Clinical and Non-Clinical Characteristics Associated with Medication Use Among Children with Serious Emotional Disturbance

Our study explores the clinical and non-clinical characteristics associated with medication use among children with serious emotional disturbance who are referred into community-based family-driven system of care settings. Using data collected as part of the Comprehensive Community Mental Health Services for Children and Their Families Program initiative, our study provides results from analyses completed on 7,009 children and adolescents with serious emotional disturbance. Using both bivariate and multivariate statistical analyses, the researchers found that females entering systems of care were less likely to have received medication in the 6-months prior to entry, as were children of African-American and Native-American heritage compared to children from non-Hispanic White heritage. Children referred from mental health, child welfare or who were self-referred were more likely to use medications than those referred from juvenile justice. Children with histories of prior inpatient, outpatient, day treatment, or school-based services were between 2 and 4 times more likely to use medications than children without such histories. Children with family histories of mental illness and those who were Medicaid recipients were also more likely to use medications. Family income was also positively related to medication use and younger children were more likely to use medications than older children. Implications of the findings are discussed.     

The Use of Stimulant Medication and Behavioral Interventions for the Treatment of Attention Deficit Hyperactivity Disorder: A Survey of Parents’ Knowledge, Attitudes, and Experiences

We examined parents’ knowledge, attitudes, and information sources regarding Attention-Deficit/Hyperactivity Disorder (ADHD), including treatment with stimulant medication and behavioral interventions. Responses from parents with a child diagnosed with ADHD and parents without a child diagnosed with ADHD were also compared. Participants consisted of 146 parents of elementary age children from Wisconsin. The surveyed parents were aware of issues surrounding ADHD and the use of stimulant medication, but there were several areas where they possessed inaccurate or incomplete factual information. Parents who had a child diagnosed with ADHD rated the effects of stimulant medication more positively and side effects as less severe than other parents. They also rated behavioral interventions as less effective on all questions. Implications of the study are discussed.     

早期经历影响个体成年后行为的表观遗传学机制

既往研究已证实早期经历与个体成年后的行为密切相关,然而早期经历对个体成年后的行为产生长期影响的分子生物机制并不清楚。近年来越来越多的研究表明表观遗传因素在早期经历调控成年个体行为中发挥了重要功能。表观遗传是研究没有DNA序列变化,但是可遗传和可逆转的基因组功能的调控。本文试图从早期经历参与调控个体成年后行为表现以及基因表达的相关表观遗传学修饰进行综述。     

'The healing power of love': The literary/analytic bond of marriage in Freud's essay on Gradiva

Freud 's declared position regarding the management of 'transference love' advocated 'abstinence', objectivity and even 'emotional coldness in the analyst'. However, his essay on Jensen's Gradiva reveals an identification with an involved and responsive 'maternal' analytic position associated with theorists such as Ferenczi, Balint and Winnicott. These theorists attribute the origins of transference love to the pre-oedipal stage, shaping their analytic model on the basis of the early relationship with the mother. Freud generally had difficulty identifying with such a position, since it entailed addressing his own inner feminine aspects. Yet a literary analysis of his 'Gradiva' reveals this stance in his textual performance, i.e. in the ways in which he reads and retells Jensen's story. Freud 's narration not only expresses identification with Zoe, the female protagonist, but also idealizes her 'therapeutic' conduct, which is closer in spirit to that of object-relations theorists. His subtext even implies, however unintended, that an ideal treatment of transference love culminates in a psychical 'marriage' bond between the analytic couple, a metaphor used by Winnicott to describe the essence of the mother–baby (analyst/patient) bond. Freud 's reading process is itself analogous to Zoe's 'therapeutic' conduct, in that both perform a creative and involved interaction with the text/patient.     

Child's behaviour in mother–child interaction predicts later emotional and behavioural problems

The aims were to examine the association of maternal or child interactive behaviour with emotional and behavioural problems of the child simultaneously and 3 years later, and to assess whether there is continuity in children's emotional and behavioural symptoms from 2 to 5 years. Sixty‐five 2‐year‐old children with their mothers were videotaped during a feeding situation. Their mothers completed the CBCL at 2 years and when the children were 5. Simultaneously, there were no strong correlations between child's emotional and behavioural problems and maternal or child interactive behaviour. Subsequently, mothers' higher sensitivity and more optimal structuring, as well as child's higher involvement of the mother, were associated with lower levels of child externalizing and total problem scores. Also, less responsive children showed more externalizing symptoms 3 years later. There was continuity of emotional and behavioural problems from 2 to 5 years. Problems in mother–child interaction may predict behavioural problems in the child subsequently. Besides maternal behaviour, it is important to consider the interactive behaviour of the child. Children who are less responsive and who show less involvement of the mother are more likely to subsequently present more externalizing symptoms, and these children should be recognized and treated early. Copyright © 2009 John Wiley & Sons, Ltd.     

Resilience in the Face of Maternal Psychopathology and Adverse Life Events

Maternal psychopathology has long been recognized as a risk factor for psychopathology in offspring; however, some resilient youth achieve a favorable outcome in the presence of maternal psychopathology. We identified factors that predicted resilience among youth who were exposed to adverse life events, and also examined whether the same factors protected youth against maternal psychopathology and adverse life events. Main and interaction effects of child and family factors were examined employing cross-sectional data from a household probability sample of 1285 youth aged 9 through 17 collected at four sites. On average, children exhibited a greater degree of resilience when they had higher IQ, closer parental monitoring, better family functioning, higher educational aspiration, and were female. Interaction between maternal psychopathology and IQ was significant, and there was a trend between maternal psychopathology and gender. A higher IQ is a protective factor against both maternal psychopathology and adverse life events; whereas being a girl seems to be a protective factor against maternal psychopathology, but not adverse life events.     

幼儿害羞与社会适应:母亲教养方式的调节作用

本研究以487名幼儿为被试,探讨害羞与社会适应的关系,以及母亲教养方式在害羞与社会适应之间的调节作用。幼儿母亲完成儿童社会偏好量表和教养方式问卷,幼儿教师完成对幼儿社会适应的评价。结果表明:(1)害羞与不合群和同伴排斥显著正相关;(2)母亲教养方式在害羞与社会适应之间具有调节作用。具体来说,母亲温暖、说理和鼓励自主的教养方式可减弱害羞幼儿的消极适应,而体罚和指令型的教养方式会加剧害羞幼儿的消极适应。研究结果对于害羞幼儿的干预具有重要价值。