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Biomedical subjects

C R Pfeffer

Publications and source records attributed to C R Pfeffer.

At least 73 records · Page 4Linked to original sources
PubMed1984

Modalities of treatment for suicidal children: an overview of the literature on current practice.

Childhood suicidal behavior is a complex symptom that requires a carefully planned treatment program that includes multiple modalities of care. These modalities combine individual, family, environmental, and psychopharmacological interventions. The therapist's personal conscious and unconscious characteristics may have a great influence on treatment outcome. A supportive patient-therapist relationship is one of the most important elements in diminishing the child's suicidal proclivities. Treatment requires a long-term approach that constantly reassesses potential for serious suicidal risk. Psychiatric hospitalization may be required to protect the child from self-inflicted harm and to allow evaluation and appropriate intervention. Psychotherapy used in conjunction with medication, when indicated, may permit the best therapeutic outcome. Finally, planning systematic studies of psychiatric treatment efficacy for suicidal children remains one of the most challenging aspects of improving prevention measures against suicidal tendencies in youngsters.

Adolescent↗
PubMed1983

Predictors of assaultiveness in latency age children.

The authors evaluated the presence of assaultive behavior in 103 children, aged 6-12 years, seen in the psychiatric inpatient and outpatient services of a municipal hospital. No racial or ethnic differences were found. Boys were significantly more assaultive than girls and used fire setting and hitting with objects more often. Inpatients were significantly more assaultive than outpatients. Children with conduct disorders, specific developmental disorders, and mental retardation were more assaultive than those with neurotic disorders. Multiple regression analysis showed that the child's past aggressive behavior, absence of anxiety and depression, and parental assaultive behavior were the best predictors of assaultive behavior.

Ambulatory Care↗
PubMed1983

Suicidal and assaultive behavior in children: classification, measurement, and interrelations.

In 102 children aged 6 to 12 years who were in a municipal psychiatric inpatient or outpatient clinic, the authors identified four groups of suicidal and/or assaultive behaviors. Logistic regression analyses showed that neurosis, intellectualization, and low levels of aggression predicted membership in the nonassaultive-nonsuicidal group; intense aggression, parental suicidal behavior, parental assaultive behavior, and compensation predicted it in the assaultive-suicidal group; depression, a minimum of aggression, and adjustment disorder predicted it in the suicidal-only group; and intense aggression and absence of depression predicted it in the assaultive-only group. Two clearly distinct types of suicidal children were delineated.

Acting Out↗
PubMed1982

Psychopathology of latency age children. Relation to treatment planning.

One hundred three children, ages 6 to 12 years, who were evaluated in a psychiatric outpatient clinic and an inpatient unit of a large municipal hospital, were compared with regard to suicidal and assaultive behaviors, recent and chronic affects and behaviors, recent environmental stresses, family background, and ego functioning. The hospitalized children showed multiple deficits in ego functioning, more dangerous acting out behaviors, disabilities in regulation of affect states, and more severe psychopathology of the parents, primarily the mother. Multiple regression analyses showed that the child's assaultive behavior, suicidal behavior, antisocial behavior, reality testing, parental separation, and parental pregnancy complications accounted for 51.2 per cent of the variance in the prediction of psychiatric hospitalization. Recommendations are made concerning indications for psychiatric hospitalization.

Aggression↗
PubMed1982

Interventions for suicidal children and their parents.

Five features of the family organization of suicidal children include family inhibition of change, lack of defined generational boundaries, severity of spouse conflict, projection of inappropriate parental feelings onto the child, and a symbiotic parent-child interaction. The treatment of suicidal children must encompass a holistic family technique. The acute phases of treatment include protecting the child from harm, promoting family recognition of the seriousness of the child's suicidal behavior, promoting appropriate parental role responsibilities, and effecting an immediate significant family change. During the long-term process of treatment, attention must be focused on the child's unique psychopathology, the conflicts that preclude appropriate parental response to the child's needs, and the characterological difficulties of each parent.

Child↗
PubMed1981

Parental suicide: an organizing event in the development of latency age children.

This paper proposes that children who are especially vulnerable to parental suicide have not resolved earlier developmental issues of separation-individuation. Five children, ages 6 to 12, were studied intensively. Parental suicide during the child's latency age period has profound influences on children's ego development and character formation because during this time childhood ego functioning is rapidly maturing and superego functions are developing. The trauma of parental suicide is heightened when difficulties for the surviving parent in mourning interfere with open discussion between the parent and child about the death. Parental suicide may stimulate childhood suicidal impulses if the child identifies with and idealizes the dead parent and has wishes of reuniting with the deceased.

Child↗
PubMed1981

Suicidal behavior of children: a review with implications for research and practice.

The author reviews the environmental and psychological factors associated with suicidal behavior of children aged 6-12 years; the incidence of such behavior seems to be increasing. Assessment of a child's suicide potential should focus on such issues as depression, family communication patterns, the child's concepts about death, and the state of ego functioning. The author emphasizes the need for more systematic investigations of suicidal behavior among children, more precise methods of interviewing and recognizing potentially suicidal children, and widespread education of the public about this life threatening

Attitude to Death↗
PubMed1981

The family system of suicidal children.

The organizational characteristics of the family system of psychiatrically hospitalized suicidal latency-age children include lack of generational boundaries, severely conflicted spouse relationships, parental feelings projected into the child, symbiotic parent-child relations, and an inflexible family system. Five cases illustrate a spectrum of family psychopathology and resultant childhood suicidal tendencies.

Adolescent↗
PubMed1980

Psychiatric hospital treatment of assaultive homicidal children.

This article defines a spectrum of homicidal behavior of children, specifies conflicts of assaultive children, and describes the hospital treatment of such children. Hospitalization is often the best first phase of treatment with goals of redirecting homicidal impulses, strengthening ego functioning, and reducing conflicts for the child and parents.

Aggression↗
PubMed1980

Unanswered questions about childhood suicidal behavior: perspectives for the practicing physician.

This paper presents a review of the current literature and the author's personal experience with suicidal children ages 6 to 12 years. Although completed suicide among children is rare, suicidal threats and attempts are common. Factors contributing to suicidal risk include environmental stress within the family and such intrapsychic factors as depression, hopelessness, worthlessness, and preoccupation with death. Depression and suicidal behavior of parents is a specific factor correlating with high risk for childhood suicidal behavior. Interviewing techniques, assessment and early recognition of high-risk children, efficacy of treatment modalities, methods of educating the community and improving statistical data collection are suggested as a focus for study of the suicidal child. Systematic and sophisticated investigations are needed to improve knowledge, preventive techniques, and intervention methods of childhood suicidal behavior.

Child↗
PubMed1979

Clinical observations of play of hospitalized suicidal children.

This paper emphasizes the usefulness of play observation for diagnosis, treatment, and understanding suicidal behavior of children. Predictive indicators of play for potential suicidal behavior are themes of separation and loss, repetition of dangerous and reckless behavior, misuse and destruction of toys, and repetitive acting out of omnipotent fantasies. The selection of a suicidal method is partly derived from unconscious motivations that are illustrated in play themes. This study revealed a characteristic suicidal technique of latency age children seems to be jumping from heights.

Acting Out↗
PubMed1979

A model for acute psychiatric inpatient treatment of latency-age children.

Beginning with the premise that acute inpatient treatment of severely disturbed latency-age children offers enormous advantages over other types of interventions, the author describes a model for such treatment. The model consists of three phases: initial, working-through, and termination. It has a psychoanalytic basis and takes into account changing factors, such as the child's symptoms and the attitudes of both the child and his parents throughout different stages of the hospitalization. A case history illustrates the various phases and the treatment interventions used.

Acute Disease↗