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Behavioral and Mental Health Disorders (Including Attentional Disorders)

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Neurodevelopmental Pediatrics

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Abstract

The focus of this chapter is on behavioral and mental health disorders (BMHDs). The disorders represent an amalgamation of challenging behaviors, emotional and behavioral consequence of brain dysfunction associated with medical and neurological disorders, and equally complex, primary psychiatric disorders. The emphasis is on autism spectrum disorders (ASD), attention-deficit hyperactivity disorder (ADHD), cerebral palsy (CP), and fetal alcohol spectrum disorder (FASD). As discrete entities, there are many differences between their underlying pathophysiology and phenotypic expression. Genome-wide association scans suggest some shared predisposition and sensitivities to negative environmental and psychosocial experiences.

These concepts are elaborations of the biopsychosocial model. This model rests on the multi-direction interrelationships between life experiences (psychosocial forces) such as temperament, attachment and adverse experiences, and the complex of predisposing factors noted above.

The primary challenge for the authors is dealing with the breadth of this subject. There are dozens of behavioral and psychiatric disorders to consider. Narrowing the focus to those listed above requires condensing the explosive growth of new information from genetics, epigenetics, translational neurosciences, neurophysiology, and functional neuroimaging of pediatric neurodevelopmental disorders into a single chapter. Two issues dominate (1) the transactional nature of gene environment interactions on emerging phenotypes, and (2) the growing realization that many of these phenotypes represent spectrum disorders that suggest final common pathways.

From a biopsychosocial perspective, the neurodevelopmental disorders reviewed in this chapter differ in terms of pathophysiology, but are not mutually exclusive disorders. For example, ADHD is common in children with CP, FAS, and ASD. This realization reinforces the idea that many neurodevelopmental/psychiatric disorders are not discrete entities with firm boundaries. They are in fact products of many biological and psychosocial influences.

From a behavioral health perspective, the negative consequences of adverse childhood experiences on these disorders are not a linear or deterministic process. Resilience and other protective factors and timely interventions can attenuate or prevent some of the negative outcomes discussed in this chapter.

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Authors and Affiliations

  1. Department of Pediatrics, Morehouse School of Medicine, Atlanta, GA, USA

    I. Leslie Rubin

  2. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA

    I. Leslie Rubin

  3. Southeast Pediatric Environmental Health Specialty Unit, Emory University School of Medicine, Atlanta, GA, USA

    I. Leslie Rubin

  4. Break the Cycle of Health Disparities, Inc., Atlanta, GA, USA

    I. Leslie Rubin

  5. The Rubin Center for Autism and Developmental Pediatrics, Atlanta, GA, USA

    I. Leslie Rubin

  6. Psychiatry and Behavioral Sciences, Pediatrics, Maternal Substance Abuse and Child Development Program (MSACD), Emory University School of Medicine, Atlanta, GA, USA

    Claire D. Coles

  7. Dept of Psychiatry, UNC Program on Neurodevelopmental Psychiatry, Chapel Hill, NC, USA

    Jarrett Barnhill

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  1. I. Leslie Rubin
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  2. Claire D. Coles
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  3. Jarrett Barnhill
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Correspondence to I. Leslie Rubin .

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Editors and Affiliations

  1. Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia

    David D. Eisenstat

  2. Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada

    Dan Goldowitz

  3. Department of Pediatrics and School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

    Tim F. Oberlander

  4. Department of Pediatrics, University of Alberta, Edmonton, AB, Canada

    Jerome Y. Yager

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Rubin, I.L., Coles, C.D., Barnhill, J. (2023). Behavioral and Mental Health Disorders (Including Attentional Disorders). In: Eisenstat, D.D., Goldowitz, D., Oberlander, T.F., Yager, J.Y. (eds) Neurodevelopmental Pediatrics. Springer, Cham. https://doi.org/10.1007/978-3-031-20792-1_40

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