Kids talk about the 'good pill' - Ritalin - Behavior

Science News, May 27, 1989 by Bruce Bower

Kids talk about the 'good pill'

Stimulant drugs such as Ritalin can have unintended psychological side effects on hyperactive children and their families, psychiatrist Peter S. Jensen of Eisenhower Army Medical Center in Fort Gordon, Ga., reports in a new study. When medication is the only treatment offered for hyperactivity, youngsters often perceive themselves as "bad" and suffer a loss of self-esteem, he says. In these cases, parents tend to avoid dealing with family conflict and often ignore the emotions underlying a child's behavior.

Jensen and his colleagues administered depression and anxiety questionnaires to 20 children placed on stimulants by pediatricians and who met psychiatric criteria for hyperactivity. The children, average age 9-1/2 years, were also asked to draw a picture of the pill they took, a picture of themselves taking the pill and a picture of their families. The drawings were used to prompt discussions of what each child thought about the medication and its purpose.

Jensen's team also obtained interviews and questionnaire responses from both parents of each child.

Stimulant medication is seen as a "magic bullet" by most children and their parents, the study found. If a younger's behavior does not improve, parents assume the medication dose should be increased. They also found children often disavowed any responsibility for their behavior and claimed they needed a "good pill" to control themselves.

Distressing family events, such as divorce, usually preceded hyperactive behavior, Jensen says. In addition, children and parents reported considerable anxiety and depression that were not addressed openly, but which fueled youngters' hyperactive symptoms, he asserts.

Medication may help ward off obvious symptoms of hyperactivity, Jensen contends, but careful attention must be paid to the family situation (SN:6/18/88, p.399) and the meanings parents and children attach to stimulant treatment.