Object relations and referential activity in physically abused adolescents.

This study compared the object relations and language functions of 15 physically abused and 15 nonabused adolescents. The adolescents provided a 5-minute narrative about their mothers, which was scored for referential activity and object relations. As predicted, the abused adolescents tended to have lower levels of affect tone, indicating more malevolent relationship paradigms. Contrary to what was predicted, however, there were no significant differences between groups on overall measures of referential activity and object relations. Further, the abused adolescents tended to have higher levels of two elements of referential activity (concreteness, imagery), indicating increased verbal ability to express emotional experience. While predicted correlations were found between object relations and referential activity for the nonabused group, the abused group showed higher symbolizing and verbalizing capacity, associated with more malevolent representations of relationships. The findings do not support the view that physically abused adolescents experience developmental lags, instead suggesting that they organize and use emotional and symbolizing processes differently from nonabused adolescents. The implications for treatment are discussed.

Mental health care in a high school based health service.

This paper describes the mental health services provided at a high school based health center that integrates mental health and medical services. Five years after the inception of the center in 1988, mental health visits had quadrupled. In 1992 alone, students made 1,002 mental health visits. Strikingly, one-third of these students reported problematic substance use among other family members. Other leading reasons for utilizing mental health services included pregnancy (19%), past or present suicidal ideation (14%), obesity (8.7%), ongoing depression (8%), and issues related to sexuality (7.5%).