A comprehensive study of the literature in the Canadian Medical Journal finds that spanking children results in poor outcomes: lower IQ scores.
The arguments against spanking and corporal punishment are even stronger when considering its re-traumatizing effects on children who have experienced complex trauma.
Showing posts with label Research. Show all posts
Showing posts with label Research. Show all posts
Feb 10, 2012
Feb 5, 2012
Attachment Therapy Companion
The book I wrote with 2 colleagues, Attachment Therapy Companion, will be out in July an is now listed on the Norton website:
http://books.wwnorton.com/books/Attachment-focused-Therapy/
The book is meant to be a statement of best practice in the provision of attachment focused therapy. It described the theory base for this approach, appropriate and evidence-based principles for evaluation and treatment, and ethical principles of practice.
It is a must read for anyone practicing treatment grounded in attachment theory.
http://books.wwnorton.com/books/Attachment-focused-Therapy/
The book is meant to be a statement of best practice in the provision of attachment focused therapy. It described the theory base for this approach, appropriate and evidence-based principles for evaluation and treatment, and ethical principles of practice.
It is a must read for anyone practicing treatment grounded in attachment theory.
Sep 25, 2011
Dr. Becker-Weidman @ Justice For Children in Syracuse
Dr. Becker-Weidman will be presenting at the 2011 Building Justice for Children Conference in Syracuse October 25-27. He will be talking about Assessing Children's mental health and trauma issues.
Jul 27, 2011
Mental Health issues of Adopted Children
The National Institutes of Health released a report this week stating “adopted children have higher rates of mental health problems than all other children.”
For those of us in the adoption world, the report — the 15th in a series issued since 1997 by the Federal Interagency Forum on Child and Family Statistics – may state the obvious. But it is also throws a gauntlet at the feet of social service agencies and policy makers.
During the past twenty years, the adoption landscape has been radically transformed. From the secretive adoption of babies born to unwed and predominantly white mothers, the norm today is arranged, open adoption of newborns, children from foster care or children from institutions and orphanages in far flung parts of the world.
Recent statistics help put this shift into perspective. Out of the approximately 135,000 children adopted in the U.S. last year, 11,000 (most between the ages of one and two) were internationally adopted. Here in the U.S. just over 52,000 children were adopted into non-family member homes from foster care.
Adam Pertman, Executive Director of the Evan B. Donaldson Adoption Institute, and author of Adoption Nation (Basic Books, Perseus Book Group, 2000) said in an interview that, “many adopted kids today enter their new families with pre-adoption lives. For them, this means they’ve experienced abuse, neglect, or [if from an inter-country placement] institutionalization.”
Older parents who can’t have their own children are a key factor driving the demand for more international and foster care adoptions. Not only are these new adoptive families not genetically linked, many parents, like myself, don’t even know the genetic history of the children we end up calling our own.
The upside to this expanded adoption domain has been a tremendous surge in diversity. Parents don’t try and adopt children that look like them nor do they demand infants. The linear homogenous family model is out and the crazy quilt is in. The downside, though, is inadequate support to help parents understand the history of their child or to help prepare these families for potential difficulties, both behavioral and cognitive. In their giddy rush to form a family, naïve parents can be blindsided when confronted by the reality of their adopted child’s extreme needs. To help theses parents cope, an industry of medical, cultural and emotional support services have emerged.
Nothing could underscore the point more clearly than the return in April 2010 of adoptee Artyom Savalyev to his native Russia. His single mother, Torry Hansen, allegedly overwhelmed by seven-year old Atryom’s unpredictable and unstable behavior, determined she could no longer parent him. Instead, Hansen sent her son back on a plane to Russia, by himself, with a note pinned inside his jacket. Artyom remains in Russia at an undisclosed location while the case against Hansen languishes in limbo.
Dr. Lisa Albers Prock, a Developmental Behavioral Pediatrician at Children’s Hospital Boston, and a leading advocate of ‘adoption medicine,’ says she tries to prepare parents for what to expect, but it’s hard, she says, for anxious new parents to grasp the complexities of “kids that have been fully programmed and have to be reprogrammed” in a new setting.
The new NIH report highlights some of the realities on the ground. Of the families surveyed, almost 30 percent of adopted children had moderate to severe health problems and foster care children were the most susceptible. In addition to health problems, many of these children also had an assortment of cognitive deficits such as learning disabilities, ADD and ADHD, or behavior and conduct disorders. Exposure to alcohol or drugs during pregnancy is often thought to be the culprit behind these deficits, as is infant trauma, which can have serious and long-lasting implications later in life.
While this data is distressing, Pertman says reports like this are “helpful and a good wake-up call.” To Pertman, these findings demand that policy makers take notice. The once mandatory emphasis on placement should now shift, he says, “to looking at how to help these kids and families succeed.” The NIH findings also coincide with his Institute’s most recent policy and practice report on the need for post-adoption services.
The NIH report demonstrates families feel challenged. But instead of retreating or giving up, these parents are demanding help. Despite the old Beatles refrain, “Love is all you need,” sometimes you also need a safety net.
For those of us in the adoption world, the report — the 15th in a series issued since 1997 by the Federal Interagency Forum on Child and Family Statistics – may state the obvious. But it is also throws a gauntlet at the feet of social service agencies and policy makers.
During the past twenty years, the adoption landscape has been radically transformed. From the secretive adoption of babies born to unwed and predominantly white mothers, the norm today is arranged, open adoption of newborns, children from foster care or children from institutions and orphanages in far flung parts of the world.
Recent statistics help put this shift into perspective. Out of the approximately 135,000 children adopted in the U.S. last year, 11,000 (most between the ages of one and two) were internationally adopted. Here in the U.S. just over 52,000 children were adopted into non-family member homes from foster care.
Adam Pertman, Executive Director of the Evan B. Donaldson Adoption Institute, and author of Adoption Nation (Basic Books, Perseus Book Group, 2000) said in an interview that, “many adopted kids today enter their new families with pre-adoption lives. For them, this means they’ve experienced abuse, neglect, or [if from an inter-country placement] institutionalization.”
Older parents who can’t have their own children are a key factor driving the demand for more international and foster care adoptions. Not only are these new adoptive families not genetically linked, many parents, like myself, don’t even know the genetic history of the children we end up calling our own.
The upside to this expanded adoption domain has been a tremendous surge in diversity. Parents don’t try and adopt children that look like them nor do they demand infants. The linear homogenous family model is out and the crazy quilt is in. The downside, though, is inadequate support to help parents understand the history of their child or to help prepare these families for potential difficulties, both behavioral and cognitive. In their giddy rush to form a family, naïve parents can be blindsided when confronted by the reality of their adopted child’s extreme needs. To help theses parents cope, an industry of medical, cultural and emotional support services have emerged.
Nothing could underscore the point more clearly than the return in April 2010 of adoptee Artyom Savalyev to his native Russia. His single mother, Torry Hansen, allegedly overwhelmed by seven-year old Atryom’s unpredictable and unstable behavior, determined she could no longer parent him. Instead, Hansen sent her son back on a plane to Russia, by himself, with a note pinned inside his jacket. Artyom remains in Russia at an undisclosed location while the case against Hansen languishes in limbo.
Dr. Lisa Albers Prock, a Developmental Behavioral Pediatrician at Children’s Hospital Boston, and a leading advocate of ‘adoption medicine,’ says she tries to prepare parents for what to expect, but it’s hard, she says, for anxious new parents to grasp the complexities of “kids that have been fully programmed and have to be reprogrammed” in a new setting.
The new NIH report highlights some of the realities on the ground. Of the families surveyed, almost 30 percent of adopted children had moderate to severe health problems and foster care children were the most susceptible. In addition to health problems, many of these children also had an assortment of cognitive deficits such as learning disabilities, ADD and ADHD, or behavior and conduct disorders. Exposure to alcohol or drugs during pregnancy is often thought to be the culprit behind these deficits, as is infant trauma, which can have serious and long-lasting implications later in life.
While this data is distressing, Pertman says reports like this are “helpful and a good wake-up call.” To Pertman, these findings demand that policy makers take notice. The once mandatory emphasis on placement should now shift, he says, “to looking at how to help these kids and families succeed.” The NIH findings also coincide with his Institute’s most recent policy and practice report on the need for post-adoption services.
The NIH report demonstrates families feel challenged. But instead of retreating or giving up, these parents are demanding help. Despite the old Beatles refrain, “Love is all you need,” sometimes you also need a safety net.
Jan 9, 2011
Can Empathy be taught?
Empathy is an essential ingredient for good parenting, good treatment, and good psychotherapy. Empathy allows one to see the world through the eyes of the other, walk in that person's shoes, share emotions, and build common experiences. Intersubjectivity, share emotions, share attention, and complimentary intentions form a core of empathy. It is these shared experiences (when concordant) that can help form the bedrock of stable, secure, safe, and positive relationships.
Many people are aware of "mirror neurons" as a neurological component of empathy. Mirror neurons are activated when one observes another's actions and the same motor neurons in the observers brain are activated as the ones in the "doers" brain that are necessary to carry out the action. Mirror neurons are activated in the emotional centers of the brain when we observe another and share affect.
While all this interesting and informative, it is not prescriptive. The question is, "is there some way to teach or enhance empathy?" Well, it turns out there are a number of ways. One of the easiest, simplest, and best ways is simply to listen and listen carefully. This is one way to get into another's head, so to speak.
Traditional views of the communication process held that speech and listening happened in two different parts of the brain: Broca's area and Wernicke's area. Yet studies show that communication partners unconsciously change their grammar structure, their speaking rate, and even their body postures to that of their partner. One could say that their communication changes show empathy for each other; some call this establishing a common ground. Studies by Dr. Hasson at Princeton University and graduate student Lauren Silbert demonstate this. The study involved having Ms. Silbert talk about emotionally meaningful events, tell stories from her life, while in a functional MRI. Then subjects were put into the f-MRI and listened to the recorded stories.
The most attentive listeners' key brain regions "lit up" in a f-MRI before her words came out. This suggests that the subjects anticipated what Ms. Silbert was going to say; empathy.
So helping parents, professionals, and therapists listen more carefully, more fully, and more deeply will increase their empathic capabilities. Listening is a skill that can be taught, improved on, and mastered.
For more information see:
Center For Family Development
Useful books & DVD's are:
Attachment Parenting
Principles of Attachment Parenting
Creating Capacity for Attachment
Dyadic Developmental Psychotherapy: Essential Practices & Methods
Introduction to Dyadic Developmental Psychotherapy
Many people are aware of "mirror neurons" as a neurological component of empathy. Mirror neurons are activated when one observes another's actions and the same motor neurons in the observers brain are activated as the ones in the "doers" brain that are necessary to carry out the action. Mirror neurons are activated in the emotional centers of the brain when we observe another and share affect.
While all this interesting and informative, it is not prescriptive. The question is, "is there some way to teach or enhance empathy?" Well, it turns out there are a number of ways. One of the easiest, simplest, and best ways is simply to listen and listen carefully. This is one way to get into another's head, so to speak.
Traditional views of the communication process held that speech and listening happened in two different parts of the brain: Broca's area and Wernicke's area. Yet studies show that communication partners unconsciously change their grammar structure, their speaking rate, and even their body postures to that of their partner. One could say that their communication changes show empathy for each other; some call this establishing a common ground. Studies by Dr. Hasson at Princeton University and graduate student Lauren Silbert demonstate this. The study involved having Ms. Silbert talk about emotionally meaningful events, tell stories from her life, while in a functional MRI. Then subjects were put into the f-MRI and listened to the recorded stories.
The most attentive listeners' key brain regions "lit up" in a f-MRI before her words came out. This suggests that the subjects anticipated what Ms. Silbert was going to say; empathy.
So helping parents, professionals, and therapists listen more carefully, more fully, and more deeply will increase their empathic capabilities. Listening is a skill that can be taught, improved on, and mastered.
For more information see:
Center For Family Development
Useful books & DVD's are:
Attachment Parenting
Principles of Attachment Parenting
Creating Capacity for Attachment
Dyadic Developmental Psychotherapy: Essential Practices & Methods
Introduction to Dyadic Developmental Psychotherapy
Dec 6, 2010
Effects of Institution care on adoptees
What happens when children from severely-deprived institutional backgrounds are adopted into caring families?
Many children adopted internationally have spend months or years in institutional settings. Orphanage care can, at best, be described as neglectful. There is often multiple caregivers and little consistency in care. The opportunity for a caregiver to develop a sensitive, attuned, and responsive relationship with the infant/child is limited or non-existent.
We are finding some answers to these questions bit by bit, as the English and Romanian Adoptees (ERA) Study continues to follow a group of over 300 children adopted from Romanian orphanages in the early 1990s. The ERA researchers are in the process of comparing the Romanian adoptees to non-adopted children as well as to adopted children who never had institutional care. This work is enormously time-consuming and complex, and involves repeated measurements and interviews at different ages, plus delays associated with analyzing, writing, and publishing the results of each phase of the investigation.
A recent presentation of the children’s characteristics up to age fifteen has been published by Michael Rutter and co-authors as "Deprivation-specific psycholcogical patterns: Effects of institutional deprivation" (Monographs of the Society for Research in Child Development, Serial No. 295, Vol.75, No. 1, 2010). The 252 pages of this monograph are absolutely packed with information.
An aspect of the monograph that will be of interest to many is the question raised in the title: whether there are psychological patterns that follow severe social and other deprivation in early life. The ERA investigated a group of characteristics that seemed more likely to occur in post-institutional children than in other adoptees. The following items were included:
1. Quasi-autism: A behavior pattern not identical with autism, but including rocking, self-injurious behavior like hair-pulling, unusual and exaggerated sensory responses, and tantrums in response to changes in routine, as reported in parent interviews (Gindis, B. [2008]. Institutional autism in children adopted internationally: Myth or reality? International Journal of Special Education, 23, 118-123).
2. Disinhibited attachment, as shown in unusual friendliness toward strangers and failure to show strong preferences for familiar people in threatening circumstance. The monograph describes disinhibited attachment as including “inappropriate approach to unfamiliar adults, a failure to check back with a caregiver in unfamiliar settings, and willingness to accompany a stranger and wander away from a familiar caregiver. It is often associated with a lack of appropriate physical boundaries, so that children may interact with strangers intrusively and even seek out physical contact… there is sometimes inappropriate affectionate behavior with strangers and undue physical closeness” ( Monograph, p. 58) .
3. Cognitive impairment, including problems with “mentalization” or the ability to understand what other people might believe or feel about a situation.
4. Inattention and overactivity similar to attention-hyperactivity disorders.
While by no means all children who had come from institutions displayed these problems, even those who had spent more than 6 months in a Romanian orphanage, the ERA group reported that over 90% of those who still showed the behaviors at age 15 had spent more than 6 months in severe deprivation. Those who persisted to age 15 with these problems had often improved (for example, become more likely to be helpful or comforting to others), but odd behaviors still occurred. Some children “annoyed other people but did not know why, and difficulties making or keeping friends were common… In a few cases, … inappropriate remarks included excessively outspoken sexualized use of language” ( Monograph, p. 86). Some children were reported as fascinated with collections, including those of “useless rubbish” like chocolate wrappers.
Many children adopted internationally have spend months or years in institutional settings. Orphanage care can, at best, be described as neglectful. There is often multiple caregivers and little consistency in care. The opportunity for a caregiver to develop a sensitive, attuned, and responsive relationship with the infant/child is limited or non-existent.
We are finding some answers to these questions bit by bit, as the English and Romanian Adoptees (ERA) Study continues to follow a group of over 300 children adopted from Romanian orphanages in the early 1990s. The ERA researchers are in the process of comparing the Romanian adoptees to non-adopted children as well as to adopted children who never had institutional care. This work is enormously time-consuming and complex, and involves repeated measurements and interviews at different ages, plus delays associated with analyzing, writing, and publishing the results of each phase of the investigation.
A recent presentation of the children’s characteristics up to age fifteen has been published by Michael Rutter and co-authors as "Deprivation-specific psycholcogical patterns: Effects of institutional deprivation" (Monographs of the Society for Research in Child Development, Serial No. 295, Vol.75, No. 1, 2010). The 252 pages of this monograph are absolutely packed with information.
An aspect of the monograph that will be of interest to many is the question raised in the title: whether there are psychological patterns that follow severe social and other deprivation in early life. The ERA investigated a group of characteristics that seemed more likely to occur in post-institutional children than in other adoptees. The following items were included:
1. Quasi-autism: A behavior pattern not identical with autism, but including rocking, self-injurious behavior like hair-pulling, unusual and exaggerated sensory responses, and tantrums in response to changes in routine, as reported in parent interviews (Gindis, B. [2008]. Institutional autism in children adopted internationally: Myth or reality? International Journal of Special Education, 23, 118-123).
2. Disinhibited attachment, as shown in unusual friendliness toward strangers and failure to show strong preferences for familiar people in threatening circumstance. The monograph describes disinhibited attachment as including “inappropriate approach to unfamiliar adults, a failure to check back with a caregiver in unfamiliar settings, and willingness to accompany a stranger and wander away from a familiar caregiver. It is often associated with a lack of appropriate physical boundaries, so that children may interact with strangers intrusively and even seek out physical contact… there is sometimes inappropriate affectionate behavior with strangers and undue physical closeness” ( Monograph, p. 58) .
3. Cognitive impairment, including problems with “mentalization” or the ability to understand what other people might believe or feel about a situation.
4. Inattention and overactivity similar to attention-hyperactivity disorders.
While by no means all children who had come from institutions displayed these problems, even those who had spent more than 6 months in a Romanian orphanage, the ERA group reported that over 90% of those who still showed the behaviors at age 15 had spent more than 6 months in severe deprivation. Those who persisted to age 15 with these problems had often improved (for example, become more likely to be helpful or comforting to others), but odd behaviors still occurred. Some children “annoyed other people but did not know why, and difficulties making or keeping friends were common… In a few cases, … inappropriate remarks included excessively outspoken sexualized use of language” ( Monograph, p. 86). Some children were reported as fascinated with collections, including those of “useless rubbish” like chocolate wrappers.
Sep 4, 2010
Dyadic Developmental Psychotherapy WIKI
There is a new Wiki devoted to Dyadic Developmental Psychotherapy that readers may want to view.
Click on this link to get there.
The url is: http://dyadicdevelopmentalpsychotherapy.wikia.com/wiki/Dyadic_Developmental_Psychotherapy_Wiki
The Wiki has just started, but already has many articles about Dyadic Developmental Psychotherapy and related topics that readers will find quite useful and interesting.
Click on this link to get there.
The url is: http://dyadicdevelopmentalpsychotherapy.wikia.com/wiki/Dyadic_Developmental_Psychotherapy_Wiki
The Wiki has just started, but already has many articles about Dyadic Developmental Psychotherapy and related topics that readers will find quite useful and interesting.
Jan 6, 2010
Treatment for PTSD
Post Traumatic Stress Disorder (PTSD) is quite different from Complex Trauma. PTSD is a clinical diagnosis usually applied when an person has experienced a life-threatening event and develops certain symptoms. Complex Trauma refers to the pervasive effects of chronic early maltreatment within a care-giving relationship. Complex Trauma usually results in more impairments that does PTSD.
Dyadic Developmental Psychotherapy is an evidence-based, effective, and empirically validated treatment for Complex Trauma.
Post-traumatic stress disorder (PTSD) is characterized by symptoms such as repeated, intrusive upsetting memories of the trauma; avoidance of similar situations and things which might remind one of them; a feeling of detachment from others; hypervigilance, and overarousal. It is associated with problems at work and at home and it is estimated that between 1% and 14% of people might suffer from it over the course of their lifetime. A team of researchers from New York reviewed 57 studies into treatments for PTSD and acute stress disorder which can often lead to it. They found that there was the strongest evidence for trauma-focused cognitive-behavioural therapy (CBT) and eye-movement desensitization and reprocessing (EMDR). There was some evidence that stress innoculation training, hypnotherapy, interpersonal psychotherapy and psychodynamic psychotherapy were effective for PTSD and that trauma-focused CBT was effective for acute stress disorder. The study also found evidence that trauma-focused CBT was effective for assault- and road-traffic-accident-related PTSD.
Ponniah, Kathryn and Hollon, Steven D. - Empirically supported psychological treatments for adult acute stress disorder and posttraumatic stress disorder: a review Depression and Anxiety December 2009, 26(12), 1086-1109
Dyadic Developmental Psychotherapy is an evidence-based, effective, and empirically validated treatment for Complex Trauma.
Post-traumatic stress disorder (PTSD) is characterized by symptoms such as repeated, intrusive upsetting memories of the trauma; avoidance of similar situations and things which might remind one of them; a feeling of detachment from others; hypervigilance, and overarousal. It is associated with problems at work and at home and it is estimated that between 1% and 14% of people might suffer from it over the course of their lifetime. A team of researchers from New York reviewed 57 studies into treatments for PTSD and acute stress disorder which can often lead to it. They found that there was the strongest evidence for trauma-focused cognitive-behavioural therapy (CBT) and eye-movement desensitization and reprocessing (EMDR). There was some evidence that stress innoculation training, hypnotherapy, interpersonal psychotherapy and psychodynamic psychotherapy were effective for PTSD and that trauma-focused CBT was effective for acute stress disorder. The study also found evidence that trauma-focused CBT was effective for assault- and road-traffic-accident-related PTSD.
Ponniah, Kathryn and Hollon, Steven D. - Empirically supported psychological treatments for adult acute stress disorder and posttraumatic stress disorder: a review Depression and Anxiety December 2009, 26(12), 1086-1109
Dec 5, 2009
How the brain is affected by relationships
In the “Clinician’s Digest” section of the November/December 2009 issue of Psychotherapy Networker http://psychcentral.com/psychotherapy/, Garry Cooper discusses a study led by psychiatrist Jakob Koch of Christian-Albrechts University in Kiel, Germany suggesting that “effective psychotherapy with depressed clients is associated with changes at the brain’s cellular level,” increasing the production of a key brain protein that assists in creating neural pathways. In this study they used Interpersonal Psychotherapy (IPT) which looks through the lens of both cognitive and interpersonal issues. It would be interesting to know how other theoretical orientations would fare.
There is a lot known about the power of oxytocin (the hormone of love) to bond people together but oxytocin can also be an ally to encourage therapeutic change. According to Linda Graham, MFT and trainer on the integration of relational psychology, mindfulness and neuroscience, it is “the neurochemical basis of the sense of safety and trust that allows clients to become open to therapeutic change.” It was a class I recently took with Linda, “The Neuroscience of Attachment,” that left me feeling so inspired about the implications of this in my practice. As a therapist, it’s nice to have something solid and research-based to hang my hat on.
Daniel Siegel, MD, one of the pioneers in this field has been saying for years that there is potential for the growth of new brain cells via relationships. I remember seeing him speak at a conference about five years ago but got derailed somehow and didn’t follow up on any further research on the matter. I’m glad to have made my way back to these concepts so I can further learn how to provide the most fertile soil possible for therapeutic change within the four walls of my own psychotherapy office.
The power of the “relationship” is not to be underestimated. Important relationships can do monumental damage – or they can facilitate profound healing. Many psychotherapists have known that the therapeutic relationship is one that can provide a “safe container” for emotional and psychological healing. Many of us believe that by providing a stable, nurturing model of something “different,” there is the potential for a corrective experience that the client can integrate into his life.
Now we know there is the potential for changes within the brain as well — which is only more encouragement for the lasting, deep shifts that we hope for our clients — and they hope for themselves. Perhaps the commonly held belief that “people can’t change” will finally, truly be a thing of the past.
There is a lot known about the power of oxytocin (the hormone of love) to bond people together but oxytocin can also be an ally to encourage therapeutic change. According to Linda Graham, MFT and trainer on the integration of relational psychology, mindfulness and neuroscience, it is “the neurochemical basis of the sense of safety and trust that allows clients to become open to therapeutic change.” It was a class I recently took with Linda, “The Neuroscience of Attachment,” that left me feeling so inspired about the implications of this in my practice. As a therapist, it’s nice to have something solid and research-based to hang my hat on.
Daniel Siegel, MD, one of the pioneers in this field has been saying for years that there is potential for the growth of new brain cells via relationships. I remember seeing him speak at a conference about five years ago but got derailed somehow and didn’t follow up on any further research on the matter. I’m glad to have made my way back to these concepts so I can further learn how to provide the most fertile soil possible for therapeutic change within the four walls of my own psychotherapy office.
The power of the “relationship” is not to be underestimated. Important relationships can do monumental damage – or they can facilitate profound healing. Many psychotherapists have known that the therapeutic relationship is one that can provide a “safe container” for emotional and psychological healing. Many of us believe that by providing a stable, nurturing model of something “different,” there is the potential for a corrective experience that the client can integrate into his life.
Now we know there is the potential for changes within the brain as well — which is only more encouragement for the lasting, deep shifts that we hope for our clients — and they hope for themselves. Perhaps the commonly held belief that “people can’t change” will finally, truly be a thing of the past.
Oct 28, 2009
Child Sexual Abuse causes later problems
An investigation published in the current issue of Psychotherapy and Psychosomatics explores the link between child sexual abuse and inability to express emotions in adulthood.
Alexithymia, a clinical condition typified by a reported inability to identify or describe one’s emotions, is associated with various forms of psychopathology, including depression. Highly alexithymic (HA) outpatients are more likely to be female, less likely to have children and are characterized by more somatic-affective symptoms of depression and interpersonal aloofness.
The Authors of this investigation extended these findings by examining personality traits and childhood sexual abuse history. Participants were 94 depressed patients [57.45% with recurrent major depressive disorder (MDD), 37.23% with single-episode MDD, 5.32% with depressive disorder not otherwise specified] 50 years of age and older recruited from psychiatric treatment facilities in Upstate New York. Individuals completed the Structured Clinical Interview for DSM-IV Axis I disorders. Alexithymia was assessed with the 20-item self-report Toronto Alexithymia Scale. Its 3 subscales measure difficulty identifying feelings and distinguishing them from bodily sensations (DIF), difficulty describing and communicating feelings (DDF) and externally oriented thinking (EOT), the latter being a tendency to focus on concrete details of external events rather than on aspects of inner experience. Depressive symptom severity was assessed with the Beck Depression Inventory-II (BDI-II). Five personality domains, i.e. neuroticism, extraversion, openness to experience, agreeableness and conscientiousness, were assessed with the NEO Personality Inventory. History of childhood sexual abuse was assessed using the Childhood Sexual Abuse subscale of the Childhood Trauma Questionnaire. A latent class cluster analysis (M-Plus 4.20) was performed on the DIF, DDF and EOT subscales. All 3 indicators favored a 3-cluster solution. This solution identified 3 groups, i.e. low alexithymia (LA; n = 11, 63.64% women), moderate alexithymia (MA; n = 40, 60% women) and HA (n = 43, 60.47% women). The distribution of mood diagnoses, single-episode MDD, recurrent MDD and depressive disorder not otherwise specified was not significantly different among the 3 alexithymic clusters (p> 0.05). The Authors conducted 10 separate multivariate generalized logit regressions; odds ratios were calculated for LA versus HA and MA versus HA class membership. Putative predictors were total BDI-II and the 3 subscales, childhood sexual abuse and the 5 personality domains. Covariates were age, gender and education. The 3 BDI-II subscales as well as the total score significantly distinguished LA and MA from HA. Lower levels of depressive symptoms significantly decreased the odds of HA membership. Odds ratios ranged between 0.32 and 0.94 (p< 0.05).
Childhood sexual abuse distinguished MA from HA; lower levels of childhood sexual abuse decreased the odds of HA membership (p< 0.05). Neuroticism, openness and conscientiousness also distinguished the 3 groups. Low neuroticism decreased the odds of HA membership, with odds ratios ranging between 0.95 and 0.97 (p< 0.01). Low openness and conscientiousness increased the odds of HA membership, with odds ratios ranging between 1.02 and 1.07 (p<0.05).
The HA group in this study was characterized by higher neuroticism and lower openness to experience and conscientiousness, a profile that reflects a distressed personality type, which has been related to poorer health outcomes and general functioning and more psychological distress. A similar personality profile was observed for the MA group, with the notable exception being their above-average levels of agreeableness and openness to experience. Interestingly, the HA group was characterized by more childhood sexual abuse compared to the MA patients. These findings add to the mounting evidence for a relationship between childhood sexual abuse and alexithymia; individuals with a history of childhood sexual abuse may have a reduced capacity to experience emotion in relation to their trauma, and this phenomenon may generalize to experiencing all emotions. Childhood sexual abuse has been found to interfere with the development of emotion regulation and to be related to attachment disturbance. The combination of childhood sexual abuse and alexithymia must be considered in the design and implementation of treatment studies, as these patients are more resistant to treatment (the attachment disturbance makes it more difficult for these clients to engage in a therapeutic relationship) and have slower recovery rates and poorer outcomes. Identifying a patient as alexithymic may suggest a history of early traumatic events which increases the likelihood and severity of depression. Treatment should be tailored to address the depressive symptoms along with the affective experience (identification, differentiation, labelling and management of feelings).
Source:Psychotherapy and Psychosomatics: Topciu, R.A. ; Zhao, X.; Tang, W; Heisel, M.J.; Talbot, N.L.; Duberstein, P.R. Childhood Sexual Abuse and Personality Differentiating High and Low Alexithymia in a Depressed Population. Psychother Psychosom 2009;78:385-387
Alexithymia, a clinical condition typified by a reported inability to identify or describe one’s emotions, is associated with various forms of psychopathology, including depression. Highly alexithymic (HA) outpatients are more likely to be female, less likely to have children and are characterized by more somatic-affective symptoms of depression and interpersonal aloofness.
The Authors of this investigation extended these findings by examining personality traits and childhood sexual abuse history. Participants were 94 depressed patients [57.45% with recurrent major depressive disorder (MDD), 37.23% with single-episode MDD, 5.32% with depressive disorder not otherwise specified] 50 years of age and older recruited from psychiatric treatment facilities in Upstate New York. Individuals completed the Structured Clinical Interview for DSM-IV Axis I disorders. Alexithymia was assessed with the 20-item self-report Toronto Alexithymia Scale. Its 3 subscales measure difficulty identifying feelings and distinguishing them from bodily sensations (DIF), difficulty describing and communicating feelings (DDF) and externally oriented thinking (EOT), the latter being a tendency to focus on concrete details of external events rather than on aspects of inner experience. Depressive symptom severity was assessed with the Beck Depression Inventory-II (BDI-II). Five personality domains, i.e. neuroticism, extraversion, openness to experience, agreeableness and conscientiousness, were assessed with the NEO Personality Inventory. History of childhood sexual abuse was assessed using the Childhood Sexual Abuse subscale of the Childhood Trauma Questionnaire. A latent class cluster analysis (M-Plus 4.20) was performed on the DIF, DDF and EOT subscales. All 3 indicators favored a 3-cluster solution. This solution identified 3 groups, i.e. low alexithymia (LA; n = 11, 63.64% women), moderate alexithymia (MA; n = 40, 60% women) and HA (n = 43, 60.47% women). The distribution of mood diagnoses, single-episode MDD, recurrent MDD and depressive disorder not otherwise specified was not significantly different among the 3 alexithymic clusters (p> 0.05). The Authors conducted 10 separate multivariate generalized logit regressions; odds ratios were calculated for LA versus HA and MA versus HA class membership. Putative predictors were total BDI-II and the 3 subscales, childhood sexual abuse and the 5 personality domains. Covariates were age, gender and education. The 3 BDI-II subscales as well as the total score significantly distinguished LA and MA from HA. Lower levels of depressive symptoms significantly decreased the odds of HA membership. Odds ratios ranged between 0.32 and 0.94 (p< 0.05).
Childhood sexual abuse distinguished MA from HA; lower levels of childhood sexual abuse decreased the odds of HA membership (p< 0.05). Neuroticism, openness and conscientiousness also distinguished the 3 groups. Low neuroticism decreased the odds of HA membership, with odds ratios ranging between 0.95 and 0.97 (p< 0.01). Low openness and conscientiousness increased the odds of HA membership, with odds ratios ranging between 1.02 and 1.07 (p<0.05).
The HA group in this study was characterized by higher neuroticism and lower openness to experience and conscientiousness, a profile that reflects a distressed personality type, which has been related to poorer health outcomes and general functioning and more psychological distress. A similar personality profile was observed for the MA group, with the notable exception being their above-average levels of agreeableness and openness to experience. Interestingly, the HA group was characterized by more childhood sexual abuse compared to the MA patients. These findings add to the mounting evidence for a relationship between childhood sexual abuse and alexithymia; individuals with a history of childhood sexual abuse may have a reduced capacity to experience emotion in relation to their trauma, and this phenomenon may generalize to experiencing all emotions. Childhood sexual abuse has been found to interfere with the development of emotion regulation and to be related to attachment disturbance. The combination of childhood sexual abuse and alexithymia must be considered in the design and implementation of treatment studies, as these patients are more resistant to treatment (the attachment disturbance makes it more difficult for these clients to engage in a therapeutic relationship) and have slower recovery rates and poorer outcomes. Identifying a patient as alexithymic may suggest a history of early traumatic events which increases the likelihood and severity of depression. Treatment should be tailored to address the depressive symptoms along with the affective experience (identification, differentiation, labelling and management of feelings).
Source:Psychotherapy and Psychosomatics: Topciu, R.A. ; Zhao, X.; Tang, W; Heisel, M.J.; Talbot, N.L.; Duberstein, P.R. Childhood Sexual Abuse and Personality Differentiating High and Low Alexithymia in a Depressed Population. Psychother Psychosom 2009;78:385-387
Oct 9, 2009
Teen maturity
Teenagers are as logical as adults but lack their social and emotional maturity. This might not be a surprise to too many parents but it comes as the result of a study of 935 10-30 year-olds by researchers at Temple University in Philadelphia. Participants in the study were tested on their psychosocial maturity, including tests of impulse control, sensation seeking, resistance to peer influence, future orientation (jam today vs jam tomorrow) and risk perception. They were also tested on their cognitive abilities such as logical thinking. There were no differences in psychosocial maturity throughout the 10-17 year-old age group but there were differences between those who were 16-17 and those 22 and over, and between those who were 18-21 and those above 26. People's cognitive capacities got better from 11-16 but their was no improvement thereafter.
You can find out more about this research at
http://www.sciencedaily.com/releases/2009/10/091007153745.htm
You can find out more about this research at
http://www.sciencedaily.com/releases/2009/10/091007153745.htm
Sep 16, 2009
John Rosemond got it wrong
In a Baltimore Sun article, Sept 2nd 09, John Rosemond, wrote an article that is inaccurate regarding the factors sometimes associated with adoption. He claims that "Attachment Disorder lacks scientific proof," and goes on to state, "The facts: A consistent body of hard, objectively gathered scientific evidence to the effect that adopted children are more prone to psychological problems than children who live with one or two biological parents is lacking." The article goes on to criticize "adoption specialists," and describes the "case" of a three-year old to bolster his point. I find that the article is simplistic and distorted.
Mr. Rosemond has little or no training on the subject about which he is writing here. Mr. Rosemont is a "Psychological Associate," holding a MS. His background does not qualify him to offer expert advice on this particular topic.
Mr. Rosemond's statement is just wrong. Many children adopted through the child welfare system and internationally have suffered years of maltreatment (abuse and/or neglect). As you know, in the US and most countries, it is very difficult to remove a child from the parents and even more difficult to terminate parental rights. Things have to be pretty gruesome to have a parent's rights terminated and the child placed for adoption. So, the facts are: There is a consistent body of hard, objectively gathered scientific evidence to the effect that adopted children are more prone to psychological problems than children raised from birth. For example, Approximately 2% of the population is adopted, and between 50% and 80% of such children have attachment disorder symptoms (Carlson, Cicchetti, Barnett, & Braunwald, 1995; Cicchetti, Cummings, Greenberg, & Marvin, 1990).Children who have experienced chronic maltreatment and resulting complex trauma are at significant risk for a variety of other behavioural, neuropsychological, cognitive, emotional, interpersonal and psychobiological disorders (Cook et al. 2005; van der Kolk 2005). Many children with histories of maltreatment are violent (Robins 1978) and aggressive (Prino & Peyrot 1994) and as adults are at risk of developing
a variety of psychological problems (Schreiber & Lyddon 1998) and personality disorders, including antisocial personality disorder (Finzi et al. 2000), narcissistic personality disorder, borderline personality disorder and psychopathic personality disorder (Dozier et al. 1999). Neglected children are at risk of social withdrawal, social rejection and pervasive feelings
of incompetence (Finzi et al. 2000). Children who have histories of abuse and neglect are at significant risk of developing PostTraumatic Stress Disorder as adults (Andrews et al. 2000; Allan 2001). Children who have been sexually abused are at significant risk of developing anxiety disorders (2.0 times the average), major depressive disorders (3.4 times average), alcohol abuse (2.5 times average), drug abuse (3.8 times average) and antisocial behaviour (4.3 times average) (MacMillian 2001). The effective treatment of such children is a public health concern (Walker et al. 1992).
Mr. Rosemont goes on to state, " On the other hand, there is significant evidence to the effect that even orphaned children exposed during their early, supposedly "formative" years to severe conditions of emotional deprivation and material neglect recover quite nicely when adopted by loving parents." This statement does have an element of truth to it. One element of helping children who have experienced chronic early maltreatment within a caregiving relationship is loving parents. But there are other elements necessary to address and resolve the underlying traumas that may be continuing to distort the child's relationships and psychological functioning.
Mr. Rosemond has little or no training on the subject about which he is writing here. Mr. Rosemont is a "Psychological Associate," holding a MS. His background does not qualify him to offer expert advice on this particular topic.
Mr. Rosemond's statement is just wrong. Many children adopted through the child welfare system and internationally have suffered years of maltreatment (abuse and/or neglect). As you know, in the US and most countries, it is very difficult to remove a child from the parents and even more difficult to terminate parental rights. Things have to be pretty gruesome to have a parent's rights terminated and the child placed for adoption. So, the facts are: There is a consistent body of hard, objectively gathered scientific evidence to the effect that adopted children are more prone to psychological problems than children raised from birth. For example, Approximately 2% of the population is adopted, and between 50% and 80% of such children have attachment disorder symptoms (Carlson, Cicchetti, Barnett, & Braunwald, 1995; Cicchetti, Cummings, Greenberg, & Marvin, 1990).Children who have experienced chronic maltreatment and resulting complex trauma are at significant risk for a variety of other behavioural, neuropsychological, cognitive, emotional, interpersonal and psychobiological disorders (Cook et al. 2005; van der Kolk 2005). Many children with histories of maltreatment are violent (Robins 1978) and aggressive (Prino & Peyrot 1994) and as adults are at risk of developing
a variety of psychological problems (Schreiber & Lyddon 1998) and personality disorders, including antisocial personality disorder (Finzi et al. 2000), narcissistic personality disorder, borderline personality disorder and psychopathic personality disorder (Dozier et al. 1999). Neglected children are at risk of social withdrawal, social rejection and pervasive feelings
of incompetence (Finzi et al. 2000). Children who have histories of abuse and neglect are at significant risk of developing PostTraumatic Stress Disorder as adults (Andrews et al. 2000; Allan 2001). Children who have been sexually abused are at significant risk of developing anxiety disorders (2.0 times the average), major depressive disorders (3.4 times average), alcohol abuse (2.5 times average), drug abuse (3.8 times average) and antisocial behaviour (4.3 times average) (MacMillian 2001). The effective treatment of such children is a public health concern (Walker et al. 1992).
Mr. Rosemont goes on to state, " On the other hand, there is significant evidence to the effect that even orphaned children exposed during their early, supposedly "formative" years to severe conditions of emotional deprivation and material neglect recover quite nicely when adopted by loving parents." This statement does have an element of truth to it. One element of helping children who have experienced chronic early maltreatment within a caregiving relationship is loving parents. But there are other elements necessary to address and resolve the underlying traumas that may be continuing to distort the child's relationships and psychological functioning.
Aug 7, 2009
Effects of early maltreatment on development
An empirical study completed by me at the Center for Family Development has just been published in Child Welfare, which is the Journal for the Child Welfare League of America. The article is
Becker-Weidman, A., (2009). Effects of Early Maltreatment on Development: A Descriptive Study Using the Vineland Adaptive Behavior Scales-II, 88(2) pp.137-161.
Children with histories of chronic early maltreatment within a care giving relationship may develop complex trauma or developmental trauma disorder and experience a variety of deficits in several domains. This study explored the effects of complex trauma on the development of 57 children, as measured by the Vineland Adaptive Behavior Scales-II. This is the first descriptive study to report on the significant discrepancies between chronological and developmental ages in adopted and foster children. This study found that adopted and foster children with a psychiatric diagnosis of reactive attachment disorder show developmental delays i the domains of communication, daily living skills, and socialization. The average adaptive behavior composite score for the children in this study yielded a developmental age (age equivalency) of 4.4 years, while the average chronological age was 9.9 years. The study describes the various delays in each domain and then discusses the implications for treatment and parenting, schools, child welfare policy, programs, and practices, and for further research.
Becker-Weidman, A., (2009). Effects of Early Maltreatment on Development: A Descriptive Study Using the Vineland Adaptive Behavior Scales-II, 88(2) pp.137-161.
Children with histories of chronic early maltreatment within a care giving relationship may develop complex trauma or developmental trauma disorder and experience a variety of deficits in several domains. This study explored the effects of complex trauma on the development of 57 children, as measured by the Vineland Adaptive Behavior Scales-II. This is the first descriptive study to report on the significant discrepancies between chronological and developmental ages in adopted and foster children. This study found that adopted and foster children with a psychiatric diagnosis of reactive attachment disorder show developmental delays i the domains of communication, daily living skills, and socialization. The average adaptive behavior composite score for the children in this study yielded a developmental age (age equivalency) of 4.4 years, while the average chronological age was 9.9 years. The study describes the various delays in each domain and then discusses the implications for treatment and parenting, schools, child welfare policy, programs, and practices, and for further research.
Jun 24, 2009
Children with Sexual Behavior Problems
Children with sexual behavior problems, a broad category including such diverse behaviors as public masturbation, touching others, and aggressive behaviors, are challenging for the adults in their lives. The most recent issue of Child Maltreatment, Vol. 13, #2, May 2008 is devoted to this topic. The issue describes important material regarding assessment, treatment, policy and stereotypes.
I found the material that countered “common knowledge,” most interesting. Do children who have been sexually abused develop sexual behavior problems? Yes, they do have increased rates of sexual behavior problems (SBP), as do other children with other types of trauma. In fact exposure to violence has a much stronger association with SPB’s than does prior sexual abuse. The material makes clear that SBP’s are complex behaviors with multidimensional elements.
The issue is encouraging and supportive of our work. Several articles make the point that including the family in treatment is an important element of efficacious treatment.
The article by Mark Chaffin on policy is very interesting. The perception that youthful sex-offenders are high risk, unique and require special treatment, are homogeneous, and impossible or very difficult to treat turns out to be false. Research shows that children with SBP’s pose a low long-term risk for future child sexual abuse perpetration and sex crimes. For example, for teenage sex offenders the long-term future sex offense rates are between 5% (for those who received treatment) 15% (for those without treatment). For pre-teen children the range is 2% to 10% at ten year follow-up. At ten year follow-up the rate of sex abuse perpetration among those with SBP’s who received treatment was no different than for those children with ADHD. This and other material supports the argument that the policy issue of putting such children on public lists is simply bad policy. Other material shows that children with SBP’s do not require specialized treatment and that generally effective treatment approaches are effective for these children.
There are several other excellent articles in this issue. One describes the impact of various maltreatment experiences on sexualized behaviors. Another describes predictors of SPB’s among children with complex histories of maltreatment. There are two outcome studies and a very well written meta-analysis of treatment for children with SBP’s. Finally, the issue ends with the Report of the ATSA Task Force on Children with Sexual Behavior Problems which describes best practices for the evaluation and treatment of children with SBP’s and various policy recommendations.
In summary, this is an outstanding journal issue and it should be in every clinician’s library.
I found the material that countered “common knowledge,” most interesting. Do children who have been sexually abused develop sexual behavior problems? Yes, they do have increased rates of sexual behavior problems (SBP), as do other children with other types of trauma. In fact exposure to violence has a much stronger association with SPB’s than does prior sexual abuse. The material makes clear that SBP’s are complex behaviors with multidimensional elements.
The issue is encouraging and supportive of our work. Several articles make the point that including the family in treatment is an important element of efficacious treatment.
The article by Mark Chaffin on policy is very interesting. The perception that youthful sex-offenders are high risk, unique and require special treatment, are homogeneous, and impossible or very difficult to treat turns out to be false. Research shows that children with SBP’s pose a low long-term risk for future child sexual abuse perpetration and sex crimes. For example, for teenage sex offenders the long-term future sex offense rates are between 5% (for those who received treatment) 15% (for those without treatment). For pre-teen children the range is 2% to 10% at ten year follow-up. At ten year follow-up the rate of sex abuse perpetration among those with SBP’s who received treatment was no different than for those children with ADHD. This and other material supports the argument that the policy issue of putting such children on public lists is simply bad policy. Other material shows that children with SBP’s do not require specialized treatment and that generally effective treatment approaches are effective for these children.
There are several other excellent articles in this issue. One describes the impact of various maltreatment experiences on sexualized behaviors. Another describes predictors of SPB’s among children with complex histories of maltreatment. There are two outcome studies and a very well written meta-analysis of treatment for children with SBP’s. Finally, the issue ends with the Report of the ATSA Task Force on Children with Sexual Behavior Problems which describes best practices for the evaluation and treatment of children with SBP’s and various policy recommendations.
In summary, this is an outstanding journal issue and it should be in every clinician’s library.
Apr 18, 2009
A few articles that may be of interest to professionals and parents
Amminger GP, Berger GE, Schäfer MR. Omega-3 fatty acids supplementation in children with autism: A double-blind randomized, placebo controlled pilot study. Biol Psychiatry 2007; 61(4):551-553.
Researchers found that treatment with Omega-3 fatty acids was superior to placebo in controlling symptoms autism and associated symptoms including hyperactivity and stereotypy. Amminger and colleagues conducted a double-blind, randomized, placebo-controlled pilot study. The primary outcome measure was a change in scores from baseline to week 6 on the Aberrant Behavior Checklist (ABC).
Cicchetti, D. (2001). The impact of child maltreatment and psychopathology on neuroednocrine functioning. Development and Psychopathology 13, 783-804.
The findings of this study concluded that maltreated children with reported clinical-level internalizing problems have higher cortisol levels compared to non-maltreated boys who had lower levels of cortisol. The findings conclude that maltreatment and different forms of psychopathology have an effect on neuroendocrine regulation.
Chisholm, K. (1998). A Three year follow-up of attachment and indiscriminate friendliness in children adopted from Romanian orphanages. Child Development, 69 (4), 1092-1106.
This research article examines attachment and indiscriminately friendly behavior in children who spent at least 8 months in a Romanian orphanage (RO). The findings of this research indicate that RO children displayed significantly more insecure attachment behaviors in comparison to the control groups. These children had significantly more indiscriminately friendly behavior, behavior problems, and parents reported more parenting stress.
Delahanty, D., Nugent N., Christopher, N., Waltsh, M. (2005). Initial urinary epinephrine and cortisol levels predict acute PTSD symptoms in child trauma victims. Psychoneuroendocrinology, 121 (2).
Results of this study indicated that elevated initial cortisol and epinephrine levels immediately following a traumatic event continued to predict the development of acute PTSD symptoms; particularly in boys.
Forbes, H., Dziegielewski, S. (2003) “Issues facing adoptive mothers of children with special needs.” Journal of Social Work, 3 (3): 301-320.
The purpose of this article is to identify and understand the challenges that mothers face after they adopt special needs children. The study examines adoptive mothers who sought therapeutic assistance after the placement of their child and the difficulties they endured.
Ghuman J. K., (2007). Comorbidity moderates response to methylphenidate in the preschoolers with attention deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 17 (5), 563-580.
According to a recent analysis of data from the Preschoolers with ADHD Treatment Study (PATS), funded by the National Institutes of Health’s National Institute of Mental Health (NIMH), preschoolers who are diagnosed with ADHD and who also have three or more coexisting disorders, are not likely to respond to treatment with the stimulant methylphenidate, regardless of dosage,
Goodman, W.K., Murphy, T.K, Storch, E.A. (2007). Risk of adverse behavioral effects with pediatric use of antidepressants. Psychopharmacology, 191 (1), 87-96.
This article reviews the Food and Drug Administration’s (FDA) decision to issue a “black box” warning about the risks associated with children and adolescents during the treatment of antidepressants.
Gunnar, M. (2001). Effects of early deprivation. Findings from orphanage-reared infants and children. In C. Nelson and M. Luciana (Eds.) Handbook of developmental cognitive neuroscience (617-629).
The focus of this article is to discuss and review the research concerning physical, cognitive, and emotional development of children adopted from Romanian orphanages over the last 15 years. The trends of early deprivation and possible outcomes are also evaluated.
Gunnar, M. & Cheatham, C. (2003). “ Brain and behavior interface: stress and the developing brain.” Infant Mental Health Journal, 24 (3), 195-211.
Research on infants and children who have been maltreated early in life is reviewed to show stress hormone activity. The researchers focus on enhancing care later in development and the possible reversal of the effects on behavior and neurobiology of early experiences. The authors review literature in the field and conclude that the longer the child is neglected the higher degree of developmental delays occur. Studies on the neuroendocrin systems show the effects on the HPA system and CORT systems in response these stressors.
Hughes, J.W., Watkins, L., Blumenthal, J.A., Kuhn, C., Sherwood, A. (2004). Depression and anxiety symptoms are related to increased 24-hour urinary norepinephrine excretion among healthy middle-aged women. Journal of Psychosomatic Research, 57; 353-358.
The objective of this study was to evaluate the relationship between levels of self-reported symptoms of depression and anxiety and 24-hour urinary catecholamine excretion. Norepinephrine, epinephrine and cortisol are examined.
Levy, F., Swanson, J. M. (2001). Timing space and ADHD: the dopamine theory revisited. Australian and > New Zealand Journal of Psychiatry, 35, 504-511.
The objective of this study was to review the dopamine theory of Attention Deficit Hyperactivity Disorder (ADHD) in terms of the advances made in research over the past decade. Serotonergic agents were found to have a calming affect on psycho-stimulants in which the dopamine transporter (DAT) gene was disrupted.
Moms who dine on fish could boost baby’s brain (2007). Pharmacy Times, 82.
This article comments on research from the US National Institutes of Health (NIH), which found that women who eat seafood during pregnancy may increase brainpower of their children. The authors list fish oil supplements as an alternative, and found that women who took these supplements during pregnancy had children with better developmental skills.
Oades, R.D. (2005). The control of repsonsiveness in ADHD by catecholamines: evidence for dopaminergic, noradrenergic and interactive roles. Developmental Science, 8 (2), 122-131.
The neurological base of Attention Deficit Hyperactivity Disorder (ADHD) from a neurochemistry and psychopharmacology standpoint, as well as the catecholamine based behavioral systems, are evaluated by Oades and colleagues. Dopamine and noradrenalin neurotransmission to the motor and cognitive symptoms of ADHD were studied.
Purvis, K.B., Cross, D.R., & Kellerman, G. (2006). “An experimental evaluation of targeted amino acid therapy with at-risk children. Journal of Alternative and Complementary Medicine, 12 (6), 591-592.
This article explains the connection that neurotransmitter levels and ratios have on the behavior of at-risk youth. This comprehensive study found that targeted amino acid therapy, in conjunction with scheduled feedings and behavioral interventions, regulated the brain chemistry in children adopted from Russian orphanages.
Watts-English, T., Fortson, B., Gibler, N., Hooper, S. De Bellis, M. (2006).“ The psychobiology of maltreatment in childhood.” Journal of Social Issues, 62 (4) 717-736.
Authors of this article review empirical findings of neuropsychological functioning in children with Post Traumatic Stress Disorder (PTSD). Serotonin deregulation, cortisol, the limbic system and neuro-imaging techniques are evaluated in regards to brain development.
Weidman-Becker, A. (n.d.). Child Abuse and neglect: effects on child development, brain development, and interpersonal relationships. International Adoption Article Directory. Retrieved October 17, 2007 from http://www.adoptionarticlesdirectory.com/article.php?id=42&act=print
This article is intended for parents and individuals in the mental health field. It clearly defines the correlation between neglect and abuse early in life and the long lasting effects it has on brain development.
Weidman-Becker, A. (n.d.). Recognizing attachment concerns in children. International Adoption Article Directory. Retrieved October 17, 2007 from http://www.adoptionarticlesdirectory.com/article.php?id=45&act=print
The focus of this article is to provide the audience with background information on attachment, how attachment disorders develop, and why healthy brain chemistry is reflective of healthy attachment in the first two years of life. The author describes what attachment disorders look like in all developmental stages of childhood.
Yehuda, R., Southwick, S., Giller, E.L., Ma, X., Mason, J.W., (1992). Urinary catecholamine excreation and severtiy of PTSD symptoms in Vietnam combat veterans. Journal of Nerv. Mental Disorders, 180 (5), 321-325.
This study found that urinary dopamine and norepinephrine levels were significantly correlated with the severity of PTSD symptoms. The researchers concluded that these findings supported the theory that enhanced sympathetic nervous system (SNS) activation plays a major role in PTSD and that increased SNS arousal may be closely linked to the severity of certain PTSD clusters.
Researchers found that treatment with Omega-3 fatty acids was superior to placebo in controlling symptoms autism and associated symptoms including hyperactivity and stereotypy. Amminger and colleagues conducted a double-blind, randomized, placebo-controlled pilot study. The primary outcome measure was a change in scores from baseline to week 6 on the Aberrant Behavior Checklist (ABC).
Cicchetti, D. (2001). The impact of child maltreatment and psychopathology on neuroednocrine functioning. Development and Psychopathology 13, 783-804.
The findings of this study concluded that maltreated children with reported clinical-level internalizing problems have higher cortisol levels compared to non-maltreated boys who had lower levels of cortisol. The findings conclude that maltreatment and different forms of psychopathology have an effect on neuroendocrine regulation.
Chisholm, K. (1998). A Three year follow-up of attachment and indiscriminate friendliness in children adopted from Romanian orphanages. Child Development, 69 (4), 1092-1106.
This research article examines attachment and indiscriminately friendly behavior in children who spent at least 8 months in a Romanian orphanage (RO). The findings of this research indicate that RO children displayed significantly more insecure attachment behaviors in comparison to the control groups. These children had significantly more indiscriminately friendly behavior, behavior problems, and parents reported more parenting stress.
Delahanty, D., Nugent N., Christopher, N., Waltsh, M. (2005). Initial urinary epinephrine and cortisol levels predict acute PTSD symptoms in child trauma victims. Psychoneuroendocrinology, 121 (2).
Results of this study indicated that elevated initial cortisol and epinephrine levels immediately following a traumatic event continued to predict the development of acute PTSD symptoms; particularly in boys.
Forbes, H., Dziegielewski, S. (2003) “Issues facing adoptive mothers of children with special needs.” Journal of Social Work, 3 (3): 301-320.
The purpose of this article is to identify and understand the challenges that mothers face after they adopt special needs children. The study examines adoptive mothers who sought therapeutic assistance after the placement of their child and the difficulties they endured.
Ghuman J. K., (2007). Comorbidity moderates response to methylphenidate in the preschoolers with attention deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 17 (5), 563-580.
According to a recent analysis of data from the Preschoolers with ADHD Treatment Study (PATS), funded by the National Institutes of Health’s National Institute of Mental Health (NIMH), preschoolers who are diagnosed with ADHD and who also have three or more coexisting disorders, are not likely to respond to treatment with the stimulant methylphenidate, regardless of dosage,
Goodman, W.K., Murphy, T.K, Storch, E.A. (2007). Risk of adverse behavioral effects with pediatric use of antidepressants. Psychopharmacology, 191 (1), 87-96.
This article reviews the Food and Drug Administration’s (FDA) decision to issue a “black box” warning about the risks associated with children and adolescents during the treatment of antidepressants.
Gunnar, M. (2001). Effects of early deprivation. Findings from orphanage-reared infants and children. In C. Nelson and M. Luciana (Eds.) Handbook of developmental cognitive neuroscience (617-629).
The focus of this article is to discuss and review the research concerning physical, cognitive, and emotional development of children adopted from Romanian orphanages over the last 15 years. The trends of early deprivation and possible outcomes are also evaluated.
Gunnar, M. & Cheatham, C. (2003). “ Brain and behavior interface: stress and the developing brain.” Infant Mental Health Journal, 24 (3), 195-211.
Research on infants and children who have been maltreated early in life is reviewed to show stress hormone activity. The researchers focus on enhancing care later in development and the possible reversal of the effects on behavior and neurobiology of early experiences. The authors review literature in the field and conclude that the longer the child is neglected the higher degree of developmental delays occur. Studies on the neuroendocrin systems show the effects on the HPA system and CORT systems in response these stressors.
Hughes, J.W., Watkins, L., Blumenthal, J.A., Kuhn, C., Sherwood, A. (2004). Depression and anxiety symptoms are related to increased 24-hour urinary norepinephrine excretion among healthy middle-aged women. Journal of Psychosomatic Research, 57; 353-358.
The objective of this study was to evaluate the relationship between levels of self-reported symptoms of depression and anxiety and 24-hour urinary catecholamine excretion. Norepinephrine, epinephrine and cortisol are examined.
Levy, F., Swanson, J. M. (2001). Timing space and ADHD: the dopamine theory revisited. Australian and > New Zealand Journal of Psychiatry, 35, 504-511.
The objective of this study was to review the dopamine theory of Attention Deficit Hyperactivity Disorder (ADHD) in terms of the advances made in research over the past decade. Serotonergic agents were found to have a calming affect on psycho-stimulants in which the dopamine transporter (DAT) gene was disrupted.
Moms who dine on fish could boost baby’s brain (2007). Pharmacy Times, 82.
This article comments on research from the US National Institutes of Health (NIH), which found that women who eat seafood during pregnancy may increase brainpower of their children. The authors list fish oil supplements as an alternative, and found that women who took these supplements during pregnancy had children with better developmental skills.
Oades, R.D. (2005). The control of repsonsiveness in ADHD by catecholamines: evidence for dopaminergic, noradrenergic and interactive roles. Developmental Science, 8 (2), 122-131.
The neurological base of Attention Deficit Hyperactivity Disorder (ADHD) from a neurochemistry and psychopharmacology standpoint, as well as the catecholamine based behavioral systems, are evaluated by Oades and colleagues. Dopamine and noradrenalin neurotransmission to the motor and cognitive symptoms of ADHD were studied.
Purvis, K.B., Cross, D.R., & Kellerman, G. (2006). “An experimental evaluation of targeted amino acid therapy with at-risk children. Journal of Alternative and Complementary Medicine, 12 (6), 591-592.
This article explains the connection that neurotransmitter levels and ratios have on the behavior of at-risk youth. This comprehensive study found that targeted amino acid therapy, in conjunction with scheduled feedings and behavioral interventions, regulated the brain chemistry in children adopted from Russian orphanages.
Watts-English, T., Fortson, B., Gibler, N., Hooper, S. De Bellis, M. (2006).“ The psychobiology of maltreatment in childhood.” Journal of Social Issues, 62 (4) 717-736.
Authors of this article review empirical findings of neuropsychological functioning in children with Post Traumatic Stress Disorder (PTSD). Serotonin deregulation, cortisol, the limbic system and neuro-imaging techniques are evaluated in regards to brain development.
Weidman-Becker, A. (n.d.). Child Abuse and neglect: effects on child development, brain development, and interpersonal relationships. International Adoption Article Directory. Retrieved October 17, 2007 from http://www.adoptionarticlesdirectory.com/article.php?id=42&act=print
This article is intended for parents and individuals in the mental health field. It clearly defines the correlation between neglect and abuse early in life and the long lasting effects it has on brain development.
Weidman-Becker, A. (n.d.). Recognizing attachment concerns in children. International Adoption Article Directory. Retrieved October 17, 2007 from http://www.adoptionarticlesdirectory.com/article.php?id=45&act=print
The focus of this article is to provide the audience with background information on attachment, how attachment disorders develop, and why healthy brain chemistry is reflective of healthy attachment in the first two years of life. The author describes what attachment disorders look like in all developmental stages of childhood.
Yehuda, R., Southwick, S., Giller, E.L., Ma, X., Mason, J.W., (1992). Urinary catecholamine excreation and severtiy of PTSD symptoms in Vietnam combat veterans. Journal of Nerv. Mental Disorders, 180 (5), 321-325.
This study found that urinary dopamine and norepinephrine levels were significantly correlated with the severity of PTSD symptoms. The researchers concluded that these findings supported the theory that enhanced sympathetic nervous system (SNS) activation plays a major role in PTSD and that increased SNS arousal may be closely linked to the severity of certain PTSD clusters.
BAAF Journal: Latest Research
BAAF (British Association for Adoption & Fostering) Winter 2007 - Vol 31 (4)
The experience of adoption (1): a study of intercountry and domestic adoption from the child’s point of view
Amanda Hawkins, Celia Beckett, Jenny Castle, Christine Groothues, Edmund Sonuga-Barke, Emma Colvert, Jana Kreppner, Suzanne Stevens and Michael Rutter
Key words: adoption, children’s views, children’s attitudes, intercountry adoption, ERA study, Romania
The study team compared views about adoption for two groups of 11-year-old children (n = 180). Their analyses compared the views of children according to their pre-adoption background: UK domestic adoptees placed before the age of six months versus intercountry adoptees who had experienced extreme deprivation for up to three-and-a-half years in Romania prior to placement. Remarkably few differences were found between these groups, with the exception of two areas. Older-placed adopted children from Romania were significantly more likely to find it difficult to talk about adoption than domestic adoptees, and to feel different from their adoptive families. However, supplementary analyses suggested that these differences were due to increased levels of difficulties within the older-placed Romanian group, rather than whether they were adopted internationally or domestically. The implications of the similarities and differences between these groups for policy and practice are discussed.
The authors are researchers, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College, London, UK.
Celia Beckett is also a senior social worker for PACT (Parents and Children Together), Reading, UK
Edmund Sonuga-Barke is Professor of Psychology Developmental Brain-Behaviour Unit, School of Psychology, University of Southampton, UK and the Child Study Center, New York University, USA
An examination of adoption support services for birth relatives and for post-adoption contact in England and Wales
Clive Sellick
Key words: birth family support services, adoption support, post-adoption contact
Support services for the birth relatives of adopted children have received far less research scrutiny than those for adopters and the children themselves. Sellick reports the first stage ‘mapping’ survey of a government commissioned study into birth relative support services and services supporting contact following changes in policy and legislation. The type, range and delivery of such services, commissioned or provided, by local authority and voluntary adoption agencies and adoption support agencies in England and Wales are examined. The survey found that good opportunities exist for linking birth relative and contact support services. However, real challenges remain in promoting support services and reaching birth relatives, and in funding and commissioning such services, particularly from the non-governmental sector.
Clive Sellick is Senior Lecturer in Social Work and Director of International Programmes, School of Social Work and Psychosocial Sciences, University of East Anglia, Norwich
The Child Wise Programme: a course to enhance the self-confidence and behaviour management skills of foster carers with challenging children
Martin Herbert and Jenny Wookey
Key words: challenging behaviour, looked after children, foster carers, attachment, Child Wise Parent Training Programme, cognitive-behavioural training, collaborative group work, placement instability
Looked after children with a history of maltreatment and abandonment are prone to develop high rates of mental health difficulties. They tend to suffer from multiple impairments, sometimes involving cognitive deficits and extremes of antisocial behaviour. Foster carers' management skills and emotional resources are tested to the limit. A further concern is the contribution of challenging behaviour to the unplanned termination of foster placements. Carers, if they are not to feel deskilled by the increasing numbers of children with special needs placed with them, require a more focused preparatory and follow-up training than they usually receive. This study questioned whether a broadly based cognitive behavioural programme could, by increasing carers’ behaviour management skills and self-assurance, reduce the challenging behaviour of looked after children and the resultant instability of placements. The answers were sought from a randomised controlled study of foster carers attending the parent training Child Wise Programme (CWP) designed by the authors. The programme combines course leaders’ professional experience of working with challenging children and parent groups, and foster carers’ personal expertise based on living with and caring for challenging children.
The intervention, with an experimental group of 67 foster carers and a comparative waiting-list control group of 50 carers, succeeded in meeting just over half of its key aims. An increase in the confidence of the carers was a significant gain. Also positive was the majority of personal reports indicating improvements in looked after children's behaviour, changes generally attributed to the acquisition of new behaviour management skills. Although some of the statistical comparisons were disappointing in their failure to reach significant levels (eg the reduction in placement breakdowns), they provided useful information about ways of improving the training. Qualitative methods were used to explore the subjective responses of participants to the Webster-Stratton and Herbert (1994) collaborative style of training employed. These produced valuable insights into the personal and professional dilemmas of a foster carer's role, as well as data which contributed to the evaluation of the training programme.
Martin Herbert is Emeritus Professor in Clinical and Community Psychology at
Exeter University, and Honorary Consultant Psychologist at the Royal Devon
and Exeter NHS Health Care Trust
Jenny Wookey is a Consultant Clinical Psychologist at the Plymouth Hospitals
NHS Trust, and a Supervisor for the Clinical Psychology Doctoral courses at
Plymouth and Exeter Universities
The Hope Connection: a therapeutic summer day camp for adopted and at-risk children with special socio-emotional needs
Karyn B Purvis, David R Cross, Ron Federici, Dana Johnson and L Brooks McKenzie
Key words: international adoption, adoption, child behaviour, attachment, sensory, self-regulation, intervention, camp
Large numbers of North American and Western European families are adopting children with serious socio-emotional needs. Other children experience similar deficits as a result of neglect and abuse by carers. Often these children are diagnosed with psychopathology and receive drug treatments that can be ineffective and even detrimental. The authors report on The Hope Connection, a project designed to meet the needs of these at-risk children and their families. Its core is a theoretically integrated summer day camp offering activities that are attachment rich, sensory rich and behaviourally structured. Pre-test and post-test data indicate that summer camp had a significant impact on the children’s behaviour (n = 19), as indicated by parent-report measures of child behaviour problems and attachment. These findings are discussed with regard to possible future directions of programmeme implementation and evaluation.
Karyn B Purvis and David R Cross are Associate Directors of the Institute of Child Development, and Professors of Psychology, and L Brooks McKenzie is an MA-Doctoral student, Texas Christian University
Ron Federici is a Neuropsychologist, Federici & Associates
Dana Johnson is Director of the Division of Neonatology and Director of the International Adoption Clinic, University of Minnesota
Inside the foster family: what research tells us about the experience of foster carers’ children
Robert Twigg and Tracy Swan
Key words: Foster carers’ children, foster family, foster care
Although foster care is the main source of out-of-home care for children and young people, little is known about the dynamics of the foster family. This article focuses on one subsystem of the foster family system, the foster parents’ own children. Fourteen research studies (nine published, five unpublished) were reviewed which involved approximately 232 respondents ranging in age from seven to 32 when interviewed and including nearly equal numbers of males and females. Findings include benefits of fostering, impact of fostering on foster carers’ children, responses to loss of role and parental attention, and the impact of the child welfare or foster care system. The authors conclude with several recommendations designed to make fostering a more positive experience.
Robert Twigg is Associate Professor, Faculty of Social Work, University of Regina, Canada
Tracy Swan is Assistant Professor, Memorial University of Newfoundland, Canada
Training and experience: keys to enhancing the utility for foster parents of the Assessment and Action Record from Looking After Children
Sarah Pantin and Robert Flynn
Key words: Looking After Children, Assessment and Action Record, foster care, training, Canada
The Looking After Children (LAC) approach is now widely used internationally in child welfare. The approach, which originated almost two decades ago, aims systematically to raise the standard of corporate parenting and improve the outcome of young people in out-of-home care. The Assessment and Action Record (AAR) from LAC is used to monitor young people’s developmental progress on a year-to-year basis. Clearly, foster carers are central to the successful implementation of LAC and it is important that they perceive the AAR to be useful in carrying out their fostering duties. Previous research in the UK and Australia found that foster carers believed the Record to be useful, especially if they were just getting to know the child or if the child had been in multiple placements. The study reported here draws on survey information provided by 93 foster carers in the province of Ontario, Canada. The authors found that foster carers who had received what they saw as higher-quality training rated the AAR as being more useful in their work. Interestingly, however, the amount of experience they had had in using the instrument was unrelated to their ratings of its usefulness. Overall, high-quality training emerged as a central feature of effective implementation. Specific recommendations were made in relation to LAC training curriculum requirements and stakeholder involvement.
Sarah Pantin is a graduate of the Clinical Psychology programme, University of Ottawa, Canada
Robert Flynn is Professor of Psychology and Director of the Centre for Research on Educational and Community Services at the same university
The experience of adoption (1): a study of intercountry and domestic adoption from the child’s point of view
Amanda Hawkins, Celia Beckett, Jenny Castle, Christine Groothues, Edmund Sonuga-Barke, Emma Colvert, Jana Kreppner, Suzanne Stevens and Michael Rutter
Key words: adoption, children’s views, children’s attitudes, intercountry adoption, ERA study, Romania
The study team compared views about adoption for two groups of 11-year-old children (n = 180). Their analyses compared the views of children according to their pre-adoption background: UK domestic adoptees placed before the age of six months versus intercountry adoptees who had experienced extreme deprivation for up to three-and-a-half years in Romania prior to placement. Remarkably few differences were found between these groups, with the exception of two areas. Older-placed adopted children from Romania were significantly more likely to find it difficult to talk about adoption than domestic adoptees, and to feel different from their adoptive families. However, supplementary analyses suggested that these differences were due to increased levels of difficulties within the older-placed Romanian group, rather than whether they were adopted internationally or domestically. The implications of the similarities and differences between these groups for policy and practice are discussed.
The authors are researchers, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College, London, UK.
Celia Beckett is also a senior social worker for PACT (Parents and Children Together), Reading, UK
Edmund Sonuga-Barke is Professor of Psychology Developmental Brain-Behaviour Unit, School of Psychology, University of Southampton, UK and the Child Study Center, New York University, USA
An examination of adoption support services for birth relatives and for post-adoption contact in England and Wales
Clive Sellick
Key words: birth family support services, adoption support, post-adoption contact
Support services for the birth relatives of adopted children have received far less research scrutiny than those for adopters and the children themselves. Sellick reports the first stage ‘mapping’ survey of a government commissioned study into birth relative support services and services supporting contact following changes in policy and legislation. The type, range and delivery of such services, commissioned or provided, by local authority and voluntary adoption agencies and adoption support agencies in England and Wales are examined. The survey found that good opportunities exist for linking birth relative and contact support services. However, real challenges remain in promoting support services and reaching birth relatives, and in funding and commissioning such services, particularly from the non-governmental sector.
Clive Sellick is Senior Lecturer in Social Work and Director of International Programmes, School of Social Work and Psychosocial Sciences, University of East Anglia, Norwich
The Child Wise Programme: a course to enhance the self-confidence and behaviour management skills of foster carers with challenging children
Martin Herbert and Jenny Wookey
Key words: challenging behaviour, looked after children, foster carers, attachment, Child Wise Parent Training Programme, cognitive-behavioural training, collaborative group work, placement instability
Looked after children with a history of maltreatment and abandonment are prone to develop high rates of mental health difficulties. They tend to suffer from multiple impairments, sometimes involving cognitive deficits and extremes of antisocial behaviour. Foster carers' management skills and emotional resources are tested to the limit. A further concern is the contribution of challenging behaviour to the unplanned termination of foster placements. Carers, if they are not to feel deskilled by the increasing numbers of children with special needs placed with them, require a more focused preparatory and follow-up training than they usually receive. This study questioned whether a broadly based cognitive behavioural programme could, by increasing carers’ behaviour management skills and self-assurance, reduce the challenging behaviour of looked after children and the resultant instability of placements. The answers were sought from a randomised controlled study of foster carers attending the parent training Child Wise Programme (CWP) designed by the authors. The programme combines course leaders’ professional experience of working with challenging children and parent groups, and foster carers’ personal expertise based on living with and caring for challenging children.
The intervention, with an experimental group of 67 foster carers and a comparative waiting-list control group of 50 carers, succeeded in meeting just over half of its key aims. An increase in the confidence of the carers was a significant gain. Also positive was the majority of personal reports indicating improvements in looked after children's behaviour, changes generally attributed to the acquisition of new behaviour management skills. Although some of the statistical comparisons were disappointing in their failure to reach significant levels (eg the reduction in placement breakdowns), they provided useful information about ways of improving the training. Qualitative methods were used to explore the subjective responses of participants to the Webster-Stratton and Herbert (1994) collaborative style of training employed. These produced valuable insights into the personal and professional dilemmas of a foster carer's role, as well as data which contributed to the evaluation of the training programme.
Martin Herbert is Emeritus Professor in Clinical and Community Psychology at
Exeter University, and Honorary Consultant Psychologist at the Royal Devon
and Exeter NHS Health Care Trust
Jenny Wookey is a Consultant Clinical Psychologist at the Plymouth Hospitals
NHS Trust, and a Supervisor for the Clinical Psychology Doctoral courses at
Plymouth and Exeter Universities
The Hope Connection: a therapeutic summer day camp for adopted and at-risk children with special socio-emotional needs
Karyn B Purvis, David R Cross, Ron Federici, Dana Johnson and L Brooks McKenzie
Key words: international adoption, adoption, child behaviour, attachment, sensory, self-regulation, intervention, camp
Large numbers of North American and Western European families are adopting children with serious socio-emotional needs. Other children experience similar deficits as a result of neglect and abuse by carers. Often these children are diagnosed with psychopathology and receive drug treatments that can be ineffective and even detrimental. The authors report on The Hope Connection, a project designed to meet the needs of these at-risk children and their families. Its core is a theoretically integrated summer day camp offering activities that are attachment rich, sensory rich and behaviourally structured. Pre-test and post-test data indicate that summer camp had a significant impact on the children’s behaviour (n = 19), as indicated by parent-report measures of child behaviour problems and attachment. These findings are discussed with regard to possible future directions of programmeme implementation and evaluation.
Karyn B Purvis and David R Cross are Associate Directors of the Institute of Child Development, and Professors of Psychology, and L Brooks McKenzie is an MA-Doctoral student, Texas Christian University
Ron Federici is a Neuropsychologist, Federici & Associates
Dana Johnson is Director of the Division of Neonatology and Director of the International Adoption Clinic, University of Minnesota
Inside the foster family: what research tells us about the experience of foster carers’ children
Robert Twigg and Tracy Swan
Key words: Foster carers’ children, foster family, foster care
Although foster care is the main source of out-of-home care for children and young people, little is known about the dynamics of the foster family. This article focuses on one subsystem of the foster family system, the foster parents’ own children. Fourteen research studies (nine published, five unpublished) were reviewed which involved approximately 232 respondents ranging in age from seven to 32 when interviewed and including nearly equal numbers of males and females. Findings include benefits of fostering, impact of fostering on foster carers’ children, responses to loss of role and parental attention, and the impact of the child welfare or foster care system. The authors conclude with several recommendations designed to make fostering a more positive experience.
Robert Twigg is Associate Professor, Faculty of Social Work, University of Regina, Canada
Tracy Swan is Assistant Professor, Memorial University of Newfoundland, Canada
Training and experience: keys to enhancing the utility for foster parents of the Assessment and Action Record from Looking After Children
Sarah Pantin and Robert Flynn
Key words: Looking After Children, Assessment and Action Record, foster care, training, Canada
The Looking After Children (LAC) approach is now widely used internationally in child welfare. The approach, which originated almost two decades ago, aims systematically to raise the standard of corporate parenting and improve the outcome of young people in out-of-home care. The Assessment and Action Record (AAR) from LAC is used to monitor young people’s developmental progress on a year-to-year basis. Clearly, foster carers are central to the successful implementation of LAC and it is important that they perceive the AAR to be useful in carrying out their fostering duties. Previous research in the UK and Australia found that foster carers believed the Record to be useful, especially if they were just getting to know the child or if the child had been in multiple placements. The study reported here draws on survey information provided by 93 foster carers in the province of Ontario, Canada. The authors found that foster carers who had received what they saw as higher-quality training rated the AAR as being more useful in their work. Interestingly, however, the amount of experience they had had in using the instrument was unrelated to their ratings of its usefulness. Overall, high-quality training emerged as a central feature of effective implementation. Specific recommendations were made in relation to LAC training curriculum requirements and stakeholder involvement.
Sarah Pantin is a graduate of the Clinical Psychology programme, University of Ottawa, Canada
Robert Flynn is Professor of Psychology and Director of the Centre for Research on Educational and Community Services at the same university
Apr 10, 2009
Good Resource
A great resource is the Psychology Wiki. Since this is administered by identified persons and experts, not just anyone who wants to edit and administer, the material is much more reliable and vetted. There are excellent articles there about
Dyadic Developmental Psychotherapy
Complex Trauma
Attachment Theory
Attachment Therapy
Reactive Attachment Disorder
and many other topics.
Go to:
http://psychology.wikia.com/wiki/Main_Page
to find it. I encourage you to look at the site for reliable information and to register and edit where you feel you have something to add.
Dyadic Developmental Psychotherapy
Complex Trauma
Attachment Theory
Attachment Therapy
Reactive Attachment Disorder
and many other topics.
Go to:
http://psychology.wikia.com/wiki/Main_Page
to find it. I encourage you to look at the site for reliable information and to register and edit where you feel you have something to add.
Apr 5, 2009
Dyadic Developmetal Psychotherapy receives support
The new book, Treating Complex Traumatic Stress Disorder, edited by Christine Courtois and Julian Ford, The Guilford Press, NY, 2009, supports the various elements, principles, and techniques of Dyadic Developmental Psychotherapy. The chapter on family therapy approaches states, "Meta-analytic studies have found family based treatments to be more effective than treatment as usual (TAU)...The strongest evidence for the efficacy of family therapy for traumatic stress disorders is provided by studies with families of traumatized toddlers and preschool- or early elementary school-aged children." pp394-395.
The book describes the importance of affect regulation, focusing on attachment relationships in treatment, attention to developmental level and processes, emotional regulation, titrated exposure to traumatic memories, therapeutic alliance, intersubjectivity, and other topics that are core principles and methods of Dyadic Developmental Psychotherapy. It is heartening to find additional support for the use of DDP in the treatment of attachment and trauma disorders.
The book describes practice principles for treating children with complex traumatic stress disorder which are quite consistent with previous material published about DDP over the last several years:
1. Safety First
2. A relational bridge must be developed to engage, retain, and maximally benefit the child and caregiver(s).
3. Diagnosis, treatment planning, and outcome monitoring are always relational.
4. Diagnosis, treatment planning, and outcome monitoring are always strengths-based.
5. All phases of treatment should aim to enhance self-regulation competencies.
5a. Emotional regulation.
5b. Attention, memory, decision making (information processing).
5c. Self-regulation of consciousness and motivation.
5d. Bodily self-regulation.
5e. Relational self-regulation.
6. Determining with whom, when, and how to address traumatic memories.
7. Preventing and managing relational discontinuities and psychosocial crises.
from pages 67-78.
As described and elaborated in the book, these principles have also been previously described and elaborated on in various publications about DDP (several books and journal articles).
The book describes the importance of affect regulation, focusing on attachment relationships in treatment, attention to developmental level and processes, emotional regulation, titrated exposure to traumatic memories, therapeutic alliance, intersubjectivity, and other topics that are core principles and methods of Dyadic Developmental Psychotherapy. It is heartening to find additional support for the use of DDP in the treatment of attachment and trauma disorders.
The book describes practice principles for treating children with complex traumatic stress disorder which are quite consistent with previous material published about DDP over the last several years:
1. Safety First
2. A relational bridge must be developed to engage, retain, and maximally benefit the child and caregiver(s).
3. Diagnosis, treatment planning, and outcome monitoring are always relational.
4. Diagnosis, treatment planning, and outcome monitoring are always strengths-based.
5. All phases of treatment should aim to enhance self-regulation competencies.
5a. Emotional regulation.
5b. Attention, memory, decision making (information processing).
5c. Self-regulation of consciousness and motivation.
5d. Bodily self-regulation.
5e. Relational self-regulation.
6. Determining with whom, when, and how to address traumatic memories.
7. Preventing and managing relational discontinuities and psychosocial crises.
from pages 67-78.
As described and elaborated in the book, these principles have also been previously described and elaborated on in various publications about DDP (several books and journal articles).
Mar 16, 2009
Study finds Developmental Delays among children with RAD
The Center's study, "Effects of Early Maltreatment on Development: A Descriptive study using the Vineland Adaptive Behavior Scales-II." has been accepted for publication in a prestigious professional journal and will be in print this summer. The study found the following:
Children with histories of chronic early maltreatment within a care-giving relationship, Complex Trauma, or Developmental Trauma, suffer from a variety of deficits in many domains. This study explored the effects of Complex Trauma on development, as measured by the Vineland Adaptive Behavior Scales-II. This is the first descriptive study to report on the large discrepancies between chronological and developmental ages in adopted and foster children. This study found that adopted and foster children with a psychiatric diagnosis of Reactive Attachment Disorder show developmental delays in several areas. Adaptive behavior and developmental age in the Communication, Daily Living Skills, and Socialization domains was, on average, significantly below the average chronological age of the 57 children in this study. Among children in this study, the average Adaptive Behavior Composite score yielded an age equivalency or developmental age of four years four months, while the average chronological age was nine years ten months.
The article describes the implications of these findings for psychotherapy, parenting, child-welfare policy, and educational settings.
As soon as the article is published I will post information on how to get a reprint.
Children with histories of chronic early maltreatment within a care-giving relationship, Complex Trauma, or Developmental Trauma, suffer from a variety of deficits in many domains. This study explored the effects of Complex Trauma on development, as measured by the Vineland Adaptive Behavior Scales-II. This is the first descriptive study to report on the large discrepancies between chronological and developmental ages in adopted and foster children. This study found that adopted and foster children with a psychiatric diagnosis of Reactive Attachment Disorder show developmental delays in several areas. Adaptive behavior and developmental age in the Communication, Daily Living Skills, and Socialization domains was, on average, significantly below the average chronological age of the 57 children in this study. Among children in this study, the average Adaptive Behavior Composite score yielded an age equivalency or developmental age of four years four months, while the average chronological age was nine years ten months.
The article describes the implications of these findings for psychotherapy, parenting, child-welfare policy, and educational settings.
As soon as the article is published I will post information on how to get a reprint.
Feb 9, 2009
New Research on Developmental Functioning
We have completed a study that is due to be published soon that shows that children with Reactive Attachment Disorder and Complex Trauma function at a much younger age than their chronological age. The study used the Vineland Adaptive Scales -II and found that the children in the study had a developmental age notably lower than their chronological age. In addition, we found that their receptive communication score was significantly lower than their expressive communication score, suggesting that at times the child's not "listening" may be caused by the child not understanding what the child was asked, rather than being non-compliance or defiance. There are a number of other important findings for this study, which is the first of it's kind to explore the developmental functioning of this group of children.
The article describes several important implications for clinical practice, parenting, child welfare practice, education, and further research.
I will post additional information about this study in later posts and as soon as the article is published, I will provide a link to it.
The article describes several important implications for clinical practice, parenting, child welfare practice, education, and further research.
I will post additional information about this study in later posts and as soon as the article is published, I will provide a link to it.
Subscribe to:
Posts (Atom)
