[Comment to the opinion-based campaign against neuropsychiatry].
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At least five per cent of the general population of children suffer from severe neuropsychiatric impairment. Autism spectrum disorders, ADHD/DAMP, Tourette's syndrome, and a variety of cognitive impairment/neurological syndromes with severe behavioral/emotional symptoms are included among the child neuropsychiatric disorders, the majority of which will lead to ongoing social and academic problems in adult life. Substantial numbers of those affected commit crimes in early adult life, and the incidence of the above-mentioned disorders is higher among young criminal offenders. Early diagnosis, educational, psychological, and, occasionally, medical therapies can affect outcome in a positive way. Child neuropsychiatric disorders should therefore be recognized at an early age so that attitudes can be changed from rejection to understanding, and a gloomy psychosocial outcome avoided.
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The purpose of this study was to assess the uncooperative behavior of low income preschool children receiving dental treatment and the factors associated with that behavior. The sample consisted of 177 Brazilian children of both sexes, ages from three to six years. The children were observed during their dental appointments and their behavior was categorized by the Frankl Behavioral Rating Scale. The oral health of the children was evaluated on the basis of a clinical examination and classified using the dmft index. A history taking with the child's parent or guardian provided current medical condition, dental history, and family situation. Of the children, 1 percent presented definitely positive behavior, 59 percent positive behavior, 28 percent negative behavior, and 12 percent definitely negative. A significant association was found between children with negative behavior and the variables of the child's age, parent's or guardian's education, learning or behavioral problems, parent's or guardian's anxiety, child oral health status, general health problems, history of hospitalization, and dental history.
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In the field of developmental research, there is a long tradition of using story completion tasks with play figures for preschoool children. In contrast, story completion tasks are not often used in the clinical assessments of young children. In this paper we will present the MacArthur Story Stem Battery (MSSB), a typical story completion task, which is useful in clinical as well as in research settings. We will give two clinical case examples in order to demonstrate how compelling this method is for young children because they can continue the stories with the help of play figures. In this way the instrument can help to open a window into the inner world of young children.
AIM: To evaluate the short-term follow-up outcome in four subgroups of uncooperative child dental patients referred to a specialist paediatric dental clinic in Sweden. METHODS: Seventy children, classified into four groups (based on fear, temperament, behaviour and verbal intelligence), were followed-up at their public dental clinics after termination of specialist dental treatment. Questionnaire assessments of children's dental and general fear, parental dental fear, emotional stress, locus of control and parenting efficacy were made by parents pre and post treatment and at follow-up and were analysed within and between groups. At follow-up, parents rated their children's coping and procedure stress, while treatment acceptance was rated by the dentists. RESULTS: Decreases in child dental fear were maintained at follow-up, although a third of children still had moderate or high dental fear. For those children who had been classified into the externalising, impulsive group, an increased risk of non-acceptance (RR=3.7) was indicated. The risk of dental fear at follow-up was increased for the group of fearful, inhibited children (RR=3.8). For the study group as a whole a poorer follow-up outcome could be predicted by avoidance behaviour (OR 12.9-16.6) and moderate or high post treatment dental fear (OR 6.5- 21.3). CONCLUSIONS: Fearful, inhibited child dental patients may need, due to dental fear, extra attention even after successful dental treatment at a specialist clinic. Externalising, impulsive children constitute a special challenge for dentistry. The continued need for adjusted management after termination of specialist treatment can be predicted from avoidance behaviour and post treatment dental fear scores.
Children and adolescents in residential care represent a high risk population for mental disorders. We examined in an epidemiologic survey the level of professional psychopharmacological and psychotherapeutic treatment in relation to the prevalence of mental disorders among this group. The study includes 689 children and adolescents living in 20 residential care institutions in a two-step design. Participants with elevated scores in a screening questionnaire were then assessed by a standardized clinical examination. Data on psychopharmacological and psychotherapeutic treatment were obtained and correlated with the prevalence of mental disorders. Wishes for cooperation with psychiatry on the part of the child welfare providers were recorded by a self-constructed questionnaire. 57.1% of the children and adolescents of our sample fulfilled the criteria for one or more ICD-10 F diagnosis. As most frequent disorders we found conduct disorders (CD), ADHD and depressive disorders. Highest levels of psychopharmalogical treatment were found in ADHD (25 to 33.3%), half of the children and adolescents with ICD-10 F diagnosis got psychiatric or psychotherapeutic treatment. Compared to the high prevalence of severe mental disorders in children and adolescents living in residential care the levels of psychopharmacological and psychiatric/psychotherapeutic treatment seem to be low, especially in those with conduct disorders (CD) and ADHD. Cooperation between the child welfare providers and child and adolescent psychiatry services should get intensified. Adequate psychiatric diagnostic and multimodal therapeutic procedures are necessary.
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The article deals with the conditions of personality formation. A particular significance is attributed to the time and forms of incorporation of mental activity into practical one. Formation of the moral behaviour of children in various microsocial groups (family, school) is analyzed.
While all these problems have been seen in pediatric cancer patients, and some may occur more frequently than in the general population, it is worth reemphasizing that the majority of patients and families are psychiatrically intact. They are generally highly resilient and resourceful in coping with this potentially devastating illness. A vigorous program of support groups, recreational therapy, and academics can enhance the patients' and families' ability to function. For those few who develop psychiatric disorders, effective therapeutic intervention is very important in their recovery from both psychiatric and oncologic illness.
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Noncompliant behavior in early childhood (i.e., exaggerated, but age-appropriate negativism) has been inadequately studied. This longitudinal study explores preschool temperament and maternal behavior as current correlates of negativistic behavior at age 4, and early maternal characteristics and infant temperament as etiological variables in the production of negativism. Longitudinal evidence was collected from 62 mother-child dyads, representative of all social classes. This evidence included home observations of maternal and child behavior at 4 years, a temperament questionnaire at 4 years, a questionnaire about infant temperament, and observational and interview measures at various stages from birth to 3 years, of infant behavior and maternal characteristics. The findings suggest that infant and childhood temperament (especially the degree of infant fussiness) are highly predictive of physical noncompliance, and that physical noncompliance is unrelated to maternal or demographic variables. A combination of maternal variables including warmth, closeness, and verbal directiveness, both positive and negative, as well as child variables, predict verbal noncompliance. Demographic variables, temperament, and maternal attitudes predict passive noncompliance. Noncompliance is viewed as a complex phenomenon in which constitutional and environmental variables interact.
The background of psychotherapy is discussed along with fundamental theory and indications for dynamic therapy. Dynamic psychotherapy is defined, and steps for its implementation are described.