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Objective: To present data from a general infant psychiatry clinic, including range and frequency of presenting symptoms, relationship between symptoms and diagnoses, and comparison of two diagnostic systems, DSM-IV and Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-3). Method: A retrospective chart review was conducted for 177 children, ages birth to 58 months, who were seen between 1982 and 1997. Presenting symptoms were identified. Subjects were given diagnoses using both DSM-IV and DC: 0-3. Presenting symptom variables were reduced using subjective and empirical determinants. Stepwise regression analyses were used to determine whether presenting symptoms and demographic variables predicted diagnoses. Results: Descriptive statistics on the distribution of current presenting symptoms and assigned diagnosis were compared with previous studies. The study demonstrated interrater reliability for diagnoses using both diagnostic systems, evidence of diagnostic validity via the regression analyses, and good concordance where DSM-IV and DC: 0-3 overlap. DSM-IV disruptive behavior disorders may be better conceptualized in DC: 0-3 as regulatory disorders, leading to alternative conceptualization of the disorder and a different course of treatment. Conclusions: This study clarifies a developmental progression of presenting symptoms and diagnoses and suggests the need for continued diagnostic re-evaluation in early childhood. Greater attention to relationship factors and consideration of trauma factors is encouraged. J. Am. Acad. Child Adolesc. Psychiatry, 2004;43(5):578-587. Key Words: young children, infant psychiatry clinic, diagnostic systems.

The birth and hospitalization of a preterm infant have powerful effects on the emerging parent-infant relationship. Characteristics of parents, infant factors, and factors in the hospital and Neonatal Intensive Care Unit (NICU) environments--in addition to the circumstances surrounding preterm birth--may disrupt parent-infant relationships. Parents make extraordinary efforts to maintain relationships with their hospitalized premature babies; fathers of preterm infants may be more involved in their care than fathers of full-term babies. The task-oriented NICU environment sometimes overlooks relationship development. Infant-family professionals can reduce the negative effects of relationship disruptions and promote the mental health of preterm babies and their families through psychoeducational interventions with families, mental health services in the NICU, staff training to support the parent-infant relationship, emotional support for NICU staff, and developmentally supportive and family-centered practices.

In the late 1960s and early 1970s, psychiatrists, psychoanalysts, and developmental psychologists pioneered the study of infant mental health. The author, a clinician who helped to develop the field of infant mental health, uses an anecdote-enriched account of his 30-year career to describe the origins and evolution of the infant mental health field, including influential early research and researchers, the establishment of key training and clinical programs, and the creation of ZERO TO THREE's "Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood" ("DC:0-3"). According to Harmon, "DC:0-3" has helped fill the need for developmentally sensitive diagnostic system that can serve as a "common language" for clinicians, researchers, and families. Infant mental health knowledge now informs practice in NICUs, Early Head Start, services for young children who have been abused or neglected, and programs for mothers in recovery from substance abuse and their children.

Fourteen children (ages 3-6) from a therapeutic day treatment preschool program for maltreated children were administered the Weschler Preschool and Primary Scales of Intelligence-Revised. The abused preschoolers scored significantly lower than the population mean on four of the five subscales. Only on Picture Completion did they score significantly higher. (Author/CR)

Research was conducted to analyze research validity, the validity of a whole study. A model was developed for understanding research validity based on the concepts of T.D. Cook and D.T. Campbell. The influence of the reliability and validity of instruments utilized in the study on the research validity of a whole study was also examined. Moreover, similarities and differences between measurement and research reliability and validity were analyzed.

Identification and treatment of the substance-abusing physician has led to outcome studies focusing on years of abstinence and resultant work performance, but little has been written addressing the therapeutic changes recovery brings in the personal lives of these physicians or in their approach to similarly addicted patients. The unique position of recovering psychiatrists engaged in the treatment of substance-abusing patients has not been addressed. Self-disclosure is a major issue and becomes unavoidable if the psychiatrists meet their patients at Twelve-Step meetings. This paper begins a discussion of the issues of self-disclosure and anonymity for recovering psychiatrists. The informal method used to gather information highlights the sensitivity of these issues for both patients and psychiatrists. The clinical examples show the importance of evaluating the psychodynamic impact of self-disclosure on the patient, the psychiatrist, and their treatment relationship. Keywords - self-disclosure; treatment; substance abuse; Alcoholics Anonymous; transference.

Teenagers with sex chromosome abnormalities (SCA) may score lower on intelligence tests while facing more psychological and social problems than their healthy siblings. SCA is a genetic disorder with an extra or missing X or Y chromosome. Researchers compared the results of psychiatric interviews and intelligence testing among 39 SCA teenagers and their healthy 27 siblings (the control group). The participants were between 12 and 19 years old. SCA teenagers scored an average of 21 points below the IQ levels of the control group. Despite more special education efforts during school, less SCA teenagers completed high school. Depression was the most frequent diagnosis among other psychiatric conditions. The 11 girls with a 47,XXX genetic abnormality functioned at low levels of adaptation and had the most psychiatric and behavioral problems. A stable and loving family life was thought to be responsible for the high degree of adaptation among some patients., Objectives. Children with sex chromosome abnormalities (SCA) are known to be at increased risk for neuromotor, language, learning, and behavioral problems, but little is known of psychosocial adaptation of SCA adolescents. This study was conducted to evaluate psychologic characteristics of unselected SCA adolescents, including socialization, educational progress, separation from family, and incidence and severity of psychiatric disturbance. Methods. Thirty-nine propositi identified through the screening of 40 000 consecutive Denver newborns, including boys with 47,XXY karyotypes and girls with 47,XXX, 45,X, and partial X monosomy, or SCA mosaic karyotypes, have been followed longitudinally into adolescence. Twenty-seven siblings served as controls. Between 12 and 19 years of age, all participated in blind psychiatric interviews and were administered standardized intelligence and achievement tests. Results. SCA propositi demonstrated a mean IQ score 21 points lower than that of control subjects. In addition, lower mean scores were seen on achievement test results as well as lower overall psychosocial adaptation scores and increased incidence of psychiatric disturbance. Depression was the most frequent psychiatric diagnosis. Propositi were more likely to receive special education assistance in high school and were less likely to graduate from high school than were controls. Of the three nonmosaic propositi groups, the 47,XXX girls demonstrated the poorest overall psychosocial adaptation and highest degree of psychiatric disturbance. Mosaic girls were indistinguishable from control subjects. Marked variability was found among all three nonmosaic groups, with some individuals in each group demonstrating relatively strong psychosocial adaptation. Conclusions. The presence of nonmosaic sex chromosome abnormality increases the risk for impeded cognitive skills, learning abilities, and psychosocial adaptation in adolescence. The factors that allow for stronger adaptation in some of these adolescents include the presence of a stable and supportive family environment. The outlook for adaptation in unselected SCA adults remains uncertain. Pediatrics 1995; 96:302-308; sex chromosomes, adolescents, psychosocial., ABBREVIATIONS. SCA, sex chromosome abnormalities; GAS, Global Assessment Scale. Sex chromosome abnormalities (SCA) are the result of the addition, deletion, or structural variation of an X or Y chromosome and [...]

Probability and nonprobability are the two major kinds of sampling techniques used for obtaining selected sample from a population. Probability sampling, in which every participant has a known nonzero probability of being selected, consists of four main types; simple random sample, systematic sampling with a random start, stratified random sampling and cluster sampling. In nonprobability sampling, every participant has an unknown chance of being selected. The types of nonprobability sample include quota, purposive and convenience. These types of sampling methods have different effects on the internal and external validity of a research study.

Research is defined as a 'disciplined inquiry' that must be conducted and its results, disseminated, to enable other researchers to thoroughly examine their logical arguments. Aside from increasing knowledge within the discipline, research also functions as a means to increase knowledge within oneself as a professional user of research to be able to assess and evaluate new developments within the discipline. Its dimensions include applied versus theoretical, laboratory versus field, self-report versus researcher observation and quantitative versus qualitative research, applications.

The paper reviews research on the issue of continuities and discontinuities in development, focusing on affective and cognitive-motivational aspects. The theoretical view of Rene Spitz is reviewed. Findings comparing abused/neglected and perinatal risk infant populations with normal infants illustrate differences in both affective and cognitive-motivational development. (Author/DB)

Posttraumatic stress disorder (PTSD) in abused and neglected preschool children often leads to extreme and disabling symptoms that require a highly structured treatment program. Clinical results indicate that clonidine, a presynaptic alpha 2-adrenergic agonist, is effective in reducing symptoms of aggression, hyperarousal and sleep difficulties in children with severe PTSD. However, caution is advised when using psychotropic medications in preschool children.