Prevalence and correlates of mental and neurodevelopmental symptoms and disorders among deaf children and adolescents: a systematic review protocol.

INTRODUCTION: Little is known of the prevalence and correlates of mental and neurodevelopmental symptoms and disorders among deaf children and adolescents. Research suggests that this is a vulnerable population group at high risk of these disorders. However, little is known of correlates of prevalence estimates of these mental disorders and it seems that heterogeneous tools have been used to derive these estimates. Given the heterogeneity of studies measuring the prevalence and correlates of mental and neurodevelopmental symptoms and disorders among deaf children and adolescents, we seek to systematically examine and synthesise observational epidemiological evidence in this area to articulate a more detailed account of these symptoms and disorders and their correlates among this population group. METHODS AND ANALYSIS: We will conduct a systematic search of the following electronic databases to identify published observational epidemiological studies examining the prevalence and correlates of mental and neurodevelopmental symptoms and disorders among deaf children and adolescents: EBSCOhost, ERIC, PsycARTICLES, PsycINFO, PubMED, ScienceDirect, SCOPUS and Web of Science. As research in this area is limited, eight databases have been included to widen our search to include as many articles as possible. The search terms will be related to mental and neurodevelopmental symptoms and disorders as well as deaf children and adolescents. Two reviewers will review and extract data from each article independently and, where relevant, discuss differences to reach consensus. Additionally, the reviewers will assess overall study quality and risk of bias using a quality appraisal scale. Findings from studies will be synthesised to produce a quantitative review that summarises existing evidence on mental and neurodevelopmental symptoms and disorders among deaf children and adolescents and their correlates. The publication date of studies will not be restricted so that as much data as possible that fit our inclusion criteria can be sourced. We will conduct our searches between August 2020 and March 2021. ETHICS AND DISSEMINATION: This systematic review will use publicly available data and therefore does not require a direct ethical review. The protocol was however submitted for ethics waiver clearance with Stellenbosch University Health Research Ethics Committee. The protocol will be disseminated in a peer-reviewed journal. The review protocol was registered with the PROSPERO International Prospective Register of systematic reviews (http://www.crd.york.ac.uk/PROSPERO). PROSPERO REGISTRATION NUMBER: CRD42020189403.

The reliability of clinical, history-based attachment classifications: an exploratory study.

Objective: Mental health professionals frequently classify children's attachment style using a combination of the parent/caregiver interview, an interview with the child, the interviewer's clinical impressions, and at times, the child's responses to projective tests not aimed at eliciting attachment specific information. However, no studies have been conducted on the validity or reliability of attachment classifications based on developmental histories. This study aimed to investigate the accuracy of history-based attachment classifications. Method: Attachment classifications based on intake interviews, administered to 35 eight to twelve-year- old children and their caregivers attending an outpatient mental clinic service in a government hospital in Johannesburg, were compared to classifications obtained through the Attachment Story Completion Test (ASCT). The level of agreement between rates and across assessment measures was analysed. Results: The association between ASCT and history-based attachment classifications was poor. Conclusion: The possible misclassification of children's attachment styles according to histories has implications for both diagnosis and treatment.

Working with a child's envy in the transference.

In literature, envy has long been written of as one of the seven cardinal sins. In biblical mythology, envy as a consequence of vanity can be understood to be the reason for archangel Lucifer's fall from a state of heavenly grace and unionship. Freud was the first psychoanalytic theorist to introduce the idea of envy, albeit through his controversial concept of penis envy. Karl Abrahams and Melanie Klein later placed envy at the crucial developing stages of the relationship between primary caregiver and infant. Klein boldly identified envy as a primary constitutional emotion. However, the presence and difficulties of envy in clinical work remain largely underreported, more so in work with children. This paper asks whether an attachment base can be secure if envy is dominant. The analysis of a nine-year-old girl ('Kirsten') and her envious transference with her therapist will be examined, to explore the relationship between envy and attachment security. While contemporary research focuses on developing attachment theory in relation to specific psychiatric conditions, this paper will discuss affect as the binding link or disruptive force between self and object representations, that then determine attachment security.