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PubMed1989

Is major depressive disorder in childhood a distinct diagnostic entity?

One approach to validation of the construct of major depressive disorder in childhood was examined. Multivariate analyses of parents' responses on the Child Behavior Checklist (CBCL) were undertaken to determine whether a depressive symptom component would emerge and whether a group of children with pure depressive disorder could be isolated. The study involved 284 children (91 inpatients and 193 outpatients) aged 6 to 11 years. Principal components analyses identified a weak depression component among the CBCL items. Other components were aggressive, anxious, withdrawn, and immature. Cluster analyses designed to isolate a group of children with pure depressive disorder did not accomplish that goal. The results suggest that current enthusiasm for the diagnosis of major depressive disorder in children may be misplaced, and that a dimensional dysthymic syndrome that accompanies many other problems may better explain patterns of symptoms in children. The importance of the use of multiple methods to validate important psychiatric diagnoses is discussed.

Child↗

PubMed1995

Psychological profile of patients suffering from Crohn's disease and ulcerative colitis.

Patients with Crohn's disease (CD, n = 61) and ulcerative colitis (UC, n = 24) were studied using an interview and a series of percept-genetic tests describing anxiety, defensive strategies, and the self-image. Attention was specifically directed at a subgroup of CD (n = 15) with its inflammation limited to the colon (colon Crohn, CC). There was also a control group (n = 43). CC had more immature parent relations than the other groups. They were more childishly concrete and more alexithymic. While CC differ from other Crohn patients in many respects, the real cleft opens up with regard to UC, in spite of location of their illness. CC patients obviously have a psychological profile of their own.

Adaptation, Psychological↗

PubMed1996

[Retinoblastoma: clinical and molecular diagnostic aspects].

Retinoblastoma, a tumor of the immature retina concerns babies and young infants in particular. They make up for 14% of malignomas in the first years of life. There are two types of retinoblastoma: In the first two alleles of the gene Rb1 must be inactivated sequentially in the same retinoblast cell until this may escape control. In this case the retinoblastoma is always unilateral and unifocal. This is explained by the lower frequency of two mutations in one retinoblast. The other type, however, is inherited: One allele Rb1 is inactivated in all cells of the organism by mutation. The probability that a second mutation arrives in different retinoblasts is thus high. In this case bilateral multifocal tumors develop. Characterization of the Rb1 gene has permitted identification or at least determination of a haplotype in persons at risk. This knowledge is decisive for early recognition of babies at risk and for genetic counselling.

Child, Preschool↗

PubMed1998

A psychometric evaluation of the Defense Style Questionnaire in methadone patients.

The self-report Defense Style Questionnaire (DSQ) was designed to assess defenses along a developmental continuum. Factor analysis of the original DSQ suggested that the scale assessed four factors or types of defenses, whereas a more recent factor analysis indicated the DSQ measured three-factors: Immature, Neurotic, and Mature. No data, however, regarding the reliability or unique construct validity of DSQ dimensions was published. This article reports on factor analyses of two DSQ versions in a sample of 215 methadone maintenance patients. Results indicate that both DSQ versions are unidimensional, assessing only Immature defenses. The lack of published psychometric data raises concerns regarding the true reliability of DSQ dimensions reported in previous investigations. Prior statements based on DSQ findings may have been incorrect if the DSQ factors were unreliable. Findings from this investigation stress the importance of requiring and evaluating the psychometric integrity of an instrument before employing it in research.

Adult↗

PubMed1999

Problem drinking and psychological well-being: a five-year follow-up study from adolescence to young adulthood.

The psychological well-being of 651 Finnish adolescents (approximately age 17) was followed to young adulthood (age 22) and examined in terms of their drinking styles at age 22. The young adults were grouped into four categories delineating drinking style (non-users, non-problem drinkers, presumptive problem drinkers, and problem drinkers), and each group was examined for evolved paths of psychological well-being. The psychological profile of the participants was comprised of seven variables: self-esteem, trait anxiety, somatic symptoms, eating concerns, and mature, neurotic, and immature defense styles. The comparison of the drinking style categories revealed that future problem drinkers had lower states of psychological well-being already in adolescence and that the differences became more pronounced during the transition to young adulthood. Poor psychological well-being is a risk for the development of later problem drinking, although the profile of this poor psychological state is somewhat different in women and men.

Adolescent↗

PubMed2004

Spontaneous separation of epiretinal membrane in young subjects: personal observations and review of the literature.

BACKGROUND: Idiopathic epiretinal membranes (ERM) grow on the surface of the internal limiting membrane (ILM) and are a very uncommon condition in young subjects. METHODS: We report six young subjects with ERM and describe the spontaneous separation of the membranes. The functional and anatomical recovery was assessed by Snellen visual acuity, Amsler grid and funduscopy. Selected cases were additionally assessed by optical coherence tomography (OCT). RESULTS: All subjects initially claimed a sudden, unilateral, reduction in visual acuity (VA) with severe distortion at the age of 15-30 years. No ocular trauma or disease was ascertained in any case. Initial fundus examination demonstrated a gray-whitish ERM with translucent stress lines over the macula. Visual recovery occurred in all cases after resolution of the ERM. Sequential OCT demonstrated the successive peeling of an ERM accompanied by normalization of foveal thickness. CONCLUSIONS: Young subjects should be counseled about the favorable prognosis for maintaining good vision and possible spontaneous membrane separation. Conservative observation is advocated if the visual disturbance is located temporally, as functional recovery and spontaneous membrane separation may occur. When the contracting forces of the immature ERM are stronger than its adhesions to the retina, the membrane may separate spontaneously.

Adolescent↗

PubMed1988

Boys who became offenders. A follow-up study of 2203 boys tested with projective methods.

Future offenders have more ratings than controls on variables indicating psychopathology. The characteristics which most consistently and significantly discriminate between preoffenders and controls, and which also turned out to be the best predictors of future criminality, are those which previously have been observed in subjects with serious mental disorders. The results indicate that the high degree of psychopathology in subsequent offenders is associated with distortion of body image and with poor reality orientation, i.e. that the most prominent characteristics of future offenders are related to a weakness of the ego. Future offenders seem to have a sufficiently developed ego to handle common tasks. However, their ego fails when they are confronted with unfamiliar and frustrating situations. The inability of subsequent offenders to complete a task properly, with failure on difficult and provocative tasks, shows that they have not developed adequate defence mechanisms and that they have a low tolerance for frustration. They are emotionally immature, instable and impulsive. In short, they are dominated by id impulses. There is no indication of gender confusion (homosexuality) in subsequent offenders. However, there are marked differences between the drawings by cases and by controls regarding characteristics related to sexuality. These findings are interpreted as an exaggeration of masculinity and an abnormal preoccupation with sexuality combined with anxiety for the opposite sex. It is possible that severe criminality, contrary to milder forms of lawbreaking, is associated with elevated self-esteem and extroversion. There are indications that ultimate offenders experience human beings (others or themselves) as deviant, monstrous and inhuman, features which indicate that distorted self-concept and distorted self-perception are characteristics of preoffenders. The findings regarding aggression are inconsistent, just as they were in prior projects. The Draw-A-Person Test (DAP) and Colour Slide Test (CST) findings indicate that preoffenders are more aggressive and destructive than controls, whereas the Hand Test (HT) shows neither more aggression nor more acting-out tendencies in future offenders than in controls. The literature offers conflicting findings regarding depression. The CST results indicate that depression is more common in preoffenders than in controls.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed1995

Evidence-based ethics and the care of premature infants.

Despite the success of newborn intensive care, a vexing ethical question remains: Which preterm infants are so malformed, sick or immature that newborn intensive care should not be administered? In an attempt to answer this question, this article examines current clinical practices and the persisting effects of the controversial Baby Doe regulations. The scientific evidence for current practices is critically analyzed in relation to fundamental ethical issues for marginally viable patients of any age. A variety of strategies--some highly provocative--is proposed and discussed to facilitate better-informed, better-justified, more broadly acceptable, and more fiscally responsible ethical decisions in the care of preterm infants.

Persons with Disabilities↗

PubMed1987

Factorial dimensions of the Revised Behavior Problem Checklist: replication and validation within a kindergarten sample.

The factor structure of the Revised Behavior Problem Checklist (RBPC) was examined in a large sample of suburban kindergarten children. Teacher-rated dimensions of Conduct Disorder, Attention Problems-Immaturity, Anxiety-Withdrawal, and Psychotic Behavior were closely replicated, and a new factor labeled Unmotivated-Isolated was also revealed. These principal components were consistent across gender and across subsamples of children differing as to risk status for learning failure. Evidence was found for the divergent validity of the externalizing dimensions of Conduct Disorder and Attention Problems-Immaturity with respect to criterion measures of alternative behavior ratings, cognitive functioning, and academic achievement. Parent-rated components of Conduct Disorder, Attention Problems-Immaturity, Hyperactive-Impatient, Tense-Withdrawn, Anxiety, and Passive-Conforming were less clearly validated, and parent-teacher agreement was modest. It was concluded that the RBPC shows promise for the assessment of preschool-aged children and that narrow-band externalizing dimensions of inattentive versus conduct-disordered behavior are reasonably distinct at this age.

Anxiety Disorders↗

PubMedDate not supplied

Alexithymia: relationship with ego defense and coping styles.

There is controversy in the literature as to whether alexithymia reflects a deficit in the cognitive processing of emotions or a defensive coping style. Previous studies with clinical populations reported a strong association between alexithymia and a maladaptive (immature) ego defense style. The present study was designed to examine this relationship in nonclinical populations, and also to explore the relationships between alexithymia and three general styles for coping with stressful situations. Sample 1, 287 nonclinical adults, completed the Twenty-Item Toronto Alexithymia Scale (TAS-20) and the Defense Style Questionnaire (DSQ). Sample 2, 83 undergraduate students who had been categorized previously into alexithymic and nonalexithymic subgroups, completed the DSQ and the Coping Inventory for Stressful Situations (CISS). In sample 1, the TAS-20 and its three factors were associated most strongly with an immature defense style, weakly with a neurotic defense style, and negatively with a mature defense style. In sample 2, alexithymic students scored significantly higher than nonalexithymic students on the immature and neurotic defense factors of the DSQ and significantly lower on the mature defense factor. Alexithymic students also scored significantly higher on the emotion-oriented coping scale and the distraction component of the avoidance-oriented coping scale of the CISS and significantly lower on the task-oriented coping scale. The results fail to support the view that alexithymia is an adaptive defense or coping style.

Adaptation, Psychological↗

PubMed1981

In vitro synthesis of hemoglobin and hemoglobin chains in the BFUe-derived colonies form person with alpha- or beta-thalassemia.

The synthesis of alpha and non-alpha chains of human hemoglobin (Hb) was studied in reticulocytes and in BFUe-derived cell colonies from patients with alpha chain or beta chain deficiencies. The subjects included normal adults (alpha alpha/alpha alpha) with or without a beta chain variant (Hb S, Hb Leslie) or an alpha chain variant (Hb G-Georgia); alpha-thalassemia-2 heterozygotes (alpha 0 alpha/alpha alpha) with an alpha chain variant (G-Georgia or G-Philadelphia); an alpha-thalassemia-1 heterozygote (alpha 0 alpha 0/alpha alpha); alpha-thalassemia-2 homozygotes (alpha 0 alpha 0/alpha 0 alpha) with a beta chain variant (Hb S), an alpha chain variant (G-Philadelphia), a Hb S homozygosity with Hb G-Philadelphia, or a Hb G-Philadelphia homozygosity; and three black beta +-thalassemia homozygotes. Data from reticulocyte in vitro synthesis analysis showed the expected deficiencies. However, similar analyses of the Hb synthesized in cell colonies (even from the black beta-thalassemia homozygotes) gave (nearly) balanced sigma alpha/sigma non-alpha ratios. It is speculated that this balanced synthesis is due to a most effective proteolysis in the immature erythroblast which rapidly removes free alpha or beta chains. The levels of Hb F and Hb A2 were considerably increased in these proerythroblasts; a two- to threefold increase in the synthesis of Hb A2 was observed over that seen in the reticulocytes.

Adolescent↗

PubMed1980

[Clinical systematics of retarded mental development].

The clinical classification of mental retardation is reported. Three main clinical groups were screened: 1) mental retardation, due to the immaturity of the emotional-volitional sphere (different forms of mental infantilism); 2) mental retardation due to disturbances in the cognitive sphere (in stable neurodynamical and encephalopathic disturbances, deficiency in the higher cortical and subcortical functions; in disturbed regulation of cognitive activity); 3) general mental retardation, due to a combination of a disturbed cognitive sphere with organic infantilism. The paper concerns differential criteria for oligophrenia. It is recommended that children with stable retardation of the cognitive sphere be taught in special schools.

Brain Diseases↗

PubMed1993

[Affective respiratory and reflex paroxysms--evaluation of anamnestic data, clinical manifestations and therapy].

The authors elaborated data, using the retrospective method, of a group of 146 patients with affective respiratory and reflex paroxysms. They focused attention on clinical manifestations of the disease, anamnestic data suggesting possible damage or immaturity of stem structures, the influence of heredity and the family environment. They found that in 63.7% the disease was manifested before the age of 1 year, most frequently at the age of 9-12 months. The cyanotic type of paroxysms was found in 67.5% of the patients, the pallid type in 21% and 3.5% of the patients suffered from both types of paroxysms. In 27.4% perinatal risks were recorded. The influence of a family-history was statistically significant in relation to the patient's age during the first attack: in patients with a positive family-history the mean age being by 1.8 months lower. 82.9% of the patients had a normal neurological finding, the EEG was evaluated as normal in 89.6% of 125 thus examined children. Psychological examinations made in 12 children revealed in all instances anomalies of personality with a predominance of lack of compliance and adaptability to the environment. Deterioration of the health status as a result of affective respiratory and reflex paroxysms was not recorded in any of the patients.

Child↗

PubMed1995

Dopamine D2 receptor gene (DRD2) haplotypes and the defense style questionnaire in substance abuse, Tourette syndrome, and controls.

The defence style questionnaire (DSQ) was administered to Caucasian males consisting of 123 subjects from a V.A. addiction treatment unit (ATU), 42 Tourette syndrome (TS) subjects, and 49 controls. For the ATU and TS subjects, there was a significant decrease in the mean score for mature defenses and a significant increase in mean score for immature defenses compared to controls. Many of the individual subscores showed the same significant differences. Dopamine D2 receptor (DRD2) gene haplotypes, identified by allele specific polymerase chain reaction of two mutations (G/T and C/T) 241 base pairs apart, were determined in 57 of the ATU subjects and 42 of the controls. Subjects with the 1 haplotype tended to show a decrease in mature and an increase in neurotic and immature defense styles compared to those without the 1 haplotype. Of the eight times that the subscale scores were significant for haplotype 1 versus non-1, they were always in this direction. There results suggest that the DRD2 locus is one factors controlling defense styles. The difference in the mean scores between controls and substance abuse subjects indicates that other genes and environmental factors also play a role.

Alcoholism↗

PubMed2003

Defense styles, impulsivity and suicide attempts in major depression.

BACKGROUND: The aim of our study was to identify if defense mechanisms are associated with impulsivity and lifetime suicide attempts in depressed patients. SAMPLING AND METHODS: The Defense Style Questionnaire, the Impulsivity Rating Scale and the Impulse Control Scale were used in 77 depressed inpatients. RESULTS: Impulsivity was correlated positively with immature and neurotic styles and negatively with mature style. Some but not all defense mechanisms were relevant in this respect. The number of lifetime suicide attempts was positively correlated not only with impulsivity, but also with immature style and to a lesser extent with neurotic style. Several defense mechanisms were involved in these correlations: undoing, projection, passive aggression, acting out, splitting and somatization. CONCLUSIONS: Like impulsivity, defense styles may be relevant to discriminate recurrent suicide attempters in depression. Prospective assessment of defense styles and suicide attempts in depression is needed.

Adolescent↗

PubMed1968

[Character changes in the premorbid phase of patients with nuclear schizophrenia].

This report is based on an investigation into the premorbid characters of 51 patients afflicted with "nuclear schizophrenia" (the nature of course of the disease having been bland in 19, paranoid in another 19, and hebephrenic in 13 cases). The characters in premorbidity may be divided into 3 groups: schizoid (20 cases); reactive-labile (15 cases); and explosive-epileptic (13 cases). The development of all patients afflicted with "nuclear schizophrenia" showed characteropathies conditioned by asynchronism, slowed rate of motor maturation, and affective immaturity. In the bland course of disease a narrowing of interests, one-sidedness, unstability, and quick fatigability are found at an early stage. In the paranoid course of disease a lack of drive was found in development: initiative-less, passive children who subordinated themselves, In the later hebephrenic forms there was found, in development, a weakness in emotional contact with an in the affective response to the environment. The study of characteropathies may contribute to an early prophylaxis.

Adolescent↗

PubMed2001

The comprehensive assessment of defense style: measuring defense mechanisms in children and adolescents.

This study introduces the Comprehensive Assessment of Defense Style (CADS), a new method to assess descriptively the defensive behavior of children and adolescents. Parents of 124 children and adolescents referred to a mental health clinic, of 104 nontreated children, and of 15 children whose fathers were treated for posttraumatic stress disorder completed the CADS. Factor analysis of 28 defenses yielded one mature factor, one immature factor of defenses expressed in relations with the environment (other-oriented), and one of defenses expressed in relations with the self (self-oriented). The CADS significantly discriminated between patients and nonpatients. Psychiatric patients used more immature and fewer mature defenses than control subjects, and adolescents used more mature and fewer other-oriented defenses than children. Girls used more mature and fewer other-oriented defenses than boys. The reliability and validity data of the CADS are encouraging. The three defense factors may be implemented for diagnostic and clinical purposes as well as for screening for psychopathology risk in untreated populations.

Adolescent↗

PubMed1982

Penile malformation and mental health. A controlled psychiatric study of men operated for hypospadias in childhood.

Aspects of mental health were investigated by means of interviews and register data in 34 men operated on for hypospadias in childhood and in 36 matched control subjects. Most hypospadiacs adjust well both in childhood and adult age. However, they reported more neurotic disturbances in their childhood than the controls. Shyness and enuresis were common troubles among the probands, and they had been more timid, isolated and mobbed. Similar although less striking differences in mental health were reported also in adult age. Depression and anxiety were dominating symptoms. The interviewer assessed the hypospadiacs to show more anxiety and to use more immature defence mechanisms and consequently to have less stress tolerance. The probands were further judged to have less capacity for social relations and their overall capacity to utilize existent psychological resources was small as compared to the controls. The findings indicate that hypospadiacs are more prone to neurotic (but not psychotic) disturbances than other young men and have more disturbed social relations. The need for psychological guidance for the boys and their parents is stressed.

Adolescent↗