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Editorial                                                                                                                                            Open Access

## There is no Such Thing as a Child

Ole Jakob Storebø, Pernille Darling Rasmussen & Sven Bölte

Winnicott's  assertion  that  young  children  do  not exist independently but rather function in relationship  to  their  primary  caregivers  (1)  is  the focus of the first four papers in this issue. His idea underlines  the  attachment  between  a  mother  and her  child  as  well  as  the  importance  of  the  child's family environment. Parents and their offspring are connected  in  an  intimate  way,  and  mothers  and fathers  can  be  both  the  causes  and  the  cures  of psychological problems within their children. Before the predominance of biological psychiatry, attachment  and  family  factors  were  viewed  as  the most important components of the theoretical foundations  of  child  and  adolescent  psychiatry  in Scandinavia.  Much  of  child  psychopathology  was attributed to psychodynamic processes (2,3). However, it seems that a slight paradigm shift back toward  more  of  a  focus  on  the  child  within  the family  may  be  occurring.  This  may  offer  a  more balanced view of the child and his or her problems that  does  not  neglect  the  importance  of  parenting and the family. The four articles presented here all tackle family relationships and the interactions between children and their parents.

The  first  article  by  Bendiksen  and  colleagues discusses  the  Mother  and  Child  Cohort  Study,  a prospective study (N = 807) that looked at the early identification of attention-deficit/hyperactivity disorder (ADHD)  in young children (4). The authors  show  that  added  burdens  and  problems within  family  relationships  were  associated  with more  ADHD  symptoms  as  measured  by  parental rating scales. This may well indicate early emerging coercive cycles and therefore be an important target for early prevention and intervention strategies. It is difficult to state anything  causal here,  but this research is important, because it indicates detectable early signs of ADHD in very small children.

The association between ADHD and attachment has  been  demonstrated  in  many  studies  on  many different  levels  and  the  research  on  the  topic  of attachment  is  again  increasing  in  Scandinavia  (5). For instance, in the Child and Adolescent Psychiatry Department in Region Zealand, Denmark, a coming observational follow-up study will examine whether parents' attachment competencies are important to treatment response  and  prognosis  in  children  with ADHD.

The second article in this issue deals with the risk for  suicide  among  adolescents.  Petersen  and  Elklit review the Faroese Adolescent Trauma Study (N = 687), which provided important data about the roles of attachment, negative affectivity, and social support in suicide attempts in a total population of Faroese  adolescents  (6).  The  authors'  results  show the  necessity  of  taking  gender  into  account  when researching  risk  and  protective  factors  for  suicide attempts  and  when  establishing  arrangements  to prevent and treat suicide attempts among adolescents.

The study by Esbjørn and colleagues explores the relationship between maternal and paternal perceptions of parenting and childhood anxiety (7). The  perceived  rearing  behaviors  and  the  parental sense of competence (i.e., satisfaction and efficacy) of  the  parents  of  anxious  children  (n  =  59)  were compared with those of a nonclinical control sample (n = 44). In line with the findings from the literature  that  addresses  externalizing  disorders,  it was  found  that  the  parental  sense  of  competence was significantly associated with childhood outcomes.

Finally, in the article by Alves and colleagues, the association  between  parental  achievement  values and emotional problems among preadolescent children was mediated by parents' comparisons with their  own  achievement  values  (8).  Higher  levels  of parental  achievement  values  were  associated  with more comparisons, and this relationship was stronger for preadolescents with immigrant backgrounds.  Comparisons  were  only  linked  to emotional problems among  preadolescents with immigrant backgrounds.

All four of these articles highlight the considerable complexity of researching psychopathology in children and adolescents as well as the critical importance of understanding children within the  context  of  their  family  units.  Among  other things, this means that it is necessary to look at the parents' level of functioning and parental perceptions of their own abilities and opportunities in  relation  to  the  children's  well-being.  Moreover, when  studying  children,  the  importance  of  taking factors such as age and gender into consideration is vital.

On  a  more  general  note  with  regard  to  the development of the Scandinavian Journal of Child and Adolescent  Psychiatry  and  Psychology (SJCAPP),  we  are happy  to  be  experiencing  increased  interest  in  our journal . This  has  been  indicated  by  the  fact  that articles published in this journal are beginning to be cited; we also are receiving an increasing amount of submissions.

At  the  moment,  we  are  preparing  an  application to  have  SJCAPP  indexed  in  the  large  databases. Most  of  these  services  require  indexed  journals  to have at least two years of publishing activity, and we have now reached that point. Thus, we are hopeful that  SJCAPP  will  soon  be  indexed  in  Thomas Reuter, with its first official impact factor calculated three years thereafter. In the meantime, we will have an  unofficial  impact  factor  calculated  in  the  spring of 2016.

One  of  the  upcoming  special  issues  of  SJCAPP will  focus  on  attachment  and  the  development  of psychopathology.  Later  this  year,  our  dear  readers can look forward to a special issue about personality disorder, with Mickey Kongerslev and Erik Simonsen  serving  as  its  editors.  Next  spring,  a special issue about psychosis created in conjunction with Ulrik Haahr and Sune Bo will be published; we have just sent out a call for papers for that issue.

## References

1. Winnicott DW. The maturational processes and the facilitating environment. Studies in the theory of emotional development. London: Hogarth Press Books Ltd., 1965.
2. Bowlby J. A Secure Base: Clinical applications of attachment theory. London: Routledge, 1988.
3. Thomsen PH (ed). Børne- og ungdomspsykiatrien i Danmark gennem 50 år. Et jubilæumsskrift. Børne- og Ungdomspsykiatrisk selskab i Danmark [50 years of child and adolescent psychiatry in Denmark] Avaialable from: http://bupnet.dk/media/03-10-29FestSkrift[1].pdf
4. Bendiksen B, Aase H, Svensson E, et al. Symptoms of ADHD and co-occurring oppositional defiant disorder and conduct disorder in
5. young preschool children; the impact on functional impairment. Scand J Child Adolesc Psychiatr Psychol 2014;2(3):95-105.
5. Storebø OJ, Skoog M, Rasmussen PD, et al. Attachment competences in children with ADHD during the Social-Skills Training and Attachment (SOSTRA) randomized clinical trial. J Atten Disord 2014;Feb 14 Epub.
6. Petersen T, Elklit A. Risk factors for suicide attempts in the total population of Faroese eighth graders Scand J Child Adolesc Psychiatr Psychol 2014;2(3):106-14.
7. Esbjørn   BH, Caspersen   ID, Sømhovd   MJ, Breinholst   S,   ReinholdtDunne   M. Exploring the contribution of parental perceptions to childhood anxiety. Scand J Child Adolesc Psychiatr Psychol 2014;2(3):115-23.
8. Alves DE, Gustavson K, Roysamb E, Oppedal B, Zachrisson HD. Preadolescents with immigrant backgrounds: the relationship between emotional problems, parental achievement values, and comparison. Scand J Child Adolesc Psychiatr Psychol 2014:2(3):124-34-