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 CRG Newsletter: Girls' and Women's 
Behavioral Health Issues
Spring 2017,Volume 7 (1)
In This Issue
Looking Back...
Stress in Girls and Women
Screen Time
Self-Esteem and Academics
Dyslexia in Girls
Females with ADHD
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The world celebrated the International Day of Women on March 8th.  In a similar spirit, this issue salutes girls and women by addressing some of the most common behavioral health issues that can uniquely affect females.  Behavioral healthcare professionals continue to devote much-needed attention to best practices in diagnosing and treating 50.8% of the U.S. population.  Historically, researchers have often focused on boys and men in developing what we know about ADHD, personality disorders, and other mental health issues.  Pioneers such as Dr. Patricia Quinn and Dr. Kathleen Nadeau and Dr. Marsha Linehan have devoted their careers to educating us about gender-based differences in such disorders.  This leads to more effective referrals, more accurate diagnoses, and more timely treatment for females who may not present with the same profile of symptoms better understood in males.
 
This Spring Issue begins with an important update from one of our own female pioneers, Dr. Julie Steck , who co-founded CRG in 1993.  After a vibrant career helping countless children, adults, families, and school systems and with years of selfless service in professional organizations and mentoring roles, Dr. Steck has announced plans to begin a transition-to-retirement period.  Read more about Dr. Steck's plans as she looks back while also planning the next exciting chapter(s) in her life.
 
The rest of this issue is filled with five timely and well-researched articles by some of our most prolific female providers.   First, Dr. Steck presents an overview of stress in girls and women.  This brief data based article provides striking statistics for our consideration.  Megan Skelding , CRG's Psychiatric Mental Health Nurse Practitioner, then explores the impact of ramped-up social media use and screen time on teenage girls' health and well being.  Dr. Sarah Norris , psychologist, provides Part 1 of a fascinating, two-part discussion of the decline in girls' academic success and self-efficacy in middle school.  This article explores the trend's causes; stay tuned for a future article about solutions.  Next, Dr. Steck interviews CRG psychologist, Dr. Janel Burchfield , about dyslexia in girls.  Dyslexia is a common form of learning disability and is seen in smart girls (and boys and adults) who struggle to read, write, and/or do math.  Dr. Steck rounds out this issue with a final piece that explores stress and anxiety in females with ADHD, a condition that remains under-diagnosed and under-treated. 
 
We hope you will enjoy these articles and encounter success with your bracket choices during March Madness!
 
CRG Newsletter Editor

Looking Back and Moving Forward...

In August 1974, I began my career working with children as a Teacher of the Deaf.  Moving forward, I never paused in taking the next step - pursuing a master's degree in school psychology, working at the Indiana School for the Deaf and moving to California to work at the California School for the Deaf.  In 1980 I returned to Indiana to pursue a doctoral degree in School Psychology, had the opportunity to do an internship and work at Riley Hospital Child Development Center, and then moved to private practice.  Along the way, I married and had three children.  I gained a daughter-in-law and have embraced two grandchildren.
Julie Steck
Julie T. Steck, Ph.D., HSPP

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Female Response to Stress
The Winter 2015 edition of the CRG newsletter focused on women's mental health.  This issue is meant to continue the dialogue on that issue, focusing on how females respond to stress and the impact on individual and family functioning when females are experiencing difficult times and situations.  While both males and females experience stress and mental health conditions, the presentation and prevalence of conditions is very different.  Consider these statistics from the American Psychiatric Association ( www.apa.org), the National Institute of Mental Health ( http://www.nimh.nih.gov/health/topics/women-and-mental-health/index.shtml), the National Institute of Health ( www.nih.gov) and the National Center for Post-Traumatic Stress Disorder ( www.ptsd.va.gov):


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Screen Time and Teenage Girls:  
Questions, Concerns, and Suggestions
Note:  David Parker interviewed CRG's psychiatric mental health nurse practitioner, Megan Skelding, about a growing trend she sees in her practice.
 
DP:  What led to your interest in this topic?
 
MS:  In this day and age, technology cannot be escaped. As a medical provider, I frequently encounter teens who have difficulty turning off social media whether it is in my office, at school, or home. In turn, this can and does create conflict amongst them and their parents.  In fact, one-third of parents and teenagers say they argue daily about screen time ( PBS Newshour ).  Not surprisingly, 92% of teenagers report going online daily, including 24% who report being online "constantly" with the accessibility and convenience of digital media (Lenhart, 2015).  

Megan Skelding, APRN, PMHNP

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Middle School Girls:  
Self-Esteem and Academic Issues
For girls, puberty and the transition from elementary to middle school often occur at the same time. A drop in self-esteem and declining academic achievement often accompany this important life stage.  Girls are changing schools and shuffling peer groups while their bodies are undergoing a remarkable transformation (Lerner, 2007).  Due to the number of changes in their lives and physical appearance, adolescent girls often feel a great deal of stress and their motivation to succeed in school suffers.   Research (2006) by Catherine Steiner-Adair, Ed.D., director of the Eating Disorders Education and Prevention at McClean Hospital, finds that girls' self-confidence declines as they move from childhood into adolescence.  Achievement motivation suffers as greater emphasis is placed on the way they look.   

Sarah J. Norris, Ph.D., HSPP

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Specific Learning Disorders in Reading 
(Dyslexia) and Girls:
An Interview with

Specific Learning Disorders (SLD) with impairment in reading and/or writing (also known as dyslexia) is one of the most common neurodevelopmental disorders included in the American Psychiatric Association's  Diagnostic and Statistical Manual - 5th Edition (2013).  The prevalence rate ranges from 15% to 20% and SLD's are found in all races and cultures.  Dyslexia, as well as the other neurodevelopmental disorders, is a spectrum disorder.  This means that the condition causes varying degrees of impairment from mild to severe.  The International Dyslexia Association

defines dyslexia as:

 

Janel Burchfield, Psy.D., HSPP

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Stress, Anxiety and More in
Females with ADHD
ADHD is a neurodevelopmental disorder with onset during childhood that often persists into adulthood. In the most recent
National Survey of Children's Health  (Visser et al., 2014), it was reported that 11% of U.S. children and adolescents ages 4 to 17 have been diagnosed with ADHD in their lifetime.  Of those who had ever been diagnosed with ADHD, 8.8% were reported to currently have symptoms of ADHD.  When examining those currently diagnosed with ADHD, 12.1% of males met criteria for ADHD and 5.5% of females met criteria for ADHD.   This reflects that males are twice as likely to be diagnosed with ADHD.  These findings are consistent with previous research (Froehlich et al., 2007).  In that study, the prevalence of ADHD in children in the U.S. ages 8 to 15 was found to be 8.7%.  The incidence of ADHD in males was found to be 11.8% and in females it was 5.4%.  Thus, it appears that males are at least twice as likely to be diagnosed with ADHD as opposed to females.  And females often go undiagnosed. 


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