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Biomedical subjects

N Van Broeck

Publications and source records attributed to N Van Broeck.

3 recordsLinked to original sources

Long-term psychosocial adjustment following pediatric liver transplantation.

This study assessed long-term psychosocial adjustment to pediatric liver transplantation in 146 patients aged 4-25 yr, who had received a transplant 2-12 yr previously. Evaluations of psychosocial adjustment and related variables were based on the Harter Self-Perception Profiles for children, Child Behavior Checklist (CBCL), and children's academic level. Up to the age of 8 yr, transplant children as a group did not perceive themselves as less competent than healthy peers. Gender effects were characterized by older girls perceiving significantly less scholastic cognitive competence than their healthy peers. Adolescent and young adult boys had significantly lower global self-worth and lower perceived athletic competence than their healthy peers. In comparison to normative data of healthy children, CBCL parent-reported scores revealed significant deficits in competences for all age groups. Only for the older boys, however, did these deficits reported by the parents reach a pathological level. The majority of transplant children also had significantly higher problem scores, but they remained within the normal range, except for the older boys whose internalizing problems reached a borderline level. Our results suggest that liver transplantation does not substantially affect schooling. Regardless of statistically significant differences in psychosocial adjustment, the majority of the transplant children functioned at a normal level. For adolescent and young adult boys, however, the presence of problems and the lack of competences observed by parents and by the youngsters themselves reached borderline to pathological levels. Our findings stress the importance of psychological post-transplant follow-up with increased attention of caregivers to child and parental concerns about their long-term psychosocial adjustment process.

Adaptation, Psychological↗

Neuropsychological study in treated thyroid dysgenesis.

Neuropsychological assessment was carried out in 57 patients aged 3.0 to 17.5 years (mean 8.5) with thyroid dysgenesis under adequate long-term therapy. Starting age of hypothyroidism as estimated by bone age at diagnosis was prenatal in 32 cases, close to birth in 13 cases and postnatal of 1-12 months in 12 cases. Hypothyroidism of prenatal onset results in severe neuropsychological disorders and mental retardation if not treated early. Only some signs of "minimal brain dysfunction" which compensate with advancing age and normal IQ are found in these children if therapy is started before one month of age. Hypothyroidism starting at birth does not result in mental retardation but neuropsychological disorders are found. They are more frequent if treatment is started after 6 months of age. Children who become hypothyroid between 1 and 12 months of age are usually not mentally retarded and show minor neuropsychological disorders.

Adolescent↗

[Psychotherapy in children and youths].

Child and adolescent psychotherapy form a large proportion of the total amount of psychotherapeutic efforts. Because of the age of the patients, the positive or negative impact is considerable. From the literature we learn that the efforts made to evaluate psychotherapy effects are not in balance with the amount of executed therapies. Meta-analyses of the available controlled therapy-evaluation studies offer a limited but rather encouraging view on the effectiveness of child and adolescent psychotherapy. Also on the differences in effectiveness according to the therapeutic orientation or the treated disturbance some interesting conclusions can be drawn. Unfortunately, these conclusions are based on a limited number of studies, because few clinicians conduct systematic research on therapy effectiveness. Systematic therapy evaluation requires some explicit decisions. The clinician has to decide on the description of the disturbance and the use of a diagnostic system, on the choice of standardized assessment procedures, on the operationalization of his therapeutic techniques and on the availability of norm groups and/or appropriate control conditions. In our psychology and psychotherapy training programs, attention for therapy evaluation is rather limited. Only a small number of students or trainees is explicitly trained in this aspect of therapeutic work. The available literature offers some interesting suggestions to enhance the quantity and the quality of the research in this area.

Adolescent↗