In the past several years, we have seen an increase in gun violence and mass shootings in the U.S. As a result, there is increased discussion about gun control and the right to bear arms. Many are questioning the cause of aggression and violent behavior in youth and pointing to the impact of violent video games, television shows and movies. Occasionally, the issue of mental illness is raised, mostly in regard to preventing those with mental illness from possessing firearms.
Unfortunately, the issue of recognizing, diagnosing and treating of mental illness is rarely raised. There seems to be no movement toward better funding of mental health treatment or better access to care. There is a great deal of research and knowledge about mental health disorders and their impact on individuals and families. However, this information is being overlooked and lost in the current political climate.
CRG (Children’s Resource Group) has been committed to increasing awareness and providing research-based and comprehensive treatment for the past 25 years. As professionals, we have experienced what the research confirms:
- Half of all lifetime cases of mental illness begin by age 14 (1).
- According a large research study on the lifetime prevalence of mental disorders in adolescents, 22.2% of youth experience a severe mental health impairment.
- The most commonly reported condition was anxiety with a prevalence rate of 31.9 % and a median age of onset of 6 years of age.
- The next most common conditions were behavior disorders with a prevalence rate of 19.1% and a median age of onset at 11 years.
- The prevalence of mood disorders was 14.3% and median age of onset was 13 years.
- The prevalence of substance use disorders was 11.4% with median age of onset 15 years. Approximately 40% of those with one class of disorder met criteria for another class of disorder. Mood disorders and behavior disorders caused the most functional impairment (3).
- In a more recent study, the rate of severe mental illness was found to be highest in the population of young adults, ages 18-25 (2).
These sobering statistics magnify the need to take child and adolescent mental health issues seriously and to focus on effective identification and treatment approaches. This issue of our newsletter will focus on the externalized behavior disorders presented in children and adolescents: Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), Attention Deficit Hyperactivity Disorder (ADHD), and Disruptive Mood Dysregulation Disorder (DMDD). In the Diagnostic and Statistical Manual of Mental Disorders (5th Edition, 2013), ODD and CD are classified as Disruptive, Impulse-Control, and Conduct Disorders. ADHD is classified as a Neurodevelopmental Disorder. DMDD is classified as a Depressive Disorder. All these conditions are often first manifested by externalized behaviors. While not all youth who have externalized behavioral difficulties will go on to have severe mental illness, those with these disorders are at higher risk for ongoing mental health concerns as well as educational, employment, relationship and legal issues.
Many children and adolescents with these externalized behavioral difficulties also have co-occurring internalized disorders (anxiety, depression, or bipolar disorder). Our next issue of the CRG newsletter will focus on the internalized disorders.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Kessler R.C., Chiu W.T., Demler O., Merikangas K.R., Walters E.E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. General Psychiatry, 62(6), 617-627.
- Mental Illness. National Institute of Mental Health.
- Merikangas, K R., He, J., Burstein, M., Swanson, S.A., Avenevoli, S., Cui, L., … Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: Results from the national comorbidity study-adolescent supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989.
- Clinical Characteristics of Oppositional Defiant Disorder and Conduct Disorder.