by admin | Feb 24, 2014 | Religion
There is some evidence for an association between religious practice and positive mental health in the Irish context. In a study of mothers coping with a child or adolescent or indeed adult with autism Patricia Coulthard and myself found that carers who sought comfort in prayer had significantly better mental health than those who did not. There are many forms of prayer, one type is petitionary prayer, but all have the acknowledgement of a supreme being in common. Therefore not only is the person praying physically carrying out an activity, praying, they are also in some sense handing the problem on, by deferring to a higher authority. This may lessen feelings of guilt and responsibility. This change of attribution away from the self, combined with the physical activity of doing something may aid the carer to cope more adequately.
In the Irish context in this study carers reported significantly more support from their personal beliefs than from organised religion. The formal churches to which they belonged did not help them to cope and were rarely there as a resource.
The various clergymen did not seem to know how to relate to a mother who suddenly has an autistic child diagnosed. The churches to which the participants in our study belonged did not have an outreach to these isolated families with a child with autism. The clergy seemed to need to be educated on how to manage this crisis situation and as to the spiritual support they could give to these families with an autistic or disabled child. This may be just the occasional visit to acknowledge the existence of the child with autism in the family. These children with autism have been baptised into their church and are just as valid members as the rest of the parish.
Around the time of the diagnosis of the child with autism 23 of the 60 mothers studied prayed to deal with the stress. When the children were at the primary school age 37% of the families used prayer as a coping resource and indeed in some situations the mother’s faith kept her going. At the time of adolescence 17 out of the 60 mothers sought comfort in their religious beliefs or prayed as a coping mechanism. When these children with autism were adults 6 out of the 60 parents still prayed for a magic cure. In all approximately half of the mothers used prayer as a coping strategy. Those who sought comfort in prayer had statistically speaking better mental health.
Prayer was both a resource and a coping strategy.
In another study conducted in Ireland in the 1980s by Professor Hannah McGee and myself and published in Pathways to Child Hospitalisation which was about the home versus hospital care of children with gastroenteritis. We found that statistically far more of the mothers who were able to manage their child at home and didn’t need to have their child in hospital often attended religious services and indeed often did this accompanied by their partner. Clearly this association between religious practice and mental health needs to be teased out more in the Irish context. There is no such thing as a ‘god gene’ indeed the concept is absurd but there is a personality predisposition to spirituality.
Geoffrey Kluger in an article Is God in our Genes? Time, October 25th, 2004, Page 62 – 72 discusses the Temperament and Character Inventory (TCI). ‘Among the traits that TCI measures is one known as self-transcendence, which consists of three other traits: self-forgetfulness, or the ability to get entirely lost in an experience; transpersonal identification, or a feeling of connectedness to a larger universe; and mysticism, or an openness to things not literally provable. Put them all together and you come as close as science can to measuring what it feels like to be spiritual’. “This allows us to have the kind of experience described as religious ecstasy” says Robert Cloninger. Hamer studied spirituality using ‘Cloninger’s self-transcendence scale, placing them on a continuum from least to most spiritually inclined. Then he went poking around in their genes to see if he could find the DNA responsible for the differences. Spelunking in the human genome is not easy, what with 35,000 genes consisting of 3.2 billion chemical bases. To narrow the field, Hamer confined his work to nine specific genes known to play major roles in the production of monoamines – brain chemicals, including Serotonin, Norepinephrine and dopamine, that regulates such fundamental functions as mood and motor control’. He found ‘a variation in a gene known as VMAT2 – for vesicular monoamine transporter – seemed to be directly related to how the volunteers scored on the self transcendence test. Those with the nucleic acid cytosine in one particular spot on the gene ranked high. Those with the nucleic acid adenine in the same spot ranked lower’. Twin studies have shown similarities in their spiritual feelings. Thomas Bouchard stated ‘whether we are drawn to God in the first place is hard wired into our genes’. He also stated ‘it is completely contradicted my expectations’. Michael Persinger states that the god experience ‘is a brilliant adaptation. It is built in pacifier’ for example to do with the contemplation of our death. This is the opposite to novelty seeking. It is possible though that religious ecstasy might be more closely linked to novelty seeking. A book on the topic is called God Gene: How Faith is Hard Wired into Our Genes, Doubleday, 2004 by Dean Hamer. In personality traits such as discussed here multiple genes of small effect are operating
by admin | Feb 24, 2014 | Suicide
Dr. Arnold Ludwig studied the New York Times Book Review Biographies from 1960 to 1980 and found that 18% of the poets he studied had completed suicide. According to Jamison Ludwig ‘compared individuals in the creative arts with those in other professions (such as businessmen, scientists, and public officials), he found that the artistic group showed two to three times the rate of suicide attempts’ (Jamison, 1993).
Jamison also points out that ‘biographical studies, as well as investigations conducted on living writers and artists, show a remarkable and consistent increase in rates of suicide’. She points out that ‘the artistic groups .. demonstrate up to 18 times the suicide rate’ compared to the expected rate in the general population. This is higher than found in the Ludwig study.
Jamison points out (that the following artists completed suicide: Heinrich von Kleist, Ann Sexton, George Trakl, Marina Tsvetayeva, Ernest Hemmingway, Malcolm Lowry, Virginia Wolff, Vincent von Gogh, Arshile Gorky, Mark Rothko, Nicolas de Stael, Thomas Lovell Beddoes, John Berryman, Thomas Chatterton.
Jamison also points out that the following made a ‘suicide attempt’: Charles Baudelaire, William Cowper, Edgar Alan Po, Percy Bysshe Shelley, Francis Thompson, Maxim Gorky, Hermann Hesse, Hector Berlioz, Eugene O’Neill, Mary Wollstonecraft, Robert Schumann, Dante Gabriel Rossetti.
Suicidal Thoughts:
A. Alvarez stated in his book The Savage God that ‘a suicidal depression is a kind of spiritual winter, frozen, sterile, unmoving. The richer, softer, and more delectable nature becomes, the deeper that internal winter seems, and the wider and the more intolerable the abyss, which separates the inner world, from the outer. Thus suicide becomes a natural reaction to an unnatural condition. Perhaps this is why, for the depressed, Christmas is so hard to bear. In theory it is an oasis of warmth and light in an unforgiving season, like a lighted window in a storm. For those who have to stay outside, it accentuates, like spring, the disjunction between public warmth and festivity, and cold, private despair’. Lord Byron also suffered considerable suicidal thoughts. Percy Bysshe Shelley also experienced considerable suicidal thoughts. Graham Green experienced suicidal thoughts. William Styron in his book Darkness Visible wrote about his suicidal depression and stated ‘the pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come – not in a day, an hour, a month, or a minute. If there is mild relief, one knows that it is only temporary; more pain will follow. It is hopelessness even more than pain that crushes the soul. So the decision-making of daily life involves not, as in normal affairs, shifting from one annoying situation to another less annoying – or from discomfort to relative comfort, or from boredom to activity – but moving from pain to pain. One does not abandon, even briefly, one’s bed of nails, but is attached to it wherever one goes’. For Leo Tolstoy ‘the thought of suicide came to me as naturally then as the thought of improving life had come to me before’.
It would appear that the great artist experiences both tremendously deep and complex emotions. They have access to emotional experiences and the extremes. The complexity of their emotional life is great. All this is very helpful for their creativity but also makes them more likely for suicidal thoughts and suicidal behaviour. They are less logical and rational then non-artistic people and are governed by the logic of emotions. Of course the logic of emotions is very often not logical. This makes them more vulnerable to suicidal experiences.
K. Jamison in her book Night Falls Fast states that ‘I have a hard-earned respect for suicides ability to undermine, overwhelm, outwit, devastate, and destroy’. Jamison is an Honorary Professor of English at the University of St. Andrews in Scotland has Bipolar disorder and has attempted suicide. This experience appears to be more common in persons with major artistic creativity than the general population.
Of course one has to be very careful with selected samples of geniuses with artistic ability. They are no way representative of the total population of persons with artistic creativity. Of course there is clear association between depression, suicide, and artistic creativity. What the prevalence of these might be in the total population of artists in Ireland is unknown. We can’t generalise the total population.
It is interesting that both Ann Sexton and Abbie Hoffman received Manic Depressive Disorder diagnosis and were given lithium but stopped taking the lithium and completed suicide thereafter. It is possible to reduce the suicide rate in artistic people with proper treatment of their psychiatric problems. It is likely that the vast majority of artistic people who complete suicide have psychiatric problems. Clearly an additional factor is that abuse of alcohol and drugs is not uncommon in artistic people. There is a myth that alcohol increases creativity. What alcohol does is to increase depressive feelings and not creativity. Alcohol and drug abuse is clearly also associated with depression. Indeed it appears to me that being creative is what keeps people alive. It would appear to me that suicide and depression are much more common where the artist experiences a creative block and that they are particularly vulnerable at that point. The great philosopher Ludwig Wittgenstein as illustrated in the book Autism and Creativity was able to resist suicide by a continuing ability to be philosophically creative as a research philosopher. Indeed it may be that a creative block leads to depression leads to alcohol abuse leads to suicidal behaviour.
In terms of social drinking this is an entirely different matter. It is unlikely that ordinary social drinking will have a negative effect on creativity and indeed might have a positive effect. Stephen Pritzer points out that ‘many writers recognise they could not write well while they were drinking. F. Scott Fitzgerald and Ring Lardner said they went on the wagon when they worked’. He also points out that ‘writers who used alcohol occasionally saw it as an aid in getting started or a stimulus when they were tired’. This makes sense. Clearly excessive drinking is damaging but smaller amounts might be positive for social functioning and indeed for physical health generally. One must also remember that there is often a depressed period following a creative spurt. This has to be managed by a creative writer. Of course in addition the vast majority of artists are poorly paid and suffer a great deal of financial stress. It is a very insecure profession. It is hardly surprising therefore then that it is stressful and this stress makes people in this profession more vulnerable to anxiety and depression. Clearly there are genetic factors in relation to creativity, alcohol abuse and depression. The alcohol abuse only makes it much more likely that the artist will not be able to produce their potential. I don’t believe the story that Coldridge wrote Kublai Khan while on opium. If it is true then he could only have been taking very minor amounts. It is interesting to compare this with great mathematicians, scientists, and inventors (Fitzgerald, 2004). The stress in their life was generally much less than those with artistic creativity. In addition great scientists, inventors, etc. often find very useful places for themselves in society either in the academic world or in the industrial world and therefore do not have insecure lives from a financial point of view. They are also in general far better paid financially. Not every highly successful artist is capable as well of dealing with fame. They may feel they have to continue to produce great work which they may no longer feel able to. They may engage in self destructive paths of drinking and notoriety with suicide as an outcome. Being successful may set the bar too high for them and they may be unable to repeat it and therefore develop writers block followed by depression and alcohol abuse.
Reference:
Ludwig A. M. (1992). Creative Achievement and Psychopathology: Comparison among Professions. American Journal of Psychotherapy, 46, 330 – 356.
Jamison K. (1993). Touched with fire. Free Press: New York.
Jamison K. (2000). Night falls fast. Picador.
Alvarez A. (1973). The Savage God. Random House: New York.
Styron W. (1990). Darkness Visible. Random House: New York.
Pritzer S. (1999). Encyclopaedia of Creativity. Academic Press: San Diego. Edited by M. Runco and S. Pritzer.
Fitzgerald M. (2004). Autism and Creativity. Brunner Rutledge Hove.
by admin | Feb 24, 2014 | Adolescence, Suicide
Worldwide there is about one death every 40 seconds and about one million suicides per year. Suicide is the leading cause of death worldwide, particularly in younger people.
According to Dr. John Connolly there has been a twelve-fold increase in suicide between 1960 and 2000 in 15 to 34 year olds. The Union of Students in Ireland has estimated that 25 persons per year between the ages of 20 and 24 complete suicide. In data collected during 2002 the National Suicide Foundation Registry found that there was increased Parasuicide by 5.7% in the Midland Health Board, 11.9% in the Mid Western Health Board, 8.5% in the South Eastern Health Board, and 12.7% in the Southern Health Board. They also pointed out that Parasuicide was highest among young women aged 15 to 19 with 1 per 160 of the total population of 15 to 19 year olds being involved. Parasuicide rates were higher in urban areas and varied between 63 per 100,000 in Leitrim and 429 per 100,000 in Limerick. They found that alcohol was involved in 46% of male suicides and 38% of female suicides. Parasuicide made up 1% of all casualty attendances. The types of drugs used in overdose include (a) 40% minor tranquillisers, (b) 43% at least one analgesic drug (Paracetamol involved in 30% of drug overdoses), (c) 23% antidepressants (18% SSRI), (d) Paracetamol was involved in 33% of overdoses by women and 23% of overdoses by men.
It is clear that there are major associations between suicidal behaviour and alcohol or drug abuse. There is a higher risk if there is an easily available method and higher risk in populations of persons who are depressed and persons with schizophrenia. Hopelessness is closely associated with suicidal behaviour. Other factors include narcissistic wounds to the personality i.e. shame or public humiliation. Imitation plays a role for example after Marilyn Monroe’s death. Unemployment and genetic factors are also important. The social contact factors include anomie, alienation, western industrialised societies, sense of meaningless in life, ‘worship of the Euro’, a history of sexual abuse, drop out from education, and bullying can also be factors. Other factors include poor problem solving skills, relationship problems and loneliness, as well as having a history of impulsivity and Attention Deficit Hyperactivity Disorder. Another condition sometimes involved is persons with Asperger’s syndrome, which is a social relationship disorder. Personality features associated with suicide and behaviour include antisocial behaviour, emotional dysregulation, and depressive personality.
Males are at increased risk of suicide because it is harder for them to find an identity in our society and they often have a sense of being lost. They have greater difficulties in expressing their feelings particularly emotional feelings and describing interpersonal difficulties. The female has better verbal skills, better empathy, better interpersonal skills than the male and this is important in reducing completed suicide. The male mind is more of a mechanical mind which is less good at emotional processing.
Almost anything can be a warning sign of suicidal behaviour in adolescents but the following have been noted: truancy, poor school performance, anxiety and depression, withdrawn behaviour, change in behaviour, sleep disturbance, impulsiveness, and low frustration tolerance. Protective factors against suicidal behaviour include prior experience of self-mastery and success, good mental health, and healthy socialising and coping strategies, as well as success at school and work.
In assessing the adolescent with possible suicidal ideas or actual suicidal ideas it is important first to listen and then not to panic and to realise that purely legalistic thinking will interfere with one’s ability to listen to the patient. It is important to ask relevant questions including thoughts and intensions about suicide, plans, wills, available methods, family history of suicide, imitation issues, depression, and hopelessness. If a school teacher or anybody else becomes aware that an adolescent is suicidal it is important to remain in touch with them to give them a telephone number or mobile and to take action to bring the matter to the attention of their family. It is one of the few areas were confidentiality to a friend does not apply. Keeping the friend alive is all that matters. The adolescent will often need to get first in touch with their G.P. and then with a Psychiatrist or Psychotherapist / Counsellor to deal with the matters that are concerning them. Sometimes these contacts need to be on a daily basis in the early stages of treatment.
In terms of postvention that is dealing with a family post suicide it is important to avoid fault finding or blame. Truthfulness is very important. The family need time to work through the feelings they have in relation to the suicide and this may reduce the likelihood of intergenerational effects later on.
In terms of suicide prevention in schools it is important that adolescents are helped to deal with stress and distress and learn life skills. They have to be thought to manage stress, loss, how to manage upset of a break-up of a relationship, and academic problems. Developing problem solving is critical. Some isolated students also need very much to develop social skills and active programmes to prevent bullying in school are of critical importance.
by admin | Feb 24, 2014 | Substance Abuse
The effect of chemical dependency either alcohol or drugs in children is very great. Parental alcoholism or drug abuse of a serious kind has a hugely detrimental effect on the family atmosphere and on the parent’s ability to rear their children. Children in these families live in a climate of anxiety and fear. There is enormous unpredictability and uncertainty in the families. The children never know what to expect or what is going to come next. They are in a state of bewilderment. A recent advertisement on the billboards asked why is mummy strange after she works late? This was the best that a child could make out of mother’s drinking. These children live with constant fear of catastrophe. They develop a sense of the world as being catastrophic and dangerous. They mistrust everybody and everything. They are confused by what is going on. They witness domestic violence, parental blackouts, and the whole paraphernalia of drug addiction with syringes, needles, rolling paper, and indeed they may have to assist in this process by holding, buying or giving drugs to a parent. They suffer enormous shame and also indulge in a great deal of self-blame and guilt. Young children tend to blame themselves for things that happen in the family. They may also be frightened by the families contact with drug dealers and the lack of finances. They will lack money for school books, clothes, and experience poverty.
There are huge communication deficits in the family and this is increased by the denial about what is going on in the family and the denial by parents of their chemical dependency. They are aware of the importance of secrecy and not disclosing what is happening in the family. Timothy Rivinus in his book Children of Chemically Dependent Parents published by Brunner-Mazel, New York, 1991, states that children of alcoholics live “thousands of little debts of their parents each year”. These children are often ‘shell shocked’ by the traumas that they witness and show symptoms of Post Traumatic Stress Disorder with repetitive fearful dreams and intrusive thoughts about events that they have witnessed in the family. It is not uncommon for parents suffering from addiction to be hostile, abusive, and critical of their children. The children have massive unmet needs in terms of nurturing, empathy, and the experience of normal family life.
It is not surprising that these children often suffer from depression, hopelessness and low self-esteem. They develop a false self to protect themselves from the outside world. They are often mistrustful of people and can become masochistic and self-destructive themselves in their later behaviour. In later life they can engage with destructive partners. Suicidal behaviour is also not rare in these circumstances as children. They can also become pseudo-adults and heroic figures looking after their parents. This reversed parenting is not healthy and can lead to later difficulties if not talked out. Sometimes it can be used in a more healthy fashion by these children as adults becoming therapists or engaging in the helping professions themselves. These children often show symptoms of Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, problems in attachment with human beings, as well as eating disorders, delinquency, substance abuse, and other acting out disorders. In School they will often have educational problems and may engage in truancy. If mother drank very excessively during pregnancy they may show evidence of foetal alcohol syndrome.When these children grow up and become parents themselves they may either over indulge their own children and become enmeshed with them. As adults these children of alcoholics may not have a clear vision of their parents, they may not be aware of the positive aspects of their parents. Recovering these positive aspects of their parents is of critical importance to mental health. When they marry they may expect their spouse to cure the hurt child in them and this is often an excessive and impossible demand. They really have to come to terms with being a child of an alcoholic or chemically dependent parent but not become a victim. This can be helped by them working out an accurate narrative of their life experience.
Protective factors for these children can include having a high I.Q., an easy temperament, support for these children from a sibling from a non-alcoholic parent, or from a mentor at School. Al Teen where the secrets and denial in the family can be tackled and the child’s history can be spoken openly can be quite helpful.
Unfortunately professionals working with children do not often take sufficiently detailed drug and alcohol histories from parents. This can lead to very confused understanding of the family. Unfortunately in Adult Psychiatry there is a huge denial of the impact of the alcoholic parent on the child and Adult Psychiatrists refer children for counselling or to a Child Psychiatrist only on the most infrequent occasions. In addition the parents and indeed the children can have undiagnosed and untreated Attention Deficit Hyperactivity Disorder which may underlie many of the problems. This lack of identification of this condition can also mean the treatment is either inadequate or misguided. Early and proper early intervention with both psychotherapeutic behavioural and family interventions as well as active pharmacological treatment of Attention Deficit Hyperactivity Disorder can significantly reduce later problems.
by admin | Feb 24, 2014 | Creativity
Persons with High Functioning Autism or Asperger’s syndrome can show considerable creativity. Indeed they have the capacity for extreme creativity in a small number of cases. Evidence of minor creativity would be more common. The features of autism / Asperger’s syndrome that would enhance creativity would include intense focus on narrow interests. It is rarely possible to make major advances in science without this narrow intense focus. The lack of interest in emotional issues means that there is far more time available for intellectual mathematical, philosophical, and other scientific pursuits. Their time is not taken up with interpersonal relationships and with ordinary everyday life. They are often workaholics and their whole life is devoted to their creative pursuit. Persons with autism often have abnormal brain functioning and indeed brain structure and these deficits in some way enhance creativity. This kind of creativity has genetic underpinning of a type that has not yet been fully elucidated. Heritability factors account for about 93% of the variants in the aetiology of autism / Asperger’s syndrome. The following are some examples of this creativity.
Henry Cavendish
Henry Cavendish (1731 – 1810) had High Functioning Autism / Asperger’s syndrome. He was an enormously successful scientist. He had enormous difficulties in interpersonal relationships. He was a man of enormous routines and regularities in his conduct of his life. He was very poor at speech making. Nevertheless he could be very precise in his use of language. He lacked empathy in interpersonal relationships and Berry notes Cavendish’s “striking deficiencies as a human being”. Indeed “his habitual profound withdrawal lead one contemporary to characterise him as ‘the coldest and most indifferent of mortals’”. He had an awkward gait and there is absolutely no doubt that like Newton and Einstein he had High Functioning Autism / Asperger’s syndrome.
Charles Babbage
Charles Babbage (1792 – 1871) also had High Functioning Autism / Asperger’s syndrome. He was the father of the modern computer. He was an autodictat. He spent a great deal of his life trying to build calculating machines. The first one was called a ‘difference engine’ and the second an ‘analytical engine’. According to Swade Babbage’s engine ‘gave new impetus to the notion of a “thinking machine” and stimulated the debate about the relationship between the mind and physical mechanism’. He had major problems in interpersonal relationships. He worked largely in isolation. He had a socially immature personality not uncommon in persons with High Functioning Autism / Asperger’s syndrome. He suffered from anxiety and depression. He was an excellent mathematician. He was described as an eccentric and comic figure. He was naïve and showed a lack of commonsense.
Archimedes
Archimedes (C 287 – 212 BC) also had High Functioning Autism / Asperger’s syndrome. He was an extremely eccentric individual spending as much of his life isolated in solitary. He had a good mechanical mind. He invented what is called the Archimedes screw for pumping water which is still used to this day. He was highly regarded as an engineer and inventor. He only liked to talk to mathematicians. He was the discoverer of what is called the Archimedes principal i.e. that the floating body will displace its own weight in fluid. He was an obsessive mathematician. He neglected his personal hygiene. Like Newton he left his meals untouched when he was deep in mathematics.
Norbert Wiener
Norbert Wiener (1894 – 1964) was another mathematician with High Functioning Autism / Asperger’s syndrome. He was an autodictat, a linguist, and a rather absent minded professor. He was a socially immature child. He lacked empathy and was tactless with people. He was rather a lone wolf and was uncertain about how to conduct conversations. He was a very poor teacher. He was very routine bound. He was a rather clumsy child which is not uncommon with HFA / ASP and indeed like many others he suffered from anxiety and depression. He was described as being very eccentric.
Nikola Tesla
Nikola Tesla was a famous electrical inventor who had High Functioning Autism / Asperger’s syndrome. He had a photographic memory. He was a linguist. He was an avid reader. He had an obsessive compulsive personality type. He was an autodictat. He had major difficulties in social relationships, was socially immature and naïve. He was extremely controlling and spoke with a high pitched voice. He was extremely naïve in dealing with people who would finance his inventions. He was very much a loner and remained unmarried and was extremely interested in pigeons. He had no capacity to manage money. His main interest was in inventions. He was the inventor of radio among many other things.
David Hilbert
The mathematician David Hilbert (1862 – 1943) had High Functioning Autism / Asperger’s syndrome. He was a great mathematician. He showed eccentric interpersonal behaviour and was socially immature. His only interest was in discussing mathematical subjects. He showed extreme self control. Routines were extremely important to him. He tended to show repetitive language. Nevertheless he was very precise in his use of words. He showed lack of empathy. He believed no scientist should marry. He suffered from anxiety and depression.
G. H. Hardy
The great English mathematician G. H. Hardy had High Functioning Autism / Asperger’s syndrome. He was a very eccentric man who never married. Routine was extremely important to him. His great interest in life was mathematics. He loved cats. He was extremely honest in his behaviour. Later he suffered from depression and attempted suicide. Attempting suicide is not uncommon in persons with High Functioning Autism / Asperger’s syndrome.
Dimitri Mendeleyev
Dimitri Mendeleyev who developed the periodic table in chemistry had High Functioning Autism / Asperger’s syndrome. He had major difficulties in interpersonal relationships. He was most eccentric looking. He cut his hair once a year. He had tremendous focus on chemistry and on chemical elements and it was this intense focus that brought him success. Like so many successful people with HFA / ASP he performed poorly in school.
Edward Teller
The most classic person of all with Asperger’s syndrome was Edward Teller the father of the H Bomb and the subject of a recent book called Edward Teller – The Real Strangelove from Harvard University Press.
Asperger’s syndrome is characterised by avoidance of eye contact, problems reading non-verbal behaviour, being a loner with a lack of social know-how, having problems sharing thoughts, and problems with empathy. They often speak with a high pitched or unusual tone of voice and repeat phrases. Gillberg calculates that 0.3% to 0.5% of the population has it. they like routine and have preservation of sameness. As children they often line things up, flap their hands, and are fussy eaters. They often have narrow obsessive interests in engineering, mechanics, astronomy, science, palaeontology, etc. It is one of the most missed diagnosis in adult psychiatry. They are misdiagnosed as Schizophrenia Personality Disorder and a wide variety of other diagnosis. This leads to inappropriate treatments which only aggravate the situation. hopefully the Irish Psychiatric Association, Irish College of Psychiatrists, and the Mental Health Commission will examine the issue. Psychiatric CPD has failed in relation to Asperger’s syndrome and indeed adult Attention Deficit Hyperactivity Disorder which in reliable epidemiological studies in USA affects 4.4% of the population.
