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W R Beardslee

Publications and source records attributed to W R Beardslee.

At least 37 records · Page 2Linked to original sources
PubMed1996

"Speech after long silence": the use of narrative therapy in a preventive intervention for children of parents with affective disorder.

This article is an attempt to explain why the stories of those who suffer from affective disorder have gone unspoken, and to describe how the Preventive Intervention Project (PIP) helps to elaborate a narrative process within families. The PIP is a short-term, psychoeducational intervention focused on enhancing family understanding of affective disorder, and on building resiliency in children. Detailed descriptions of interventions with two families are used to demonstrate how the PIP works with parents and children: to move the narrative process from private to shared meaning. We discuss how cultural "canons" regarding affective illness reinforce a tendency to keep that experience private. We then show how the PIP provides an alternative, "schematic base" of understanding that facilitates a family's ability to begin a dialogue about their illness. We hope to demonstrate how this modernist, psychoeducational framework can be integrated with a more open-ended, postmodern construction of meaning.

Adolescent↗
PubMed1994

Depressive disorders and suicidal intent in adolescent suicide attempters.

This study describes the relationships between the presence of a depressive disorder, suicidal intent, and the medical seriousness of a suicide attempt in an adolescent sample. Consecutive adolescents who attempted suicide were evaluated for the presence or absence of current DSM-III-R depressive disorders (DD). Adolescent suicide attempters with DD were compared with those without DD regarding the level of their suicide intent and the medical seriousness of their suicide attempt. Adolescent suicide attempters with a diagnosis of DD were found to have a higher level of suicidal intent than were those without depressive illness. There was no relationship between the medical seriousness of the suicide attempt and the presence of DD. Clinicians should specifically assess for DSM-III-R DD as a means of determining suicidal intent in adolescent suicide attempters.

Adolescent↗
PubMed1993

Preventive intervention with the children of depressed parents. A case study.

Children of parents with depression are at significant risk for impairment, but little is known about preventive intervention strategies prior to the onset of illness in the children. This paper discusses a preventive approach to assisting families in helping children cope with parental affective disorder. A case study is presented which demonstrates the compatibility of this family-based intervention with psychoanalytically oriented treatment for the parent. Key aspects of this work include the enhancement of self-understanding and resiliency in children.

Adolescent↗
PubMed1993

Comparison of preventive interventions for families with parental affective disorder.

Twenty families participated in a random assignment trial of two cognitive psychoeducational preventive interventions for families with parental affective disorder. Twelve families were assigned to a clinician-based intervention and eight to a lecture-based intervention, with assessment prior to intervention and an average of 18 weeks following intervention. Both groups were satisfied and believed they received help from the intervention. The clinician-based group was significantly more satisfied overall, and reported significantly more changes in both behaviors and attitudes about their illness from pre- to postintervention. Both groups showed significant decrease in degree of upset over issues of concern from pre- to postintervention. The clinician-based group reported receiving significantly more help with their primary concern. The implications of these findings are discussed.

Adolescent↗
PubMed1993

The impact of parental affective disorder on depression in offspring: a longitudinal follow-up in a nonreferred sample.

OBJECTIVE: This study explored the effects of parental affective disorder on offspring in a nonreferred health maintenance organization 4 years after initial examination. METHOD: The sample, average age 18.5 years, included 91% of the 153 youngsters initially studied. The main instruments were structured diagnostic interviews scored according to criterion systems for both parents and children; assessment of the youngsters was blind to the previous assessment. RESULTS: Rates of major depressive disorder were higher in the children of parents with affective disorder (26%) compared with those whose parents had no disorder (10%). CONCLUSION: Depression and other parental affective disorders, as they occur in the community in parents who often are neither recognized nor treated, are associated with serious affective disorder in offspring. Clinical and preventive approaches for these offspring are needed and should be targeted to all families in which there is serious parental affective disorder, not just those who present for psychiatric treatment.

Adolescent↗
PubMed1992

The disruptive behavioral disorder in children and adolescents: comorbidity and clinical course.

Comorbidity, time to recovery, rate of chronicity, and probability of recurrence following recovery were studied in 51 children diagnosed with attention deficit disorder, conduct disorder, and oppositional defiant disorder. Thirty-three percent of the children had two of the above diagnoses, and one child had all three diagnoses. The mean duration of attention deficit disorder was 8 years up to the time of the interview; the mean duration of oppositional defiant disorder was 4.5 years, and the mean duration of conduct disorder was 3 years. Life-table estimates showed that 14% of the children would not have recovered 15 years after the onset of their disorder. Rates of recurrence were high following recovery from each of these disorders.

Adolescent↗
PubMed1992

Chronic course of anxiety disorders in children and adolescents.

In a naturalistic study that assessed the lifetime psychiatric histories of 275 children ascertained independently of diagnostic or treatment-seeking behavior, 38 (14%) of the children had a history of anxiety disorder. Rates of comorbidity of depression and other psychiatric disorders were high. Life table estimates of the duration of illness indicate a more protracted time to recover than expected, because 46% would be ill for at least 8 years. Moreover, of those who recovered from their first episode of anxiety disorder, many had experienced recurrence before interview. After conducting pooled analyses, investigators performed separate analyses for children with separation disorder and overanxious disorder. Median age of onset of these conditions was surprisingly young: 10 years of age for overanxious disorder and 8 years of age for separation disorders.

Adolescent↗
PubMed1992

Initial findings on preventive intervention for families with parental affective disorders.

OBJECTIVE: The purpose of this study was to develop a clinician-based cognitive, psychoeducational, preventive intervention for families with parental affective disorder that would be suitable to widespread use, test its feasibility and safety, and define the areas affected by the intervention. The intervention was designed to increase understanding of parental illness and resilience in the children. METHOD: The authors studied the first seven families (14 parents) to receive the intervention. Enrollment criteria included affective disorder during the preceding year in at least one parent, presence of at least one child between the ages of 8 and 14 years who was not psychiatrically ill at the time of participation, and willingness to participate in the research study. The intervention consisted of parent, child, and family sessions. Assessment included semistructured interviews with parents about affective disorders, standard ratings of marital satisfaction and therapeutic alliance, and a recently developed semistructured interview to assess response to the intervention. RESULTS: Overall satisfaction with the intervention was rated moderate to high by parents. No harm was reported. Ten of 14 parent subjects reported five or more behavior and attitude changes that they attributed to the intervention. The most frequent behavior and attitudinal changes reported were increased discussion of the illness and related issues and increased understanding of information about affective illness. CONCLUSIONS: The authors conclude that the intervention is safe and feasible in families with parental affective disorder.

Adult↗
PubMed1991

Depression in children and adolescents: new data on 'undertreatment' and a literature review on the efficacy of available treatments.

This article reports on the treatment received by 38 adolescents during an episode of major depression which had a median duration of 4 months. The one subject who received any pharmacologic treatment was prescribed an antianxiety agent. Sixteen percent received psychotherapy. These results are consistent with evidence from studies of adults indicating that depression is underrecognized and undertreated. An important caveat is that the small sample size limits the generalizability of these findings. Moreover, which medication should be prescribed when a diagnosis of depression is made is not yet known with certainty, as literature reviews indicate that more controlled trials of psychotherapeutic and psychopharmacologic treatments for adolescents with depression are needed to better understand the efficacy of treating depressed adolescents.

Adolescent↗
PubMed1990

Maternal expressed emotion and parental affective disorder: risk for childhood depressive disorder, substance abuse, or conduct disorder.

Expressed emotion (EE) refers to a set of emotional aspects of speech for which ratings have been derived. Seven independent studies have established that higher EE ratings in the relatives of patients with schizophrenia predict higher rates of relapse in these patients and two studies have established an association of higher EE in spouses with relapse of depression in their mate. There are no previous studies of parental EE as a predictor of childhood affective disorder or other disorders not in the schizophrenia spectrum. In this study we investigated the relationship between the level of maternal EE and the incidence of DSM-III affective disorder (major depression or mania or dysthymia), substance abuse, or conduct disorder in 273 children. We found that a higher degree of maternal expressed emotion was associated with a three-fold increase in a child's risk (odds multiplier) for having at least one of the following diagnoses: depressive disorder (major depression or dysthymia), substance abuse, or conduct disorder. This increased risk acts in addition to the increased risk of child diagnosis associated with parental affective illness. Research and clinical implications are discussed.

Adolescent↗
PubMed1990

Adaptation in adolescence: the influence of time and severe psychiatric disorder.

This study reports the development of adaptive processes in two groups of adolescents assessed initially and 2 years later with clinical research interviews. Students from a public high school (N = 44) and inpatients on an adolescent psychiatric ward (N = 51) formed the two subject groups. The psychiatrically hospitalized group had significantly improved scores after a 2-year interval on four of six adaptive process Summary Scales: Task Orientation, Relatedness, Self Knowledge, and Inner Synthetic Functions. However, these higher scores did not reach the levels of the high school group at either point of assessment. The scores in the high school group remained stable over time except for an increase in the area of Self Knowledge. The value of this interview-derived assessment, in comparison to other forms of measurement, is discussed, and consideration is given to factors which contribute to the differences between groups.

Adaptation, Psychological↗
PubMed1990

Psychological functioning in children with cyanotic heart defects.

The relationship between congenital heart disease (CHD) and psychological functioning was studied in 63 children with transposition of the great arteries (TGA) and 77 children with tetralogy of Fallot (TF). These youngsters were compared with a group of 36 children originally diagnosed with CHD, but who spontaneously recovered (SR) without medical intervention. All children were under one year of age when diagnosed and were given psychological testing between 5.5 and 6.3 years. Children with TGA and TF had poorer overall psychological functioning and significantly greater central nervous system (CNS) impairment than the SR children. However when the effects of IQ and CNS impairment were controlled, there were no differences between groups. The diagnosis of a severe cyanotic heart defect does not appear to make a child more likely to have emotional disorder in the absence of other factors.

Activities of Daily Living↗
PubMed1989

Psychiatric outcome of burned children and adolescents.

Recent medical and surgical advances allow many severely burned patients to survive who formally would have died. Assessment of psychiatric outcomes with these patients may provide ways of measuring effects of acute burn care methods on later quality of life, specify more accurately their emotional needs during rehabilitation, and stimulate further research. Thirty children, aged 7 to 19, with severe burns are compared with 30 nonburned subjects matched for age, sex, SES, and parents' marital status according to DSM-III criteria. The burned children had significantly higher levels of overanxious disorder, phobias, and enuresis, but they had the same rates of present depressive disorders.

Adaptation, Psychological↗
PubMed1989

The role of self-understanding in resilient individuals: the development of a perspective.

Three studies are reviewed in which an in-depth life-history approach was used, and in which a strong connection was demonstrated between self-understanding and resilience. Subjects were civil rights workers in the South, survivors of childhood cancer, and adolescents whose parents had serious affective disorders. Dimensions of the concept of self-understanding which are evident in all three investigations are explored, and the study of resilience as part of an integrative approach to the understanding of human behavior is outlined.

Adolescent↗
PubMed1989

Children of parents with affective disorder.

Depression is a family illness. The pediatrician's involvement is as a physician for the family. Initially, his or her role is as a diagnostician for the family. The presence of depressive symptoms in either a parent or a child requires investigation and may signal distress in other members of the family as well as the individual with symptoms. Often, even for parents, depressive symptoms will be first evident to the pediatrician. This provides a significant responsibility and the opportunity to function as a physician for the family in distress. An ongoing collaborative relationship with a psychiatrist or other mental health professional will aid in the treatment of disorder in the parents. Furthermore, in the absence of acute illness, there is an opportunity to discuss and help the family to understand the illness and to encourage resiliencies within the child or children. There is also the opportunity for continued follow-up, both of the parental distress and of the children's adaptive functioning.

Child Behavior Disorders↗
PubMed1988

Resilient adolescents whose parents have serious affective and other psychiatric disorders: importance of self-understanding and relationships.

Eighteen young men and women whose parents had major affective disorders, often in combination with other serious psychiatric disorders, were selected from a larger sample on the basis of their good behavioral functioning as adolescents at initial assessment. When they were reassessed an average of 2 1/2 years later, 15 of the 18 were still functioning well. Considerable self-understanding, a deep commitment to relationships, and the ability to think and act separately from their parents characterized these young people. Many of them were taking care of their ill parents. The implications of these findings for preventive and clinical intervention are discussed.

Adaptation, Psychological↗