But the authors also describe inevitable disagreement about, for example, exactly where to draw the line between normal and unhealthy aggression or exactly how to balance the need for symptom relief and the need for schools and communities to accommodate a diverse range of children.
"What we've learned is that diagnoses don't have clear boundarieswhat counts as healthy and unhealthy anxiety or healthy and unhealthy aggression, for example, is not written in nature," said Parens. "Human beings living and working in particular places and times define them. This leads to inevitable disagreements about whether a cluster of moods and behaviors is best understood as disordered, about how exactly to describe some symptoms, and about whether or which particular diagnosis is warranted."
"One of our conclusions is that because diagnosis and treatment decisions invariably involve value commitments, there will be disagreements, especially on the margins and in difficult cases," said Johnston. "How one weighs, for instance, the parental obligations both to shape children and to let them unfold in their own ways can influence how one responds to difficult diagnostic and treatment decisions."
The report also concludes that too little is done to improve children's environments that contribute to their problematic behaviors.
"We need to remove the barriers that stand in the way of optimal care for those children who are suffering from moods and behaviors that no one would consider normal or healthy," the authors say.
The project was designed to better understand the controversies surrounding the diagnosis of mental disorders in children in the United States, and recent increases in the use of medications to treat those disorders.
It examined questions such as: Why are these diagnoses so controversial? Why do some people feel that children are over-medicated, while others are
|Contact: Mary Crowley|
The Hastings Center