Resiliency: research and practical implications for pediatricians.
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Adaptation, Psychological↗
Biomedical subjects
W R Beardslee
Publications and source records attributed to W R Beardslee.
Depression among adolescent mothers: a pilot study.
Eighteen women less than 22 years old, who had their first child during adolescence, were assessed with a standard in-depth diagnostic interview for the presence of and/or history of depression and other disorders. Eight of the 18 women (44%) had experienced at least one episode of major depressive disorder at some point in their lives. A majority of episodes had their onset during pregnancy. Moreover, six women (33%) were experiencing a diagnosable form of depression at the time of the interview. Most of the women who had been depressed experienced at least part of their depression while they were raising their children. Whereas these preliminary findings need to be replicated due to the small sample size, they draw attention to the need for the integration of mental health assessment and treatment in service programs for adolescent mothers.
Adolescent↗
Maternal depression: a concern for pediatricians.
Maternal depression is common in clinical experience but has not been fully addressed in the pediatric literature. Depression can refer to either depressive symptoms or a diagnosable depression. Depression among mothers occurs frequently, is persistent, and is related to other factors such as low social class and marital disharmony. Studies demonstrate an association between a mother's depression and adverse outcomes for her child including low birth weight, behavior problems, somatic complaints, poor growth, accidents, and affective illness. Affect and child-rearing characteristics of depressed mothers seem to be important factors in mediating these poor outcomes. Pediatricians have a special role in helping depressed mothers and their children.
Adult↗
Impact of severity and chronicity of parental affective illness on adaptive functioning and psychopathology in children.
We report on the impact of specific indexes of the severity and chronicity of parental depression, measures of familial discord, and demographic variables as predictors of impaired adaptive functioning and psychopathology in children. Seventy-two children and their mothers from 37 families were interviewed in person. At least one biological parent in each family had a depressive disorder but neither parent had a history of mania, schizophrenia, or schizoaffective disorder. Almost every measure of severity and chronicity of depression in the biological parents has a statistically significant association with currently impaired adaptation and the presence of a DSM-III-diagnosed disorder in the children, as do the measures of increased discord among married or separated parents. Depression in the mother is more strongly associated with increased psychopathology in the children than is depression in the father.
Adaptation, Psychological↗
Exposure to parental alcoholism during childhood and outcome in adulthood: a prospective longitudinal study.
The effects of children's exposure to parental alcoholism was assessed using records from an existing prospective 40-year longitudinal study of working-class families: 176 men who had grown up with an alcoholic parent or parents were compared with 230 men without such exposure. Degree of exposure to alcoholism in the childhood family environment was highly correlated in later life with alcohol use, alcoholism, time in jail, sociopathy, and death, but not with increased rates of unemployment, poor physical health, or measures of adult ego functioning. Most of the impairments observed occurred in those subjects who actually developed alcoholism. Exposure to alcoholism in the family environment and family history of alcoholism independently contributed to the later development of alcoholism.
Alcoholism↗
The impact of the threat of nuclear war on children and adolescents.
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Adolescent↗
An approach to evaluating adolescent adaptive processes: scale development and reliability.
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Adaptation, Psychological↗
But are they cases? Validity of DSM-III major depression in children identified in a family study.
The authors examine the validity of the diagnosis of major depression in nine children and adolescents assessed as part of a study of offspring of parents who had affective disorders. The authors conclude that these nine children were suffering from valid cases of affective disorder because disruptions in multiple domains of functioning accompanied the major depression. The seriousness of the impairment and the finding that few of these children received any treatment at all strongly suggest the need for a heightened awareness among clinicians about the seriousness of depression in children whose parents have affective disorders.
Adolescent↗
Prospective prediction of alcoholism and psychopathology.
A child psychiatrist made predictions of adult alcoholism and psychopathology using psychiatric histories obtained in adolescence from men followed prospectively for 40 years. Prediction of psychopathology reached significance but prediction of alcoholism was at chance level. This finding and the frequently suggested possible association between personality type and development of alcoholism are discussed.
Adolescent↗
Familial influences in childhood depression.
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Adolescent↗
Commitment and endurance: common themes in the life histories of civil rights workers who stayed.
First-person life histories of a group of civil rights workers who have maintained a long-term commitment to the Movement are summarized and analyzed. The importance of relationships with others, changes in the ways the workers viewed themselves, the development of faith in their work, and the reconciliation of their Movement experiences with those of their past life emerge as central themes in their accounts.
Adult↗
Children of parents with major affective disorder: a review.
The authors review published studies of the children of parents with major affective disorder and report the rates of diagnosable disorder in the children, their clinical symptoms and other behavioral disturbances, and the differing impact of parental illness at different ages and stages of development. There is significant risk to children in having parents with major affective disorder, and considerable impairment is evident in these children. The authors discuss the methodological issues in the studies and offer suggestions for future investigations.
Adolescent↗
The effects of infantile malnutrition on behavioral development: a follow-up study.
Thirty-one children and young adults who had been severely malnourished in infancy due to intestinal disease, were compared with sibling controls for psychometric intelligence, academic performance as judged by teacher ratings, and developmental history as judged by parental questionnaires. Older members of the sample were also examined on the Lincoln-Oseretzky Motor Development Scale and by a brief psychiatric interview. There were no significant differences between patients and controls on any outcome measure. Furthermore, previously malnourished individuals were performing at or above age equivalent norms on all psychological tests. The findings suggest that the adverse behavioral effects of severe infantile malnutrition observed in children below the age of 5 yr are, to a large extent, compensated during development when the children are raised in supportive home and school environments.
Child Behavior↗
Affective disorder in childhood: separating the familial component of risk from individual characteristics of children.
In studying the risk of affective disorder in children, the investigator must deal with the problem that there are two possible units of analysis: the child and the family. An analysis based on children must take account of the intercorrelation within a sibship to produce correct results, while a family-based analysis makes it difficult to investigate individual characteristics of children that help determine the net risk. A two-stage iterative approach to this problem is proposed, yielding estimates of the effect of family-based factors (parental illness, family social class, marital status of parents) and individual factors (age and sex of child, previous non-affective illness). This technique is applied to a sample of 275 children from 143 families representing a wide range of familial risk for affective disorder. The final family-based model (predicting at least one child with affective disorder in the sibship) indicates a six-fold increase in risk to the child associated with maternal affective disorder (P less than 0.001), a three-fold increase in risk associated with paternal affective disorder (P less than 0.05) and divorce or separation of the biological parents, and a suggestion of increased risk in the highest social class (P = 0.06). The excess sibship risk, due to child factors age, prior anxiety disorder, and prior childhood diagnosis, contributed significantly to the family prediction (P less than 0.001).
Anxiety Disorders↗
Psychiatric disorder in adolescent offspring of parents with affective disorder in a non-referred sample.
The relationship between parental psychopathology and psychiatric disturbance in 153 offspring aged 6-19 was assessed in 81 families randomly selected from a prepaid health plan. Offspring of parents with a history of affective disorders and of parents with non-affective psychiatric disorders had higher rates of psychiatric diagnoses and poorer adaptive functioning than children of parents who had never experienced a psychiatric illness. Offspring whose parents had affective disorder had a rate of affective disorder of 30% compared to a rate of 2% in the rest of the sample. This relationship between parental affective disorder and poor child outcome was observed when the separated and divorced families were removed from the analyses.
Adolescent↗
Generativity and community in mental health: continuity and challenge.
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Child↗
Developmental psychiatry: is there any other kind?
This paper describes the importance of the developmental perspective in psychiatry and addresses the lack of a developmental focus in the DSM-based descriptive empirical model. Although the publication of DSM-III in 1980 represented a "breakthrough" in psychiatry, the revisions of its diagnostic framework over the subsequent two decades have not adapted to the rapidly evolving changes in the field. In this paper we argue that, like once-grand theories, the breakthroughs in the diagnostic framework need to transform. The developmental perspective provides an interdisciplinary and conceptual framework linking facts and theories. It is inherent in different aspects of psychiatry and readily accommodates the descriptive-empirical model by means of inclusive concepts borrowed from developmental psychopathology and psychobiology. It also makes important contributions to a process-oriented approach to measurement. Developmentally operationalized and multidimensional constructs stand to broaden psychiatric domains beyond diagnosable disorders. This argues for preventive and early treatment interventions for a variety of mild, subthreshold, or delayed symptoms of various conditions, based on an understanding of the causal mechanisms and developmental processes involved.
Child Psychiatry↗
Adolescents and the threat of nuclear war: the evolution of a perspective.
The authors briefly review recent work in the area of the impact of the threat of nuclear war on children and adolescents. They explore some of the difficulties inherent in understanding the possible effects of the threat of nuclear war on children based on their research experience in the area.
Adaptation, Psychological↗