I don’t normally post these types of news stories, but because it could impact children’s evaluations and IEPs, I’ve decided to do so.
A story in yesterday’s Boston Globe reports that two sisters who posed as licensed psychologists provided testing/evaluation services to children with special needs.
Sara Morrison reports:
According to the attorney general’s office, Nita Guzman and Nina Tischer are 49-year-old twins who ran two psychological service corporations based in Lowell. They are accused of assuming the identities of psychologists, a mental health counselor, and a social worker to provide services in the Lowell area. They then allegedly billed various agencies for those services to the tune of about $580,000.
If the charges are true, the sisters’ victims (besides the taxpayers) are children with special education needs and people with mental health disabilities.
They are accused of performing $60,000 worth of psychological evaluations of special education students in the Lawrence public school system. They allegedly used a licensed psychologist’s credentials to do so. Neither sister is a licensed psychologist.
They’re also accused of pulling the same scam on UMass Medical School when the duo evaluated people applying for mental health disability benefits.
Read more on Boston.com.
Additional details can be found in a press release from the Massachusetts Attorney General’s Office, including the allegation that Nita Guzman, through her company New England Psychological Consultants, Inc., allegedly billed Medicaid, Medicare, and Lawrence Public Schools more than $550,000 for unlicensed mental health services. Her twin sister, Nina Tischer, through her company PsychSupport, Inc., billed a division of UMass Medical School more than $30,000 for unlicensed psychological examinations. If those names appear on your child’s evaluation, you may wish to contact your child’s school district.
Most readers probably already know that Tourette’s is more common in males than females. But what about in post-adolescence? Do gender differences make a difference in tic symptoms later in life? A newly published study by Lichter and Finnegan suggest that symptoms may be more common and more severe in women than in men. Gender, by itself, however, does not account for much of the differences in tic symptoms and does not account for gender differences in psychosocial functioning. The latter seems more related to tic severity and comorbid disorders:
Although boys are disproportionately affected by tics in Tourette syndrome (TS), this gender bias is attenuated in adulthood and a recent study has suggested that women may experience greater functional interference from tics than men.
The authors assessed the gender distribution of adults in a tertiary University-based TS clinic population and the relative influence of gender and other variables on adult tic severity (YGTSS score) and psychosocial functioning (GAF score). We also determined retrospectively the influence of gender on change in global tic severity and overall TS impairment (YGTSS) since adolescence.
Females were over-represented in relation to previously published epidemiologic surveys of both TS children and adults. Female gender was associated with a greater likelihood of tic worsening as opposed to tic improvement in adulthood; a greater likelihood of expansion as opposed to contraction of motor tic distribution; and with increased current motor tic severity and tic-related impairment. However, gender explained only a small percentage of the variance of the YGTSS global severity score and none of the variance of the GAF scale score. Psychosocial functioning was influenced most strongly by tic severity but also by a variety of comorbid neuropsychiatric disorders.
Eur Psychiatry. 2014 Sep 2.
Influence of gender on Tourette syndrome beyond adolescence.
Lichter DG, Finnegan SG.
Carousel Image: Dreamstime
A new study suggests that watching yourself tic in the mirror may increase tics:
Gilles de la Tourette syndrome (GTS) is characterized by motor and phonic tics. It is unknown how paying attention to one’s own tics might modulate tic frequency. We determined tic frequency in freely ticcing GTS patients while they were being filmed.
In Study 1, we investigated 12 patients (1) alone in a room (baseline); (2) alone in front of a mirror. In Study 2, we replicated these conditions in 16 patients and additionally examined how watching a video, in which the individual was shown not ticcing, affected their tic frequency.
In both studies, tic frequency was significantly higher when patients watched themselves in a mirror compared to baseline. In contrast, tic frequency was significantly reduced in the video condition.
Paying attention to one’s own tics increases tic frequency when tics are not suppressed and appears to be specific for attention to tics, rather than attention to the self.
Cogn Neurosci. 2014 Sep 4:1-7.
Visual feedback of own tics increases tic frequency in patients with Tourette’s syndrome.
Brandt VC, Lynn MT, Obst M, Brass M, Münchau A.
There is some new research that may alarm some readers, so I’ll say this at the top: just because your child has OCD, it does not mean that he or she will develop schizophrenia.
Obsessive compulsive disorder diagnosis linked to higher rates of schizophrenia
Bottom Line: A diagnosis of obsessive-compulsive disorder (OCD) appears to be associated with higher rates of schizophrenia and schizophrenia spectrum disorders.
Authors: Sandra M. Meier, Ph.D., of Aarhus University, Denmark, and colleagues.
Background: OCD and schizophrenia are distinct and infrequently overlapping disorders. But some studies have suggested higher rates of co-existing illness with the two disorders in patients.
How the Study Was Conducted: The authors assessed the potential relationship between the two disorders using data from Danish registers. A total of 3 million people born between 1955 and 2006 were followed up from 1995 through 2012. The authors used incidence rate ratios (IRRs) as a measure of relative risk.
Results: A total of 16,231 people developed schizophrenia and 447 (2.75 percent) of them had a prior diagnosis of OCD. A total of 30,556 people developed a schizophrenia spectrum disorder and 700 (2.29 percent) of them had a prior OCD diagnosis. The data suggest a prior diagnosis of OCD was associated with an increased risk of developing schizophrenia (IRR=6.90) and schizophrenia spectrum disorders (IRR=5.77) later in life. The children of parents diagnosed with OCD also had an increased risk of developing schizophrenia (IRR=4.31) and schizophrenia spectrum disorders (IDD=3.10).
Discussion: “Despite the fact that our results indicate putative overlapping etiological factors of OCD and schizophrenia or schizophrenia spectrum disorders, they do not necessarily suggest that these disorders should be aggregated into one global diagnosis. However, given these findings and the fact that OCD and schizophrenia co-occur with one another at a higher rate than would be expected in the general population, the phenotypes of these disorders are potentially more similar than currently acknowledged. … Further research is needed to disentangle which genetic and environmental risk factors are truly common to OCD and schizophrenia or schizophrenia spectrum disorders.”
The full research report is available for free online at JAMA Psychiatry
Family Dinners Good for Teens’ Mental Health, Could Protect From Cyberbullying
Bottom Line: Cyberbullying was associated with mental health and substance use problems in adolescents but family dinners may help protect teens from the consequences of cyberbullying and also be beneficial for their mental health.
Author: Frank J. Elgar, Ph.D., of McGill University, Montreal, Canada, and colleagues.
Background: About 1 in 5 adolescents has experienced recent online bullying and cyberbullying, like traditional bullying, can increase the risk of mental health problems in teens as well as the misuse of drugs and alcohol. It is important to understand whether cyberbullying contributes uniquely to mental health and substance use problems independent of its overlap with traditional face-to-face bullying. Family dinners are an outlet of support for adolescents.
How the Study Was Conducted: The authors examined the association between cyberbullying and mental health and substance use problems, as well any moderation of the effects by family contact and communication through family dinners. The study included survey data on 18,834 students (ages 12-18) from 49 schools in a Midwestern state. The authors measured five internalizing problems (anxiety, depression, self-harm, suicide ideation and suicide attempt), two externalizing problems (fighting and vandalism) and four substance use problems (frequent alcohol use, frequent binge drinking, prescription drug misuse and over-the-counter drug misuse).
Results: Nearly 19 percent of the students reported they had experienced cyberbullying during the previous 12 months. Cyberbullying was associated with all 11 of the internalizing, externalizing and substance use problems. Family dinners appeared to moderate the relationship between cyberbullying and the mental health and substance use problems. For example, with four or more family dinners per week there was about a 4-fold difference in the rates of total problems between no cyberbullying victimization and frequent victimization. When there were no dinners the difference was more than 7-fold.
Discussion: “Furthermore, based on these findings, we did not conclude that cyberbullying alone is sufficient to produce poor health outcomes nor that family dinners alone can inoculate adolescents from such exposures. Such an oversimplified interpretation of these associations disregards other exacerbating and protective factors throughout the social environment. Instead, these findings support calls for integrated approaches to protecting victims of cyberbullying that encompass individual coping skills and family and school social supports.”
The research report was published on JAMA Pediatrics (subscription required to access full article).
Photo credit: Dreamstime