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[Pathological protective and defensive reactions in early childhood].
A group of pathological defenses has been observed in infants between three and eighteen months of age who have experienced danger and deprivation to an extreme degree. The early defenses, "avoidance", "freezing", and "fighting", are apparently summoned from a biological repertoire on the model of "flight or fight". Before there ist an ego, pain ca bei transformed into pleasure of obliterated from consciousness while a symptom stands in place of the original conflict.
Psychiatric consultation for physically ill children.
In addition to age-appropriate information about his physical condition and its treatment, the child needs help with the feelings associated with being ill or injured. If the feelings are so powerful that a state of despair exists, or are strongly defended against with self-defeating and unresponsive behavior, consultation with the child psychiatrist should be requested.
Behavior symptoms in three transracially adopted Asian children: diagnosis dilemma.
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Narcissism and the self in homicidal adolescents.
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[Gabrielle or the story of a noise. "Mother-child" hospitalization in a case of breath holding spell].
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The psychological impact of the Intifada on Palestinian children in the occupied West Bank and Gaza: an exploratory study.
The mental health of 796 Palestinian children living in the occupied West Bank and Gaza Strip was assessed in terms of reported psychological status and behavioral symptoms. Results, interpreted within the context of the 1987 uprising (Intifada), indicate that exposure to political and military violence may be associated with the onset of conduct problems and fears, although active participation in the conflict may enhance self-esteem and shield children from development of psychological symptoms.
A preventive intervention program for bereaved children: problems of implementation.
A brief, standardized intervention program to facilitate children's adjustment to the terminal illness and death of a parent posed the following implementation problems: estimation of patient life expectancy; engagement of the family in crisis; adhesion to the parental guidance model; and termination of formal clinical intervention. Resolution of these issues is described, and adaptation of such programs to other high-risk populations is considered.
Treatment of attachment disorder of infancy in a neonatal intensive care unit.
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Child adaptational development in contexts of interparental conflict over time.
This multi-method study sought to identify parameters of developmental change and stability of child reaction patterns to interparental conflict in the context of family relations in a sample of 223 6-year-old children and their parents followed over the course of one year. Consistent with the sensitization hypothesis, interparental withdrawal and hostility each consistently and uniquely predicted child distress reactions to conflict even after analytically controlling for parental warmth. Associations were found across multiple domains of child responding (i.e., overt negative affect, subjective negative affect, internal representations) and both concurrent and prospective, autoregressive analyses. Results of the autoregressive path analyses indicated moderate stability in each of the domains of conflict reactivity over the 1-year longitudinal period.
A pilot study of school-age children of men with moderate to severe alcohol dependence: maternal distress and child outcomes.
This pilot study examined maternal characteristics and children's internalizing and externalizing problems among 53 families (26 alcohol-dependent men, 27 controls) recruited from the general community in a north-east metropolitan area. Comparisons by family type revealed significant differences in maternal depression, social support, life events and children's anxiety, depression and problem behaviors. Factor analysis and hierarchical multiple regression revealed that a maternal distress factor accounted for significant amounts of variance in child outcome variables in addition to that accounted for by fathers' alcohol dependence symptoms. Future studies of school-age children of alcohol-dependent men should routinely sample indices of maternal distress to improve assessments of children's developmental contexts.
Elective brief psychotherapy with children.
There does not as yet exist a clearly unifying concept of brief psychotherapy with children. Various forms of shortened treatment have been reported as successful. The technique described in this paper is a form of individual therapy based on psychoanalytic principles, especially those of ego psychology. It is primarily recommended for children who have suffered a real of symbolic object loss. Distinctive features include the early definition of a focus, a predetermined time limit, and careful attention to termination issues. The goals are relatively ambitious. When successful the therapy results in persistent psychodynamic changes. Case examples are used to illustrate how these positive results may occur through the medium of identification with the therapist, which permits a resolution or lessening of ambivalent dependence. This in turn allows the treatment experience to act as a model for future relationships with limited givers.
Family background and physical health of adolescents admitted to an inpatient psychiatric unit, II: Physical health.
The charts of 100 adolescents admitted to a special unit of a provincial psychiatric hospital were reviewed. These patients primarily had a conduct disorder (71.6% of boys and 77.5% of girls) or an affective disorder (6.6% of boys, 15.0% of girls). There was a higher incidence of congenital disorders in the population than expected, suggesting that such disorders may predispose to psychological troubles later in life. Convulsions also occurred more often in this population. Most patients (78.3% of boys and 85.0% of girls) had one or more medical diagnoses. Several potentially serious findings (anemia, pregnancy, hepatomegaly, thyroiditis) were first noted on the admission physical examination. Patients with conduct disorder had certain health problems that are likely to be the result of the psychiatric disorder, such as liver function changes in drug and alcohol abusers and abnormal Pap smears in sexually active girls with multiple partners. If these medical conditions are not followed and treated, they have the potential for causing serious problems at a later date. These findings point out the continued need for the expertise of psychiatrists and other physicians in children's mental health facilities.
Representations of attachment relationships in children of incarcerated mothers.
Representations of attachment relationships were assessed in 54 children ages 2.5 to 7.5 years whose mothers were currently incarcerated. Consistent with their high-risk status, most (63%) children were classified as having insecure relationships with mothers and caregivers. Secure relationships were more likely when children lived in a stable caregiving situation, when children reacted to separation from the mother with sadness rather than anger, and when children were older. Common reactions to initial separation included sadness, worry, confusion, anger, loneliness, sleep problems, and developmental regressions. Results highlight need for support in families affected by maternal imprisonment, especially efforts to promote stable, continuous placements for children, in addition to underscoring the importance of longitudinal research with this growing but understudied group.
Habit disorders--prevalence and etiology.
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Family background and physical health of adolescents admitted to an inpatient psychiatric unit, I: Principal caregivers.
A retrospective chart review of 100 consecutive adolescents discharged from a provincial psychiatric hospital adolescent unit was conducted. At the time of admission, eighty-four percent no longer lived with one or both of the biological parents. The children remained with the mother more often than with the father. However, boys who had lost their principal male caregiver more often acquired a new one, compared with girls. The latter tended to remain more in a single-mother home. Thirty-four patients were no longer in the care of either parent at admission. Seventy-four had a conduct disorder. Members of this group were more likely to have lost one or both parents. Recent loss of a parent seemed to be related to a combined diagnosis of depression and conduct disorder. Parental loss was not prominent among one class of the patients with conduct disorder--those with under-socialized aggressive disorders. The latter were often still in their intact biological family of origin, and in four instances they presented serious cases of aggressive actions in the absence of any history of parental deprivation.
Are ataques de nervios in Puerto Rican children associated with psychiatric disorder?
OBJECTIVE: To provide the first empirical analysis of a cultural syndrome in children by examining the prevalence and psychiatric correlates of ataques de nervios in an epidemiological study of the mental health of children in Puerto Rico. METHOD: Probability samples of caretakers of children 4-17 years old in the community (N = 1,892; response rate: 90%) and in clinical services (N = 761; response rate 72%) were administered structured interviews to assess the presence and correlates of ataques de nervios. RESULTS: Nine percent of children in the community sample and 26% of children in the clinical sample had a reported history of an ataque de nervios. In contrast to the overall community and clinical samples, which had more boys in them, the ataque de nervios groups in both samples had more girls in them. Family history of ataques de nervios was associated with ataques de nervios in children in both samples. Across a wide range of depression, anxiety, and disruptive disorders, children who reported an ataque de nervios were more likely to meet research criteria for psychiatric disorder in both samples. CONCLUSIONS: Ataques de nervios are a frequently reported cultural syndrome among children in Puerto Rico. Adolescent girls are more likely to report this experience. Ataques de nervios have a significant relationship with psychiatric disorder and impairment in Puerto Rican children.
Mediators of the relation between maternal depressive symptoms and child internalizing and disruptive behavior disorders.
Drawing on a normative sample of 224 youth and their biological mothers, this study tested 4 family variables as potential mediators of the relationship between maternal depressive symptoms in early childhood and child psychological outcomes in preadolescence. The mediators examined included mother-child communication, the quality of the mother-child relationship, maternal social support, and stressful life events in the family. The most parsimonious structural equation model suggested that having a more problematic mother-child relationship mediated disruptive behavior-disordered outcomes for youths, whereas less maternal social support mediated the development of internalizing disorders. Gender and race were tested as moderators, but significant model differences did not emerge between boys and girls or between African American and Caucasian youths.