George W. Bush - The Complete Psychiatric Workup

[leveymg]

It started with FAS (Fetal Alcohol Syndrome). George W. Bush showed mild symptoms as a child that were diagnosed later in life as ADD (Attention Deficit Disorder), Conduct Disorder (CD), and Narcissistic Personality Disorder (NPD).

www.fetalalcohol.com/what-is-fase.htm
What is Fetal Alcohol Syndrome/Fetal Alcohol Effects?
How FAS/FAE occurs | Behavioural/Learning Difficulties | Statistics | History | Links
Fetal alcohol syndrome (FAS) is a birth defect syndrome caused by the mother's intake of alcohol during pregnancy. The spectrum of alcohol-related diagnoses includes Fetal Alcohol Syndrome (FAS), Fetal Alcohol Effects (FAE), PFAS (Partial Fetal Alcohol Syndrome), ARND (Alcohol Related Neurodevelopmental Disorder) or ARBD (Alcohol Related Birth Defects). All of these birth defects are entirely preventable and can happen to anyone, regardless of age, race or socioeconomic status.

In order to receive a diagnosis of FAS from a physician, three criteria must be present:

1) Characteristic facial features include - a flattened midface, thin upper lip, indistinct/absent philtrum and short eye slits







1) Growth retardation - lower birth weight, disproportional weight not due to nutrition, height and/or weight below the 5th percentile.

2) Central Nervous System neurodevelopmental abnormalities such as - impaired fine motor skills, learning disabilities, behaviour disorders or a mental handicap (the latter of which is found in approximately 50% of those with FAS)

In order to receive a diagnosis of PFAS, only two of the three above criteria must be present and must include some facial features and brain differences. To receive a diagnosis of ARND, only one of the above three criteria must be present and must be a brain difference. These fetal alcohol effects are often thought to be less damaging than the "full-blown" syndrome, however, they are often more debilitating to the person's quality of life.


Fetal Alcohol Syndrome/Fetal Alcohol Effects are PERMANENT and cannot be outgrown.

SNIP


FAS/FAE children have learning disabilities, which can include difficulties in:
· learning language and language use, especially receptive language
· generalizing information
· mastering new or recently learned skills
· memory (ie. remembering something from a year ago but not from yesterday)
· predicting outcomes or cause and effect
· distinguishing fact from fantasy
· distinguishing friends from strangers (ie. may think someone they met five minutes ago is a friend)
· lack of learning from experience because they do not understand cause and effect, behaviour and experience


FAS/FAE adults continue to have the same learning difficulties they had as youth, and also often have difficulty with:
· the legal and court system, due to lack of understanding of cause and effect
· controlling alcohol consumption
· maintaining custody of their children
· mental health issues



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How FAS/FAE occurs:
Alcohol's effects are more harmful to a fetus than those of all other drugs, including cocaine. When a woman drinks alcohol, it reaches the placenta in a few moments and passes through the growing fetus. The mother's body can break down one drink in approximately three hours, but alcohol stays in the fetus for much longer.

One drink = ½ ounce of absolute alcohol, which is contained
in one 12 oz. beer, one 4 oz. glass of wine, or one mixed drink as
poured in a bar. Most people drink at home where alcohol is not measured, so "1 drink" may actually be 2 drinks or more.

Alcohol is a teratogenic drug, which means it can cause birth defects when taken after conception. Different types of drinking affect the fetus in different ways. Binge drinking (consuming a large amount of alcohol in a short period of time) is more harmful than drinking the same amount over the course of a week because the mother's blood alcohol content is much higher. The mother's health, amount of alcohol consumed, time during the pregnancy during which the alcohol was consumed, and her metabolism all affect the fetus in various ways. In addition, the regions of the developing brain and body that are affected by alcohol vary, depending on when the alcohol was taken into the mother's system. Women who drink during pregnancy may give birth to a child with FAS/FAE, and may also have problems with their pregnancy, such as a miscarriage, a stillborn or premature baby.

Drinking during breastfeeding is also harmful for the baby.


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Behavioural/Learning Difficulties:
Children with FAS usually reach their intellectual peak around Grade 4 and begin to notice the differences between themselves and peers.

Teenagers with FAS often have low self-esteem because of the learning and social differences between themselves and their peers. They may do unsafe things in order to be accepted, such as take a dangerous dare or engage in sexual activity to get love and attention. They have a very poor understanding of consequences and may feel depressed or even suicidal.

Adults with FAS are at high risk for mental health problems. They are often socially isolated, have difficulty with interpersonal relationships and may have difficulty functioning in many environments. Adults with FAS have spotty memories and often have difficulty distinguishing fact from fantasy. They need supported housing and employment programs because independent living is rarely an option.



This disability is PERMANENT -
people with FAS/FAE do not 'get better.'

Other Disorders Commonly Diagnosed with FAS:
People with FAS/E often have dual diagnoses or co-morbidity, but they are not necessary for an FAS/E diagnosis.

Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD)
ADHD is different with FAS/E- while it looks like an attention deficit or distractibility, in actuality it is a deficit in information encoding and perception.

Conduct Disorder
Depression
Obsessive Compulsive Disorder (OCD)
Oppositional Defiant Disorder (ODD)
Attachment Disorder

Oppositional Defiant Disorder (ODD)
What is it?
ODD is a psychiatric disorder that is characterized by two different sets of problems. These are aggressiveness and a tendency to purposefully bother and irritate others. It is often the reason that people seek treatment. When ODD is present with ADHD, depression, tourette's, anxiety disorders, or other neuropsychiatric disorders, it makes life with that child far more difficult. For Example, ADHD plus ODD is much worse than ADHD alone, often enough to make people seek treatment. The criteria for ODD are:

A pattern of negativistic, hostile, and defiant behavior lasting at least six months during which four or more of the following are present:
1. Often loses temper
2. often argues with adults
3. often actively defies or refuses to comply with adults' requests or rules
4. often deliberately annoys people
5. often blames others for his or her mistakes or misbehavior
6. is often touchy or easily annoyed by others
7. is often angry and resentful
8. is often spiteful and vindictive
The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.


Conduct disorder
In some ways, conduct disorder is just a worse version of ODD. However recent research suggests that there are some differences. Children with ODD seem to have worse social skills than those with CD. Children with ODD seem to do better in school. (1). Conduct disorder is the most serious childhood psychiatric disorder. Approximately 6-10% of boys and 2-9% of girls have this disorder.

Here is the Definition.

A. A repetitive and persistent pattern of behavior in which the basic rights of others or major society rules are violated. At least three of the following criteria must be present in the last 12 months, and at least one criterion must have been present in the last 6 months.
Aggression to people and animals
often bullies, threatens, or intimidates others

often initiates physical fights

has used a weapon that can cause serious physical harm to others (a bat, brick, broken bottle, knife, gun)

physically cruel to animals

physically cruel to people

has stolen while confronting a victim ( mugging, purse snatching, extortion, armed robbery)

Destruction of property
has deliberately engaged in fire setting with the intention of causing serious damage

has deliberately destroyed other's property other than by fire setting

Deceitfulness or theft
has broken into someone else's house, building or car

often lies to obtain goods or favors or to avoid work

has stolen items of nontrivial value without confronting a victim (shoplifting, forgery)

Serious violations of rules
often stays out at night despite parental prohibitions, beginning before 13 years of age

has run away from home overnight at least twice without returning home for a lengthy period

often skips school before age 13






B. The above problem causes significant impairment in social , academic, and occupational functioning.
So how are ODD and CD related?
Currently, the research shows that in many respects, CD is a more severe form of ODD. Severe ODD can lead to CD. Milder ODD usually does not. The common thread that separates CD and ODD is safety. If a child has CD there are safety concerns. Sometimes it is the personal safety of others in the school, family, or community. Sometimes it is the safety of the possessions of other people in the school, family or community. Often the safety of the child with CD is a great concern. Children with ODD are an annoyance, but not especially dangerous. If you have a child with CD disorder in your home, most likely you do not feel entirely safe. Or, you do not feel that your things are entirely safe. It is the hardest pediatric neuropsychiatric disorder to live with as a sibling, parent, or foster parent. Nothing else even comes close. It is worse than any medical disorder in pediatrics. Some parents have told me that at times it is worse than having your child die.

Conduct Disorder and comorbidity
It has been common in the past for people to think that conduct disorder is just the beginning of being a criminal. Up until the last few years, children with conduct disorder were often "written off". It is now clear that this is true only with a minority of cases. It is very easy to focus on the management of the CD child and forget to check the child out for other neuropsychiatric disorders. A careful examination of children with CD almost always reveals other neuropsychiatric disorders. Some of the most exciting developments in this area of medicine involve understanding these phenomena. It is called comorbidty, that is the tendency for disorders to occur together.

It is very common to see children with CD plus another one or two neuropsychiatric diagnoses. By far the most common combination is CD plus ADHD. Between 30-50% of children with CD will also have ADHD (1). Another common combination is CD plus depression or anxiety. One quarter to one half of children with CD have either an anxiety disorder or depression (3). CD disorder plus substance abuse is also very common.

Narcissistic Personality Disorder (NPD)

(definition from from Diagnostic and Statistical Manual of Mental Disorders, 4th edition, 1994, commonly referred to as DSM-IV, of the American Psychiatric Association.)

Narcissistic Personality Disorder (NPD) is a pattern of self-centered or egotistical behavior that shows up in thinking and behavior in a lot of different situations and activities. People with NPD won't (or can't) change their behavior even when it causes problems at work or when other people complain about the way they act, or when their behavior causes a lot of emotional distress to others (or themselves? none of my narcissists ever admit to being distressed by their own behavior -- they always blame other people for any problems). This pattern of self-centered or egotistical behavior is not caused by current drug or alcohol use, head injury, acute psychotic episodes, or any other illness, but has been going on steadily at least since adolescence or early adulthood.



A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy. The disorder begins by early adulthood and is indicated by at least five of the following:

1. An exaggerated sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements). The simplest everyday way that narcissists show their exaggerated sense of self-importance is by talking about family, work, life in general as if there is nobody else in the picture. Whatever they may be doing, in their own view, they are the star, and they give the impression that they are bearing heroic responsibility for their family or department or company, that they have to take care of everything because their spouses or co-workers are undependable, uncooperative, or otherwise unfit. They ignore or denigrate the abilities and contributions of others and complain that they receive no help at all.

[Metta]

1. An impressive piece of work. Well thought out and supported.

Very nice, indeed. I tip my hat to you. Have a donut. :donut: :donut: :)

[yurbud]

2. you got my hope up with the "running away from home." when Bush elected a friend said...

Bush's presidency will end the way most college students end their studies, they just start forgetting to show up.

[leveymg]

3. I doubt he graduates.

[tnlefty]

4. I'm so glad that my OBs were very strict about NO drinking

during pregnancy - not even an occasional glass of wine with dinner. My pregnancies were difficult enough and looking back I know that I didn't need even the slightest complicating factor that I could control.

Great post!

[spacelady]

5. Nice work, now send to major media.

I swear if the evidence hit them over the head, they would shout "Sir! May I have another? & they would roll over AGAIN!

[yurbud]

6. they would probably do a report on why the rest of us don't have normal pointy ears and a gargoyle

nose like Bush.

"Why are so many Americans odd looking compared to savior Darth Bush?"

[rman]

7. Interesting, but lets not forget

that W is not the one running the show.