Forensic child and adolescent psychiatry: a review of the past 10 years

BACKGROUND AND METHODS: Risk factors for recurrence of Crohn's disease and the evidence for progress in reducing recurrence following resection were reviewed. A Medline based literature review was carried out. RESULTS AND CONCLUSION: Only smoking has been confirmed as a significant adverse risk factor for recurrence. Evidence for differing recurrence rates in fibrostenosing disease and perforating disease is inconclusive, but such a classification along with the endoscopic findings of recurrence may have a place in the analysis of therapeutic trials. Minimal resectional surgery with clearing of only macroscopic disease seems to be justified, with no clear benefits from different anastomotic techniques. Recent trials offer encouraging evidence of the usefulness of 5-aminosalicylic acid, particularly higher-dose regimens started early after resection, although the long-term benefits are uncertain. The oral steroid, budesonide, offers a potent treatment with minimal side-effects, but evidence of its prevention of recurrence is presently weak.     

Childhood and adolescent depression: a review of the past 10 years. Part I

OBJECTIVE: To qualitatively review the literature of the past decade covering the epidemiology, clinical characteristics, natural course, biology, and other correlates of early-onset major depressive disorder (MDD) and dysthymic disorder (DD). METHOD: A computerized search for articles published during the past 10 years was made and selected studies are presented. RESULTS: Early-onset MDD and DD are frequent, recurrent, and familial disorders that tend to continue into adulthood, and they are frequently accompanied by other psychiatric disorders. These disorders are usually associated with poor psychosocial and academic outcome and increased risk for substance abuse, bipolar disorder, and suicide. In addition, DD increases the risk for MDD. There is a secular increase in the prevalence of MDD, and it appears that MDD is occurring at an earlier age in successive cohorts. Several genetic, familial, demographic, psychosocial, cognitive, and biological correlates of onset and course of early-onset depression have been identified. Few studies, however, have examined the combined effects of these correlates. CONCLUSIONS: Considerable advances have been made in our knowledge of early-onset depression. Nevertheless, further research is needed in understanding the pathogenesis of childhood mood disorders. Toward this end, studies aimed at elucidating mechanisms and interrelationships among the different domains of risk factors are needed.     

Adolescent substance abuse: a review of the past 10 years

VTG was purified from seabream Sparus aurata plasma by ion exchange chromatography on a DEAE-Sepharose column. The vitellogenin was characterized and its properties were determined. The molecular mass of the native form, obtained by Sephadex G-200 column, was around 450 kDa, whereas an apparent molecular mass of 180 kDa was detected by electrophoresis under denaturing and reducing conditions, suggesting a dimeric form for the native protein. The presence of carbohydrates was determined using concanavalin A, while the presence of phosphate groups was detected by Stains-all, a cationic stain. These data together with the sex specificity, the estrogen inducibility, and the cross-reactivity of the abVTG against the major yolk proteins identifies this protein as vitellogenin. The validated ELISA was used for a rapid and reliable measurement of plasma VTG changes related with those of estradiol-17beta in female broodstock.     

National distribution of child and adolescent psychiatrists

OBJECTIVE: To describe the national distribution of child and adolescent psychiatrists by state, community, and youth population. METHOD: Data on child and adolescent psychiatrists were compiled for states and counties and compared by state, county characteristics, number of youth, percentage of youth living in poverty, and child and adolescent psychiatry residents. RESULTS: The number of child and adolescent psychiatrists per 100,000 youth varied greatly by state and county. Child and adolescent psychiatrists were significantly more likely to be located in metropolitan counties and counties with a low percentage of children living in poverty. The distribution of child and adolescent psychiatrists was not significantly related to the distribution of child and adolescent psychiatry residency training programs. CONCLUSIONS: The shortage of child and adolescent psychiatrists is accentuated for nonmetropolitan areas and youth at greatest risk for mental disorders by the current pattern of distribution.     

Children of affectively ill parents: a review of the past 10 years

OBJECTIVE: To review the literature investigating the effects of parental affective illness on children over the past decade. METHOD: A computerized search of articles published over the past 10 years was completed. Articles were reviewed and relevant studies are presented. RESULTS: Over the course of the past 10 years a number of longitudinal studies have confirmed that children of affectively ill parents are at a greater risk for psychiatric disorders than children from homes with non-ill parents. Life table estimates indicate that by the age of 20 a child with an affectively ill parent has a 40% chance of experiencing an episode of major depression. Children from homes with affectively ill parents are more likely to exhibit general difficulties in functioning, increased guilt, and interpersonal difficulties as well as problems with attachment. Marital difficulties, parenting problems, and chronicity and severity of parental affective illness have been associated with the increased rates of disorder observed in these children. CONCLUSION: The presence of depression in parents should alert clinicians to the fact that their children also may be depressed and therefore in need of services. J. Am. Acad. Child Adolesc.     

Mental retardation: a review of the past 10 years. Part II

OBJECTIVE: To review the literature over the past decade on mental retardation, particularly with respect to genetics and behavioral phenotypes. METHOD: A computerized search was performed for articles published in the past decade, and selected papers were highlighted. RESULTS: The study of mental retardation has benefited considerably by advances in medicine generally, and by developments in molecular neurobiology in particular. These advances in genetics have led to new insights regarding the causes of mental retardation, as well as a growing appreciation of behavioral phenotypes associated with some mental retardation syndromes. CONCLUSIONS: Although the study of developmental disorders has advanced significantly over the past decade, considerable work remains. Mental retardation should remain the model for the utility of the biopsychosocial approach in medicine.     

Posttraumatic stress disorder in children: a review of the past 10 years

OBJECTIVE: To review current knowledge about the clinical presentation, assessment, and treatment of posttraumatic stress disorder (PTSD) in children. METHOD: The literature on PTSD in children is examined. RESULTS: Over the past 10 years, PTSD has been described in children exposed to a variety of traumatic experiences. Little is known about the epidemiology of the disorder in children. Partial symptomatology and comorbidity are common. A variety of factors influence response to trauma and affect recovery. They include characteristics of the stressor and exposure to it; individual factors such as gender, age and developmental level, and psychiatric history; family characteristics; and cultural factors. Since the condition is likely to occur after disaster situations, much of the literature describes the child's response to disaster and interventions tend to include efforts within schools and/or communities. A number of clinical approaches have been used to treat the condition. CONCLUSIONS: While assessment has been studied extensively, the longitudinal course of PTSD and treatment effectiveness have not been. Biological correlates of the condition also warrant greater attention.     

Anxiety disorders in children and adolescents: a review of the past 10 years

OBJECTIVE: To critically review the research on anxiety disorders in children and adolescents, focusing on new developments in the past 10 years. METHOD: This review includes recent articles which contribute to the conceptualization, assessment, and treatment of childhood anxiety disorders. RESULTS: Information was organized into a developmental framework. Anxiety disorders research has shown steady progress. CONCLUSIONS: More research is needed, particularly in the areas of neurobiological basis of anxiety disorders, longitudinal studies, and treatment.     

Bonding of fractured tooth segments: a review of the past 20 years

The technology of tooth-bonding materials has developed over the past 20 years to achieve results that are quick, minimally invasive and esthetically pleasing. The following paper is an overview of the advances in tooth-bonding technology over the past 20 years.     

Psychological testing and the analytically trained child psychologist.

The author reviews some of the unique contributions that psychoanalytic theory brings to the testing of children and adolescents. Although demand for child evaluations has burgeoned in recent decades, the trend is toward atheoretical assessment; test findings are rarely linked to a coherent theory of personality and a developmental framework. The author delineates skills that analytically trained child psychologists bring to the testing situation, allowing them to place clinical observations and results within the context of the child's ongoing development and emerging sense of self. These include recognizing characteristic modes of thinking, relating, and fantasizing during different developmental phases; making meaningful use of transference and countertransference reactions; examining the quality of children's play and narratives; and using the feedback process to help parents contemplate their child's inner life. In conclusion, the author suggests that the testing tradition of Rappaport, Gil, and Schafer is highly relevant for contemporary child evaluation. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychological testing in evaluation of child sexual abuse

In order to assess the utility of psychological testing in evaluating allegations of child sexual abuse, the empirical literature is reviewed in an attempt to answer two questions. First, are there systematic and significant differences on psychological tests between sexually abused and nonabused children? Second, are these differences on psychological testing a direct result of sexual abuse, or are they a result of other coexisting factors that might cause psychological distress? Cognitive measures, personality inventories, symptomatology checklists, and projective tests with sexually abused children are reviewed. While a variety of standardized instruments have been administered to sexually abused children, relatively few have been utilized in empirical studies. Findings have been mixed, with stronger differences between sexually abused and nonabused children generally found on measures completed by parents than on measures administered directly to children. Sexually abused children often fall between nonabused and psychiatric groups. Use of measures specific to sexual abuse is advocated. While psychological tests may currently have limited use in validating suspected sexual abuse, they may be extremely useful in the clinical treatment of the child.     

Psychological testing and psychological assessment: A review of evidence and issues.

This article summarizes evidence and issues associated with psychological assessment. Data from more than 125 meta-analyses on test validity and 800 samples examining multimethod assessment suggest 4 general conclusions: (a) Psychological test validity is strong and compelling, (b) psychological test validity is comparable to medical test validity, (c) distinct assessment methods provide unique sources of information, and (d) clinicians who rely exclusively on interviews are prone to incomplete understandings. Following principles for optimal nomothetic research, the authors suggest that a multimethod assessment battery provides a structured means for skilled clinicians to maximize the validity of individualized assessments. Future investigations should move beyond an examination of test scales to focus more on the role of psychologists who use tests as helpful tools to furnish patients and referral sources with professional consultation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

我国近10年寄生虫病的发生与流行特征

我国血吸虫病、疟疾、淋巴丝虫病和黑热病等重要寄生虫病的防治,历经几代人卓有成效的防治,现已达到了消除或有效控制,防治工作取得了举世瞩目的成就.在农村通过采取改厕改水、初级卫生保健以及卫生宣教等一系列的综合防治措施,使得我国土源性线虫的感染率有了大幅度的下降.     

Promoting healthy sexuality: guidelines for the school-age child and adolescent

The purpose of this article is to provide the clinician with practical information to promote the healthy sexuality of the school-age child through adolescence. Much of the current literature related to sexuality is problem-focused; this article focuses on sexuality from a health promotion viewpoint. The development of a healthy sexuality is a life-long process with different issues and problems pertaining to each age group. Issues common to the school-age child and adolescent include changing physical characteristics and body image concerns. A set of guidelines has been developed that can be used in the clinical setting. In order to follow a holistic approach to health promotion with these age groups, the clinician must address sexuality. These guidelines will provide the information the clinician will need to initiate a discussion about sexuality. Patient education guidelines are also presented that will help the parent, child, and adolescent in sexual issues and understanding. Suggested reading materials about sexuality are also presented.     

Psychological testing at the end of the millenium: A brief historical review.

The author presents a brief historical overview of the origins of psychological testing 100 years ago and its continuing development. Special emphasis is placed on test administration and test standardization procedures. The author also illustrates how short-term immediate social needs have stimulated innovation and long-term development. Accommodation to test-taker differences has been a long-standing technical detail, and the development and refinement of group testing procedures has been critical to large-scale use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Cognitive Interview: A meta-analytic review and study space analysis of the past 25 years.

The Cognitive Interview (CI) is a well-established protocol for interviewing witnesses. The current article presents a study space analysis of laboratory studies of the CI together with an empirical meta-analysis summarizing the past 25 years of research. The study space comprises 57 published articles (65 experiments) on the CI, providing an assessment of the boundary conditions underlying the analysis and application of this interview protocol. The current meta-analysis includes 46 published articles, including 20 articles published since the last meta-analysis conducted a decade earlier (K?hnken, Milne, Memon, & Bull, 1999). Reassuringly for practitioners, the findings of the original meta-analysis were replicated with a large and significant increase in correct details and a small increase in errors. In addition we found that there were no differences in the rate at which details are confabulated. Importantly, the effect sizes were unaffected by the inclusion of recent studies using modified versions of the CI. The CI appeared to benefit older adult witnesses even more than younger adults. We highlight trends and gaps in research and discuss how our findings can inform policy and training decisions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)