Principal Investigator:Erik Parens, and Josephine Johnston

Funders:National Institute of Mental Health

The Hastings Center's Fund for Families and Children

Project Website

• Troubled Children: Diagnosing, Treating, and Attending to Context

Purpose

To produce an integrated analysis in plain English of the controversies surrounding the growing use of psychotropic medications in children and to identify areas where further empirical and conceptual work can help to advance those debates.

Key Issues

• The growing number of children treated with psychotropic medications has given rise to controversies about the medications’ safety and efficacy and about the value and meaning of pharmacological treatment of childhood emotional and behavioral disturbances.
  • “Macro” controversies include debates over the role of values in defining psychiatric disorders, the relative roles of nature and nurture in the etiology of childhood behavioral and emotional disturbances, the problem of stigma as a potential cause for under-treatment, and the desire for diagnostic labels as a possible cause for over-treatment.
  • "Micro” issues include debates over the safety, efficacy, and implementation of agreed-upon best practices.
• Unfortunately, these debates usually occur in isolation, even though they are intimately connected, and people often talk past each other. If they do not receive an integrated, accessible analysis there can be no effective and productive discussion of them, and no progress toward resolving them.

Published Reports

• Parens, Erik and Josephine Johnston. "Troubled Children: Diagnosing, Treating, and Attending to Context." Special Report, Hastings Center Report 41, no. 2 (2011).
  
• Parens, Erik and Josephine Johnston. "Controversies Concerning the Diagnosis and Treatment of Bipolar Disorder in Children." Child and Adolescent Psychiatry and Mental Health 4, no. 9 (2010). 
• Parens, Erik and Josephine Johnston. "Facts, Values, and Attention-Deficit Hyperactivity Disorder (ADHD): An Update on the Controversies." Child and Adolescent Psychiatry and Mental Health 3, no. 1 (2009).
• Parens, Erik and Josephine Johnston. "Understanding the Agreements and Controversies Surrounding Childhood Psychopharmacology." Child and Adolescent Psychiatry and Mental Health 2, no. 5 (2008).