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Comment by droithomme | Hacker News Reader

Diagnosing a child as a psychopath is pretty questionable. In addition, diagnoses of psychopathy in adults is difficult and expert psychiatrists have admitted even they are fooled.

I was not surprised then when the article admitted that the parents diagnosed the disorder themselves, and then shopped around for therapists until they found one in another state willing to agree with their diagnosis. I bet it made them feel good when they finally found a doctor willing to support their amateur diagnostic efforts.

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To be fair, this is often not a tractable situation for parents. The child behaves in a manner that the parents don't know how to address (which doesn't surprise me with the kind of materials available out there). Most parents can't deal with a kid that expresses violent intent toward other kids, regardless of what's the accurate diagnosis in that situation. Various attempts to address the situation didn't work. What then?

I was reading the other day about a situation that was far simpler. The child just screamed constantly nonstop for a year and neither a therapist nor a pediatrician was able to provide anything useful.

When the system doesn't work, people are going to take matters in their own hands, however problematic that may be. This is not a bad thing.

I think the article could have been clearer but it sounds like they described the recommended treatments in the previous paragraphs. None of them worked and the child did not "outgrow" her condition as predicted by everyone that they saw. Considering they have seven other children that are not particularly troublesome, the most common diagnosis that it was the parenting to blame might drive the most reasonable parent to seek other options, especially after the horror movie-esque “I want to kill all of you.” and "Four months later, Samantha tried to strangle her baby brother, who was just two months old." Someone might consider it reasonable for the safety of the other children to give up at that point but they continued to seek treatment options.

There's another factor at play in Samantha's case - she was adopted. The article mentions that no evidence of abuse was ever uncovered by previous parents (both biological and foster), but who knows?

You're right, they did adopt a half sister who may have not shared any family home with Samantha at all or was cohabiting a home, could have used some more info on that.

This NYT article from 2012 addresses this point: "Can You Call a 9-Year-Old a Psychopath?", http://www.nytimes.com/2012/05/13/magazine/can-you-call-a-9-...

The article's answer is basically yes, but it is not easy. Yes, many of the typical criteria used to diagnose psychopathy are normal traits in children at certain ages. But one of the counterpoints is that what are the chances that people suddenly become psychopaths in adulthood? It's likely they exhibit some diagnosable traits in childhood.

> “What fits with the behaviors I’m seeing?” Eventually she found one condition that did seem to fit—but it was a diagnosis that all the mental-health professionals had dismissed, because it’s considered both rare and untreatable.

They dismissed it because it's rare and untreatable, not because it didn't fit the symptoms.

> I bet it made them feel good when they finally found a doctor willing to support their amateur diagnostic efforts.

I doubt I'll see a more ironic statement this week. Congrats.

Funny. I can't believe it feels "good" for any parent to conclude that their child has an incurable predilection for callousness and violence that could lead to a life in and out of jail.

Maybe you have some problems with empathy yourself, if your understanding of feelings is that faulty?

Think of it as if you were raising a zombie, all deep in the uncanny valley. This is how some people feel when facing a psychopath.

They don't quite act within human parameters.

To overcome this you have to be quite callous yourself. It is a reaction and emotion.

Exactly. Psychology is not totally exact... think of the false positive rate (it's going to be big!) and the toll a false positive would take on a child's life. Think of a mentally ill parent doing exactly what you say. That is terrifying to me.

Imagine the toll on a parent if the child remains undiagnosed and untreated. Imagine constantly viewing yourself as a failure for 18+ years because you are unable to control your child's behavior - as they go from hurting pets for fun to hurting siblings and school peers...

Not to mention the toll on their victims.

>Imagine constantly viewing yourself as a failure for 18+ years because you are unable to control your child's behavior

I understand this sentiment, but looking at it from another angle, this sentiment suggests control/blame issues on the part of the parent. Which itself can be classified as a "mental illness".

This highlights how often the macro social environment is ignored in the production of mental issues, and how the blunt of the blame is placed on the individual.

I'm not sure I understand what you're trying to say... that if a parent tends to blame issues with their children on themselves, that parent has a mental illness? I don't think you understand a parent's position in society. It may not be a beneficial reaction, but it's presently a fairly normal one.

Indeed it is "normal" in the sense that it is common, but allow me to elaborate.

>>Imagine constantly viewing yourself as a failure for 18+ years because you are unable to control your child's behavior

This sentiment implies the impossible and horrid belief that a parent has and should exercise absolute control over their child's mind.

Incessantly blaming yourself for 18+ years for something you were never in control of in the first place is self-destructive and masochistic. Furthermore having such an attitude is toxic to those around you, like that of a infectious disease, and would only serve to reinforce the mental issues of the child.

All children have empathy problems. It's a capacity you develop as you get older (some kids develop it faster or slower). If you diagnose your child with that kind of mental illness in the early stages of development you are completely insane and probably need to have your custody taken away.

It definitely can't be left to the parents, but of course a determined parent is going to shop around for a diagnosis, and of course some people are really hungry for a diagnosis. On the other hand it can be tragic when parents deny a problem and prevent their kid from getting treatment.

It sucks that so many parents let their own wishes interfere with their kids' medical needs, from inventing food allergies to denying mental illness. Some people just looooove a diagnosis (for themselves or their kid) because they love using it to give a certain context to their lives, and some people will live in denial for years because they don't trust doctors or fear stigma.

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