Showing papers in "Journal of Child and Adolescent Psychiatric Nursing in 2007"
TL;DR: Cognitive-behavioral and skills-based approaches are the most widely studied and empirically validated treatments for anger and aggression in youth.
Abstract: BACKGROUND: Anger and its expression represent a major public health problem for children and adolescents today. Prevalence reports show that anger-related problems such as oppositional behavior, verbal and physical aggression, and violence are some of the more common reasons children are referred for mental health services. METHODS: An extensive review of the literature was conducted using the following online search engines: Cochrane, MEDLINE, PsychINFO, and PubMed. Published and unpublished articles that met the following criteria were included in the review: (a) experimental or quasi-experimental research designs; (b) nonpharmacologic, therapy-based interventions; and (c) study participants between 5 and 17 years of age. RESULTS: Cognitive-behavioral and skills-based approaches are the most widely studied and empirically validated treatments for anger and aggression in youth. Commonly used therapeutic techniques include affective education, relaxation training, cognitive restructuring, problem-solving skills, social skills training, and conflict resolution. These techniques, tailored to the individual child's and/or family's needs, can foster the development of more adaptive and prosocial behavior. Language: en
101 citations
TL;DR: Some degree of relational aggression seems to be a normal response to conflict for many girls, from preschool through adolescence; however, more research needs to be conducted to determine at what level, or what subtypes, of relational aggressors are predictive of future deviant behavior.
Abstract: TOPIC: Defining and exploring the concept of relational aggression, or the purposeful intent to inflict harm on another through a social relationship. PURPOSE: This study aims to describe the concept of relational aggression as it has been shaped through recent research, to contrast relational aggression with other types of aggression, and to explore the influence of gender and the formation of a self-concept in the development of relational aggression. SOURCES: A review of the literature from 1969 to 2005 from selected nursing, child development, women's studies, and psychology publications. CONCLUSIONS: Some degree of relational aggression seems to be a normal response to conflict for many girls, from preschool through adolescence; however, more research needs to be conducted to determine at what level, or what subtypes, of relational aggression are predictive of future deviant behavior. Language: en
75 citations
TL;DR: Although evidence for the effective treatment of children with attachment disorders is minimal and inconclusive, the two major perspectives, developmental psychology and neuropsychoanalysis, offer guidelines for practice.
Abstract: TOPIC: Attachment theory and reactive attachment disorder (RAD). PURPOSE: To highlight current perspectives on attachment theory, RAD, and treatment implications using a case study of an 8-year-old patient with RAD. SOURCES: Selected multidisciplinary literature related to attachment theory and RAD. CONCLUSIONS: The literature provides a body of work that substantiates the importance of early attachment relationships to human development and highlights gaps in our knowledge related to treatment of children with RAD. The quality of early attachment relationships is correlated with future personality and brain development. Attachment disturbances are associated with psychopathology in childhood and adulthood. Although evidence for the effective treatment of children with attachment disorders is minimal and inconclusive, the two major perspectives, developmental psychology and neuropsychoanalysis, offer guidelines for practice. Language: en
58 citations
TL;DR: In resource-poor settings with few trained mental health professionals, community workers were taught basic mental health interventions by teams of psychiatrists, nurses, and social workers and had implications for natural and man-made disasters in developed and developing countries.
Abstract: OBJECTIVES: The tsunami disaster in South Asia affected the mental health and livelihoods of thousands of child and adult survivors, but psychological aspects of rehabilitation efforts are frequently neglected in public health initiatives. METHODS: Professional teams from the National Institute of Mental Health and Neurosciences in Bangalore, India, traveled to the worst-affected areas in South India and implemented a mental health program of psychosocial care for child and adult survivors. This descriptive report is based on observations of child and adult survivors in Tamil Nadu State of India during January-March 2005. OBSERVATIONS: Symptoms of emotional distress were observed in child and adult survivors. A train-the-trainer community-based model was implemented for teachers and community-level workers to respond to the emotional needs of children and adults. CONCLUSION: In resource-poor settings with few trained mental health professionals, community workers were taught basic mental health interventions by teams of psychiatrists, nurses, and social workers. This train-the-trainer, community-based approach has implications for natural and man-made disasters in developed and developing countries. Language: en
52 citations
TL;DR: In this paper, the characteristics of 17 homeless teenage mothers (HTM) were described and compared to housed mothers, HTMs were younger, had more depressive symptoms and negative life events, and fewer social supports.
Abstract: PROBLEM: Homeless families headed by young mothers are increasing. This preliminary study describes the characteristics of 17 homeless teenage mothers (HTM).
METHODS: HTMs completed questionnaires researching depression, self-esteem, maternal competence, and sources of stress and support.
FINDINGS: HTMs had positive maternal competence and self-esteem scores. When compared to housed mothers, HTMs were younger, had more depressive symptoms and negative life events, and fewer social supports.
CONCLUSIONS: HTMs represent a high-risk group with fewer available supports and many complex life stressors. School-based programs can benefit HTMs by offering support, helping them continue their education, and assisting with on-site school-based childcare.
49 citations
37 citations
TL;DR: Choosing disordered eating behaviors as a method of control occurred when the young women lacked connected and close relationships with others, and when meaningful relationships were present in their lives, the dysfunction abated.
Abstract: PROBLEM: Approximately 5% of American women suffer from eating disorders and scores more exhibit signs of disordered eating. The purpose of this study was to gain an understanding of disordered eating in adolescence.
METHODS: Grounded theory method was employed. In-depth interviews were conducted with 15 college women to explore their experiences with disordered eating.
FINDINGS: Choosing disordered eating behaviors as a method of control occurred when the young women lacked connected and close relationships with others. Conversely, when meaningful relationships were present in their lives, the dysfunction abated.
CONCLUSIONS: Psychosocial and dietary assessments are necessary to identify youngsters without connected relationships and/or predispositions to disordered eating.
35 citations
TL;DR: A case is made for designing and implementing group interventions to meet the mental health needs of this important group of individuals.
Abstract: TOPIC: Bereavement is considered by many to be among the most stressful of life events, and it becomes particularly distressing when it concerns the suicide death of a parent. Such an event is especially traumatic for children. PURPOSE AND SOURCES: The purpose of this paper is to present a case for support group interventions designed specifically for child survivors of parental suicide. The authors provide a theoretical framework for supportive group interventions with these children and describe the structure of an 8-week bereavement support group for this special population of suicide survivors. CONCLUSIONS: A case is made for designing and implementing group interventions to meet the mental health needs of this important group of individuals. Language: en
34 citations
TL;DR: There are distinct gender differences in depressive symptom expression that are identifiable before adolescence and may be associated with normative development, according to a convenience sample of suburban middle-class public school fifth and sixth graders.
Abstract: PROBLEM: Depressive symptoms in children have been linked to recurrent problems with depression, school problems, and risky health behaviors Adolescent girls report depressive symptoms three to four times more frequently than adolescent boys Few studies, however, have examined gender-related depressive symptoms in younger, school-aged children METHODS: In the present study, gender differences in depressive symptoms in children ages 10-12 years were explored using the Children's Depression Inventory (CDI) with a convenience sample of 122 suburban middle-class public school fifth and sixth graders FINDINGS: A distinct pattern of depressive symptom expression was found with girls reporting more internalizing and more negative self-esteem, and boys reporting more externalizing and more school problems CONCLUSION: These findings suggest that despite similarities on a total depressive symptom score, there are distinct gender differences in depressive symptom expression that are identifiable before adolescence and may be associated with normative development Language: en
33 citations
TL;DR: Based on an understanding of physiologically expected care postbirth, special care for postinstitutionalized adopted children might include: close physical contact via use of a sling and cosleeping; breastfeeding or nurturing through food; and responsive caregiving.
Abstract: TOPIC: Optimizing caregiving for newly adopted postinstitutionalized children.
PURPOSE: To consider a template of care for postinstitutionalized children based on experiences that physiological measures suggest are expected by infants postbirth.
SOURCES: Published literature and clinical experience.
CONCLUSION: Based on an understanding of physiologically expected care postbirth, special care for postinstitutionalized adopted children might include: close physical contact via use of a sling and cosleeping; breastfeeding or nurturing through food; and responsive caregiving. In replicating earlier missed experiences, parents may assist emotional development in their child and promote attachment development.
27 citations
TL;DR: A body of research is developing that suggests VLBW children may have specific, yet subtle, attention problems that may differ from those of other children.
Abstract: PROBLEM: Children born prematurely have been shown to have a range of problems that often result in delayed academic achievement.
METHODS: The current study assessed both attention problem scores (Child Behavior Checklist) and actual performance on tasks tapping three attention networks in a sample of children (n = 94) born with very low birth weights (VLBW; ≤ 1500 grams).
FINDINGS: Attention problem scores were extremely low and did not predict children's actual attention performance.
CONCLUSIONS: A body of research is developing that suggests VLBW children may have specific, yet subtle, attention problems that may differ from those of other children.
TL;DR: Screening of youth with mood spectrum problems for bipolar disorder should occur in every diagnostic assessment and should be ongoing due to range of mood symptoms and the cyclical and episodic nature of this disorder.
Abstract: TOPIC: Pediatric bipolar disorder can cause severe disturbances in global functioning. Diagnosing pediatric bipolar disorder is challenging due to the range of symptom expression, developmental differences as compared to adults, presence of comorbid disorders, and developing diagnostic criteria. Treating this disorder can be equally challenging due to frequent symptom relapse and the dearth of research until recently on effective psychopharmacological interventions that guide clinical prescribing practices.
PURPOSE: This paper will help child psychiatric nurses have a better understanding of the unique presentation of pediatric bipolar disorder to facilitate selection of appropriate medication treatment options, taking into account symptom presentation, presence of comorbid diagnosis, drug efficacy, adverse effects, and drug–drug interactions based on research findings.
SOURCES: Literature specific to assessment and psychopharmacological treatment of pediatric bipolar disorder was reviewed.
CONCLUSIONS: Screening of youth with mood spectrum problems for bipolar disorder should occur in every diagnostic assessment and should be ongoing due to range of mood symptoms and the cyclical and episodic nature of this disorder. Youth with bipolar disorder may manifest symptoms and course that differ from adults. Additionally, co-occuring disorders are common in this population, which can complicate medication selection. Psychopharmacological treatment with the use of specific mood stabilizers and/or atypical antipsychotic medications is warranted depending on symptom presentation; however, monotherapy with mood stabilizers has not demonstrated effectiveness in long-term remission of pediatric bipolar symptoms. Recent research indicates that a combined treatment with two mood stabilizers or a mood stabilizer and an antipsychotic holds promising results for pediatric bipolar I, for youth with acute manic symptoms plus psychosis, and for long-term remission of symptoms.
TL;DR: Mentoring of schoolchildren is difficult to accomplish using college mentors because of time and schedule commitments, and when college mentors are used, grade allocation seems to be a stronger incentive than when payment is the sole reward.
Abstract: PURPOSE: This study aims to utilize nursing and other college students in conducting a mentoring project aimed at determining outcomes of behavior and attitude of high-risk middle school students over a 5-year period.
METHOD: A quasi-experimental study with a sample of fifth and sixth graders was conducted in which mentored subjects were tested using multiple instruments and school data to identify behavioral and attitudinal outcomes. Statistical analyses were conducted using chi-square and one-way analysis of variance.
FINDINGS: Academically below-average males in the treatment group were the only cohort demonstrating significant change across all measures. The magnitude of change in this cohort, however, did significantly affect treatment group outcomes overall. Females in both treatment and control groups reflected similar changes.
CONCLUSIONS: Mentoring of schoolchildren is difficult to accomplish using college mentors because of time and schedule commitments. When college mentors are used, grade allocation seems to be a stronger incentive than when payment is the sole reward. Males whose grades are below average demonstrated positive outcomes from the mentoring experience.
TL;DR: An innovative clinical experience for graduate students to shape the role of advanced psychiatric mental health nurses in rural, minority schools using evidence-based approaches is described.
Abstract: Seventy to eighty percent of youth receiving mental health services receive these services in schools. Nurses have been identified as the second major provider of mental health services in the schools, yet little has been written about the role of psychiatric mental health nurses in rural school-based clinics or how they were trained in this role. This paper describes an innovative clinical experience for graduate students to shape the role of advanced psychiatric mental health nurses in rural, minority schools using evidence-based approaches. The authors describe the context, theoretical frameworks, role development, outcomes, and lessons learned.
TL;DR: Clinical assessment and awareness of risks in physical restraints is essential for the safety and well-being of the child.
Abstract: TOPIC: Crisis situations of youth in treatment settings may require restraints. Restraints should only be used in situations where there is imminent danger to the child and when there is no alternative. They are meant to maintain the child's safety, but there is risk for respiratory compromise.
PURPOSE: Nursing care of children in restraints must include respiratory assessment and, when indicated, immediate intervention to prevent disastrous outcomes.
SOURCES: Review using PubMed and established texts confirms that clinical skills and knowledge is essential to child and adolescent psychiatric nursing.
CONCLUSIONS: Clinical assessment and awareness of risks in physical restraints is essential for the safety and well-being of the child.
TL;DR: Sustainable HIV/AIDS prevention programs that address stigma, promote HIV testing, and reinforce safer sex practices are needed.
Abstract: PROBLEM: In the Caribbean region, women and young girls are becoming infected with HIV at a 6:1 rate more than men. Our study investigated effective methods for reducing HIV/AIDS risks among adolescent girls in the Caribbean.
METHODS: One hundred females, aged 15–21, were randomly assigned into a control or intervention group. Subjects were assessed at baseline and postintervention.
FINDINGS: Analysis of variance revealed that items measuring feelings about self, perceived risk, and sexual attitudes had statistically significant postintervention increase.
CONCLUSION: Sustainable HIV/AIDS prevention programs that address stigma, promote HIV testing, and reinforce safer sex practices are needed.
TL;DR: Treatment foster care is an evidence-based approach that is less restrictive and offers troubled youth an opportunity to engage and grow within a family setting.
Abstract: PROBLEM: Similar to the children in J. D. Salinger's novel, The Catcher in the Rye, youth in foster care face the specter of “going over the cliff.”
METHODS: The empirical basis for “treatment foster care” is reviewed, concluding that treatment foster care is both a clinically and cost-effective form of community-based treatment.
FINDINGS: Treatment foster parents prevent the fall of foster youth into the chasm of school failure, involvement with juvenile justice, and dependent living as adults.
CONCLUSION: Treatment foster care is an evidence-based approach that is less restrictive and offers troubled youth an opportunity to engage and grow within a family setting.
TL;DR: An 8-week experiential children's group incorporating art and creative activities as well as a concurrent parent group is described to bolster children's abilities to communicate with parents and other caretakers.
Abstract: The disruptive period around the time of the divorce can shatter a child's entire living milieu. An 8-week experiential children's group incorporating art and creative activities as well as a concurrent parent group is described. The aim of treatment was to bolster children's abilities to communicate with parents and other caretakers. Overall, participants were observed to effectively release painful affect, communicate more openly, and identify strengths in their family systems. Yalom's therapeutic group factors were incorporated into the treatment model. The research of Davies and Cummings related to children in the context of family therapy was also considered. Group leaders included advance practice registered nurses. Follow-up objective data collected from participants might provide further information about the efficacy of the interventions.
TL;DR: In Vietnam, child health services are primarily focused on nutritional and developmental concerns and child mental health issues, including homelessness, adolescent suicide, and sex trafficking of children are not currently governmental priorities.
Abstract: In Vietnam, child health services are primarily focused on nutritional and developmental concerns. Child mental health issues, including homelessness, adolescent suicide, and sex trafficking of children, are not currently governmental priorities. Language: en
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TL;DR: The first attempt to hold a legally recognizable central committee meeting was held by the Maryland Democratic Central Committee at the Baltimore Holiday Inn on the night of the Gramm-Lotta agreement as mentioned in this paper.
Abstract: We can tell you how the Democrat ic leadership's surrender on the budget issue is affecting the state party organizations. We were pres ent at an attempted dinner-meeting of the Maryland Democratic Cen tral Committee at the Baltimore Holiday Inn. This was the evening after the House Democrats bolted en masse to the Gramm-Lotta com promise. Although the party had planned to seat 150 or more, only 80 delegates and observers attend ed. The moderate Montgomery County delegation chose to eat at a restaurant in isolation from the rest of the party. After dinner ended at 7:30, the party stalwarts took on the major issue confronting them: their in ability to raise the 40 percent at tendance required for a quorum. This meeting was the third at tempt to hold a legally recognizable central committee meeting, and the party had gone all out. The meeting was widely adver tised, dinner was served with eclairs for dessert (dessert being a very important consideration in the state party hierarchy), a seven-foot Uni versity of Maryland basketball ce lebrity was on hand; former Ken nedy activist Karen Kuker-Kiehl, one of the "coming young Demo crats," was there in a see-through blouse and a high slit skirt; but still, no quorum could be raised. At 9:00 p.m., an elderly woman was carried in from her sickbed and the Baltimore delegation discov ered a few more additional votes without benefit of new bodies en tering the meeting room, but there was still no quorum. At this point, a fresh approach was attempted. It was suggested
TL;DR: Results indicated that psychiatrists have willingly used medication as a first-line treatment for MDD in children under age 7, despite a paucity of research support for this practice.
Abstract: PROBLEM: Limited research on pharmacologic treatments for pediatric major depressive disorder (MDD) exists.
METHODS: Prescription practices data for MDD from 1,209 American Academy of Child and Adolescent Psychiatry members collected in 1998 are compared to the current empirical support for this treatment approach.
FINDINGS: Results indicated that psychiatrists have willingly used medication as a first-line treatment for MDD in children under age 7, despite a paucity of research support for this practice.
CONCLUSIONS: Recent warnings regarding the use of selective serotonin reuptake inhibitors warrant the need to reexamine current prescription practices of psychiatric care providers for children diagnosed with MDD.