One of the recurring themes of this blog is the tendency of mental health researchers and practitioners to look at a patient's symptoms without any investigation into the home environment, and decide that they, or their brains, are the entire problem.Psychological problems in kids are roughly divided into externalizing behaviors and internalizing behavior. The former is basically acting out: doing poorly in school, being hyperactive, being oppositional, getting into fights, throwing tantrums and the like. The latter refers to things like anxiety and depression. Either way, today kids who have any of these problems are in danger of being labeled with mental disorders such as ADHD, bipolar disorder, and even "oppositional defiant disorder," which I refer to as "spoiled brat disorder."These know-nothing researchers act as if living in a tense or chaotic home environment is good for children's emotional life and that they do not become distractible or agitated under these circumstances.As I have often joked, when it comes to looking at the home environment, most mental health professions will - if they say anything at all - label it as "within normal limits (WNL)." What WNL usually really means is "We never looked." If they do "look," they may ask the parents one or two questions about discipline, and take their answers at face value as valid or complete.Or if they really want to pretend they obtained have the whole picture, they can ask the child's teacher what the kid's behavior is like at school. Of course, teachers are likely to have less patience with kids who are distractible, and then have lower expectations of them. The kids will pick up on this, and the teacher's attitude causes these kids to become even more distressed, which makes the teacher have even less patience and lower expectations of them, and so on in a vicious circle. (This long-term process was described by Peter M. Senge in his amazing book, The Fifth Discipline).Researchers in psychiatry, as I described in a post about borderline personality disorder researchers, are even worse than practitioners at ruling out environmental causes as the explanation for symptomatic children. They never even read summaries of the literature produced by developmental psychologists.One developmental psychologist, E. Mark Cummings, summed up quite nicely the type of results that this literature routinely shows . He was quoted in a recent article in the Atlantic (http://www.theatlantic.com/education/archive/2016/10/the-effects-of-a-simmering-parental-grudge/503015/#article-comments) that described a recent study ("The Multiple Faces of Interparental Conflict: Implications for Cascades of Children's Insecurity and Externalizing Problems," P.T. Davies, R.F. Hentges, J.L. Coe; E.M. Cummings, Journal of Abnormal Psychology [in press]):“Children are like emotional geiger counters,” said E. Mark Cummings, a professor of psychology at the University of Notre Dame who has conducted extensive studies on the effects of marital discord on kids for more than 20 years. Children, he explained, are incredibly attuned to parents’ emotional communication with each other; they’re keenly aware that, for their parents, nonverbal expression is key to communicating feelings.For many couples, holding onto a grudge—smoldering but not letting a disagreement erupt into a fighting match—may seem like the best way to deal with a conflict. But research shows this kind of discord can significantly interfere with a child’s behavior and sense of emotional security. When exposed to prolonged unresolved conflict, kids are more likely to get into fights with their peers at school and show signs of distress, anger, and hostility. They may also have trouble sleeping at night, which can undermine their academic performance. In fact, according to various studies that measured children’s emotional responses to interparental hostility, disengagement and uncooperative discord between couples has shown to increase a child’s risk of psychological problems, including depression, anxiety, social withdrawal, and aggression."Here is the abstract of the study. Notice how the study was longitudinal - meaning it looked at parental behavior and children's reactions to it over an extended period of time - and used multiple measures and multiple observers. Researchers also actually observed the family members interacting with one another while engaged in various conflict resolution tasks. That's what a researcher has to do to in order vastly improve his or her chances to see what is really going on at home and to see what the most important causal factors are for psychological distress in young people.This multistudy article examined the relative strength of mediational pathways involving hostile, disengaged, and uncooperative forms of interparental conflict, children's emotional insecurity, and their externalizing problems across 2 longitudinal studies. Participants in Study 1 consisted of 243 preschool children (M age = 4.60 years) and their parents, whereas Study 2 consisted of 263 adolescents (M age = 12.62 years) and their parents. Both studies utilized multimethod, multi-informant assessment batteries within a longitudinal design with 3 measurement occasions. Across both studies, lagged, autoregressive tests of the mediational paths revealed that interparental hostility was a significantly stronger predictor of the prospective cascade of children's insecurity and externalizing problems than interparental disengagement and low levels of interparental cooperation. Findings further indicated that interparental disengagement was a stronger predictor of the insecurity pathway than was low interparental cooperation for the sample of adolescents in Study 2. Results are discussed in relation to how they inform and advance developmental models of family risk.