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A six-session group program model is described. It is designed to facilitate the adjustment of preschoolers to separation and divorce of parents. Goals are specified and the plan of each group session outlined. Some preliminary observations regarding outcome are discussed.
Parental conflict and children's behavioral and social adjustment were measured at two periods in 100 families entrenched in custody and visitation disputes. More frequent access to both parents was associated with more emotional and behavioral problems in the children; different effects were noted for boys and girls.
Thirty-eight children playing or observing a soccer game were the victims of a lightning strike which killed one other child. Interviews with the children and their families documented a number of emotional effects of this disaster, chiefly situational adjustment reactions. The most common reactions involved anxiety, particularly at times of storms. However, the most severely upset children exhibited sleep disturbances, separation anxiety, and nocturnal enuresis. One of two side-flash victims experienced depression for several months; the other experienced no significant emotional upset. Both suffered medical complications and had no memory for the incident. While all children reached at follow-up were doing quite well, those who were most upset by the incident were more likely to refuse to play soccer during the follow-up interval. Stories told to pictures of lightning revealed projections of the children's emotional upset, various defensive reactions to the incident and an increased sense of subjective probability for lightning injuries.
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The authors examined depressive symptoms and behavior disorders in 102 systematically interviewed children aged 7 to 17 years to elucidate the category of masked depression. They found that it was possible to diagnose these children using adult research criteria and that more children with depression were identified using a systematic interview than were identified using standard evaluation procedures. Although children with a depressive disorder may also exhibit behavior disorders that overshadow the depression, an alert clinician conducting a thorough interview should be able to identify the "masked" depression.
Twenty-three children involved in a school-bus kidnapping were studied from 5 to 13 months following the event. Each child suffered posttraumatic emotional sequelae. The author found that the children suffered from initial misperceptions, early fears of further trauma, hallucinations, and "omen" formation. Later they experienced posttraumatic symptoms consisting of posttraumatic play, reenactment, personality change, repeated dreams (including predictive dreams and those in which they died), fears of being kidnapped again, and "fear of the mundane." Differences between child and adult response to psychic trauma are discussed.
For this retrospective study, six adult patients in psychoanalytic psychotherapy participated in 45-min audiotaped individual sessions that focused on their reaction to the language deprivation they experienced following their immigration to the United States during their later childhood years. The content analysis of these sessions showed that all six patients experienced the impact of language deprivation in a strikingly similar way. Four consecutive stages were identified: withdrawal, despondency, adaptation, and integration. On the basis of these preliminary observations, the author makes tentative recommendations aimed at ameliorating the consequences of language deprivation in immigrant children and suggests systematic research on these children.
Physical or sexual abuse of children is a psychopathic situation wherein both the abused child and the problem parent require collateral therapy with the eventual aim of rehabilitating the family by reinstating the child. The abusive diathesis of the parent is rooted in her or his inadequately nurtured childhood.
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Divorce is frequent in our society. It is a "marker" of high stress periods that precede and follow it. The events surrounding it have clear negative effects on the physical and mental health of all those involved. The issues and the reactions, different for fathers and mothers and for children, are determined by the sex and developmental stage. The effects are interactive and events subsequent to the divorce influence the restoration of competent functioning. This paper examines these differential effects, methods of helping in the resolution process and opportunities of preventive work with this high risk population.
Sexual victimization of children is a relatively new area of enquiry and initial studies have been directed towards identification and etiology. It is only recently that treatment issues are beginning to be addressed. This paper first reviews the literature on the direct and indirect effects of sexual abuse on the child victim, and outlines five key issues in treatment. The major foci in treatment to date are described and a number of existing models, which have been devised to address these treatment issues, are briefly summarized.
The adjustment of pre-school and latency age children, at the time of a custody/access dispute between their parents, was studied in relation to the children's age, sex and whether they were living with a parent of the same or the opposite-sex. Few adjustment problems were noted; however, older children and boys were more vulnerable. Sex of custodial parent did not predict children's adjustment.
The process of bereavement in children ranges from the absence of grief to symptoms of anxiety and conduct disturbances. Some psychoanalytic opinion holds that the absence of grief, associated with lack of cognitive maturity, leads to the development of psychopathology later in life. Other writers describe a mourning response, taking the form of ambivalence, anxiety, and care giving, which may protect against subsequent depression. This paper describes the affective response in 16 children ages four to 17 years, two to three years following the death of a parent, in order to further characterize developmental aspects of the emotional repertoire of bereavement. Only children aged 12 and over were depressed according to the Poznansky Children's Depression Rating Scale and criteria in the DSM-III. Conduct disturbances were observed in the younger children and some of the older children and were correlated with depression in the group as a whole. This suggests that the expression of depressive affect depends on maturation and that the young child may register grief only through anxiety and negativism. Examples of this spectrum of responses are offered in two case vignettes.
The role of the family home as an attachment object was investigated in 57 preschool age children coping with the stress of a parental divorce. Results indicated that preschool age children of divorce exhibited an increased level of attachment to the family home as compared with children matched for age and socioeconomic status from intact family units who moved away from the family home. In addition, preschool age children who moved from the family home but show a high attachment to it demonstrate better behaviour adjustment than both the groups of children of divorce who showed low attachment after moving from the family home and the group who remained living in the family home after divorce (p less than .05).
In recent years abductions during divorce custody and access disputes have received greater attention from both the lay and medical press. However, little has been written on the psychopathology of the abductors or the impact on children of being kidnapped by a parent. In this study 20 cases of abduction, involving 20 parents and 37 children, were examined after the children had been located and returned to the custodial parent. Characteristics of the abduction and psychopathology seen in the children are compared to those of a control population. The outcome of assessments conducted by the family court clinic after the abductions are profiled.
This study investigated the mental health of Portuguese children in Canada. Preliminary work involved a survey of professionals serving the Portuguese community and the translation and assessment of a standardized child behaviour checklist. Forty-five Portuguese children and 45 non Portuguese children referred to a children's mental health centre were compared on demographic and family indicators and their referral source. There were similar proportions of boys and girls in the two groups, similar types of services were requested, and they had similar treatment histories. The Portuguese children were older at the time of referral and were more likely to be referred by educational agencies than the non Portuguese children. Portuguese families appeared to experience different stresses than non Portuguese families. Implications of these findings for the provision of culturally sensitive interventions for Portuguese children and their families are discussed.
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