Development of Prospective Memory: Tasks Based on the Prefrontal-Lobe Model

This study investigated the development of prospective memory using tasks based on the prefrontal-lobe model. Three groups each of 30 children, adolescents, and young adults were compared on prospective-memory performance using ongoing tasks with two levels of cognitive demand (low and high), and two levels of importance (unstressed and stressed) of remembering prospective cues. The Self-Ordered Pointing Task (SOPT), Stroop Color Word Interference Test, and Tower of London were also used to assess relationships between prospective memory and prefrontal-lobe functions. The children remembered fewer prospective cues than either the adolescents or adults, but the adolescents and adults remembered equally well. This trend increased significantly as the cognitive demand of the ongoing tasks increased. However, stressing or not stressing the importance of remembering made no difference to prospective-memory performance. Performance on the SOPT and Stroop Colour Word Interference predicted performance on the high- but not on the low-demand condition. These findings implicate the maturation of the brain's prefrontal region in the development of prospective memory.     

Mental rotation of letters,pictures, and three-dimensional objects in German dyslexic children

This study examines mental rotation ability in children with developmental dyslexia. Prior investigations have yielded equivocal results that might be due to differences in stimulus material and testing formats employed. Whereas some investigators found dyslexic readers to be impaired in mental rotation, others did not report any performance differences or even superior spatial performance for dyslexia. Here, we report a comparison of mental rotation for letters, three-dimensional figures sensu Shepard and Metzler, and colored pictures of animals or humans in second-grade German dyslexic readers. Findings indicate that dyslexic readers are impaired in mental rotation for all three kinds of stimuli. Effects of general intelligence were controlled. Furthermore, dyslexic children were deficient in other spatial abilities like identifying letters or forms among distracters. These results are discussed with respect to the hypotheses of a developmental dysfunction of the parietal cortex or a subtle anomaly in cerebellar function in dyslexic readers.     

Prevalence and associated factors of poly‐victimization in Chinese adolescents

Multiple types of victimization or poly‐victimization (PV) can occur simultaneously during childhood, resulting in outcomes that are detrimental and difficult to reverse. Very few studies have focused on PV in Chinese adolescents. The present study is based on information collected from a stratified cluster sample of 1,561 females and 1,594 males aged 12–18 years living in Shandong Province, China. A self‐administered questionnaire was used to assess background information, the Juvenile Victimization Questionnaire was used to measure the extent of victimization and PV, the Screen for Child Anxiety Related Emotional Disorders was used to measure anxiety levels, and a Depression Self‐rating Scale for Children was used to ascertain depression. A majority of the study sample (66.2%) had experienced at least one form of victimization over the past year. Prevalence of PV was 16.9%, and was significantly higher among males (21.1%) than females (12.5%). Younger ages, one‐child families, and lower socioeconomic status were positively associated with PV. Logistic regression analysis indicated that smoking, alcohol consumption, exposure to pornography, and anxiety‐ and depression‐like symptoms were risk factors of PV. Results of this study highlight the need for further exploration of factors related to the PV of Chinese adolescents.     

Contribution of parents' adult attachment and separation attitudes to parent‐adolescent conflict resolution

This study examined the contribution to parent‐adolescent conflict resolution of parental adult attachment styles and attitudes toward adolescent separation. Questionnaires were completed by 295 couples with early to late adolescent children. Structural equation models were used to test self and partner influences on conflict resolution for three attachment orientations: confidence (model A), anxiety (model B) and avoidance (model C). Model A showed self influences between parents' confidence orientation and negotiation and also via positive attitudes towards separation. Also, the fathers' use of negotiation was facilitated by the mothers' confidence orientation and vice versa, indicating partner influences as well. Model B showed self influences between parents' anxiety orientation and the use of dominance and withdrawal and also via negative attitudes towards separation. Model C showed self influences between parents' avoidance orientation and dominance and withdrawal, and a partner influence between fathers' avoidance and mothers' use of dominance. The results indicated that the parents' adult attachment system and the parenting system were related in the area of conflict resolution, and that self influences were stronger than partner influences.     

Projective identification fifty years on: A personal view

Since its introduction by Melanie Klein in 1946 the concept of projective identification has inspired, baffled, rankled, but always mesmerized its adherents and opponents alike. I offer in this paper a brief outline of the concept's development over the past fifty years by way of some thoughts on a personal journey of discovery surrounding its meaning and clinical usefulness to my work as a child therapist. I would like to suggest that definitions in current use seem to be derived more from adult work than from work with children, which has sometimes skewed the debate surrounding the concept in a particular direction. In both its conceptual guises, namely, as an unconscious 'phantasy' and as an interpersonal feature of the transference, projective identification is a logical extension of certain aspects of Klein's work with small children. In child work too the developmental status of the concept comes more into focus.     

Types of sexual transference and countertransference in psychotherapeutic work with children and adolescents

The question of normal sexuality begins to arise in the treatment of severely sexually abused or sexually offending patients. The author suggests that it is an interesting and delicate moment during the process of recovery when less perverse, more normal sexuality appears mixed with, or even disguised by, the more habitual perverse fantasies. Writers in the adult field have drawn distinctions between perverse, eroticized and normal erotic transferences, and between Oedipal and post-Oedipal sexuality. Some have also distinguished between countertransferences in the analyst of an erotised versus a normal erotic nature. The paper discusses whether these distinctions could have any relevance for child patients. Freud and Klein have taught us much about the child's sexuality in relation to his interest in and attraction to his parents as sexual beings. But can we also detect some origins in earlier experiences in infancy of the child's later capacity to feel himself a sexual being capable of being wanted by an other? How might such a feeling of sexual self-worth differ from narcissism and from sexualised exhibitionism? The paper asks how therapists might deal with such problems and such possibly healthy developments.     

Psychodynamic psychotherapy for children and adolescents: a critical review of the evidence base

For many years psychoanalytic and psychodynamic therapies have been considered to lack a credible evidence-base and have consistently failed to appear in lists of ‘empirically supported treatments’. This study systematically reviews the research evaluating the efficacy and effectiveness of psychodynamic psychotherapy for children and young people. The researchers identified 34 separate studies that met criteria for inclusion, including nine randomised controlled trials. While many of the studies reported are limited by sample size and lack of control groups, the review indicates that there is increasing evidence to suggest the effectiveness of psychoanalytic psychotherapy for children and adolescents. The article aims to provide as complete a picture as possible of the existing evidence base, thereby enabling more refined questions to be asked regarding the nature of the current evidence and gaps requiring further exploration.     

The Oedipus complex as observed in work with couples and their children

In work with couples where there is a child referred to a Child and Adolescent Mental Health Service, there are opportunities to observe and to work with unresolved Oedipal issues brought by the parents to the task of creating a family. These conflicts can be seen enacted by the child or children, either internally or externally. Examples are given from five cases: the first two from brief family work where the children are under five and the difficulties are to some extent resolved. The next two demonstrate more intractable problems of psychopathology where the parental Oedipal conflicts are handed down to the next generation, and the paper concludes with an example of couple work in relation to individual therapy with a child, where despite the pressure of considerable pathology in the parents' backgrounds there is a will to integration and progress is made.     

A pre-suicide state in an adolescent female 1

Abstract

During a pre-suicide state, the enactment of a suicide fantasy is the motive force. The nature and function of a suicide fantasy is explored in this paper in the context of the impact of puberty on the female body image and against the background of the pre-Oedipal and Oedipal father's relationship with his daughter. Case material from the analysis of an adolescent girl is presented to illustrate the crucial role of the father, in the transference, prior to a suicide attempt.

La force motrice qui sous-tend l'état pré-suicidaire est la mise en acte d'un fantasme suicidaire. Cet article explore la nature et la fonction du fantasme suicidaire dans le contexte de l'impact, chez une adolescente, de la puberté sur son image du corps avec, en toile de fond, la relation que le père, pré?dipien et ?dipien, entretient avec sa fille. Un matériel clinique extrait de l'analyse d'une adolescente est présentée afin d'illustrer le rôle crucial du père au sein du transfert avant la tentative de suicide.

Mots-clés: État pré-suicidaire, fantasme suicidaire, puberté et image du corps chez la fille, père pré?dipien et ?dipien, transfert, contre-transfert

Riassunto: Durante lo stato pre-suicidio, il motivo forza è la messa in atto di una fantasia di suicidio. Nell'articolo viene esplorata la natura e la funzione della fantasia di suicidio considerando l'impatto della pubertà sull'immagine del corpo femminile e sullo sfondo di una relazione pre-edipica ed edipica del padre con sua figlia. Viene presentato il materiale dall'analisi di una adolescente per illustrare il ruolo cruciale del padre, nel transfert, precedente al tentato suicidio.

Parole chiave: stato pre-suicidio, fantasia di suicidio, immagine corporale femminile e della pubertà, padre pre-edipico ed edipico, transfert, contro-transfert

Während eines prä-suiziden Zustands, ist das Ausagieren einer Suizidphantasie die motivierende Kraft. Die Eigenschaft und Funktion einer Suizidphantasie wird in diesem Artikel im Zusammenhang mit dem Einfluss der Pubertät auf das weibliche Körperbild und mit dem Hintergrund der prä-ödiplaen und ödipalen Beziehung des Vaters zu seiner Tochter exploriert. Es wird Fallmaterial aus der Analyse eines adoleszenten Mädchens vorgestellt, um die wichtige Rolle des Vaters in der Übertragung vor einem Suizidversuch zu illustrieren.

Keywords: Prä-suizider Zustand, Suizidphantasie, Pubertät und das weibliche Körperbild, prä-ödiplaer und ödipaler Vater, Übertragung, Gegenübertragung     

Revisiting ‘What works for whom?’: A qualitative framework for evaluating clinical effectiveness in child psychotherapy

This paper describes a framework for evaluating the effectiveness of child psychotherapy used by child psychotherapists in an inner city Child and Adolescent Mental Health Service (CAMHS). The Hopes and Expectations for Treatment Approach (HETA) involves using the assessment for psychotherapy that normally precedes treatment to derive a baseline from which to generate a set of hopes/expectations as regards the effects of the treatment on the part of parents and the psychotherapist, to be revisited one year after the start of the psychotherapy and/or at its completion. The Strength and Difficulties Questionnaire, for parents and schools, was also administered before and after the treatment. The characteristics of the first 30 children referred for psychotherapy over a particular time period are described. Of the first 15 children in this group to complete one year of individual psychotherapy, all showed change or significant change in the areas concerning parents' and therapists' hopes at the end-of-year review, as rated by parents and psychotherapists. A case of a child with conduct disorder is used to describe how the assessment generated a psychoanalytic formulation, how the therapist's understanding was fed back to the parents, and how the parents' and therapist's hopes and expectations were derived and recorded. This case illustrates powerfully the impact of trauma in the parents' backgrounds on the internal world of the child, and how the method provides a useful bridge between parent and child work. Feedback from the psychotherapists, the parents and the referrers using the framework is reviewed, and in conclusion the paper argues for the framework's value in promoting good practice in the treatment and management of complex cases and in enhancing awareness of the nature and scope of the psychotherapy process.