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PubMed2000

Disturbances of attachment in young children adopted from institutions.

In this article, the author describes a discrepancy between popular media accounts of reactive attachment disorder (RAD) and its clinical and scientific description. The literature on serious disturbances of attachment in children adopted out of institutions is reviewed. The author concludes that children adopted from institutions are at dramatically increased risk for disturbances, although the majority of such children do not demonstrate problems. Both the duration of deprivation and the postinstitutional caregiving environment seem to be importantly related to outcome. Inhibited/withdrawn RAD is exceedingly uncommon in children adopted from institutions (at least after 1 or more years), but disinhibited/indiscriminate RAD is quite persistent. Long after children become attached to adoptive parents, a number of them continue to exhibit indiscriminate sociability. Three explanations for this divergence of recovery curves are considered. It is likely that future systematic studies will illuminate many areas that are unclear at this time.

Adaptation, Psychological↗
PubMed1992

Are children who steal different from those who are aggressive?

Data on 2181 children referred to a child psychiatry service were analyzed to determine if there were specific correlates for aggressive behavior and for stealing behavior. Compared with stealers, aggressive children tended to be younger and more immature males, and to come from stressed families with a history of mental illness. These findings support the notion that there are biological and reactive components to aggression.

Adolescent↗
PubMed1977

The children of psychiatric patients: clinical findings.

Findings are presented on 42 children of school age, the offspring of 26 adult psychiatric patients. Psychiatric disorder was found in 19 (45 per cent) of the children, compared with 12 (26 per cent) of 47 children from a control group of families. Families with disturbed children differed from the remaining families in the following ways: presence of frank marital discord, the diagnosis of personality disorder in the parents, the inability of the father to tolerate angry situations, and the presence of siblings of under 9 years of age. Six months later 9 of the 19 children had improved considerably. In almost every family this was associated with improvement in the condition of the parents. It is suggested that the psychiatric disorder of these children is reactive to the presence of emotional turmoil in the families.

Adolescent↗
PubMed2000

Emotion regulation and parenting in AD/HD and comparison boys: linkages with social behaviors and peer preference.

Children's emotion regulation strategies and parenting responses in a family task that elicited frustration are investigated by comparing core attention-deficit/hyperactivity disorder (AD/HD) symptomatology, emotional reactivity, and emotional regulation in the prediction of social behaviors and peer social preference. Participants were boys, ages 6-12 years, either with AD/HD (n = 45) or without problem behaviors (comparison; n = 34). A high-aggressive subgroup of AD/HD boys showed a significantly less constructive pattern of emotional coping than did both a low-aggressive AD/HD subgroup of boys and nondiagnosed comparison boys, who did not differ. With statistical control of core AD/HD symptomatology, noncompliance in a naturalistic summer camp was predicted by boys' overall emotion regulation and three specific strategies (emotional accommodation, problem solving, negative responses) during the parent-child interaction. Emotional accommodation and negative responses to the frustration task also marginally predicted social preference at the camp. These emotion regulation variables outperformed emotional reactivity in predicting such outcomes. Some emotion-related parenting behaviors were associated with child coping in the task. We discuss the relationship of emotion regulation to core AD/HD symptomatology and emotional reactivity, and the role of parents' behaviors in influencing children's emotional responses.

Affect↗
PubMed1998

Cutaneous Rosai-Dorfman disease.

We report a patient with purely cutaneous Rosai-Dorfman disease (RDD) who presented with a solitary, asymptomatic plaque on the back of her left thigh, with characteristic, large histiocytoid cells exhibiting emperipolesis histologically. Cutaneous lesions occur in 27% of patients with lymph node involvement in RDD however purely cutaneous disease has only been reported on 18 previous occasions. The aetiology is unknown, although it is though to be a reactive disorder rather than neoplastic, possibly an immunological response to an infectious agent.

Adult↗
PubMed1991

Child and adolescent psychiatric patients in adulthood.

A total of 142 consecutive patients cared for by child and adolescent psychiatry were followed up to the age of 33-37 years; 49% were treated in adult psychiatry between the ages of 20-25 years, and 20% of these were hospitalized. The frequency of hospitalization was 4-5 times that of a control group. Between the ages of 20-34 years, 32% were admitted some time for inpatient psychiatric care. Psychiatric diagnoses of the patients: schizophrenia 4%, manic-depressive 5%, neurosis and reactive insufficiency 11%, personality disorders and/or abuse diagnosis 12%. Patients with a schizophrenia diagnosis in adulthood needed the most hospitalization. The symptom picture was stable from child and adolescent psychiatric care through to adulthood, but abuse increased with age. The frequency of sick leave was 2.5 times higher among the child and adolescent psychiatric care patients than among the control group. At the age of 34-36 years, 13% of the former patients received disability benefits as compared with 1% for the same age groups in the entire population of Sweden. Twenty-one percent received sentences for criminal offenses from the age of 20-34 years. The number of crimes decreased with increasing age. Nearly 50% were in contact with the social welfare services, 3 times as many as in the control group. A third of the men completed their national military service. A total of 6 men and 1 woman died, indicating an increased mortality rate for men. All deaths except one were related to the mental disorder.

Adolescent↗
PubMed2002

Treatment of autism spectrum children with thiamine tetrahydrofurfuryl disulfide: a pilot study.

OBJECTIVES: In a Pilot Study, the clinical and biochemical effects of thiamine tetrahydrofurfuryl disulfide (TTFD) on autistic spectrum children were investigated. SUBJECTS AND METHODS: Ten children were studied. Diagnosis was confirmed through the use of form E2, a computer assessed symptom score. For practical reasons, TTFD was administered twice daily for two months in the form of rectal suppositories, each containing 50 mg of TTFD. Symptomatic responses were determined through the use of the computer assessed Autism Treatment Evaluation Checklist (ATEC) forms. The erythrocyte transketolase (TKA) and thiamine pyrophosphate effect (TPPE), were measured at outset and on completion of the study to document intracellular thiamine deficiency. Urines from patients were examined at outset, after 30 days and after 60 days of treatment and the concentrations of SH-reactive metals, total protein, sulfate, sulfite, thiosulfate and thiocyanate were determined. The concentrations of metals in hair were also determined. RESULTS: At the beginning of the study thiamine deficiency was observed in 3 out of the 10 patients. Out of 10 patients, 6 had initial urine samples containing arsenic in greater concentration than healthy controls. Traces of mercury were seen in urines from all of these autistic children. Following administration of TTFD an increase in cadmium was seen in 2 children and in lead in one child. Nickel was increased in the urine of one patient during treatment. Sulfur metabolites in urine did not differ from those measured in healthy children. CONCLUSIONS: Thiamine tetrahydrofurfuryl disulfide appears to have a beneficial clinical effect on some autistic children, since 8 of the 10 children improved clinically. We obtained evidence of an association of this increasingly occurring disease with presence of urinary SH-reactive metals, arsenic in particular.

Arsenic↗
PubMed1976

Psychiatric disorder in children with birth anomalies. A retrospective follow-up study.

A group of 273 children and adolescents, aged 8 to 19 years, who had been treated for a congenital malformation during their 1st month of life, were studied using psychiatric interviews with the child and at least one of his parents. The child was also given a Wechsler intelligence test. The rate of psychopathological disturbance was as high as 49% (the classification used included organic brain disorder and mental retardation). Developmental deviations, psychoneurotic disorder and reactive disorder were the commonest types of disturbance (in 18, 17, and 11% respectively). Eleven percent were suffering from organic brain disorder and 8% had an IQ of no more than 50. The malformed children were compared with 509 children from the general population in terms of behaviour disturbance as rated by their teacher. Approximately one child in five in both groups presented behaviour problems, and behaviour was labelled as antisocial in 10% of children in both groups. The two groups of children did not differ significantly in regard to the family's social class, annual income, father's educational background, or the number of children in the family, but the parents of the malformed children had recieved psychiatric treatment more often than the control group parents.

Adolescent↗
PubMed1979

Preliminary validation of a set of content analysis scales applicable to verbal samples for measuring the magnitude of psychological states in children.

Scores on 17 psychological dimensions of the Gottschalk-Gleser content analysis scales were obtained from 5-minute speech samples of 37 white children hospitalized on the psychiatric service of a general hospital. These content analysis scores were compared to identical scores obtained from a normative sample of 109 white children. Groups of children were classified by the Group for the Advancement of Psychiatry (GAP) system as having Healthy Responses (N = 2), Personality Disorders (N = 17), Reactive Disorders (N = 9), Psychoneurotic Disorders (N = 7), and Developmental Deviations (N = 2), and by DSM-III as having Parent-Child Problems (N = 2), Conduct Disorders (N = 26), Anxiety Disorders (N = 7), and Special Developmental Disorders (N = 2). By either classification, these groups of children showed salient differences in their scores in certain psychological dimensions from the same types of scores occurring with the normative group. These findings provide initial construct validation of the Gottshalk-Gleser content analysis scales when applied to speech samples obtained for children. Moreover, the profiles of children's psychological characteristics obtained by this method provide, in themselves, an objective descriptive and dynamic classification.

Adolescent↗
PubMed2003

Elevated levels of measles antibodies in children with autism.

Virus-induced autoimmunity may play a causal role in autism. To examine the etiologic link of viruses in this brain disorder, we conducted a serologic study of measles virus, mumps virus, and rubella virus. Viral antibodies were measured by enzyme-linked immunosorbent assay in the serum of autistic children, normal children, and siblings of autistic children. The level of measles antibody, but not mumps or rubella antibodies, was significantly higher in autistic children as compared with normal children (P = 0.003) or siblings of autistic children (P <or= 0.0001). Furthermore, immunoblotting of measles vaccine virus revealed that the antibody was directed against a protein of approximately 74 kd molecular weight. The antibody to this antigen was found in 83% of autistic children but not in normal children or siblings of autistic children. Thus autistic children have a hyperimmune response to measles virus, which in the absence of a wild type of measles infection might be a sign of an abnormal immune reaction to the vaccine strain or virus reactivation.

Antibodies, Viral↗
PubMed2005

The psychobiological theory of attachment: a viable frame of reference for early intervention providers.

Psychobiological Attachment Theory (PAT) (Kraemer, 1992) provides a way of thinking about caregiver-infant relationships for use in clinical practice. This manuscript describes how the theory translates into a frame of reference that can be used in practice within the context of natural environments. A discussion of the theoretical base, function/dysfunction criteria, postulates regarding change, and presentation of an evaluation guide, provides a practical tool for use in early intervention practice.

Adaptation, Psychological↗
PubMed1995

[Limits of PINI (prognostic nutritional anf inflammatory index) in the evaluation of nutritional status in children].

The prognosis inflammatory and nutritional index (PINI) is a score based on albumin, glycoprotein acid and C-reactive protein levels. PINI was developed to evaluate nutritional and inflammatory status of patients presenting inflammatory syndromes with or without denutrition. In the present study conducted over a period of 6 days in the Pediatric Department of Bambri Hospital in the Central African Republic, we evaluated the usefulness of PINI for follow-up of 25 undernourished Central African children presenting marasmus (n = 15) or kwashiorkor (n = 10) associated with a laboratory documented inflammatory process. All children received nutritional support. We assessed the influence of inflammatory and nutritional factors on PINI values. Data measured in blood samples taken from 16 patients who also presented documented inflammatory manifestations but were not undernourished. A parallel decrease in C-reactive protein and PINI was observed from D0 to D6 and an increase in albumin and prealbumin from D3. There was a positive correlation between C reactive protein values and PINI on D0, D3 and D6. There was no significance difference between PINI and C reactive protein levels in the two study groups. In contrast, a significant difference was observed between albumin and prealbumin. These findings indicate that PINI is of little value for evaluation of inflammatory processes associated with malnutrition. The two main drawbacks of PINI are first that it is more sensitive to the inflammatory than nutritional factors and second that the physical and pharmakinetic parameters used for its calculation are too different.

C-Reactive Protein↗
PubMed1999

Heterogeneity of risk aggregation for alcohol problems between early and middle childhood: nesting structure variations.

We examined how family and child risk factors jointly affected stability and change in externalizing behavior over time in a prospective study of eventual alcohol use disorder. Study participants were community-recruited alcoholic and control families, and their initially preschool-aged male and female children (N = 335). Family risk varied as a function of both parental alcoholism (ALC) and antisocial personality disorder (ASPD) and was evaluated for both parents. Child risk was characterized by a set of risky temperament attributes pertaining to high activity, high reactivity, and low attention span. Externalizing behavior was used as the proxy indicator for later alcohol problems. For children in the high family risk group (involving current ALC in both parents or current ALC + ASPD comorbidity or both), child risk when children were 3-5 years old (Wave 1) directly predicted externalizing behavior when children were 6-8 years old (Wave 2), even when Wave 1 child risk was controlled for. In addition, parents' negative interaction with children at Wave 1 mediated the effect of child risky temperament on Wave 2 externalizing behavior. No such pattern was observed in the low family risk group, where only autostability effects were predictive of outcomes at Wave 2. The importance of nesting structure as an ingredient in the epigenesis of risk was discussed. Its particular relevance in understanding the process of risk transmission among offspring from antisocial alcoholic families was emphasized.

Adult↗
PubMedDate not supplied

Interparental discord and child adjustment: prospective investigations of emotional security as an explanatory mechanism.

Advancing the process-oriented study of links between interparental discord and child adjustment, 2 multimethod prospective tests of emotional security as an explanatory mechanism are reported. On the basis of community samples, with waves spaced 2 years apart, Study 1 (113 boys and 113 girls, ages 9-18) identified emotional security as a mediator in a 2-wave test, whereas Study 2 (105 boys and 127 girls, ages 5-7) indicated emotional security as an intervening mechanism in a 3-wave test. Relations between discord and emotional security increased as children moved into adolescence in Study 1. Emotional security was identified as an explanatory mechanism for both internalizing and externalizing problems in children.

Adaptation, Psychological↗