Mental Health Riddle

Thanks again to Thais Tepper for sending on this thought-provoking riddle  and explanation as it gets to the heart of the gap of the reality of the conditions of many international adoptees and the sugar-coating of conditions that agencies (and even adoptive parents) promote.

 

The following is a true case study taken from  this link . Before looking at the link, read the paragraph below and ask yourself the following question: What diagnosis does this person have? Scroll to below the puzzle piece for the explanation.

“At age of three years, patient #1 was first noted to be largely unresponsive to verbal or physical punishment. Her behavior became progressively disruptive, so much so that, by age 14, she required placement in the first of several treatment facil- ities. Her teachers considered her to be intelligent and academically capable, but she routinely failed to complete assigned tasks. Her adolescence was marked by disruptive behavior in school and at home (for example, failure to comply with rules, frequent loud confrontations with peers and adults). She stole from her family and from other children and shoplifted frequently, leading to mul- tiple arrests. She was verbally and physically abusive to others. She lied chronically. Her lack of friends was conspicuous. She ran away from home and from treatment facilities. She exhibited early and risky sexual behavior leading to a pregnancy at age 18. Contingency management in residential treatment facilities and the use of psychotropic medication were of no help. After repeatedly putting herself at physical and financial risk, she became entirely dependent on her parents and on social agencies for financial sup- port and oversight of her personal affairs. She did not formulate any plans for her future and she sought no employment. Whenever employment was arranged, she was unable to hold the job due to lack of dependability and gross infractions of rules. Affect was labile and often poorly matched to the situation, but super- ficial social behavior was unremarkable. She never expressed guilt or remorse for her misbehavior. There was little or no evidence that she experienced empathy, and her maternal behavior was marked by dangerous insensitivity to the infant’s needs. She blamed her misdeeds and social difficulties on other people, and she denied any difficulties with cognition of behavior.”

 

REFORM Puzzle Piece

Answer: The answer is NOT RAD. Instead, this woman was raised in an intact stable family, but sustained a prefrontal brain injury as a toddler. Many entrenched in the “RAD is everywhere” mode would think it was RAD.

Thais says, “Children in orphanages have prefrontal brain injury [as this person in the case study], resulting from neglect, maltreatment, malnutrition or physical abuse. Remember, a large percentage of Russian kids were taken from their abusive parents by court order, before they were put in an institution. ” The most recent statistic that Rally found was 95% of those in Russian institutions are social orphans.

Then there is the added issue of FAS.This link is an abstract of a 2006 study by Dr. Laurie Miller. 234 children from a Murmansk baby home were randomly selected to determine if they had  indications of Fetal Alcohol Syndrome.They were compared with their institutionalized peers. Conclusion: ” More than half of residents of the baby homes in Murmansk, Russia, have intermediate (45%) or high (13%) phenotypic expression scores suggesting prenatal exposure to alcohol. Despite good physical care, stable daily routine, availability of well-trained specialists, and access to medical care, these vulnerable children show significant growth and developmental delays compared with their institutionalized peers.”