Self-relation of adolescents in a family with a step-father

This article represents an empirical study of adolescent's self-relation in a family where the mother has re-married. In many studies self-awareness and its functional aspect--self-relation--are selected as new stages in adolescence. The family is considered to be the most important factor in a child's and adolescent's personality development. Literature reviews on the specifics of a child's development in a family with a second marriage present some of the problems facing the parents and children in it. In the present article, problems of relations between children and parents are discussed. A principal finding of this report is that adolescents from families with a stepfather have a less flexible self-relation than adolescents from families with the biological father; to have a positive self-relation they need defence mechanisms. At the same time, analysis of adolescents' drawings shows that adolescents from families with a stepfather exclude themselves from the family system. In addition, the article discusses gender differences in self-relation in two types of families.     

Differences in protective factors of substance use in early and middle adolescence

This study focuses on possible differences in protective factors of substance use in early and middle adolescence. These possible differences are analysed by means of the same structural equation model applied to two different samples of adolescents: the first sample is made up of 450 adolescents, ages 12 to 14 years, and second of 203 adolescents, ages 15 to 17 years. The results indicate that adequate family communication is a protective factor in both samples, whereas high social self-esteem is proposed as a risk factor in middle adolescence. The adolescent's family self-esteem and attitudes towards authority are also relevant factors in both samples. These results may have important implications in the development of future intervention programmes.     

Slips of the analyst.

Understanding the analyst's work and its vicissitudes has been a major focus of recent psychoanalytic writing. This study on slips of the analyst represents an attempt to advance our understanding of analytic work. The slips described support the view that slips reflect not simply contributions from instinctual life, but active work-related goals of the analyst in carrying out the analytic tasks. Countertransference is discussed as reflected in the disturbance of intentionality betrayed by the occurrence of a slip. The essential role of the analyst's understanding his or her own reactions is emphasized.     

Work conditions, social status and sex differences in primary and secondary enuresis

From previous investigations on the enuresis problem a distinction between primary and secondary enuresis is established. The first type concerns children who have never been dry and the second those with acquired enuresis. The theory is advanced that primary enuresis is a development problem mainly due to delayed cortical development or insufficient bladder capacity, whereas secondary enuresis is regarded as caused by an increased anxiety level. Some social and psychological factors in this theory, i.e., the mother's working conditions, the social status of the family, and the sex of the child, are empirically examined in an investigation of 82 children 7–15 years old. The results support the view that the main factors in the enuresis problem are related to the child's daily practice and in the socialization form of the family.     

Parent and child agreement on anxiety disorder symptoms using the DISC predictive scales

Growing recognition of the negative impact of anxiety disorders in the lives of youth has made their identification an important clinical task. Multiple perspective assessment (e.g., parents, children) is generally considered a preferred method in the assessment of anxiety disorder symptoms, although it has been generally thought that disagreement between parent and youth ratings of the child's emotions is common. This study examined parent and child reports of the child's anxiety disorder symptoms using the Diagnostic Interview Schedule for Children-Predictive Scales (DISC-PS) in a clinic-referred sample of substance using adolescents. Parents and adolescents (N = 480) who were referred for substance abuse treatment were screened for anxiety disorder symptoms using the DISC-PS at pretreatment. Results suggest similar (low) levels of agreement between the parent report and child report versions as found with other anxiety symptom and anxiety disorder measures. Findings provide data on multi-informant agreement and highlight issues in the use of the DISC-PS to identify anxiety problems in youth.     

On medicine, culture, and children's basic interests: a reply to three critics

Margaret Mohrmann, Paul Lauritzen, and Sumner Twiss raise questions about my account of basic interests, liberal theory, and the challenges of multiculturalism as developed in Children, Ethics, and Modern Medicine. Their questions point to foundational issues regarding the justification and limitation of parental authority to make decisions on behalf of children in medical and other contexts. One of the central questions in that regard is whether adults' decisions deserve to be respected, especially when they seem contrary to a child's or adolescent's basic interests. Questions about respect, in turn, focus attention on other's decisions about what seems good for families and children, decisions that may be paternalistic or utilitarian. Such decisions are further complicated by a child's or adolescent's budding autonomy and need for respect and recognition. Pediatric bioethics grounded in an account of a child's basic interests produces a theory of negative and positive rights for assessing adults' actions in relation to children, especially (but not only) when adults demand respect in their expressions of care.     

青少年心目中的理想父母形象研究

以690名初一、高一和大一学生为被试,采用自制的词表,运用因素分析方法研究青少年心目中的理想父母形象,并比较不同青少年理想父母形象之差异。结果发现:(1)当代青少年心目中理想父母形象应具备的五项主要特征是:尊重沟通、与子为友,能力强、善于交际,正义乐群,正视现实,品德好、有原则;(2)女孩比男孩更重视父母与她们的沟通与相处;(3)随着年龄的增长,孩子对父母与自己相处态度的要求逐渐提高,而对父母的能力、生活态度、品德的要求逐渐降低;(4)是否独生子女、家庭收入水平对青少年心目中的理想父母形象也有一定影响,不同家庭结构青少年心目中的理想父母形象则没有差异。     

Triangulation and adolescent development in the U.S. and Japan.

Using an indirect measure of family structure, relationships between parents and adolescents were studied in 99 U. S. and 60 Japanese families. As two-person relationships tend toward instability under stress, a third person may be drawn in to stabilize the system. Parents, for example, may avoid the tension in the marital relationship by focusing together on an adolescent's problem, or pull the adolescent into a coalition with one parent. Either way the parents are said to have "triangled" the adolescent. In this study, a relationship is found between parents avoiding tension in their own relationship and their tendency to triangle an adolescent. Triangled daughters, in both cultures, had lower scores on ego development, supporting the hypothesis that such patterns can be detrimental to the adolescent's personal development. The discussion includes comments on cross-cultural research.     

The development of adolescent sexual intimacy: implications for counseling

This paper proposes a perspective for understanding the development of adolescent sexual intimacy. A "transitional stage" is described in which adolescents, driven by a variety of developmental needs influenced by external forces such as peers and family, experiment with sexual behaviors. The completion of the transitional stage results in the adolescent's ability to achieve "relational" sexual intimacy, which is also described. The problems and implications for counseling associated with the biophysiological and family dynamic influences on the development of adolescent sexual intimacy are discussed.     

Perceived Intrafamilial Connectedness and Autonomy in Families With and Without an Anxious Family Member: A Multiple Informant Approach

Perceived intrafamilial “emotional connectedness” and “autonomy” were investigated within families with and without an anxious family member using a multiple informant approach. The sample consisted of 32 mothers with a current anxiety disorder and 56 controls, their partners, and their anxious and nonanxious teenage children. No differences were found with respect to the perceived family relationships of family members with versus without anxious mothers. However, compared with nonanxious adolescents, anxious adolescents perceived less autonomy in relation to both parents. Mothers of anxious adolescents also perceived their children to be less autonomous toward them and their partners, than mothers of nonanxious adolescents. In contrast with “autonomy,” “emotional connectedness” was not reported to be different between families with and without an anxious adolescent. Agreement among family members and the importance of perceived individual autonomy in the development of anxiety are discussed.     

Comorbidity of anxiety and depression in children and adolescents.

Anxiety and depression in children and adolescents are reviewed, including differential diagnosis, assessment of symptoms, family history data, developmental features, and clinical correlates. Findings indicate that 15.9% to 61.9% of children identified as anxious or depressed have comorbid anxiety and depressive disorders and that measures of anxiety and depression are highly correlated. Family history data are inconclusive. Differences emerged among children with anxiety, depression, or both disorders. Anxious children were distinguishable from the other 2 groups in that they showed less depressive symptomatology and tended to be younger. The concurrently depressed and anxious group tended to be older and more symptomatic. In this group, the anxiety symptoms tended to predate the depressive symptoms. Findings are discussed in the context of a proposed developmental sequence.     

Healing traumatized children: creating illustrated storybooks in family therapy

In this article we describe the therapeutic practice of creating illustrated storybooks in family therapy with traumatized children. Illustrated stories offer a predictable structure to sessions and facilitate engagement and participation of children in therapy. The therapeutic emphasis of storybooks can be adjusted to take into account a child's life story, verbal capacity, level of anxiety, and traumatic hyperarousal. The creation of storybooks is an active process that embraces important aspects of trauma-specific interventions, including expression of trauma-related feelings; clarification of erroneous beliefs about the self, others, or the traumatic event; and externalization of traumatic stimuli into artwork, allowing for exposure and habituation of the arousal response. A focus on visual images together with narrative takes advantage of children's developmental capacities and spontaneous pleasure in the creation of art, thus minimizing anxiety and enhancing feelings of mastery, competence, and hope. The creation of storybooks is compatible with family interventions that foster a safe family context, strengthen attachment relationships, insure appropriate structure and boundaries, and enhance parenting capacity as well as those interactions that facilitate understanding and dialogue between family members.     

Verhaltenstherapie bei Kindern und Jugendlichen mit Angststörungen

Research into anxiety disorders of children and adolescents have been neglected for a long time. Current work on the prevalence and on the course of anxiety disorders of children and adolescents impressively substantiates that (1) anxiety disturbances are the most frequent mental disorders of children and adolescents and, (2) represent important factors of risk for the development of anxiety disorders, depression and substance dependence/abuse in adulthood. The recent developments in behavior therapy on anxiety disorders with children and adolescents are presented first and the results of a meta-analysis of behavior therapy studies are summarized. The results of the meta-analysis show that anxiety disorders can be treated successfully in children and adolescents with behavior therapy. The follow up data show that therapy successes remain stable over a timespan of several years. In comparison of individual and group therapy as well as child and family-based therapy, there are no important differences with regard to therapy success.     

Parent-adolescent reciprocity in negative affect and its relation to early adult social development.

The purposes of this 9-year, prospective longitudinal study were (a) to investigate hypothesized reciprocal growth in negative emotions between parents and adolescents and (b) to examine the influence of this reciprocal process on the development of social relationships during early adulthood. The results showed that both parents' and adolescents' initial levels of negative emotion toward each other predicted the rate of growth and rate of change in growth of expressed negative affect. In addition, the analyses indicated that an adolescent's enmeshment in reciprocal negativity in the family of origin carried over into early adult social relationships. The findings demonstrate the reciprocal nature of negative affect in interactions between parents and adolescents and suggest that family experience with this interactional style may have an adverse influence on the development of early adult social relationships.     

Therapeutic techniques for the treatment of certain infantile personality disorders in ego disturbed children

This paper has discussed certain ego disturbed children of preschool and school age with infantile personality disorders. Although these children do not form a sharp diagnostic category, it is of clinical importance to differentiate them both from the neuroses and from other more serious ego disorders. These predominantly infantile children suffer chronic ego arrest and deviations as well as some degree of internal conflicts. Reality adaptation is characteristically distorted, ego defenses imbalanced, and social relations aberrant. Unlike some other borderline types, however, these children have no significant potential for psychosis. They are not prone to panicky anxiety attacks, or to psychoticlike ego regressions or withdrawal. Ego disturbed children with infantile personality disorders pose certain typical problems of therapeutic technique. They do not possess the ego strength for classical analysis, nor are they suitable candidates for a purely supportive or nurturing treatment. I have argued that the particular psychopathology of these children requires a form of corrective developmental treatment in which the therapist plays a flexible role and uses a combination of techniques corresponding to the child's progressive ego development. Early in treatment primarily supportive and nurturing techniques are used to promote a corrective identification and strengthen the defenses. As treatment proceeds, however, selected interpretations are introduced to modify the internal conflicts that block personality integration and development. Especially important are the mobilization and interpretation of hostile aggression. In the later treatment phases the therapist becomes increasingly more frustrating to the child's infantile wishes, encouraging reality adaptation and social maturation. The various shifts in therapeutic technique create resistances whose interpretation and working through are integral to the treatment process and cure.     

Factor structure of the Spanish version of the Spence Children Anxiety Scale (SCAS)

This paper presents the Spanish version of the Spence Children Anxiety Scale (SCAS), a rating scale for children and adolescents assessing anxiety disorders as they appear in the DSM-IV. SCAS scores were subjected to confirmatory factor analyses in a sample of 1671 children 10 to 17 years old. Results supported the proposed structure of six interrelated scales. This structure is completely invariant (except for means) in boys and girls and across age groups. Overall, girls scored slightly higher than boys. The relationship of SCAS scores with the child's age was nonexistent or very low and negative. The least frequent anxiety problems among children and adolescents were panic attacks and agoraphobia. Problems that most frequently presented extreme high scores were obsessive-compulsive disorder and social phobia. It is concluded that the Spanish version of the SCAS can confidently be used in the assessment of anxiety disorders in children.     

Developmental Trajectories of Anxiety Symptoms in Early Adolescence: The Influence of Anxiety Sensitivity

Children and adolescents seem to suffer from anxiety disorders at rates similar to adults. Interestingly, anxiety symptoms appear to generally decline over time within children as evidenced by lower rates in early and middle adolescence. There is some evidence that there may be heterogeneous subpopulations of adolescent children with different trajectories of anxiety symptoms, including a class of adolescents with elevated levels of anxiety that do not dissipate over time. Anxiety sensitivity has been identified as an important risk factor in the development of anxiety psychopathology. This study prospectively examined the development of anxiety symptoms in a sample of 277 adolescents (M _age?=?11.52; 44 % female, 56 % male) over a 3 year period including the influence of anxiety sensitivity on this development. Further, this study investigated whether there were distinct classes of adolescents based on their anxiety symptom trajectories and including anxiety sensitivity as a predictor. Consistent with other reports, findings indicated an overall decline in anxiety symptoms over time in the sample. However, three classes of adolescents were found with distinct anxiety symptom trajectories and anxiety sensitivity was an important predictor of class membership. Adolescents with elevated anxiety sensitivity scores were more likely to be classified as having high and increasing anxiety symptoms over time versus having moderate to low and decreasing anxiety symptoms over time. There are important implications for identification of adolescents and children who are at risk for the development of an anxiety disorder.     

The Role of the Family in Childhood Obsessive–Compulsive Disorder

While obsessive–compulsive disorder is widely recognized to have a strong genetic component, psychosocial factors are also acknowledged to be important. The primary focus of this paper is on familial factors associated with OCD in children and adolescents. It explores the family context as a possible risk factor in the development and maintenance of the disorder, including parental modeling, expressed emotion, parenting style, and family accommodation of the child's symptoms. The involvement of the family in the treatment of the disorder is also reviewed. Finally, future directions for research investigating familial factors in childhood OCD are presented.     

"This strange disease": adolescent transference and the analyst's sexual orientation

The treatment of adolescents by gay analysts is uncharted territory regarding the impact of the analyst's sexuality on the analytic process. Since a core challenge of adolescence involves the integration of the adult sexual body, gender role, and reproductive capacities into evolving identity, and since adolescents seek objects in their environment to facilitate both identity formation and the establishment of autonomy from primary objects, the analyst's sexual orientation is arguably a potent influence on the outcome of adolescent development. However, because sexual orientation is a less visible characteristic of the analyst than gender, race, or age, for example, the line between reality and fantasy is less clearly demarcated. This brings up special considerations regarding discovery and disclosure in the treatment. To explore these issues, the case of a late adolescent girl in treatment with a gay male analyst is presented. In this treatment, the question of the analyst's sexual orientation, and the demand by the patient for the analyst's self-disclosure, became a transference nucleus around which the patient's individual dynamics and adolescent dilemmas could be explored and clarified.