50. årgang, 6.2014 Rundt om diagnoser

Beskrivelse

Strand, Henning (Chief educational psychologist in Herlev). Psychiatric Diagnoses
as Social Constructs. Pædagogisk Psykologisk Tidsskrift, 2013, Vol. 50, 6,
3-15. – The article takes off at the ADHD diagnosis, but also to a large degree the
problems and differences concerning child psychiatric categories and diagnoses.
The introduction is a short history of the ADHD diagnosis, aiming at showing how
diagnoses are developed in concord with the dominant societal discourses at a specific
time. Then follows a closer look at the paradigms underlying the concepts of
diagnoses. The consequences of diagnoses for professionals, parents, children, and
other parties are expanded. The dramatic rise in the number of children diagnosed
with ADHD, and the large differences in the prevalence of children from one region
to the other are discussed, and finally the focus is directed at medical and non-medical
forms of intervention. – Henning Strand

Fisker; Tine, Basse (Ph.d., visiting lecturer and consultant). The Prevalence of
Children in or With Difficulties. Pædagogisk Psykologisk Tidsskrift, 2013, Vol.
50, 6, 16-29. – The prevalence of children with psychiatric diagnoses is increasing.
It is no easy task to estimate the exact prevalence of children with diagnoses, and
this article will discuss why. It is however possible to estimate the prevalence of
children in or with difficulties. This article presents a literature review on the
screening studies, which estimate the prevalence of children in or with difficulties.
The purpose of a literature review is to summarize a narrow field of research. Since
research, which is occupied with estimating prevalence, is of a quantitative character,
it offers no frame for explanation and gives no directions for future actions or
interventions. In the last part of this article the author therefore discusses why these
results are of relevance for the pedagogical psychological professions and it discusses
the significance of a possible rise in the number of children in or with difficulties
in the years to come. – Tine Basse Fisker

Røgilds; Lars, Ask (Consultant and Feuerstein trainer). Why is it not Interesting
that my Son can Drive a Forklift Truck? Pædagogisk Psykologist Tidsskrift,
2013, Vol. 50, 6, 30-43. – In this article the father of a teenage boy diagnosed with a
mental handicap presents the view that the professional educational world often
fails to be sensitive to the potentials and abilities of children with diagnoses. The
article argues that the diagnose holds a risk of becoming a self-fulfilling prophecy
as it seems to promote a focus on disability and dysfunction, instead of a focus on
ability and learning potential. It is suggested that professionals in special education
undertake a paradigmatic shift of focus from focusing on diagnosis to a developmental
psychopathological paradigm in which inspiration can be found in in resilience-
factors and inside knowledge of the specific child in the home-environment as
well as in the children’s ‘peak-performances’. With theoretical and methodological
inspiration from the Israeli professor Reuven Feuerstein it is argued that professional
educators as well as parents are instrumental in facilitating cognitive and emotional
development, and that professionals ought to, intentionally, take this role. –
Lars Ask Røgilds

Jensen, Christina Mohr & Steinhausen, Hans-Christoph (Ph.d student at the University
Hospital in Aalborg & professor at the University Hospital in Aalborg). The
Scientific Understanding of ADHD From the Psychiatric Perspective. Pædagogisk
Psykologisk Tidsskrift, 2013, Vol. 50, 6, 44-57. – Knowledge about diagnostic
procedures and understanding of the aetiology and mechanisms underlying Attention-
Deficit/Hyperactivity Disorder (ADHD) is essential for professionals working
with people with ADHD. Diagnosis of ADHD is complicated by factors such as
the changing manifestations of core symptoms during development, sex differences,
due to the challenges posed by differential diagnostics and due to the high rate of
comorbidity that exists in patients with ADHD. Transactional processes between
genetic, neuroanatomic, neuropsychological and environmental factors are involved
and through multiple pathways lead to the endpoint of ADHD behaviours. It is pivotal
to understand these processes to improve the outcomes for children and adolescents
with ADHD through careful assessment and interventions targeted at the
difficulties and problems relevant for each child both as an individual and at the social
level. – Christina Mohr Jensen og Hans-Cristoph Steinhausen

Bøttcher, Louise (Lecturer at the University of Aarhus). On the knife’s edge. Balancing
between biomedical and contextual understandings of neurodevelopmental
diagnoses. Pædagogisk Psykologisk Tidsskrift, 2013, Vol, 50, 6, 58-
68 – Diagnoses of neurodevelopmental disorders are intended and used as descriptions
of the social, cognitive and emotional functioning of individual children. From
a biomedical point of view, it is assumed that the developmental problems are
based in biological deficits at the genetic, neural and/or neuropsychological level.
However, no matter the state of the child’s individual genetic etc. situation, his or
her development is at the same time a social process enabled through its participation
in culturally established institutional practices. The challenge is that the demands
and expectations in the institutional practices are adapted to children with
normal psychophysical functioning. Children with biological aberrations will often
experience the demands and expectations as too high and/ or themselves enact demands
on the environment that are not readily accommodated. It is suggested that
the problems experienced by the child and its surroundings – and expressed in the
designation of the diagnosis – can be understood as an incongruence between the
individual development of the child and demands and expectations in the specific
relations and institutions in which the child participates. Understood this way, the
diagnosis can be used as a tool to analyse the relation between the child and the institutional
contexts by highlighting what types of questions it is important to investigate.
– Louise Bøttcher

Elvén, Bo Hejlskov (Authorized psychologist). Developmental disorders and
symptoms. Pædagogisk Psykologisk Tidsskrift, 2013, Vol. 50, 6, 69-81 – Developmental
disorders are sometimes a controversial matter among psychologists, but
serve an important function for both pupils and schools. It is however not the diagnostic
criteria that are most relevant in planning and executing the teaching of
children with developmental disorders. It is often a good idea to widen the diagnostic
assessment into an assessment of both diagnosis and perception, empathy, central
coherence, executive functions, affect regulation and stress management abilities
in order to provide relevant information useful in educational planning and
teaching. Teaching and behavior management on the basis of Vejes model of intervention
can incorporate adjustments based on such assessment. – Bo Hejlskov
Elvén

Hertz, Søren (Child and youth psychiatrist at PsykCentrum Hillerød). Inviting to
a Process that may be even more Attractive. Pædagogisk psykologisk Tidsskrift,
2013, Vol. 50, 6, 82-94. – The article takes its starting point in the fact that
diagnoses can seem attractive. It argues to place yourself in a position, where you
could be part of creating a process, that could turn out to be even more attractive. It
takes the reader through different issues like the growing individualization of problem
understandings, the premises of the diagnostic system itself, the implications
of modern neuroscience and also these preferred values based on behavior as ways
of communicating and therefore as invitations to the surroundings. A case is described
as an illustration of the headline of the article. The CMM theory is used to create
attention as to how cultural constructions easily become universal truths. The
article ends with a discussion of the necessity of organizational changes to facilitate
developmental potentialities. – Søren Hertz

Gøtzsche, Peter C. (Professor at the Nordic Cochrane Centre, Rigshospitalet).
Overdiagnosis and Overtreatment in Child Psychiatry. Pædagogisk Psykologisk
Tidsskrift, 2013, Vol. 50, 6, 95-100. – Because of loose diagnostic criteria, far
too many healthy people get a psychiatric diagnosis and a treatment that is often
harmful for them. This problem has worsened considerably in recent years, partly
due to the fact that many leading psychiatrists are on industry payroll. Psychiatric
drugs may have a short-term effect in some people but in the long-term they often
create the diseases they were aimed at alleviating or even worse diseases such a bipolar
disorder that requires treatment with antipsychotic drugs, which are very
dangerous. An additional problem is that we don’t know what the long-term consequences
are for the brains of children that get psychotropic drugs. It is important to
diagnose much less and to reduce the use of drugs in children substantially, and to
focus on pedagogical and sociopsychological measures instead. – Peter C. Gøtzsche