bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethnocentrism as a Form of Intuition in Psychology
Authors: Teo Thomas , Febbraro Angela R.
Published: November 2003

Ethnocentrism is conceptualized as a basic Kantian form of intuition that plays aknowledge-producing role. Although all cultures have developed their particular forms of intuition, the focus of this analysis is on Western ethnocentrism, which is discussed in four psychological manifestations. The most explicit expression of Western ethnocentrism in academia is scientific racism, which has been an important research program in the history of the science of mental life. Another manifestation of ethnocentrism as a form of intuition in Western psychology is researchers’ prejudices, which play a significant role in the context of discovery. Besides these two explicit manifestations of ethnocentrism, a hidden one is analyzed, which expresses itself in terms of exclusion or disregard of non-Western views, or in their assimilation without a reconceptualization of mental life. In this type of ethnocentrism it is assumed that Western psychological conceptualizations are superior. Finally, a fourth manifestation is discussed, which expresses itself in the institutional practices of academia, such as hiring, publishing and teaching.
Piezoelectric Materials at Elevated Temperature
Authors: Schulz Mark J. , Sundaresan Mannur J. , Mcmichael Jason , Clayton David , Sadler Robert , Nagel Bill
Published: November 2003

Piezoelectric ceramic patches are the mainstay for actuating and sensing in smart structures, but these patches are limited in the temperature range in which they can operate. Operation at temperatures above ambient is desired for new applications of smart structures, including in aircraft, turbine engine components, space vehicles, and others. The decrease in the actuation and sensing capability with increasing temperature is mainly due to the loss of the piezoelectric properties through depoling. The decrease in performance is also due to the compliance of the adhesive used to bond the patch to the structure, the insulating film covering the patch, and the inside adhesive bonding the film to the wafer. This paper discusses the general properties and modeling of piezoelectric materials, and then experimentally characterizes the performance of piezoelectric ceramic patches used as sensors bonded onto an aluminum beam operating at moderately elevated temperatures. It is shown that the piezoelectric property of the sensor decreases with increasing temperature until the properties are almost completely lost, and also the piezoelectric properties return each time when the sensor is cooled. Finally, high temperature nanotechnology is investigated as an approach that might replace piezoelectric ceramics for sensing and actuating of smart structures at high temperatures.
Complex Concurrent Engineering and the Design Structure Matrix Method
Authors: Yassine Ali , Braha Dan
Published: November 2003

Concurrent engineering (CE) principles have considerably matured over the last decade. However, many companies still face enormous challenges when implementing and managing CE practices. This is due to the increased complexity of engineering products and processes, on one hand, and the lack of corresponding CE models and tools, on the other hand.

This paper focuses on four critical problems that challenge management while implementing CE in complex product development (PD) projects. We refer to these problems as: iteration, overlapping, decomposition and integration, and convergence problems. We describe these problems proposing a unified modeling and solution approach based on the design structure matrix (DSM) method, which is an information exchange model that allows managers to represent complex task relationships to better plan and manage CE initiatives.
The Dynamics of Collaborative Design: Insights from Complex Systems and Negotiation Research
Authors: Klein Mark , Sayama Hiroki , Faratin Peyman , Bar-Yam Yaneer
Published: November 2003

Almost all complex artifacts nowadays, including physical artifacts such as airplanes, as well as informational artifacts such as software, organizations, business processes, plans, and schedules, are defined via the interaction of many, sometimes thousands of participants, working on different elements of the design. This collaborative design process is typically expensive and time-consuming because strong interdependencies between design decisions make it difficult to converge on a single design that satisfies these dependencies and is acceptable to all participants. Recent research from the complex systems and negotiation literatures has much to offer to the understanding of the dynamics of this process. This paper reviews some of these insights and offers suggestions for improving collaborative design.
Note: Influence of the Packaging Material on the Major Volatile Compounds of Tsipouro, A Traditional Greek Distillate
Authors: Flouros A. I. , Apostolopoulou A. A. , Demertzis P. G. , Akrida-Demertzi K.
Published: November 2003

Tsipouro is a traditional Greek alcoholic beverage, produced by distillation of fermented grape pomace. Some of the by-products of the alcoholic fermentation such as acetaldehyde, ethylacetate and amyl alcohols are mainly responsible for the aroma of alcoholic beverages and their amounts specify the quality of the distillate. Several tsipouro samples were stored for 12 months in three types of containers (PET, PVC and glass bottles) to determine the effect of thepackaging material on changes in aroma of the distillate. Determination of volatile compounds was performed by gas chromatography and identification by mass spectrometry. The results revealed that the major volatile constituents of tsipouro were not significantly affected by the container material. Changes in concentrations could be attributed to the natural evolution of the distillate. However, migration of plasticisers from plastic containers into the distillate has been detected, an issue that requires further investigation.
Note: Behaviour of Escherichia Coli O157: H7, Listeria Monocytogenes 4b and Yersinia Enterocolitica O3 in Pasteurised and Non-pasteurised Kefir Fermented for One or Two Days
Authors: Gulmez M. , Guven A.
Published: November 2003

The behaviour of three selected food-borne pathogens, E. coli O157: H7, L. monocytogenes 4b and Y. enterocolitica O3, added to fermented and pasteurised kefir was monitored. Populations of the three strains increased in one-day-fermented kefir, but only E. coli O157: H7 increased in two-days-fermented kefir during fermentation. None of the strains grew during cold storage (4 1 C), although E. coli O157: H7 and L. monocytogenes 4b survived up to 21 days in all samples cold. Y. enterocolitica O3 was the most susceptible strain that was present in one-day-fermented kefir for at least 14 days. Twodaysfermented kefir samples were more acidic thanthose of one-day-fermented samples, but none of the samples was safe enough to create an environment to eliminate the pathogens.
Sensitive Issues in Vulnerable Conditions
Authors: Honkatukia Päivi , Nyqvist Leo , Pösö Tarja
Published: November 2003

This article discusses the experiences of the ethical dilemmas encountered in a research project on teenage reformatory school residents’ understanding of violence.The study is based on group interviews of teenage youth (15 interview sessions) in two Finnish reformatory schools.The agenda for the interviews dealt with the adolescents’views on violence, experiences of it in different contexts such as home, school and residential care, as well as their moral judgement of it. The study has been motivated by the growing body of knowledge and concerns about youth violence, linking the experiences of violence, seen as traumatic, with behavioural and psychosocial problems. We would like to contribute to that debate by saying something about violence as defined by young people.

Confidentiality and voluntary participation are some of the basic principles guiding the research process.The ethical issues are, however, more complicated.The actual act of asking young people to speak about violence can be (re)traumatizing. On the other hand, it is important to give them a chance to speak. The dilemma of misusing the young people’s participation in the research and the option of giving space for voices to be heard is one of the ethical dilemmas confronted in this paper.
A Feminist in Brussels (and Glasgow, Berlin, Düsseldorf...)
Authors: Sarikakis Katharine
Published: November 2003

This article discusses the conditions of research in international and European contexts, in particular European elite politics and politicians, arguing that the researcher is a central agent and research instrument in this process. The article suggests that the researcher finds herself renegotiating parts of her socially assigned identity in relation to European national and international structures and discusses the ways in which the gendered ‘self’ remains the centre of a research project above other identity componentseven in such conditions that might appear to be gender neutral. The article examines the micro-politics of research from the level of archive research to elite interviewing.
The Youngest Case of Pervasive Refusal Syndrome?
Authors: Taylor Sharon , Dossetor David R. , Kilham Henry , Bernard Elizabeth
Published: November 2003

To date, the youngest previously recorded case of pervasive refusal syndrome (PRS) was eight years old. A four-year-old Australian-born Chinese boy presented to a tertiary paediatric referral centre with a four-week history of food refusal and selective mutism; he was severely dehydrated and marasmic. During admission several behavioural problems were noted including: persistent refusal to eat or drink, obsessions with images of food, failure to cooperate, lack of social interaction and toileting in inappropriate places. There were features of early maternal separation, concerns over the quality of parenting and confusion of language and culture. An exhaustive assessment (to exclude an organic explanation) by a multi- disciplinary team was completed. All investigations were normal with the exception of the single photon emission computerized tomography (SPECT) scan, which showed mild increase uptake to the right insular and mild decrease uptake to the right temporal region. He was hospitalized for 67 days over which time his medical difficulties resolved. The differential diagnosis included an organic disease, child abuse, an eating disorder, a degenerative disorder, reactive attachment disorder, pervasive developmental disorder and a psychotic disorder, which were all considered. We felt that this case fulfilled the diagnostic criteria for PRS and was the youngest reported case. The similarity of the SPECT scan result with that found in anorexia nervosa is of interest and suggests that there is a neurobiological vulnerability common to this group of disorders.
‘The Rules of Engagement’: A Case Study of a Group with ‘Angry’ Adolescents
Authors: Sharry John , Owens Conor
Published: November 2003

Using a case study, this article examines the process of engagement within group work with adolescents identified as having anger problems. We look at how the traditional social learning model of anger management can be complemented by ideas from constructive therapies such as solution-focused therapy, in building cooperation with this client group who are often seen as demotivated or ‘hard to engage’. Using the case example, we detail how blocks to group process were created by our assumptions about the boys’ perceptions and understanding of anger, and show how the constructive approaches gave us a way of understanding, which allowed a more cooperative and collaborative way of working.
A Model for Change at the Outpatient–Inpatient Interface in Child Psychiatry
Authors: Sourander Andre , Piha Jorma
Published: November 2003

We describe a treatment model linking child psychiatric inpatient treatment with the professional outpatient network. The child, the family and the ward community together are seen as an extended therapeutic system. The ward subsystem interacts with both the family system and the professional network. A network meeting on admission brings together the previous outpatient treatment efforts and in- patient treatment plans, formulating new solutions and identifying family strengths. A network meeting at discharge creates a supportive outpatient network of local professionals, aware of each other’s intentions and efforts.
Thinking Clearly about Evaluations of Suspected Child Abuse
Authors: Leventhal John M.
Published: November 2003

Determining whether an injury in a young child is due to child abuse can be a challenging task. Although much has been written about the types of injuries that are due to abuse, little information is available about the processes of gathering data and making clinical decisions. In this article, I describe an approach to providing effective evaluations and offer 14 suggestions focused on the process of conducting an evaluation and eight focused on decision-making.
Child and Adolescent Mental Health Needs Assessment and Service Implications in an Inner City Area
Authors: Davis Hilton , Day Crispin , Cox Antony , Cutler Lucy
Published: November 2003

A random sample of 253 parents and young people were interviewed to elicit: (i) the number, type and severity of psychosocial problems in children/young people; and (ii) the number and type of risk factors for mental health in a very deprived inner city locality. The results suggest high levels of need for mental health services, with, for example, 37% of children having three or more problems, and over 51% having three or more risk factors. From subjective case-by-case analysis, preliminary criteria were derived for judging the level of required service response and the numbers likely to present appropriate to the various tiers of service. Of the 25% of the sample expressing a need for help, 6% were judged to be manageable by community staff (e.g. health visitors) with support from child mental health specialists, 4% by specially trained community staff (e.g. parent advisers), 8% by solo child and adolescent mental health specialists and 7% by generic or specialist child mental health teams.
Early Physical Intervention for Young People with Atypical Gender Identity Development
Authors: Wren Bernadette
Published: November 2003

This article describes the misery and frustration of young people for whom the external reality of the body is at odds with their gender identity. As hormonal and surgical treatments to alter the sexual body increase in sophistication, clinicians may be under pressure to provide this treatment to the under-18s – if only for the postponement of puberty. This pressure is especially powerful in the absence of evidence for the effectiveness of psychological treatment in reconciling cross- gendered youngsters to their bodies. Current practice is outlined and the legal context is described briefly. The clinician’s dilemmas are explored with particular reference to conflicting views of adolescent development, our limited understanding of the aetiology of gender dysphoria, the lack of empirical data on the impact of early physical intervention and changing cultural attitudes to transsexuality.
Commentary on Walters and Whitehead’s (1997) ‘Anorexia Nervosa in a Young Boy with Gender Identity Disorder of Childhood: A Case Report’
Authors: Zucker Kenneth J.
Published: November 2003

This commentary on Walters and Whitehead’s (1997) case report reviews some of the rationales for therapeutic intervention with children with gender identity disorder. Factors that might either facilitate or impede the prospects for therapeutic change are also reviewed. A case example of a three-year-old boy is provided in which gender identity conflict was apparently resolved.
Functional Visual Loss in Childhood and Suggestibility
Authors: Abe Kazuhiko , Suzuki Takashi
Published: November 2003

Visual disturbance in which no organic ophthalmological or neurological abnormalities are found is referred to as functional (or psychogenic) visual loss. Based on our preliminary results on this disorder, we set out to examine whether the individual’s suggestibility and the effect of suggestion play a major role in its etiology and course; specifically, whether the age trend of suggestibility is reflected in the age distribution of this disorder and whether a non-damaging physical trauma of the face or head precipitates visual loss in a large number of cases, and whether suggestion therapy is effective. Fifty-nine children with this disorder, 43 girls (73%) and 16 boys (27%), were studied. The distribution of their age-of-onset peaked at 8–9 years and was similar to the age trend for suggestibility in childhood. The visual loss had followed a minor trauma to the head, conjunctivitis or eye pain in 32% of the cases. Thirty-three children were treated with simple suggestion and 28 (85%) recovered visual acuity within four sessions. These results indicate that suggestibility is associated with this disorder and that suggestion therapy is effective for its treatment.
A New Taxonomy: The Uluru Personal Experiential Profile
Authors: Nunn Ken , Nicholls Dasha , Lask Bryan
Published: November 2003

The detail and scholarship of the two major psychiatric taxonomies, ICD-10 and DSM-IV, have made an invaluable contribution to classification in child and adolescent psychiatry. Nonetheless, persistent minority voices have challenged their applicability to clinical practice. We tentatively offer for discussion a new taxonomy which we believe complements existing paradigms and has more clinical relevance. It is multitheoretical and attempts to fill the gap that exists between the language of the helped and that of the helper. A series of vignettes is provided to illustrate the clinical application of the new taxonomy.
School Refusal: A Changing Problem Which Requires a Change of Approach?
Authors: Place Maurice , Hulsmeier Jessica , Davis Sue , Taylor Elizabeth
Published: November 2003

School refusal is a condition which was delineated by a large quantity of empirical work carried out in the 1960s and 1970s. The current study reveals a pattern at variance with the traditional picture of the child and their family, with the children generally coming from socially deprived backgrounds, having significant difficulties relating to peers, and a family life containing conflict and stress. The pattern described suggests that elements of therapeutic intervention may need to be altered to give the greatest opportunity for the youngsters to overcome their school attendance difficulties and minimize the likelihood of future psychiatric problems.
Psychotherapeutic Treatment of Traumatized Infants and Toddlers: A Case Report
Authors: Gaensbauer Theodore John
Published: November 2003

The treatment of children traumatized under the age of 3 years has presented particular challenges. The cognitive immaturity, lack of verbal fluency and uncertain memory capacities of very young children have made it difficult to know how traumatic events are represented internally and how their effects may be alleviated. Addressing these difficulties, this article describes the psychotherapeutic treatment of a 3-year-old boy traumatized at 22 months of age by a medical illness and its associated treatments. The goals of the therapy were to relieve symptoms and help the child integrate the traumatic experience, while promoting the parents’ crucial role in the child’s recovery. The case material illustrates the usefulness of active structuring of the child’s play as a vehicle for understanding the child’s experience of a trauma. It also documents the child’s impressive memory for the medical events and his comprehension of their implications, as well as the influence of the rapid developmental changes occurring in early childhood on the processing of the trauma. Lastly, the case highlights the disruptive impact of traumatically induced anger on children’s development and the importance of facilitating its appropriate expression so that a traumatic experience can be resolved fully.
A Study of a Support Service for the Current Carers of Sexually Abused Girls
Authors: Rushton Alan , Miles Gillian
Published: November 2003

Intervention in support of the current carers is seen as an important part of a treatment package for sexually abused girls. This article, one element of a comparative treatment trial, describes the characteristics and backgrounds of the current carers, the nature of the help provided to them and their responses to the help. One of the main aims of involving and supporting carers was to try to ensure regular attendance of the girls in the therapy and this was largely achieved. Although there were no simple relationships between help for the carers and treatment outcome for the girls, a strong association was found between a positive attitude by the birth mothers toward the treatment and improvement in the girls. The possible reasons for this are discussed together with practice and research considerations when planning dual interventions to attend to the needs of the girls and their carers.
Emotional Abuse: The Work of a Multidisciplinary Consultation Group in a Child Psychiatric Service
Authors: Boulton Sylvia , Hindle Debbie
Published: November 2003

The identification, assessment and treatment of emotional abuse demands a multi- disciplinary approach due to the complexity and multifactoral nature of the task in hand. Child psychiatry services have an important part to play. Common themes emerging in our work are outlined, illustrated with case material, which have furthered our understanding of damaging family interactional patterns and the psychological effect they have on children. Some repeated experiences in the process of intervention are explored in the article. The existence of the consultation group has been essential to pull together our thinking around this complicated and demanding area of clinical work.
Assessing Children’s Perspectives on Sibling Placements in Foster or Adoptive Homes
Authors: Hindle Debbie
Published: November 2003

This article emphasizes the importance of accessing children’s perspectives as part of the decision-making process in relation to the placement of siblings in foster or adoptive homes. Two case examples illustrate a proposed assessment model in which the children were seen together and separately. This model provided a predictable structure in which to observe the children’s interactions, their verbal and non-verbal communication and play, and to begin to think about their shared and individual needs. The case examples also illustrate one aspect of sibling relationships that can be overlooked - the children’s deep sense of relatedness and belonging to each other. The importance of a systematic approach to this difficult, and often painful, area of work cannot be overestimated.
Children Involved in Road Traffic Accidents: Psychological Sequelae and Issues for Mental Health Services
Authors: Stallard Paul , Velleman Richard , Baldwin Sarah
Published: November 2003

Although road traffic accidents involving children are common daily events it is only recently that the psychological consequences arising from such traumas have been investigated. This article summarizes the current research and highlights, by the use of case histories, the psychological reactions typically experienced by child traffic accident victims. Mental health services are not routinely provided to this group of children and the possible treatment implications are discussed.
An Art Therapy Group for Children Traumatized by Parental Violence and Separation
Authors: Kozlowska Kasia , Hanney Lesley
Published: November 2003

This article describes the treatment of five traumatized children (aged 4–8 years) using adjunctive group art therapy, and reviews the theoretical basis for such a treatment strategy. All the children had been exposed to cumulative traumatic experiences involving threats to caregivers in the context of conflictual, violent and unresolved parental separation. All presented with symptoms of post-traumatic stress, developmental problems related to trauma, had difficulties with any discussion of traumatic events or family concerns, and reacted with hyperarousal and/or an ‘emotional shutdown’ response. Previous treatments included a combination of social, family, psychological and biological interventions including: outpatient family therapy, medication, admission to a therapeutic day programme, inpatient family work and home visits by nurses, with partial response. The group, a structured, low anxiety, interactive setting, was a therapeutic intervention developed by a child psychiatrist and an art therapist to facilitate further therapeutic change. The therapeutic use of artworks facilitated exposure to traumatic cues in a less direct manner, allowed for desensitization of anxiety and unpleasant body sensations, helped the children recount the story of the parental separation and to label and articulate affective states using art and narrative. Positive family changes and coping skills the children were using to manage ongoing stresses were made overt. Positive expectations of the future were promoted. Key therapeutic and theoretical aspects of the group intervention are described.
Music Therapy for Adolescents
Authors: Tervo Jukka
Published: November 2003

This article is based on 20 years of clinical music therapy work with adolescents in co-operation with psychoanalysts and psychotherapists. Music, and in particular rock music, can give adolescents the possibility to express, be in contact with and share among themselves feelings of anger, rage, grief, longing and psychological disintegration. Music also provides adolescents with opportunities to experience closeness and isolation and to explore their sexual fantasies and feelings.
Treatment Adherence in Adolescents: Development and Psychopathology
Authors: Shaw Richard J.
Published: November 2003

The failure of the adolescent medical patient to adhere to prescribed medical treatment is one of the major reasons for psychiatric consultation in pediatric medical settings. This article reviews the developmental issues that interfere with treatment adherence in adolescents with chronic physical illness as well as the importance of co-morbid psychiatric disorders. Incomplete adherence is conceptualized as a clinical phenomenon that can be understood by considering both developmental and psychopathological factors that influence health care behavior. Interventions designed to enhance treatment adherence need to consider both developmental issues and psychiatric co-morbidity in order to improve outcome.
Developing Practice on a Ward for Adolescents with Psychiatric Disorders
Authors: Wilkinson Simon R.
Published: November 2003

The therapeutic principles and practice on a psychiatric inpatient unit for adolescents are described. The practice has grown out of applications of ‘multisystemic treatment’ principles. The major challenges have been to ensure the formulation of concrete goals for treatment from the perspective of the adolescents and their parents, and ensuring that gains made on the ward can be generalized to local networks. The use of inpatient family therapy integrated with weekends at home, while the adolescent is an inpatient on the ward, is described.
Description and Evaluation of a Day-Centre-Based Behavioural Feeding Programme for Young Children and their Parents
Authors: Douglas Jo , Harris Brenda
Published: November 2003

A day-centre-based feeding programme is described in which families who have young children with severe and chronic eating problems attend for one morning once every two weeks for 12 attendances. It is a focused, change-directed programme that treats a wide range of eating problems. The approach is based on behavioural management strategies in a biopsychosocial model of assessment and treatment. The issues and choices in the development of this programme are discussed. An evaluation questionnaire directed specifically at outcome criteria for young children with feeding problems is included. Results of evaluations from parents and clinicians using this questionnaire indicate that it successfully identifies clinical change relevant to the goals of treatment. Data are presented on the outcome of intervention.
Art and Play Group Therapy for Pre-School Children Infected and Affected by HIV/AIDS
Authors: Willemsen Hessel , Anscombe Elizabeth
Published: November 2003

This article presents the therapeutic approaches used in art and play therapy for children infected and affected by HIV/AIDS. We discuss developmental issues of individual children that emerged whilst participating in these groups and the processes involved. Issues of loss and separation related to bereavement are especially addressed. By providing a sense of containment we enabled these children to tolerate and integrate the traumatic experiences they have undergone.
Selective Mutism, Social Phobia and Moclobemide: A Case Report
Authors: Maskey Sean
Published: November 2003

The literature on childhood elective/selective mutism and its relationship to social phobia is reviewed briefly. A chronic case, resistant to multiple psychological treatments, is described. The results of a novel treatment approach with moclobemide, a reversible monoamine oxidase inhibitor, are evaluated and discussed.
The Aims of Child Psychotherapy: A Kleinian Perspective
Authors: Barrows Paul
Published: November 2003

This article describes the aims of child psychotherapy from a Kleinian perspective. Following a brief historical overview, it uses a children’s story and clinical material to suggest that one aim may be described as helping the child to reintegrate split- off parts of the personality. It is argued that this approach is significantly different from those that are targeted at symptom relief. The importance of interpretation is emphasized as the means by which the child is given an experience of being able to think about feelings that may previously have been disowned. The ability to own these feelings is seen as integral to mental health.
Pervasive Refusal Syndrome: A Parent’s Perspective
Authors:   Anonymous
Published: November 2003

This article is the first to offer a parent’s perspective on pervasive refusal syndrome. It describes how a family, and in particular the parents, are able to help their child through the illness and into a complete and sustained recovery.
Children’s Perceptions of Body Shape: A Thinness Bias in Pre-Adolescent Girls and Associations with Femininity
Authors: Pine Karen J.
Published: November 2003

Despite research documenting the body image concerns of adolescent females, and the association with eating disorders, less is known about children’s perceptions of body shape or the developmental roots of adolescent concerns. This study, involving 140 children aged 5-11, explored what children think is the ideal shape for an adult male and female and whether body shape is related to masculinity and femininity. Children saw a range of figures from very thin to very fat and were asked which they thought was ‘the nicest shape for a lady (or man) to be’. Girls and boys agreed about what is the ideal male shape, but differed in their perception of the ideal female shape from as early as 5 years old. Girls selected an ideal female figure that was significantly thinner than that chosen by boys, and the girls also aspired to a thinner figure for themselves. Girls as young as 9 years, though not overweight, admitted they were dieting. Also, 61% of 11-year-old girls said their mothers dieted compared with only 12% of boys. Significantly more stereotypically feminine traits were associated with a thinner female figure than with a fatter one, whilst masculine traits were not associated with any particular male somatotype. The findings suggest that to be feminine, a female has to be thin although males can be either thin or fat and still be considered masculine. The implications in terms of the distorted beliefs underlying eating disorders are discussed.
In-Patient Admission of Adolescents with Mental Disorder
Authors: Gowers Simon G. , Clarke Judith , Alldis Marcia , Wormald Paul , Wood Natalie
Published: November 2003

Whilst all developed countries report high rates of adolescent mental disorder, there has been a decline in adolescent in-patient provision in the UK in recent years. This report shows that only 0.3% of adolescents requiring psychiatric admission in the North West of England were admitted to an adolescent psychiatric unit, the rest being treated in adult mental health or non-psychiatric facilities. These findings point to a considerable need for and under-provision of adolescent psychiatric services, including in-patient beds, in North West England. This situation probably exists elsewhere in the UK, where development of adolescent and youth services has lagged behind Europe and North America.
Who Do You Think You Are? Drawing the Ideal Self: A Technique to Explore a Child’s Sense of Self
Authors: Moran Heather
Published: November 2003

The art of designing and asking questions is a key task in psychological therapies. Therapists working with children need to do this in a way that allows them to give a meaningful answer. This article introduces a technique that enables children to become actively involved in the therapeutic process and to gain a better understanding of themselves. ‘Drawing the Ideal Self’ requires little equipment but provides the therapist and child with a permanent record of their work together. Step-by-step instructions and a case example are included in this article. It could be useful to all mental health professionals who need to plan directions in therapy or to design interventions with a child.
Children of Somatically Ill Parents: A Methodological Review
Authors: Romer Georg , Barkmann Claus , Schulte-Markwort Michael , Thomalla Götz , Riedesser Peter
Published: November 2003

The children of seriously ill parents are at risk for emotional disturbances. This review covers five former reviews, three theoretical articles, five case studies and 39 sample studies from the last 15 years. Methodological problems and shortcomings of previously published studies are discussed in detail. Based on former reviews and theoretical approaches, a developmental framework for children’s adaptation processes is elaborated. Empirical studies are analysed with a differentiation of how various results were correlated with the types of parental diseases and children’s age groups studied, as well as with various methodological designs and instruments applied. It appeared evident that children of seriously ill parents had higher scores on symptom scales than did controls, with a tendency towards internalizing symptomatology. In several studies, adolescent daughters of ill mothers appeared to be at highest risk for maladjustment. Ill parents’ subjective perception of their impairment predicted children’s symptoms better than the objective degree of severity of their disease. Although subgroups of children adjusted well, covariant protective mechanisms could not be clearly identified. In conclusion, suggestions for further research include ethical standards, a profound theoretical framework for any hypothesis to be tested, a combination of qualitative and quantitative methodology, the integration of the child’s subjective dimension by semi-structured or open interviews, and the consideration of coping as a process through longitudinal designs.
The Relationship between Adjustment of Mothers with HIV and their Adolescent Daughters
Authors: Lee Martha B. , Lester Patricia , Rotheram-Borus Mary Jane
Published: November 2003

The emotional distress, self-esteem and problem behaviors of adolescent daughters aged 11–18 years ( n= 121) and their mothers with HIV were examined and related to reports of parental disclosure of serostatus and adolescents’ perceived bonds with their parents. Most mothers with HIV reported emotional distress in the clinical range (70%). The levels of emotional distress, self-esteem and drug use were significantly correlated between mothers and daughters. Adolescent’s emotional distress was significantly related to maternal disclosure of HIV status. Daughters who perceived their mothers as highly caring also perceived them as low in overprotection. Daughters who perceived their mothers as low in caring were more emotionally distressed and reported more conduct problems and lower self-esteem. Interventions to enhance adjustment of daughters in families coping with HIV must focus on mental health symptoms and mother–daughter bonds.
The Parentified Child
Authors: Earley Louise , Cushway Delia
Published: November 2003

Young carers are children under the age of 18 who provide care to a family member. Concern has been raised within the welfare services that these children are involved in levels and types of care that are developmentally inappropriate and that jeopardize their health and development. Despite a vast literature on the psychological impacts of caregiving upon adult carers, there has been little investigation into the impacts upon children. This review focuses on one main area of research that has examined children as caregivers; research on the ‘parentified child’. This literature derives from the traditions of systemic theory and is primarily concerned with establishing how caregiving as a child impacts upon adult functioning. Studies suggest that identity development and personality, interpersonal relationships and relationships with an individual’s own children could be affected. How the literature conceptualizes caring and the psychological theories that underpin the concept of parentification are discussed. The empirical studies are then summarized under four headings; precursors to parentification, impacts upon adult relationships, direct impacts upon the child and circumscribed research. Conceptual and methodological limitations are discussed. These include the lack of a clear definition of parentification, and problems with measurement, sampling and design. Finally, recommendations for improving and developing the parentification literature are presented that draw upon studies of resiliency, adult care giving and attachment.
Attention Deficit Hyperactivity Disorder is Associated with Attachment Insecurity
Authors: Clarke Leanne , Ungerer Judy , Chahoud Katrina , Johnson Susan , Stiefel Ingeborg
Published: November 2003

The literature on attention deficit hyperactivity disorder (ADHD) and attachment is reviewed, and we describe an investigation of the relationship between attachment insecurity and ADHD. Nineteen boys, aged 5–10 years with DSM-IV diagnoses of ADHD were compared with 19 control children on three representational measures assessing internal working models of attachment and the self: the Separation Anxiety Test, the Self Interview, and a Family Drawing rated with an attachment-based scoring system. Consistent support was found for the hypothesis that ADHD is associated with insecurity of attachment, with the ADHD group obtaining poorer scores on all three measures. The nature of attachment insecurity in the ADHD group was one of heightened emotional expression characterized by strong, out of control affects, and was consistent with an anxious-ambivalent or disorganized attachment style. We argue that quality of attachment with primary caregivers should be assessed when children present with symptoms of ADHD, and that where insecure attachment relationships are found, treatment must incorporate relationship-building components.
Cognitive Behaviour Therapy for Adolescents with Psychological Disorders: A Group Treatment Programme
Authors: Vickers Bea
Published: November 2003

Cognitive behaviour therapy (CBT) is a structured, collaborative psychotherapy, which emphasizes the link between thoughts, feelings and behaviour in maintaining psychological disorders. Over the last decade, CBT techniques have been shown to have a robust efficacy in studies with the child and adolescent population, and more recently, when delivered as group interventions for young people. This article describes the clinical outcome of eight adolescents who attended a 12- session CBT group programme run once a week within a Child and Adolescent Mental Health Service (CAMHS). The group differs from previous CBT groups for adolescents described in the literature, in that those attending had a wide range of different psychiatric and developmental disorders. Most had received some type of previous psychological or psychopharmacological intervention, but had remaining deficits, particularly in the area of social relating. The therapeutic techniques used, the setting and the principles are described in detail. Results are presented in terms of clinical change, as reported by the adolescent’s carers, their schools and the group participants themselves. It is concluded that the CBT group programme is a user-friendly and clinically valuable adjunct to other therapeutic methods, specifically in ameliorating social skill deficits, which, untreated, would be a risk factor for relapse. Further quantitative research into the properties of the CBT group programme is indicated.
Child and Adolescent Gambling Behavior: Current Knowledge
Authors: Hardoon Karen K. , Derevensky Jeffrey L.
Published: November 2003

The past decade has witnessed a widespread proliferation of gambling venues, increased participation in gambling activities and gambling-related problems, and, as a result, an expansion of research in this area. Research concerned with youth gambling has revealed that children and adolescents are at an increased risk for the development of gambling-related problems. There is a significant amount of evidence that suggests that underage youth are actively participating in both legal and illegal forms of gambling. With increases in the availability and accessibility of gambling activities, the problems that youth gamblers face are likely to increase and/or worsen. The growth of the current generation of youth involvement in gambling has not occurred without personal, social and economic costs. Between 4 and 8% of adolescents report significant pathological or problem patterns of gambling, whereas 10–15% remain at risk for the development of severe problems.
The Assessment of the Child with Autism: A Family Perspective
Authors: Reid Sue
Published: November 2003

This article describes a psychodynamic approach to autism developed by the author under the auspices of the Tavistock Autism Research Workshop; the approach pays particular attention to the impact on the family of living with a person with autism. Particular emphasis is placed on the use of observation and counter-transference.
Developmental Delay, Symbolic Play and Non-Directive Play Therapy
Authors: Ryan Virginia
Published: November 2003

This paper focuses on non-directive play therapy with maltreated and neglected young children, and explores ways in which their symbolic play seems to be activated and accelerated during play therapy. The frameworks of attachment and cognitive development are utilized to examine therapeutic relationships. Examples from normal development and from therapeutic work are given in order to describe more precisely the seemingly essential features in the development of symbolic play in young children. The important features of a child’s social environment, physical environment and internal state which seem to contribute to the activation of symbolic play are then discussed in more detail. Finally, it is argued, studying a child’s transition from concrete to symbolic play during play therapy contributes to our understanding not only of damaged and delayed children’s development, but also provides additional information on normal children’s development of this capacity.
A Mental-Health Service for Young People in the Care of the Local Authority
Authors: Arcelus Jon , Bellerby Tina , Vostanis Panos
Published: November 2003

Children in care constitute a deprived and needy group of young people, who are at high risk of developing mental-health problems and disorders. This article describes the development of a direct access child and adolescent mental-health service for children living in residential units or with foster families, with data on the pattern and characteristics of referrals, and discussion on the arising difficulties. The main aims of this service are, to be responsive and flexible, to provide mental- health assessment and treatment, and to work with residential care staff, foster parents and field social workers. Young people referred to the mental-health service had high rates of abuse, history of offending behaviour, poor school attendance and frequent previous contacts with child mental-health services. There were also high rates of child mental-health disorders, particularly mixed conduct and depressive disorders, and history of self-harm. Anticipated benefits include a coordinated and cost-effective assessment, improved mental-health outcome, contribution to the care plan and prevention of further difficulties. Joint commissioning between health and local authorities should prioritize children in care. Different models of mental-health provision may be appropriate and require evaluation.
Developmental Approaches to the Patient with Pediatric and Psychiatric Comorbidity
Authors: Steiner Hans
Published: November 2003

Pediatric and psychiatric illness can combine in complex patterns, which have implications for diagnosis, treatment, and outcome. The knowledge base in pediatric psychiatry (child psychiatry as it applies to pediatric practice) has expanded considerably in the past two decades. The careful documentation of the epidemiology of comorbidity in cross-sectional and longitudinal studies in clinical and population-based samples is enabling us to shift our attention to the examination of developmental pathways and predictable patterns of relationships between pediatric and psychiatric illness. We describe a pragmatically based model for the clinician who works in the primary care setting. The model is based on the biopsychosocial model of disease. We enrich our perspective by adding the theoretical framework of developmental psychopathology, as it informs child psychiatric practice. Context, complexity, and continuity are concepts that can be easily accommodated within the synthetic framework of developmental theory. The approach of developmental psychiatry is particularly well suited to the diagnosis and treatment of the child or adolescent suffering from both pediatric and psychiatric illness, because it allows the integration of diverse data and accounts for complex clinical situations.
Pediatric Psychiatry at Lucile Salter Packard Children’s Hospital at Stanford
Authors: Lock James , Steiner Hans
Published: November 2003

This article describes the historical evolution of the Comprehensive Pediatric Care Unit (CPCU), a pediatric psychiatry inpatient service at Lucile Salter Packard Children’s Hospital at Stanford. The CPCU developed initially as an inpatient treatment program for children with a variety of somatoform disorders, but has evolved to become the interconnecting link for pediatric consultation and a flexible resource for intensive treatment needs of a wide range of children and adolescents with combined medical and psychiatric problems.
Severe Somatoform Disorder in Adolescence: A Case Series Using a Rehabilitation Model for Intervention
Authors: Lock James , Giammona Andrew
Published: November 2003

This article describes a multidisciplinary approach to the treatment of adolescent patients with severe and unremitting somatoform disorders on an inpatient pediatric psychiatry unit. The treatment approach includes the use of a rehabilitation model for behavioral shaping, supportive therapies, family therapies, and an adolescent treatment milieu. The article also provides a case example and results from a consecutive case series of seven patients treated using this approach. The patients treated using this approach demonstrated significant improvements in global assessments of functioning, decreased dependence on medical devices (wheel- chairs, crutches, feeding tubes), and a decreased need for pediatric interventions.