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PubMed1995

[Protein profile in malnutrition states of the Ivory Coast child].

Prospectively assessment of nutritional status, besides anthropometric parameters measurements, included determination of the following plasma proteins: albumin, transferrin, retinol-binding protein and thyroxine-binding prealbumin, usually regarded as useful indices of protein depletion states. Patients' inflammatory or infectious diseases were investigated by measuring the two most reliable acute-phase reactants (orosomucoid and c-reactive protein). This study was conducted on a group of 56 pediatric patients malnourished and 54 age- and sex-matched healthy subjects as controls. Data showed a higher prevalence of inflammatory process during the course of malnutrition as revealed progressive but severe alteration of the Prognostic Inflammatory and Nutritional Index (PINI) or CRP x a1-GPA/Alb x TBPA. On the other hand, kwashiorkor and marasmus seemed to be a precipitating cause of infectious or/and inflammatory process. We, therefore, conclude that the PINI scoring system should be for the pediatricians, a sensitive and precious tool allowing the correct follow-up of inflammatory pole in nutritional disorders in developing countries.

Blood Proteins↗
PubMed2006

Changing toddlers' and preschoolers' attachment classifications: the Circle of Security intervention.

The Circle of Security intervention uses a group treatment modality to provide parent education and psychotherapy that is based on attachment theory. The purpose of this study was to track changes in children's attachment classifications pre- and immediately postintervention. Participants were 65 toddler- or preschooler- caregiver dyads recruited from Head Start and Early Head Start programs. As predicted, there were significant within-subject changes from disorganized to organized attachment classifications, with a majority changing to the secure classification. In addition, only 1 of the 13 preintervention securely attached children shifted to an insecure classification. Results suggest that the Circle of Security protocol is a promising intervention for the reduction of disorganized and insecure attachment in high-risk toddlers and preschoolers.

Adolescent↗
PubMedDate not supplied

Earned-secure attachment status in retrospect and prospect.

Past research with the Berkeley Adult Attachment Interview demonstrates that retrospectively defined earned-secures (who coherently describe negative childhood experiences) parent as effectively as do continuous-secures (who coherently describe positive childhood experiences), but manifest liabilities in the form of depressive symptomatology. This article presents data from a 23-year longitudinal study that replicate and extend prior research, testing a key premise that earned-secures so defined actually have a history of insecure attachments that change over time and/or endure consistently harsh or ineffective parenting in their youth. Discrepant with assumptions, retrospective earned-secures were not more likely than continuous-secures to have been anxiously attached in infancy and were observed in childhood and adolescence to have encountered among the most supportive and structured maternal parenting in a high-risk sample. Prospectively defined earned-secures (operationalized using participants' infant attachment classifications) did indeed go on to have success in their close relationships, many without reporting relatively high levels of internalizing distress in adulthood.

Adaptation, Psychological↗
PubMed2005

[Children's drawings: a case study of the psychotherapeutic treatment of a seven year old boy].

The paper explores the meaning of childrens' pictures as a symbol for growing autonomy. The psychotherapy of a 7-years old turkish boy, who came to treatment with a destroyed identity, will be described. The parents failed to support the boy's development by adequate mothering. The aggressive symptomatic as it emerged at the beginning of the psychotherapy is shown in a shipwreck. During therapy he succeeds to develop age-appropriate autonomy that is shown in a series of drawings.

Aggression↗
PubMed2005

"What is genuine maternal love"? Clinical considerations and technique n psychoanalytic parent-infant psychotherapy.

The question of what is genuine maternal love was posed by a mother struggling to understand and value the nature of her bond with her small baby. The question surfaced time and again in the context of this dyad's long-term parent-infant psychotherapy and has challenged me to examine my thinking and, indeed, has produced impassioned discussions within the Parent Infant Project team at The Anna Freud Centre. In this paper I will address this question through sessional material of this mother and baby and discuss issues of technique in response to it, including my countertransference and conceptualization.

Adult↗
PubMed1978

Affective disorder in Asian immigrants.

Socio-cultural factors play a contributory role in presentation and symptomatology of affective illness. Cultural shock, communication barriers, fear of loss of racial identity, different child rearing attitudes and dietary restrictions may all contribute towards the manifestation of reactive depression. An understanding of the immigrant's background will greatly help the therapist in management of his patient.

Adjustment Disorders↗
PubMed2004

Platelet 5-HT uptake in boys with conduct disorder.

Dysregulation of serotonergic function has been found to be associated with aggression in animals, human adults and adolescents. However, studies with children have shown conflicting results. The objective of this study was to investigate whether the kinetic characteristics (Vmax and Km) of 5-HT uptake in platelets are different in children with the diagnosis of conduct disorder according to ICD-10 and healthy age-matched controls. In addition to the standardized assessment of general psychopathology, methods assessing narrowband aggressive symptoms (Child Behavior Checklist) and emotional reactivity to an experimentally induced provocation (Taylor's competitive reaction time task) were used in both groups. We found a trend for a lower mean Vmax of platelet 5-HT uptake in 14 conduct-disordered boys compared with healthy controls (n=15). If, however, 2 patients with a low degree of aggression and emotional reactivity were excluded, the difference became significant (mean=4.27, SD=3.49 in patients and mean=8.45, SD=4.63 in controls). A significant negative correlation was found between parent-rated aggression scores and Vmax (r=-0.41, p < 0.05, n=29). These data suggest that dysfunction of 5-HT transport mechanisms might be associated with specific behavioral symptoms in conduct-disordered children.

Adolescent↗
PubMed2000

Attachment disorder behavior following early severe deprivation: extension and longitudinal follow-up. English and Romanian Adoptees Study Team.

OBJECTIVE: To examine attachment disturbances and disorder in a sample of children adopted into the U.K. following severe early privation and in a comparison sample of nondeprived, within-country, early-placed adoptees. METHOD: The subjects, 165 children adopted from Romania and 52 adoptees from the U.K., were assessed at age 6 years; longitudinal data (at ages 4 and 6 years) were available on the 111 Romanian adoptees placed in U.K. homes before 24 months of age and on all U.K. adoptees. Information on attachment disorder was derived from a semistructured interview with the parent; in addition, data on children's cognitive and social development were assessed using standardized assessments. RESULTS: Analyses revealed a close association between duration of deprivation and severity of attachment disorder behaviors. In addition, attachment disorder behaviors were correlated with attentional and conduct problems and cognitive level but nonetheless appeared to index a distinct set of symptoms/behaviors. Finally, there was marked stability in individual differences in attachment disorder behaviors and little evidence of a mean decrease over this 2-year period. CONCLUSIONS: The findings offer construct validation for the attachment disorder construct and highlight clinical and conceptual questions that require further research.

Adoption↗
PubMed2004

Emotional reactivity in children with attention-deficit/hyperactivity disorder.

OBJECTIVE: This study examined Barkley's (1997b) theory regarding the emotional regulation of children with Attention-Deficit/Hyperactivity Disorder (ADHD). METHOD: Mothers of children with and without ADHD between the ages of 6 and 15 were asked to rate their child's emotional response on each of three measures. RESULTS: Children with ADHD were rated as significantly more emotionally reactive to both immediate and future events than were children without ADHD. Differences at both the immediate and future time periods were stronger in response to negative as opposed to positive emotional events. In response to the consequences of their behavior, however, children with ADHD were rated as less emotionally reactive than children without ADHD. DISCUSSION: Conclusions are made in reference to Barkley's theory and implications are explored.

Adolescent↗
PubMed1975

Some recent developments in psychiatric genetics.

The methods and results of some recent family, twin and adoption studies of childhood behaviour disorders, crime, alcoholism, psychopathic personality and neurosis are briefly described. The data of Slater (1938) on the parents and children of manic-depressives are reanalysed. Bipolar affective illness were more frequent in the families of bipolar than unipolar probands. There was no support for sex-linked inheritance in either group or for further genetic subdivision of the unipolar group according to age of onset or alcoholic or psychopathic family history. It is suggested that for the time being we may have to be satisfied with three broad and aetiologically overlapping clinical types of depression: bipolar, unipolar and reactive.

Adoption↗
PubMed2006

[Predictors of antisocial behaviour. Peripheral psychophysiological findings in children and adults with conduct disorder].

Many studies have shown that psychophysiological parameters of processing emotional stimuli are associated with different personality traits in children, adolescents, and adults. Individuals with low autonomic baseline arousal, low orienting reaction, accelerated habituation, and reduced excitability particularly to punishing stimuli are characterised by a reduced experience of anxiety, decreased behaviour inhibition, and increased sensation seeking. These characteristics seem to raise the likelihood of dis-social behavior and are perceived as prognostically favourable for the development of antisocial personality disorders in childhood and adolescence. In contrast, an increased disposition towards anxiety, which is associated with increased autonomic reactivity, is recognised as a protective factor. Current data have shown that through special training, child and adolescent autonomic reactivity could be enhanced. Due to its versatility, this biological marker might be used for prevention in children at greater risk of developing antisocial behaviour.

Adult↗
PubMed1987

Child and family attributes of failure-to-thrive.

Forty-one Boston children hospitalized with non-organic failure-to-thrive (FTT) were matched with 41 control subjects on age, socioeconomic status (SES), sex, and race. A precoded maternal interview was used to evaluate family stress, isolation, infant health, and the temperament and social maturity of the child. A regression analysis was performed with 27 variables thought to be potentially associated with the FTT diagnosis. Ten variables explained 81% of the between group variance on F-tests. The most significant distinctions were poor child health (p less than 0.001), high reactivity to visual and auditory stimuli (p less than 0.001), and disordered feeding interaction (p less than 0.005). Other case-comparison differences included social isolation, few maternal opportunities to escape caregiving, the presence of a male adult in the family, fewer available extended family, fewer violent disagreements between parents, greater number of maternal unmarried years. Children with FTT appeared to have developmental idiosyncrasies. These conspire with social and familial factors to yield the current profile of non-organic FTT. This study questions whether such findings are the cause of FTT or are better understood as a result.

Child Abuse↗
PubMed2002

[Attachment representation of adolescents in residential care].

In this investigation the attachment representations of adolescents in residential care were examined for the first time. 72 adolescents were interviewed by using the Adult Attachment Interview (AAI). At the same time the degree of adolescent psychopathology was recorded. For this purpose the caregivers completed Achenbach's Child Behavior Checklist (CBCL), the adolescents themselves answered Achenbach's Youth Self Report (YSR). The adolescents in this sample proved to be severely burdened in psychopathological terms. They had access to only an insecure and, in many cases, an extremely insecure attachment representation. For a sub-group of adolescent mothers the early infant-mother attachment was examined using Ainsworth's Strange Situation. The findings show an intergenerational transmission of insecure attachment relationships. The implications of these results for the practice of residential care inspired by attachment theory are discussed.

Adolescent↗
PubMed2002

Attachment disturbances in young children. I: The continuum of caretaking casualty.

OBJECTIVE: To determine whether signs of disordered attachment were greater in young children being reared in more socially depriving caregiving environments. METHOD: Three groups of children were studied by means of structured interviews with caregivers that were administered over several months in Bucharest, Romania, in 1999: (1) 32 toddlers living in a typical unit (standard care) in a large institution in Bucharest; (2) 29 toddlers living in the same institution on a 'pilot unit" designed to reduce the number of adults caring for each child; and (3) 33 toddlers living at home who had never been institutionalized. The presence of attachment disorders and other behavioral problems was assessed by caregiver/ parent report. RESULTS: Children on the typical unit (standard care) had significantly more signs of disordered attachment than children in the other two groups. Both the emotionally withdrawn and the indiscriminately social pattern of attachment disorder were apparent in these children, but cluster analysis suggested that mixed patterns are more typical. CONCLUSIONS: The continuum of caretaking casualty is reflected by increasing signs of disordered attachment in toddlers living in more socially depriving environments.

Caregivers↗
PubMed1999

Low-grade monoclonal Epstein-Barr virus-associated lymphoproliferative disorder of the brain presenting as human immunodeficiency virus-associated encephalopathy in a child with acquired immunodeficiency syndrome.

The association of the Epstein-Barr virus with human immunodeficiency virus-associated primary central nervous system lymphomas is well known. We describe a pediatric patient infected with human immunodeficiency virus who developed a lesion in the central nervous system that appeared to be histologically reactive and that proved to be an Epstein-Barr virus-associated monoclonal B-cell lymphoproliferative disorder by molecular analysis. An 8-year-old girl was diagnosed with vertically transmitted human immunodeficiency virus infection at age 5, for which she was treated empirically with a combination of zidovudine and didanosine. At the age of 7 years, during evaluation for entry into an antiretroviral protocol, a single hypodense frontal lobe lesion was identified by computed tomography. After unsuccessful treatment for presumed toxoplasmosis and progressive neurologic deterioration, a stereotactic brain biopsy was performed. Although the biopsy contained a polymorphic lymphoid infiltrate that appeared to be cytologically reactive, polymerase chain reaction and in situ hybridization studies revealed a monoclonal Epstein-Barr virus-associated B-cell lymphoproliferative disorder, which was reminiscent of polymorphic B-cell hyperplasia observed in the setting of immunosuppression following organ transplantation. Postoperative therapy included steroids and antiretroviral therapy. The lesion decreased slightly in size, and the child's neurologic status was relatively unremarkable for 5 months. Subsequently, she developed cytomegalovirus retinitis, progressive encephalopathy, and died with pancytopenia. This case represents a newly described manifestation of Epstein-Barr virus-associated lymphoproliferative disorder, a diagnosis that should be considered in patients with neurologic symptoms and immunodeficiency. In addition, this case exhibited histologic features reminiscent of posttransplant lymphoproliferative disease, a histologic pattern that to our knowledge has not previously been reported in the setting of acquired immunodeficiency syndrome.

AIDS Dementia Complex↗