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Biomedical subjects

H L MacMillan

Publications and source records attributed to H L MacMillan.

25 records · Page 2Linked to original sources

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↗

Public health nurse home visitation for the tertiary prevention of child maltreatment: results of a pilot study.

The purpose of this pilot study was to assess the feasibility of using public health nurse home visitation for the tertiary prevention of child maltreatment. The intervention was designed to provide support to the parents, education about child-rearing and child development and to assist families obtaining help from other services. Eighteen families referred from the Hamilton-Wentworth child protective agencies participated in the intervention. Enrolment criteria included first episode of suspected or verified child physical abuse or neglect, ongoing involvement with a child protective agency, index child less than 12 years of age and remaining in the home, and agreement to participate in the study. Home visits were provided weekly on average over a period of six months and the nurses were available by telephone. Pilot assessment included review of medical records, semi-structured interviews to gather background information, checklists of child-rearing attitudes, child behaviour and development. The participants were interviewed about their response to the intervention. The high degree of mobility of the families posed a problem in recruitment. Nevertheless, the public health nurses were able to develop a working alliance with 14 of the 18 families (77%) who participated. The participants gave permission for review of their medical records and reported that the methods of assessment were acceptable. The authors conclude that the intervention and assessment procedure are feasible and acceptable for preventing the recurrence of child maltreatment. Any decision about effectiveness of the intervention awaits a longitudinal, controlled trial.

Adult↗

Outcome, prognosis, and risk in a longitudinal follow-up study.

This study reports the results of a 4-year follow-up of a community sample of children who were ages 4 to 12 in 1983 at the first wave of data collection. Results on outcomes revealed that conduct disorder showed the greatest stability especially from late childhood to early adolescence. In multivariate analyses, both family dysfunction and problems getting along with others significantly predicted the persistence of one or more psychiatric disorders 4 years later, and low income predicted one or more psychiatric disorders among children free of disorder 4 years earlier. The implications of the results for the child psychiatric field, especially prevention, are discussed.

Adolescent↗