Abandoned child syndrome | |
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Specialty | Psychiatry |
Abandoned child syndrome is a proposed behavioral or psychological condition that is said to result from the loss of one or both parents. Abandonment may be physical or emotional; that is, the parent may abandon the child by failing to be present in their life, or by withholding affection, nurturing, or stimulation. [1] As a result, abandoned children may also suffer physical trauma, which may stem from factors such as neglect, malnutrition, starvation, and abuse. [2] Furthermore, abandonment may be either intentional or non-intentional; the parent may willingly leave the child, or they may be alienated from the child by force. Forced separation of a parent from their child may stem from a number of potential causes, including (but not limited to) alienation following a divorce, placement of the child in foster care, or political conflicts. [3] With the nurture and support of a "facilitative environment", the child can develop the ability to cope with the trial of abandonment. [4]
Abandoned child syndrome is not currently recognized as a mental disorder in popular medical manuals like the ICD-10, [5] DSM-IV, [6] or DSM-5. [7]
Symptoms may be physical or mental, and may extend into adulthood and perhaps throughout a person's life. These symptoms can show themselves differently in childhood and in adulthood.
Adults that have experienced abandonment often display negative behaviors in current relationships. Among these symptoms include issues with intimacy, relationship sabotage, insecurity, codependency, being a "people pleaser", etc. This can cause the attachment style of the adult to change as they get older, such as an anxious attachment style. This can cause these adults to constantly worry that their friends or partners are going to constantly leave them, always trying to please others, giving too much into romantic relationships, not understanding boundaries, constantly looking for signs of uneasiness in others, staying in a toxic relationship because of fear of loneliness, and many more. [8]
In children, transient separation anxiety is a normal part of their development and is usually experienced between 10 and 18 months, however it will not develop when the child experiences abandonment from birth, there being no connection to become separated from, or anxious about. It is common to end around the age of 3, but can be concerning when the symptoms of separation anxiety occur for an extended period of time. This can lead children to manifest symptoms such as a worry of being abandoned, feeling anxious when dropped off at a daycare, school, or family member's house, clinginess, or even being ill but not showing the physical attributes of being ill. Children who have experienced the loss of a caregiver or parent may also experience more drastic symptoms in their life such as an addiction to drugs or harmful substances, eating disorders, and self-harmful thoughts and actions. Adopted children may display unique symptoms of abandonment such as aggression, withdrawal, depression, sleeping troubles, etc. [9]
When children are raised without the psychological or physical protection they need, they may internalize a substantial amount of fear, which is also referred to as chronic loss. Not receiving the necessary psychological or physical protection results in abandonment. If children live with repeated abandonment, these experiences can cause shame. Shame arises from the painful message implied in abandonment: "You are not important. You are not of value." This is the pain from which people need to heal. [10] [ better source needed ] As the child grows older, these internalizations can lead to them physically hurting themselves, or getting into drugs and alcohol. Over time they will start to treat the people close to them differently and will become more irritable and angry. Another cause for these internalizations can be the Socio-Economic status of the child's family and the environment they are surrounded with. [11]
Abnormal psychology is the branch of psychology that studies unusual patterns of behavior, emotion, and thought, which could possibly be understood as a mental disorder. Although many behaviors could be considered as abnormal, this branch of psychology typically deals with behavior in a clinical context. There is a long history of attempts to understand and control behavior deemed to be aberrant or deviant, and there is often cultural variation in the approach taken. The field of abnormal psychology identifies multiple causes for different conditions, employing diverse theories from the general field of psychology and elsewhere, and much still hinges on what exactly is meant by "abnormal". There has traditionally been a divide between psychological and biological explanations, reflecting a philosophical dualism in regard to the mind–body problem. There have also been different approaches in trying to classify mental disorders. Abnormal includes three different categories; they are subnormal, supernormal and paranormal.
Dependent personality disorder (DPD) is a personality disorder characterized by a pervasive psychological dependence on other people. This personality disorder is a long-term condition in which people depend on others to meet their emotional and physical needs. Dependent personality disorder is a cluster C personality disorder, which is characterized by excessive fear and anxiety. It begins prior to early adulthood, and it is present in a variety of contexts and is associated with inadequate functioning. Symptoms can include anything from extreme passivity, devastation or helplessness when relationships end, avoidance of responsibilities, and severe submission.
Avoidant personality disorder (AvPD) or anxious personality disorder is a Cluster C personality disorder characterized by excessive social anxiety and inhibition, fear of intimacy, severe feelings of inadequacy and inferiority, and an overreliance on avoidance of feared stimuli as a maladaptive coping method. Those affected typically display a pattern of extreme sensitivity to negative evaluation and rejection, a belief that one is socially inept or personally unappealing to others, and avoidance of social interaction despite a strong desire for it. It appears to affect an approximately equal number of men and women.
Parental alienation is a theorized process through which a child becomes estranged from one parent as the result of the psychological manipulation of another parent. The child's estrangement may manifest itself as fear, disrespect or hostility toward the distant parent, and may extend to additional relatives or parties. The child's estrangement is disproportionate to any acts or conduct attributable to the alienated parent. Parental alienation can occur in any family unit, but is claimed to occur most often within the context of family separation, particularly when legal proceedings are involved, although the participation of professionals such as lawyers, judges and psychologists may also contribute to conflict.
Attachment disorder is a broad term intended to describe disorders of mood, behavior, and social relationships arising from unavailability of normal socializing care and attention from primary caregiving figures in early childhood. Such a failure would result from unusual early experiences of neglect, abuse, abrupt separation from caregivers between three months and three years of age, frequent change or excessive numbers of caregivers, or lack of caregiver responsiveness to child communicative efforts resulting in a lack of basic trust. A problematic history of social relationships occurring after about age three may be distressing to a child, but does not result in attachment disorder.
Reactive attachment disorder (RAD) is described in clinical literature as a severe disorder that can affect children, although these issues do occasionally persist into adulthood. RAD is characterized by markedly disturbed and developmentally inappropriate ways of relating socially in most contexts. It can take the form of a persistent failure to initiate or respond to most social interactions in a developmentally appropriate way—known as the "inhibited form". In the DSM-5, the "disinhibited form" is considered a separate diagnosis named "disinhibited attachment disorder".
Dissociative disorders (DDs) are a range of conditions characterized by significant disruptions or fragmentation "in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior." Dissociative disorders involve involuntary dissociation as an unconscious defense mechanism, wherein the individual with a dissociative disorder experiences separation in these areas as a means to protect against traumatic stress. Some dissociative disorders are caused by major psychological trauma, though the onset of depersonalization-derealization disorder may be preceded by less severe stress, by the influence of psychoactive substances, or occur without any discernible trigger.
Complex post-traumatic stress disorder is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.
Childhood trauma is often described as serious adverse childhood experiences. Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse. They may also witness abuse of a sibling or parent, or have a mentally ill parent. These events can have profound psychological, physiological, and sociological impacts leading to lasting negative effects on health and well-being. These events may include antisocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Additionally, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.
Traumatic stress is a common term for reactive anxiety and depression, although it is not a medical term and is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The experience of traumatic stress include subtypes of anxiety, depression and disturbance of conduct along with combinations of these symptoms. This may result from events that are less threatening and distressing than those that lead to post-traumatic stress disorder. The fifth edition of the DSM describes in a section titled "Trauma and Stress-Related Disorders" disinhibited social engagement disorder, reactive attachment disorder, acute stress disorder, adjustment disorder, and post-traumatic stress disorder.
Charles H. Zeanah Jr. is a child and adolescent psychiatrist who is a member of the council (Board) of the American Academy of Child and Adolescent Psychiatry (AACAP).
Mental disorders diagnosed in childhood can be neurodevelopmental, emotional, or behavioral disorders. These disorders negatively impact the mental and social wellbeing of a child, and children with these disorders require support from their families and schools. Childhood mental disorders often persist into adulthood. These disorders are usually first diagnosed in infancy, childhood, or adolescence, as laid out in the DSM-5 and in the ICD-11.
The effects of domestic violence on children have a tremendous impact on the well-being and developmental growth of children witnessing it. Children can be exposed to domestic violence in a multitude of ways and goes beyond witnessing or overhearing, although there is disagreement in how it should be measured. Children who are exposed to domestic violence in the home often believe that they are to blame, live in a constant state of fear, and are 15 times more likely to be victims of child abuse. Close observation during an interaction can alert providers to the need for further investigation and intervention, such as dysfunctions in the physical, behavioral, emotional, and social areas of life, and can aid in early intervention and assistance for child victims.
Childhood schizophrenia is similar in characteristics of schizophrenia that develops at a later age, but has an onset before the age of 13 years, and is more difficult to diagnose. Schizophrenia is characterized by positive symptoms that can include hallucinations, delusions, and disorganized speech; negative symptoms, such as blunted affect and avolition and apathy, and a number of cognitive impairments. Differential diagnosis is problematic since several other neurodevelopmental disorders, including autism spectrum disorder, language disorder, and attention deficit hyperactivity disorder, also have signs and symptoms similar to childhood-onset schizophrenia.
Autophobia, also called monophobia, isolophobia, or eremophobia, is the specific phobia or a morbid fear or dread of oneself or of being alone, isolated, abandoned, and ignored. This specific phobia is associated with the idea of being alone, often causing severe anxiety.
The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood is a developmentally based diagnostic manual that provides clinical criteria for categorizing mental health and developmental disorders in infants and toddlers. It is organized into a five-part axis system, which includes domains such as clinical disorders, relational context, medical and developmental conditions, psychosocial stressors, and functional emotional development. The book has been translated into several languages and is used globally for the assessment of children up to five years of age.
Separation anxiety disorder (SAD) is an anxiety disorder in which an individual experiences excessive anxiety regarding separation from home and/or from people to whom the individual has a strong emotional attachment. Separation anxiety is a natural part of the developmental process. It is most common in infants and little children, typically between the ages of six to seven months to three years, although it may pathologically manifest itself in older children, adolescents and adults. Unlike SAD, normal separation anxiety indicates healthy advancements in a child's cognitive maturation and should not be considered a developing behavioral problem.
Emotional abandonment is a subjective emotional state in which people feel undesired, left behind, insecure, or discarded. People experiencing emotional abandonment may feel at a loss. They may feel like they have been cut off from a crucial source of sustenance or feel withdrawn, either suddenly or through a process of erosion. Emotional abandonment can manifest through loss or separation from a loved one.
Disinhibited Social Engagement Disorder (DSED), or Disinhibited Attachment Disorder, is an attachment disorder in which a child has little to no fear of unfamiliar adults and may actively approach them. It can significantly impair young children's abilities to relate with adults and peers, according to the Diagnostic and Statistical Manual of Mental Disorders, as well as put them in dangerous and potentially unsafe conditions. Common examples of this include sitting on a person's lap of which they do not know or leaving with a stranger.
Adult Attachment Disorder (AAD) develops in adults as the result of an attachment disorder, or Reactive Attachment Disorder, that goes untreated in childhood. It begins with children who were not allowed proper relationships with parents or guardians early in their youth, or were abused by an adult in their developmental stages in life. According to attachment theory, causes and symptoms of the disorder are rooted in human relationships over the course of one's lifetime, and how these relationships developed and functioned. Symptoms typically focus around neglect, dysfunction, abuse, and trust issues in all forms of their relationships. These symptoms are similar to those of other attachment disorders, but focus more on relationships later in life rather than those in earlier years. To be considered to have AAD, you must demonstrate at least 2-3 of its symptoms. These symptoms include: impulsiveness, desire for control, lack of trust, lack of responsibility, and addiction. While the DSM-5 does not recognize it as an official disorder, Adult Attachment disorder is currently being studied by several groups and treatment is being developed. Some of these studies suggest splitting AAD into two groups, avoidance and anxious/ambivalent. More recent and advanced medical practice advocates for four categorisations;