Is early effeminate behavior in boys early homosexuality?

This report continues the study of early effeminate behavior in boys. A previous article reported on the long term follow-up of 55 boys and the resulting outcome in homosexuality. In this paper an effort is made to explore further the nature of the connection between childhood effeminate behavior and adult homosexuality. Individual signs are discussed with regard to relevant aspects of their development. It is concluded that early effeminate behavior is not merely a forerunner of homosexuality in that it forecasts homosexuality, but that is is in fact the earliest stage of homosexuality itself.     

Clinical utility of early memories as a predictor of early therapeutic alliance

The present study aims to empirically explore the relationship between clinician-rated early memories (EMs) and patient ratings of alliance that were obtained after a therapeutic model of assessment (TMA; Finn & Tonsager, 1997; Fischer, 1994). This study utilizes the Social Cognition and Object Relations Scale (SCORS; Westen, 1995) to obtain information from early memory narratives about an individual's level of object representations. With data gathered from 57 participants, the authors examined whether an individual's EM narratives can provide insight into his or her object representations and how such material relates to the development of an intimate connection with the therapist. Results supported our hypotheses as meaningful correlations were found between certain SCORS variables and patient-rated therapeutic alliance. The clinical utility and research implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).     

A study of cranial computertomograms in very early and early onset schizophrenia

Summary. The cranial computer-assisted tomograms of 19 patients suffering from schizophrenic psychoses with onset by age of 14 were examined. The emphasis was on the extent of the inner liquor spaces. Compared to healthy controls, at the beginning of illness a significant enlargement was revealed only in the patient group with very early onset schizophrenia (VEOS, onset prior to the age of 12), whereas children with early onset (EOS, 12 to 14 years of age) showed no significant brain pathology. As a second result, an increase in the extent of the inner liquor spaces seems to correlate with the duration of illness. It is therefore concluded that psychoses interfere with neurodevelopmental processes and cause more severe brain pathology in very young children, already detectable at the onset of the illness. EOS, on the other hand, induces progressive morphological abnormalities over the course of the illness. Received February 2, 2001; accepted July 11, 2001     

Sleep problems and early developmental delay: implications for early intervention programs

Sleep disorders negatively impact behavior, cognition, and growth--the same areas targeted by early intervention. Conversely, developmental delays and disabilities may themselves precipitate sleep disorders. Young children with developmental delays experience sleep disorders at a higher rate than do typically developing children; the most common types are difficulties initiating or maintaining sleep and sleep disordered breathing. To date, attention has been focused on sleep problems in children with specific conditions (e.g., autism, genetic syndromes, prematurity, and seizure disorder). The authors review evidence of sleep problems' broader impact across the range of children screened for early intervention. Eligibility evaluations for early intervention address the five developmental domains: adaptive, motor, cognitive, communication, and socioemotional. Disordered sleep may be symptomatic of socioemotional and adaptive problems. Assessing sleep problems within the evaluation may help establish eligibility for early intervention services and would maximize developmental potential by ensuring timely identification, referral, and treatment.     

Improving early seizure detection

Over the last decade, the search for a method able to reliably predict seizures hours in advance has been largely replaced by the more realistic goal of very early detection of seizure onset, which would allow therapeutic or warning devices to be triggered prior to the onset of disabling clinical symptoms. We explore in this article the steps along the pathway from data acquisition to closed-loop applications that can and should be considered to design the most efficient early seizure detection. Microelectrodes, high-frequency oscillations, high sampling rate, high-density arrays, and modern analysis techniques are all elements of the recording and detection process that in combination with modeling studies can provide new insights into the dynamics of seizure onsets. Each of these steps needs to be considered if detection devices that will favorably impact the quality of life of patients are to be implemented. This article is part of a Supplemental Special Issue entitled The Future of Automated Seizure Detection and Prediction.     

Depersonalization in early adolescence

Depersonalization is a comparatively rare disease in the psychiatric field. Particularly, its occurrence in early adolescence or even before seems to be quite uncommon. We have observed 120 cases of depersonalization, of which only 16 cases had their onset before the age of 15. Among them, we will present here 6 cases for which a detailed observation was available. It is very difficult for these minors to put their feeling into verbal expressions because the experience of depersonalization is a "negative symptom." Adult patients can explain metaphorically how they feel. However, children can use only similes. Therefore, in the case of depersonalization, children have more difficulty in expressing their feeling than adults. This might cause to clinically overlook depersonalization in children. Even in our observation of the cases reported here, we found after a while that their complaints actually meant experiences of depersonalization, although their explanations were at first obscure. These 6 cases showed common personality traits that they are passive in interpersonal relationship and that they easily become frustrated or hold a sense of inferiority even at trifles.     

Thoughts on early intervention

The concept of early psychological intervention in response to traumatic events has been a compelling notion since World War I. Recently, its wisdom applied to mass disasters such as September 11th, has been called into question. A review of relevant research reveals support for its continued utilization, but not without caution. Crisis intervention, in response to mass disasters, should consist of an integrated multi-component intervention system.     

Characteristics of early psychosis

There is little research on characteristics related to course and prognosis of early-onset psychosis. The present article aims to advance our knowledge of this disorder for the purpose of proper diagnosis and treatment. It focuses on premorbid and prodromal characteristics, treatment history, symptoms and classifications, and differences between subgroups with affective and schizophrenic psychosis. A chart review was constructed to study a group of 129 subjects (12-18 years) with psychotic symptoms referred to the University Medical Center in Utrecht. The group was characterized by early-but nonspecific-treatment, developmental problems (mostly social), and clear prodromal symptoms. Drug abuse, depressive symptoms, and suicidal behavior were also frequent. Male sex, a relatively long prodromal phase, school problems, and drug abuse were more indicative of the schizophrenic subgroup. Introversion was characteristic for boys with schizophrenia. Classifications, however, were not stable. These findings suggest that early recognition of psychosis can be enhanced in health and youth care facilities. Careful examination of the prodromal phase seems helpful to differentiate between schizophrenic and affective psychosis.     

Impact of early vs. late childhood early life stress on brain morphometrics

Previous studies of early life trauma suggest that in addition to its emotional impact, exposure to early life stress (ELS) is associated with alterations in brain structure. However, little attention has been devoted to the relationship between emotional processing and brain integrity as a function of age of ELS onset. In the present study we examined whether ELS onset in older ages of youth rather than younger ages is associated with smaller limbic and basal ganglia volumes as measured by magnetic resonance imaging (MRI). We hypothesized that later age of manifestation during youth is associated with smaller volumetric morphology in limbic and basal ganglia volumes in adulthood. A total of 173 individuals were divided into three groups based on the age of self-reported ELS. The three groups included individuals only experiencing early childhood ELS (1 month–7 years, n = 38), those only experiencing later childhood ELS (8 years –17 years, n = 59), and those who have not experienced ELS (n = 76). Anterior cingulate cortex (ACC), hippocampus, amygdala, insula and caudate volumes were measured using a T1-weighted MRI. Analyses confirmed that later childhood ELS was associated with volumetric reductions in the ACC and insula volumes, while ELS experienced between the ages of 1 month and 7 years was not associated with lower brain volumes in these regions. The results may reflect the influence of more fully developed emotional processing of ELS on the developing brain and reinforce a body of research implicating both the ACC and insula in neuropsychiatric disorders and emotional regulation.     

微量白蛋白尿对急性脑梗死患者早期预后的影响

目的探讨微量白蛋白尿(MAU)对急性脑梗死患者的早期预后是否有影响。方法随机选取安徽医科大学第二附院神经内科住院急性脑梗死患者130例,用免疫比浊法测量患者的24 h尿白蛋白,根据有无MAU分为两组。用美国国立卫研究院卒中量表(NIHSS)评分表示神经功能缺损程度,用改良的Rankin量表(mRS)评分表示残疾程度。于发病48 h内和治疗后14 d时对患者进行NIHSS评分和mRS评分。比较两组患者神经系统缺损的程度是否有差别。mRS≤2分为残疾较轻,表示预后好,mRS>2分为残疾较重,表示预后差。应用二元逻辑回归分析来探讨MAU对神经功能预后的影响。结果入院时两组的神经功能缺损并无明显差异(Z=-1.566,P=0.117),MAU阳性的急性脑梗死患者治疗后的的神经功能缺损明显重于MAU阴性的患者(Z=-2.878,P=0.004)。尿中白蛋白的含量与发病时NIHSS评分(rs=0.175,P=0.046)和治疗后14 d时NIHSS评分(rs=0.393,P=0.004)均呈正相关。应用偏相关分析控制入院时NIHSS评分分析尿白蛋白与出院时NIHSS的相关性,结果显示尿白蛋白量与出院时NIHSS评分依然呈正相关(rs=0.194,P=0.027)。MAU阳性患者的预后较MAU阴性患者差,主要表现在无变化的患者较多(χ2=8.614,P=0.004),而进步的患者较少(χ2=8.893,P=0.002)。二元逻辑回归分析显示MAU阳性患者预后差的风险要高于MAU阴性患者3.073倍(P=0.025)。结论MAU与急性脑梗死患者神经功能缺损程度相关,是急性脑梗死患者预后差的独立危险因素。     

Treating psychosis: is there more to early intervention than intervening early?

While the possibility of early intervention following the initial onset of psychotic disorders such as schizophrenia is an exciting development, a closer examination of the nature and content, as well as the timing, of treatment is required for this new approach to be successful. Modification and integration of diverse treatments need to be empirically investigated for their potentially greater effectiveness in patients who are, in general, much younger, naive to the mental health system, and possibly capable of full integration into society. Reducing delay in treatment initiation may be complex, may involve adopting early identification strategies, and may pose significant systemic and conceptual challenges. The 2 aspects of early intervention--integration of phase-specific treatments and early case identification--need to go hand in hand to ensure that another opportunity will not be missed in our efforts to improve the outcomes of these most serious of all mental disorders.