Biomedical subjects
Publications and source records attributed to D K Shrier.
Records were reviewed for 358 children and adolescents treated on 410 visits to a psychiatric emergency room in Newark. The study supports the need for more specialized emergency psychiatric services. Guidelines for the allocation of resources for children need to be developed.
Sexual harassment and sexual discrimination continue to be pervasive problems for women in business, academia, and medicine, with widespread and often serious health, emotional, and economic consequences. It is important that health care providers become aware of the common physical and emotional symptoms associated with these victimization experiences and serve as supportive and informed resources to their patients.
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Most information pertaining to male child sexual abuse victims is derived from cases presenting to the criminal-justice system, the mental-health system, hospital emergency rooms, and retrospective studies of college populations, all of which may be biased samples. This paper reports a six-year experience in an adolescent medicine clinic in which all medical interviews of adolescent males included questions about sexual molestation. Forty adolescent males reported sexual victimization during their preadolescent years. This study group of 40 was compared with a randomly selected age-matched group whose responses were negative to the same questions. None of the study group had previously been identified by medical or legal systems as having been molested. Twenty-five percent of the victimized males reported sexual dysfunction compared to 5% of the nonvictimized males, and 60% stated that the sexual abuse had a significant impact on their lives. Consequently, we conclude that questions about sexual molestation should be included as part of routine histories in adolescent clinics.
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Explore the source record for details and available documents.
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This overview of death and dying focuses on the dying child and surviving family members. Children's concepts of death at different developmental stages are reviewed. These range from an inability to distinguish death from other forms of separation prior to age 3, through partial concepts of death until, by age 10 to 15 years, children are able to conceptualize death as universal, inevitable and final. The importance of adults assisting in the child's growing comprehension of death is stressed. The stages of grief and mourning, as outlined by Kubler-Ross, are reviewed from the perspective of the child and family: denial, anger, bargaining, depression and acceptance. Recognition is given to the variations in coping styles among different family members. The special circumstances related to the death of an infant and the impact of the death of a child on the surviving siblings are discussed. Specific helpful interventions to assist families in coping with mourning are described. The death of a child remains one of the most painful and difficult events for a family and its physician to accept.
The authors developed reliable clinical rating scales to compare 35 children with school phobia and their families with a matched sample of children with other neuroses and their families. Twice as many school phobic children as children with other neuroses showed excessive separation anxiety, dependency, and depression. Although a mutually hostile-dependent interaction was found in most of the families of children with school phobia, the development of school phobia appeared to be dependent on defects in character development in the children as well. The authors discuss the etiological significance of the almost universal parental pathology and family malfunction for both groups of children.
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The goals, format, curriculum, and faculty of a first-year medical school elective focusing on balancing commitments to a medical career and family are described in order to encourage replication at other institutions. While the course is offered to both men and women, the issues discussed have particular relevance to women physicians, the majority of whom continue to carry the major responsibilities for family and household in addition to their medical careers. Topics include: the rewards of being a parent, parent-child attachment, the dual-career family at different developmental stages, physicians' life-styles, family planning, child care and training options, specialty choice and practice alternatives. The eight sessions are presented through a combination of seminar, videotapes, readings, and interviews of physicians, their spouses and children.