SEARCH · PubMed Health

Results for “PERSONALITY, IMMATURE”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

480 records · Page 27Linked to original sources

PubMed1994

Developmental delay in healthy premature infants at age two years: implications for early intervention.

Ninety-four healthy full-term and preterm infants, who differed because of immaturity, not medical or social risk factors, were assessed at 3 and 24 months of age. Preterm infants scored significantly lower on the Bayley Mental Development Index (MDI), but not the Psychomotor Development Index (PDI) compared with full-term infants at 24 months (age corrected for prematurity). Nine factors, which included a combination of environmental and infant temperament variables, accounted for 36% of the variance in MDI scores. Separate regression analyses by infant group found that the caregiving environment, Home Observation for the Measurement of the Environment (HOME total score), contributed more to the variance in preterm than full-term development, despite the fact that the HOME scores were high and did not differ between groups at 2 years of age. These findings provide further evidence of the need to continue developmental follow-up for healthy low birth weight (LBW) preterm infants and of the important influence of early caregiving factors on later development, even for middle-class, LBW preterm infants.

Child, Preschool↗

PubMed2005

Plasticity imbalance in mental disorders the neuroscience of psychiatry: implications for diagnosis and research.

In 1895 Freud tried to explain mental disorders using the neurophysiological knowledge of his time. He soon abandoned this attempt realizing it was immature considering the neuroscientific knowledge available to him. For the rest of his career he limited himself to psychological formulations. Along the same lines, lacking etiology for mental disorders, the diagnostic system of psychiatry is exclusively descriptive. The need for a brain related diagnosis of mental disorders is important for developing better treatments and more reliable diagnosis. Today with the development of neuroscience it is time to go back to Freud's initial attempts and explain mental disorders as altered neuronal organizations in the brain. The neural network level is chosen as the relevant description level for mental functions. Plasticity is chosen as a general concept for neuronal dynamics explaining neuropathology of psychiatric disorders. Plasticity is divided according to timescales into "fast plasticity," "slow plasticity" and "stable plasticity". It is proposed that normal mental functions require optimal balance among all the plasticity timescales. Mental disorders arise when such balance is disturbed, thus mental disorders could be reformulated as deficiencies of the different plasticity processes. Changes in coherence synchrony and phase-locking membrane potentials in cortically spread neuronal ensembles are all expressions of fast plasticity. Synaptogenic and neurogenic processes, such as brain derived neurotrophic factor-dependent processes, are defined as slow plasticity. Finally those synaptic and neuronal pathways that consolidated into long lasting circuits are referred to as stable plasticity. With the aid of a neural network model simulating the plasticity imbalance, a mathematical formulation could be realized for mental disorders. Once achieved this mathematical formulation could form a guiding framework for interpreting brain-imaging data collected from psychiatric patients. Such a model is realized using interconnected "modules" each simulating the relevant plasticity dynamics relevant for the model. Diagnosing plasticity imbalance has some advantages over current descriptive psychiatric diagnosis. It is brain-related thus less stigmatising in the sense that mental disorders are brain disorders and not "person" disorders. The diagnostic system is much more flexible allowing for a high degree of variations and combinations in the description of the disorders thus naturally accounting for comorbidities. Most importantly, this diagnostic model is brain-related offering research targets for intervention and a theoretical framework guiding such interventions.

Biomedical Research↗

PubMedDate not supplied

Factors related to grade retention in children with short stature.

A recent study by Holmes et al. (1982) revealed a high degree (23%) of grade retention in a group of children with significant short stature secondary to growth hormone deficiency (GHD), constitutional delay (CD); or Turner's Syndrome (TS). Parents indicated in a free response format that 'immaturity' and 'small size' were the reasons for retention. The present follow-up study obtained academic achievement data on 47 of the 56 short children from the Holmes et al. (1982) study to assess what role academic factors, not spontaneously mentioned by parents, may have had in the retention decision. Results indicated that despite repeating a year in the primary grades, the group of retained children were still functioning 6 months below grade expectation, compared to grade appropriate achievement in the never-retained group. Parents and teachers were both accurate in their perceptions of children's academic achievement. Behavioural ratings by teachers indicated more adjustment difficulties for retained children, while parent ratings of behaviour showed a similar high level of problems for short children regardless of retention status. Although both groups of children possessed average intellectual abilities, the retained children obtained lower IQ scores than the never retained children. In summary, a majority of short children were achieving appropriate grade levels, but a substantial minority were experiencing under-achievement, behaviour problems, and grade retention, despite average intelligence.

Achievement↗

PubMed2002

Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis.

CONTEXT: The cognitive and behavioral outcomes of school-aged children who were born preterm have been reported extensively. Many of these studies have methodological flaws that preclude an accurate estimate of the long-term outcomes of prematurity. OBJECTIVE: To estimate the effect of preterm birth on cognition and behavior in school-aged children. DATA SOURCES: MEDLINE search (1980 to November 2001) for English-language articles, supplemented by a manual search of personal files maintained by 2 of the authors. STUDY SELECTION: We included case-control studies reporting cognitive and/or behavioral data of children who were born preterm and who were evaluated after their fifth birthday if the attrition rate was less than 30%. From the 227 reviewed studies, cognitive data from 15 studies and behavioral data from 16 studies were selected. DATA EXTRACTION: Data on population demographics, study characteristics, and cognitive and behavioral outcomes were extracted from each study, entered in a customized database, and reviewed twice to minimize error. Differences between the mean cognitive scores of cases and controls were pooled. Homogeneity across studies was formally tested using a general variance-based method and graphically using Galbraith plots. Linear meta-analysis regression models were fitted to explore the impact of birth weight and gestational age on cognitive outcomes. Study-specific relative risks (RRs) were calculated for the incidence of attention-deficit/hyperactivity disorder (ADHD) and pooled. Quality assessment of the studies was performed based on a 10-point scale. Publication bias was examined using Begg modified funnel plots and formally tested using the Egger weighted-linear regression method. DATA SYNTHESIS: Among 1556 cases and 1720 controls, controls had significantly higher cognitive scores compared with children who were born preterm (weighted mean difference, 10.9; 95% confidence interval [CI], 9.2-12.5). The mean cognitive scores of preterm-born cases and term-born controls were directly proportional to their birth weight (R(2) = 0.51; P<.001) and gestational age (R(2) = 0.49; P<.001). Age at evaluation had no significant correlation with mean difference in cognitive scores (R(2) = 0.12; P =.20). Preterm-born children showed increases in externalizing and internalizing behaviors in 81% of studies and had more than twice the RR for developing ADHD (pooled RR, 2.64; 95% CI, 1.85-3.78). No differences were noted in cognition and behaviors based on the quality of the study. CONCLUSIONS: Children who were born preterm are at risk for reduced cognitive test scores and their immaturity at birth is directly proportional to the mean cognitive scores at school age. Preterm-born children also show an increased incidence of ADHD and other behaviors.

Attention Deficit Disorder with Hyperactivity↗

PubMed1995

[Angioma in childhood: current criteria for therapy].

After examining the most recent literature on this subject, the authors assess the state of the art of current knowledge regarding cutaneous angioma in the light of their personal experience. The histological, biological and clinical characteristics are analysed and enable a new nosographic evaluation of this frequent pathology which must be differentiated from vascular malformations. In the light of these unique features, the authors examine the current forms of treatment for angioma using local, systemic or physical therapy. Cutaneous angioma may be present at birth or may appear during the first months of life, occasionally regressing spontaneously up until the child is seven years old. They also present a population of proliferating endothelial cells. This explains the possibility that these neoformations will spontaneously regress, an event that must be taken into account before commercing therapy. With regard to their diagnosis valuable information is provided by telethermography, ultrasonography, Doppler scan and CAT. If an angioma is present from the first weeks of life, a wait-and-see policy should be adopted unless the lesion is localised in an orbital, mammary, palpebral, subglottic, nasal or labial region. Local therapy of angioma using sclerosant substances is now controversial; the best results are obtained using periodical administrations of triamcinolone acetonide or betamethasone. Systemic treatment with prednisone is indicated in forms localised on the orbita where interlesional injections are frequently followed by complications such as hematoma and infections. Systemic treatment requires an interdisciplinary approach, especially in pediatrics, due to the repercussions which the use of high dose conrticosteroids provokes on hormone function in children. The use of alpha interferon with discordant results has recently been reported in the literature. In superficial forms physical therapy may be more appropriate. Cryotherapy provoked a lesion caused by cold: an ionic alteration of tissues through freezing leads to necrosis. Plesiotherapy has been now virtually abandoned due to the risks of growing tissue. In terms of therapy and application there has been a widespread increase in the use of argon laser over the past years: the "Tunable Dye Laser" present unique characteristics which allow the wave length to be modulated in relation to the colour and depth of the lesion to be treated, causing selective photothermolysis. Encouraging results can be obtained by subjecting immature angioma to applications every 3-4 weeks using an every of 7-8 J/cm2. The use of the tunable dye laser is, however, preferable in superficial angioma. Compressive therapy using elastic bandages or specially made garments is effective only in those localisation where it is possible to obtain compression, like limbs and the parotid region. From the above comments it can be seen that the treatment of immature angioma is extremely complex due to their clinical and evolutive variability. It is therefore vital to following the rules laid down by experience: waiting for the involution of the angioma, even if it is commonly observed event, is often difficult to achieve due to the scarce collaboration of parents. Moreover, it is important to achieve a close interdisciplinary collaboration between pediatrician, dermatologist and plastic surgeon.

Child↗

PubMed1984

Play in the psychotherapy of selfobject relating.

Current literature dealing with narcissistic character disorder attempts to differentiate between mature relating with consensually validated whole objects and immature, more primitive relating with mirroring and validating selfobjects. In the latter case the object is especially valued for its role in buttressing a damaged or fragile self. The persistence into adult life of this more primitive relating to selfobjects can be viewed as a restitutive attempt, a healing by second intent. Through such a mechanism, attempts are made to make good deficits left by perceived failures of the primary object. These attempts include the setting up of relationships with figures whose empathic capacity is in some way sensed to be corrective, and the setting up of relationships with selfobjects which are in part created by the subject to provide himself with the kind of validating selfobject which has been longed for, yet never experienced. Winnicott conceives of transitional experience as an intermediate area allowed to the infant between primary creativity and objective perception based on reality testing. Transitional relating usefully clarifies the concept of selfobjects in emphasizing its common features with the transitional object. Transitional objects and selfobjects both contain the idea that the psychic apparatus is equipped with self-healing capacities. They tell us something about the nature of those self-healing capacities. The mental apparatus, as the physical apparatus, can attempt to heal itself in the face of injury or disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2001

New strategy for better geriatric oral health in Japan: 80/20 movement and Healthy Japan 21.

A review of strategies for better geriatric oral health in Japan is presented. The rapid growth of the aged population in Japan has been associated with the decreasing ability of family caregivers to provide home care due primarily to immature social support systems. As rural ageing has a stronger likelihood of this trend, there is a difference in the oral health of older adults in urban and rural areas. A national survey demonstrated that only 29.8% of the adult population in rural areas had at least one dental visit in the preceding year versus 34.0% in urban areas. Another national survey showed that the proportions of the elderly with untreated teeth that have decay and those without any treated teeth in metropolitan areas, urban areas, and rural areas were 6%, 7% and 12%, respectively. Maintaining good oral health is crucial for maintaining quality of life in later years. A survey in a rural area in Japan demonstrated that, among elderly with nine or fewer natural teeth who wore no dentures, 45% were bed-bound or house-bound. However, among those with 10 or more natural teeth, 80% were active and able to go out alone. Another survey suggested very few house-bound elderly requested dental care, although most of them had oral health problems and mastication dysfunction. A new strategy, 'Healthy Japan 21' suggests positive actions to keep 20 or more teeth by the age of 80, and encourages collaboration between local health authorities and dental associations to encourage positive oral care for the frail elderly including domiciliary dental services within communities.

Activities of Daily Living↗

PubMed2006

Partnering with patients--a concept ready for action.

AIM: This paper is a report of a concept analysis of partnership within the context of a professional-patient relationship. BACKGROUND: The concept of partnership has been previously characterized as immature, with a need for further consensus and consistency. Critical attributes previously reported include relationship, power sharing and negotiation, with empowerment as the primary consequence. METHOD: Rodgers' evolutionary method of analysis for concept development was used to re-examine the concept of partnership. Historical documents and previously published conceptual papers were reviewed for context. A search of multidisciplinary literature published between 2000 and 2004 was undertaken using the keywords of 'partnership' and 'partnering', combined with nurse/professional/physician-client relationship. Attributes, uses, antecedents and consequences were inductively derived from the citations analysed (n = 62). RESULTS: Previous authors affirmed that partnership involves a process and a consistent set of eight attributes. Relationship, shared power, shared decision-making and patient autonomy are attributes that distinguish partnership from other related concepts. Most of the literature, however, consisted of expert opinion or descriptive research. Little progress has been made in applying theory, developing tools to test the process, identifying when partnerships are needed and what specific outcomes occur when they are present. CONCLUSION: Partnerships between healthcare providers and patients develop over time. They are created to support patients in having a greater voice in their care and to empower them in self-management. A descriptive model of partnership is proposed to support researchers in generating or applying existing theory to the development of research designs and tools that could test how this process actually works.

Concept Formation↗

PubMedDate not supplied

Italian version of the defense style questionnaire.

The Defense Style Questionnaire (DSQ) assesses defensive behavior by empirically evaluating conscious derivatives of defense and coping mechanisms in everyday life. It was developed on the assumption that defenses can be ordered along a maturity-immaturity continuum and tend to group into clusters, or defensive styles. The original factor analytical study, by Bond et al. (1983) identified four styles, called maladaptive, image-distorting, self-sacrifice, and adaptive styles. Successive studies only partially confirmed this factor structure. We present the factor structure and the main psychometric features of the Italian version of the questionnaire. The DSQ was translated into Italian by the back-translation method and administered to a sample of 294 men (mean age, 33.33 years) and 333 women (mean age, 32.38 years). An exploratory factor analysis identified three factors largely corresponding to Bond's maladaptive, image-distorting, and adaptive defensive styles and to analogous factors identified by other authors. Accordingly, three defense style scales were constructed, containing respectively 37, 17, and 12 items. These scales showed intercorrelations compatible with the hierarchical model of defensive functioning at the base of the questionnaire, acceptable, though ameliorable, test-retest reliabilities (r's = .79, .63, and .81, respectively) and, with the exception of the Adaptive Style scale, sufficient internal consistencies (alphas: .85, .72, .57). However, only the Maladaptive Style scale, probably due to its greater length, showed values of reliability and internal consistency high enough to warrant clinical use in its present form. Further investigation is required to find new items that may improve the reliability of the Image-Distorting and the Adaptive Style scales.

Adaptation, Psychological↗

PubMedDate not supplied

[Hearing impairment and psychopathological disorders in children and adolescents. Review of the recent literature].

OBJECTIVE: Hearing impairment is a multifaceted condition with medical and social aspects. If the neuropsychiatric impact of deafness on children has been investigated by researchers from a variety of fields and backgrounds, their conclusion is that children with hearing impairment follow many different developmental pathways. The aim of this paper is to examine the relationships between hearing impairment and mental health and the effect of impaired communication on family development. METHOD: From a review of the literature, the authors examine the relationships between hearing impairment and mental disorders in children and adolescents in terms of prevalence, clinical features and etiological factors. The fami-ly dynamics and the parents-child interactions were also explored. RESULTS: The assessment of psychiatric disorders in hearing-impaired children sets some methodological pro-blems. Accurate evaluation is hampered by the immature language exhi-bited by many hearing-impaired children and by the difficulties that may be encountered in establishing rapport if the child does not understand the examiner's verbal exchanges. Several authors point out the lack of communication skills and experiences with hearing-impaired children on the part of many examiners. In addition, delays have been observed for the development of social maturity in hearing-impaired children and the parents' descriptions may reflect their own worries, rather than the emotional-behavioral functioning of the child. The measurement of psychiatric symptoms is then compromised insofar as many of the assessment procedures are highly verbal and were standardized for normal-hearing children. These difficulties may explain that the pre-valence rates of mental disorders in hearing-impaired children and adolescents found in the literature vary from 15% to 60%. If autism and deafness may both confound each others' dia-gnosis, several studies also point out the high comorbidity observed between these 2 conditions. The significance of this association remains unclear. Many of the authors conclude that hearing impairment is unlikely to be an etiological factor in autism. However, auditory impairment may be a marker for brain damage in autism. Although some studies showed high rates of depression and anxiety disorders, particularly social phobias, in deaf and hard-of-hearing children and adolescents, most of the studies conclude that the prevalence of affective disorders in hearing-impaired children and adolescents is comparable with estimates of prevalence for hearing young people. A number of studies have suggested that deaf children show greater degrees of impulsivity than hearing children. However, it seems that this background of greater impulsivity does not lead to higher rates of attention-deficit/hyperactivity disorder (ADHD) among deaf children. Using standardized instruments to estimate the prevalence of ADHD in this population, recent studies conclude that deaf children with hereditary deafness are not at greater risk of developing ADHD but that children with acquired deafness are, and that this difference is probably related to the medical conditions and family climates distinguishing these two groups. Psychotic disorders are no more common among hearing-impaired young people than among young people with normal hearing. However, some recent studies showed that the presentation of schizophrenia can differ in deaf people because of the high frequency of visual hallucinations observed in them. Lastly, if primitive personality has been described as being more prevalent among hearing-impaired children and adolescents, most of the studies found a normal range of emotional-behavioral functioning in them. In summary, if varying incidences of emotional disturbances and behavioral problems have been reported for hearing-impaired children and adolescents, except autism, it seems that children with hearing impairment experience the same range of mental health problems as hearing children. A variety of demographic, medical and educational factors were investigated as possible etiological factors for the psychiatric disorders observed in hearing-impaired children. Factors such as medical conditions, degree of deafness, communication ability and social deprivation may play a role. However, many studies also emphasize that a number of other variables, including educational methods, parental adaptation and parental support, may have an impact, positive or negative, on the development of the hearing-impaired child. By this way, numerous investigations have shown that deaf children of deaf parents attain better emotional and cognitive development than do deaf children of hearing parents. CONCLUSION: A number of questions remain about the neuropsychiatric and psychosocial aspects of hearing-impairment in children. For instance, few studies have been conducted to examine the impact of the different methods of communication and education on the psychosocial adjustment of deaf children. However, this review clearly show that appropriate and effective management can occur only when the mental health professionals are know-ledgeable and sensitive to the unique characteristics and experiences of hearing-impaired children and adolescents.

Adolescent↗

PubMed1976

[The hyperkinetic child. Psychopathological aspects (author's transl)].

The hyperkinetic syndrome, such as it is abundantly described in the literature of American authors, is clearly defined by the association in a young child, essentially at the beginning of schooling, of hyper-activity, psycho-motor instability, affective and learning disorders, emotional lability, immaturity, etc. It would appear that psycho-stimulants (in particular amphetamines) bring about a spectacular improvement in these children, representing a therapeutic test that confirms the diagnosis. In America, insistence is placed on the physiopathogeny of the disorders, and on the minimal cerebral dysfunction. This pathology, which, it would appear, does not seem to have been recognised in France, where the psychomotor instability is only one among many symptoms. We report here a synthetic clinical study of hyperkinetic children observed over a period of several years. They are particular in that they were seen at an early age (between 18 months and 4 years old). The psychopathological study of the early stages (which is usually missing in the literature) makes it possible to objectify a preliminary phase dominated by negative signs, of the "silent series": depressive and regressive tendencies, later hidden by agitation. We underline the importance of the early distorsion of the mother-child link, which appears to be a determining factor in the appearance of the hyperkinetic syndrome. These date (which tend to contradict many studies) lead one to reject the chemotherapy solution, and in particular psychostimulants for the greater majority of cases, and rather to intervene at an early stage, and ideally speaking preventively, to instigate above all a psychotherapy of the child and often of the mother (co-therapy), to restore a good level of communication, and the mother-child link. This in-depth approach should make it possible to avoid a purely symptomatic treatment, with its uncertain effects, and its often undersirable evolution.

Child↗

PubMed1999

Enforced expression of the GATA-2 transcription factor blocks normal hematopoiesis.

The zinc finger transcription factor GATA-2 is highly expressed in immature hematopoietic cells and declines with blood cell maturation. To investigate its role in normal adult hematopoiesis, a bicistronic retroviral vector encoding GATA-2 and the green fluorescent protein (GFP) was used to maintain the high levels of GATA-2 that are normally present in primitive hematopoietic cells. Coexpression of the GFP marker facilitated identification and quantitation of vector-expressing cells. Bone marrow cells transduced with the GATA-2 vector expressed GFP as judged by flow cytometry and GATA-2 as assessed by immunoblot analysis. A 50% to 80% reduction in hematopoietic progenitor-derived colony formation was observed with GATA-2/GFP-transduced marrow, compared with marrow transduced with a GFP-containing vector lacking the GATA-2 cDNA. Culture of purified populations of GATA-2/GFP-expressing and nonexpressing cells confirmed a specific ablation of the colony-forming ability of GATA-2/GFP-expressing progenitor cells. Similarly, loss of spleen colony-forming ability was observed for GATA-2/GFP-expressing bone marrow cells. Despite enforced GATA-2 expression, marrow cells remained viable and were negative in assays to evaluate apoptosis. Although efficient transduction of primitive Sca-1(+) Lin- cells was observed with the GATA-2/GFP vector, GATA-2/GFP-expressing stem cells failed to substantially contribute to the multilineage hematopoietic reconstitution of transplanted mice. Additionally, mice transplanted with purified, GATA-2/GFP-expressing cells showed post-transplant cytopenias and decreased numbers of total and gene-modified bone marrow Sca-1(+) Lin- cells. Although Sca-1(+) Lin- bone marrow cells expressing the GATA-2/GFP vector were detected after transplantation, no appreciable expansion in their numbers occurred. In contrast, control GFP-expressing Sca-1(+) Lin- cells expanded at least 40-fold after transplantation. Thus, enforced expression of GATA-2 in pluripotent hematopoietic cells blocked both their amplification and differentiation. There appears to be a critical dose-dependent effect of GATA-2 on blood cell differentiation in that downregulation of GATA-2 expression is necessary for stem cells to contribute to hematopoiesis in vivo.

3T3 Cells↗