http://www.stltoday.com/stltoday/news/stories.nsf/stlouiscitycounty/s... Science tries to find secrets of teen brains By Tina Hesman and Matt Franck ST. LOUIS POST-DISPATCH 12/10/2005 New brain research is shattering assumptions held for generations about the adolescent mind, fueling a battle over teen mental health, the rights of parents and the effectiveness of treatment. The findings are forcing scientists to redraw the line between normal teen behavior and severe mental illness, while questioning how the brain truly develops. The picture that's emerging is a teen brain not merely awash in a brief tide of hormones but also in the middle of a tumultuous overhaul. Those transitions, scientists now believe, are so significant that they may unlock the mysteries of mental illness, explaining why some teens take their own lives, why others harm their classmates and loved ones, or why some emerge later in life with crippling mental disorders The research - much of it published a year ago - already looks forward to a day when teens could be tested for suicidal depression as easily as they are for diabetes. But already there are signs that society, and parents in particular, would reject such a tool. Efforts to offer even the most basic mental health questionnaire to high school students have been met with fierce resistance nationwide. Critics have attacked state and federal calls for increased screening, most notably in Illinois. Those actions are fed by a belief that millions of children have wrongly been medicated to control their behavior. Many parents question the validity of a mental health diagnosis, fearing that their children have been or will be falsely tagged with a stigma they'll never outgrow. At the center of the controversy is the teen brain, its confounding architecture and the profound question of what's typical in a teen and what's not. Behavior that's normal in a 13-year-old, most of us would call pathological in a 30-year-old, said Joseph Parks, medical director for the Missouri Department of Mental Health. But where do you make the cutoff? Under the old thinking, the adolescent brain was fully formed, needing only to be filled with facts, figures and experiences to become an adult mind. At the same time, many people rejected the idea that young people were even capable of developing mental illnesses. You couldn't even get the diagnosis until about the mid-(19)80s, said Dr. Kelly N. Botteron, an assistant professor of child psychiatry at Washington University. Earlier child psychiatrists thought kids were not even cognitively capable of getting depressed. Teen brains are different The new research, key portions of which were completed in St. Louis, show a teenage brain as an organ in transition with a volatile and vulnerable composition. It's not entirely clear that the brain is ever finished developing, said Dr. John Csnernansky, director of the Conte Center for the Neuroscience of Mental Disorders at Washington University. The evolving teenage brain clearly isn't adultlike until the early 20s. So the old stereotypes of teens may have some merit. If teens act young and stupid, it may be because brain areas that dampen impulsivity and govern rational thought are among the last to mature. All that is fine when the brain develops normally. But what's shaking up those involved with mental health is what happens when the teen brain fails to successfully reinvent itself as an adult brain. Researchers increasingly believe if that process misfires, teens are vulnerable to developing mental illness. In fact, many now believe that several severe mental illnesses have roots in the developing teen brain. That's true, they say, even if symptoms aren't seen until years or decades later. What concerns many is the possibility that early warning signs might be disregarded, as parents, educators and others ignore what looks to them like typical teen behavior. Early identification matters, because treating the disorders early could head off the worst manifestations of the diseases, giving young adults a better chance at a productive life. If an adult gets depressed and loses a year of function, they can generally get back close to where they were; but if a kid loses a year, it's really hard to catch up again in terms of development, Botteron said. The implications of the research are vital in an age when society is increasingly aware of the consequences of abnormal and violent teen behavior. Although no one can say for certain whether school shootings such as the one at Columbine High School in Colorado in 1999 are the result of mental illness, few question that early detection would reduce violent acts by teens. Sometimes mental illness is to blame when children disrupt class or get into fights at school. Some may turn to drug and alcohol use to help ease the pain, leading to run-ins with the law. A survey of teens at the St. Louis Detention Center in 2003 suggests that 81 percent have at least the warning signs of mental illness and anxiety disorders. Perhaps the chief hope of the new research is that it could someday mean the difference between life and death for teenagers suffering from bipolar disorder (often called manic depression), schizophrenia and major depression. Each of those disorders can lead to suicide, which for years has ranked as the second- or third-leading cause of death for teens. Resistance to screening Kaitlin Harris was one of 94 Missourians ages 15-24 to commit suicide last year. Pretty, popular and a straight-A student, Kaitlin, 15, of Ballwin, looked to those who knew her as if she had the world. But on March 25, 2004, she finally lost the battle she'd been fighting with depression for more than three years. I don't think Kaitlin wanted to end her life, said Robin Harris, her mother. She wanted to end her pain. Harris is now pushing her school district to adopt a program aimed at identifying early those teens who are potentially suicidal. But determining when and how to respond to warning signs of adolescent mental illness is a thorny ethical issue with explosive implications. Nowhere has the controversy been greater than in Illinois, where a state-appointed commission's report calling for universal mental health screening for school-age children was assailed as an encroachment of parental rights. The commission has since retreated from its recommendation. Critics have also attacked a federal panel's call for increased screening. In the wake of the criticism, several federal agencies have said that they do not support universal mental health screening for children, particularly without parental consent. Leading the fight against teen mental health screening is a coalition of critics that has made allies of Scientologists such as Tom Cruise and conservative activists such as Phyllis Schlafly. Much of their opposition is _base_d on religious grounds. Some question whether mental illness even exists. Others parents fear that a child they view as normal will be incorrectly labeled as mentally ill. But perhaps a greater share of the resistance is rooted in skepticism over whether mental illness in youth can even be accurately diagnosed, much less treated. Those doubts increase as more children are medicated for behavior problems. Mental health professionals say there's some validity to the criticism. They point to a system that tolerates hasty diagnoses, often by physicians with no mental health expertise. In short, they admit that at the very least, the field of adolescent mental health suffers from a crisis of credibility - one that scientific research may be unable to address. Seeking definitive tests Much of the skepticism about mental illness and its diagnosis is grounded in the fact that doctors have no blood tests, brain scans or chemical analysis from which to _base_ their conclusion. You can't examine somebody's thoughts like you can X-ray their insides, said Dr. Anne Glowinsky, a psychiatrist at Washington University. When somebody comes to the ER and says 'I'm suicidal,' we don't have a test for that. Most of what scientists know about how mental illness affects the brain comes from examinations of dead people. Until recently, scientists couldn't peer into living brains to look for changes associated with normal development or the ravages of disease. That is beginning to change, as researchers develop ever-more sensitive brain scanners. In the past several years research groups have published composite pictures of healthy brains and those affected by mental illness. The differences between the healthy group and people with depression, schizophrenia and bipolar disorder appear striking, but don't distinguish between causes of psychiatric disorders and the consequences of having a mental illness. And the composite pictures are somewhat misleading. They present the most clear-cut findings from studies of dozens to hundreds of brains. But a snapshot of an individual brain may fall somewhere between normal and mentally ill. Consequently, scientists still can't scan an individual and say with certainty that the person does or does not have a mental illness _base_d upon the structure or function of the brain. But new efforts to define normal, healthy development and to track brain changes associated with mental illness may lead to predictive tests that could show which children are at risk of getting a psychiatric disease. Parents are already familiar with growth curves that rate their children's weight, height and head size. The new studies may lead to a similar growth curve for brain development, Botteron said. But a brain scan for mental health as reliable as a mammogram or colonoscopy is probably decades away, scientists say. For now, psychiatrists and psychologists must still rely on interviews and observations of children's behavior to diagnose mental illness.
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Dear Editor,     After reading the article Science tries to find secrets of teen brains (12/10/2005) it appears some fact-finding is necessary.  First would be the facts on just what mental illness consists of.  Exactly what is it and how does one know it when one sees it?  Next, how do we know that it is the brains that are causing the unwanted behavior? Next, how is it the job of schools to screen for mental illness?  Next, what occurs when a brain reinvents itself or when that process misfires as the authors so glibly wrote.     The authors also mention _object_ions to mental health screening _base_d on religious grounds.  I am interested to know what the authors meant by this.  What success has TeenScreen had in predicting suicide? The article states that the program's developers say it's successful, but where is the proof?  The authors are negligent with their facts in stating flatly that the Church of Scientology is opposed to mental health treatment.  In my opinion it would be more accurate to say that the Church of Scientology is opposed to harmful and unworkable forms of mental health treatment.  On this where would the authors stand?     The best way for mental health professional to win over skeptical parents would be to come clean on what they know and don't know.  The figure of 81% of detainees showing the warning signs of mental health and anxiety disorders is given in the article, but it is not stated how many of those 81% were already on psychiatric drugs or illegal drugs. The mental health professionals who have presented brain scans of children with ADHD as evidence that is a legitimate disease of the brain, when all of the subjects were already on the brain-altering drug Ritalin, were practicing not only junk science, but fraud.  Until the mental health professionals can weed out the charlatans from their ranks, there will be an uphill battle to win public confidence.  A good first step would be to demand the use of the Scientific Method in conducting and reporting their research. Steve Dockendorf

Dear Editor, Reporters Franck and Thesman mention new brain research ,   unlock the mysteries of mental illness and The research - much of it published a year ago and don't even name specifically what research they're referring to. Why don't you share with your readers what ground breaking research you are speaking of?  The New York Times just reported on June 14, 2005 that Psychiatrists have been searching for more than a century for some biological marker for mental disease, to little avail. Has your paper discovered something new? The reporters mention Columbine but don't relate that practically one for one, straight down the line, the common denominator of school shooters is psychotropic drugs. Your reporters even had the audacity to say that TeenScreen is _base_d on the latest brain research . What a joke! TeenScreen is _base_d on the Diagnostic and Statistical Manual. Ever heard of it? The DSM has disorders voted in by psychiatrists! Wow! What a science! TeenScreen - _base_d on latest brain research!  That's complete and utter hogwash. I'd like to ask your reporters how TeenScreen could be _base_d on the lastest brain research when TeenScreen has been operating since 1991! I'd also like to ask your reporters where they came up with such drivel. Your reporters did get one thing right however: mental illness and its diagnosis is grounded in the fact that doctors have no blood tests, brain scans or chemical analysis from which to _base_ their conclusion. Since no biological test exists which can determine mental illness, why then do psychiatrists insist on using biological means: Drugs and Shock Treatment? Whoever edited this story missed the boat. You want documented evidence of TeenScreen? See here: www.psychsearch.net/teenscreen.html Ken Kramer

Dear Editor, Re: Science tries to find secrets of teen brains By Tina Hesman and Matt Franck ST. LOUIS POST-DISPATCH 12/10/2005 Thank you for your article on TeenScreen. As you say in 10 or 15 years there may be a brain scan for mental illness, but there isn't now. And don't forget when they decide what scan indicates what mental illness, even the best scientific minds will have to draw from their own subjective opinions, which if gotten off on the the wrong track could lead to a society of disaster. TeenScreen is very unscientific and solely subjective. The conclusion the observer finds is _base_d on their own past environmental experiences, their own emotions (including genes) and subjective teachings promoted by the alledged communistic APA. There is too much money involved in pushing drugs on teenagers, to even remotely find a true somewhat accurate mental health screening of a teenager. The results of the observers findings are influenced by the alledged communistic APA and the pill pushing drug companies, who know one can deny have a lot of potential money to make off of this project. As a result of the billions involved, it would be very tempting for the CEO of a drug company to twist the results a little bit. And then together with the alledged communistic and self worshiping, self promoting APA, what kind of conclusions and/or delusions are going to be drawn concerning the mental quality of an innocent teenager. John Cash (Professional character analyst and 50 years of psychiatric experience and training)

Dear Editor, This article was extremely well written, in my view.  It shows just how ludicrous these psychiatrists can be in their scheming - in their own words.  Can I rant here just a bit? Teens have special brains?  Oh, please.  This is beyond bizarre.   I would like to see proof.  Where is the proof and where are the lab tests. How do they collect statistics of all these so-called suicidal teens. Are these teens that are already taking their drugs such as ritalin, side effects of which, cause the teen to think such thoughts?   Or, do they do a survey after showing violent death movies in school, like they did at my childrens grade school. Where is any cure or  real help towards humanity, in these people's entire sordid history? As long as they continue their lobbying for bizarre 5 minute screenings, trying to gather political support through fear mongering, twisting facts to suit their own ends and undermining parental rights, then whining when someone challenges their sanity for such behaviors, they will continue to have troubles and controversies  that will backlash on them as a group, not just their silly programs. I do think it is happening now.  Yes, I see it.  Do you? Judy Adams Wisconsin Parent of 3 grown sons (True story:  In 1994 a school counselor told me my 13 yr. old son was depressed and in danger.  I asked him how he determined that - he said my son fit the profile.  He said he was trained to find out these things.  He referred me to a psychiatrist for my son.  I took my son to our family doctor.  My son had an EAR INFECTION.   Antibiotics handled it in one week.  I reported that counselor and he only received a simple reprimand.  This was over 10 years ago, people.  Kids are being evaluated and lives ruined in just that way, even without teen screen. Protect your children.  Tell them what is going on and give them power to say no on their own. When the psychs come around, HIDE your children and watch your own back.) Thank you.

Sir,    If Teen Screen is so effective, and so for the good of the child , why is such a technique as PASSIVE CONSENT (where the parents have to sign a form saying No and the child must turn it in, or else the child is considered to have been given consent to go through this so-called screening) used to avoid parental responsibility? It seems to me that if the truth were told about Teen Screen, then parents would be eager to have their at-risk children screened. But as it is, somehow the parents are left out of the process...     I suspect that a good breakfast (eggs and such rather than a bowl of cold cereal and a Pop-Tart) along with a loving family would do more for a child's self-esteem and alleged depression than any state sponsored mental health screening! When my son was in school, I used to get up in the morning and feed him breakfast, and counselled him to avoid Cokes, and he turned out amazingly UN-depressed. Remember the movie from the '60s _title_d: YOU ARE WHAT YOU EAT . Carter Manierre