Journal of the American Academy of Child Psychiatry

Lewis, Dorothy Otnow; Balla, David ; Shanok, Shelley ; Snell, Laura

2012 Journal of the American Academy of Child Psychiatry

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Prompted by the clinical recognition of serious psychopathology in both delinquent children and their parents, we report an epidemiological study of the possible association of delinquency, parental psychiatric treatment and/or hospitalization, and parental criminality. We also examine questions of assortative mating among psychiatrically impaired and criminally involved parents of delinquents. Findings suggest that delinquency, children's psychopathology, parental psychiatric impairment, and parental criminality may be different manifestations of an entire family's severe adaptational problems. Whether the psychiatric or criminal justice systems become involved may depend primarily on which system is impinged upon at a given time.

Cohen, Donald J.; Caparulo, Barbara ; Shaywitz, Bennett

2012 Journal of the American Academy of Child Psychiatry

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Congenital, developmental, and idiopathic acquired aphasia form a spectrum of primary childhood aphasias characterized by profound disturbances in expressive language, relatively much better language comprehension; by the capacity for inner language, imaginative play, gesture, mime, and warm social relations; and by a variety of associated behavioral and cognitive difficulties (dependency, immaturity, hyperactivity, encoding and decoding problems). The presence of paroxysmal electroencephalographic abnormalities suggests cortical dysfunction. In contrast to this spectrum, the childhood autism syndrome appears earlier in life (during a prelinguistic developmental phase) and is characterized by an impoverishment of inner language; paucity of mime, gesture, and imitation; and much greater disturbance in social attachment and regulation of anxiety. Midbrain and brainstem dysfunctions involving catecholamine pathways may underlie some aspects of this syndrome. Because of complex, reciprocal effects between various neurological systems in the central nervous system, there may be mixed aphasic‐autistic syndromes and familial clustering of both types of disorders. Intensive language training starting in the preschool years and possibly introduction of systematic sign language may be useful for both groups and especially valuable for aphasic children with more intact language competence.

Rossman, Paul G.; Knesper, David J.

2012 Journal of the American Academy of Child Psychiatry

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Within the population of hospitalized adolescents exists a group characterized by (1) the frequent and gratifying recourse to disruptive acts: sexual promiscuity, property destruction, and abusive behaviors; and (2) the perception of significant adults as tormenting and persecutory. We call these patients disruptive adolescents.Disruptive behaviors often elicit intense negative reactions from treatment personnel, cementing the patient's preexisting view of the environment as persecutory, and resulting in further disruptive acts. Therapeutic intervention must interrupt this cycle and help the patient gain control of the disruptive actions. Two cases are presented to detail a treatment intervention, integrating behavioral and psychodynamic approaches. Psychodynamic theory is employed to rationalize and systematize the available behavior modification techniques. Emphasis is placed upon the complementarity between the initial use of behavioral treatment strategies and the psychotherapy which follows.

Tisza, Veronica B.; Dorsett, Peter ; Morse, Joan

2012 Journal of the American Academy of Child Psychiatry

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Adolescents suffering from end‐stage renal disease face the life‐prolonging, and hopefully lifesaving, procedures of hemodialysis and transplantation, and the struggle to prevent rejection of the allograft. They also experience, according to their age and developmental stage, the psychophysiological thrust and the social demand of adolescence. Through the case histories of patients who had their kidney transplants almost 3 years ago, this paper attempts to demonstrate how four teenagers are handling their age‐appropriate growth tasks. This case material derives from the cumulative observations of the renal transplant group, which includes a psychiatric team.

Freedman, D. A.; Montgomery, J. R.; Wilson, R. ; Bealmear, P. M.; South, M. A.

2012 Journal of the American Academy of Child Psychiatry

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Because he was considered at risk for combined immune deficiency disease an otherwise healthy boy was delivered by Caesarean section and placed at once in a germ‐free environment. He has been maintained in reverse isolation since. The present report reviews aspects of his developmental progress during his first 52 months. Despite the highly atypical character of his living situation, he shows, at this time, no evidence of deviant emotional or intellectual development.

Neubauer, Peter B.; Flapan, Dorothy

2012 Journal of the American Academy of Child Psychiatry

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This report is a mid‐latency follow‐up of children previously studied during nursery school. The study shows that there is a need to question many of our assumptions about the development of children from birth to latency. The existence of an infantile neurosis is confirmed. The peak proportion of children judged as showing interference with their developmental progression was at age 6. By the age of 8, many of these children had begun to progress again in their development. Changes in the groupings of the children from year to year seemed to be more characteristic than stability of groupings. Between 4 and 6 years of age the change was toward more pathology and/or interference with development. Between 6 and 8½ the change was in a positive direction, toward health. Findings suggest that early latency appears to be a period of expansion for girls more often than it does boys. Interference with developmental progression occurred earlier in girls. Practically all of the children in this study showed various degrees of pathology at different times during the 5 years of the project. However, the effect of pathology on development was not obviously apparent or easily anticipated. Symptoms alone could be misleading; the same clinical picture had different meanings for different children depending on the impact on development.

Gadpaille, W. J.

2012 Journal of the American Academy of Child Psychiatry

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Cross‐cultural and cross‐species developmental data are examined with the goal of defining tentatively the process of psychosexual development that might be considered species‐specific for Homo sapiens.In comparison with this speculative norm, it is hypothesized that much of what is regarded as normal adolescent sexuality in the United States middle class represents psychologically delayed childhood. The pathogenic implications are discussed with respect to the expectable consequences of emotional development that must take place significantly past its critical or optimal period, and research possibilities are suggested.