Potential traumatic events in early childhood and behavioural resilience: a longitudinal case control study

Abstract

Resilience can be evidenced when an exposure to potentially traumatic event (PTE) has no negative impact on behavior. This study explored the effects of exposure to PTE applying a longitudinal design with 592 children (mean age 4 years) followed across three years. Children who had experienced a PTE and those who had not, were compared over time. Behavioral difficulties and prosocial behaviour for children experiencing PTE did not differ from those who had not experienced a PTE suggesting resilience among the exposed children. PTE in itself seems to carry minimal risk for symptoms of behaviour difficulties among preschool children.     

Human resilience in a degrading environment: A case study in China

Psychological aspects of environmental degradation were studied among 753 Chinese farmers. A good fit was found for a structural equation model postulating a relationship between various input variables (i.e. environmental degradation, socio-economic status, education, coping, and locus of control), a latent variable (called resilience), and three output variables (i.e. stress, marginalization, and depression). Higher scores on internal locus of control, problem solving, socioeconomic status, and modernity and lower scores on environmental degradation, avoidance, and support seeking were associated with more resilience.     

The search for the mother: narcissistic regression as a pathway of mourning in childhood.

Previous observers, following Freud's formulations in Mourning and Melancholia, have disagreed over the question of whether the child can mourn. To support the thesis that the child does mourn but in a different way from the adult, the author focuses on the importance of the child's identification with the lost love object, the narcissistic regression, and the associated autoerotic activities. Clinical material is presented from the analysis of a latency child and of an adult, both of whom lost their mothers during childhood.     

A twin study of personality and temperament during middle childhood

In a study of 105 same-sex twin pairs, ages 7 to 10 years, maternal ratings on 23 bipolar scales yielded six factors designated as compliant morality, applied cognitive, sociability, emotionality, tough-mindedness, and activity-distractibility. Analyses by twin pairs (68 identical, 37 fraternal) indicated that correlations for identical pairs were significantly higher than fraternal pairs on all but one factor: tough-mindedness. Profile analyses for the six factors indicated that the profiles of scores across the factors were more concordant for the identical twin pairs. Correlations obtained from the individual scales produced differences between the identical and fraternal twin pairs as well. Overall, the data suggested that several components and the total organization of those components of personality and temperament are genetically influenced.     

Psychosocial stress and HPA functioning: no evidence for a reduced resilience in healthy elderly men

In order to investigate if HPA functioning is altered with age, the present study was conducted. Fifteen healthy elderly men (60-76 years; mean age 66.5 +/- 1.48 yrs.) and 12 younger adults (20-29 years; mean age 25.6 +/- 0.77 yrs.) collected salivary free cortisol profiles after awakening for basal HPA activity. Then, all subjects were exposed to the "Trier Social Stress Test" (TSST). This psychosocial stress protocol consists of a free speech and a mental arithmetic task of 13 minutes duration performed in front of an audience. Beside the assessment of endocrine and cardiovascular responses to the stressful task ratings of depression, mood and perceived stressfulness were obtained. Results show that younger and elderly men had similar morning cortisol profiles after awakening with both groups showing the expected rise after awakening (P=0.004). The TSST induced significant increases in ACTH, total plasma cortisol, saliva free cortisol, and heart rates (all P<0.0001). Regardless of age, both age groups showed comparable endocrine response patterns when confronted with the stressor. However, cardiovascular responses were significantly higher in younger men compared to elderly men (P=0.03). Catecholamine data revealed significant norepinephrine and epinephrine increases due to the stressor (both P<0.0001) with a trend toward elevated norepinephrine levels in elderly men (P=0.058). In sum, the investigated basal and response parameters of HPA functioning neither support the idea of a reduced resilience in healthy aged humans nor do they appear to strengthen assumptions derived from the so called "glucocorticoid cascade hypothesis".     

Reflections on death and mourning in relation to Dickens' novel Our Mutual Friend

Both Bion and Jung indicate in their theories of oscillating cycles of coniunctio/mortificatio and Ps<-->D that the toleration of psychic states of disintegration is both dangerous and essential to new development and that change is resisted and feared. Our fear of growth and development is described by Jung in the mortificatio phase of the coniunctio cycles where movement can be forward towards coniunctio or backwards into disiunctio and by Bion in his delineation of a grid, with its negative grid, where the normal direction of growth may be permanently reversed. Both highlight the inevitability of elements destructive to thought being present in the psyche and the need to know these forces. This paper relates their ideas to the difficult processes of mourning explored by Dickens in his novel Our Mutual Friend.     

Epidemiology and preventive interventions: Parental death in childhood as a case example

Illustrates how standard epidemiologic principles form the knowledge base to justify a preventive intervention for an at-risk population. These principles were applied to a sample of 92 from the population of children aged 8 to 15 at alleged risk for mental health disorders because a parent died. Prior work on this alleged risk population is sparse and flawed. Validly determining the population effect of an alleged risk factor requires assessing the influence of sampling bias. The bias found, underrepresentation of deaths of a mother, did not influence the relations among death of a parent and children's depression and conduct disorder, and the modifiable mediators of risk to be changed by the preventive intervention. The epidemiologic measure of effect indicated that death of a parent is a risk factor for major depression but not for conduct disorder among youth. Families recruited for the preventive intervention by epidemiologic methods (ES families) did not differ significantly from the earlier families on whom the knowledge base was formed. Families referred to the intervention by self or others significantly differed from the ES families in two ways that constituted serious biases. The implications of these biases for prevention were discussed.     

His and her marriage: A multivariate study of gender and marital satisfaction

This study examined gender differences in marital satisfaction using the multidimensional marital inventory ENRICH. Contrary to previous research, the results indicated that men are somewhat more satisfied with their marriages than women. The findings also suggest that religion is a more important part of the marriage for men, whereas women esposed egalitarian roles to a greater extent. A significant interaction was found between marital distress and gender on the Sexual Relationship, Communication, Parenting and Children, and Equalitarian Roles scales, indicating that these areas may be particularly important in distressed couples. The differences in husbands' and wives' marital satisfaction found in this study are consistent with research suggesting that men obtain greater mental health benefits from marriage than do women. The explanation of the obtained gender differences are discussed with regard to measurement issues, sampling procedures, and power and task inequities. Sampling and differences in marital tasks and power are cited as the best explanations of the findings.     

A model of mourning: change in schemas of self and other

The mourning process may serve an evolutionary purpose, one that has allowed maximum survival characteristics. By passage through the phases of grief, the bereaved person prepares to make new commitments to others and to accept new personal roles. This passage involves an unconscious change in mental structures of meanings about the self and other people. This paper examines mourning in terms of such person schemas.     

A preliminary study of sex differences in brain activation during a spatial navigation task in healthy adults

The hippocampus plays a significant role in spatial memory processing, with sex differences being prominent on various spatial tasks. This study examined sex differences in healthy adults, using functional magnetic resonance imaging (fMRI) in areas implicated in spatial processing during navigation of a virtual analogue of the Morris water-maze. There were three conditions: learning, hidden, and visible control. There were no significant differences in performance measures. However, sex differences were found in regional brain activation during learning in the right hippocampus, right parahippocampal gyrus, and the cingulate cortex. During the hidden condition, the hippocampus, parahippocampal gyrus, and cingulate cortex were activated in both men and women. Additional brain areas involved in spatial processing may be recruited in women when learning information about the environment, by utilizing external cues (landmarks) more than do men, contributing to the observed sex differences in brain activation.     

Vulnerability and resilience: a critical nexus

Not all forms of human fragility or vulnerability are unavoidable. Sometimes we knowingly and intentionally impose conditions of vulnerability on others; and sometimes we knowingly and intentionally enter into and assume conditions of vulnerability for ourselves (for example, when we decide to trust or forgive, enter into intimate relationships with others, become a parent, become a subject of medical or psychotherapeutic treatment, and the like). In this article, I propose a presently overlooked basis on which one might evaluate whether the imposition or assumption of vulnerability is acceptable, and on which one might ground a significant class of vulnerability-related obligations. Distinct from existing accounts of the importance of promoting autonomy in conditions of vulnerability, this article offers a preliminary exploration of the nature, role, and importance of resilience promotion, its relationship to autonomy promotion, and its prospects for improving human wellbeing in autonomy inhibiting conditions.     

Learning about life and death in early childhood

have argued that young children initially understand biological phenomena in terms of vitalism, a mode of construal in which "life" or "life-force" is the central causal-explanatory concept. This study investigated the development of vitalistic reasoning in young children's concepts of life, the human body and death. Sixty preschool children between the ages of 3 years, 7 months and 5 years, 11 months participated. All children were initially given structured interviews to assess their knowledge of (1) human body function and (2) death. From this sample 40 children in the Training group were taught about the human body and how it functions to maintain life. The Control group (n=20) received no training. All 60 children were subsequently reassessed on their knowledge of human body function and death. Results from the initial interviews indicated that young children who spontaneously appealed to vitalistic concepts in reasoning about human body functioning were also more sophisticated in their understanding of death. Results from the posttraining interviews showed that children readily learned to adopt a vitalistic approach to human body functioning, and that this learning coincided with significant development in their understanding of human body function, and of death. The overall pattern of results supports the claim that the acquisition of a vitalistic causal-explanatory framework serves to structure children's concepts and facilitates learning in the domain of biology.     

Parenting a damaged child: mourning, regression, and disappointment

This paper is an examination of the long-term parenting experiences of parents who have given birth to CNS damaged infants. In particular, the focus is on the mourning, regression, rage, and depression that frequently attend these parents throughout their lives and can become pathological and pathogenic interferences with the provision of good-enough parenting. Several clinical vignettes were presented, each of which illustrated the usefulness of different psychoanalytic clinical theories about normality and pathology of parenting and parent-child interaction. The now-classical contribution of Solnit and Stark (Mourning and the Birth of a Defective Child, 1962) is reviewed along with Benedek's and others' psychoanalytic theories about normal parenting. The thinking of these writers is within the framework of structural/libidinal theory and seems to be useful in describing certain parenting problems that concern the mourning and regressive aspects of parenting. However, it was proposed that some of the adaptive coping and pathology encompassed by Solnit and Stark's explanations is not comfortably illuminated by the structural clinical theory of conflict and drives. Freud's discussion (1917) compares mourning and melancholia, which he differentiated as related but dynamically distinct clinical phenomena. This work is briefly recalled as an earlier point in theory building where structural theory was not sufficient to explain clinical depression and rage that exceeds normal mourning (as in Freud's melancholia). It is felt that an additional theoretical perspective on parenting provided by self psychology can fill in some of the gaps left by structural theory explanations. The self psychology perspective is particularly helpful with understanding the rage, ambivalence, and chronic depression often experienced by parents of damaged children. According to this perspective, the damaged child is a disappointing selfobject for the parent, and the parent's self organization will give him the resources to cope adaptively or to develop narcissistic pathology. Three types of intrapsychic problems for a parent are described: mourning the lost object, the fantasied perfect child; experiencing and recovering from regression to early identifications with his own parents; withstanding tension and regulating one's self (experiencing chronic depression and rage) when confronted with a great disappointment in a selfobject (represented by the damaged child). It is important when designing intervention strategies in a hospital or pediatric clinic setting to clarify which type of problem is the major focus of the parent's struggle.(ABSTRACT TRUNCATED AT 400 WORDS)     

Biased attention in childhood Anxiety disorders: A preliminary study

This study provides preliminary tests of two hypotheses: (1) Anxiety-disordered children show an attentional bias toward emotionally threatening stimuli, and (2) normal controls show an attentional bias away from emotionally threatening stimuli. Twelve children, 9 to 14 years of age, with primary diagnoses of anxiety disorder were compared with 12 normal controls matched for age, gender, vocabulary level, and reading ability. Subjects completed a reaction time task that measured visual attention toward threatening versus neutral words. The anxious group showed the predicted attentional bias toward threat words. However, controls did not show the predicted bias away from threat words. These results are the first showing that biased attentional processing occurs among clinically anxious children. The potential role of such an attentional bias in childhood anxiety disorders and future direction for research are discussed.This research was supported by a Seed Grant and a Small Grant to the first author from The Ohio State University. Portions of this paper were presented at the 27th Annual Convention of the Association for the Advancement of Behavior Therapy, Atlanta, November 1993. Thanks are extended to the participants and all those who helped with the project.     

Visual agnosia and prosopagnosia in childhood: a prospective case study.

Selective impairments in visual processing are well documented in adults but rarely reported in children. The few childhood cases reported are mostly retrospective accounts with little attention paid to developmental, assessment or management issues. We report a prospective case study of a boy with prosopagnosia and visual processing deficits of presumed developmental origin. At the age of 4 years, AL presented with a range of cognitive and visual recognition deficits. Subsequent assessments revealed an evolving pattern in visual recognition and dissociations between developing skills. At the age of 7 AL has impairments in early perceptual analysis, visual organisation and in complex visual processing. Although he can identify facial features and match faces he is unable to recognise familiar faces. His reading and spelling are developing normally. The nature of his deficits and his progress are discussed within a cognitive neuropsychological framework.     

Establishing the constructs of childhood behavioral disturbances in a Chinese population: A questionnaire study

The behavioral problems of Chinese children were examined in a questionnaire study of a representative sample of 3,069 seven-year-old Chinese schoolboys in Hong Kong using Rutter's questionnaires for completion by parents and teachers. Separate robust dimensions of hyperactivity, antisocial, and neurotic behaviors were evident. The correlations among different dimensions were similar to those reported in the West. Short-term longitudinal analysis suggested that these dimensions were stable over time and that antisocial behaviors might develop in hyperactive children. The finding highlights the necessity of differentiating the hyperactive domain from the antisocial one. A significant source effect was found in all three dimensions. Chinese schoolboys had nearly two times the level of questionnaire-rated hyperactivity compared with school boys in the West; but it is premature to conclude that hyperactivity is more common in Chinese schoolboys in Hong Kong. Cross-cultural differences in adults' expectations and tolerance remain a plausible explanation.This study was supported by the Croucher Foundation. We would like to thank the Education Department of Hong Kong for assistance in sampling. We are particularly grateful to the children, teachers, and parents who participated in this study.     

Executive coaching enhances goal attainment,resilience and workplace well-being: a randomised controlled study

In a randomised controlled study, 41 executives in a public health agency received 360-degree feedback, a half-day leadership workshop, and four individual coaching sessions over 10 weeks. The coaching used a cognitive-behavioural solution-focused approach. Quantitative and qualitative measures were taken. This is the first published randomised controlled study in which coaching was conducted by professional executive coaches external to the organisation. Compared to controls, coaching enhanced goal attainment, increased resilience and workplace well-being and reduced depression and stress. Qualitative responses indicated participants found coaching helped increase self-confidence and personal insight, build management skills and helped participants deal with organisational change. Findings indicate that short-term coaching can be effective, and that evidence-based executive coaching can be valuable as an applied positive psychology in helping people deal with the uncertainly and challenges inherent in organisational change. Practical impactions are discussed and recommendations are made for the effective measurement of coaching outcomes.     

Five minutes after death: A study of beliefs and expectations

This paper examines the beliefs and expectations that a sample of 508 people hold about the first five minutes after death. A substantial minority believed that they will experience the main elements of the neardeath experience (NDE). In general these elements were cited more frequently than were Biblical images. Six percent of the sample said that postmortem survival for them will be a negative and disturbing experience. We discuss these results in terms of their methodological implications for other survey work and their theoretical contribution toward our understanding of negative NDEs.