Hard is Normal: Military Families' Transitions Within the Process of Deployment.

US military deployments have become more frequent and lengthier in duration since 2003. Over half of US military members are married, and many also have children. The authors sought to understand the process of deployment from the perspective of the military family. After a thorough search of the literature, 21 primary research reports of 19 studies with an aggregate sample of 874 were analyzed using qualitative metasynthesis. The deployment process was experienced in four temporal domains. The military family as a whole shared the pre-deployment transition: all family members felt uncertain about the future, needed to complete tasks to "get ready" for deployment, and experienced a sense of distancing in preparation for the upcoming separation. The AD member went through the deployment transition independently, needing to "stay engaged" with the military mission, building a surrogate family and simultaneously trying to maintain connection with the family at home. In parallel, the home front family was going through a transposement transition, moving forward as an altered family unit, taking on new roles and responsibilities, and trying to simultaneously connect with the deployed member and find support from other military families. In post-deployment, the family went through the "reintegration" transition together, managing expectations, and readjusting family roles, all needing understanding and appreciation for their sacrifices during the recent separation. Effective family communication was important for military family well-being after deployment but unexpectedly challenging for many. Clinical, research, and policy recommendations are discussed.

Behavioural changes following routine ENT operations in two-to-ten-year-old children.

Behavioural changes in 85 two-to-ten-year-old children were evaluated by the parents one day, one week and one month after a routine ENT operation. Twenty (23%) children showed no changes. Behavioural problems at least once during the observation time were seen in 52 (61%) and improvements in 28 (33%) children, 15 (17%) had both. There was no statistically significant difference between the children treated as day cases and those hospitalized for one or two nights, or between the girls and the boys. The proportion of children showing behavioural problems decreased from 59% at 1 day to 32% at 1 month after the operation. The highest incidence of problematic changes occurred in children aged 3, 5 years or younger (79%), and the incidence was lowest in the 5.0-6.9-year-olds (43%). The most common changes were an increase in seeking attention from the parents (in 34% of the children), temper tantrums (25%), waking up at nights (16%) and problems in eating (16%).

A pilot study of school-age children of men with moderate to severe alcohol dependence: maternal distress and child outcomes.

This pilot study examined maternal characteristics and children's internalizing and externalizing problems among 53 families (26 alcohol-dependent men, 27 controls) recruited from the general community in a north-east metropolitan area. Comparisons by family type revealed significant differences in maternal depression, social support, life events and children's anxiety, depression and problem behaviors. Factor analysis and hierarchical multiple regression revealed that a maternal distress factor accounted for significant amounts of variance in child outcome variables in addition to that accounted for by fathers' alcohol dependence symptoms. Future studies of school-age children of alcohol-dependent men should routinely sample indices of maternal distress to improve assessments of children's developmental contexts.

Behavioral problems in sons of incarcerated or otherwise absent fathers: the issue of separation.

The decade of the 1980s witnessed more than a doubling in the number of incarcerated individuals. Little is known about the psychological reactions of children whose parents are incarcerated, although a variety of behavioral disorders apparently related to separation, stigma, and deception of the child has been reported. The possibility of aggressive or antisocial behavior emerging in sons of incarcerated fathers has been mentioned as of particular concern in some reports. This article discusses salient themes in the literature on the reactions of children to parental incarceration, with an emphasis on boys' reactions to incarceration of their fathers. It critiques this literature and compares the findings with literature on the effects of separation in father absence related to other causes (for example, divorce, death, military service). Behavioral or emotional disorder associated with paternal incarceration probably is related mainly to associated factors such as the meaning of the incarceration to the child, the remaining caretaker's psychological characteristics and psychopathology, the parenting relationship between the caretaker and the child, and the coping capacities and resources of the family, rather than to the separation itself. Recommendations for further research in this increasingly important field are provided.

The effects of a mother's second pregnancy on the firstborn child.

Mothers in the last trimester of the second pregnancy admit to being less active, more tired and moody than previously. Many were more anxious than usual. Their first child frequently showed behavioural changes. Those surveyed were between 1 1/2 and 4 years of age and showed more clinging, sleep disturbance and misbehaviour with tantrums than expected. It is presumed that the mother's pregnancy induces anxiety in her child with consequent behavioural changes.

[Effect of marked obesity on the emotional status of children]. / Wplyw otylosci znacznego stopnia na stan emocjonalny dziecka.

Fifty children with overweight exceeding 50% of the expected weight were studied for establishing the occurrence of emotional disturbances caused by lack of acceptance by peers. Obese children were found to suffer often from discrimination by their schoolmates which was, in some degree, connected with their low fitness. This may lead to various emotional disturbances requiring even psychotherapeutic measures.

[Psychosocial dwarfism in three siblings]. / Psychosozialer Kleinwuchs bei drei Geschwistern.

Three siblings with deprivation dwarfism are described. Special investigations did not reveal any pathological findings apart from retarded bone age in two children and metaphyseal growth lines. The three siblings demonstrated immediate catch-up growth after removal from the deprivating environment. Problems of etiology, diagnosis and treatment are discussed.

Developmental and psychosocial considerations in pediatric dermatology practice.

The psychologic implications of childhood skin disorders have received too little attention. Viewing these conditions in a broader developmental framework could facilitate practice by improving the doctor-patient relationship, increasing compliance rates, and enhancing professional satisfactions. Several key developmental points and concepts are relevant to pediatric dermatologic practice.

[Psychopathologic structure of reactive depression in young children]. / Psikhopatologicheskaia struktura reaktivnykh depresii u detei rannego vozrasta.

Thirty-four children, aged 1 to 3.5 years, with a reactive depressive state were examined. Using the ontogenetic approach, the authors analyze affective as well as somatovegetative, psychomotor and behavioural disorders in the structure of the abnormal state. The authors have identified stages of disease development, as well as productive and negative dysontogenetic disturbances secondary to protracted reactive depressions in young children.

[Anamnesis in child psychology. Analysis of the technic. Its diagnostic and therapeutic value]. / Anamnesis en psiquiatría infantil. Análisis de la técnica. Su valor diagnóstico y terapéutico.

Author wishes to demonstrate that partially not directed interview based on free association of ideas and memories is one of the indispensable parts of exploration for the gathering of exact data in Infantile Psychiatry. Use of another technique, perhaps more "scientific" paradoxically risks leaving to one side and ignoring closest pathogenesis to the first causes of the illness and with it forfaits the possibility of administering a treatment which may consider the etiology of the disorder. To illustrate this postulate, the author chooses the area of precocious infantile anorexia and examines the gathering of data in successive interviews; why the new data are radically changing the initial etiopathogenic hypothesis which are being elaborated in the course of the interviews and why the selected treatment is being modified in a essential way. This technique not only requires an important time investment but a respectful listening altitude on the part of the consultant as well limiting to a minimum his interventions and transmitting a feeling of security to parents and child which makes possible his free remembrance activity and with it, the emergence of pathogenic emotions. On the other hand therapeutic yield in real terms the efficient psychotherapeutic intervention "mutant" as some authors would say, are highest in these moments: "Iron is best shapable when red-hot".

Possible conservation-withdrawal reaction in two infants.

Two breast-fed infants with weight loss are described. Despite their mothers' assertions that their breast-feeding was adequate, the infants gained weight rapidly on complementary feeding and became more responsive. Previously they had rather passively accepted suboptimal intakes, crying little and sleeping excessively. Discussion centers on whether these infants illustrated the conservation-withdrawal state, since apart from their poor weight gains, they were otherwise well.

Effects of rapid urbanisation on child behaviour and health in a part of Khartoum, Sudan.

A study of child behaviour and health in a newly urbanised part of Khartoum was carried out in 1979-1980 on 245 children aged 3-15 yr. The same area had been investigated in 1965. Results show improvement in somatic health in older children. Behavioural symptoms increased more in boys than in girls, and more in older than in younger children, probably in proportion to the extent of their exposure to new external influences. In general there were still fewer behavioural problems in this population than has been reported from other developing and developed countries. Favourable aspects of community life still operating include extended family relations, durable marital commitments and mutually supportive communal interdependence and traditions of social control.

Child snatching: a new epidemic of an ancient malady.

Eighteen children kidnapped successfully or abortively by a parent were psychiatrically evaluated; 16 were found to have one or more of five functional changes: (1) aftereffects of severe fright or psychic trauma, (2) effects of mental indoctrination, (3) grief or rage about parental abandonment, (4) rejection of the offending parent, and (5) exaggerated identification with a parent or wish fulfillment about a parent. There are serious problems at the law-psychiatry interface regarding stolen children. Both fields must direct their efforts to the prevention of these family tragedies. Psychiatric evaluation is indicated for every child who returns from a child-stealing experience. Pediatricians and child psychiatrists may help the courts to understand the child's point of view by testifying regarding medical findings as well as by interpreting the child's testimony and behavior to the court.