THE WORLDWIDE BURDEN OF INFANT MENTAL AND EMOTIONAL DISORDER: REPORT OF THE TASK FORCE OF THE WORLD ASSOCIATION FOR INFANT MENTAL HEALTH

Children worldwide experience mental and emotional disorders. Mental disorders occurring among young children, especially infants (birth –3 years), often go unrecognized. Prevalence rates are difficult to determine because of lack of awareness and difficulty assessing and diagnosing young children. Existing data, however, suggest that rates of disorders in young children are comparable to those of older children and adolescents (von Klitzing, Dohnert, Kroll, & Grube, 2015 ). The lack of widespread recognition of disorders of infancy is particularly concerning due to the unique positioning of infancy as foundational in the developmental process. Both the brain and behavior are in vulnerable states of development across the first 3 years of life, with potential for enduring deviations to occur in response to early trauma and deprivation. Intervention approaches for young children require sensitivity to their developmental needs within their families. The primacy of infancy as a time of unique foundational risks for disorder, the impact of trauma and violence on young children's development, the impact of family disruption on children's attachment, and existing literature on prevalence rates of early disorders are discussed. Finally, global priorities for addressing these disorders of infancy are highlighted to support prevention and intervention actions that may alleviate suffering among our youngest world citizens.     

Difficulties in amae: A clinical perspective

The Japanese word amae refers initially to the infant's feelings and attachment behavior toward the mother. Doi has vividly described how amae is carried through into adulthood characterizing Japanese social and family relationships and Japanese psychology. Exploring implications of the amae concept for infant research will be helped by including other aspects of amae manifest in clinical work: (1) Amae takes place in the complex vicissitudes of motherhood in Japan in which the mother fulfills her social as well as emotional needs through her infant; (2) as the child grows older he or she learns that amae can only be fulfilled if he or she is able to meet the parent's and the social demand for achievement; (3) there is a long tradition of inhibition of amae among women which is passed on from generation to generation affecting the quality of mothering; (4) the intuitive aspect of good enough amae in the parent-in-fant relationship is being lost due to rapid ongoing social changes. Therapeutic endeavors to retrieve the intuitive aspect of amae prove effective for the increasing numbers of relationship disturbances in infancy.     

Speech sound errors in patients with conduction and Broca's aphasia

Speech sound errors exhibited by three conduction and three Broca's aphasic patients on naming and word-repetition tasks were subjected to phonemic and subphonemic analyses. In the conduction aphasic patients, errors occurred equally often on consonants and vowels in both the naming and word-repetition tasks, while in the Broca's aphasic patients errors occurred selectively on consonants. Transposition errors occurred almost as often as substitution errors in the conduction aphasic patients, while substitution errors constituted the majority of errors in the Broca's aphasic patients. The Broca's aphasic patients, as compared to the conduction aphasic patients, exhibited a markedly higher number of substitution errors occurring between phonemes separated by a single subphonemic feature on the naming task. On the basis of these findings, it was hypothesized that the differences in the error patterns of the two types of aphasia reflected differences in the underlying mechanisms of the impairment in each type.     

Re-examining the factor structure of the California Critical Thinking Disposition Inventory

This study re-examined the factor structure of the California Critical Thinking Disposition Inventory developed by Facione and colleagues. Analysis showed that the four factors had some cross-validity with four factors in Walsh and Hardy's 1997 study. The results suggest the possibility of developing a more efficient short version of the inventory and calls for further improvement.     

Cross-cultural issues in the treatment of intractable anorexia nervosa

This paper presents a case of intractable anorexia nervosa in a child burdened beyond her capabilities by unresolved conflicts in a parent. The dynamics will be assessed in the context of open systems theory of family function to suggest that the mother's conflicts, fixated at the time she left her native country, and her attempts to adapt to a new one, combined with other family members' failure to understand or appreciate the mother's cultural roots, interrupted the patient's normal maturation/development. The paper also presents a successful course of treatment of the binational anorexic girl, using a comprehensive inpatient program, emphasizing intensive family therapy with an open systems theory framework.The earlier version of this paper was presented at the Sixth World Congress of the International College of Psychosomatic Medicine, Montreal, Canada, September, 1981. Helpful comments by Regina Casper, M.D., helpful discussion by Kenneth Calestro, M.A., and support and encouragement by Katharine N. Dixon, M.D. are greatly appreciated.     

Establishing emotional mutuality not formed in infancy with Japanese families

Young mothers in Japan today are faced with a conflict between the traditional image of motherhood and a sometimes lonely life without physical and emotional support from their husbands, family, and community. As a consequence of this, more and more children are becoming emotionally disturbed as a result of poor mother-child interactions that arise as early as infancy. With several cases of poor interaction, hospital treatment was undertaken to establish emotional mutuality between mother and child through therapeutically induced regression into infancy. Each mother-child pair was hospitalized in the baby unit of the pediatric ward, and the mother provided consistent emotional availability to her child. The child then regressed into infantile states that involved the following four phases: (1) The child began to interact with her mother more actively; (2) she became demanding, like a toddler in the rapproachment crisis; (3) the mother's sustained acceptance won the trust of her child, who began to show a strong attachment to her; (4) the child began to progress to a stage appropriate to her age and used the mother as a secure home base. Each child lost previous symptoms and acquired a stable character. This approach, which utilized the Japanese affinity for intimacy and regression, proved effective in the management of psychopathologies rooted in infancy.