Author Archive
Suicide Pact Forensic Case, Dr Saul and Dr Garbarino Testify
THIS ARTICLE was written by BY JESSICA STEPHEN
Issues of social immaturity and isolation, combined with romantic images from vampire novels, allegedly led a then-16-year-old boy to attempt suicide with a classmate, doctors testified Monday.
And, doctors concluded, the juvenile court system should be the venue to deal with the teen, who is facing an attempted murder charge in adult court for the alleged suicide pact.
“This is not a conventional crime,” said Dr. James Garbarino, a Loyola University professor who has written nearly two dozen books about child development, trauma and youth violence. Garbarino met with the teen in February, weeks before his 17th birthday.
“This is a mental health crisis that almost coincidentally involved criminal behavior,” Garbarino said. “Two troubled kids formed a suicide pact and were intent on implementing the plan, which was not directed at attacking people outside that little delusional system.”
Suicide pact
The boy was charged in December after reportedly telling police he and a 16-year-old girl made a mutual suicide pact. The boy led his father to the Hooker Lake boat launch, where the father found the girl bleeding Nov. 17 and called police.
“She said all I had to do was guide her hand,” the boy said, allegedly adding that he “took the knife and cut across her wrist. I then took the knife and cut my left wrist.” Both teens survived.
Under Wisconsin law, anyone over age 10 accused of a homicide-related offense can be charged automatically as an adult. But, as part of the reverse waiver process, the boy’s attorneys have the right to ask the court to consider hearing the case in juvenile court.
Juvenile court recommended
As part of a reverse waiver hearing that will continue in July, Garbarino testified Thursday that prosecuting the boy in adult court would not likely deter others and would not be in the boy’s best interests.
“This seems like such a, to use the term, no-brainer,” said Garbarino, who advocated for prosecuting the case in juvenile court. “It would be a travesty to do anything else.”
Dr. Jenna Saul, a child and adolescent psychiatrist from Wisconsin Rapids, echoed Garbarino’s conclusions. She also met with the boy in February.
In their testimony for the defense, both doctors described the boy as socially naive, young for his age and drawn in by the opportunity to love and be loved.
‘Utter infatuation’
Garbarino talked about the boy’s “utter infatuation” with the girl, as well as how taken the boy was with romantic vampire literature.
Saul said the boy spent his life trying to please others, even at the expense of disregarding himself, particularly after the girl said she could no longer bear the pain of living.
“He’s willing to do anything for other people,” Saul said. “So, he’s particularly vulnerable to being willing to be this self-sacrificing. … He wanted to help. He wanted to, in some way, take away the hurt for her. She came up with a solution: I need to die,” Saul said. “And he did not want her to have to die alone.”
Did not seek help
His pattern of not seeking help — from dealing with feelings about his parents’ separation to not asking for help after his special education services were withdrawn and his grades declined — also played a role.
Saul came to that conclusion after she asked the boy what he might have done differently, if he faced this situation again.
“His answer was he would have made sure he had met (the girl) when it was years before. … So, they could have been together, and she wouldn’t have had to suffer,” Saul said.
“It was astounding. He wasn’t asking for help. That wasn’t part of his repertoire, even after going through this.”
That indicated a need for mental health treatment, not incarceration, the doctors said.
The teen is out of jail on bond, under supervision from his parents.
© Copyright Kenosha News.
Ashley Judd: Misogynistic Judgments of Women’s Appearances
Ashley Judd Slaps Media in the Face for Speculation Over Her ‘Puffy’ Appearance
THIS EDITORIAL first appeared at The Daily Beast at http://www.thedailybeast.com/articles/2012/04/09/ashley-judd-slaps-media-in-the-face-for-speculation-over-her-puffy-appearance.html
Ashley Judd’s ‘puffy’ appearance sparked a viral media frenzy. But, the actress writes, the conversation is really a misogynistic assault on all women.
The Conversation about women’s bodies exists largely outside of us, while it is also directed at (and marketed to) us, and used to define and control us. The Conversation about women happens everywhere, publicly and privately. We are described and detailed, our faces and bodies analyzed and picked apart, our worth ascertained and ascribed based on the reduction of personhood to simple physical objectification. Our voices, our personhood, our potential, and our accomplishments are regularly minimized and muted.
As an actor and woman who, at times, avails herself of the media, I am painfully aware of the conversation about women’s bodies, and it frequently migrates to my own body. I know this, even though my personal practice is to ignore what is written about me. I do not, for example, read interviews I do with news outlets. I hold that it is none of my business what people think of me. I arrived at this belief after first, when I began working as an actor 18 years ago, reading everything. I evolved into selecting only the “good” pieces to read. Over time, I matured into the understanding that good and bad are equally fanciful interpretations. I do not want to give my power, my self-esteem, or my autonomy, to any person, place, or thing outside myself. I thus abstain from all media about myself. The only thing that matters is how I feel about myself, my personal integrity, and my relationship with my Creator. Of course, it’s wonderful to be held in esteem and fond regard by family, friends, and community, but a central part of my spiritual practice is letting go of otheration. And casting one’s lot with the public is dangerous and self-destructive, and I value myself too much to do that.
However, the recent speculation and accusations in March feel different, and my colleagues and friends encouraged me to know what was being said. Consequently, I choose to address it because the conversation was pointedly nasty, gendered, and misogynistic and embodies what all girls and women in our culture, to a greater or lesser degree, endure every day, in ways both outrageous and subtle. The assault on our body image, the hypersexualization of girls and women and subsequent degradation of our sexuality as we walk through the decades, and the general incessant objectification is what this conversation allegedly about my face is really about.
A brief analysis demonstrates that the following “conclusions” were all made on the exact same day, March 20, about the exact same woman (me), looking the exact same way, based on the exact same television appearance. The following examples are real, and come from a variety of (so-called!) legitimate news outlets (such as HuffPo, MSNBC, etc.), tabloid press, and social media:
One: When I am sick for more than a month and on medication (multiple rounds of steroids), the accusation is that because my face looks puffy, I have “clearly had work done,” with otherwise credible reporters with great bravo “identifying” precisely the procedures I allegedly have had done.
Two: When my skin is nearly flawless, and at age 43, I do not yet have visible wrinkles that can be seen on television, I have had “work done,” with media outlets bolstered by consulting with plastic surgeons I have never met who “conclude” what procedures I have “clearly” had. (Notice that this is a “back-handed compliment,” too—I look so good! It simply cannot possibly be real!)
Three: When my 2012 face looks different than it did when I filmed Double Jeopardy in 1998, I am accused of having “messed up” my face (polite language here, the F word is being used more often), with a passionate lament that “Ashley has lost her familiar beauty audiences loved her for.”
Four: When I have gained weight, going from my usual size two/four to a six/eight after a lazy six months of not exercising, and that weight gain shows in my face and arms, I am a “cow” and a “pig” and I “better watch out” because my husband “is looking for his second wife.” (Did you catch how this one engenders competition and fear between women? How it also suggests that my husband values me based only on my physical appearance? Classic sexism. We won’t even address how extraordinary it is that a size eight would be heckled as “fat.”)
Ashley Judd on her new show “Missing”
Five: In perhaps the coup de grace, when I am acting in a dramatic scene in Missing—the plot stating I am emotionally distressed and have been awake and on the run for days—viewers remarks ranged from “What the f–k did she do to her face?” to cautionary gloating, “Ladies, look at the work!” Footage from “Missing” obviously dates prior to March, and the remarks about how I look while playing a character powerfully illustrate the contagious and vicious nature of the conversation. The accusations and lies, introduced to the public, now apply to me as a woman across space and time; to me as any woman and to me as every woman.
That women are joining in the ongoing disassembling of my appearance is salient. Patriarchy is not men. Patriarchy is a system in which both women and men participate. It privileges, inter alia, the interests of boys and men over the bodily integrity, autonomy, and dignity of girls and women. It is subtle, insidious, and never more dangerous than when women passionately deny that they themselves are engaging in it. This abnormal obsession with women’s faces and bodies has become so normal that we (I include myself at times—I absolutely fall for it still) have internalized patriarchy almost seamlessly. We are unable at times to identify ourselves as our own denigrating abusers, or as abusing other girls and women.
A case in point is that this conversation was initially promulgated largely by women; a sad and disturbing fact. (That they are professional friends of mine, and know my character and values, is an additional betrayal.)
That the conversation about my face was initially promulgated largely by women is a sad and disturbing fact.
News outlets with whom I do serious work, such as publishing op-eds about preventing HIV, empowering poor youth worldwide, and conflict mineral mining in Democratic Republic of Congo, all ran this “story” without checking with my office first for verification, or offering me the dignity of the opportunity to comment. It’s an indictment of them that they would even consider the content printable, and that they, too, without using time-honored journalistic standards, would perpetuate with un-edifying delight such blatantly gendered, ageist, and mean-spirited content.
Ashley Judd responds to her critics on ‘Nightly News.’
I hope the sharing of my thoughts can generate a new conversation: Why was a puffy face cause for such a conversation in the first place? How, and why, did people participate? If not in the conversation about me, in parallel ones about women in your sphere? What is the gloating about? What is the condemnation about? What is the self-righteous alleged “all knowing” stance of the media about? How does this symbolize constraints on girls and women, and encroach on our right to be simply as we are, at any given moment? How can we as individuals in our private lives make adjustments that support us in shedding unconscious actions, internalized beliefs, and fears about our worthiness, that perpetuate such meanness? What can we do as families, as groups of friends? Is what girls and women can do different from what boys and men can do? What does this have to do with how women are treated in the workplace?
I ask especially how we can leverage strong female-to-female alliances to confront and change that there is no winning here as women. It doesn’t actually matter if we are aging naturally, or resorting to surgical assistance. We experience brutal criticism. The dialogue is constructed so that our bodies are a source of speculation, ridicule, and invalidation, as if they belong to others—and in my case, to the actual public. (I am also aware that inevitably some will comment that because I am a creative person, I have abdicated my right to a distinction between my public and private selves, an additional, albeit related, track of highly distorted thinking that will have to be addressed at another time).
If this conversation about me is going to be had, I will do my part to insist that it is a feminist one, because it has been misogynistic from the start. Who makes the fantastic leap from being sick, or gaining some weight over the winter, to a conclusion of plastic surgery? Our culture, that’s who. The insanity has to stop, because as focused on me as it appears to have been, it is about all girls and women. In fact, it’s about boys and men, too, who are equally objectified and ridiculed, according to heteronormative definitions of masculinity that deny the full and dynamic range of their personhood. It affects each and every one of us, in multiple and nefarious ways: our self-image, how we show up in our relationships and at work, our sense of our worth, value, and potential as human beings. Join in—and help change—the Conversation.
- Ashley Judd is a prolific actress, who will next be seen in ABC’s new midseason show, Missing. Judd most recently appeared in Dolphin Tale alongside Morgan Freeman, Harry Connick Jr. and Kris Kristofferson.
- Judd is also on the board of directors for PSI (Population Services International), which she joined in 2004 after serving as Global Ambassador for PSI’s HIV education and prevention program, YouthAIDS since 2002. Judd has visited PSI programs in Thailand, Cambodia, Madagascar, Kenya, South Africa, Guatemala, Honduras, Nicaragua, El Salvador, India, Rwanda and the Democratic Republic of Congo. In her work, she witnesses the lives of the exploited and poor to help educated the world about the reality of global poverty and bring solutions to the devastating effects of social injustice and gender inequality.
- Judd was the subject of three award-winning documentaries aired in more than 150 countries worldwide on VH1, The Discovery Channel and The National Geographic Channel. In her role as PSI board member, Judd has graced the covers of countless magazines and been the subject of newspaper and television interviews bringing vital awareness to issues closest to her heart, gender inequality and poverty alleviation.
- Judd has visited legislators on Capitol Hill, addressed the General Assembly of the UN on the scourge human trafficking, spoke at the National Press Club, testified before the Senate Foreign Relations Committee for the protection of vulnerable women from violence, sexual abuse and HIV and, most recently served as an expert panelist at Clinton Global Initiative to discuss the issue of safe water and the empowerment of girls in the developing world.
- Recently, Judd has come on board as a spokesperson for organizations Defenders for Wildlife and The Sierra Club providing her time and voice to advocate against practices of aerial wolf hunting (Defenders for Wildlife) and mountaintop removal coal mining (The Sierra Club).
- She resides in Tennessee and Scotland with her husband, the international racing star Dario Franchitti. They have 8 beloved pets and enjoy a quiet, rural life.
School Health Education Can Trigger Eating Disorders
Often, when nutrition is taught in school, there is a heavy focus on “good foods vs. bad foods.”
- Youth are often taught how to read food labels and count calories. The “destructive nature” of unhealthy foods is frequently discussed.
- Some nutrition classes also use tactics such as demonstrations of globs of fat to scare children into healthy eating.
- Often an implicit message that being thin equates with health, while being overweight equates with being unhealthy is conveyed.
- There are also often messages that a person who chooses to eat these “bad foods” is somehow failing to demonstrate willpower.
Nutrition education that uses scare-tactics, or shaming, or that make strong generalizations about health and nutrition, or that focus on body images and stereotypes all pile pressure on kids to approach food and nutrition in unhealthy ways.
While it is important to teach children about nutrition, it should be taught alongside body-image awareness.
- It is possible to teach nutrition in a body-positive way
- Nutritional education is a large part of eating disorders treatment.
It is possible to discuss nutrition in ways that reduce the risk of pressuring kids into making unhealthy choices by:
Avoiding scare tactics –
Help children learn mindfulness in their eating. This is a skill that can be utilized so that a person can comfortably listen to their body–and feed it so that it is satisfied, and never too hungry, or too full. As they learn about choosing a variety of foods, eating various foods in moderation, and making smart choices, they can learn to enjoy eating instead of fearing it. It is also appropriate to promote a healthy lifestyle following the nutritional guidelines and age appropriate exercise.
Teaching parents as well–
Parents are in charge of grocery shopping, meal planning, and cooking, and ultimately responsible for a child’s nutritional experience; they need to be on the same page as their children when it comes to nutrition.
Avoiding sweeping generalizations – Be mindful of your word choices and developmental level of your students. In early elementary school children, a brief sound bite on television or radio that talks about the relationship between eating red meat and heart attacks – can be interpreted very concretely, so that they fear this food completely, for themselves and their family members.
Remain body positive –
Avoid comments about body weight, shape, and size when describing nutrition. Proper nutrition is not just about weight, shape and size. The goal should be to focus on overall wellness–healthy at any weight.
In a recent study of patients at the inpatient eating disorders treatment program for children and adolescents at Rogers Memorial Hospital, 15 % traced triggers for their eating disorders to school programming.
As our nation becomes increasingly concerned with obesity, the desire to improve children’s nutritional habits is understandable. While attempting to help our youth avoid obesity, we must remain mindful that how we present this information can trigger disordered eating in children and adolescents.
Posted in Eating Disorders, Safety and Prevention, School and Education | 
Tags: anorexia, bulimarexia, bulimia, Eating Disorders, nutrition | 
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Eating Disorders Advocate Responds to Dr. Oz and Pro-Ana Movement
This article first appeared in the Bradenton Herald
Lisa S. Kantor: An Open Letter to Dr. Oz
By Lisa S. Kantor
Posted: 7:53pm on Mar 19, 2012; Modified: 7:58pm on Mar 19, 2012
LOS ANGELES, March 19, 2012 — /PRNewswire/ — Along with countless professionals and families dealing with the physical, emotional and financial consequences of eating disorders, I am deeply disturbed by the way your recent program, “Dying to Be Thin: Meet the Skinniest Women in America,” had the unintended effect of glamorizing the deadliest of all mental illnesses. Rather than documenting the tragedy associated with eating disorders and providing encouragement to sufferers to seek help, you perpetuated myths about the disease and provided harmful information to millions. I believe this show did more harm than good. As a physician, you have a responsibility to improve your coverage of eating disorders in future shows.
“Dying to Be Thin,” while tantalizing, serves to perpetuate one of the deadliest misconceptions about eating disorders. People with eating disorders are not necessarily “skinny” or “thin,” and certainly not everyone who dies from an eating disorder is underweight. In fact, many people die at a very normal weight, especially if they have bulimia. You mentioned on your show that the “more acute cases” were the “thinner” women. That myth is also dangerous to disseminate. Those who weigh less than others are not necessarily “more acute” than others at a “healthy weight.” That misconception has long created stigmas associated with eating disorder sufferers and has often led to under-treatment by physicians who think that because a woman is not thin, she is not as acute. Your focus on thinness did a grave disservice by failing to educate your audience scientifically about what eating disorders really look like.
In giving air time to the Pro-Ana movement, you referred to it as “a dangerous new trend that helps women be skinny at any cost.” The Pro-Ana movement is not new. Pro-Ana (and Pro-Mia) sites have been around since the dawn of the Internet. Far from being “trendy,” they are a very dangerous facet of an eating disorder underground that preys on the mentally ill. Had you consulted an eating disorders expert, you would never have offered your audience direct access to the websites and their images. Studies show that doing so causes harm. One study, on college-aged women (none of whom had eating disorders), discovered that after viewing pro-eating disorders websites, 84% reduced their calorie intake by more than 2,000 calories per week. Only 56% of the women realized they were eating less. Results of the study also indicated that the women exposed to the pro-eating disorders website had decreases in self-esteem and perceived attractiveness.
My days are spent in and out of federal courts battling insurance companies that deny benefits for seriously ill women and men who seek adequate treatment for their diseases – even though a federal law and many state laws mandate that insurers provide similar levels of treatment for mental illnesses as they provide for physical illnesses. Shows such as the one you aired trivialize this disease and undermine the progress well-respected groups such as the International Association for Eating Disorders Professionals, the Eating Disorders Coalition, the National Eating Disorders Association, and the Binge Eating Disorder Association have achieved. Still, getting the national media to take eating disorders seriously without parading dangerously thin women across the television screen is about as difficult as getting an insurance company to pay for a therapeutic length of stay at a residential treatment facility.
It is hard for me to believe that either you or your staff did any legitimate research about eating disorders before planning the programs. Were you aware that professionals in the eating disorder field were in touch with producers at your show in recent months offering the benefits of their expertise free of charge should you plan to air segments about eating disorders? Those calls and e-mails appear to have been ignored.
You owe it to your many viewers to correct the harm your recent program caused. First, please remove all material from your website and blog that mentions the Pro-Ana movement. Second, work with some of the many excellent professionals at reputable facilities around the country to plan follow up segments to properly educate your audience about how people can recover from eating disorders and lead productive and fulfilled lives not centered on food. You have an opportunity to teach millions across the country, including other physicians who might watch your show, the real skinny about eating disorders. I hope you will do the right thing.
About Lisa S. Kantor
Lisa S. Kantor, a Los Angeles lawyer and member of the Board of Directors of the Eating Disorders Coalition, is the country’s premier legal advocate for patients with eating disorders who have been denied health insurance benefits for treatment. In 2011, the 9th U.S. Circuit Court of Appeals ruled for her client in Harlick v. Blue Shield, creating one of the most influential decisions ever in mental health parity litigation and paving the way to making treatment and recovery for severe mental illnesses more attainable. For more information, go to www.kantorlaw.net.
SOURCE Lisa S. Kantor
Posted in Advocacy/legislation, Eating Disorders, Safety and Prevention, Womens Mental Health |
Tags: anorexia, bulimarexia, bulimia, eating disorder |
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How to report suicidal content/threats on Facebook
How to report suicidal content/threats on Facebook
Facebook Help: How do I help someone who has posted suicidal content on the site?
If you have encountered a direct threat of suicide on Facebook, please immediately contact law enforcement.
You can submit reports of suicidal content to Facebook by clicking:
http://www.facebook.com/help/?search=suicidal#!/help/contact.php?show_form=suicidal_content
For reports in the United States, we also recommend that you contact the National Suicide Prevention Lifeline, a 24/7 hotline, at 1.800.273.TALK (8255). If possible, please encourage the user who posted the content to contact the Lifeline as well. You can view a list of suicide prevention hotlines in other countries by visiting http://www.befrienders.org and choosing from the dropdown menu at the top of the page.
We encourage you to learn about how to identify and respond to warning signs of suicidal behavior online at the following address: http://www.suicidepreventionlifeline.org/GetHelp/WhatifSomeoneIKnowNeedsHelp.aspx
National Suicide Prevention Lifeline:
- Lifeline wants people to report to Facebook first, as Facebook has the ability to provide identifying information and the process is faster if they can report all info to the Lifeline at that time.
- Facebook works with the Lifeline once the content is reported.
- (If it is international, then Facebook works with the appropriate international organization.)
- Facebook receives the notification, then provides the Lifeline with all information about the user. Unfortunately, Lifeline cannot comment on the process from Facebook’s end but believes that given Facebook’s sensitivity to suicide risk and knowing that their safety team works on the weekends, the Lifeline believes that the process is pretty quick and that it is the most efficient and quickest method for a user to receive help.
How to Talk to Your Younger Child About Sex
This article by Laura Scholes, in which she interviews Dr. Jenna, appeared first on http://www.greatschools.org
Just when the tantrums have subsided and you think it’s safe to take your child on an extended shopping trip again, don’t be surprised if you encounter another land mine in the checkout line.
“Mommy, how did the baby get into that lady’s tummy?” your five-year-old asks in a loud voice, pointing at the very pregnant woman in front of you.
As unnerving as such questions often are for parents, they’re completely normal. “In preschool, kids start noticing and asking questions about how mom and dad have different body parts,” says Jenna Saul, MD, a child and adolescent psychiatrist in Auburndale, WI. “Then, by the time they turn five, the curiosity about body parts turns into a preoccupation with where babies come from.”
At my own house, the conversation began even earlier. At two, my daughter spotted a scar on my stomach, and I fumbled my way through a TMI explanation of a C-section: my first sex talk fail.
That first (uncomfortable) sex question
Whether the first sex question happens in private or very much in public, it catches almost every parent off guard.
Katrina Alcorn, an Oakland, CA, blogger, says she never worried about the “sex talk.”
“I didn’t think it would be a big deal,” says Alcorn, who has three children. “I’m progressive. I’m body positive. I’ll make sure my kids know what they need to know.”
Then, in the car one day, Alcorn’s second grade daughter announced that she wanted to marry a girl because she didn’t want to die in childbirth.
“I was just floored,” Alcorn says. “But I tried to gather my thoughts and address her concerns one by one. I said, first of all, it’s really rare that people die in childbirth, and I don’t think that would happen to you. Second of all, it’s fine if you want to marry a girl, and you don’t have to decide now. Finally, you can adopt a baby whether you’re with a boy or a girl.”
Alcorn was proud of herself for dealing with her daughter’s questions with such aplomb — but in the end her child got the last word. “She said, ‘I still want to marry a girl because I think kissing boys is gross and anyway, I don’t want to have sex.’ I couldn’t believe the sex talk snuck up on me without me being prepared for it!”
Why you should talk sooner rather than later
Although teenagers today are waiting longer to have sex, research shows that 13 percent have had sex by age 15, and by their 19th birthday, seven in 10 teens have had intercourse. And because young adults are not marrying until their mid-20s, on average, this means they’re at increased risk for unintended pregnancy and sexually transmitted infections.
So even though talking to your young child — preschool to fifth grade — about sex may seem premature, it’s actually the ideal time to do it. As your child enters her tweens and teens and becomes self-conscious about her body and about personal matters in general, it will become increasingly difficult to raise the issue. Take advantage of this window of opportunity to create a foundation of openness and honesty with your child.
“This stuff is very hard and complicated to talk about, but for me it is a health issue,” says Robie H. Harris, a former teacher and now celebrated author of a series of children’s books about sex and the body, including It’s Perfectly Normal, and Who Has What. “I write these books because I feel that this is part of life, and it’s okay to wonder about it. It’s important not just to kids’ physical health, but also to their emotional health.”
Not one talk, but many
Most experts agree that “the talk” really isn’t a talk anymore, but an ongoing conversation, one that starts much earlier than it did even a few decades ago.
“Limiting your child’s education about sex to a single talk produces an atmosphere of shame,” says Wendla A. Schwartz, M.D., a child and adolescent psychiatrist and medical director of Solutions Psychiatric Associates in Los Gatos, CA. “Children will definitely ask, and if a parent has in his mind that a five-year-old isn’t ready for ‘the talk,’ then he gets flustered and says, ‘Go ask your mother,’ and then the mother gets flustered. Kids are great at detecting discomfort, so by the time ‘the talk’ comes around at puberty, they’ve got the idea that sex is shameful and bad, and that’s going to stick with them forever.”
Instead, make it an ongoing, low-key dialogue between you and your child that begins when they are very young and goes on throughout their tween and teenage years.
What to say, how to say it
When it comes to sex, the best strategy is to let your child lead the discussion, rather than giving her a full-blown, lengthy presentation.
“In the very early ages, parents need to focus their efforts on really listening to their children and answering their questions truthfully,” says Saul. “At first, using the child’s own language to describe body parts is a good way to make kids comfortable; then you can teach them the actual names — penis, vagina, womb — as it becomes appropriate.”
Schwartz agrees that parents should let kids take the lead. “The best approach with all kids is to only answer the question they ask,” she says. “One of the really beautiful things about young children is that they’re incredibly inquisitive. They have such a tremendous level of curiosity that you really don’t have to worry that they’re going to forget to ask. As they’re ready for the information, they will probe for it.”
So when the questions start coming, give as brief and as honest an answer as you can and know that when they’ve learned enough, they’ll tune out — and that’s fine. Be prepared by having some age-appropriate books on hand before your child starts asking questions. Robie Harris recommends reading through the books by yourself first, to make sure you agree with the information and the way it’s presented. Books can help neutralize a charged topic; they also give your child the opportunity to do additional research on her own.
Kids are resilient
Don’t worry if you flub the sex conversation the first time — or even the second.
“We all make mistakes,” says Schwartz, who has stumbled on the topic of sex with her own kids. “Don’t freak out if you don’t get things right. Remember: over the years you’ll get plenty of chances to ‘practice’ giving good information. Besides, lucky for us, kids are amazingly resilient.”
To see the article where it originally appeared, go to:
http://www.greatschools.org/parenting/sex-education/5288-how-talk-younger-child-sex.gs?page=all
Posted in Development, Safety and Prevention, School and Education, Sexuality and Gender |
Tags: child development, parenting, sex, sexuality |
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No Evidence of Increased Risk of Suicide with Antidepressants
In 2005, the FDA issued a black box warning for antidepressants and suicidal thoughts and behavior in children and young adults.
- Many clinicians felt that this warning was inconsistent with their clinical experiences, and that it was not consistent with the data.
- In Wisconsin, the rate of prescribing these agents to children did not decrease after the black box warning was issued, and the rate of suicide did not change. In other states, where the rate of prescribing of antidepressants decreased, there was an observed increase in suicidality.
Researchers have now completed a study intended to determine the short-term safety of antidepressants by standard assessments of suicidal thoughts and behavior in youth, adult, and geriatric populations and the mediating effect of changes in depressive symptoms. They used data from intent-to-treat person-level longitudinal data of major depressive disorder from 12 adult, 4 geriatric, and 4 youth randomized controlled trials of fluoxetine hydrochloride and 21 adult trials of venlafaxine hydrochloride.
They extracted data from the suicide items of the Children’s Depression Rating Scale–Revised (CDRS-R) and the Hamilton Depression Rating Scale as well as adverse event reports of suicide attempts and suicide during active treatment. Data were analyzed from 9185 patients (fluoxetine: 2635 adults, 960 geriatric patients, 708 youths; venlafaxine: 2421 adults with immediate-release venlafaxine and 2461 adults with extended-release venlafaxine).
An analysis of the data showed that suicidal thoughts and behavior decreased over time for adult and geriatric patients randomized to fluoxetine or venlafaxine compared with placebo. No differences in suicidality were found for youths on fluoxetine or effexor compared to placebo. In adults, reduction in suicide ideation and attempts occurred through a reduction in depressive symptoms. In all age groups, severity of depression improved with medication and was significantly related to suicide ideation or behavior.
Study authors concluded that
- Fluoxetine and venlafaxine decreased suicidal thoughts and behavior for adult and geriatric patients by decreasing depressive symptoms.
- In youths, depression responded to treatment, but no significant effects of treatment on suicidal thoughts and behavior were found.
- No evidence of increased suicide risk was observed in youths receiving active medication.
See the published article:
Suicidal Thoughts and Behavior With Antidepressant Treatment
Reanalysis of the Randomized Placebo-Controlled Studies of Fluoxetine and Venlafaxine
Robert D. Gibbons, PhD; C. Hendricks Brown, PhD; Kwan Hur, PhD; John M. Davis, MD; J. John Mann, MD
Arch Gen Psychiatry. Published online February 6, 2012. doi:10.1001/archgenpsychiatry.2011.2048
Posted in Suicide, depression |
Tags: antidepressants and suicide, depression, treatment of suicide |
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Openness about eating disorders overdue
February 5, 2012, Mark Baldwin, The Republic, Columbus, IN
Although we don’t exactly shout it from the rooftop, my family never has hidden the experience of our middle daughter’s struggle with anorexia nervosa, the eating disorder that leads some people — and especially smart and pretty young women — to starve themselves.
Very often, the conversation produces a flash of understanding.
There was the baseball executive. The City Council member back in Wisconsin. The fellow parishioner. The neighbor. The casual professional acquaintance.
All had firsthand experiences with eating disorders.
Surprised? You shouldn’t be.
After all, the theme of National Eating Disorders Awareness Week, to be held Feb. 26 to March 3, is “Everybody Knows Somebody.”
Lynn Grefe, president of the National Eating Disorders Association, pegs the number of Americans battling a form of the illness — anorexia or one of its evil cousins, bulimia or binge eating disorder — at 24 million, a figure that dwarfs the number of those suffering from, for example, Alzheimer’s disease, estimated at about 5.4 million in 2011.
Some estimates put the eating disorders number as high as 30 million.
“The piece that’s missing is ‘eating disorders not otherwise specified,’” Grefe says. “That’s probably where most people are.”
To put it simply, that means sufferers are prone to bouncing pinball-fashion from anorexia to bingeing to bulimia.
Here’s one more fact to make you shiver: The mortality rate for eating disorders is higher than for any other mental illness, with death typically resulting from medical complications or suicide. And anorexic patients remain at higher risk for premature death for years after treatment.
One key to reducing the awful toll is to raise public awareness. Ignorance of eating disorders, their warning signs and their long-term effects is widespread. Teachers, coaches, physicians and plenty of others who ought to know, don’t
And that brings me to Daughter No. 3, a clever and articulate lass named Jane, who was required by circumstances beyond her control to transfer to Columbus North High School before her senior year. With the change of schools, of course, came the requirement that she produce a senior project.
Almost on the fly, Jane decided to draw a positive result from the experience of her sister’s illness and make eating disorder awareness the focus of her project.
One result of her work will be on display at 6:30 p.m. Feb. 16 at Bartholomew County Public Library, where Jane will screen a documentary called “Someday Melissa,” the story of Melissa Avrin, a New Jersey woman who died three years ago at 19 after a grueling battle with bulimia. The movie was produced by Melissa’s mom, who resolved to make something good come out of her daughter’s death.
The documentary will be followed by a question-and-answer session with a representative of the Coalition for Overcoming Problem Eating at Indiana University in Bloomington.
I suppose I shouldn’t be surprised by Jane’s choice of topic. The two sisters are best friends — except, of course, when they’re mortal enemies. They’re very different, but their bond is unbreakable.
Her sister’s ordeal has been a significant influence on Jane’s teenage years. Like alcoholism, eating disorders distort family routines nearly beyond recognition as the illness exerts a centripetal force that draws all things to it.
Life in a household struggling with an eating disorder can be isolating. After all, who else understands that for the sufferer, “dinner” can be a few strands of chicken breast and a lettuce leaf?
Let me rephrase that. It was isolating — until it became clear just how many families out there have dealt with the same thing.
That’s why I’m writing today. If an eating disorder has wrapped itself around someone you love — or if you simply want to learn more — head to the library on the 16th.
A six-week hospital stay provided Daughter No. 2 some valuable tools for coping with her illness, though eating remains a high-anxiety endeavor. A sharp, sympathetic therapist in Bloomington has made a difference. Still, you can’t wave a magic wand to make an eating disorder vanish.
If you know what I mean, we should talk.
Mark Baldwin is editor of The Republic, Columbus Indiana which is where this post was published. You can reach Mr. Baldwin at 379-5665 or by email at mbaldwin@therepublic.com. Follow him on Twitter @MarkFBaldwin.
Mother Turns Grief Into Action Preventing Eating Disorders
A Mother’s Loss, a Daughter’s Story
Melissa Avrin, 16, in the summer of 2006.
By ROBIN POGREBIN, for the New York Times
Published: April 21, 2010
ANDREW AVRIN sits on a beige couch in a nondescript room, a fruit still-life partly visible on the wall behind him, twisting his fingers while, off-camera, an unseen interviewer prompts him to talk about his sister, Melissa, who died last year at the age of 19 after a long battle with bulimia.
Related
MOTHER-TURNED-PRODUCER Judy Avrin collaborated with Jeffrey Cobelli, left, on a film about her daughter, Melissa.
Melissa at 18 in May 2008, with her mother, Judy.
“There was no food in the house,” he says, looking off to the side as his eyes fill. “If I went out with friends, I could not bring leftovers home because they would be gone by the next morning.”
Once, he explains, in the middle of a bitterly cold night, he looked out the window and saw Melissa on the curb, going through the garbage. “I went outside and I yelled her name,” he recounts in the interview, his voice breaking. “Just the way she looked back at me — it was so empty, vacant. It was a deer in the headlights, but that doesn’t even explain it.”
It is a hard scene for anyone to watch, but even more so for the film’s producer — Judy Avrin, Melissa’s mother, who decided to make a documentary about her daughter’s life and, ultimately, her death.
People deal with grief in their own ways, and those who have been spared the loss of a daughter or a son can only imagine how they would choose to try to cope. For Ms. Avrin, coping meant confronting her anguish and trying to make something good come out of it.
The idea for a film didn’t occur to her immediately. In the weeks following Melissa’s death, Ms. Avrin mostly avoided her daughter’s bedroom, and tried to resume some semblance of normalcy, going back to work three days a week as the coordinator for a consortium of academic libraries in New Jersey. But one day she sat down to read Melissa’s leather-bound journal.
Someday …
I’ll eat breakfast.
I’ll keep a job for more than 3 weeks.
I’ll have a boyfriend for more than 10 days.
I’ll love someone.
I’ll travel wherever I want.
I’ll make my family proud.
I’ll make a movie that changes lives.
The film, called “Someday Melissa” and now in the editing stages, has become for Ms. Avrin salve, distraction and cause — a way to get the word out to other families grappling with eating disorders that they are not alone; to sound the alarm that eating disorders have the highest mortality rate of any mental illness; to help make sense of the senseless event that was losing her teenage daughter.
“I kept saying, ‘This is an amazing way for me to channel my grief,’ ” Ms. Avrin said. “But it also allowed me to put off grieving.”
Ms. Avrin, 56, got the idea for the film from one of Melissa’s therapists, Danna Markson, who introduced her to Jeffrey Cobelli, 27, a filmmaker. Over the last several months of working on the project, Ms. Avrin has come to know more than she ever intended to about eating disorders — how their seriousness has been underestimated, their treatment underinsured, their deaths underreported.
The process hasn’t been easy, and some, like her ex-husband, initially questioned the impulse to do it at all. Melissa’s best friend since first grade, Nicole Kendrick, who also suffers from an eating disorder, said she was incredulous when she first learned that Ms. Avrin was making the film. “I thought she was crazy,” Ms. Kendrick said. “I guess I didn’t realize how deep a mother’s love can run.”
But Ms. Avrin said that making the film has been easier than doing nothing at all. “I’ve never once thought this was more than I could bear,” she said, in an interview at her home in Totowa, N.J. “If anything, the more I continue, the more I know it’s the right thing to do.”
The difficulty of reliving her daughter’s decline has been mitigated by the public response. “Sometimes I think: ‘I’m a suburban mom. Who am I to think I could make a difference in the world?’ ” Ms. Avrin said. “But then I read the messages that keep coming in from people I know and people I don’t know who say Melissa’s story has motivated them to fight one more day.”
On Melissa’s Facebook page and on the film’s Web site — somedaymelissa.com — Ms. Avrin continues to get feedback. “Thank you,” says one entry posted on the Web site’s guestbook page. “This could save one person’s life. That life may be mine.”
Ms. Avrin and Mr. Cobelli have interviewed Melissa’s family members, doctors and friends, along with prominent experts in the field, like Dr. Thomas R. Insel, the director of the National Institute of Mental Health; and Dr. B. Timothy Walsh, the founding director of the Eating Disorders Research Unit at the New York State Psychiatric Institute, and Dr. Evelyn Attia, the director of the Columbia Center for Eating Disorders, both at Columbia University Medical Center.
“I get a lot of requests, but there was something about this one I thought was particularly striking,” said Dr. Insel of the mental health institute. “I wanted to hear more of the story.”
“It was such an extraordinary expression of love,” he said, “a powerful way of honoring and remembering the daughter she lost.”
Although those closest to Melissa agreed to be interviewed for the film, participating wasn’t easy. William Avrin, Melissa’s father, said that he might have preferred to keep his experience to himself and that he was in no hurry to revisit his memories of Melissa. “I have a hole in my heart and it will be there forever,” he said in a telephone interview. “I don’t really try to describe what it’s like to lose a child.”
But he felt he had to do it for the film. “Clearly, Judy’s a champion of this project,” he said. “I’m a little bit more personal and inward. I’m still struggling with the whole thing. This is her way of dealing with it, and I respect that.”
In the documentary interview, filmed at his home in Hamburg, N.J., Mr. Avrin visibly struggles to describe what it was like to be thousands of miles away in Japan on business when he found out his daughter had died. At first he appears almost devoid of emotion, delivering his words in flat, deliberative sentences as he sits in a blue button-down shirt in front of his fireplace mantel. But then you can see tears trickling down into his salt-and-pepper mustache. “What was I thinking?” he says, repeating the question. “I was thinking my daughter is dead. That’s not supposed to happen. I couldn’t believe it. I didn’t — didn’t know what to think. I was in shock.”
Upon returning from Japan, Mr. Avrin decided not to view his daughter’s body. “Judy thought it would be better if I didn’t,” he said, “that I’d remember her like the last time that I saw her.”
Melissa died on May 6, 2009. Cause of death: heart attack due to complications from an eating disorder. Just a few days before, Melissa learned she had been admitted to Emerson College. The official letter of acceptance arrived a week after she died and sits unopened.
Melissa’s brother, Andrew, who is completing his Master of Science degree in engineering, said he believes the documentary has become essential to his mother’s emotional resilience. “It’s the only way she knows how to move forward,” he said.
At the same time, Andrew said he worried that the documentary would ultimately prove to be just a Band-Aid, postponing the heartbreak that is bound to rear its head when the film is completed. “The trick becomes moving forward with life but not letting everything this project is fill the void completely,” he said, “so the second this project finishes, you don’t crash.”
To be sure, Ms. Avrin doesn’t always hold it together. She did not conduct the interviews with her ex-husband or with her son (her collaborator, Mr. Cobelli, did). “We would have just sat there and cried,” she said.
In the interviews she did do, there have been times when she has broken down during or afterward. In concluding her discussion with Dr. Leslie Sanders, one of Melissa’s doctors, for example, Ms. Avrin starts to cry, and the cameras keep rolling. “I still remember being in your office and — I think her potassium was off — and you said, ‘I’ll be your quarterback,’ ” Ms. Avrin tells Dr. Sanders. “I didn’t know who to turn to next and I felt like I was in such good hands with you.”
Dr. Sanders responds: “I think what I remember about that first visit is just being struck at how little her life had become — I think at that point she was barely in school — and how much she was struggling, not just physically, I think physically was the least of it, but just emotionally and how we needed to do something intensive, and quickly, to get her life back.”
BORN Dec. 21, 1989, Melissa seemed in her early years to be a happy little girl. Her family lived in Wayne, N.J., and then in Pine Brook, N.J., spending two years in Coral Gables, Fla., in between, where Mr. Avrin was transferred for his work with a specialty chemical company. Melissa did well in school — producing A’s and short stories.
But at age 13, thing started to change. Melissa’s mood darkened; she didn’t want to go to school or do extracurricular activities. She developed stomach problems and constipation. Ms. Avrin took her to a pediatric gastroenterologist who said Melissa probably had an eating disorder. “I reacted the way most parents do: ‘That’s not possible,’ ” Ms. Avrin said. “We didn’t go back to him.”
In the early stages, the Avrins did not really see what was going on, in part because Melissa wasn’t visibly underweight, in part because they didn’t want to. But clues started to show up that were too stark to ignore — logs of cookie dough that disappeared from the freezer along with whole boxes of cookies from the cabinet. Empty pizza boxes. “I found containers with chewed and spit-out food and I’d never heard of that before,” Ms. Avrin tells Dr. Sanders during their filmed interview. “Is that very common?”
Ms. Avrin wrapped the fridge in locks and chains, hid her purse and made sure never to leave money lying around. “It didn’t have to be good junk food — if she wanted to go on a binge, it could be a dozen eggs,” Ms. Avrin said of Melissa. “Anything that wasn’t nailed down, she would eat.”
Ms. Kendrick, in her own interview for the film, alternates between smiling recollections of her childhood friend and sad eyes as she recalls Melissa’s downward spiral. “People who knew her in the last two years never really saw who she really was,” she says. “She was so energetic and funny and just ridiculous but not, like, in an obnoxious way. And then, as she started to worry about what other people thought, that’s when it started to be in more of an attention-getting way. When things got really bad, that kind of all just slowly disappeared and it just became very monotone — down. And we didn’t really see that energetic, fun Melissa anymore.”
Eventually, Melissa was sent away for professional help against her will and thus began a series of programs over the next few years that had varying degrees of success. It wasn’t until Melissa’s third round of in-patient treatment — when she and other young women testified about their eating disorders in front of their families — that her father began to fully understand. “I really said, ‘Wow this is almost like heroin addiction,’ ” he says in his film interview. “They need to purge because it makes them feel high and it’s something they need to do. I never appreciated that.”
In the course of making the film, Ms. Avrin has become something of a public service announcement on eating disorders. She was a featured speaker last October at the first walk to raise money for the National Eating Disorders Association. At its benefit dinner in March in New York, the evening opened with a clip from Ms. Avrin’s film. She is due to be in Washington in late April to lobby Congress as part of an Eating Disorders Coalition.
She said she is happy to play the role of advocate, to help try to remove the stigma that still cloaks eating disorders and keeps people from acknowledging the disease as the cause of death in obituaries. “I want it to come out of the shadows,” Ms. Avrin said. “I want people to talk about it, for people to get treatment faster, to reach doctors on the front lines. I want parents to open their eyes and not be swayed by being glad that their kid fits into size 4 jeans — to stop focusing on looks.”
Ms. Avrin is aiming to finish her documentary project by June, in time for summer film festival deadlines, and she said she is determined to get theatrical distribution. It would seem the ultimate act of acceptance. Yet in her film interview with Dr. Sanders, Ms. Avrin sounds like a mother still wrestling with remnants of denial.
“I’ve always been the glass half-full — I’ve always been an optimist,” she says, reaching under her eyeglasses to wipe away tears. “I always believed that she really would be somebody who could recover, even though, looking back, I realized the odds were stacked against her because of the level of her illness.”
“But I never lost hope and, you know,” she adds, “I still believe that she could have beaten it.”
A version of this article appeared in print on April 22, 2010, on page E1 of the New York edition.
Posted in Advocacy/legislation, Eating Disorders |
Tags: advocacy, anorexia, bereavement, bulimia, death of a child, Eating Disorders, grief, inspiration |
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ADHD Meds show no increased risk of death
Drugs to treat attention deficit hyperactivity disorder, (stimulants such as Ritalin/methylphenidate or Adderall/ amphetamine) for ADHD, don’t appear to put kids at higher risk of heart problems or death.
Scattered reports of sudden deaths among children on the medications have caused concern among parents and doctors in recent years, and several of the drugs now carry warnings about heart complications and behavioral side effects.
New research findings are reassuring.Funded by Shire, the researchers examined claims data from Medicaid and a commercial insurer. The study includes more than 240,000 kids ages three to 17, who received ADHD drugs and were followed for 135 days on average.
The researchers then compared those children to more than 965,000, who didn’t take the drugs but were of similar age and gender and came from the same states as the users.
That weasy officially for the researchers, because often the claims data didn’t match the hospital records.
Based on the data they could calculate, investigators estimated that there would be six sudden deaths or cardiac arrests per 1,000,000 kids taking ADHD drugs for a year.
That’s slightly more than the four per 1,000,000 kids in the comparison group. But because the numbers are so small, the difference could easily have been due to chance.
There were no strokes or heart attacks in the ADHD group, and the researchers estimate it’s very unlikely that the true rates would exceed 24 cases per 1,000,000 per year.
Rates of death “from any cause,” which were the most reliable numbers in the insurance data, were 179 per 1,000,000 kids per year in the ADHD group and 300 per 1,000,000 in the comparison group.
“For kids who would benefit from ADHD medications, the potential cardiovascular risks should not dissuade physicians from prescribing the drugs,” Hennessy told Reuters Health.
The findings, published in the journal Pediatrics, are in line with two previous reports that didn’t find evidence of a link between sudden death and ADHD drugs.
However, they run counter to one small 2009 study that found stimulant use was more common (1.8 percent) in children who died suddenly from cardiac arrest than in those who died in car accidents (0.4 percent).
One expert who was not involved in the current study said the results were hard to interpret due to the small number of deaths and heart problems.
“The new findings confirm that if there is an association between stimulants and cardiac events, it is quite rare,” Almut Winterstein, of the University of Florida College of Pharmacy in Gainesville, told Reuters Health.
But she added that at this point, there is no telling how the millions of kids on ADHD medicines will fare down the road.
“We will need to wait another decade to understand whether even slightly increased blood pressure and heart rate over several years during childhood results in increased cardiovascular risk in later life,” she said in an email.
The risk of death is certainly no higher in children who take ADHD medications than in children who don’t,” said Sean Hennessy, a pharmacist at Philadelphia’s University of Pennsylvania, who led the work.
Hennessy acknowledged that studying cardiovascular events using insurance data in youth is complex, and that he awaits the results of The U.S. Food and Drug Administration’s large safety study on stimulants.