Biomedical subjects
B J Tonge
Publications and source records attributed to B J Tonge.
Treatment of childhood anxiety disorders using behaviour therapy and pharmacotherapy.
Although the treatment of childhood anxiety disorders can be approached from numerous theoretical perspectives, the concentration of research has been on the efficacy of behaviour therapy. Behaviour therapy procedures are briefly described and evaluated, including systematic desensitisation, flooding, modelling, reinforcement and cognitive procedures. We also review research findings on pharmacotherapy, focusing on benzodiazepine and antidepressant usage. Finally, several conclusions are drawn concerning the scientific and clinical status of these treatment approaches for childhood anxiety disorders.
Childhood obsessive-compulsive disorder.
Childhood OCD is a distressing and debilitating condition. Childhood OCD is not a simple exaggeration of the rituals and superstitions that occur over the course of normal development. More males than females are diagnosed as having OCD. Not unexpectedly, anxiety and affective disorders are often associated with childhood OCD. Compulsive personality disorder is also an associated feature for a proportion of children with OCD. Treatment usually involves individual psychotherapy and family counselling, although behavioural treatment and medication (clomipramine) have also been used by clinicians.
The impact of television on children and clinical practice.
The impact of television on children and child development and on the practice of child psychiatry is reviewed. Evidence from research is that children learn from watching television and the programs they see can change their behaviour. Programs with violent and aggressive themes tend to make children more aggressive and disobedient. Cultural sex-role and social stereotypes depicted on the television can also influence children's perceptions of society. Programs specifically designed for different age groups of children which depict pro-social behaviour are likely to lead children to become more friendly, co-operative and self-controlled. The use of television in child psychiatric clinical work supervision and research, and its potential to reduce the psychological trauma experienced by children in the legal proceedings of child abuse cases is discussed. More research is needed to determine the content and intervening variables that effect the acquisition of both positive and negative behaviour from television and enhance its promotion of mental health.
Depression in children.
Unhappiness and transient feelings of depression are common normal experiences for many children. Persistent depressive illness occurs in about 2 per cent of children and seriously affects social, educational and emotional development. Treatment usually requires family therapy and behavioural and psychotherapeutic measures. Antidepressant medication has an occasional role in cases with a biological basis.
Autism.
Autism is a range of serious biologically determined pervasive developmental disorders, which may co-exist with other problems such as mental retardation and epilepsy. The children have perceptual cognitive, communication, and social deficits, which change over time. Treatments that most facilitate improvement and social adjustment rely on behavioural, educational and cognitive approaches.
Mental health, or I'm ok and so are my parents.
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Conjoint mother-child admission in-patient management of crises in mother-infant relationships.
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Psychological and educational correlates of strabismus in school children.
The results of a study investigating the relationship of psychiatric and cognitive disorder with strabismus and its treatment in primary school aged children are reported. Results suggest that children with strabismus have a higher prevalence of psychiatric disorder, particularly an emotional disorder or psychosis. Subjects also had an increased risk of having educational problems and of exhibiting difficulties with tasks involving visual perception. Variables related to the nature and treatment of the strabismus did not appear influential in the development of the psychiatric disorder. Family disruption was significantly associated with both the presence of strabismus and emotional and behavioural problems in the children reported by parents and teachers.
'I'm upset, you're upset and so are my mum and dad'.
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Adolescence: a family affair.
In 'The Winter's Tale' Shakespeare has an old shepherd say: "I would there were no age between ten and twenty three, or that youth would sleep out the rest; for there's nothing in between but getting wenches with child, wronging the ancientry, stealing and fighting." Shakespeare highlights that the risks and crises of adolescence are development of adult sexuality; separation from parents (the 'ancientry') and development of independence; and the expression of (and coping with) aggressive feelings. I would add a fourth task: formation of an identity and development of the adult mind.