Lack of public awareness about the role of mental illness in domestic, family and elder abuse is a real impediment to reducing abuse within the boundaries of the Kuring Gai LAC.
EMOTIONS - the elephant in the room
The road ahead in addressing domestic conflict requires increased public awareness that the inability to regulate emotions, is a significant
contributor to relationship stress, and in extreme cases violence within families.
It is well established that the inability to regulate emotions can be due to a treatable genetic disorder
which affects approximately 5% of the world’s population. However, less than
one-quarter of adults living with it have been diagnosed and helped (1).
There are two fundamental ways that untreated
sufferers of this condition respond to emotional stress. Where the sufferer internalizes emotions
they may experience depression and loss of self-esteem. Where the emotions are
externalized, pain can be expressed as rage at the person or situation that
wounded them (2). Fortunately, in the latter case the direct effect of
this condition on violence is generally moderate and manageable.
On the other hand this genetic disorder is often
accompanied by other mental illnesses such as Oppositional Defiance Disorder
(ODD). Around 40% develop ODD, and where their conduct problems persist from childhood into adulthood they are more likely to lie, and be verbally aggressive
and violent toward romantic partners and or close persons (3). Current
data indicates about one in three ODDs will move on into a more serious
disorder involving aggression and the law (4).
Approximately 4.4% of US adults have attention-deficit/hyperactivity disorder (ADHD). Yet, this condition re-mains underdiagnosed as only 10.9% of adults with ADHD receive treatment. To complicate diagnosis, adults with ADHD often have comorbid psychiatric disorders, which may mask the symptoms of ADHD.
Emotional dysregulation and Attention-Deficit/Hyperactivity Disorder
First, emotion dysregulation is prevalent in ADHD throughout the lifespan and is a major contributor to impairment. Second, emotion dysregulation in ADHD may arise from deficits in orienting towards, recognizing and/or allocating attention to emotional stimuli; these deficits that implicate dysfunction within a striato-amygdalo-medial prefrontal cortical network. Third, while current treatments for ADHD often also ameliorate emotion dysregulation, a focus on this combination of symptoms reframes clinical questions and could stimulate novel therapeutic approaches. Link to PDF
Severity of the Aggression/Anxiety-Depression/Attention (A-A-A) CBCL Profile Discriminates between Different Levels of Deficits in Emotional Regulation in Youth with ADHD
Recent research has begun to recognize that child patients with ADHD manifest deficient emotional self-regulation (DESR). DESR is characterized by poor self-regulation including such symptoms as low frustration tolerance, impatience, quickness to anger, and being easily excited to emotional reactions. This study showed that 36% of children with ADHD had a positive CBCL-DESR profile and concludes that Severity scores of the A-A-A CBCL profiles can help distinguish two groups of emotional regulation problems in children with ADHD.
Oppositional Defiant Disorder Is Better Conceptualized as a Disorder of Emotional Regulation
The regulation of emotions can be defined as the process by which individuals influence which emotions they have, when they have them, and how they experience and express them. Dysregulation can be defined as the lack of temper control, affective lability, and emotional overreaction. Deficient regulation of emotions is a pervasive and impairing component of many psychiatric disorders seen in childhood, presenting in uni-polar and bipolar mood disorders, anxiety disorders, and behavior disorders including ADHD and Oppositional Defiant Disorder (ODD).
Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study
Conclusions:
By their young adult years, ADHD youth were at high risk for a wide range of adverse psychiatric outcomes including markedly elevated rates of antisocial, addictive, mood and anxiety disorders. These prospective findings provide further evidence for the high morbidity associated with ADHD across the life-cycle and stress the importance of early recognition of this disorder for prevention and intervention strategies.
Conduct disorder (CD) refers to a set of problem behaviours exhibited by children and adolescents, which may involve the violation of a person, their rights or their property. It is characterised by aggression and, sometimes, law-breaking activities.
CD is one of a group of behavioural disorders known collectively as disruptive behaviour disorders, which include oppositional defiant disorder (ODD) and attention deficit hyperactivity disorder (ADHD). Early intervention and treatment is important, since children with untreated CD are at increased risk of developing a range of problems during their adult years including substance use, personality disorders and mental illnesses.
The road ahead in addressing domestic conflict requires increased public awareness that the inability to regulate emotions, is a significant
contributor to relationship stress, and in extreme cases violence within families.
