ABSTRACT
In summary, symptom checklists and rating scales are a cost-effective means of deriving an extensive amount of clinical information in a relatively short period of time. Measures designed to assess affect in children have primarily been self-report inventories owing to the subjective nature of the constructs being assessed. However, subscales for the assessment of anxiety and depression by significant others (parent, teacher, clinician) can be found on more general measures of behavior such as the Conners' Parent and Teacher Rating Scales, the Achenbach Parent and Teacher Forms of the Child Behavior Checklist, and the Brief Psychiatric Rating Scale for Children. In choosing from the array of available measures, emphasis should be placed on an examination of the psychometric properties of the scales. Inventories with demonstrated reliability and validity will provide the clinician with a much more useful profile of a patient's symptoms than will instruments with undocumented or poor psychometric properties. A major concern for all structured interviews is the relative lack of detailed reliability or validity studies. In addition, there are important caveats for such research. A high internal reliability may only demonstrate that one narrow aspect of depression has been measured or a high test-retest reliability may indicate that the interview is measuring a stable trait rather than a current state. Research on the validity and efficiency of the interviews requires careful consideration and consensus regarding acceptable comparison standards. At this time, variants of the "best estimate diagnosis" methodology appear to have gained widest acceptance. In general, there remains much work to be done before the distinct capabilities of the structured interviews are established. It should be noted that in all cases these interviews are evolving instruments and continue to undergo revision and refinement. However, one difference has evolved and may be relevant to the choice of instrument in specific studies. The highly structured interviews, such as the DICA and the DISC, are amenable to epidemiologic screening. They cover a wide range of disorders and have a relatively low threshold for disorder or high sensitivity. In application, these instruments will tend to overdiagnose. It will be necessary to use good clinical judgment in ruling out those disorders that do not apply. In contrast the semistructured interviews, such as the K-SADS and the ISC, have a relatively high diagnostic threshold or relatively high specificity for a few disorders. These instruments are probably best used for the purpose for which they were designed; that is, the selection of depressed and or anxious subjects for research studies.(ABSTRACT TRUNCATED AT 400 WORDS)
Subject(s)
Anxiety Disorders/diagnosis , Depressive Disorder/diagnosis , Personality Tests , Psychiatric Status Rating Scales , Adolescent , Anxiety Disorders/psychology , Child , Depressive Disorder/psychology , Humans , PsychometricsABSTRACT
Sexual victimization of children is a relatively new area of enquiry and initial studies have been directed towards identification and etiology. It is only recently that treatment issues are beginning to be addressed. This paper first reviews the literature on the direct and indirect effects of sexual abuse on the child victim, and outlines five key issues in treatment. The major foci in treatment to date are described and a number of existing models, which have been devised to address these treatment issues, are briefly summarized.
Subject(s)
Adaptation, Psychological , Child Abuse, Sexual/psychology , Child Reactive Disorders/psychology , Affective Symptoms/psychology , Child , Child Behavior Disorders/psychology , Female , Humans , Interpersonal Relations , Psychotherapy/methodsSubject(s)
Anxiety Disorders/diagnosis , Depressive Disorder/diagnosis , Psychological Tests , Adolescent , Child , Female , Hospitals, Psychiatric , Humans , Male , Manuals as Topic , PsychometricsABSTRACT
The present study examined the relationship between anxiety and depression in children in the context of proposed adult models. The results support the qualitative distinction between anxious and depressed patient groups on subsets of rating scale measures and clinical variables. In contrast to anxious children who were younger, (day patients) had been ill for longer than one year, presented with behavioral problems, and were low on observer ratings of depressive symptoms; depressed children were older, (inpatients) had been ill for less than one year, presented with emotional problems and were high on observer ratings of both anxious and depressive symptoms. The finding that the older depressed children were concurrently anxious while the younger anxious children were not concurrently depressed is discussed from the viewpoint of a hypothesized temporal sequence between anxiety and depression. The implication of this and other related findings are discussed in regard to their importance for differential diagnosis and prognosis.
Subject(s)
Anxiety Disorders/diagnosis , Depressive Disorder/diagnosis , Psychiatric Status Rating Scales , Adolescent , Age Factors , Anxiety Disorders/psychology , Brief Psychiatric Rating Scale , Child , Child Behavior , Chronic Disease , Depressive Disorder/psychology , Diagnosis, Differential , Female , Humans , Male , Manifest Anxiety Scale , PrognosisABSTRACT
Recent research in the field of mental retardation has pointed to a better-defined population with exacting prevalence of the basic pathology and related disabilities. Advances in the areas of prevention and treatment have further reduced the prevalence and incidence of mental retardation. Current legislation and legislative procedures have led to a more equitable and fairer application of human rights to all citizens. However, discrepancies and ambiguities still remain with respect to interpretation of the spirit of the law as related to the retarded. Financial restraints and serious economic hardship have impacted on social and political attitudes and created two-tier systems of the rich and poor with the retarded referred to as "surplus population." This situation has, in turn, influenced the availability of resources, manpower, training, and research in this field. The future could be brighter if sociologic and philosophic changes parallel technologic advances. It is our duty and commitment to continue and further the developments in all spheres relevant to the retarded in order to maximize human potential whenever possible.
Subject(s)
Intellectual Disability , Jurisprudence , Adolescent , Canada , Child , Criminal Law , Financing, Government , Human Rights , Humans , Marriage , Social Justice , Sterilization , United StatesSubject(s)
Anxiety Disorders , Depressive Disorder , Antidepressive Agents, Tricyclic/therapeutic use , Anxiety Disorders/complications , Anxiety Disorders/diagnosis , Depressive Disorder/complications , Depressive Disorder/diagnosis , Electroconvulsive Therapy , Female , Humans , Male , Personality , Prognosis , Psychiatric Status Rating ScalesABSTRACT
A 34-year-old woman with symptoms associated with a confirmed ureteral calculus was found to be in atrial fibrillation on arrival at the emergency department. When her symptoms had improved, it was noted that the atrial fibrillation had reverted spontaneously to a sinus rhythm. Subsequent evaluation did not reveal a common etiology of the atrial fibrillation. Transient atrial fibrillation has been associated with many diverse conditions. It has not been previously reported in association with acute ureterolithiasis.
