Klinički dječji psihijatrijski intervju je „zlatni standard“ dijagnostike u dječjoj i adolescentnoj psihijatriji. U radu su prikazane osnove vođenja psihijatrijskog i psihoterapijskog intervjua. ...Intervju zahtjeva fleksibilnost, otvorenost, znanje, iskustvo, kao i određeno umijeće. Temelj intervjua jest empatično razumijevanje. Teme koje se elaboriraju u intervjuu razlog su dolaska, procjena intrapsihičkih i interpersonalnih mogućnosti, teme obitelji, vršnjaka, sposobnosti djeteta/ adolescenta, te druge teme. U završnoj fazi intervjua elaboriraju se teme radnog saveza, te dogovora o daljnjoj suradnji i eventualnom psihoterapijskom liječenju. Prvi intervju u dječjoj psihijatriji često je više terapijski orijentiran, odnosno motivacijski, dok će sljedeći intervjui biti više dijagnostički intonirani.
We used population sample data from 25 societies to answer the following questions: (a) How consistently across societies do adolescents report more problems than their parents report about them? (b) ...Do levels of parent-adolescent agreement vary among societies for different kinds of problems? (c) How well do parents and adolescents in different societies agree on problem item ratings? (d) How much do parent-adolescent dyads within each society vary in agreement on item ratings? (e) How well do parent-adolescent dyads within each society agree on the adolescent's deviance status? We used five methods to test cross-informant agreement for ratings obtained from 27,861 adolescents ages 11 to 18 and their parents. Youth Self-Report (YSR) mean scores were significantly higher than Child Behavior Checklist (CBCL) mean scores for all problem scales in almost all societies, but the magnitude of the YSR-CBCL discrepancy varied across societies. Cross-informant correlations for problem scale scores varied more across societies than across types of problems. Across societies, parents and adolescents tended to rate the same items as low, medium, or high, but within-dyad parent-adolescent item agreement varied widely in every society. In all societies, both parental noncorroboration of self-reported deviance and adolescent noncorroboration of parent-reported deviance were common. Results indicated many multicultural consistencies but also some important differences in parent-adolescent cross-informant agreement. Our findings provide valuable normative baselines against which to compare multicultural findings for clinical samples.
A pilot study was conducted to examine the efficiency and satisfaction of cognitive behavioral therapy (CBT) intervention in youth with epilepsy regarding coping strategies. The CBT intervention was ...based on the main principles and empirically supported cognitive-behavioral techniques. The intervention consists of epilepsy education, stress education, and coping skill strategies. Seventeen children and adolescents aged 9-17 diagnosed with epilepsy for at least one year, with at least average intelligence and no history of serious mental illness completed the CBT intervention during summer camp, providing data on the efficiency of and satisfaction with CBT intervention. Upon completion of the CBT intervention, study subjects achieved significantly higher scores on the following Scale of Coping with Stress subscales: Problem solving; Seeking for social support from friends; Seeking for social support from family; and Cognitive restructuring, for both measures of usage frequency and effectiveness of each subscale. The participants reported a high level of satisfaction with the CBT intervention. This study provided explanation of research limitations and recommendations for future clinical trials.
Somatic Symptom Disorder (SSD), formally known as somatoform disorder, can be found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in the category titled: Somatic Symptom and ...Related Disorders. In the 10th revision of the International Classification of Diseases (ICD-10), somatoform disorder can be found under the code F45, with the more specific F45.4 being: persistent somatoform pain disorder. A multidisciplinary approach is often used in the treatment of this disorder. Medical professionals involved in the team include: pediatricians, child and adolescent psychiatrists, psychotherapists, psychologists, nurses, and other collaborating professionals. In this case report we present the case of a boy who had an unfavorable course of illness with recurring abdominal pain, loss of functionality, and inability to attend school for months. The patient was treated multiple times, both as an inpatient and outpatient, by pediatricians, child and adolescent psychiatrists, as well as the other members of the multidisciplinary team. Unfavorable prognostic factors in this case were: resistance and recurrence of symptoms, tension, and high emotional sensitivity. On the other hand, favorable prognostic factors were: motivation for treatment and an appropriate level of development of mental structure. During the patient’s last treatment in the hospital on the Department of Child and Adolescent psychiatry, an improvement in symptoms was achieved with a reduction of pain, as well as the reestablishment of school attendance at the hospital. In a number of cases, SSD has a chronic course, which poses a great challenge for treatment in practice today.
This article presents, in the form of a clinical illustration, a therapeutic group of bereaved mothers with special reference to their dreams about their deceased children. The article presents ...descriptions of the emotions of these mothers and countertransference feelings, a topic that, to our knowledge, has not been frequently studied. The group was small, analytically oriented, slow-open, comprised of women bereaved by the death of a child, and conducted by a female therapist. Over more than three years, the group included 20 members in total. This article describes a number of dreams recorded during a period when the group included seven members. Dreams helped the group members access their emotional pain, helplessness, yearning for a relationship with the deceased, guilt, and feelings of survival guilt. The transference-countertransference relationships were characterized by holding. Countertransference feelings of helplessness predominated. The therapist and the group as a whole contained various emotions, allowing the group members to return to the normal mourning processes from the parallel encouragement of group development and interpersonal relationships.
We discuss the dynamics of an analytic group when a female member spoke about her three-year-old child suffering from a malignant disease. The group was slow-open and consisted of six members and the ...female therapist (the first author). The group held sessions one and a half hours a week for approximately five years. The therapist conducted the group in accordance with the theoretical background of Foulkes. During the period described in this article (10 months), the group went through hard times; they moved from an initial fear of disintegration to gradual recovery by working through the previous separation anxiety of individual members and of the group as a whole. We believe that the threatening loss (i.e., facing the fear of death) led to more profound interactions. In our opinion, the well-developed coherency very much contributed to the gradual recovery.
Svako se dijete rađa i živi u određenom socijalnom kontekstu, intenzivnih socijalnih interpersonalnih relacija, većinom unutar obiteljskog konteksta. Primjereno roditeljstvo/skrbništvo i partnerstvo ...u obitelji karakterizira: dobra suradnja partnera, otvorena, direktna komunikacija, s jasnim i iskrenim neverbalnim izrazima, kontinuitet i koherencija u odnosima, čvrstoća, ali i fl eksibilnost obiteljskog sustava u cjelini. U literaturi postoje različiti modeli dijagnostike obitelji, a ovise o teorijskom usmjerenju pojedinog pravca. Potrebna je integracija različitih psihodinamskih, sustavnih i kognitivno bihevioralnih smjerova i terapija. Nekad je dovoljno u praksi od strane različitih stručnjaka (dječji i adolescentni psihijatri, pedijatri, drugi suradni stručnjaci) se samo orijentirati na progresivne tendencije cijele obitelji, odnosno pružiti suportivni terapijski stav roditeljstvu/skrbništvu.
Objective: To build on Achenbach, Rescorla, and Ivanova (2012) by (a) reporting new international findings for parent, teacher, and self-ratings on the Child Behavior Checklist, Youth Self-Report, ...and Teacher's Report Form; (b) testing the fit of syndrome models to new data from 17 societies, including previously underrepresented regions; (c) testing effects of society, gender, and age in 44 societies by integrating new and previous data; (d) testing cross-society correlations between mean item ratings; (e) describing the construction of multisociety norms; (f) illustrating clinical applications. Method: Confirmatory factor analyses (CFAs) of parent, teacher, and self-ratings, performed separately for each society; tests of societal, gender, and age effects on dimensional syndrome scales, "DSM"-oriented scales, Internalizing, Externalizing, and Total Problems scales; tests of agreement between low, medium, and high ratings of problem items across societies. Results: CFAs supported the tested syndrome models in all societies according to the primary fit index (Root Mean Square Error of Approximation RMSEA), but less consistently according to other indices; effect sizes were small-to-medium for societal differences in scale scores, but very small for gender, age, and interactions with society; items received similarly low, medium, or high ratings in different societies; problem scores from 44 societies fit three sets of multisociety norms. Conclusions: Statistically derived syndrome models fit parent, teacher, and self-ratings when tested individually in all 44 societies according to RMSEAs (but less consistently according to other indices). Small to medium differences in scale scores among societies supported the use of low-, medium-, and high-scoring norms in clinical assessment of individual children. (Contains 5 tables and 4 figures.)
Parent-teacher cross-informant agreement, although usually modest, may provide important clinical information. Using data for 27,962 children from 21 societies, we asked the following: (a) Do parents ...report more problems than teachers, and does this vary by society, age, gender, or type of problem? (b) Does parent-teacher agreement vary across different problem scales or across societies? (c) How well do parents and teachers in different societies agree on problem item ratings? (d) How much do parent-teacher dyads in different societies vary in within-dyad agreement on problem items? (e) How well do parents and teachers in 21 societies agree on whether the child's problem level exceeds a deviance threshold? We used five methods to test agreement for Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) ratings. CBCL scores were higher than TRF scores on most scales, but the informant differences varied in magnitude across the societies studied. Cross-informant correlations for problem scale scores varied moderately across societies studied and were significantly higher for Externalizing than Internalizing problems. Parents and teachers tended to rate the same items as low, medium, or high, but within-dyad item agreement varied widely in every society studied. In all societies studied, both parental noncorroboration of teacher-reported deviance and teacher noncorroboration of parent-reported deviance were common. Our findings underscore the importance of obtaining information from parents and teachers when evaluating and treating children, highlight the need to use multiple methods of quantifying cross-informant agreement, and provide comprehensive baselines for patterns of parent-teacher agreement across 21 societies.
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