Child and Adolescent Psychiatry Consulting

Archive for the ‘Family Law’ Category

What you say to your child is important.
Here are some tips to assure that what you say won’t damage your child

Sticks and stones will break my bones,
But names will never hurt me.

Many of us who are now parents understand that this children’s rhyme does not provide true comfort, and that the words of playmates DID hurt us.

Words can hurt children, and the damage inflicted on a child by the thoughtless remarks of a parent or other adult can torment a child–for their lifetime.

In fact, emotional abuse, though it is often ignored, can be far more devastating than the physical abuse that so often captures media headlines.

The emotional abuse of harsh words, spoken thoughtlessly, can lead a child feeling berated, belittled, demoralized. The impact this has on a child’s emotional development is insidious. A child’s spirit can be destroyed, and they may lose any positive sense of self. Emotional abuse destroy’s a child’s ability to feel loveable, to love himself or herself, and has a negative effect on a child’s ability to care for and get along with others. Emotional abuse increases self-destructive and antisocial behavior. Emotional abuse has been linked to eating disorders, promiscuity and suicide.

None of us is perfect, and many of us can recall a time when we’ve lost our self-control, and said something hurtful and demoralizing to our children, over something minor. We might say things like: “You clumsy idiot! You can’t do anything right!”

When words like these are repeated often enough, the child’s sense of self-esteem plummets and he or she begins to agree with his parents’ assessment of him: he or she really is dumb, a jerk, an idiot, a moron. The child begins to learn that love is not without conditions. And since it seems impossible to meet his or her parent’s expectations, the child becomes satisfied with settling for the “loser” role.

In too many homes today, the lights are on but no one is there. People are home but not home. Inattentive and verbally abusive parents are producing children who seem normal but are not what they should be, what they could have been.

There are studies that demonstrate that this abusive, humiliating and demeaning parenting behavior is transmitted from generation to generation, meaning that adults who had abusive parents tend to parent their own children the same way. This pattern will continue until a parent is willing to change their behaviors, change the dynamics, and find a way to interact differently with their own children. They must be willing to see and acknowledge that they are saying and doing to their children.

To change this pattern, treatment often requires treating the parent and the child, helping the parent feel respected and empowered, and allowing them to change the ways they respond to their child.
The problem of verbal abuse is REAL, and COMMON, but difficult to document, and, therefore, difficult to intervene to prevent. Certain stressors can increase the problem of verbal abuse, job loss, marital problems, financial concerns. Often, adults attempt to cope with these stressors using alcohol and other drugs, but this tends to make matters worse. Parents then lose their inhibitions, and may say terrible things to their children that they later regret.

How can you be sure your words build up rather than destroy your children?

† Guard your vocabulary. There are some words that people in a family should never say to each other. Words like stupid, dummy, jerk, idiot, worthless and freak have no place between parents and their children.

† Avoid absolute statements such as “You never . . . ” Or “You always . . . ” Have a sense of good manners with your family. This doesn’t mean that you must avoid all conflict or that you can’t set limits.

† Separate the child’s actions from the child. Instead of responding to a tantrum with a barrage of abusive language, let him know that you love him — but not his actions, which are unacceptable.

† When things happen that can set off an explosion, take time out. Wait. And then wait some more. When you hold your tongue until the heat of the moment has passed, it’s a lot easier to respond with love rather than anger.

† Be available. Be willing to stop and peek in on your child’s world. He or she will feel more valuable because of it. Don’t start interrogating the minute the child walks in the door.

Wait until you’re relaxed and instead of probing about his day, why not share your day? Instead of accusing, compliment. Instead of insisting, be silent.

† Active listening refers to a kind of listening and a response that does not judge, ridicule or order. And the more we listen without judging, the more we help our children to accept their feelings, we improve their problem-solving ability and increase their willingness to listen to us.

† Teach by example. Let your kids hear you acknowledge your mistakes. Risk being humble. Dare to say, “I’m sorry” to your children when appropriate. Apologizing reveals that the truth is larger than your ego and their feelings are more important than your pride.

If you can accept yourself in spite of your limitations, all the while working to be the best you can be, you’ve gone a long way to help your kids value themselves.

Based on the work of Jean Guarino, free-lance writer.

Attorney General Eric Holder  Spoke at the National Association of Counties Legislative Conference in Washington, D.C. ~ Monday, March 7, 2011

He noted that the Association of Counties, and the Department of Justice have common goals, of doing more and more to serve our citizens while resources diminish. He identified two specific priorities for the Justice Department:

“how we can improve the effectiveness of our juvenile justice system, and how we’re going to ensure that every American can access the legal services they need and deserve.”

He noted that “one of the most important lessons I learned as a federal prosecutor, as a judge, as a United States Attorney, as Deputy Attorney General, as Attorney General – and, above all, as a father of three children: that the work of protecting, assisting, and empowering our young people could not be more urgent.   “

He noted that:

• The nation’s juvenile justice system is in need of change, that it doesn’t spend resources as wisely as it should, and does not improve as many lives as it could.

• Although African-American youth make up 16 percent of the overall youth population, they make up more than half of the juvenile population arrested for committing a violent crime.

• Abused and neglected children are 11 times more likely than their non-abused and non-neglected peers to be arrested for criminal behavior.

• That so many of those who enter our juvenile justice system either can’t afford – or do not know to ask for – access to legal guidance.

• Some youth even plead guilty to criminal offenses without the advice of a lawyer.

• Even though many of those who are incarcerated enter the juvenile justice system for non-violent offences, they often emerge violent – or, at the very least – traumatized.

• A scientific review of nine “Scared Straight” programs around the country showed that children ordered into these programs are nearly 30 percent more likely to offend than youths who are not.

• In another study, 12 percent of the adjudicated youth in state-operated and large locally or privately operated juvenile facilities reported experiencing at least one incident of sexual victimization while incarcerated.

“A recent Utah Youth Suicide Study reported that young victims of suicide had nearly a seven in ten chance of an association with the juvenile justice system, calling us to question whether the current system is improving lives – or devastating them.”

TRANSITIONING OUT OF JUVENILE JUSTICE

• Each year, 100,000 young people exit formal custody.   And some of them have nowhere to go.   Too many of these young people return to unstable homes – or end up in shelters, on the streets, or in other potentially dangerous, or violent, situations.   And many are not welcomed back to their community school and struggle to find educational opportunities.
• Within a year of reentry, one study found that only 30 percent of previously incarcerated youth are involved in either school or work.   The unfortunate fact is that many end up in our jails and prisons.

Robert Kennedy believed that the link between justice and children could never be broken without compromising our founding ideals – and our most sacred principles.   He was right.

Mr. Holder noted that justice in the juvenile system is a moral issue that makes good fiscal sense:

• “How we treat our children answers the question of who we are as a nation.”
• “Better serving our young people makes good economic sense by keeping them out of over-stressed and under-funded corrections facilities and saving precious law enforcement resources.”

Mr. Holder advised that we

• Broaden our approach to juvenile justice and ensure that sound research and respected analysis are a part of our decision-making process”.
• Transition from a prosecution-and-punishment model to a prevention-and-intervention paradigm.  Adopt  a comprehensive plan of action that engages law-enforcement partners, medical professionals, social services providers, lawyers, parents, teachers, coaches, mentors, and community leaders.

Mr. Holder talked about the success of the Safe Start Program, and  the launch of the Defending Childhood Initiative – the federal government’s most comprehensive effort ever to address and overcome the crisis of childhood exposure to violence, that President Obama pledged $25 million to this initiative in his budget proposal.

Mr. Holder talked about alternatives to juvenile justice involvement for youths involved in minor offenses.

• He mentioned specifically, the Civil Citations program in Miami-Dade County where youth who commit minor misdemeanors are  referred to targeted interventions aimed at reducing delinquent behavior and providing positive social outlets instead of arresting them and placing them in the juvenile justice system.  This program has reduced recidivism to 3 percent  and arrests by 30 percent for youth that participate in the program.

In addition to his emphasis on intervention and prevention over punishment, Mr. Holder also addressed the failure of our justice system to provide juveniles (as well as adults) with access to legal services.

According to The Office of Juvenile Justice and Delinquency Prevention’s Survey of Youth in Residential Placement :

• Only one half of young people in detention facilities have a lawyer.
• In many jurisdictions, youth are encouraged – whether explicitly or implicitly – to waive their right to counsel.
• When juveniles assert their right to have a lawyer, court-appointed lawyers often enter the picture too late.
• Across the country, too many public defender officers are underfunded and understaffed

Mr. Holder discussed his Department’s new Access to Justice Initiative:

• An office established in an effort to ensure that quality legal representation is available, affordable, and accessible to all Americans.
• Includes an agenda to help counties face the “impossible choice between funding critical health and human services or upholding core Constitutional rights.”

The  Office of Justice Programs is also working to implement solutions for indigent defense and juvenile justice reform by:

• Establishing the Indigent Defense Hiring Project
• Working with the National Juvenile Defender Center to establish a National Fellowship Program for law school graduates to become public defenders for three years.

SCRANTON – Having just about completed the bribery and extortion portion of their case, federal prosecutors in the Mark Ciavarella trial are expected to focus on allegations the former Luzerne County judge jailed kids for cash.

The U.S. Attorneys Office presented  20 witnesses last week to establish its case that Ciavarella accepted kickbacks from the developer and extorted money out of the operator of two juvenile detention facilities, then took steps to hide the source of the income.

The government alleges Ciavarella and  former Luzerne County Judge Michael Conahan made various rulings that paved the way for construction of the juvenile centers, then worked to ensure admissions remained high so that Powell could continue paying them the kickbacks they demanded. Conahan pleaded guilty last year to one count of racketeering conspiracy.

Attorney Robert Powell, who co-owned the PA Child Care and Western PA Child Care centers, and Robert Mericle, the contractor who built the facilities, provided damaging testimony against the former jurist over four days of testimony. Powell testified for approximately 6 hours over two days, detailing how Ciavarella and Conahan repeatedly demanded money despite his protests that the facilities were not performing as well financially as the judges believed. Prosecutors say Powell paid the judges $733,500 from 2004 to 2006.

Sandra Brulo, a longtime juvenile probation department official who alleges she was threatened with termination for questioning practices within the department, will testify this week. An unknown number of current and former probation officers are also expected to testify they were pressured to detain children, even when they believed it was not in their best interest. Brulo served as deputy director of forensic programs for the juvenile probation department until February 2009, when she was charged with illegally altering a juvenile’s record. She has previously recounted a phone call she received from Conahan in which he angrily accused her of being responsible for limiting admissions to PA Child Care, located in Pittston Township. Brulo said Conahan was angry that the “ramp-up” process the state Department of Public Welfare utilized to determine the number of new admissions at the facility was too strict.

Judge Conahan began screaming at me and accused me of being responsible for the ramp-up limits. He said Robert Powell had bills to pay and that the ramping limits were limiting admissions–Sandra Brulo

Ciavarella is on trial for a 39-count indictment for charges of racketeering, honest services fraud, money laundering, bribery, extortion, wire fraud and tax evasion. Testimony resumes today at 8:30 a.m. before U.S. District Judge Edwin Kosik. The prosecution is expected to conclude its case by Tuesday or perhaps Wednesday. Ciavarella’s defense is expected to last several days, with the case possibly going to the jury by Friday. His attorneys have indicated he will testify but have not said how many other witnesses they intend to call.

SOURCE: By Terrie Morgan-Besecker tmorgan@timesleader.com
Law & Order Reporter

New York State will spend  $170 million this year on 21 juvenile facilities, employing more than 2,000 employees to oversee fewer than 700 children.

The facilities are disastrously mismanaged, and as many as 80 percent of the young men who serve time end up committing more crimes within a few years of their release.

Low-risk youths — those found guilty of crimes like shoplifting, trespassing and petty theft — should be sent to community-based programs that do a much better job of rehabilitation and are only $15, 000 per youth per year, instead of $220,000 per year in the state juvenile facilities.  For youth whose families can follow through on recommendations, multisystemic therapy is a less expensive and more efficient intervention. Multisystemic therapy keeps children in their family’s homes, in their communities.

Decades of research show that keeping young offenders locked up far from their families is a sure way of turning them into career criminals. Preliminary data collected by the New York City juvenile justice system suggests that recidivism for children handled through the city’s largest community-based program, Juvenile Justice Initiative, could be lower than 20 percent. This program provides intensive counseling and services to the family, to help parents better manage the child’s behavior.

The Juvenile Justice initiative, and similar nonprofit programs have helped the city cut the number of youths it sends upstate by more than 60 percent since 2002. These programs have reduced the number of children in state facilities  from more than 2,300 in 2000 to about 680 today.

Gladys Carrión, the commissioner of the state’s Office of Children and Family Services, has closed several unneeded facilities in the last three years, with a struggle. The politically powerful unions that represent juvenile facility workers are fighting to keep facilities open no matter what the cost to children or the state.

The unions succeeded in passing a law in 2006 that requires the state to give one year’s notice to workers before closing any juvenile facility. In January the state ordered the closure of the Tryon boys’ facility in upstate Fulton County. The facility — which gained national notoriety after a mentally ill 15-year-old boy died there in 2006 — has been empty of children since June. It still has a staff of 80 people working there and will only officially shut down in January 2012.

Child Protective Services investigated more than three million cases of suspected child abuse in 2007, but a new study suggests that the investigations did little or nothing to improve the lives of those children.

In 1973, Congress passed the Child Protective Services Act, designed to encourage more thorough and accurate reporting and record-keeping in child abuse cases. In New York, for example, there are now Child Protective Services offices in every county, paid for in part with federal funds.

Researchers examined the records of 595 children nationwide, all at similar high risk for maltreatment, tracking them from ages 4 to 8, 164 that were investigated for suspected abuse or neglect, and 431 families that had not been investigated. The scientists then interviewed all the families four years later.

The scientists looked at several factors: social support, family functioning, poverty, caregiver education and depressive symptoms, and child anxiety, depression and aggressive behavior — all known to increase the risk for abuse or neglect. They were unable to find any differences in the investigated families compared with the uninvestigated in any of these dimensions, except that maternal depressive symptoms were worse in households that had been visited.

One possible interpretation of this result would be that the investigated families were at greater risk to begin with, and that the investigation helped them to recover to the expected level of risk. But if this were so, the authors write, households with recent investigations would have greater risk than households with more distant investigations. Statistical analysis found no such association. They concluded that Child Protective Services investigations had little or no effect.

The researchers were in some ways unsurprised by their findings. Even when services are offered, they usually take aim at immediate risks — substance abuse, or domestic violence — not abiding problems like poverty or poor social support. Whatever interventions were offered apparently failed to reduce the risk for future child abuse.

Dr. Kristine A. Campbell, the lead author of the study, said that it may be too easy to blame Child Protective Services. “I believe that C.P.S. has a critical role,” she said. “As a pediatrician, when I’m there in the middle of the night with a child who has been beaten up, I need them. But we have to look at other systems that can really create a safety net for these children.”

Still, C.P.S. serves an important role in gathering information. This study supports the idea that it is time for further discussion of the role of protective services, beyond investigation.The difficulty is, that C.P.S. is charged with dealing with acute issues. We do not have a means for C.P.S. to deal with the chronic, underlying issues.

The study appears in the October issue of The Archives of Pediatrics & Adolescent Medicine, has certain weaknesses: some potentially modifiable risk factors — intimate partner violence and substance abuse, for example — were not included in the data they used. And not all of the five different geographical sites systematically collected information on all risk factors.

An editorialby Dr, Abraham B. Bergman was published with the study, titled “Child Protective Services Has Outlived Its Usefulness,” and suggests some essential changes: child abuse,  is a crime and should be investigated by the police; public health nursing services should be the first to respond to concerns of child neglect; social workers should assess appropriate living situations and work with families to obtain services, and not be engaged in law enforcement.

On Jan. 27, Julie Powers, 50, a mother of two in Tampa, drove her 13-year-old son, Beau, home from soccer practice and allegedly shot him in the head “for talking back” to her. Then she went upstairs and shot Calyx, her 16-year-old daughter dead as she sat at her computer doing her homework, according to an arrest affidavit. At the time, her husband was serving in Qatar as an army colonel. Powers said her kids were “mouthy.”

This is an unusual situation, because typically, it is younger children who are more likely to be killed. And usually, if a child is killed for being “mouthy” it is the result of a parent losing their temper, being aggressive, and throwing a child against a wall.

Killing newborns is much more common than killing older children.

As far as death by homicide goes, you’re more likely to be killed on the day you are born than on any other day of your life.

Younger children are much more likely to be killed than teenagers. If a child is killed for being “mouthy,” the remark that came out here, that’s more likely to lead to fatal battering. [Usually, in such cases,] a 3-to-5-year-old is thrown against a wall in an overzealous attempt at discipline and dies — as opposed to [a parent] planning to kill and shooting them with a gun.

Typically, circumstances in which parents kill their children include:

“ALTRUISM”:  When a mother plans to take her own life and believes her children are better off in heaven with her.

PSYCHOSIS:  The parent is acutely psychotic.

FATAL BATTERING: [as described above].

UNWANTED:  such as when a mother has  an infant born out of wedlock.

SPOUSAL REVENGE: a parent kills the children to hurt the partner, typically after infidelity or a separation

The case in Florida doesn’t appear to fit into any of these categories, based on the information we currently have. It is likely that there is more to the case than that the children were merely being mouthy.

When parents kill their children, the methodology may depend on the child. Age is one factor: a  3-year-old can be easily strangled or overdosed. Teens are not going to cooperate in being killed so the use of a knife or gun is more necessary. In some cases of fathers who kill teenagers there has been a real standoff and hostility, but that’s not typical for mothers.

Fathers are more likely to murder the whole family. In 95% of those cases in which whole families are killed, the fathers are the killer.

Is there any way to prevent these types of crimes?

There is no easy answer to intervening here. Better access to mental health care may be helpful.

Awareness; a woman who is very depressed and has young children who makes a suicide attempt has a 1-in-20 chance that she will try to take the kid with her. Specific inquiries about thoughts of harm toward children should occur in any evaluation of a seriously depressed mother.

What happens to parents who kill their children?

Most parents who kill their children go to prison rather than mental institutions. According to the FBI, women who kill their children and are not found insane, serve a mean length 17 years in prison. In women who kill newborns, the mean length is 9 years. Of all homicide perpetrators, none have a higher incidence of being found insane than mothers who kill their children.

Mothers who commit infanticide

They are not a general danger to the community. There are infanticide laws in 22 countries, including England, Canada and Australia — instead of women being charged with murder, mothers who kill children that are less than 1 year old are charged with infanticide. In the U.K., the vast majority get probation rather than prison. The recidivism rate is very low. The risk of suicide is substantial, however.

Hundreds of Young Organizers and Advocates Set to Descend on D.C. to Demand Congress and Obama Protect Children in Juvenile Justice System

National Network wants JJDPA (S.678) Reauthorized and PROMISE Act [H.R. 1064/S.435] Passed

11.30.2010– Press and media are invited from 10 a.m. to 12 p.m. on Monday Dec. 6 at 480 L’Enfant Plaza, SW Washington, D.C., for a rally, performances, and personal stories of tragedy, redemption and victories – and potential solutions.

(Washington, D.C., USA) – Youth, parents and advocates are descending on the nation’s capital to declare in a unified voice that the U.S. juvenile justice system is unaccountable, expensive, and unsafe – and that Congress and Obama need to pass legislation that protects children.

On Dec. 4-5, the Community Justice Network for Youth (CJNY) will be hosting a National Conference in downtown D.C. for hundreds of its members. On Monday, Dec. 6, the network will launch its “Week of Action” at a press conference – a call being taken up by attendees from 19 states who are pushing for reauthorization of the Juvenile Justice Delinquency and Prevention Act (JJDPA), [S.678 in the Senate], and to pass Youth PROMISE (Prison Reduction through Opportunities, Mentoring, Intervention, Support, and Education) Act [H.R. 1064/S.435].

After the press conference, attendees will travel to the Capitol to push their state representatives to enact these reforms, which will provide the only real oversight in an arbitrary system.

“The midterm elections revealed that the Administration and Congress need our base support,” said Tshaka Barrows, program director of CJNY. “We will let our elected officials know we are willing to support them only if they work to reform this nation’s broken juvenile justice system.”

The national network’s “National Week of Action” is intended put a fresh face on an emergent movement to push for transformation of the juvenile justice system. Approximately 93,000 young people are held in juvenile justice facilities across the U.S. States spend about $5.7 billion each year imprisoning youth, even though the majority are held for nonviolent offenses and could be managed safely in the community, according to the Justice Policy Institute (JPI).

Some community-based alternatives to detention and incarceration have been shown to reduce recidivism by up to 22 percent, and some have yielded up to $13 in benefits to public safety for every dollar spent. By contrast, 70 percent of incarcerated youth are held in state-funded residential facilities at an average cost of $240.99 per day per youth, according to JPI.

Speakers at the press conference will include: LeaJay Harper of The Center for Young Women’s Development in CA; Tarsha Jackson of Texas Families of Incarcerated Youth; Juan Pacheco of The Gathering for Justice in D.C.; Chino Hardin of Institute for Juvenile Justice Reform and Advocacy in NYC and Mallory Hanora of the Massachusetts Task Force on Racial Disparities.

***To RSVP for the event or request an interview with spokespeople and speakers contact Shadi Rahimi, CJNY Communications Director, (415) 321-4100 X102

Community Justice Network

The American Psychiatric Association has a controversy to sort through when deciding whether to  include parental alienation, a disputed term conveying how a child’s relationship with one estranged parent can be poisoned by the other, in its catalog of mental disorders , the DSM-V.

There’s broad agreement that this sometimes occurs, usually triggered by a divorce and child-custody dispute. But there’s bitter debate over whether the phenomenon should be formally classified as a mental health syndrome — a question now before the psychiatric association as it prepares the first complete revision since 1994 of its Diagnostic and Statistical Manual of Mental Disorders.

Dr. Darrel Regier, vice chair of the task force drafting the manual notes that they have received more mail commenting on this issue than any other. “The passions on both sides of this are exceptional.”

This debate has raged since the 1980s.

On one side of the debate are advocates for battered women and others who consider “parental alienation syndrome” to be an unproven and potentially dangerous concept useful to men trying to deflect attention from their abusive behavior. Joan Meier, a professor at the George Washington University Law School who has written extensively on domestic violence and child custody reports that there is no science to support the existence of parental alienation.

On the other side are legions of firm believers in the existence of a syndrome, who say that recognition of parental alienation in the psychiatric manual would lead to fairer outcomes in family courts and enable more children of divorce to get treatment so they could reconcile with an estranged parent.

“This is a problem that causes horrible outcomes for children. … All the arguments I’ve heard against it are trivial,” said Dr. William Bernet, a psychiatry professor at the Vanderbilt University School of Medicine.

The American Psychiatric Association first published its Diagnostic and Statistical Manual of Mental Disorders, known as the DSM, in 1952. The last major revision was published in 1994 (DSM-IV) and updated in 2000 (DSM-IV TR), and the fifth edition — DSM-V — is due for publication in May 2013.

Work groups in various fields have been reviewing numerous proposals for additions to the 283 disorders in the current edition. Parental alienation remains on a list of proposals that are subject to further review, though it did not pass muster with the work group dealing with childhood and adolescent disorders.

“There is not sufficient scientific evidence to warrant its inclusion in the DSM,” Regier said in a statement.

In an interview, Regier — who directs the APA’s research division — said the proposal technically remains alive pending final presentations by the end of 2011. But he described chances for inclusion of parental alienation as “slim” — given that it has not been selected for field trials that normally would be a prerequisite for official recognition.

Bernet said it was “flatly ridiculous” for the APA to contend there is not enough information available to warrant including parental alienation in the DSM. He cited legal developments and new research in numerous foreign countries.

Dr. Bernet’s proposal defines parental alienation disorder as “a mental condition in which a child, usually one whose parents are engaged in a high conflict divorce, allies himself or herself strongly with one parent, and rejects a relationship with the other parent, without legitimate justification.”

Parental alienation surged onto the pop-culture radar screen a few years ago as a consequence of the bitter divorce and child custody battle involving actors Alec Baldwin and Kim Basinger. Baldwin was harshly criticized by some feminist groups for citing parental alienation syndrome as a source of his estrangement with his daughter.

The concept is a source of confusion and division in the legal profession, as some lawyers try to evoke parental alienation and others challenge that tactic.

Elizabeth Kates, a Pompano Beach, Fla., lawyer who deals often with child custody cases, is skeptical of the role parental alienation can play in such disputes: “It’s a very easy claim to make … but the problem arises when it’s used in court to obscure the investigation of whether there’s been abuse.”

She said the initial impetus for recognition of parental alienation syndrome came in large part from the fathers’ rights movement, but suggested much of the momentum now comes from psychologists, consultants and others who could profit if the concept had a more formal status in family court disputes.

“It’s monetary,” Kates said. “These psychologists and therapists make huge money doing the evaluations and therapies.”

Texas Supreme Court Justice Debra Lerhmann, chair of the American Bar Association’s family law section, said the issue of possible alienation can be raised in child custody proceedings whether or not any such phenomenon is classified as a disorder by health professionals.

“Anyone who’s in this business knows there are situations where that in fact is happening — and sometimes it’s alleged but is not happening,” she said. “Even if it’s not in the manual, relevant evidence can still be brought in.”

Meier, the George Washington law professor, has urged judges to be cautious in how they allow the topic to be raised in cases where one estranged parent is accused by the other of abuse.

“You’ve got to assess the abuse first, without poisoning it with a claim of alienation,” Meier said. “Only after abuse is ruled out do you then move on to the question of alienation.”

Does your husband or wife constantly forget chores and lose track of the calendar? Do you sometimes feel that instead of living with a spouse, you’re raising another child? Your marriage may be suffering from attention deficit hyperactivity disorder.

Is ADHD affecting your marriage?  Mental health experts note that attention problems can take a toll on adult relationships.

In a marriage, the common symptoms of the disorder — distraction, disorganization, forgetfulness — can easily be misinterpreted as laziness, selfishness, and a lack of love and concern.

It is estimated that at least 4 percent of adults have ADHD; about 10 million U.S. adults, with only about 1.2 million of affected adults in treatment, and with many adults having never received the diagnosis as children.

As many as half of all children with A.D.H.D. do not fully outgrow it and continue to struggle with symptoms as adults.

Symptoms can include trouble with maintaining employment or completing schooling, marital difficulties,  financial challenges, repeated driving violations/tickets,

Adults with attention disorders often learn coping skills to help them stay organized and focused at work, but experts say many of them struggle at home, where their tendency to become distracted is a constant source of conflict.

Some research suggests that adults with ADHD are  twice as likely to be divorced; another study found high levels of distress in 60 percent of marriages where one spouse had the disorder.

Spouses of adults with ADHD often feel they cannot count on their partner. They may feel that the spouse is not dependable such that the unaffected spouse must take responsibility for everything.

Sometimes the unaffected spouse can become chronically angry, frustrated that they dont help around the house, that they are inconsiderate, or that they cannot count on the spouse to complete simple tasks such as running to the bank, paying bills on time, or picking up the kids. They may feel they have no choice but to constantly nag to make sure things get done.

Spouses with attention deficit, meanwhile, are often unaware of their latest mistake, confused by their partner’s simmering anger. A lengthy to-do list or a messy house feels overwhelming to the A.D.H.D. brain, causing the person to experience paralysis, and they accomplish nothing, which further infuriates their spouse. This does not happen due to laziness or selfishness, it happens due to the difficulty with task planning and organization.

Although treatment often starts with medication, it typically doesn’t solve a couple’s problems. Talk therapy may be needed to unpack years of accumulated resentments.

Behavioral therapy and coping strategies — for both partners — are essential. Long, to-do lists given to the spouse with ADHD will not be productive. instead, asking that one task at a time be targeted is more helpful.

Young men who attempt suicide before age 18 are much more likely as adults to be aggressive toward their girlfriends or wives, including hitting and injuring their partners.

The Study, published online in Psychological Medicine is based on data from 153 males from higher-crime neighborhoods who were assessed yearly from ages 10 to 32, and their romantic partners who participated when the men were ages 18 to 25.

This  new research highlights the need for intervention with suicidal teens: 58 percent of youth in that study group who attempted suicide went on to injure a partner, compared to 23 percent of young men who did not attempt suicide.

The study began when the men were kids, and before anyone had data to predict who would become violent. David Kerr of Oregon State University and Deborah Capaldi of the Eugene-based Oregon Social Learning Center, controlled for other problems suicidal youth can have which are also linked to violence to partner, such as aggression, depression, substance use, and family abuse history.

The researchers still found that young men who attempted suicide were more aggressive toward their partners.

The researchers had data from official domestic violence arrest records, women’s own reports of injury, and live observations of the couples.

In the past, domestic violence has been primarily attributed to cold, controlling and calculating individuals.

This study supports a growing body of research indicating that both men and women who are physically aggressive toward a partner have histories of aggressive and impulsive  behavior.

This study is important for prevention and treatment as well:

If a man is told that domestic violence is due to a need to coldness, a need to control, and systematic battering,  he may dismiss his difficulties, since this pattern doesn’t apply to him. If clinicians explain to men that their difficulties are related to the need to control anger and impulsive  reactions while under stress, they may be more aware that they are at risk, and better able to take responsibility for treatment.