Narrowing the focus

Since the last post, I’ve attended numerous seminars and workshops to help stimulate my thinking on the types of theoretical frameworks and methodological approaches I will use in my research.

My original interest was in exploring adolescent depression and using the prevalent cognitive models (e.g., negative self-schemas as proposed by Beck, 1967, 1987, and hopelessness theory, as discussed by Abramson, Metalsky, & Alloy, 1989) to understand (on a deeper level) this condition’s connected to negative education outcomes (e.g., low academic achievement, poor attention and concentration, and increased school dropout). However, I have since become aware of a current problem facing psychiatrists: the challenge of differentiating vulnerable individuals who go on to develop psychotic disorders (such as schizophrenia) from those who do not. There are multiple reasons for this difficulty. One example is that psychotic-like symptoms (e.g., hallucinations and delusions) can also be features of other non-psychotic conditions (e.g., anxiety and depression; Kelleher, Keeley, et al., 2012). Another issue pertains to development, where some behaviours displayed by adults (e.g., talking to a make-believed friend) might be indicative of psychopathology, yet the same behaviour enacted by children would not be perceived as abnormal (Findling, Schulz, Kashani, & Harlan, 2001).

Psychotic disorders have also been associated with school problems, along with other issues (e.g., poor social relatedness, blunted emotions, disruptive behaviours; Findling et al., 2001). Some of these adverse outcomes, however, may be attenuated with early detection and treatment (e.g., with antipsychotic drugs and/or psychosocial therapy; Findling et al., 2001; Hayman, Kessler, Vikram, & Whiteford, 2006). Because children and adolescents spend a majority of their time in school, this setting provides an opportune place to identify individuals at risk for psychotic disorders and refer them to appropriate help. As mentioned above, detecting individuals who might meet criteria for psychotic disorders is confounded by numerous factors. This is precisely why I am interested in this condition, as there is a need to identify variables that have a higher discriminatory power.

I have not specified who would be identifying at-risk individuals intentionally, as this opens up Pandora’s Box with regards to whether or not a school and its staff should take responsibility (or at least partially responsibility) for children’s mental health. As it might be inferred from the title of this blog, my underlying argument is that schools should contribute towards promoting children’s psychological well-being by working collaboratively with mental health practitioners. Undoubtedly the school’s role is to teach individuals necessary skills to function within society, but children and young people cannot properly acquire such skills if they are suffering from a condition that interferes with their learning. Thus, children’s schooling and their mental health should not be viewed as separate entities, but rather as a holistic system that works in conjunction to develop educated AND psychologically healthy individuals.

References:

Abramson, L. Y., Metalsky, G. L., & Alloy, L. B. (1989). Hopelessness depression: A theory based subtype of depression. Psychological Review, 96, 358-372.

Beck, A. T. (1967). Depression: clinical, experimental and theoretical aspects. New York: Harper & Row.

Beck, A. T. (1987). Cognitive models of depression. Journal of Cognitive Psychotherapy, An International Quarterly, 1, 5-37.

Findling, R. L., Schulz, S. C., Kashani, J. H., & Harlan, E. (2001). Psychotic disorders in children and adolescents. London, UK: SAGE Publications Inc.

Hayman, S., Kessler, R., Vikram, P., & Whiteford. (2006). Mental Disorders. In D. T. Jamison, J. G. 
Breman, A. R. Measham, & D. Chisholm (Eds.), Disease control priorities in developing countries (2nd ed., pp. 605–625). Washington, DC. 

Kelleher, I., Keeley, H., Corcoran, P., Lynch, F., Fitzpatrick, C., Devlin, N., Molloy, C., et al. (2012). Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies. The British Journal of Psychiatry: The Journal of Mental Science, 201, 26–32.