[Are child guidance centers oriented to the middle class? Consequences for psychosocial planning]. / Sind Erzieherungsberatungsstellen mittelschichtorientiert? Konsequenzen für die psychosoziale Planung.

The widespread opinion, that child guidance clinics were adapted to the standards of middle-class families is a prejudice. Investigations during the past 15 years have shown, that the percentage of lower-class families at least reaches the average rate of lower-class families in the west-german population. A lot of confusion concerning this question is due to certain investigations using unprecise methods and not clearly defined references. The tendency, that Child- and Adolescent Psychiatrists (working as an independent service or integrated into a multiprofessional team) are frequented slightly more often by lower-class families than child guidance clinics without doctors, is becoming increasingly evident. This however does not in our opinion justify the foundation of independent child-psychiatric-services in the first front. This would also conflict with the recommendations made by the "Psychiatry-Enquete". Instead it is advisable to integrate appropriately qualified doctors in all child guidances clinics. This kind of teamwork helps to overcome misunderstandings as well as narrow minded views and makes mutual understanding and learning possible, it improves the inevitable essential cooperation and through that ameliorates the quality of the auxiliary-service for the clients. To meet the needs of lower-class clients, we have to search for new ways of thinking and coping in child guidance work and these services should be made known through professional public relation work.

[Attention and distractibility in hyperkinetic children. Methods and results of research]. / Aufmerksamkeit und Ablenkbarkeit bei hyperkinetischen Kindern. Methoden und Forschungsergebnisse.

Sustained attention in children was investigated with a new method in which 4 measures of attention are recorded simultaneously over a period of 30 minutes during a self-paced operant task. A preliminary study with 56 normal children revealed that performance speed and brief lapses in attention have low validity as measures of attention, but errors and especially impulsive reactions have high validity. Impulsive behavior is thus characteristic not only for hyperactive children but also for normal children with attentional problems in everyday situations. The subjects in the main investigation were 12 hyperactive boys aged 8 to 11 years old. Hyperactivity had to be the major complaint, with the diagnosis substantiated by a pediatrician's findings and by a high motor-activity score in a teacher's assessment. Twelve normal boys matched for age, IQ and grade in school served as control subjects. All children attended regular schools and were of normal intelligence. The validity of the selection procedure was confirmed by the significantly lower heart rate found in the hyperactive group. Attention was assessed for 30 minutes under quiet and distraction conditions. The groups differed significantly in number of errors and number of impulsive reactions, but only in the absence of distraction. The stress of sustained attention for 30 minutes did not increase the differences; on the contrary, they decreased. A special type of attentional deficit in hyperactive children could not be confirmed. Our results do not support the hypothesis that hyperactive children are more distractible, have more frequent brief lapses in attention or have a poorer ability to sustain attention than normal children. Rather, they suggest that the attentional deficits represent a personality trait.

Behavioral effects of carbamazepine after single and repeated administration in emotionally labile subjects.

The sample investigated consisted of two groups of emotionally labile healthy male subjects who were given either 100 mg/day of the antiepileptic drug carbamazepine (n = 16) or placebo (n = 16) for 8 days. Subjects were selected on the basis of their scores in the neuroticism scale of the Freiburg Personality Inventory (FPI-A: N score greater than or equal to 6). By means of an extensive test battery (ratings of emotional state, emotional reactivity tests, performance tests, physiological parameters) at day 1 and day 8 of ingestion the psychotropic effects of carbamazepine were evaluated as well as the differences in effects after single and repeated administration. Behavioral effects could be demonstrated for carbamazepine after single administration, but the differences found were rather small and limited to four parameters. After several days of administration carbamazepine revealed clear effects on psychological parameters. It is concluded that a drug like carbamazepine needs more than a single administration to be effective in psychological tests, in contrast to tranquilizing, sedating, neuroleptic and stimulating drugs. Carbamazepine has this characteristic common with antidepressant drugs. The experiment demonstrated that carbamazepine is a drug which under the chosen dose level conditions has a positive influence on subjective emotional states, e.g. reduction of deactivation and emotional tension (anxiousness).