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The middle-class family and middle-class adolescents in a state of disarray: a social-psychiatric analysis.

Because mental health professionals tend to focus their attention on the complex of factors involved in the provision of psychotherapeutic and related services, they often do not give primary attention to the serious instabilities afflicting marriage and family among the middle class and are insufficiently aware of parents' deficiencies in rearing their children well. Moreover, they frequently underestimate the increasing prevalence of character defects and disorders and the acting-out problems they cause among middle-class adolescents and youths, who are widely involved in sexual activity, drug use, and theft and whose educational performance has sharply declined. Using a social-psychiatric perspective, this paper discusses the major sociocultural factors that greatly influence the problems straining and breaking up marriage and family among the middle class. It also examines the reasons for parental inadequacies that contribute heavily to their children's becoming impulse-dominated and involved in self-impairing and socially harmful problems.

Achievement↗

Hard-to-manage preschool boys: externalizing behavior, social competence, and family context at two-year followup.

Boys, identified as hard to manage in preschool, were followed up 2 years after initial assessment. Mothers, fathers, and teachers continued to rate hard-to-manage boys as having more problems with attention and impulse control, and as more oppositional, than comparison boys who had been problem-free at intake; problem boys also were rated as less socially competent by all three informants. Differences in severity were apparent as a function of initial referral source. Boys identified as showing significant problems by at least two informants (28% of the problem boys) were especially low in social competence and their mothers reported more symptoms of depression and parenting stress. Family adversity, lower IQ, and severity of symptoms at intake discriminated boys with continuing problems from those with less serious difficulties at followup. Control boys with potentially emerging problems were characterized by more family problems than the remaining control boys. Implications for the development of problems in young children are discussed.

Child↗

A prospective longitudinal study of attachment disorganization/disorientation.

The research explores the antecedents and consequences of attachment disorganization from a prospective longitudinal perspective. The relations of attachment disorganization/disorientation to endogenous (e.g., maternal medical history, infant temperament) and environmental (e.g., maternal caregiving quality, infant history of abuse) antecedents and to behavioral consequences from 24 months to 19 years are examined. For the 157 participants in the longitudinal study, attachment disorganization was correlated significantly with environmental antecedents (e.g., maternal relationship and risk status, caregiving quality, and infant history of maltreatment), but not with available endogenous antecedents. Infant history of attachment disorganization was correlated with consequent variables related to mother-child relationship quality at 24 and 42 months, child behavior problems in preschool, elementary school and high school, and psychopathology and dissociation in adolescence. Structural models suggest that disorganization may mediate the relations between early experience and later psychopathology and dissociation. The findings are considered within a developmental view of psychopathology, that is, pathology defined in terms of process, as a pattern of adaptation constructed by individuals in their environments.

Adolescent↗

Prosocial development in relation to children's and mothers' psychological problems.

The study tested whether children's prosocial behavior was negatively or positively related to children's and mothers' psychological problems. Participants were 149 London families when mothers were pregnant and followed up in infancy and at ages 4 and 11. Children's cooperation at 4 and general prosocial tendencies at 11 were negatively associated with externalizing problems but unrelated to internalizing problems. A subgroup of children who were more prosocial than average expressed clinically significant worries about family members. Maternal depression decreased prosocial behavior in the eyes of adults, but children of depressed mothers saw themselves to be prosocial. Early cooperation protected children against later risk for externalizing problems, even when their early behavioral problems were taken into account.

Child↗

Childhood depression: interpersonal interactions and depressive phenomena.

The author discusses the impact of parental disability, particularly parental depression, on children. Depression in children, which takes different forms according to the child's developmental level, may mirror or be a response to similar affect in a parent. Clinicians need to take note of the relationship between child and caretaker and of the various manifestations of childhood depression in order to avoid underdiagnosing this disorder.

Adolescent↗

Child behavior checklist profiles of children and adolescents with and at high risk for developing bipolar disorder.

In order to recognize behavioral patterns in children and adolescents at risk for developing bipolar disorder, this study examined Child Behavior Checklist (CBCL) profiles of bipolar offspring both with (BD group) and without ("at-risk" or AR group) bipolar disorder themselves. The BD youth had three CBCL subscale T scores > or = 70 (attention problems, delinquent behavior, and aggression) and scored significantly higher than healthy comparison youth on all CBCL subscales. AR youth did not have any T scores > or = 70; however, they scored higher than healthy comparisons in the anxiety/depression, attention problems, aggression, and withdrawal subscales. AR and BD youth differed significantly on all scales except somatic complaints and anxiety/depression.

Adolescent↗

Prenatal mood disturbance predicts sleep problems in infancy and toddlerhood.

BACKGROUND: Experimental animal data link prenatal stress with sleep disturbance in offspring, but the link in humans is unclear. AIMS: To investigate the link between prenatal maternal anxiety and depression and infant sleep disturbance from 6 to 30 months of age. STUDY DESIGN: Longitudinal prospective study of a large birth cohort from pregnancy to 30 months. Questionnaire measures of anxiety and depression were completed by mothers at 18 and 32 weeks gestation and at 8 weeks and 8 months postpartum. SUBJECTS: The ALSPAC cohort, a prospective community study of women in the UK who have been followed since pregnancy. OUTCOME MEASURES: Measures of total sleep time, number of awakenings, and broadly defined sleep problems were available on children at ages 6, 18, and 30 months. RESULTS: Reliable measures of total sleep time, nighttime awakenings, and sleep problems were identified at 6, 18, and 30 months. Higher levels of prenatal maternal anxiety and depression predicted more sleep problems at 18 and 30 months, after controlling for postnatal mood and obstetric and psychosocial covariates; the association was not restricted to clinical extremes. No link with total sleep time was observed. CONCLUSIONS: Mood disturbance in pregnancy has persisting effects on sleep problems in the child, a finding that is consistent with experimental animal research. The findings add to a growing literature showing that maternal prenatal stress, anxiety, and depression may have lasting effects on child development.

Adult↗

Disruptive behavior: a dietary approach.

The effect of particular foods on levels of hyperactivity, uncontrolled laughter, and disruptive behaviors was studied in an 8-year-old autistic boy. The floor of the child's room was taped off into six equal-sized rectangles to measure general activity level. Frequency data were recorded on screaming, biting, scratching, and object throwing. A time-sample technique was used to record data on laughing. Data were gathered during four phases. During an initial 4-day period the child was fed a normal American diet. A 6-day fasting period followed, during which time only spring water was allowed. The third phase lasted 18 days and involved the presentation of individual foods. During the final phase of the study the child was given only foods that had not provoked a reaction in the third phase. Results showed that foods such as wheat, corn, tomatoes, sugar, mushrooms, and dairy products were instrumental in producing behavioral disorders with this child.

Autistic Disorder↗