly his case examples and focus involve residential treatment and more severe dysfunction---not kids who get upset at school or are around irritable parents etc.

This conceptualization makes a lot more sense to me, I work with many adolescents in RTF's and the like, and many are immediately diagnoses Bipolar and medicated with atypicals. Most of these severe cases have trauma in terms of being raped/molested--severely neglected often by parent/s. Clearly this effects the brain development and leads to many symptoms similar to Bipolar which I find to be massively over-diagnosed with the juvenile population. Basically if they act out with anger a couple times, they count that as manic episode.

My biggest concern is that we have seemed to overlook anxiety--and ascribe more biological only models/conceptualizations that often lead to learned helplessness and clients being told that they have a disease that only the pill can fix.

DVT jives with my experience much of the time, but since it basically promotes major reduction or elimination of meds for many clients--not much chance it will get headway--since Psychiatry has become chemistry, despite the fact that people's suffering in most cases continues unabated even when highly medicated. Vested interest and economics appear to strong, too bad since nearly all the theorists that I use were M.D's, but many of the newer MD's have little to no training in psychotherapy--hell they don't even usually do a diagnostic evaluation that is much longer than 10minutes and involves some massive guesswork on their part. Calling this a mental health "system' is giving it too much credit, nothing very systematic about it--in terms of serving the needs of clients. Anyway, this is becoming a rant :)

Ben's comments are spot on. I have been at the AACAP meeting this week and attended around a dozen presentations on Pediatric Bipolar Disorder. Some observations are that the presenters never mention trauma or attachment disturbances. When questioned they don't seem to have an answer to this and a prominent researcher admitted it hadn't been considered in the research she presented. They presented a lot of neuroimaging findings (some quite excellent detailed research) however again these replicate the neuroimaging findings in the traumatic stress literature - once again trauma was not considered despite this overlap. Excellent research can be done but if the basic premise is too narrow you only find what is within the realms of that premise.

Also the PBD research groups seemed to have found intensive long term family therapy to be quite effective and are looking to see if 'bipolar' can be prevented by early introduction of such. Maybe the condition isn't life long, maybe medication can be short term etc etc.

In Australia none of this is news, psychiatry fortunately has not become chemistry as Ben laments. But we have a universal single payer system that allows for up to 50 x 75 minute sessions for a patient and family per year with a psychiatrist practising individual and family therapy and pharmacotherapy on a clinical needs basis with no pressure to make diagnoses at all. Plenty of time to be sure of a diagnosis which may seem evident in first session but with time can evaporate. Not so my American colleagues lament - some insurers demand a diagnostic label on first session, others pay by diagnosis and bipolar gives more money than adjustment disorder or family relationship problem etc...

Other interesting presentations included work with monkeys showing profound influence on changing gene expression (ie switching genes on and off) due to separation from mother monkey at young age. In other words effects of environment on genes was the determining factor as in this case the genes concerned were ubiquitous amongst the monkeys.

Another observation was the emphasis on speakers disclosing potential conflicts of interest and how many speakers said they were no longer on pharma speakers bureaus, also any pharma sponsored poster presentations were in a different room to the posters presented by psychiatrists and psychologists and other mental health workers which were in the main area. Things are at least moving in the right direction.

I'm not going to mince words here.

It's about time the finger pointing is at parents. Whether they be abusive, neglectful or abandon their children or whether they be overindulgent, non-disciplinarians or whatever.

At least 95% of these kids are reacting to their environment, they are not mentally ill.

Take out all the mental illness jargon and call it like it is. These kids have distorted thought processes and inappropriate behaviors. Most all of them learned. Poor role models account for the lack of morals and values.

They watch a steady stream of violence and sexual escapades on TV and yet society fails to recognize how this effects children.

The argument that drugging children is cheaper than providing competent therapy (and I stress competent), no longer holds water when a months worth of drugs for a bipolar child can cost close to $2,000 on DrugStore.com

I believe $2,000 a month would cover quite a few therapy sessions for the whole family.

Finally, if parents want to learn some parenting skills I suggest they tune in to the TV show, Super Nanny, for some free lessons.