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PubMedDate not supplied

Psychological adjustment of 'surgery-only' pediatric neuro-oncology patients: a retrospective analysis.

A recent increase in diagnoses of pediatric neuro-oncology tumors combined with recent advancements in medical treatment of such tumors has resulted in a growing cohort of pediatric brain tumor survivors. These survivors are at risk for short and long-term psychological adjustment problems. Most studies regarding these survivors have focused on children who have received combinations of surgery, radiation, and chemotherapy as medical treatment. The sub-group of pediatric neuro-oncology patients who receive surgery as the only form of medical treatment has not been closely followed for adjustment problems. In this study, data were retrospectively collected from semi-structured clinical interviews with 34 'surgery-only' pediatric neuro-oncology patients who were 2 weeks to 5 years off medical treatment for their tumor. These data suggest that these survivors may be experiencing significant short and long-term mood, behavioral, and academic adjustment problems in comparison to national averages for children regarding these issues. Additional research examining the psychological adjustment process for surgery-only pediatric neuro-oncology patients is needed to validate these preliminary findings and facilitate the development of targeted interventions to address the identified adjustment problems.

Adaptation, Psychological↗
PubMed1981

Child abandonment: historical, sociological and psychological perspectives.

Even thought the act of physical abandonment is a relatively common occurrence, it remains an understudied social phenomena. It has been an act of parents since earliest times, but even in our modern enlightened society, children are still ejected from their homes and physically abandoned in frightening numbers. Even though attention has been directed toward the understanding and combating of the numerous variations of child abuse and neglect, the problem of physical abandonment is rarely discussed until sensationalistic news reports emerge to remind us that children are still left in parks or on street corners. To further understand this phenomena of child abandonment, this paper reviews the literature and examines the process from historical, sociological and psychological perspectives. This report looks to stimulate further interest in physical child abandonment and its precursor, psychological child rejection, as forms of child abuse and neglect which can and should be combated by proper psychiatric intervention.

Child↗
PubMed1979

The Primary Mental Health Project (PMHP): evaluation of current program effectiveness.

This study evaluated the effectiveness of the Primary Mental Project (PMHP), a program for early detection and prevention of school adjustment problems. Pre- and postprogram assessments were done with 215 primary-grade children seen in PMHP, usig teacher ratings of problem behaviors and competencies, and child-aide ratings of problems. School mental health professionals judged educational and behavioral changes in project children during the year. Significant across-the board improvements were found on all criterion measures. Modest intercorrelations among criterion change estimates suggested that the observed changes were due to program, rather than halo, effects. PMHP children also improved significantly more than matched, retrospective controls.

Child↗
PubMed1979

Life stress and maladaptation of children.

Social environmental variables differentiating maladapting children from matched controls in four inner-city elementary schools were investigated. Teacher selection was used to identify the maladapting children. Identified maladapting children were more likely to have been on welfare and to have experienced significantly more stressful life events during the previous year than the matched control children. The maladapting group was subdivided into welfare and non-welfare groups. Comparisons between groups on the life stress event measures indicated that the nonwelfare maladapting group experienced more life events than either the nonwelfare controls or the maladapting welfare children. The measures of life events correlated with parent ratings of behavior problems for the nonwelfare maladapting group but not for the welfare maladapting or the control groups.

Adaptation, Psychological↗
PubMed1986

Preventive intervention with latency-aged children of divorce: a replication study.

This replication study assessed the efficacy of a school-based preventive intervention for latency-aged children of divorce. The Children of Divorce Intervention Program (CODIP) emphasizes support, identifying and expressing divorce-related feelings, training situationally relevant communication, problem solving, and anger control skills, and enhancing self-esteem. Fifty-four children of divorce participated in the 11-session program conducted in small groups. Their adjustment was contrasted at pre and post with that of demographically matched peers (N = 78) from intact families on teacher, parent, self-report, and group leader measures. Children of divorce were less well adjusted than their peers before the intervention. They improved significantly after the intervention, approaching youngsters from intact families in adjustment status. The replication data support CODIP's efficacy as a preventive alternative for children of divorce. Needed future development and research steps are considered.

Adaptation, Psychological↗
PubMed1983

The psychological study of chronically ill and disabled children: are healthy siblings appropriate controls?

This study examined the appropriateness of siblings as controls in the psychological assessment of children with chronic illness or disability. Findings from 304 cases and 360 randomly selected controls were compared to findings from a subset of 206 case-sibling pairs. Cases were children 6 to 18 years of age with cystic fibrosis, cerebral palsy, myelodysplasia, and multiple handicaps, selected from specialty clinics in two teaching hospitals in the Cleveland area. Results from both data sets were in agreement on major findings indicating that children with cystic fibrosis are not at increased risk for psychopathology, whereas children in the remaining three diagnostic groups show a substantial excess in Mentation Problems and Isolation. The comparisons with matched siblings underestimated pathology in the disabled children in Regressive-Anxiety and aggressive behavior.

Adaptation, Psychological↗
PubMed1987

Ongoing postdivorce conflict and child disturbance.

This paper reports on the disturbed behavior of children who are subject to entrenched parental disputes over their custody and care after separation and divorce. The 56 children who varied in racial and socioeconomic origin were 4 to 12 years old at entry into the study. They were assessed at two points: at the time of the custody dispute and 2.5 years later. The extent of the child's involvement in the dispute and the amount of role reversal between parent and child predicted total behavior problems and aggression at the time of the legal dispute. These same factors, together with the rate of verbal and physical aggression between parents, predicted total behavior problems, depression, withdrawn/uncommunicative behavior, somatic complaints, and aggression at the 2-year follows-up. There were no main effects for sex and age. However, at the 2-year mark, girls in high-conflict families were more depressed and withdrawn, and older children in high-conflict situations had more somatic complaints and were more aggressive. The findings are considered in the light of a number of etiological mechanisms by which parental conflict affects children.

Aggression↗
PubMed1995

Distressed and nondistressed third- and sixth-grade children's self-reports of life events and impact and concordance with mothers.

This study examined the concordance of third- and sixth-grade distressed and nondistressed children's self-reports of the occurrence and perceived impact of life events that had occurred during the preceding 12 months with their mothers' perceptions. The study also examined whether maternal self-reports of dysphoria affects concordance between mother/child dyads on children's self-reports of occurrence and perceived impact of life events. Eighty-eight mother/child dyads, matched on Children's Depression Inventory scores, grade, sex, race, and school were included. Results indicated that distressed children endorsed more items on the Coddington Life Events Record (LER), and perceived them more negatively, than nondistressed children. Small, but statistically significant concordance rates were found between dyads on the occurrence of life events and the perceived impact of these events: Distressed children and their mothers had more mutually endorsed items than nondistressed children and mothers, and third-grade children had higher concordance rates with their mothers when compared to sixth-grade children. Third-grade children also appeared to commit more errors of commission on the LER. Finally, maternal distress mediated mother/child concordance. Possible explanations for these results and future research directions are discussed.

Child↗
PubMed1978

Hospitalization as a life crisis for the preschool child: a critical review.

Review of the literature on the psychological effects of hospitalization on children reveals that it has not increased substantially in quality or quantity since Vernon and his associates published their extensive review a decade ago. More recent research supports the earlier contentions that children between the ages of 6 months and 4 years are especially vulnerable to upset but are also more amenable to change and growth than other age groups. Maternal separation appears to be the primary stressor, but the presence of emotional disturbance prior to hospitalization and the child's level of cognitive development at the time may also be significant factors. Attempts to prepare children for hospitalization and surgery have met with some success, but not for preschool children. The need for some comprehensive theoretical perspective on which to base research is evident. Studies to date appear to have been based either on the concept of "anticipatory worry" or on some form of modeling theory. The author suggests that hospitalization can be considered as a life crisis for a child, a crisis that may result in blocks or distortions in his development if not mastered properly. Crisis theory provides a meaningful and useful model for understanding the experience of hospitalization for young children and for providing a basis for intervention. The psychopathology present in some children and their families is made apparent during such a crisis as hospitalization; this may present the only time when they are accesible to mental health professionals.

Adaptation, Psychological↗
PubMed1995

Children of a transsexual father: a successful intervention.

Following gender reassignment, transsexuals are often assessed in many different areas with regard to how they are functioning. However, there is little attention paid to the children they may have had prior to the operation and change in lifestyle. Children may present with problems related to the parents transsexualism, or with more generalised difficulties secondary to break-up of the family. A family of a transsexual father is described in which the children presented with difficulties and in which the intervention was successful.

Adolescent↗
PubMed1994

Identifying the mental health needs of children living in families with AIDS or HIV infection.

The present article highlights the mental health needs of children living with loved ones who have AIDS or HIV infection. In addition the article describes an intervention program which is being developed to meet the needs of the children and their families. Children who live in families affected by AIDS and HIV infection, like children who live with other life-threatening illnesses, are vulnerable to psychological distress. They experience numerous separations from parents, changes in the nature and predictability of emotional nurturing, concerns about loss, disruptions in routine and contact with peers, and economic hardship. AIDS and HIV infection present the additional stressors that stem from discrimination, stereotyping, and social ostracism. Finally, many families living with AIDS or HIV infection are disenfranchised, living under the pall of poverty and substance abuse. The intervention program described is being implemented in an urban community mental health clinic to meet the diverse mental health needs of the children living in these families. Preliminary implications of the program are discussed so as to begin a dialogue with other agencies who are challenged to meet the needs of this heterogeneous population.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Posttraumatic stress reactions among children following the Athens earthquake of September 1999.

The objective of the present study was to assess symptoms of posttraumatic stress disorder (PTSD), depression and anxiety among children 6 months after they had been exposed to an earthquake (EQ) affecting the northwestern suburbs of Athens in September 1999. A total of 115 children attending two elementary schools located at the epicentre of the EQ were assessed. A group of 48 children not affected by the EQ attending a school not affected by the EQ were used as controls. The children and their parents completed a number of questionnaires. Overall, there was a high rate (78%) of severe to mild PTSD symptoms in the EQ exposed group. Additionally, a substantial proportion of these children scored above criteria (32%) for depression compared to the control group (12.5%). Severe or moderate symptoms of PTSD were associated with high scores of depression (p = 0.002). The relationship between PTSD symptoms and anxiety was limited to the "avoidance" factor of the anxiety questionnaire (p = 0.029). Those who were most likely to be affected were children alone at the time of the EQ, and children who sustained injuries. In summary, countries where EQs are frequent should be prepared to offer psychological support to a substantial proportion of children presenting with PTSD and depressive symptoms and should educate and prepare children to cope with these events.

Adolescent↗
PubMed2005

Psychosocial treatment of children in foster care: a review.

A substantial number of children in foster care exhibit psychiatric difficulties. Recent epidemiological and historical trends in foster care, clinical findings about the adjustment of children in foster care and adult outcomes are reviewed, followed by a description of current approaches to treatment and extant empirical support. Available interventions for these children can be categorized as either symptom-focused or systemic, with empirical support for specific methods ranging from scant to substantial. Even with treatment, behavioral and emotional problems often persist into adulthood resulting in poor functional outcomes. We suggest that self-regulation may be an important mediating factor in the appearance of emotional and behavioral disturbance in these children.

Adolescent↗
PubMed1982

Abuse and deprivation in failing adoptions.

Twelve children seen in psychiatric consultation by the authors over a 3-year period were failing in their adoptive placements. All twelve had been adopted as older children (average age at adoption 5 1/2 years). Ten out of the 12 were males. A retrospective case review demonstrated that all the children shared several common characteristics: (1) a history of both neglect and abusive treatment during at least the first two years of life, (2) a behavioral pattern that was intermittently provocative and punishment seeking, and (3) an ability to elicit a sense of bewilderment and betrayal in the adoptive parents. Twenty-one months was the average duration of the adoption before the families sought the consultation. These adoptive families were all considered competent by the agencies involved. All had raised other natural and adoptive children successfully. Treatment offered by the authors seemed to be helpful in salvaging 4 of the 12 adoptive placements. The authors present these cases as a way of drawing attention to much needed research, both in better understanding the early attachment process in "older child" adoptions, and in better understanding the relative impact of abuse in influencing the child's subsequent attachment capacities.

Adoption↗
PubMed1983

Grandfather - granddaughter incest: a trigenerational view.

Grandfather-granddaughter incest accounts for about 10% of all reported cases of intrafamilial childhood sexual abuse. In a sample of 10 such cases, all referrals came from mothers of the child victims; six of these mothers had themselves been abused in childhood by the perpetrator. For eight of the 10 perpetrators, multiple child sexual victims were identified in a pattern that suggests facultative pedophilia. Only two of the 18 grandchildren sexually abused by the 10 grandfathers were asymptomatic at the time of report. Grandchild victims from chaotic families showed educational and behavioral symptoms; those from stable families exhibited fears and phobias. Eight of the 18 grandchildren were victimized by multiple perpetrators. The results cast doubt on the assumption that grandparent incest is a benign form of abuse and indicate that there is some justification for the fears expressed by adult incest victims about visitation between their children and the father-perpetrator.

Adolescent↗
PubMed1987

Factors associated with an increased impact of child sexual abuse.

Data is presented identifying factors associated with the impact of sexual abuse on children. A group of 369 sexually abused children and a comparison group of 318 children recruited from the community were compared on a parent-completed behavior rating scale. Data describing the abused children were also available from a 38-item symptom checklist completed by the child's social worker. Using a score based on the symptom checklist as the measure of the impact of sexual abuse, 15 variables were in the final regression equation explaining 42% of the variance in impact. Using a score based on parent-generated data, 5 variables were in the final equation explaining 20% of the variance. The significance of the variables in identifying factors associated with an increased impact of abuse is discussed.

Adaptation, Psychological↗