Making the Right Call

Since the 1970s, the psychological disorders of children have come much more into focus by the research community, whose work has seen such conditions as ADHD and autism spectrum disorder gain widespread visibility and awareness among parents and their respective fundraising communities.

As a result, children affected by these disorders are far more likely than in previous years to receive professional assessment and intervention – without question, a positive development, in and of itself.

At the same time, however, youngsters with less frequently encountered conditions, such as impulse-control disorders, self-injurious behavior and childhood schizophrenia, may actually experience a higher rate of misdiagnosis and inappropriate treatment.

In Assessing and Treating Low Incidence/High Severity Psychological Disorders of Childhood, Rider faculty members Dr. Stefan C. Dombrowski and Dr. Karen L. Gischlar ’03, along with Dr. Martin Mrazik of the University of Alberta, have combined their research to offer up-to-date information on these severe, if less frequently seen, psychological disorders. Through an overview, description, diagnostic classification and etiology, the three educational psychologists are able to provide assessment tools and interview protocols, psychological and pharmacological treatment options and direction for future investigations.

“We recognized a need for it,” said Dombrowski of the book, published by Springer. “I haven’t seen all these disorders compiled in one source before.”

Dombrowski, the director of Rider’s School Psychology program, said that he, Gischlar and Mrazik endeavored to make their volume as inclusive as possible, going so far as to incorporate conditions that may not even be clinically diagnosable – gang membership, for instance – but also present severe conditions, even when their root causes are subject to disagreement.

“Gangs are certainly difficult to escape, though perhaps easier than is sometimes portrayed,” explained Dombrowski, who added that the trio conducted extensive interviews with former gang members for their research. “The literature about gang affiliation often clashes with many perceptions.”

Gender identity disorder also receives significant attention in Assessing and Treating Low Incidence/High Severity Psychological Disorders of Childhood, at a time when it has also come much more into focus by the greater society.

“It’s really an intensely important topic, Dombrowski explained. “If you look at the suicide rate among individuals with gender identity disorder, it is on the level of 10 times the general population, and five times higher than those who are same-sex oriented.”

Debate rages over whether gender identity disorder is biologically based or rooted in various factors of a person’s environment. Dombrowski says that regardless of the cause, much more research is needed on the topic for the protection of affected individuals.

“Our school systems are the stewards of our children, so if you have an administrator who doesn’t understand the issue, he or she may unwittingly perpetuate certain stereotypes,” he said. “The result can include or lead to teasing and mockery. It’s a very serious situation.”

Dombrowski added that there are very few psychologists who specialize in this area – an unfortunate circumstance given the ignorance that persists among the lay community.

“Gender disorder might be the last area of the human condition for which there remains a tremendous hatred and intolerance,” he explained. “There are a great many people who still do not understand that this population is not sinful or evil. In fact, it’s not necessarily even of their choosing.”

Intended for researchers, clinicians, practicing psychologists and graduate students involved in clinical, developmental and school psychology, Assessing and Treating Low Incidence/High Severity Psychological Disorders of Childhood has been praised by the psychology community for filling critical gaps in child psychopathology reference literature.

PsycCRITIQUES, a review of books published by the American Psychological Association, praised the work as “a great starting point for clinical work, particularly in terms of theory and case conceptualization,” and says that “in representing the complexity of many of these conditions, the authors provide excellent discussions of risk factors at multiple levels.”

In their conclusion, PsycCRITIQUES reviewers Deborah A.G. Drabick and Johanna L. Carpenter announce that the book “will be a helpful tool for researchers and academics across disciplines, as well as for clinicians seeking a solid background in uncommon but serious psychological conditions among youths.”

Dombrowski, who was the recipient of Rider’s Dominick A. Iorio Faculty Research Prize at Commencement 2011, says that the very careful effort he and his colleagues took not to apply their own conclusions to subjects where there exists limited empirical literature may have inadvertently yielded the APA’s only mild criticism.

“Their only complaint, if you will, was that they wished we had posted our own thoughts on subjects like gender identity, which remains a controversial subject,” he said of their inclusive collection of research. “We did not want to condemn some of the approaches to treatment, such as gender-shaping. We do have our thoughts, but there is also a need for an element of grace in the midst of scientific understanding.”

Assessing and Treating Low Incidence/High Severity Psychological Disorders of Childhood

By Stefan C. Dombrowski, Karen L. Gischlar and Martin Mrazik

Published by Springer

Hardcover, 254 pages, $129.00