Depression in mothers of burned children

Summary The treatment of burned children needs to address also their psychic state. Since the child’s emotional state depends heavily on the emotional state of its parents, especially the mother’s, interest should also be focused on diagnosing and treating secondary psychiatric disorders in mothers of burned children. The aim of this work was to study the prevalence of depression in mothers of burned children and its predicting factors. Methods: The enrolment of mothers of burned children was done in the Burns Department, Ibn Rushd University Hospital in Casablanca, Morocco. Twenty-eight mothers of seriously burned children agreed to participate in this study. A psychiatric interview was conducted after informed consent was obtained. The mothers completed a questionnaire; the diagnosis was made according to DSM IV criteria using the Mini International Neuro-psychiatric Interview (MINI). The Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale were used to evaluate respectively the intensity of depression and the level of anxiety. Social functioning was assessed by the Global Assessment of Functioning scale (GAF). The minimum time interval between the child’s being burned and the interview with the mother was one month. Results: The prevalence of depression was 35.7%, which is much higher in the mothers of burned children as compared to the general population. Several risk factors were found such as: several burned children or burn of the only child, severity and complications of burn, and the socio-economic level. Conclusion: Depression is a common disorder in mothers of burned children. Thus early screening for depression in mothers and psychological and psychiatric support must be provided in conjunction with the treatment of the burned child.     

儿童情绪障碍相关因素的LOGISTIC回归分析

情绪障碍是儿童期常见的心理障碍之一 ,对儿童的生活和社会功能有着明显影响。本文就综合性儿科医院心理门诊中儿童情绪障碍患者的有关资料进行对照研究 ;采用Ｌｏｇｉｓｔｉｃ回归多因素分析方法 ,对引起儿童情绪障碍的相关因素作一初步分析。1　对象和方法1.1　对象病例组来源于上海医科大学儿科医院心理咨询门诊来访者 ,共 88例 ,男 :4 0例 ;女 4 8例。采用ＩＣＤ- 10精神与行为障碍分类诊断标准进行诊断。其中广泛性焦虑障碍 14例 ,惊恐障碍 6例 ,混合性焦虑抑郁障碍 9例 ,恐怖性焦虑障碍 5例 ,社交恐怖症5例 ,学校恐怖症 8例 ,分离性焦…     

Disability parameters, chronic strain, and adaptation of physically handicapped children and their mothers

Investigated the contribution of disability parameters and chronic disability-related strain to the adaptation of 50 congenitally physically handicapped 6- to 11-year-old children and their mothers. Multiple dimensions of adaptation, disability status, and chronic disability-related strain were assessed with a variety of procedures. The mothers reported their children and themselves to display significantly worse adaptation than expected for a general sample. The adaptation of these children and their mothers, however, was not significantly related to the children's disability status nor the chronic strain thereto related. An exception was that the children's social functioning could be significantly explained by both of these factors. The inability to explain most dimensions of adaptation in the children and their mothers as it relates to the conceptual model guiding this research is discussed.     

Autism--assessment and placement under The Education for All Handicapped Children Act: a case history

Over the years, various clinicians diagnosed a school-aged child as mentally retarded, mentally retarded with autistic-like features, or autistic. A school district sought to place the child locally in a school for mentally retarded children, while the child's parents desired replacement in a residential school that specialized in the education of autistic children. After a due process hearing, the child was placed in a school for autistic children. The case demonstrates the importance of independent mediation and professional assessment in placing handicapped children and examines free appropriate public education in the context of Board of Education of the Hendrick Hudson Central School District vs. Rowley (1982).     

Children With Chronic Physical Disorders: Maternal Reports of Their Psychological Adjustment

Advances in biomedical science have resulted in dramatic improvementsin the medical care of chronically ill and handicapped children.Past measurement problems have resulted in a lack of clarityregarding the psychological adjustment of these children. Themothers of 270 chronically ill and handicapped children wereadministered the Child Behavior Checklist in an attempt to identifypatterns of behavioral functioning across six pediatric chronicdisorders: juvenile diabetes, spina bifida, hemophilia, chronicobesity, juvenile rheumatoid arthritis, and cerebral palsy.In general, it was found that children in all chronic disordergroups were perceived by their mothers as evidencing on theaverage more behavioral and social competence problems thanexpected based on norms for children in general. However, theirbehavioral and social adjustment was reported as better thanthat of a normative sample of children referred to mental healthclinics. There were essentially no differences between childrenwith different chronic disorders in terms of behavior problemsand social competence. The results were taken to support theview that these children were as a group at risk for adjustmentproblems. They were also discussed in terms of the noncategorialapproach, which suggests that similar psychosocial challengesare faced across pediatric chronic physical disorders.     

Influences of motor disability on the development of scene concepts]

Two studies were conducted to investigate the influence of motor disability of the child on cognitive development. In Study I, elementary school teachers and undergraduate students were requested to rank the school subjects according to how much the teaching of each subject would facilitate scene concepts development of children. The results visually represented by the rank graphs indicated that "physical training" and "arts" which require body actions and movements were judged to be most important for scene concepts development. In Study II, both normal and physically handicapped children were asked to perform free recalls to each of the three stimuli: "my house," "my school," and "my town." The results showed the influence of the size of space implied by the stimuli on the number of the items recalled by healthy children but this influence was not the same with physically handicapped children. These results, which indicate the importance of body actions and movements for scene concepts development, were discussed in terms of education for physically handicapped children.     

Temperament Patterns in Young Neurologically Impaired Children

Parents of young neurologically impaired children completeda rating scale on their handicapped child's temperament. Theratings were examined for the incidence of the "difficult" temperamentpattern, and for the sample's distribution on nine separatetemperament characteristics. The data indicated no greater incidenceof difficult temperament in neurologically impaired childrenthan in normal children. The temperament characteristics oflow activity level and a short attention span, coupled withlow persistence were more common in this sample than in normalchildren. The results suggest that while some individual temperamentcharacteristics may be modified by handicapping conditions,not every group of handicapped children has a higher rate oftemperamentally difficult children. Additionally, moderatelyhigh parental convergence on temperament ratings was noted.     

The implications of biomarker evidence for systematic reviews

Background

The longitudinal birth cohort study is the preferred design for studies of childhood health, particularly atopic disease. Still, prospective data collection depends on recollection of the medical history since the previous visit representing a potential recall-bias. We aimed to ascertain the quality of information on atopic disease and other health symptoms reported by parental interview in a closely monitored birth cohort study. Possible bias from symptom severity and socioeconomics were sought.

Methods

Copenhagen study on Asthma in Childhood (COPSAC) is a clinical birth cohort study of 411 children born of asthmatic mothers from 1999 to 2001. Child health is monitored at six-monthly visits with particular emphasis on atopic symptoms and infections. Data from the first three study years on 260 children was compared with records from their family practitioner as an external reference.

Results

A total of 6134 medical events were reported at the COPSAC interviews. Additional 586 medical events were recorded by family practitioners but not reported at the interview. There were no missed events related to asthma, eczema or allergy. Respiratory, infectious and skin related symptoms showed completeness above 90%, other diseases showed lower completeness around 77%. There was no meaningful influence from concurrent asthma or socioeconomics.

Conclusions

The COPSAC study exhibited full sensitivity to the main study objectives, atopic disease, and high sensitivity to respiratory, infectious and skin related illness. Our findings support the validity of parental interviews in longitudinal cohort studies investigating atopic disease and illness in childhood.     

The Assessment of Child and Adolescent Personality (Book)

Evaluated the psychometric properties of the Spanish version of the Parenting Stress Index (PSI), based on the responses of 223 Hispanic mothers. Alpha coefficients were comparable to those for the original PSI. A factor analysis of the 13 PSI subscales indicated that three factors rather than the original two-factor solution more meaningfully described the Hispanic data. This study is consistent with recent research with Anglo-American mothers suggesting that the dimensions of the PSI are better described by three factors: Child Characteristics, Parent Characteristics, and Child-Parent Interaction. Multivariate analysis of variance (MANOVA) indicated that in a Hispanic sample, mothers of handicapped children reported more parenting stress than mothers of nonhandicapped children. This study supports the cross-cultural utility of the PSI.     

Comparison of Mental Age Estimates Made by Pediatricians and Mothers of Preschool Children

The mental age (MA) estimates given by pediatricians and mothersof preschool children referred to a comprehensive developmentalevaluation center were compared to the mental ages-obtainedon standardized IQ tests. The results indicate that the estimatesmade by pediatricians were significantly more accurate thanthe estimates made by mothers. The mean MA estimate providedby mothers was 5 months higher than the mean MA obtained onstandardized tests but lower than the child's chronologicalage. Mothers' estimates of expressive language were more accurateestimates of the MA scores obtained on the Bayley and Stanford-Binetthan were estimates of other areas of development. Pediatricians'estimates of MA were not significantly different from the MAobtained on the IQ tests. The results contradict previous reportsthat physicians were inaccurate in estimates of ability levelsfor children with developmental delays and have applied implicationsfor the early identification of handicapped preschool children.     

Physical status and psychosocial adjustment in children with spina bifida

Investigated the relationship between the physical status and psychosocial adjustment of chronically physically handicapped children. The status of 61 children with spina bifida regarding six specific disease or disability parameters was determined from medical charts. Their mothers completed the Child Behavior Checklist as a measure of the children's psychosocial adjustment. Children with spina bifida were reported to display on the average significantly more behavior and social competence problems than expected for children in general. However, children with differing degrees of physical problems and disability did not differ significantly in their psychosocial adjustment. The general lack of relationship between physical status and adjustment as it relates to a conceptual model guiding this research is discussed.     

Comparison of psychopathology in the mothers of autistic and mentally retarded children

The aim of this study was to evaluate anxiety, depression, alexithymia, and general psychological symptoms in the mothers of autistic children in comparison with those in the mothers of mentally retarded children. Forty mothers of autistic children and 38 mothers of mentally retarded children were included in the study. After a clinical interview, psychometric tests were performed for depression, anxiety, alexithymia, and Symptom Distress Check List (SCL-90) for general psychological symptoms. Non-depression rates was 27.5% in the mothers of autistic children whereas the rate was 55.3% in the mothers of mentally retarded children. There was no difference regarding anxiety and alexithymia between the two groups. The psychopathology in the mothers of autistic children was more frequent than in those of mentally retarded children in all sub-scales of SCL-90 (somatization obsessive-compulsive, interpersonal sensitivity, depression, anxiety, anger-hostility, phobic anxiety, paranoid thought, psychotism, and extra scale). The mothers of autistic children experienced more psychological distress than those of mentally retarded children. Our findings indicates that the assessment of autistic and mentally retarded children should include psychological assessment of their mothers.     

Age at placement,adoption experience and adult adopted people's contact with their adoptive and birth mothers: An attachment perspective

Adoption holds particular interest for attachment researchers. Although children adopted as babies experience almost continuous care by their adoptive parents, older placed children experience at least one major change of caregiver when they join their adoptive family. Moreover, in the majority of cases, older placed children have generally suffered a pre-adoption history of abuse, neglect and/or rejection. It is now being recognized that older placed children's attachment histories and internal working models (IWMs) established in relationship with their initial carers remain active in relationship with their new carers. Transactional models have helped both researchers and practitioners to understand the dynamics of parent-child relationships in cases where insecure children with histories of neglect,abuse and rejection findthemselves in new caregiving environments. The present study examines the childhood experiences of adult adopted people and their current levels of contact with their adoptive mothers, and in cases where people had searched for and found a birth relative, current levels of contact with their birth mother. Although no information was collected on the adopted adult's pre-placement history,age at placementwas used as a proxy measure to examine whether older placed children reported different adoption experiences and what their current levels of contact were with their adoptive and birth mothers. The findings show that age at placement was associated with adopted people'sreported experiences of being adopted and current rates of contact with their adoptive and birth mothers, with those placed at older ages most likely to report that they (1) did not feel they belonged in their adoptive families while growing up, (2) did not feel loved by their adoptive mother, (3) were least likely to remain in highfrequency contact with their adoptive mother, and (4) were least likely to remain in high-frequency contact with their birth mother. An attachment perspective is used to interpret the findings. Children adopted at older ages appear more likely to have experienced an insecure attachment relationship with their adoptive mother.     

The interactions of mothers with eating disorders with their toddlers: identifying broader risk factors

The connection between maternal eating disorders and feeding and eating problems among their children has been substantially demonstrated. This pilot study focused on the interactions between mothers with eating disorders and their toddlers in non-feeding situations. Twenty-eight dyads of mothers with prenatal eating disorders and their toddlers were compared to a case-matched control group with no eating disorder. Maternal current eating and co-occurring psychopathology, children’s symptoms and mother–child interactions were measured. Mothers with eating disorders were less sensitive to their children, tried to control their children’s behaviors more, and were less happy during mother–child interactions. The children in the maternal eating disorder group were rated as less responsive to their mothers and their mothers also reported more behavioral problems than those in the control group. Findings imply that maternal eating disorders may be linked with a wide range of adverse maternal and child behaviors beyond those associated with eating.     

Intergenerational transmission of late-adolescent adult attachment styles: does attachment recur?

This study was conducted to examine intergenerational transmission of attachment styles between late-adolescent children and their mothers. The purpose of the study was to reveal whether the two attachment dimensions, "Anxiety (about relationship)" and "Avoidance (of intimacy)" were related between children and their mothers, and whether these relations were mediated by the both children's and mothers' perceptions of parenting. Participants were 209 pairs of late-adolescent children and their mothers. Results revealed that the attachment dimensions of "Anxiety" and "Avoidance" in children significantly correlated to the same dimensions in their mothers. Based on attachment theory, it was hypothesized that intergenerational transmission of attachment styles was caused by the influence of the following factors: "(a) mothers' attachment styles, (b) mothers' perceptions of parenting, (c) children's perceptions of their mothers' parenting, and (d) children's attachment styles", and possible causal models of the influence processes among those variables were developed and tested in the data analyses. The results showed the validity of these processes for the intergenerational transmission of attachment styles. These results are discussed in terms of the relationships between children and mothers and late-adolescent/adult attachment styles.     

Non-genetic and non-gestational parenthood: consequences for parent-child relationships and the psychological well-being of mothers, fathers and children at age 3

BACKGROUND: Findings are presented of the third phase of a longitudinal study of children conceived by assisted reproduction procedures involving surrogacy and/or donor conception. METHODS: At the time of the child's third birthday, 34 surrogacy families, 41 donor insemination families and 41 oocyte donation families were compared with 67 natural conception families on standardized interview and questionnaire measures of the psychological well-being of the parents, mother-child relationships and the psychological well-being of the child. RESULTS: The differences found between family types reflected higher levels of warmth and interaction between mothers and their 3-year-old children in assisted reproduction families than in families with a naturally conceived child. A higher proportion of surrogacy parents than donor conception parents had told their children about the nature of their birth. CONCLUSIONS: It appears that the absence of a genetic and/or gestational link between parents and their child does not have a negative impact on parent-child relationships or the psychological well-being of mothers, fathers or children at age 3.     

A one-message question in a structured interview: investigating psychological needs of children and adolescents with eating disorders directed toward their mothers

The purpose of this study was to investigate the psychological needs of children and adolescents with eating disorders (ED) directed toward their mothers. Patients with ED have low self-assertion and various abnormal eating behaviors. Therefore, mothers face difficulty in understanding their children's psychological needs, and the mother-child relationship is sometimes strained. We developed a One-Message Question (OMQ)-structured interview. The OMQ was easy to answer, and it helped the patients with ED. We examined the relationship between psychological needs and illness phase of the children and adolescents, and we discuss the viability of implementing the OMQ in clinical settings. The subjects were 23 patients and their parents. Their parents were just asked about the patients' background. The mean age of the patients was 15.8 years, and the average age of ED onset was 13.5 years. The EDs were anorexia nervosa (n＝20) and bulimia nervosa (n＝3). The phases of patients' illness were identified as anorexic (n＝5), bulimic (n＝7), chronic (n＝3), and stable (n＝8). All subjects provided specific responses to the OMQ-structured interview. Data analyses revealed the following seven categories of patients' psychological needs directed toward their mothers:attachment, cooperation in meeting their goals, longing for love, changing attitude toward family members, respect for self-reliance, expression of apology, and expression of appreciation. These findings suggested that the OMQ-structured interview may prove useful for mothers to understand their children's psychological needs and may encourage positive interactions as a foundation for future recovery.     

Mother and adolescent representations of illness ownership and stressful events surrounding diabetes

OBJECTIVE: To assess the extent to which adolescents with diabetes and their mothers appraise diabetes as a shared entity across adolescence through (a) assessing appraisals of illness ownership and their relationship to joint responsibility for daily diabetes tasks, (b) exploring whether appraisals of shared illness ownership are associated with congruent views of what is stressful about diabetes, and (c) examining whether age-related declines occur in these shared appraisals across adolescence. METHODS: One hundred twenty-seven adolescents (ages 10-15 years, M = 12.8) and their mothers completed an interview that probed appraisals of illness ownership, the most stressful events surrounding diabetes in the past week, and a questionnaire regarding who was responsible for performing diabetes-related tasks. RESULTS: Dyads, most frequently, agreed that diabetes was a "shared" entity. Shared appraisals of illness ownership reflected the greater joint responsibility of mothers and children in daily diabetes tasks. Shared appraisals of illness ownership were not related to congruent reports of diabetes stressful events, and incongruence in appraisals of stressful events was common. With age adolescents reported less shared illness ownership and congruence regarding stressful events, age differences were not seen in mothers' reports. CONCLUSIONS: Although diabetes is often appraised as a social entity, adolescents and their mothers experience different aspects of the disease as stressful, especially as adolescents age, and become more independent in performing diabetes-related tasks.     

Occurrence of down syndrome and human sexual behavior

We analyzed the sexual habits of 80 mothers of normal children and of 33 mothers of children with the Down syndrome (DS). The data were obtained through the psychological interview technique. Unusually long intervals between intercourse at the time of conception were reported more frequently by mothers of DS children. Independent of the mother's age there was an association between the incidence of DS and long intervals between intercourse.