Blaming the Mother

The importance of listening to the mother – Tips on accessing children with behavioural difficulties.

For some time, the understanding of child behaviour problems tended to blame mothers. This was a catastrophic error, writes Professor Michael Fitzgerald

PUBLISHED IN OPINION GP IRELAND

ABOUT NAGP

The NAGP is the voice of General Practice. The NAGP was relaunched as the NAGP in order to represent the interests of general practitioners, to help shape the future of primary care and to engage in activities that improve patient outcomes.

Blaming the Mother Article by Prof. Michael Fitzgerald – Opinion GP Ireland

Blaming the Mother Article by Prof. Michael Fitzgerald - Opinion GP Ireland

Psychiatric Problems in Irish Children and Adults – From Childhood to Adulthood

A longitudinal follow up study

From Child to Adult 
A Longitudinal Study of Irish Children and their Families
Co-Author: Cleary A., Fitzgerald M., & Nixon E.
Publisher:  University College Dublin
Criterion Press Ltd.
ISBN: 1 9022 7785 6
Child to Adult Michael Fitzgerald
Free book to download on psychological problems in Irish Children and Adults. 
A follow up study of children, studied in childhood to adulthood, 21 years, showed symptom levels were high and approximately one fifth of the respondents had probable psychiatric conditions and 55% had used non prescription drugs. Behavioural deviance at age 11 was highly predictive of poor educational outcome at age 21.
A majority of mothers previously diagnosed as suffering from psychological problems when their child was 10 had now recovered. Economic disadvantage exasperated the negative outcomes.
40% of children followed up, regarded religion as important in their lives.
This book is free to download from my website.

 

Did W.B. Yeats have Aspergers Syndrome?

A number of historical figures, including Eamon de Valera, WB Yeats and American artist, Andy Warhol, had Aspergers Syndrome according to Professor Michael Fitzgerald. They all showed signs of Asperger’s syndrome, a type of autism in which the person affected generally has a very high IQ, but extremely poor social and communication skills. This is explained in the following books: ‘In Autism and Creativity: Is There a Link between Autism in Men and Exceptional Ability?’ published by Brunner-Routledge and Unstoppable Brilliance, published by Liberties Press. “WB Yeats for example did very poorly at school. He failed to get into Trinity College and was described by his teachers as ‘pedestrian and demoralised’. His parents were told he would never amount to anything”, This is typical of people with Asperger’s syndrome. They do not fit in as they do not relate to others. They are often seen as odd or eccentric and may be bullied at school as a result. Many people in Ireland are thought to have Asperger’s syndrome, with males significantly more likely to develop the condition than females. unstoppable brilliance

Mass Killers – 2 New Books – Can we identify a mass murderer (e.g. pilot, school shooter etc) in advance?

BTB 2 Young Violent and Dangerous to know

These are extremely rare events and it is almost impossible to predict with any degree of accuracy rare events. Nevertheless, we must try but at the same time realise that many of the individual features of the profile I describe about potential mass killers are not rare in the general population. It’s the more overall picture that is relevant.

We must look at:-

1. Medical history pattern deviating from average medical history pattern of pilots, students, military personnel etc

2. Childhood history of being bullied, being a loner, being very routine bound person with special interests in death, perversions, dead animals, serial killers, mass killing, police work, military activities, horror movies, killing of animals, e.g. cats etc showing callous and unemotional trails, moodiness and showing gross lack of empathy, problems reading other people’s minds emotionally, being excessively controlling and dominating, problems with reciprocal social relationships, having sensory problems, noise, taste, touch, being significantly clumsily, being very unpopular in school but having special talents with numbers, mathematics, technology, engineering, construction and logic.

Other features would include poor eye contact, problems reading non-verbal behaviour, problems sharing emotional thoughts, problems turn taking and being very poor at group games. Many or most readers will dismiss this profile as nonsensical. The only answered to them is to ask them to produce a better alternative approach to the problem. Clearly we have to be extremely careful in labelling people inappropriately. If one is totally anti-labelling or identifying potential mass killers then one has to accept the activity of mass killers.

If one hears of a person who is in an average job and who has never performed above the average or indeed less than the average level and they state they will one day be famous and that “everyone will know my name” and they have the profile outlined above then airline management or schools managers or army commanders should ask some questions and explore the background and motive of this person a little more. If in addition to the above profile already described, a person is depressed, has recently experienced stress at his job, has had personal relationship breakup or conflict with his employers or problems with his work performance, is in a position of major responsibility e.g. airline pilot, then they should be examined further, if they make unusual and bizarre statements which could be taken as a joke if one wasn’t listening carefully.

Another scenario is a pupil (almost always male) with the profile described, who shows strange comments on his social media sites, has been bullied (or is being bullied in school), is depressed, ostracised, can’t relate to girls, is a loner, has had an academic crisis or access to guns at home or elsewhere and makes violent threats, these should be investigated by the health and safety officer in school (who should be responsible for gun attacks in school) in conjunction with the management of the school where a thorough investigation should take place. People like the readership keep Adam Lanza, Harold Shipman and Timothy McVey in mind.

References:

1. ‘Autism and School Shooting’ by Michael Fitzgerald has been published in April 2015 in the book ‘Autism Spectrum Disorders – Recent Advances’ by InTech Publishing in a book edited by Michael Fitzgerald.

2. ‘Young Violent and Dangerous to Know’, a book by Michael Fitzgerald was published by Novinka, New York in 2013 and focuses on mass killers and serial killers.

3. A new book called “Psychopathy” published in 2014, edited by Michael Fitzgerald, published by Nova Science, New York, has a chapter on ‘Criminal Autistic Psychopathy’ by Michael Fitzgerald, a not uncommon diagnosis in mass killers.

New Book on Psychopathy edited by Prof. Michael Fitzgerald

Psychopathy: Risk Factors, Behavioral Symptoms and Treatment Options
Psychopathy: Risk Factors, Behavioral Symptoms and Treatment Options
Click to enlarge
Editors: Michael Fitzgerald (Department of Psychiatry, Trinity College Dublin (TCD), Dublin, Ireland)
Book Description:
Psychopathy is one of the most serious and challenging conditions that society and mental health professionals face. The consequences of the actions of persons with psychopathy on other individuals or society at large are very great. Persons with psychopathy are extremely difficult to treat and indeed some treatments in the past have been shown to cause deterioration affects. This book explores the issue of psychopathy from the point of view of the individual with psychopathy, brain aspects of the condition, cultural aspects, treatment aspects and it’s relation to autism and other empathy disorder which it can on occasion overlap with.
Offenders with high levels of psychopathy are among the most challenging persons mental health professionals have to treat. They need very careful and skilled interventions. Chromis is an innovative programme described by Tew, Bennett and Atkinson which shows promise. It is a future focused programme which pays attention to control and choice, collaboration and transparency and has a cognitive skills component, a motivation and engagement components. Marc Wilson and Samantha Harley have an interesting chapter on narcissism, psychopathy and Machiavellianism. They found a relationship between vertical individualism and all three constructs and between hierarchical and narcissism. Their conclusions suggest that hierarchical, autonomous societies may socialise members in such a way that may foster aversive personalities. Don Ambrose in his chapter on unmeritorious meritorocy focuses on a topic that severely affected almost everyone in the developed world in some way. He highlights the admiration for businessmen with psychopathic traits and the negative consequences of this. In the chapter on criminal autistic psychopathy Fitzgerald highlights the overlap between psychopathy and autism. Hans Asperger in his initial descriptions recognised the overlap between psychopathy and autism with his term autistic psychopathy. This idea faded from view over the last thirty years because there was a wish to separate autism from psychopathy. This wish did not prevent the overlap. Fitzgerald (2010) has introduced the sub group of autism spectrum disorders called criminal autistic psychopathy to cover the section of the spectrum where criminality occurs. It links with the new work on callous and unemotional traits (Fitzgerald 2003) and with mass killings, school and other location shootings where criminal autistic psychopathy is not rare.The chapter on cognitive neuroscience in child and adolescent psychopathy by Halty and Prieto point out among other issues that in the case of children with psychopathic features there is evidence of fewer references to welfare of victims when they have to justify transgressions. The chapter by Halty and Prieto on psychopathy in child and adolescent populations discuss the issue of psychopathy in children and adolescents and the importance of callous and unemotional traits as well as the influence of parenting practices in the development of child and adolescent psychopathy. Laura Nunes’s chapter on psychopathy: risk factors and behavioural symptoms focuses on treatment of options in extremely difficult area and proposes a biogram. In the chapter on Hans Asperger autistic psychopathy revisited focuses on the neglected paper of 1938 long before Leo Kanner wrote his paper on autism. Asperger worked on this topic throughout the 1930′s. It also focuses on the differential diagnosis of autism and schizophrenia, obsessive compulsive disorder and other personality disorders. Ana Calzada and colleagues give us a very important chapter on brain scanning and psychopathy. These neuroanatomic differences in violent individuals are very important in terms of aetiology diagnosis and treatment problems and important areas for future research. (Imprint: Nova)References:
Fitzgerald M. (2003) Callous-Unemotional Traits and Asperger’s Syndrome. Journal of the American Academy of Child and Adolescent Psychiatry 42, 9, 10-11.
Fitzgerald M. (2001) Autistic Psychopathy. Journal of the American Academy of Child and Adolescent Psychiatry 40, 8, 870.
Fitzgerald M. (2010) Young Violent and Dangerous to Know. Nova Science: New York.
Table of Contents:
PrefaceChapter 1. The Treatment of Offenders with High Levels of Psychopathy through Chromis and the Westgate Service: What have we Learned from the Last Eight Years?
(Jenny Tew, A.L. Bennett and R. Akinson, National Offender Management Service, Ministry of Justice, United Kingdom and The Centre for Forensic and Criminological Psychology, The University of Birmingham, Birmingham, England; The Westgate Personality Disorder Treatment Service, HMP Frankland, and National Offender Management Service, Ministry of Justice, UK)Chapter 2. Psychopathy: A Proposal for an Integrated Evaluation
(Laura M. Nunes, Fernando Pessoa University, Oporto / Portugal)Chapter 3. MRI Study in Psychopath and Non-Psychopath Offenders
(Ava Calzada-Reyes, Alfredo Alvarez-Amador, Mitchell Valdes-Sosa, Lester Melic-Garcia, Alonso Y. Aleman and Jose del Carmen Iglesias-Alonso, Department of Clinical Neurophysiology, Institute of Legal Medicine, Independence Avenue, Plaza, Havana City; Cuban Center of Neuroscience, Havana City and Department of Clinical Neurophysiology, Carlos Juan Finlay, General Hospital, Havana, Cuba)Chapter 4. Unmeritorious Meritocracy: The Ascendance of Psychopathic Plutocracy in the Globalized 21st-Century
(Don Ambrose, Rider University in Lawrenceville, New Jersey, US)

Chapter 5. Narcissism, Psychopathy and Machiavellianism: Associations between Cultural Factors and Interpersonal Dominance
(Marc Stewart Wilson and Samantha M. Hartley, School of Psychology, Victoria University of Wellington, New Zealand)

Chapter 6. Hans Asperger’s Autistic Psychopathy: Revisited
(Michael Fitzgerald, Department of Psychiatry, Trinity College Dublin (TCD), Dublin, Ireland)

Chapter 7. Criminal Autistic Psychopathy.
(Michael Fitzgerald, Department of Psychiatry, Trinity College Dublin (TCD), Dublin, Ireland)

Chapter 8. Stability of Psychopathic Traits in Youth: Long-term Trends and Comparisons with the Stability of the Five Factor Model of Personality
(Mary Ann Campbell, Rosemary Beauregard and Fred Schmidt, Psychology Department & Centre for Criminal Justice Studies, University of New Brunswick-Saint John Campus, Saint John, New Brunswick; Children’s Centre Thunder Bay, Thunder Bay, Ontario; Psychology Department, Lakehead University, Thunder Bay, Ontario, and Centre for Criminal Justice Studies, University of New Brunswick-Saint John Campus,
New Brunswick, Canada)

Chapter 9. Disordered Self in Schizophrenia and Autism Spectrum Disorders. The Autisms and the Self.
(Michael Fitzgerald and Victoria Lyons, Department of Psychiatry, Trinity College Dublin (TCD), Dublin, Ireland)

Chapter 10. Exploring Treatment Options for an Allegedly “Untreatable” Disorder, Psychopathy: An Integrative Literature Review
(Chasity Bailey, Rahul Sehgal, Adrian Coscia, Deborah Shelton, University of Connecticut, Center for Correctional Health Networks-CCHNet, School of Nursing, CT, USA, and others)

Index

Series:
Psychiatry – Theory, Applications and Treatments
   Binding: ebook
   Pub. Date: 2014
   Pages: 7×10 – (NBC-C)
   ISBN: 978-1-63463-090-0
   Status: AN

Suicidal Behaviour in Adolescents

Worldwide there is about one death every 40 seconds and about one million suicides per year.  Suicide is the leading cause of death worldwide, particularly in younger people.

 

According to Dr. John Connolly there has been a twelve-fold increase in suicide between 1960 and 2000 in 15 to 34 year olds. The Union of Students in Ireland has estimated that 25 persons per year between the ages of 20 and 24 complete suicide. In data collected during 2002 the National Suicide Foundation Registry found that there was increased Parasuicide by 5.7% in the Midland Health Board, 11.9% in the Mid Western Health Board, 8.5% in the South Eastern Health Board, and 12.7% in the Southern Health Board.  They also pointed out that Parasuicide was highest among young women aged 15 to 19 with 1 per 160 of the total population of 15 to 19 year olds being involved.  Parasuicide rates were higher in urban areas and varied between 63 per 100,000 in Leitrim and 429 per 100,000 in Limerick.  They found that alcohol was involved in 46% of male suicides and 38% of female suicides.  Parasuicide made up 1% of all casualty attendances.  The types of drugs used in overdose include (a) 40% minor tranquillisers, (b) 43% at least one analgesic drug (Paracetamol involved in 30% of drug overdoses), (c) 23% antidepressants (18% SSRI), (d) Paracetamol was involved in 33% of overdoses by women and 23% of overdoses by men.

 

It is clear that there are major associations between suicidal behaviour and alcohol or drug abuse.  There is a higher risk if there is an easily available method and higher risk in populations of persons who are depressed and persons with schizophrenia.  Hopelessness is closely associated with suicidal behaviour.  Other factors include narcissistic wounds to the personality i.e. shame or public humiliation.  Imitation plays a role for example after Marilyn Monroe’s death. Unemployment and genetic factors are also important.  The social contact factors include anomie, alienation, western industrialised societies, sense of meaningless in life, ‘worship of the Euro’, a history of sexual abuse, drop out from education, and bullying can also be factors.  Other factors include poor problem solving skills, relationship problems and loneliness, as well as having a history of impulsivity and Attention Deficit Hyperactivity Disorder.  Another condition sometimes involved is persons with Asperger’s syndrome, which is a social relationship disorder.  Personality features associated with suicide and behaviour include antisocial behaviour, emotional dysregulation, and depressive personality.

 

Males are at increased risk of suicide because it is harder for them to find an identity in our society and they often have a sense of being lost.  They have greater difficulties in expressing their feelings particularly emotional feelings and describing interpersonal difficulties.  The female has better verbal skills, better empathy, better interpersonal skills than the male and this is important in reducing completed suicide. The male mind is more of a mechanical mind which is less good at emotional processing.

 

Almost anything can be a warning sign of suicidal behaviour in adolescents but the following have been noted:  truancy, poor school performance, anxiety and depression, withdrawn behaviour, change in behaviour, sleep disturbance, impulsiveness, and low frustration tolerance.  Protective factors against suicidal behaviour include prior experience of self-mastery and success, good mental health, and healthy socialising and coping strategies, as well as success at school and work.

 

In assessing the adolescent with possible suicidal ideas or actual suicidal ideas it is important first to listen and then not to panic and to realise that purely legalistic thinking will interfere with one’s ability to listen to the patient.  It is important to ask relevant questions including thoughts and intensions about suicide, plans, wills, available methods, family history of suicide, imitation issues, depression, and hopelessness.  If a school teacher or anybody else becomes aware that an adolescent is suicidal it is important to remain in touch with them to give them a telephone number or mobile and to take action to bring the matter to the attention of their family.  It is one of the few areas were confidentiality to a friend does not apply. Keeping the friend alive is all that matters.  The adolescent will often need to get first in touch with their G.P. and then with a Psychiatrist or Psychotherapist / Counsellor to deal with the matters that are concerning them.  Sometimes these contacts need to be on a daily basis in the early stages of treatment.

 

In terms of postvention that is dealing with a family post suicide it is important to avoid fault finding or blame. Truthfulness is very important. The family need time to work through the feelings they have in relation to the suicide and this may reduce the likelihood of intergenerational effects later on.

 

In terms of suicide prevention in schools it is important that adolescents are helped to deal with stress and distress and learn life skills.  They have to be thought to manage stress, loss, how to manage upset of a break-up of a relationship, and academic problems.  Developing problem solving is critical.  Some isolated students also need very much to develop social skills and active programmes to prevent bullying in school are of critical importance.