Coping with stress during childhood and adolescence.

In this article, research on how children and adolescents cope with stress and coping's role in reducing the adverse psychological states associated with stress is reviewed. Child and adolescent coping is reflected in seven different lines of research—infants' responses to maternal separation, social support, interpersonal cognitive problem-solving, coping in achievement contexts, Type A behavior pattern in children, repression–sensitization, and resilience to stress. A variety of different coping resources, styles, and specific strategies are important in successfully adapting to stress, including efforts that focus directly on the problem, as well as attempts to deal with adverse emotions associated with stress. Directions for future research are identified, emphasizing the need for more systematic comparisons of coping across different types of stress and over time in response to a single stressful episode. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tumors in childhood and adolescence

Amplification behavior of one chromosome locus (D17S5), widely used in identification studies, is investigated. The effect of preferable amplification of alleles, characteristic of this locus, often leads to an erroneous conclusion about homozygosity. Our studies showed, that along with the hazard of typing false homozygotes in analysis of locus D17S5, more intricate cases with genotype distortion can occur in expert practice, which may be characterized not only by partial loss of the true alleles, but even by amplification of nonspecific (nonallele) fragments simulating the false-heterozygotic allele profile. Analysis of the stability of amplification profile helps solve this problem.     

Migraine in childhood and adolescence

A 62 years old man was admitted to hospital because of fever; a small superficial hepatic nodule was showed by ultrasonography. Blood cultures grew Salmonella enteritidis. Cefotaxime was administered for ten days. Fever promptly disappeared but one week later recurred with abdominal and back pain. Cultures grew again Salmonella enteritidis. Biopsy of the hepatic nodule showed hepatocarcinoma. Computed abdominal tomography showed a paraaortic mass. Angiography demonstrated hematoma communicating with the aortic lumen. The patient underwent revascularization of the involved aortic tract and resection of the hepatic nodule. Histology showed suppurative aortic endarteritis and a well-differentiated hepatocellular carcinoma with a large area of suppurative necrosis. The recovery of Salmonella species as of any uncommon bacteria from blood should warrant a through research of underlying disease, especially cancer.     

Spondylolisthesis in childhood and adolescence

Isthmic spondylolisthesis occurs in 4.4% of children. In general it is a benign condition. The majority of individuals with mild or moderate isthmic vertebral slip remain free of symptoms or get only mild symptoms. In children and adolescents with mild slip, primary treatment of pain symptoms is non-operative. Young children before the growth spurt need radiological follow-up for documentation of possible slip progression. If the slip exceeds 25% in a child, segmental fusion to prevent further progression should be considered. Uninstrumented posterolateral fusion is the method of choice for treatment of pain symptoms not responding to conservative measures in slips up to 50%. In severe slips (> 50%), anterior or combined fusion is necessary to prevent further progression of lumbosacral kyphosis. The clinical and subjective results of in situ fusion in this age group are satisfactory in 80-90% of cases. Slip reduction is possible. It requires internal fixation and is connected with a higher risk of complications. The results of slip reduction have not yet been shown to be superior to results after in situ fusion. It may be performed in cases of spondyloptosis with severe impairment of function and sagittal malalignment of the spine.     

Development of sex-differentiated preferences during late childhood and adolescence.

Examined factors influencing sex-differentiated responses to selected interests and interpersonal traits by young people in 3 age groups: 516 in late childhood (Grades 4–6), 398 in early adolescence (Grades 7–9), and 337 in late adolescence (Grades 10–12). There was limited evidence for same-sex bias during late childhood, varying by sex and race in its pervasiveness or clarity. Interpersonal traits were not generally sex stereotyped. Several interests were sex stereotyped during adolescence, but not those most directly related to academic learning. In general, interests were more strongly sex stereotyped by boys than by girls. Greater cognitive maturity generally attenuated sex stereotyping of interests. Certain developmental trends differed by sex and/or by race, and socioeconomic background (parents" education) influenced developmental trends among Blacks but not among Whites. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex role perceptions during adolescence.

Sex-role perceptions were examined by having 165 males and 141 females in Grades 7–12 respond to the Self-Esteem Inventory and the Nowicki-Strickland Adult Locus of Control Scale under 2 sets of instructions: (a) a standard set and (b) a set in which Ss were asked to respond as they thought a member of the same age and grade but of the opposite sex would respond. No sex differences were obtained on the 2 instruments under the standard set of instructions. Under opposite-sex instructions, however, both sexes credited males with being higher in self-esteem than females. On the locus of control scale, members of both sexes perceived themselves to be more internally controlled than members of the opposite sex. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Competence and self-esteem during transition from childhood to adolescence.

Change and stability in competence and self-esteem of fifth- and sixth-grade boys and girls were examined across a 1-year period, in which approximately one half of the children made the transition from elementary to secondary school (transition groups) and the other half continued in the same school (nontransition groups). Beginning at the end of the school year before transition, the Perceived Competence Scale for Children and the Teacher's Rating Scale of Child's Actual Competence were administered at 6-mo intervals. There was no notable transition effect either early or late in the new school year. Overall, children's perceived competence increased and was stable across the 1-year period. Teacher ratings also reflected competence gains for children in nontransition groups; but for children in transition groups they were substantially lower in secondary than in elementary school. The results indicate that entry into secondary school represents significant change from elementary school, but that most children negotiate the transition without undue difficulty. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental aspects of gender role flexibility and traditionality in middle childhood and adolescence.

Explored developmental patterns of gender traditionality and flexibility in 479 Ss across middle childhood and early and late adolescence and assessed the correlates of gender flexibility at these 3 developmental periods. Gender flexibility was differentiated into 2 dependent variables: self-related gender preferences and attitudes toward others. Varying theoretical developmental trends have been posited with regard to gender flexibility, but relationships obtained between age and gender flexibility were mostly positive. Several negative relationships, however, underscored the complexity of gender-related responses. Most variables assessed contributed significantly and cumulatively to the prediction of gender flexibility; socialization variables proved to be the strongest predictors of all 3 developmental levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The self-system during childhood and adolescence: Development, influences, and implications.

Research on the development of the self-system is briefly reviewed, with a special focus on major themes and issues related to childhood and adolescence. Important tasks and characteristics of the self-system that emerge during infancy, toddlerhood, childhood, and adolescence are described, helping to illustrate the numerous factors that influence changing perceptions of the self. Relationships between the self-system and social agents also are described, showing the influence of schooling and parental involvement on the development of the self. Examples from the authors' research on the relationships between gender and the development of self-beliefs are reviewed. They include examples of atypical development throughout the article, and conclude with a discussion regarding the implications of developmental research for clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hemifacial spasm in childhood and adolescence

Hemifacial spasm (HFS), a hyperactive dysfunction of the facial nerve, is rarely seen in young people. Between 1984 and 1994, we treated 924 patients with HFS by microvascular decompression at our institution. Of these, 8 (0.9%) were younger than 30 years. In most of the older patients with HFS, the offending artery which compresses the root exit zone was elongated, redundant, and focally arteriosclerotic as a result of hemodynamic effects due to aging or hypertension. On the other hand, the offending artery did not exhibit such characteristic changes of the vasculature in children and adolescents with HFS. In all of the young patients who underwent initial microvascular decompression at our clinic, the arachnoid membrane around the facial nerve was thickened and encased the artery, resulting in compression of the root exit zone of the facial nerve. Such thickening of the arachnoid surrounding the offending vessel may play an important role in the pathogenesis of HFS by trapping and encasing the artery to compress the root exit zone, particularly in the young patients.     

Nasopharyngeal carcinoma in childhood and adolescence

BACKGROUND: This study reviews the authors' experience from 1979 through 1996 in the management and outcome of 56 patients with nasopharyngeal carcinoma who were under 20 years of age. PROCEDURE: There were 33 males and 23 females, their ages ranging from 7 to 19 years (median: 16 years). Forty patients had World Health Organization type III carcinomas, 16 had T4 tumors, 41 had metastatic cervical lymph nodes, and 50 were at stage III or stage IV. Thirty-two patients were treated with radiation therapy alone and 24 with the addition of chemotherapy. Cumulative radiation dose to the primary tumor ranged from 18 to 70 Gy (median: 66 Gy) and radiation dose to metastatic cervical lymph nodes ranged from 18 to 70 Gy (median: 66 Gy). RESULTS: Follow-up ranged from 0.1 to 16.8 years (mean: 9 years). Locoregional tumoral complete response was achieved in 49 patients. Locoregional tumoral failure was observed in 12 patients and systemic failure in 11. Overall, locoregional failure-free, metastases-free, and disease-free survival rates at 5 years were 49%, 62%, 79%, and 47%, respectively, for the entire group of patients, 42%, 61%, 72%, and 42%, respectively, for patients treated with radiation therapy alone, and 58%, 63%, 87%, and 54%, respectively, for patients treated with the addition of chemotherapy. Advanced T-stage and lower radiation doses worsened locoregional failure-free survival, whereas advanced N-stage and exclusion of chemotherapy worsened metastases-free survival. CONCLUSIONS: In children and adolescents with nasopharyngeal carcinoma, radiation therapy alone results in an improved locoregional tumoral response rate and a reduced locoregional tumoral failure rate at higher radiation doses, while the addition of chemotherapy results in a reduced systemic failure rate.     

Transcranial revascularisation in childhood and adolescence

Fifteen patients under the age of 20 years underwent transcranial revascularisation surgery: 13 presented with acute strokes or recurrent transient neurological events, one with progressive dementia and one with recurrent syncope. Five underwent unilateral and seven bilateral anastomosis of the superficial temporal artery to a branch of the middle cerebral artery (STA-MCA bypass). One patient aged 22 months underwent bilateral encephaloduroarterisynangiosis (EDAS). Three patients deteriorated postoperatively: one died from a probable cardiac cause, one had subarachnoid haemorrhage and the patient who underwent EDAS suffered further permanent ischaemic damage. No further permanent ischaemic events occurred following STA-MCA bypass (median follow-up 41 months). Transient ischaemic events persisted postoperatively in four cases, but with reduced severity. The results suggest that STA-MCA bypass may be effective in protecting young patients from further permanent ischaemic events in the treated vascular territory.     

Information seeking and achievement motivation in middle childhood and adolescence: The role of conceptions of ability.

Two studies confirmed that maladaptive responses to failure in ego-involving settings depend on acquisition of the differentiated concept of ability (DCA) in early adolescence (J. G. Nicholls, 1984). Information seeking, performance, and interest in task versus ego-involving conditions were examined among 190 pupils in Grades 4 and 8 and 139 pupils in Grades 5–6 who had or had not acquired the DCA. Age and conception of ability had similar effects. Pupils who had acquired the DCA responded to the task condition with strivings to learn and requests for information relevant to acquiring mastery and to the ego condition with strivings to outperform others and requests for normative feedback. Failure undermined information seeking, performance, and interest in the ego condition only after acquisition of the DCA. Surprisingly, pupils who had not acquired the DCA responded to both conditions with strivings to assess normative success but displayed neither the costs of ego involvement nor the benefits of task involvement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of schizophrenia in childhood and adolescence

This paper reviews the management of schizophrenia occurring during childhood and adolescence. It considers the clinical features of the disorder particular to its early onset before providing a practical framework for assessment and treatment based upon a critical review of the available literature. A multi-modal approach to treatment encompassing the individual and their family is adopted with the roles of pharmacological, psychological, and environmental interventions all considered. The place of the newer "atypical" antipsychotic agents and the likelihood that they will soon become the first-line drugs of choice is particularly discussed.     

Long-term outcome of migration in childhood and adolescence

Self-injurious behavior occurring in persons with severe mental retardation is a clinically significant and poorly understood problem. Multiple neurotransmitter systems have been implicated in the pathogenesis of this behavior, particularly dopaminergic, opioidergic, and serotonergic systems. Pemoline, a central stimulant, administered systemically at high doses reliably produces self-biting behavior in the rat. The systemic bolus of pemoline produces sustained neostriatal levels of pemoline for over 24 h in a continuous infusion paradigm. Studies of the effect of cortical lesions on pemoline-mediated behaviors reveal that cortical damage, as is common in profound mental retardation, lowers the threshold for pemoline-induced self-biting behavior. Data from the corticostriatal slice suggests that sustained exposure to pemoline produces a shift in N-methyl-D-aspartate receptor-mediated responses rendering them more susceptible to dopaminergic enhancement. Thus, dopaminergic and glutamatergic interactions appear to play an important role in the development and expression of self-biting in the pemoline model.     

The role of peer affiliations, social, family and individual factors in continuities in cigarette smoking between childhood and adolescence

The continuity between early smoking experimentation and smoking at age 16 years was analysed for a birth cohort of New Zealand children. This analysis suggested that when due allowance was made for errors in reports of smoking behaviours, there was evidence of relatively strong continuity (r = 0.60) between early smoking experimentation and cigarette smoking at age 16 years. Further analysis suggested that the continuities between early smoking experimentation and later smoking arose from three pathways that linked early smoking experimentation to later smoking. First there was evidence to suggest that children who engaged in early smoking experimentation tended to affiliate with adolescent peer groups whose members smoked. In turn, these peer group affiliations reinforced pre-existing tendencies to cigarette smoking. Secondly, a small component of the apparent continuity between early smoking experimentation and later smoking arose because of common social, individual and contextual factors that were associated with both smoking experimentation and later smoking. Finally, there was evidence of moderate direct continuity in cigarette smoking behaviour over time. The implications of these findings for the development of smoking prevention programmes are discussed and it is concluded that effective programmes need to be embedded in a developmental approach which attempts to reduce both early smoking experimentation and the effects of peer pressure in adolescence on the development of cigarette smoking.     

Leptin as a metabolic regulator during fetal and neonatal life and in childhood and adolescence

Body weight is regulated by a feedback loop in which peripheral signals report nutritional information to an integratory center in the brain. The cloning of the ob gene is consistent with this concept and suggests that body fat content in adult rodents is regulated by a negative feedback loop centered in the hypothalamus/1-8/. In a recent report, two severely obese children with congenital leptin deficiency due to a homozygous frame-shift mutation involving the deletion of a single guanine nucleotide in codon 133 of the ob gene have been described. This discovery provides the first genetic evidence that leptin is an important regulator of energy balance in humans. However, it has become increasingly clear that apart from leptin's function in the central nervous system and in regulation of energy balance, leptin also acts in the periphery and might be important as a hormone modulating processes in regard to reproduction, glucose metabolism and insulin resistance, as well as growth and development of many tissues and organs either directly or indirectly. This report reviews some of the topics of leptin research that are of particular importance and relevance for pediatric and adolescent medicine and for pediatric endocrinology in particular.