Introduction
Childhood mental and developmental disorders include a range of emotional, neurodevelopmental, and behavioral disorders that have an extensive influence on social and psychological well-being. They represent an emerging and persistent challenge to health care systems around the world. Children with such disorders need significant support from their families or caretakers, as well as educational and healthcare systems, as the diseases often persist into adulthood. Moreover, children with mental and developmental disorders have higher chances of experiencing compromised developmental trajectories, with the expanding need for medical and disability services, as well as the increased risk of contact with law enforcement agencies. Such disorders as Obsessive-Compulsive Disorder (OCD) and Eating Disorders (ED) can develop in childhood and get worse throughout adolescence and adulthood if left untreated and allowed to exacerbate.
The risk factors for children to have mental and developmental disorders are primarily differentiated into lifelong and age-specific aspects (Scott et al., 2016). In particular, children’s health depends significantly on the well-being of their caretakers and families, the environment in which they live, the presence of abuse or neglect, unhealthy attachment to parents, destructive behaviors at school and home, as well as the history of mental or developmental disorders in the family (Gadsden, Ford, & Breiner, 2016). However, it is important to acknowledge the difference between child and adult mental health as children are more subjected to environmental influences and do not have the life experiences that can form their responses to such factors. The importance and the relative influence of specific risk factors on the emergence of mental or developmental disorders in children should be viewed in terms of the prevalence, strength, and link to adverse outcomes, as well as the likelihood of reducing the exposure to the potential risk factors (Scott et al., 2016). Thus, to address the adverse influence of the adverse disorders on the well-being of children, it is essential to account for the risk factors as pre-determinants of disorders as well as contributing components to diseases’ exacerbation. Core concepts to be explored further include child mental health,
In childhood, the adverse impact is vast and may encompass the individual suffering of children as well as the negative consequences for their families and peers (Dogra et al., 2018). Specifically, it has been observed that children with such disorders could experience aggression toward others as well as get distracted from learning (Scott et al., 2016). Besides, children with mental and developmental disorders are at a higher risk for psychological and physical health problems in their adulthood, the rising risk of unemployment, involvement with the criminal justice system, as well as the increased need for support due to disability.
Obsessive-Compulsive Disorder
Children may get diagnosed with Obsessive-Compulsive Disorder (OCD) when they have unwanted thoughts and the behaviors that they think they must do because of such persistent and reoccurring thoughts, which usually take up a lot of their time, interfere with daily activities, or make them upset (CDC, 2021). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines obsessions as “recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress. The individual attempts to ignore or suppress such thoughts urges, or images, or to neutralize them with some other action or thought” (American Psychiatric Association, 2013, p. 76). Compulsions are defined in DSM-5 as “repetitive behaviors […] or mental acts […] that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. They are also behaviors or mental acts aimed at preventing or reducing anxiety or distress […]; these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are excessive” (American Psychiatric Association, 2013, p. 78). It is important to note that young children may often be unable to communicate the need for compulsive behaviors or mental acts correctly.
Having OCD means experiencing compulsions or obsessions, or both at the same time. Children who have been diagnosed with OCD can have unwanted thoughts, images, and impulses that take place, again and again, thus causing anxiety and dress (CDC, 2021). Individuals who have negative temperaments and behavioral inhibitions are at a higher risk of developing OCD, as well as those with “first-grade relatives who have OCD” (Child Ming Institute, 2021). In addition, children who have experienced abuse or traumatic and severely stressful events are at a higher risk. Depending on the patient, their risk factors, and environmental characteristics, both obsessions and compulsions can change. Today, there is no unified answer as to why get diagnosed with OCD while there is a possibility of a neurological and biological component affecting brain chemistry and causing the disorders, with some children also being diagnosed with Tourette syndrome or other disorders related to tics (CDC, 2021). Besides, CDC (2021) mentions that health issues during pregnancy and birth may increase the likelihood of the disorder’s development, which is among the reasons for supporting the well-being of women during pregnancy.
Childhood trauma as a contributor to OCD development in children bears significant importance beyond the genetic and neurological factors because it shows a distinct influence of the environment on the mental well-being of an individual (McKeon & Murray, 1987). As suggested by Piras and Spalletta (2020), several aspects of childhood trauma contribute to OCD in children. Specifically, the more severe the stress of the traumatic event, the higher the likelihood of OCD’s occurrence as a result. Also, the existence of certain antecedent vulnerabilities to the pathogenic effects of stressors in OCD. Finally, it also happens that OCD exists independently from traumatic factors and develops due to genetic and neurobiological reasons, and gets exacerbated once children are exposed to trauma (Piras & Spalletta, 2020). These findings are also supported by Ou et al. (2021) who found that children with OCD who suffered more childhood maltreatment exhibit more severe symptoms of the disorder as well as depression. Childhood maltreatment is a type of traumatic event characterized by abuse and neglect suffered by individuals younger than eighteen years. It is differentiated into childhood emotional abuse, sexual abuse, physical neglect, and emotional neglect, all of which have the potential of developing trauma and psychological disorders linked to it.
Eating Disorders
Children may be diagnosed with an eating disorder (ED) when they exhibit behaviors characterized by “severe and persistent disturbance in eating behaviors and associated distress of thoughts and emotions” (American Psychiatric Association, 2021, para. 1). The disorders can evolve into serious conditions that influence the physical, social, and psychological functions of individuals. ED is differentiated into bulimia or anorexia nervosa, binge eating disorder, avoidant restrictive food intake disorder along with other specified feeding and eating disorder (Dell’Osso et a., 2016). According to DSM-5, anorexia nervosa is defined as a “restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health” (American Psychiatric Association, 2013). Bulimia nervosa, on the contrary, is an eating disorder that manifests through a child grossly overeating and then purging the food by inducing vomiting or using laxatives for preventing weight gain (American Psychiatric Association, 2021).
Notably, eating disorders may be diagnosed together with other conditions, such as mood and anxiety disorders, obsessive-compulsive disorder as well as substance abuse problems (American Psychiatric Association, 2021). Besides, evidence has shown that heritability and genes play a significant role in increasing the risks for disorders’ development; however, they can also affect individuals who have no such family history. As a rule, the treatment of EDs is concerned with a multi-dimensional approach that covers behavioral, nutritional, and psychological areas of human functioning. Besides, it is also important to consider ambivalent opinions toward treatment; the denial of the problem as to weight and eating, as well as anxiety associated with changing eating patterns, can present significant challenges to treatment.
The risk factors for EDs occurrence in children and adolescents are multi-faceted since the conditions have been shown to often co-occur with other psychological problems. Besides genetics, biochemistry has also been linked with eating disorders, with individuals who develop them having abnormal levels of specific chemicals regulating mood, appetite, sleep, and stress (Rantala, Luoto, Krama, & Krams, 2019). For example, patients diagnosed with anorexia and bulimia have been shown to have higher levels of cortisol, which is a stress hormone (“Why do young adults develop eating disorders?” 2020). Research also suggests that persons with anorexia have excessive serotonin in their blood, which results in them having to deal with constant stress (Herle et al., 2019). When it comes to psychological factors, can also contribute to ED occurrence in children and adolescents. Besides the co-occurrence of anxiety disorders and OCD, other factors that increase the risks of ED development include poor self-esteem, issues expressing and coping with emotions, high levels of impulsivity, as well as the feelings of inadequacy, and hopelessness (“Why do young adults develop eating disorders?” 2020). Therefore, the more psychological issues an individual has, the higher the likelihood of them developing eating disorders as well, with the overall quality of life decreasing.
When it comes to children and adolescents, such factors as culture and environment are crucial to consider because of their overarching impact on personal development as well as the perception of self within the context of external influences. Specifically, social pressures of dieting and attaining the perfect body image have encouraged people’s dissatisfaction with themselves and enabled continuous anxiety over the need to stay in shape (Westbrook, 2017). While in recent years, the trends have been shifting toward self-acceptance and body positivity, the persistent nature of the increased emphasis on appearance at the expense of more valuable and meaningful characteristics remains damaging to young generations’ mental health (Stuart, 2016). Besides, culturally, popular media’s emphasis on the importance of a toned silhouette, predominantly among women, perpetuates the message of the fear of food and the view is any fat is undesirable to have under any circumstances. Finally, environmental conditions are important to take into consideration because they represent immediate influences on the development of children and adolescents. Family issues, unfavorable conditions for childhood, a history of physical or sexual abuse, bullying, as well as activities encouraging thinness (e.g., gymnastics, running, dancing, modeling, and others) all have been shown to negatively influence body image and encourage the development of EDs (Blodgett Salafia, Jones, Haugen, & Schaefer, 2015). Therefore, the development of eating disorders in children and adolescents occurs as a result of not only genetic factors but also cultural and social environments that perpetuate anxiety over one’s body, causing severe distress and a desire to reduce one’s food intake.
Discussion
Finally, in both OCD and ED, developmental milestones are crucial to consider because they can help indicate points of positive versus adverse health as related to individual and environmental characteristics shaping populations’ lives. Normal behavior in the mental health context is concerned with one’s ability to control emotions, knowing how other people affect their feelings, how to form peer groups or express preferences for routing and structure, and asserting independence. Normal and abnormal development are interconnected as either one can help inform the understanding of the other (Eme, 2017). Important milestones in normal development include showing feelings by crying or smiling (from newborns to six months), responding to others’ emotions (from six months to 12 months), imitating behaviors (from eighteen months to two years), showing independence (two years), showing concern for others, being able to separate from parents (3 years), being cooperative with others (4 years), knowing the difference between reality and fantasy (5 years). Thus, health and well-being in the psychological sense are defined within the realms of children meeting their developmental, and mental health milestones.
Psychological problems are diagnosed when there is evidence of deviating from the health or normal course of milestones’ development, which is being disrupted and channeled into maladapting functioning (Beauchaine & Hinshaw, 2017). Thus, for OCD and EDs to be diagnosed in children and adolescents, the identified processes and behaviors and compared to the pre-determined milestones of normal development as related to the age of patients. Based on the results of evaluations, individuals will get the recommended course of treatment, which is likely to be concerned with a multi-faceted approach that addresses different areas of individuals’ lives.
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