Journal of the American Academy of Child Psychiatry最新文献

This case report describes treatment of a 10-year-old white boy who had set a major fire in a group home. Various episodes of serious fire-setting continued to occur until one of the authors joined with the boy in constructing a controlled fire. The exercise was repeated three times, with positive results. A three-step intervention approach is described for working with latency-age boys who set fires.

Children are appearing as courtroom witnesses with increasing frequency. Although no one has yet systematically studied the effect of trials upon children, there is considerable controversy about the effect of children upon trials. Some of the relevant issues include suggestibility, memory retention, the effect of psychic trauma upon children's thinking, and the relative developmental abilities of children. Because there are child psychiatric issues, child psychiatrists will be expected to participate in legal processes involving children as witnesses. The author of this article cites what is currently known about children in the courtroom and outlines how a child psychiatrist can most effectively participate—in the consulting room, at trial, and in the arena of public policy.

The prevalence rate of Gilles de la Tourette syndrome has been estimated to be between 1 and 5 in 10,000 in the general population of the United States. To the authors' knowledge, no recent prevalence study has been conducted on a normal, school-aged population that can be geographically and demographically defined. The prevalence rate of Tourette syndrome, using DSM-III criteria, in North Dakota's school-age children is conservatively estimated at 1.0 per 10,000 for girls and 9.3 per 10,000 for boys, with a combined prevalence of 5.2 cases per 10,000 school-age children. The male to female ratio is estimated to be 9.3 to 1.

Semistructured interviews were conducted with 27 hospitalized adolescents to explore the meanings and functions of their stuffed animals. For the adolescent girls, the stuffed animals had a variety of important intrapsychic and interpersonal meanings and roles. We suggest that asking questions to explore the possession, use and memories of the stuffed animals of disturbed adolescent girls may help in revealing pertinent psychodynamic material and in enhancing the therapeutic relationship.

This paper describes a method of evaluating children referred for suspected sexual molestation based upon our current knowledge of the symptoms and sequelae associated with child sexual abuse. This evaluation is specifically designed to differentiate between “true” and “false” cases of sexual abuse. Important forensic issues are also discussed in order to prepare the clinician for the role of an expert witness in court. Case histories are presented which illustrate the typical problems and pitfalls encountered during these evaluations.

Twenty-two male adolescents with a history of attention deficit disorder (ADD) and 22 healthy adolescents matched for age and sex participated in a study where they randomly and blindly received either 10 mg of d-amphetamine or placebo. The index subjects were treated for ADD approximately 8 years prior to this study, whereas the control subjects had no psychiatric history. At baseline, the index group made a significantly greater number of errors on a continuous performance task compared to the controls. For index adolescents alone, vigilance improved with amphetamine, which also produced a significant growth hormone release. These results suggest an ongoing cognitive deficit in the ADD adolescents, the utility of a neuroendocrine response as a measure of sympathomimetic administration, and a possible heightened neuroendocrine responsivity in adolescents with an ADD history.

Ten months after a blizzard and flood disaster struck Revere, Massachusetts, fifth-grade children in two churches wrote stories about “this coming winter.” These were assessed blindly by six mental health clinicians for signs of distress, including fear, depression, and anxiety. Children from the flooded area demonstrated more distress than those from the nonflooded area. Only girls showed this effect; for boys, there was no difference between flooded and nonflooded groups. These results, which suggest that distress can persist as long as 10 months after a natural disaster, corroborate and extend the findings of an earlier study of younger children in this community. Future studies may be able to incorporate standardized instruments using revised criteria for clinical disorders in this age group.