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Psychological dwarfism is a growth disorder commonly observed in children aged between 2 and 15. The condition is caused by extreme emotional deficiency or stress. Observable symptoms include declined growth hormone secretion, weight that is not appropriate for the height, underdeveloped skeletal age and extremely short stature (Ablon, 1984). Psychological dwarfism is a progressive condition; thus, as long as any child is left in the stressing environment, her or his mental and linear capabilities continue to degenerate. Although the condition is rather uncommon to find among children living in society, it is exceedingly common in feral children and in children kept in confined conditions or those in an abusive household (Ablon, 1984). Psychological dwarfism can cause the body to stop growing. It is mostly considered to be an impermanent condition. Regular or normal growth will resume when the cause of stress is removed. A number of paediatric endocrinologists have tried to study the condition in depth and they have come up with three subtypes of psychological dwarfism.
The first subtype of psychological dwarfism is characterized by the fact that its phase of onset is in infancy. In this subtype, failure to thrive is present, but no bizarre behaviours are observed. Generally, patients are depressed. This subtype is characterized by normal secretion of growth hormone, but the responsiveness to the growth hormone is unknown. In this particular subtype, there is no history of parental denial or rejection. In type two of psychological dwarfism, which onset is three years old, patients do not experience thriving (Kruse, 2007). Patients also suffer from depression. Unlike in subtype one of psychological dwarfism, there is decreased secretion of the growth hormone and responsiveness to the growth hormone is minimal. A history of parental rejection at this subtype of psychological dwarfism is commonly present. In type three of psychological dwarfism, which usually occurs among infants or children aged up to fifteen years old, failure to thrive is not present and bizarre behaviours are absent. Growth hormone secretion is normal, and responsiveness to growth hormone is significant. In this subtype, there is no histor of family or parental rejection (Ablon, 1984).
The Biology of Psychological Dwarfism
One of the underlying commonality in children having this condition is the extremely low levels of growth hormone secretion. Secretion of growth hormone is usually performed by the pituitary gland, and it is controlled by the hypothalamus (Scott, 1988). It involves a hormone that stimulates growth, known as Growth hormone, and a hormone that inhibits release of growth hormone, known as growth inhibiting hormone. Children with psychogenic dwarfism commonly experience a problem with the hypothalamus. The issue concerns the fact that there is too little growth hormone releasing hormone or that there is too much growth hormone inhibiting hormone. At times, these two conditions may be experienced. In addition to this, the hypothalamus may be acting differently in these kids by either being too unresponsive to growth hormone releasing hormone or being too sensitive to growth hormone inhibiting hormone (Scott, 1988).
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The reason as to why stress is the chief cause of psychological dwarfism is the fact that hypothalamus becomes hyper activated; this, in turn, activates the pituitary gland and releases adrenocorticotrophic into the blood system. In response to this, the adrenal glands prepare the body for a flight or fight response (Adelson, 2005). The immune, digestive and reproductive systems are shut down so as not to expend unneeded energy. Stress will lead to shortening of cognition and enhance sensory sensitivity. Stress also leads to an increased cardiovascular activities and heart rate. All these are attempts by the body to mobilize energy for immediate use.
These effects are extremely detrimental to the health of the child, especially if they happen over a long period of time or often. This will lead to tiredness as the body is not storing energy for later usage. As a result, neurons die due to hormones that increase cognition. In addition to insufficient growth hormones, growth system is shut down leading to the condition (Adelson, 2005).
An environment of extreme or constant stress causes psychological dwarfism. Stress releases hormones like norepinephrinne and epinephrine. This promotes fight or flight response. The body diverts resources away from other bodily functions like digestion (Stabler, 1986). This leads to children suffering from psychological dwarfism to suffer from gastrointestinal problems. The result is that the body is not in a position to assimilate or reap the benefits of nutrients consumed.
Mortality and Morbidity
Mortality or morbidity rates arising from psychological dwarfism are unknown. However, severity of the condition relates to the enduring nature of the deficiency, time of diagnosis, consequent placement into nurturing surroundings and, finally, the long-term monitoring care while living in a safe and nurturing environment (Stabler, 1986).
Sex and Race
According to most literature and studies on psychological dwarfism, there is an increased occurrence of the condition among males. All races are affected by child neglect or stress. Therefore, chances of a child suffering from the condition are relatively equal among all races.
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Primary solving of inpatient assessment of children with psychological dwarfism is providing an emergently wanted safe atmosphere. A controlled surveillance period at times is necessary to make a diagnosis (Cauldwell, 2005). This will also permit the consultants to take a comprehensive history of the child and environment in which the child lives. Pediatric endocrinologists may perform testing necessitating scrutiny and frequent blood work. Preliminary outpatient assessment can be achieved only if the child affected by the condition is removed from previous unfavourable environment. Growth hormones therapies can also be applied to promote growth (Cauldwell, 2005).
Psychological dwarfism cannot be described as a permanent condition as it can be alleviated by ensuring the child is removed from his or her current environment. There is also a potent necessity of inquiry and it is vital that all healthcare personnel become conscious of this challenging disorder (Kruse, 2007).
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