JAASEP WINTER 2008 Part 1 of 7
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Professional interest in the topic of Bipolar Disorder (BPD) has increased dramatically over the past decade (American Psychiatric Association, 2003). Once considered rare in children, BPD is becoming much more common than ever realized (Cicero, El-Mallakh, Holman, & Robertson, 2003; Wozniak, Biederman, & Kiely, 1995). With each generation a higher incidence of BPD has been reported, with the first episode earlier in the child than in the parent (Johnson & Roberts, 1995). This disorder can appear in children and adolescents, although there is some disagreement about this among professionals.
BPD typically emerges in late adolescence or early adulthood; but in some cases, it begins earlier (National Institute of Mental Health, 2001). Since no large epidemiological studies have been published regarding BPD in children younger than 9 years of age, the incidence and prevalence of this disorder during the early elementary-school years are unknown (McClure, Kubisyn, & Kaslow, 2002). However, the adult BPD literature suggests that 20-40% of adults have their onset during childhood and adolescence (Joyce, 1984; Lish, Dime-Meehan, Whybrow, Price, & Hirschfield, 1994). While there is no community data on the prevalence of childhood BPD, it may be relatively common in clinically referred children (Wozniak et al., 1995).
Abstract
Using data gathered from the “Childhood Bipolar Disorder Survey,” this study explored Pennsylvania school psychologists’ knowledge and practices when evaluating children for Bipolar Disorder (BPD). Results indicate that only a small percentage of school referrals involved children or adolescents with BPD. Participating school psychologists were moderately familiar with both the literature and psychopharmacology surrounding childhood BPD. Although doctoral-prepared school psychologists were permitted to diagnose childhood BPD more than non-doctoral practitioners, approximately half of participants trained to diagnose childhood BPD were not allowed to do so in their respective schools. Participants identified disturbed mood, depression, grandiosity, rapid cycling, and sensation seeking as the more important symptoms influencing their understanding of childhood BPD. School psychologists used clinical history, formal diagnostic criteria, collateral data, and behavioral observations as their main instruments when making a diagnosis. Educational implications and future directions for research are discussed.