SEARCH · PubMed Health
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.
A model of time-limited intervention groups for parentally bereaved children is described, and common emergent themes are discussed. These suggest that youngsters continue to struggle with death-related stress well beyond the time of the loss. The need to maintain an emotional attachment to internal representations of the deceased parent appears to be an important component of the bereavement process.
A framework is presented for a new field called developmental victomology, and two major branches are described. One would analyze developmental changes that affect children's risk for victimization, particularly in three areas: children's suitability as targets, their ability to protect themselves, and the environments they inhabit. A second branch would focus on developmental processes that affect children's reactions to victimizations and in particular, developmental tasks and critical periods, the process of cognitive appraisal, and the forms of symptom expression.
The relationship between defense mechanisms and symptoms was assessed in a group of 196 psychiatrically hospitalized adolescents. Defense mechanisms were measured through the use of the Defense Mechanisms Inventory (DMI); symptoms and problem behaviors were measured with the Youth Self-Report. Univariate and multivariate analyses indicated that externalizing symptoms are associated with defenses that locate the conflict outside of the self, whereas internalizing symptoms are associated with defenses that locate the conflict within the self. In contrast to previous reports, no gender differences were found in defense preference, though gender differences were found in the relation of defenses to symptoms. The findings are consistent with clinical theory of defense processes and support the distinction between internalizing/externalizing behaviors and personality dimensions for both symptoms and defenses. The study supports the validity of the adolescent form of the DMI.
With increasing frequency, we are observing the phenomenon of the parentally abandoned or rejected child. This can in large measure be attributed to several social/historical developments in American society (Crandall and Grossberg, 1978). Important factors contributing to the phenomenon include the much publicized "breakdown" of traditional family structures; increasing divorce rates; the urbanization of the American population, which creates a cloak of social anonymity; and the establishment of a state/federal welfare bureaucracy, which in part supplants the caretaking functions traditionally carried out by parents. Children who become the victims of parental abandonment find themselves in circumstances in which they come to the attention of an remain, at least for a time, the responsiblity of the legal system and the mental health professions. The interaction of these two institutions, with their overlapping obligations of responsibility toward protecting children, often creates its own problems. Problems arise in part from the somewhat different "interests" of children whom the legal and mental health professions seek to protect and in part from a lack of mutual understanding and knowledge concerning the respective goals, duties, and professional obligations of the two professions. By becoming familiar with the complexity of legal issues which surround the topic of intrafamily relationships in general and parental rights in particular, the psychiatric practitioner can anticipate certain problems which might occur during the course of treatment and can in some instances specify conditions or introduce safeguards in order to minimize the impact of legal intrusions upon the treatment program. The following discussion is designed to help the practitioner to achieve these goals.
Parental divorce can be conceptualized as a stressful event for all children, but one must recognize that reactions to divorce can vary widely among children. This investigation was based on two basic ideas: 1) children of divorce as a group would show deficits in academic performance compared to children from intact families, even several years after their parents' separation, and 2) because factors that promote psychological resilience and vulnerability, we expected to find normal heterogeneity within the divorce sample. Among 96 middle-school adolescents from a suburban school district near Denver, children of divorce showed significant performance deficits in academic achievement, as reflected in grade-point average and scholastic motivation in middle school, but not in nationally normed tests of scholastic aptitude and other less direct measures of behavioral conformity. An analysis of GPA over time revealed strikingly disparate patterns of achievement between divorce and control groups. Corresponding patterns of scholastic aptitude scores, absence from school and comportment revealed no systematic differences over time. These results suggest strongly that parental divorce can be a critical event in the academic development of children. Large differences in academic achievement between our divorce group as a whole and the controls cannot be attributed, at least at the time of sampling, to differences in social class or intellectual ability. Despite a similar family background, i.e., marital dissolution, a minority of the children of divorce showed vulnerability in the pattern of academic achievement over time while the majority demonstrated academic careers not unlike that of the controls.
Chronic violence is a growing problem in our society today as evidenced, among other factors, by the ever-increasing murder rate in many of our large urban centers in the United States. Emphasis has begun to be placed on chronic violence, causes that may contribute to it, and the impact of this violence on cities and the country at large. While concern has been expressed, we still have not addressed adequately, nor do we fully understand, the effects on the children who must grow up in environments where they are repeatedly being exposed to significant levels of violence.
Community violence that victimizes children is an unmitigated evil that is exacerbated by vast economic and social forces that leave people in central cities and the rural countryside adrift on seas of rolelessness, hopelessness, group disintegration, and alienation. The contemporary drug scene and the easy availability of guns greatly intensify violence on a local scale, while crimes of violence, especially with guns, appear to be level or declining in the nation as a whole. Claims that the persistently high levels of violence in mass media, mostly television, are largely responsible for violence in society represent narrow views of very large issues. These narrow views overlook essential elements of both phenomena--violence and media. Direct models of interpersonal violence in families and in the community probably give rise to more violent behavior than indirect models in media. Disinhibitory and provocative aspects of media probably do as much or more to trigger violent behavior than violent narratives and violent actions. Comprehensive meta-analysis indicates that prosocial messages on television can have greater effects on behavior than antisocial messages. These data support the contention that mass media can play a strong and positive role in alleviating some of the distress of victims of community violence, and in redirecting the behavior of some of its perpetrators so as to protect the children.
AIDS has left tens of thousands of children with dead or dying parents. This epidemic is forcing us to take a new look at loss in childhood, paying attention to the impact of the social and cultural forces in these children's surroundings on their internal/psychological worlds. This chapter is a preliminary attempt to examine these factors, integrating psychoanalytic concepts, the sociocultural context, and treatment issues. Clinical vignettes are used to illustrate throughout.
The term childhood traumatic grief (CTG) is being increasingly used to refer to the particular reaction in children that may follow the death of a loved one during a traumatic event. The goal of this case study is to describe the theoretical argument and framework for, as well as a clinical example of, cognitive-behavioral therapy (CBT) for CTG. We present a case of a five-year-old boy whose father, a firefighter, died in the line of duty at the World Trade Center on September 11, 2001. This specific case will highlight the steps of CBT for CTG, the value of assessment during the therapeutic process, and the need to consider developmental and family factors in treatment.
A survey of inpatient psychiatric social workers and a review of inpatient charts indicate that while social workers believe the inclusion of the patients' children in their practice is important, their documentation rarely reflects such activity. The authors review relevant literature on the effect of parental psychiatric illness on children, discuss the apparent schism between theory and practice, and consider the clinical and policy implications of these findings.
Managing psychological distress is a central treatment goal in Pediatric Intensive Care Units (PICUs), with medical and psychological implications. However, there is no objective measure for assessing efficacy of pharmacologic and psychological interventions used to reduce distress. Development of the COMFORT scale is described, a nonintrusive measure for assessing distress in PICU patients. Eight dimensions were selected based upon a literature review and survey of PICU nurses. Interrater agreement and internal consistency were high. Criterion validity, assessed by comparison with concurrent global ratings of PICU nurses, was also high. Principal components analysis revealed 2 correlated factors, behavioral and physiologic, accounting for 84% of variance. An ecological-developmental model is presented for further study of children's distress and coping in the PICU.
OBJECTIVE: To assess psychological adjustment in children living with human immunodeficiency virus (HIV) and their primary caregivers. METHODS: The study protocol included use of standardized questionnaires to assess emotional and behavioral health of 57 children and 54 caregivers (Phase 1). Positive screening led to standardized interviews to assess current psychiatric diagnoses (Phase 2). RESULTS: Of the 16 children who entered Phase 2, 6 (38%) met the criteria for a psychiatric diagnosis. Of the 15 adults who met the screening criteria, 13 completed a computerized psychiatric interview and all 13 (100%) met the criteria for a psychiatric diagnosis. CONCLUSIONS: While important mental health needs were identified in families with HIV, the majority of families did not exhibit mental health disorders. These results might reflect the substantial psychosocial resilience of these families. Further study is needed to determine to what extent the mental health needs of children and their caregivers are being met. In addition, identification of protective factors in resilience and coping in families living with a chronic illness is warranted.
Although a substantial number of children experience serious parental illness and death, the adjustment problems attendant to the stress of having a fatally ill parent have not been examined systematically. This paper compares the psychosocial adjustment of 62 school-aged children with a terminally ill parent (study sample) with that of children in a community sample, using several standard rating scales. Study children had significantly higher levels of self-reported depression (Children's Depression Inventory) and anxiety (State-Trait Anxiety Inventory) and lower self-esteem (Self-Esteem Inventory). Parents also reported study children's significantly higher behavior problems and lower social competence (Child Behavior Checklist). Increased professional attention to this vulnerable population is encouraged.
Explore the source record for details and available documents.
This study investigated the additive and interactive effects of multiple risk, emotionality, and self-regulation in predicting children's adjustment problems and positive adjustment using a community sample (N = 101) of children in third through fifth grades. Multiple measures of emotionality and self-regulation were used, including observational measures and mother and child report on questionnaires. Results indicated that questionnaire measures of emotionality and self-regulation predicted children's positive and negative adjustment over and above the effects of multiple risk, as well as resilience and vulnerability. Negative emotionality predicted adjustment problems, positive emotionality predicted positive adjustment, and self-regulation predicted both. In addition, observational measures of self-regulation moderated the association between multiple risk and adjustment such that children low in self-regulation were more vulnerable to multiple risk. The results suggest that emotionality and self-regulation operate as additional risk and protective factors in multiple-risk models.
Explore the source record for details and available documents.
This article examines the comparative prevalence of grief reactions, behavioral symptoms and 'pathological bereavement' in 25 kibbutz and 21 non-kibbutz children aged between 3 1/2 and 11 1/2 yr eighteen months after the death of the father in war. The findings indicate that in both kibbutz and urban settings the loss of a father becomes a serious traumatic situation for a large proportion of the children, influencing multiple areas of functioning and causing manifold behavioral symptoms. The particular differences regarding the quality of the reactive symptoms exhibited by kibbutz and non-kibbutz children appear to be related to the different sociocultural surrounding influences.
This paper is concerned with preparing paediatric patients for hospitalisation. It is concluded that most work has focused on children requiring short-stay hospitalisation for minor surgery. All of the main techniques in use (pamphlets, video or pre-admission nursing contact) appear more beneficial to the patient and family than routine care, but no method is superior. Little attempt has been made to modify the technique according to the age of the child. It is suggested that greater benefits to the child might occur where information about illness is made appropriate to the child's cognitive level. The implications of developmental changes in children's beliefs about health and illness for such education are discussed.