I am excited to share my Debunking the Myths of OCD-TED ED Lesson ! I hope you find it useful and educational. While I was not able to focus as much on effective treatment interventions like cognitive therapy and exposure and response prevention, I started a discussion platform in hopes of continuing the conversation about it! In addition, I posted excellent resources on there as well as in the Dig Deeper section so check it out!
Disorders have criteria that allows clinicians to accurately diagnose and provide treatment. The same disorder, however, can have a different presentation. One such example is the same disorder may present differently in children than it does in adults. It can sometimes be difficult to decide whether behaviors are truly diagnostic, someone’s idiosyncrasies, or part of normal childhood phases. This is especially true with OCD. While routines are part of childrens’ schedules, it is important to know the distinction between the role of developmentally appropriate routines and rituals that may mean something more like OCD. A routine is part of a child’s daily schedule like homework hour, bath time, or kisses before bed. Routines allow children to function adaptively and can offer a sense of security. A ritual in OCD, on the other hand, is something that does not provide lasting relief. A ritual in OCD is something a child feels compelled to do so much so that if they do not it results in significant distress. This is probably the biggest distinguishing factor. Children feel they need to engage in a ritual otherwise they experience severe anxiety. Engaging in the ritual comforts children with OCD but only temporarily and the anxiety returns pretty quickly. The ritual itself actually reinforces the anxiety. So when assessing whether a child is engaging in normal routines or OCD-like rituals think about the following:
- How long do the rituals provide a sense of relief?
- In OCD, rituals provide a fleeting sense of relief.
- How much time is spent on rituals?
- Spending 1-2 hours on rituals can be a sign of OCD.
- How much are the rituals interfering with daily functioning?
For more information on OCD in children visit the IOCDF’s website.
About 500,000 Australians are affected by a mental health disorder but only about 1/3 actually seek treatment. These numbers are not unique to Australia. Psychological factors such as mental health stigma and embarrassment may be reasons why individuals fail to seek treatment which leads to a growing number of individuals left with undiagnosed and untreated mental illness. Physical barriers may also contribute to not seeking treatment such as living in remote areas where care is inaccessible. With this being the electronic age it is of no surprise that therapy is now offered via such a modality. That is virtually. The key is getting people to seek treatment before the level of impairment becomes severe. Disorders of lesser severity respond quicker and better to treatment than those of greater severity. So if virtual therapy aids in removing the psychological and physical barriers that prevent individuals from seeking treatment (and we know many people don’t seek treatment) then it seems that virtual therapy may have many benefits over traditional face-to-face therapy. The critical questions are: how effective is it compared to face-to-face therapy and for what disorders? A new study to be released by the Australian Psychological Society reports promising findings that virtual therapy is just as effective as face-to-face therapy for individuals with low to moderate OCD. The findings come from an evaluation of online OCD treatments from Australia which is regarded as a world leader in e-therapy. This is encouraging news as the area of telepsychotherapy is growing!
Check out the full article here !
Since this week is OCD Awareness Week, I am going to share some videos discussing aspects of OCD. One of the most commonly asked questions I get is, “Is OCD genetic?”. Check out the video below where Dr. Wayne Goodman, an expert on OCD and chair of the psychiatry department at Mount Sinai Hospital, discuss the causes of OCD.
Dr. Goodman discusses the causes of OCD
Check it out!
Today marked the beginning of OCD Awareness Week (October 13-19)! You can participate in OCD Awareness Week by joining an online chat sponsored by the IOCDF every weekday at 12noon ET. You can check out the IOCDF’s website for more ways to participate.
The New York Times published a great article today on OCD. It accurately describes how this disorder is more than just someone’s idiosyncrasies. OCD can be quite debilitating and impact daily living, however, treatment can be highly effective. You can check out the full article here.
Let’s raise awareness about OCD!
For many, today marks the first day back to school which can mean heightened anxiety for children, parents, and people returning to work. Back to School anxiety is common and can be experienced by all those making the transition from summer to school. Now that this morning is out of the way here are some tips for helping kids this afternoon when they return home from school today!
- Let kids share their first day experiences without guiding the conversation.
- Don’t overwhelm with questions as soon as they get home or force a conversation. They may need some time before talking about their first day back.
- Allow kids to take a break and decompress before diving into their backpacks and reviewing what they need for school.
- Fit in some time for fun after school. Don’t let the first week of school symbolize the end of summer and end of fun. Enjoy some time outdoors this week after school before demands and schedules make it difficult to do so!
- Monitor kids’ reactions to school. If you notice signs of anxiety or withdrawal talk to them about it and work with the school as early as possible.
Wishing you all a safe and easy transition back to school!
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a clinical diagnosis given to a subset of children who experience an acute onset of OCD and Tourette symptoms following strep infections. PANDAS can be difficult to diagnose as there is no specific test for PANDAS and it is not yet widely received in the medical community but clinically assessing the symptoms of strep infections as well as OCD and Tic-like symptoms are crucial. IOCDF’s website has an informative page on talking to your pediatrician about PANDAS. They also included signs to help differentiate Strep Infections from other respiratory infections which are quoted below.
Clinical signs that help to differentiate common respiratory infections
Signs of Group A Streptococcal Illness
Signs of Mycoplasma or viral infections
- Sore throat without cough or runny nose
- Fever (alone or with sore throat)
- Vomiting (young child)
- Perianal or vaginal redness (young child)
- Red fine sand paper rash on trunk
- Sore throat with cough
- Stuffy or runny nose
Check out their website for more information and resources!
In honor of Mental Health Blog Day I am sharing a blog that NPR published recently on the early stages of hoarding and the inherent difficulties of diagnosing it in a younger population such as adolescents. While hoarding has become more widely recognized in both clinical and non-clinical settings, diagnosing it in its early stages and in younger patients such as teens are fairly unchartered waters. Precursor to hoarding symptoms may be present in teens but are overlooked and may be mistaken for the typical “messiness” of that developmental cohort. This is an important distinction for clinicians in targeting hoarding problems early on before they significantly impact one’s daily life. So should we be assessing atypical messiness? And if so, how??
Click on the link below for the full blog.
You probably have heard of the word “selfie”. Now officially recognized in the Oxford dictionary, there seems to be a selfie phenomenon occurring and its not just a trend typical of adolescence. It does, however, have some diagnostic utility for clinicians. How often they feel compelled to take a selfie and the associated anxiety and distress can be signs of Body Dysmorphic Disorder, a disorder characterized by a preoccupation with an imagined or perceived body defect. Its important to note that while the majority of adolescents and young adults take selfies, selfie addiction is a form of compulsion that’s reflective of this digital age. It can become debilitating involving constant checking and posing for a picture that fits certain standards. For more on BDD and selfie addiction check out the article below in the International Business Times.
Parents magazine recently published an article on how cognitive behavioral therapy is effective for young patients with Obsessive Compulsive Disorder. While the research on CBT for OCD is nothing new, most of the literature has documented its effectiveness with adults. Much less is known about how effective it is for young children with OCD. This new study provides promising data. What’s probably the most important factor with younger patients with OCD is the role of parents as co-facilitators of therapy or “co-pilots” as I like to refer to them. Its especially important that parents monitor kids’ follow through on therapy homework assignments and not engage or reinforce compulsions or reassurance seeking. This may be especially difficult for younger kids to do independently.
Check out the link below for the full article in Parents magazine.
Meaningful Activities Can Help Protect Against Depression in Adolescents
An article published in The Atlantic shared findings from a recent study that followed a group of adolescents to see how eudaimonic (Greek for happiness or human welfare) or hedonic (related to pleasurable or unpleasurable sensations) rewards correlated with depression over time.
Here are a few excerpts from the article:
First, the subjects underwent an fMRI while making a decision about whether to keep money for themselves (a hedonic reward) or to donate it to their families (eudaimonic). They also played a game to determine if they were willing to take risks for the possibility of a greater financial reward (hedonic).
The subjects then filled out a self-report questionnaire of depressive symptoms during the initial scan, and again a year later.
It turned out the teens who had the greatest brain response to the generous, family-donation financial decision had the greatest declines in depressive symptoms over time. And those who got a boost from the risk-taking game were more likely to have an increase in depression. The types of rewards the teens responded to, it seems, changed their behavior in ways that altered their overall well-being.
So whats the take away message? Well you can’t force a teenager to receive authentic pleasure from helping others, but those that do seem to carry with them a protective lining in the future. Overall well-being may be tied to morality, culture and family related values rather than immediate gratification in terms of selfish rewards.
Parenting is a tough job…an even tougher job is disciplining your child. Psychology Today published a helpful article entitled Six Smart Strategies for Disciplining Your Child.
1. Set a good example.
I agree. From a social learning perspective kids follow your behavior. Remember Bandura’s Bobo Doll Study? Yes it was about aggression but still children learn from models.
2. Be consistent!
Yes…true again. What’s the best treatment for behavior issues: contingency management. What’s one factor that makes it so successful? BEING CONSISTENT!
3. Try to understand what fuels your child’s defiant behavior.
Remember your ABC’s. Not those ABC’s …the ABC model. Antecedents-Behavior-Consequences. If you know what triggers the behavior then you know how to best handle it!
4. Take emotion out of the equation.
If you are all business…guess what they’ll know you mean business.
5. Use consequences that make sense.
Be sensible. If you throw out consequences in the heat of the moment that are not sensible and don’t implement them you lose your credibility….and then guess what you are inconsistent.
6. Make sure your consequences come on the heels of your child’s misbehavior.
Contingency management works when you associate the behavior to consequences immediately and inform the child what exactly they did that was wrong. Also use it as a teaching opportunity. Teach them appropriate ways of handing the situation next time.
The New York Times recently published an article on Michael Sam, a talented college football player who could be playing in the NFL anyday but it wasn’t about his athletic prowess. Sam has openly come out that he is gay. Now while it seems absurd that an individual’s sexuality is making headlines. While being gay is more accepted now than ever before it still has yet to be seen in certain arenas……pardon the pun. The culture of athletics, especially football, has not yet broken the barrier where athletes have come forward about being gay….until now. Read some excerpts from the NY Times piece below:
Coaches at the University of Missouri divided players into small groups at a preseason football practice last year for a team-building exercise. One by one, players were asked to talk about themselves — where they grew up, why they chose Missouri and what others might not know about them.
As Michael Sam, a defensive lineman, began to speak, he balled up a piece of paper in his hands. “I’m gay,” he said. With that, Mr. Sam set himself on a path to become the first publicly gay player in the National Football League.
“I looked in their eyes, and they just started shaking their heads — like, finally, he came out,” Mr. Sam said Sunday in an interview with The New York Times, the first time he spoke publicly about his sexual orientation.
As the pace of the gay rights movement has accelerated drastically in recent years, the sports industry has seen relatively little change, with no publicly gay male athletes in the N.F.L., the N.B.A., the N.H.L. or Major League Baseball. Against this backdrop, Mr. Sam could become a symbol for the country’s gay rights movement or a flashpoint in a football culture war — or both.
“Once I became official to my teammates, I knew who I was,” Mr. Sam said. “I knew that I was gay. And I knew that I was Michael Sam, who’s a Mizzou football player who happens to be gay. I was so proud of myself and I just didn’t care who knew. If someone on the street would have asked me, ‘Hey, Mike, I heard you were gay; is that true?’ I would have said yes.”
This is a good sign that we are moving forward.
Another celebrity, SNL All Star Will Forte, discusses his experience with OCD as he transitioned to on screen dramatic roles in his recent films.
In the article Forte goes on to say about his OCD:
“It comes in waves,” he says. “It definitely affects my everyday life. Mine is a lot of checking locks in patterns, checking stoves that I rarely use to see if the gas is on, or sinks. I don’t want to burn my house down or flood my house. But oddly, the experience in Ireland really had a major effect on my OCD. I had so much time alone and so much time to think about stuff that I realized, ‘Why am I letting this OCD rule my life the way that it does? We’re all gonna die at some point, so what if all my possessions burned down in a fire, or my house gets flooded? What am I scared of losing?’”
Another Celebrity Discusses Their Experience with OCD
This article points out what we already know- our student body is changing from what it was in the past. This stresses the importance of incorporating cultural diversity into child psychopathology, assessment and education courses. Our student demographic is quite heterogenous and not predominantly of what was once considered the “mainstream culture”. All things must be examined from a sociocultural perspective.
Do you know the difference between Obsessive Compulsive Disorder and Obsessive Compulsive Personality Disorder? Watch Dr. Pinto discuss the delay of rewards as a distinguishing feature.
Check it out,
Do you know what a school psychologist is? What their roles and responsibilities are? Check out what some school psychologists shared about what kids thought they do!
What Is a School Psychologist? | Child Mind Institute.
Man with OCD Blows Internet Away with Hauntingly Stirring Love Poem
Take a look at this poem written and performed by a man with Obsessive-Compulsive Disorder. Neil Hilborn’s ode to love describes his relationship with OCD and his romantic relationship all while showing his struggle with nervous tics. Very compelling video!
Check it out!
Risk of Adult Anxiety Seen in Children’s Stomachaches
The NY Times published a great article on a recent study on children with chronic stomach pain. As an anxiety specialist who works with children and adolescents, I commonly see kids present with recurring stomachaches that are masking anxiety issues. This really highlights the importance of early diagnosis and treatment. Anxiety disorders typically only worsen without treatment. Check out excerpts from the article below.
Researchers at Vanderbilt University tracked 332 children with recurring stomachaches that could not be traced to a physical cause — so-called functional abdominal pain — comparing them as they reached young adulthood with 147 children who had never had such stomachaches.
About half the teenagers and young adults who had had functional abdominal pain as children developed an anxiety disorder at some point, compared with 20 percent of the control group, the researchers found. The vulnerability to anxiety persisted into adulthood even if the pain had disappeared, although the risk was highest if the pain continued.
Forty percent of the children with functional abdominal pain went on to experience depression, compared with 16 percent of those who had never had these stomachaches.
The new study underscores the importance of screening children with the condition for anxiety or depression, the authors said. Anxious children tend to be good children who are concerned about doing their best, Dr. Walker said, and parents may be flummoxed by the suggestion that such a child could be grappling with a mental health issue.
The majority of the children enrolled in the study “had not seen a mental health professional, ever,” Dr. Walker said.
Misdiagnosis of OCD Could Have Serious Consequences
Children Diagnosed With ADHD Could Actually Have OCD: How Medicating For One Can Have Serious Consequences For The Other
Great article on the common misdiagnosis of OCD for ADHD. Research highlights that misdiagnosis could have potentially negative consequences.
Here are some excerpts from the article:
Moreover, a negative association between OC symptoms and response inhibition and a bias in self-perception of impulsivity was found only in the OCD group,” the researchers noted, suggesting that people with OCD tend to overestimate their impulsivity by measuring it according to an abnormally high threshold.
If diagnosed incorrectly, a child’s future path could be fraught with unnecessary medication and psychological problems stemming from self-esteem issues and behavioral disorders.
It’s more likely that a young student will be diagnosed with ADHD instead of OCD because teachers see so many people with attention problems and not many with OCD,” said Dar. “If you don’t look carefully enough, you could make a mistake.
As clinicians, parents, and teachers we need to refrain from common mistakes in diagnosis and perceiving symptoms to be something they are not. IUt can hold long-term and negative consequences that should be considered.
Summer is here and the IOCDF has listed a few programs/camps for children and adolescents with OCD. Check out the list posted on the site at the link: http://ocfoundation.org/ocdinkids/summer-programs/.
Below is information regarding NYU’s Summer Camp this August.
NYU’s Child Study Center
Who: Children, 8–13 years, with a diagnosis of OCD or other anxiety disorder
When: Monday through Friday, August 12th–16th, 9:00AM to 3:00PM
Where: New York, NY
Contact: Sarah Trosper, PhD at 646-754-4891 or email: Sarah.Trosper@nyumc.org
Check it out,
Check out my latest article, Advances in the Treatment of Body Dysmorphic Disorder, in the International Journal of Cognitive Therapy: Vol. 6, Innovations and Advances in the Cognitive-Behavioral Therapies, pp. 138-149. I am the co-author with Dr. Fugen Neziroglu. Below is the abstract and link to the journal.
Body Dysmorphic Disorder is underdiagnosed and a largely misunderstood disorder, despite more than 20 years of research, and the facts that it is associated with a high rate of suicidality, hospitalization, and poor quality of life. Cognitive behavior therapy (CBT), as well as certain pharmacological agents, have been found to be effective as treatments. This article reviews a CBT model for the acquisition and maintenance of the disorder proposed by Neziroglu, and its associated treatment protocol. Based on this model, new directions to understand BDD and its treatment are emerging. These directions include attentional training/task concentration and the role of somatosensory and perceptual processes.
Read More: http://guilfordjournals.com/doi/abs/10.1521/ijct.2013.6.2.138
Check it out!
The Wall Street Journal published a great article on the role of parents in treating anxiety disorders such as social anxiety. The evidence based treatment for anxiety disorders such as OCD and social anxiety is a form of cognitive behavioral therapy called exposure and response prevention. It basically involves systematically exposing the client to the least to most anxiety provoking situations while teaching them relaxation and cognitive strategies to help them deal with the anxiety. Exposure therapy has proven to be quite effective for social anxiety and other disorders but it is important that patients practice exposures outside of therapy and at home. For that reason the role of parents in treatment is crucial. Parents are the “at home therapists” so it is important that they are on board and included in treatment planning. Check out the article below on one teen’s success with ERP and the role her parents played!
Summer is almost officially here and with the end of school families are getting ready for their summer plans. For many families summer means sending their kids off to sleep away camp. This may be an anxiety provoking time for children and parents alike especially when children become homesick. Check out the interview below with Dr. Michael Thompson for some great insight on the matter! He discusses making the transition easier and the benefits of camp and time away from parents. Parents and camp personnel should check it out!
Dr. Natascha Santos:
It has been a long hiatus but I am back. Check out this blog post on attaining things you want in life!
Check it out!
Originally posted on ERT Ethics: Mindset Blog:
I want a promotion. I want that project. I want recognition. I deserve it, no doubt. How come others get it and not I? The answers, my friends, could be many –and I would like to talk about one simple rule: I get what I prepare for. When I am ready, it will come. Simple – but how do I get ready, and how do I know I am ready? Easy, you know you are ready when you get what you wanted. Funny, a post with circular logic; how great is that? So the real question is how do I get ready?
There are a few things to do in order to prepare to receive. First, figure out what you really want, and hold on to it. For this, it is not enough to say “it would be nice to have a $250,000 bonus this year”. You must…
View original 158 more words
Check out Dr. Santos on tonight’s episode of Hoarding: Buried Alive on TLC at 9pm!
Watch Kelly Jay, a sweet rockstar with a tough exterior, and his family attempt to get his life back after several tragedies that have left him depressed and stuck. Amidst a sea of treasures and tchotchkes his home has become a safety hazard for him and has left him isolated from his children and grandchildren. Watch his emotional story and the crew help him get his life back!
It was a pleasure working with him, his family and the crew!
I’m A Rockstar Baby!