Lemonade out of lemons--tinnitus retraining therapy.
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Counseling↗
Biomedical subjects
S Nagler
Publications and source records attributed to S Nagler.
The psychological effects of parental human immunodeficiency virus infection on uninfected children.
OBJECTIVES: To assess the mental health of children of mothers infected with the human immunodeficiency virus. DESIGNS: Matched comparison of 26 children of mothers infected with the human immunodeficiency virus and 26 children with no experience of human immunodeficiency virus infection within their families. SETTINGS: Subject children were identified through hospital acquired immunodeficiency syndrome clinics and comparison children were identified through the primary care center of the same hospital. PARTICIPANTS: Subjects and controls were aged 6 to 16 years and matched by age, sex, race, and maternal marital and employment status. MAIN OUTCOME MEASURES: Parents completed the Child Behavior Checklist and the children completed the Revised Children's Manifest Anxiety Scale and the Children's Depression Inventory. RESULTS: Controlling for confounding variables, subjects were found by the Child Behavior Checklist to be significantly more withdrawn (P < .05) and to have more problems with attention (P < .005) than controls, although total Child Behavior Checklist scores were not significantly different. Compared with control children, the subject children reported more depression on the Children's Depression Inventory (P < .05) but were not more anxious. However, compared with children of asymptomatic mothers, the children of symptomatic mothers were reported to be significantly more anxious and/or depressed on the Child Behavior Checklist (P < .01) and the children reported more anxiety on the Revised Children's Manifest Anxiety Scale (P < .05). CONCLUSIONS: This study focusing specifically on uninfected children in families affected by the human immunodeficiency virus demonstrates some of the psychological ramifications of this disease. Larger studies are required to identify factors that contribute to the vulnerabilities and resilience of such children. Attention needs to focus on ameliorating these adverse effects on the children of the acquired immunodeficiency syndrome epidemic.
Acquired Immunodeficiency Syndrome↗
Anxiety and autonomy in adolescence among father-orphaned kibbutz children.
The aim of the study was to measure levels of anxiety and autonomy in non-clinically referred kibbutz orphaned and non-orphaned adolescents. The performance of 28 kibbutz adolescents orphaned when aged 2-10 was compared to 42 non-orphaned kibbutz adolescents on the Manifest Anxiety Scale for Israeli Children, the Autonomy of the Child Test and on a general data questionnaire. Results showed that when total populations were considered, no significant differences were found on levels of manifest anxiety and levels of autonomy. When the groups were further broken down according to gender and age, it was found that older orphan girls manifested significantly greater anxiety than any group and significantly lower autonomy than older non-orphan girls. A rationale linking the vulnerability of older orphan girls to adolescent developmental theory is suggested.
Adolescent↗
Review of the NIMH Israeli Kibbutz-City Study and the Jerusalem Infant Development Study.
The National Institute of Mental Health (NIMH) Israeli Kibbutz-City Study has followed the development of offspring of schizophrenic parents from middle childhood through early adulthood. During childhood, a subgroup of offspring of schizophrenic patients showed clear neurobehavioral deficits often accompanied by poor social competence. Early followup data suggest that this subgroup of high-risk children is at greatest risk for adult schizophrenia spectrum illness. The Jerusalem Infant Development Study has followed a similar population of children at risk for schizophrenia from before birth through middle childhood. A subgroup of dysfunctioning in the high-risk children showed sensorimotor dysfunctioning in the first year of life, which was followed by perceptual, motor, and attentional dysfunctioning in childhood--identical to that found in the NIMH cohort. Results from both studies support the hypothesis that schizophrenic illness involves constitutional factors whose expression can be observed as early as infancy. Results also illustrate the importance of using data-analytic approaches that (1) look for subgroups within high-risk groups rather than only group differences between high- and low-risk groups, and (2) examine profiles of behavior rather than only single variables.
Adolescent↗
Clinical observation of high-risk children.
Systematic observations of the behavior of high-risk and control children were made during the clinical interview, the neurological examination, psychometric testing, and the experimental psychological test battery. Children were unaware that observations of them were being made and recorded. In all four examination settings, index children were seen as impaired relative to control children in their communication skills, ability to relate to the examiners, and motor behavior. There were no consistent differences between town and kibbutz subjects, and no interactions with genetic background. However, index boys showed a general trend toward greater pathology than index girls.
Child↗
Clinical-subjective evaluation of high-risk children: integration and discussion.
Clinical evaluations of index and control children from the point of view of the clinical interview, observations of the subjects during testing, the subjects' parents, and their teachers were compared. There was general agreement that index children showed more psychopathological symptoms, poorer ego development, poorer interpersonal relations, and poorer use of leisure time than their controls. By contrast, behaviors related to aggression, phobias, shame, sleep pathology, eating disorders, frustration tolerance, sexual behavior, and verbal communication skills failed to show consistent group differences. Index boys showed greater anxiety than their controls, while there were no such differences among the girls. Rearing environment exerted no apparent effect on the psychosocial functioning of the children. Factor analysis disclosed that a general factor, accounting for 32.6 percent of the variance, discriminated between index and control children, while several special factors, which represented rarely seen traits, did not discriminate. Group differences, therefore, appeared to stem from global impairment of psychosocial functioning rather than from several distinct patterns of deficit. The present results are in general agreement with previously reported evaluations of children at risk for schizophrenia.
Adaptation, Psychological↗
Adult outcomes of high-risk children: differential effects of town and kibbutz rearing.
We conducted a followup study 15 years after the initial examination of 46 of the Israeli children at risk for schizophrenia (index cases) and 44 of the control children. Thus, we were able to contact and examine 90 of the surviving 99 subjects of the investigation. Half of the subjects had grown up in the communal child-rearing setting of a kibbutz, and half had been raised by their own parents in cities in Israel. The kibbutz-index cases, at average age 25, show the highest incidence of psychiatric disorder. Environmental factors that may have led to this outcome are discussed.
Adult↗
Introduction: the Israeli high-risk study.
The literature on theories of the etiology of schizophrenia (the "nature-nurture dilemma") is reviewed, and the rationale is explicated for a study comparing the development and outcome of kibbutz- and town-reared children of schizophrenic parents. Various possible outcomes of the kibbutz-rearing experience in vulnerable children are discussed. The research team and the time table are described.
Adaptation, Psychological↗
Overall design and methodology of the Israeli high-risk study.
The unique contribution of the Israeli high-risk study is the comparison of children at risk for schizophrenia with matched controls in two settings: those raised in nuclear families in towns, and those raised in children's houses on kibbutzim. Such a design makes possible direct comparison of genetic and environmental effects on the psychosocial functioning of a group of high-risk children, over time. In this article we describe methods of collecting and examining the sample, provide an overview of the examination procedures, and describe the basic principles of data analysis.
Adolescent↗
The clinical interview.
Subjects were given in-depth interviews aimed at assessing their level of functioning within their families, with peers, at school, and in leisure activities. Subjects were interviewed when the mean age of the study population was 11 and again at mean age 16. At the time of the first interview, index subjects were impaired relative to controls in interpersonal relations, work and play activities, self-esteem, and mood. There were no apparent differences due to rearing environment or sex, and no interactions with genetic background. At the time of the second interview, index-control differences were even more widespread, with index children showing impairment in virtually all examined areas of psychosocial function. Again, there were no group differences or interactions involving environment or sex. While index and control subjects remained highly discriminable from preadolescent to adolescent periods, there was less evidence of symptom stability in individual subjects over the 5-year period.
Adolescent↗
Obituary to Dr. B. Gruenspan.
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History, 19th Century↗
Some ideological considerations underlying a mental health consultation program to the public schools.
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Affective Symptoms↗
Preventing out-of-home placement for high-risk children.
Preventing the removal of high-risk children from their families is investigated through two community-based programs. One program followed a day treatment model; the other used a home-based approach. These programs treated populations that shared common features but also had important differences. In both programs, a high percentage of children were maintained in the home and were still at home one year after discharge. It is suggested that such community-based intervention programs enhance the likelihood that high-risk children can remain with their families.
Adolescent↗