Search

Das Selbst bedarf, um in Erscheinung treten zu können, der Objekte in der Außenwelt, die es triebhaft besetzt. Der Analytiker wie auch der Patient stehen mit ihren Empfindungen, Fantasieprodukten und Objektrepräsentanzen sowie mit dem außen verorteten Gegenüber in anhaltendem Austausch. Sie tauschen sich, bewusst und vorbewusst, in einem spezifischen Setting, über welches eine Übereinkunft gefunden worden ist, in asymmetrischer Weise und mit verschiedenen Aufgaben aus. Die Squiggle-Technik von Winnicott, an einem Fallbeispiel mit einem Kind erläutert, führt in einem virtuellen Übergangsraum von Bildern zur Sprache. Der Analytiker, ungeschützter als im klassischen Setting, ist mit seiner Rêverie im Wachzustand Mit-Erzeuger, Begleiter, Betrachter, Transformierer und Deuter bei der rätselhaften Reise ins Unbekannte. Durch die Übertragungs-/Gegenübertragungs-Abläufe bewegt, muss er sich reflektierend anhaltend wiederherstellen. Im Dazwischen von sowohl intrasubjektiven als auch interpersonalen Grenzzonen ermöglicht er den bildlichen und sprachlichen Metaphern, die als ein gemeinsames Drittes entstanden sind, in ihrem aktuellen Bedeutungsgehalt zur Sprache zu kommen.

Donner la parole est un geste aimable, mais quelquefois aussi un acte violent. Trouver des « mots qui touchent » reste un art, comme nous le montre Winnicott. Chercher les mots nous impose une tâche auto-analytique difficile si nous essayons de clarifier ce qui se passe en nous-memes quand nous avons ete forces d’accueillir une identification projective. Prendre la parole et se donner mutuellement la parole pendant les seances ressemble a un morceau a quatre mains.

Individuen tauschen sich uber verschiedene kommunikative Wege aus. Averbal-gestisch-mimische Zeichen und Gesten werden in der Entwicklung allmahlich durch die verbale Sprache und Narrative ersetzt. Wie kann ein diagnostisch-therapeutischer Dialog etabliert werden, der bei einem Kind mit intensivstem elektivem Mutismus eine Aussage uber die Indikation fur eine psychoanalytische Psychotherapie erlaubt? Dieser Frage wird anhand von vier psychoanalytisch orientierten «Interviews» mit einem Knaben in der Latenz nachgegangen und auf dem Hintergrund theoretischer Ausfuhrungen und psychoanalytischer Konzepte diskutiert.

Konflikthafte biografische Erfahrungen lassen sich durch die Anamneseerhebung, evtl. Fragebogen und v. a. durch unstrukturierte psychoanalytische Interviews erfassen. Infolge des Phanomens der Nachtraglichkeit, der unterschiedlichen Speicherung in zuganglichen bzw. nichtwillentlich evozierbaren Gedachtnisbereichen und der Bildung verschiedener Schichten von Deckerinnerungen, ist es oft auserordentlich schwer zu wissen, ob die erfassten Konflikte die basalen sind oder eher solche aus spateren Uberarbeitungen. Die Relevanz der auftretenden Konflikte fur eine mogliche Weiterentwicklung des Individuums wird am offensichtlichsten in den Ubertragungs‑/Gegenubertragungsbewegungen, wo beide Protagonisten improvisierend sich vorantasten.

Die Analyse von Kindern begann schon mit dem »Kleinen Hans«. Weiterentwickelt wurde sie zunachst in Wien, dann in London und spater in Paris. Die Analyse von Jugendlichen, erst als unmoglich erachtet, wurde in der zweiten Halfte des 20. Jahrhunderts von London und den USA ausgehend theoretisch und praktisch entwickelt und hat sich als sehr fruchtbar erwiesen. Innerhalb der IPA wurde erkannt, wie wichtig es ist, die Bereiche der Kinder- und Jugendlichen-Analyse und jene der Psychoanalyse fur Erwachsene nicht langer getrennt zu halten. Die Bestrebungen zielen auf ein sogenanntes »integriertes Training« hin. Der vorliegende Beitrag mochte im Hinblick auf eine spater eventuell realisierbare Form eines »integrierten Trainings« einen Beitrag dazu leisten, den begonnenen Dialog zwischen Kinder- und Erwachsenenanalyse weiterzufuhren und zu intensivieren.

This book aspires to demonstrate the therapeutic effectiveness of long‐term analytical psychotherapy using a sizeable number of case examples. It is intended to provide an intensive insight – one n...

This study examines associations between parental capacities for triadic (mother-father-child) relationships, assessed prenatally, and the representational and behavioral functioning of their offspring at preschool age. Thirty-eight parental couples were given an intensive psychodynamic interview during their first pregnancy to assess how they anticipated their future parenthood and their relationships as threesomes (mother-father-child). The capacity for triadic relationships ("triadic capacity") was defined as the capacity of fathers and mothers to anticipate their family relationships without excluding either themselves or their partners from the relationship with the infant. Four years later, the representational and behavioral functioning of their children were assessed in depth using child narrative interviews and parental behavior ratings. The coherence of the children's narratives and the number of positive themes they expressed were significantly negatively correlated with the number of behavioral problems. In the longitudinal analyses, there were significant positive correlations between the parental triadic capacities and the coherence/number of positive themes in the children's narratives whereas parental triadic capacities showed a significant negative correlation with the number of the children's externalizing problems. The significance of triadic relational family processes for the development of children's representational world and behavioral functioning is discussed. ©2005 Michigan Association for Infant Mental Health.

The external world is represented intrapsychically in a specific way. Following the age of an infant, for example, the structure, quality, and the degree of symbolization will be different. The term representation in science is filled with different contents. In psychoanalysis, we see a development from Sigmund Freud's "(Sach- or Wort-)Vorstellungen" to internal objects, then to self-object representations and finally-following newer results of the concept of intersubjectivity and especially under the influence of infant mental- and interactional research-to self-object interaction representations. Some aspects of this development are presented more in detail. Knowing that on one hand, interaction in external reality is structured by the self-object interaction representations of each interacting partner and that on the other hand, what happens during the interactions in external reality modifies the representational world of all the interactive persons (i.e., their inner reality), one can observe constant movements from inside to outside (e.g., transference, action) and from outside to inside of the individual (e.g., perception, stimulation, containment, modification). Clinical implications for the actual way of understanding are manifold, but are here only very shortly delineated.

Objective Cognitive–perceptive ‘basic symptoms’ are used complementary to ultra-high-risk criteria in order to predict onset of psychosis in the pre-psychotic phase. The aim was to investigate the prevalence of a broad selection of ‘basic symptoms’ in a representative general adolescent population sample (GPS; N = 96) and to compare it with adolescents first admitted for early onset psychosis (EOP; N = 87) or non-psychotic psychiatric disorders (NP; N = 137). Methods Subjects were assessed with the Bonn Scale for the Assessment of Basic Symptoms (BSABS). Prevalence of at least one ‘basic symptom’ and mean numbers were compared across the three groups. Logistic regression was used to predict group membership by BSABS subscales; risk ratios were calculated to identify ‘basic symptoms’ which best discriminated between groups. Results The prevalence of at least any one ‘basic symptom’ was 30.2% in GPS compared to 81% in NP and 96.5% in EOP. Correct classification of EOP when compared to GPS was high (94.0%) and lower when compared to NP (78.6%). Cognitive symptoms discriminated best between EOP and NP. Conclusion Alike other prodromal- and psychotic-like experiences, ‘basic symptoms’ are prevalent in the general adolescent population, yet at a lower rate compared to EOP and NP. The usage of ‘at least one basic symptom’ as a screening criterion for youth at risk of developing a psychotic disorder is not recommended in the general population or in unselected psychiatrically ill adolescents. However, particularly cognitive ‘basic symptoms’ may be a valuable criteria to be included in future ‘at risk’ studies in adolescents.

Nach einem Streifzug durch die psychoanalytisch orientierte Literatur zur ADHD Trias werden die bei der ADHD-Symptomatik überzufällig häufig zu findenden frühkindlichen Entwicklungs-, Bindungs- und Beziehungsstörungen (Regulation von Triebimpulsen und Affekten, Ich-Funktionen) sowie die Rolle infantiler Traumata (Objektverlust) und psychischer Konflikte diskutiert. Im analytisch-psychotherapeutischen Prozess manifestiert sich die ADHD-Smptomtrias beim Kind z. B. in Form von intrapsychischen Konflikten auf der Ebene der Selbstrepräsentanz oder von zentralen Objektbeziehungsrepräsentanzen, die durch eine ungenügende Containing-/Holding-Funktion charakterisiert sind, in einer Beeinträchtigung selbstregulativer Funktionen, in inkonsistenter Symbolisierungsfähigkeit oder in mangelnder Regulations- und Steuerungsfähigkeit des Ichs. Wegen der Vielfalt der beteiligten Faktoren können und sollen weder die Ätiologie noch die Pathogenese dieses trisymptomatischen Störungsbildes verallgemeinert werden. Dies wird bei einem beziehungsorientierten Vorgehen besonders deutlich. Anhand eines Erstinterviews illustrieren die Autoren die Fähigkeit eines zehnjährigen (als ADHD-Patient diagnostizierten) Knaben, ein analytisch-therapeutisches Gespräch für sich zu nutzen und seine innerpsychische Erlebnis- und Problemwelt bildhaft und in narrativ-performativer Form darzustellen. Schließlich wird auf spezifische technische Besonderheiten bei der nieder- oder höher-frequenten psychoanalytischen Psychotherapie mit ADHD Kindern eingegangen: entsprechend den weitgehend prägenitalen Beziehungsformen, die sich zumeist in einer intensiven Selbstwertproblematik, narzisstischen Aggressivität und motorischen Impulsivität zeigen, verlaufen die Übertragungs-/Gegenübertragungs-Bewegungen vorwiegend über projektive und introjektive Identifizierungen. Steuerungshilfen und Grenzsetzungen sind beim Containment der Probleme oft langdauernd notwendig. Das Übersetzen von Handeln in Sprache und die Transformation der beim analytischen Therapeuten intrapsychisch ausgelösten Vorgänge in für das Kind hilfreiche Interventionen/Interpretationen erfordern eine konstante Anpassung an die inkonsistenten Ich-Funktionen und an das fragile Selbstgefühl des Kindes. Der zusätzliche Einsatz von Stimulantien, die Arbeit mit dem Umfeld und der im analytischen Bereich noch hohe Forschungsbedarf werden abschließend kurz diskutiert. Schlagwörter ADHS - psychoanalytische Psychotherapie - Frühtraumatisierung - Selbst-Objekt- Beziehungen - Selbstwertprobleme, A brief survey of the psychoanalytically oriented literature regarding the symptom triad of ADHD is followed by the discussion of frequently found disturbances in infantile development, attachment, object relations (regulation of drives and affects, ego functions) of the role of infantile trauma (object loss) and psychic conflict. In the analytic-psychotherapeutic process with a child, the ADHD-symptom-triad may manifest itself e.g. as intrapsychic conflict on the level of the self-representation or of the representation of central self-object-relations (characterized by an insuffcient containing-/holding-function), as impairment of self-regulative functions, as inconsistent symbolizing capacity or as deficient regulating and controlling capacity of the ego. The multitude of factors involved does not allow a generalisation of neither the etiology or the pathogenesis of this symptom triad. This is particularly evident in a therapeutic procedure which is relation oriented. In a first interview the authors illustrate the capacity of a ten year old boy (diagnosed as ADHD patient) to make use of the analytic therapeutic dialogue and to present his intrapsychic experiences and problems in a figurative and narrative performance. Finally some specific technical features of low or high frequent analytic psychotherapy with ADHD children are shown: according to the foremost pregenital form of relations - manifested mostly by intensive self esteem problems, narcissistic aggressiveness and motor impulsivity - the transference and counter-transference movements proceed predominantly by projective and introjective identifications. Containment of the diffculties by the therapist is often paralleled for a long period of time by assistance in regulation and by limit setting for the child. Translation of action into language and transformation of intrapsychic processes within the psyche of the therapist into helpful interventions for the child require a continuous adjustment to the inconsistent ego functions and the fragile self esteem of the child. The additional use of stimulant drugs, the work within the family and/or the social context and the high need for research in the analytical field are briefly discussed at the end. Keywords ADHD - psychoanalytic psychotherapy - early traumatisation - self-object-relations - self-esteem

Objective: The aim was to investigate the association of pretreatment social functioning (12 months before initial presentation) with symptom dimensions and social functioning at 1-year follow-up. Method: Fifty-six adolescents, age 14–18, first admitted for early onset psychosis, were evaluated at baseline and 1-year follow-up assessing psychopathology (PANSS), social functioning (Strauss and Carpenter Prognostic Scale), and duration of untreated psychosis (DUP). Results: Adolescents with low pretreatment social functioning were at risk of more severe negative symptoms and lower social functioning at follow-up. Negative symptoms at baseline were less predictive and DUP was not predictive in this sample. Conclusion: Results of this study suggest a strong longitudinal inter-relatedness between social functioning and negative symptoms in this age group. An integrative treatment approach including family interventions, social skills training, long-term specialized work/school rehabilitation, and adequate antipsychotic treatment is warranted to improve both, social functioning and negative symptoms.

Objective: The aim of this study was to investigate the associations between children's difficulties (conduct problems, hyperactivity/impulsivity, and emotional symptoms) and peer victimization and rejection in kindergarten. For the assessment of children's difficulties, the authors used a multi-informant approach. Method: A total of 153 five-year-old children were interviewed (Berkeley Puppet Interview). Teachers and parents completed the Strengths and Difficulties Questionnaire. Teachers reported on peer victimization. Peer nominations (rejection and acceptance) were conducted in a subgroup of 92 children. Combining teacher, parent, and self-reports of children's difficulties, three components were established: trait (degree of problems), informant differences resulting from perspective (self versus others), and context (kindergarten versus home). Results: Children's difficulties were significantly associated with teacher- and self-reported victimization and peer rejection ( r = 0.20-0.35), but not with peer acceptance. Conduct problems and emotional symptoms, but not hyperactivity/impulsivity, contributed independently to the variance of peer victimization and rejection. Perspective differences between children and adults according to hyperactivity/impulsivity also predicted peer rejection. Conclusion: Behavioral and emotional difficulties as well as a lack of self-awareness regarding hyperactive/impulsive behavior may place children at risk of peer victimization and rejection. Child psychiatric assessments and therapeutic strategies should thus take children's self-perception of symptoms and their peer relationships into account.

Zusammenfassung. Anhand einer Stichprobe von 69 Familien mit Kindern im Alter von 3 bis 3.5 Jahren wurde die Bedeutung mütterlicher und väterlicher psychischer Belastung und konflikthafter Paarbeziehung der Eltern für die kindliche Verhaltensregulation überprüft. Das elterliche Interaktionsverhalten mit dem Kind wurde als mögliche Vermittlungsvariable einbezogen. Die Verhaltensregulation des Kindes wurde mittels eines Elterninterviews (RABI) und eines Elternfragebogens (CBCL/2 - 3) erhoben. Zur Erfassung der psychischen Belastung der Eltern und der Qualität der Paarbeziehung wurden Fragebogen verwendet (SCL-90-R, PFB). Die Einschätzung des elterlichen Interaktionsverhaltens beruht auf einer Eltern-Kind-Spielsequenz (FEAS). Unsere Resultate erbrachten deutliche Zusammenhänge zwischen der mütterlichen psychischen Belastung sowie der konflikthaften Paarbeziehung und der Verhaltensregulation der dreijährigen Kinder, sowohl bezüglich der sozialen Kompetenz als auch bezüglich der Verhaltensprobleme. Das elterliche Interaktionsverhalten im Spiel mit dem Kind erwies sich als unabhängiger Prädiktor für die kindliche Verhaltensregulation und nicht als Vermittlungsvariable im Zusammenspiel von mütterlicher psychischer Belastung, Paarkonflikten und kindlicher Verhaltensregulation.

This study examines associations between parental capacities for triadic (mother–father–child) relationships, assessed prenatally, and the representational and behavioral functioning of their offspring at preschool age. Thirty-eight parental couples were given an intensive psychodynamic interview during their first pregnancy to assess how they anticipated their future parenthood and their relationships as threesomes (mother–father–child). The capacity for triadic relationships (“triadic capacity”) was defined as the capacity of fathers and mothers to anticipate their family relationships without excluding either themselves or their partners from the relationship with the infant. Four years later, the representational and behavioral functioning of their children were assessed in depth using child narrative interviews and parental behavior ratings. The coherence of the children's narratives and the number of positive themes they expressed were significantly negatively correlated with the number of behavioral problems. In the longitudinal analyses, there were significant positive correlations between the parental triadic capacities and the coherence/number of positive themes in the children's narratives whereas parental triadic capacities showed a significant negative correlation with the number of the children's externalizing problems. The significance of triadic relational family processes for the development of children's representational world and behavioral functioning is discussed. ©2005 Michigan Association for Infant Mental Health.

Goals of work: To define and measure the psychological integration of childhood cancer experiences into a personal biography and to explore the association between integration with illness-related factors and psychosocial conditions. Patients and methods: Analysis of cancer survivors' narratives on the course of their illness was used to measure integration. Psychosocial condition, body concepts, health locus of control, and illness-related distress were evaluated by questionnaires. Illness factors were assessed by reviewing hospital case notes and sociodemographic factors by a structured interview. Of 72 eligible subjects contacted, 60 agreed to participate. Main results: High inter-rater correlations established the reliability of the concept of testing integration by narrative analysis. Subjects with good psychological integration of the experience of cancer saw chance as having less to do with illness and health, and perceived illness and therapy retrospectively as more distressing than survivors with poor integration. In contrast, integration did not correlate with distress evoked by present feelings toward illness and therapy or by thoughts of a relapse. Conclusions: Successful integration of the experience of cancer may be associated with the ability to accept painful feelings and to allow them to emerge, and with a readiness to accept responsibility in relation to health and medical care. Assisting young cancer patients and their families to create and maintain their personal narratives of the experience of illness is an important clinical task for all professionals working in paediatric oncology

The aim of this study was to assess patterns and correlates of family variables in 31 adolescents treated for their first episode of a schizophrenia spectrum disorder (early-onset schizophrenia [EOS]). Expressed emotion, perceived criticism, and rearing style were assessed. Potential correlates were patient psychopathology, premorbid adjustment, illness duration, quality of life (QoL), sociodemographic variables, patient and caregiver "illness concept," and caregiver personality traits and support. Families were rated as critical more frequently by patients than raters (55% vs. 13%). Perceived criticism was associated with worse QoL in relationship with parents and peers. An adverse rearing style was associated with a negative illness concept in patients, particularly with less trust in their physician. Future research should examine perceived criticism as a predictor of relapse and indicator of adolescents with EOS who need extended support and treatment. Rearing style should be carefully observed because of its link with patients' illness concept and, potentially, to service engagement and medication adherence.

Results concerning satisfaction with the birth experience in different trials are difficult to compare, owing to a lack of internationally used research scales. Salmon's Item List (SIL) is easy-to-handle and would therefore be very helpful for research as well as for obstetric clinic quality control. Two hundred and fifty-one patients were investigated using a German-language version of SIL (SIL-ger); the statistical evaluation was carried out by means of a principal components analysis. Principal components analysis revealed two major findings: (1) as stated by other authors the birth experience is multidimensional, each aspect influencing the others in a non-linear way; (2) in addition to Salmon's dimensions (i.e. postnatal 'fulfillment', intranatal 'physical discomfort' and intranatal 'emotional distress') another postnatal dimension labeled 'negative emotional experience' was detected. Not only are intranatal experiences multidimensional, but so too are evaluative feelings afterwards. In addition to fulfillment, as developed by Salmon, a dimension of negative emotional experience needs to be taken into account. This dimension does not correlate in a linear way with fulfillment. It is appropriate to use SIL in research. Before using it for purposes of clinical quality control, however, larger samples need to be evaluated in order to prove the stability of the factor structure.

Based on the investigation of 52 families and their 87 offspring by means of semistructured interviews, we evaluated the coping abilities of the parent affected by multiple sclerosis (MS), the healthy parent and their children. The results show that the gender of the child significantly influences his or her coping behaviour. Daughters cope better than sons, independently of the gender of the MS-affected parent. Only the daughter’s coping is positively affected by age and disease variables. The correlation between the coping behaviour of parents and children is significant between children and their healthy parents and even stronger between children and healthy parents of the same gender. Healthy mothers and daughters cope better with the increasing disability of the father. This is not the case for healthy fathers and sons. Gender seems to be an important moderating factor in chronic parental disease and it has complex effects on the coping capacity of children.

Based on the study of 48 patients and their partners by means of semi-structured interviews, we evaluated how the ability to cope (Coping Index) with a chronic somatic disease (e.g. Multiple Sclerosis) is affected by gender, the degree of disability (assessed by the Kurtzke EDSS) and associated depression (measured by the BDI). An associated depression in a sick wife induces depressive symptoms in the healthy husband; whereas healthy wives are not affected by the depression of their sick husbands. The process of coping according to gender shows that male coping, whether as patients or partners, is influenced neither by the degree of disability nor by associated depression (their own or their partner's). Women as patients or partners are influenced in their coping process by the degree of impairment (negatively for their own, positively with increasing disability of their partner). Their ability to cope is negatively affected by an associated depression (their own or their partner's). The evaluation of the MS patient should include the partner to devise individualised treatment approaches.

Cette etude explore l'influence des peres sur les interactions familiales precoces triadiques incluant des dimensiones en matiere de generation, de representation et d'interaction. Une etude longitudinale prospective a ete faite avec un echantillon non-clinique de parents, commencant avec leur grossesse, et leur premier nouveau-ne. Cet article presente les resultats de la premiere partie de l'etude qui allait jusqu'au quatrieme mois du nourrisson. Les vues subjectives de parents a propos du parentage et de l'enfant a naite ont ete systematiquement analysees durant la grossesse, l'accent etant mis sur l'importance des parents pour le developpement du nourrisson et la famille telle qu'elle etait anticipee dans les reves des parents. Ces dimensions en matiere de representation ont ete comparees a la qualite des interactions dyadiques et triadiques parent-enfant observees apres la naissance de l'enfant. On a trouve une correlation importante entre le niveau triadique des representations des meres et des peres et les qualites d'interactions dyadiques pere-enfant, ainsi que les qualites d'interactions familiales triadiques. Une correlation specifique et importante a ete etablie entre les aspects du monde de representation du pere et la capacite du nourrisson de quatre mois a avoir un contact equilibre avec les deux parents dans un contexte d'interaction triadique.

Objective In a longitudinal prospective study on 38 couples and their first child, we examined the influence of prenatally assessed psychological factors of the parents on somatic and psychic aspects of birth, the quality of the newly established parent-child relationship and the early development of the baby. Methods Half-standardized psychoanalytic interviews with the couple (pre- and postnatally conducted, video-recorded), the Giessen test for couples, an evaluation of the parents' birth narratives and a parent questionnaire about functional symptoms of the baby were used. Results We found a high continuity between the pre- and the postnatal measurements of the partnership and the emotional experiences of the parents. Somatic complications of the birth event were not correlated with prenatally assessed psychological factors. But there exists a highly significant correlation between the mental representations and the relationships of the parents and the emotional experiences of birth, the early relationship between the parents and their baby and manifestations of functional disorders of the newborn. Conclusions Relevant psychological and psychosocial aspects should be included in the medical care of pregnant women. One should listen to the imaginations and expectations of the parents about the future parentship, including ambivalent feelings. The father should also be seen for psychological assessment.

Les interfaces entre les domaines intrapsychiques, interactionnels et intergenerationnels representent une nouvelle frontiere. A titre exploratoire, nous nous sommes exposes a une situation complexe mais controlable ainsi que le voient ceux dont l'interet principal se porte sur l'une de ces trois interfaces. Nous avons aussi entierement integre les sujets dans l'equipe, de facon a comprendre leur perspective subjective et a leur offrir une experience enrichissante. Nous avons commence avec une breve sequence de «triadification», c'est-a-dire passer d'une organisation familiale «deux plus un» a une organisation familiale «trois ensemble»

Objective. To assess the memory of various subdimensions of the birth experience in the second year postpartum, and to identify women in the first weeks postpartum at risk of developing a long-term negative memory. Design, method, outcome measures. New mothers' birth experience (BE) was assessed 48–96 hours postpartum (T1) by means of the SIL-Ger and the BBCI (perception of intranatal relationships); early postnatal adjustment (week 3 pp: T1bis) was also assessed. Then, four subgroups of women were defined by means of a cluster-analysis, integrating the T1/T1bis variables. To evaluate the memory of the BE, the SIL-Ger was again applied in the second year after childbirth (T2). First, the ratings of the SIL-Ger dimensions of T1 were compared to those at T2 in the whole sample. Then, the four subgroups were compared with respect to their ratings of the birth experience at T2 (correlations, ANOVAs and t-tests). Results. In general, fulfillment, emotional adaptation, physical discomfort, and anxiety improve spontaneously over the first year postpartum, whereas in negative emotional experience, control, and time-going-slowly no shift over time is observed. However, women with a negative overall birth experience and a low level of perceived intranatal relationship at T1 run a high risk of retaining a negative memory in all of the seven subdimensions of the birth experience. Conclusions. Women at risk of developing a negative long-term memory of the BE can be identified at the time of early postpartum, when the overall birth experience and the perceived intranatal relationship are taken into account.

This study aimed to determine longitudinal associations of early triadic family processes and 3-year-old children’s strengths and difficulties and to control those associations for family risk factors. In 80 families expecting their first child, we assessed parents’ anticipations of future family relationships (Triadic Capacity) and parents’ psychological distress, marital quality, and education level. When the children were 4 months of age, we observed triadic family interaction in a standardized laboratory play scenario. The children’s strengths and difficulties at age three were assessed using multiple methods. As expected, parents’ Triadic Capacity assessed before the child was born predicted triadic family interaction 4 months after birth. Early triadic family processes explained variance in children’s emotional functioning at age three over and above the effects of family stress factors assessed before the child was born. However, early triadic family processes did not explain children’s co-operative behaviour or children’s symptoms at age three. Results also highlighted the roles of fathers’ education level in children’s externalizing behaviour, mothers’ psychological distress at children’s low co-operative behaviour, and low marital quality in children’s internalizing behaviour.

A brief survey of the psychoanalytically oriented literature regarding the symptom triad of ADHD is followed by the discussion of frequently found disturbances in infantile development, attachment, object relations (regulation of drives and affects, ego functions) of the role of infantile trauma (object loss) and psychic conflict. In the analytic-psychotherapeutic process with a child, the ADHD-symptom-triad may manifest itself e.g. as intrapsychic conflict on the level of the self-representation or of the representation of central self-object-relations (characterized by an insufficient containing-/holding-function), as impairment of self-regulative functions, as inconsistent symbolizing capacity or as deficient regulating and controlling capacity of the ego. The multitude of factors involved does not allow a generalisation of neither the etiology or the pathogenesis of this symptom triad. This is particularly evident in a therapeutic procedure which is relation oriented. In a first interview the authors illustrate the capacity of a ten year old boy (diagnosed as ADHD patient) to make use of the analytic therapeutic dialogue and to present his intrapsychic experiences and problems in a figurative and narrative performance. Finally some specific technical features of low or high frequent analytic psychotherapy with ADHD children are shown: according to the foremost pregenital form of relations--manifested mostly by intensive self esteem problems, narcissistic aggressiveness and motor impulsivity--the transference and counter-transference movements proceed predominantly by projective and introjective identifications. Containment of the difficulties by the therapist is often paralleled for a long period of time by assistance in regulation and by limit setting for the child. Translation of action into language and transformation of intrapsychic processes within the psyche of the therapist into helpful interventions for the child require a continuous adjustment to the inconsistent ego functions and the fragile self esteem of the child. The additional use of stimulant drugs, the work within the family and/or the social context and the high need for research in the analytical field are briefly discussed at the end.