Parents Report Inadequate Support in Schools for Behavioral and Emotional Issues

Children with behavioral, emotional, or family problems typically first seek support from school psychologists, counselors, and social workers. Behavioral problems, including attention-deficit/hyperactivity disorder (ADHD), along with emotional and family problems, bullying, and homelessness, can negatively impact children’s academic success.

Approximately 1,100 parents across the United States were surveyed by the C.S. Mott Children’s Hospital National Poll on Children’s Health regarding how well their children’s public schools supported children with behavioral, emotional, or family problems. The poll revealed that 37% of parents surveyed gave an A to primary schools’ support for children with ADHD and other behavioral problems, and 34% gave an A for support for children with emotional or family problems. For secondary schools, 22% of parents surveyed gave an A for support for children with behavioral, emotional, or family problems. For overall education, 52% of parents surveyed gave primary schools an A, whereas 38% gave secondary schools an A.

“Most surprising is the lower parental confidence in secondary schools versus primary schools in public systems, in terms of support for children with emotional, family, or behavioral problems,” said Matthew Davis, MD, MAPP, director of the poll and associate professor of Pediatrics and Internal Medicine at the University of Michigan Medical School in Ann Arbor. “Generally, adolescents are at a greater risk than younger children, in terms of harming themselves and harming others. Therefore, we as a society need to offer more, rather than less, support for them and their emotional struggles.”

Some stakeholders believe that school funding should be limited to educational services due to the economy. If students need special support services, drastic cuts to these areas may interfere with students’ ability to learn and work to their full academic potential.

Dr. Davis said that in the most optimal circumstances, primary care physicians (PCPs) and schools should act together to support children and their families. However, there are many potential obstacles to good teamwork between PCPs and school staff.

“Our results indicate that one major problem is that many parents do not feel that their children’s schools are providing adequate support,” Dr. Davis said. “Based on our findings, I would encourage PCPs to ask parents openly about the amount of support they and their children are receiving from schools. If parents seem discouraged, PCPs should try to help them find other types of support within the community rather than insisting they keep trying to find support within the school setting.”

Funding for this research was provided by the Department of Pediatrics and Communicable Diseases and part of the CHEAR Unit at the University of Michigan Health System. To view the poll, please visit the University of Michigan Health System Website. ( – JV


fMRI Reveals Functioning Behind Stunted Emotional Processing in Generalized Anxiety Disorder

In a recent imaging study, patients with generalized anxiety disorder (GAD) demonstrated inhibited emotional processing. This, according to researchers, was explained by the inability of GAD patients’ brains to regulate the amygdala by engaging the pregenual anterior cingulate.

The investigation, headed by Amit Etkin, MD, PhD, at Stanford University, and colleagues, focused on implicit emotional regulation in GAD.

Etkin and colleagues scanned 17 GAD patients (mean 31.5 years of age, 65% female) and 24 healthy comparison subjects (mean 36.5 years of age, 75% female) with functional magnetic resonance imaging (fMRI) while displaying happy or fearful facial expressions. Each image was overlaid with a “happy” or “fear” caption. Some facial expressions had mismatching captions.

The comparison subjects non-intentionally regulated the emotional conflicts presented by mismatched captions. The GAD group, however, had impaired emotional adaptability and delayed reaction times. fMRI and performance results were so significantly correlated with symptoms that patients could be divided accurately by that sole criterion.

This study was funded by grants from the National Institute of Health and the residencey program of the Veterans Affairs–Palo Alto Health Care System. (Am J Psychiatry. Epub February 1, 2010). – LS


Database of Brain Tissue to Advance Research of Major Psychiatric Diseases

Biomarkers, which are biologic footprints left behind by illness, can be found in brain tissue, the most reliable vehicle that contains direct clues to psychiatric and neurologic disorders. Biomarkers can divulge clues regarding the origin of a disorder and the chain of events that cause full-blown disease.

Robert Yolken, MD, a neurovirologist at Johns Hopkins Children’s Center in Baltimore, Maryland, and colleagues from the Stanley Medical Research Institute in Baltimore, have developed a large repository of brain and tissue samples to advance the understanding and treatment of major psychiatric diseases such as bipolar disorder, major depressive disorder (MDD), and schizophrenia. 

“The medications currently used to treat mental illness can have significant side effects and often do not alleviate symptoms,” Dr. Yolken said. “We anticipate that the database will facilitate the identification of molecular pathways that can be targeted for the development of new and improved medications that primary care physicians can use more successfully in their practices.”

During the last 12 years, information from 45 human brains was obtained postmortem from people who were diagnosed with a psychiatric disorder. In total, the database contains 60 human brains, including 15 brains from people diagnosed with schizophrenia, 15 from those with bipolar disorder, 15 from those with MDD, and 15 from unaffected brains. The database also utilizes software that provides powerful analyses of 1,749 neuropathology datasets and several gene expression datasets.

Also available is information regarding other patient-specific factors, including age, sex, duration of illness, brain pH, alcohol, drug use, and smoking. The database also offers blood, lymphocytes, cerebrospinal fluid, and liver and spleen tissue from the same patients. These samples are meant to provide clues to disease activity. Yolken’s laboratory has also conducted research on the role that viral and bacterial infections, such as the human herpes virus, Epstein-Barr virus, toxoplasmosis, and influenza, play in the development of schizophrenia and bipolar disorder.

“We have found that antibody levels against Epstein-Barr virus and human herpes virus type 6 were significantly increased in the serum of patients with bipolar disorder as compared to control subjects,” Dr. Yolken explained. “Moreover, the antibody levels were significantly correlated with the dopamine receptor mRNA levels on the hippocampus of the same subjects. This suggests that exposure to certain viruses may contribute to the risk for developing psychiatric disorders by interacting with or regulating neurotransmitters.”

Funding for this study was provided by the Stanley Medical Research Institute.  ( – JV

Psychiatric dispatches is written by Lonnie Stoltzfoos and Jennifer Verlangieri.