More Shy Children Will Soon Be Diagnosed With Social Anxiety Disorder

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quiet More Shy Children Will Soon Be Diagnosed With Social Anxiety Disorderquietchild More Shy Children Will Soon Be Diagnosed With Social Anxiety Disorderquietchild1 More Shy Children Will Soon Be Diagnosed With Social Anxiety DisorderThis news comes via Christopher Lane, author of the incredibly well-reported book Shyness: How Normal Behavior Became a Sickness.

According to Lane (who heard it from Britain’s Daily Telegraph), the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-V), due to be released in 2013, will include a definition of social anxiety disorder for kids that includes fear of social situations expressed as “crying, tantrums, freezing, clinging, shrinking or refusal to speak in social situations.”

Here is Lane:

“Clinging,” “freezing,” or “shrinking”? Is the APA serious? Alas, it appears so, and with troubling consequences….If you include fear of “freezing” among children asked to perform or recite in public, then the chances are strong you’ll wind up with a fairly large number of diagnoses… So the question is, What number of children wouldn’t be eligible for such a diagnosis?”

To read the rest of Lane’s article, follow this link.

 

 


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11 Comments

  1. Barb Markway on 11.10.2011 at 11:25 (Reply)

    This is a complex topic which I’m sure will get a lot of discussion going. I only have a minute now, but may write more later. In writing about this issue with depression and overdiagnosis/overmedication, Therese Bouchard points out, and I agree, that a huge problem is our health care system that allows such a short period of time for doctors to talk to patients/make a good assessment/appropriate treatment plan. See her article here http://blog.beliefnet.com/beyondblue/2011/06/are-we-overmedicating-or-is-our-health-care-system-inadequate.html

  2. Luna on 11.10.2011 at 16:08 (Reply)

    My observation has been that labelling children is the new thing. For every non-conformist child out there we have a new label to attach to them that will furnish whomever needs it with a list of treatments to ensure this ‘misfit’ learns to become a functioning member of society who will contribute in all ways good which is just code for; turn them into the kind of person who likes team sports, group activities, does moderately to well in school (exceptionally well is a problem), has middle of the road opinions, tastes and aspirations. Overly grand aspirations may be a sign of delusional thinking. Too high grades? Over achievers who will burn out and are not balanced. Can’t we just let children develop in their own good time without worrying them to death and labelling them with anxiety disorders that are just developmental stages or simply differences in personality. We have so many poor boys in our system who are cooped up way too soon in their early developmental years expected to sit for ridiculous amounts of time labelled ADHD because they simply can’t do it. We have children who for vaguely defined reasons chafe at all authority being labelled with Oppositional Defiance Disorder. I recognize with labelling comes funding, in Canada at least, for these kids but with it often comes medication, a sense of shame and for some a belief that they have no control and that they are faulted in some way. Our society is moving to such a pitch of hysteria on so many things let us not pass some kind of psychological hypochondria on to our children.

  3. SG on 12.10.2011 at 01:53 (Reply)

    I think extroversion should be labeled a mental illness. Having to endure endless bloviating and intrusive friendliness seems like a desperate need for validation.

    1. Susan Cain on 12.10.2011 at 07:36 (Reply)

      I can understand where you’re coming from, but I don’t think of extroversion that way. I believe that both introversion AND extroversion are normal, healthy personality traits. The unhealthy part is our cultural tendency to privilege one over the other. Introverts and extroverts need each other very much — our world would be diminished without them both.

  4. Phil Holmes on 12.10.2011 at 06:41 (Reply)

    I wonder if this is the spawn not only of extraverts who wish to pathologize the behaviors they do not prefer (and therefore distrust) but perhaps also of introverts who recall with shame the times when they behaved this way as children(and are seeking in a dim, projecting fashion to “fix” in others what was never fixed in themselves). Once again, extraverted norms are being generalized as the only ones that are wholly human, wholly good, and worthy of emulation. It must occur to the good authors of the DSM that the behaviors they are diagnosing here are coming in response usually to an onslaught of loud, unexpected, and threatening stimuli, and to that extent at least are rational and make some sense. I have never seen a child behave in a “socially anxious” way without good reason (in the child’s mind) for that reaction. God help us, they shall be medicating them next, they shall be chirping and screaming with their naturally extraverted peers, and we shall get no peace.

  5. goshawk on 24.10.2011 at 18:29 (Reply)

    If I can inject an alternate viewpoint…

    Increase in diagnoses doesn’t mean the problem is new (the BS “vaccines cause autism” scare, anyone?), nor does it mean it doesn’t exist. Discovering a new mental health issue doesn’t automatically mean that medical professionals are inventing a new disorder out of normal behaviour (what, like they don’t have enough to deal with already?). Sometimes, it means the medical community is finally realising that either there is a problem they hadn’t hitherto acknowledged, or that there was an incomplete understanding of the full range of an existing problem.

    While I’m not saying the concept will never be abused by naturally extroverted caretakers who are concerned about normal shyness in children (see: the tendency for people to loosely use terms like “OCD” or “depressed” about non-disordered behaviour), I think it’s important to take a step back and curb the instinct to defensive cynicism when we talk about mental health and children. Anxiety disorders do exist, even in children, and there is strong evidence that SAnD is a real thing. Furthermore, there is mounting evidence that disorders such as anxiety and depression cause brain damage – they alter the physical structure of the brain to cause lasting mental health issues into adulthood. Thus, time is a factor, and as such it’s vital that we learn how to identify and treat disorders as early as possible in order to mitigate the harm.

    While misdiagnosis can be a real problem, especially where doctors and health professionals are overloaded and never have enough time to spend on every patient, far worse is the attitude often attached to denunciations of “diagnosis culture” – I’m sure you’ve all heard some variation of, “In my day, kids didn’t have ADHD/depression/autism, they just needed discipline/to stop whining/attention”. To which the actual response is, “actually, in your day, kids DID have these disorders – they just weren’t diagnosed and given treatment. Instead, they were likely to be branded ‘bad’ or ‘stupid’.” The increase in diagnosis of childhood mental health issues is a blessing, not a curse. And before someone starts screeching about kids having Ritalin shoved down their throats for twitching once in a classroom, the “overdiagnosis of ADHD” is a myth. (http://www.additudemag.com/addnews/24/2719.html)

    I think it’s better to try to remove the stigma from mental health issues entirely, so that those children who suffer from things like ADHD that makes them incapable of focusing even on things they enjoy, or crippling anxiety in the face of their peers, can get the help they need without their parents or medical professionals needing to fear public censure. This doesn’t necessarily mean medication – it can mean counselling and confidence-building with a professional. Even a child who is just very shy can benefit from that.

    Mental health is a real issue for everyone, including (unfortunately) children, and telling children and parents that they’re just “making it up” or “trying to medicate docility”, either directly or by scoffing at the introduction of a diagnosis standard, is a cruel backhand to the face of those already struggling with a terrible problem. To put it more simply, there are few things worse than telling someone who suffers from a mental illness or disorder that what they are feeling isn’t real.

    1. Susan Cain on 24.10.2011 at 18:46 (Reply)

      Wow, just replying very quickly to this for now because am on my way out the door, but THANK YOU for making this case so passionately and articulately. Very well said, and much to think about. I struggle with this question because I think both things are true: that normal shyness is often inappropriately branded a disease, with sensitive children being made to feel ashamed of who they are naturally; and that on the other hand children (and adults) crippled by anxiety need help without any stigma attached. Anyway, thx again for putting forward your views so bravely and well.

    2. Luna on 24.10.2011 at 19:37 (Reply)

      I think your response is very well stated and I agree with Susan Cain that it is passionate. I also agree completely with you that diagnosis is absolutely necessary for children who are suffering legitimate illness and individuals trained in these areas are best suited to establish this. My concern remains that individuals may be tempted to brush off normal childhood developmental stages as diseases. I was a teacher for fourteen yeas and have seen many a parent brow beaten by teachers who are either overwhelmed by large classes, have poor classroom control or are just not interested in dealing with different personalities. I have heard these teachers encourage parents to send their very active sons in for testing and point blank refusing to deal with them if tests are negative. Once I left teaching to be a stay at home mom I saw the other side. My son had a very difficult time in his grade four class. The teacher announced to me she had recommended testing for ADHD because he had so much difficulty concentrating in her room. I had been a consultant to new teachers prior to leaving teaching so I requested permission to audit one of her classes. Her room was absolutely chaotic, she had zero classroom control and managed the room by screaming. I could barely focus or hear myself think, it was quite clear why my son had difficulty concentrating. I refused the testing and taught him management skills to use in noisy areas but I shudder to think what would have happened had I not been informed and been at the mercy of the teacher’s opinion. I may have dragged my son off for testing that could have done real damage to his young and growing self image.

      1. goshawk on 25.10.2011 at 13:06 (Reply)

        Hi Luna,

        Yes, I absolutely agree that this sort of pressure on parents to get their kids tested is wrong when it’s based on bad evidence and poor circumstances. I just think that stigma-free, open discussion of mental health issues can only help, particularly when it comes to informing parents on the nature of mental health testing, diagnosis, and treatment – not to mention their rights within the school system. My best friend’s little sister and cousin were both diagnosed with autism, and only the professional stature of her parents (a doctor and a Crown Counsel, respectively) forced the school to acknowledge their special needs. Parents from poorer backgrounds are often completely unaware that they can request testing, or stand up to school administration and demand that their child be placed in special education, or any number of other options – just as they’re often unaware that they’re allowed to (or should be; anyone know if this isn’t the case somewhere?) audit classrooms or refuse to test their kids. So in this case, I think the real answer is more education and information for everyone.

        And as ever, the best solution would be more, better paid teachers, smaller class sizes, and a lot more funding and support for public education in general. The more time teachers have to devote to each student, the more each student becomes an individual, and the easier it will be to identify those kids in need of further assistance (and maybe treatment) in contrast to those who only need a bit more one-on-one or something.

        Of course, all of this requires, well, political action. And great discussions on the internet! It’s so refreshing to have a discussion online that doesn’t instantly degenerate into namecalling…=)

  6. Tamesin on 09.11.2011 at 20:11 (Reply)

    I was very interested to read this. Until the age of seven, I was an elective mute (perhaps they’ve changed that phrase recently, don’t know): I didn’t speak to anyone except my parents, my sister, and my very best friend Mary. I was happy, curious, had plenty of friends and interests… I just didn’t want to talk to many people. This was back in the early 1970’s, and I’m *so glad* for that! If I were a child now, I’m sure my mental health would be micromanaged and plenty of people would recommend (unnecessary) medications. Back then, the doctors acknowledged the fact that I was smart and socializing on some level, and both they and my parents adopted a “hands-off” policy. 30+ years later, I’m the head librarian of a public library and connect with hundreds of people every day. And yes, I’m talking now.
    I do remember being mute, and feeling very safe and secure in my silence. Looking back on it all, I feel like I developed certain strengths that I wouldn’t have otherwise: the abilities to listen, to observe, and to step back and take in all sides of an issue before plowing ahead. I still use those skills today. I’m still an introvert (and proud), and see my mutism as a blessing, not a curse. (Ironically, if there’s one thing we get complaints about in my library, it’s that we’re too noisy!)

    1. Susan Cain on 09.11.2011 at 21:29 (Reply)

      Wow, what an interesting perspective. Thx for sharing this, Tamesin. It sounds as if you had unusually thoughtful parents — is that right?

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