Using drawing tests to explore the multidimensional psychological aspects of children with cancer.

In seeking to understand how life-threatening illness affects children psychologically, projective testing may be beneficial, particularly when attempting to identify psychological problems in younger adolescents. The advantages of projective testing are that it does not depend on patients' verbal ability and is not invasive. Three cancer inpatients from Kyoto Prefectural University of Medicine, aged between 10 and 16 years old, participated in the study. Projective testing was used to measure the depth of participants' distress and included a tree-drawing test, a person-drawing test and a free drawing test. Results from the tree- and person-drawing tests indicated energy loss, anxiety and a sense of emptiness. However, results from the free drawing test suggested that the children had hope and a desire to recover from their illness. The combination of drawing tests in this study may increase the understanding of the internal psychological difficulties faced by children hospitalized with cancer.

Factors associated with postpartum depression and abusive behavior in mothers with infants.

AIMS: This study was conducted to examine factors associated with postpartum depression and abusive behavior in mothers with infants. METHODS: Data were collected from baby check-ups in Japan and 413 participants were included in an analysis using: (i) an Original Questionnaire; (ii) the Zung Self-rating Depression Scale (ZSDS); (iii) the Parental Bonding Instrument; and (iv) the Childcare Anxiety Scale (CAS). Covariance structural analyses were performed to examine interconnections among the Parental Bonding Instrument subscales, CAS subscales ('worry about parenting', 'burden of nursing time', 'difficulty of bonding'), ZSDS, 'fear of being abusive', and 'abusive behavior'. RESULTS: Of the 413 mothers, 14.5% showed higher than moderate levels of depression (ZSDS > or = 50). In covariance structural analyses, 'depression' was strongly influenced by 'worry about parenting' in all variances, but was not associated with 'abusive behavior'. 'Worry about parenting' also had a strong influence on 'fear of being abusive', but did not affect 'abusive behavior'. Low 'maternal care' had most influence on 'difficulty of bonding', and 'difficulty of bonding' only affected 'abusive behavior'. CONCLUSIONS: The outcome of this study suggests that excessive worrying related to postpartum depression, 'fear of being abusive', and bonding difficulty are primary predictors of child abuse. Postpartum depression was not a predictor for abusive behavior after exclusion of the impact of bonding difficulties on abusive behavior. Therefore, the correlation between postpartum depression and abusive behavior identified in previous reports may have been influenced by bonding difficulties.