Adolescent Psychiatry - Volume 7, Issue 1, 2017

Objective: As all the chronic diseases, thalassemia is physically and psychologically demanding for both the child and family. Previous studies reported that children with thalassemia had a higher risk of psychopathology. The aim of the present study was to investigate the prevalence of psychopathology in adolescents with β-thalassemia and the family functioning in their families. Methods: The study group consisted of 24 adolescents (aged 12-18) with β-thalassemia and one of their parents (mother or father). A control group of 20 adolescents matched for gender and age and one of their parents were randomly chosen from the schools of the hospital environment, and screened by a short face-to-face interview to exclude any medical illness or previous application to child psychiatry clinics. All children and parents were invited to the clinic and interviewed by a child psychiatrist then. Psychopathology in adolescents was assessed with Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, a semi-structured schedule for assessing psychopathology in children and adolescents. All adolescents and their parents also completed McMaster Family Assessment device (FAD), a self-report scale to assess family functioning in various domains. Results: The life-long prevalence of psychiatric disorders was found to be significantly higher in the patient group compared to the control group consistent with the literature, and anxiety disorders were found to be almost 2 times higher (70%) than the previous studies, indicating an increase in anxiety rates in this population. Statistical analysis of the FAD showed that the patient group had significantly higher subscores in nearly all areas, indicative of problems in family functioning, compared to the control group. The mean educational level of parents was significantly lower in the patient group, and families with poorly-educated fathers were at a higher risk of having a second thalassemic child. Conclusion: These results point to the importance of psychosocial support in chronic conditions, especially in thalassemia and to the value of multi-systemic interventions, which target not only child's medical condition but also the possible psychopathology of child and the functioning of the family

The purpose of this study was to examine gender and racial/ethnic differences in anxiety during adolescence. Objective: Differences in both symptomatology and clinical levels of anxiety were examined. Method: Surveys were administered in schools to a diverse sample of 1,000 15-17 year-old U.S. adolescents during the Spring of 2007 and the Spring of 2008. Results: When symptomatology scores were assessed, girls had higher levels of generalized anxiety, social anxiety, separation anxiety, panic disorder, and school avoidance than boys. Girls also were significantly more likely to meet the clinical cutoff for all of the anxiety disorders than boys. Racial/ethnic differences in anxiety symptomatology scores were not found. However, when clinical cutoffs were examined, Hispanic adolescents were significantly more likely to meet the clinical cutoff for social anxiety disorder and separation anxiety disorder in comparison to Caucasian adolescents and African American adolescents. Conclusion: Findings from this study underscore the need to consider both gender and race/ethnicity when examining anxiety during adolescence.

Background: While a large body of literature has investigated peer victimization among adolescents, as it relates to depression and suicidal ideation, relatively little is known about peer victimization as a risk factor for posttraumatic stress disorder (PTSD). Even less is known about the long-term effect that peer victimization has on adolescents. Methods: This manuscript presents the results of a systematic review exploring the association between peer victimization during adolescence and the risk for PTSD. The literature review synthesizes all relevant studies found on this topic and summarizes the findings. Results: The findings suggest a potential association between peer victimization and PTSD, highlighting the need for further research. As such, the topic warrants further evaluation and study from researchers, educators, and clinicians. The findings also emphasize the need to screen victimized adolescents for symptoms of PTSD, given its potential detrimental effects. Conclusion: Identifying and assessing particular vulnerabilities in victimized adolescents may prevent PTSD and other mental disorders. Directions for future research are proposed.

Background: Dyslexia, a heterogeneous syndrome, is the most recognized Developmental Reading Disorder (DRD) with 5-17% prevalence and poses as a significant disability. Its core deficits are: Phonological deficits, poor visual attention span, selective deficits in complex serial visual search tasks, sustained visual attention problems, visuospatial functioning and difficult image reproduction from memory. Much remains to be accomplished clinically to address these deficits. Methods: Mindfulness Based Rehabilitation of Reading, Attention & Memory (MBR-RAM©) is a translational mindfulness based cognitive behavioral therapy developed by the first author. MBR-RAM uses focused attention enhancement visual meditation techniques (Sanskrit: trataka) in therapist-assisted and home-practice formats to rehabilitate reading deficits, visual inattention, visual motor incoordination, information processing speed and visual memory. Visual motor incoordination indicates inability to control hand movements guided by the visual cues while reading letters. Three Caucasian subjects in this study included an 8-year-old girl and two boys aged 9 and 10 years. The objectives were to study the changes pre- and post-intervention with respect to their scores on the various clinical and neuropsychological measures. Results: Compared to the baseline, all three subjects showed clinical and statistically significant improvements in the outcome measures, which were sustained for at least 6 months after study completion. There were no adverse effects in them. Conclusion: Results of this pilot study indicate that MBR-RAM© is a feasible, low cost treatment, which is effective for rehabilitating some important deficits of dyslexia. The results need replication in future studies with better methodology to make definite conclusions.

Non-Suicidal Self-Injury is a troubling phenomenon commonly encountered by clinicians working with adolescents and young adults. Professionals and laypersons alike struggle to understand the reasons individuals engage in this behavior and there is a paucity of information regarding the development and maintenance of the behavior. Although the Williams (2010) model is helpful in understanding NSSI, there has been no assessment tool available to date that evaluates where an individual falls within the purported stages. We have developed an assessment tool for Non-Suicidal Self-Injury based on a two-factor model of assessment of NSSI. The first factor is based upon Williams's (2010) categorical stage model of the extent of NSSI development. The second factor is based on Prochaska, DiClemente & Norcross's (1992) model of Readiness for Change. These factors have import for clinical decision making, treatment planning and determination of appropriate level of care. A version of the NSSI Assessment Tool is currently being used in a residential school setting with children between the ages of 11 to 19 years. Results from the NSSI Assessment Tool can be utilized to guide treatment and tailor interventions based upon the client's stage of NSSI and Readiness for Change. Initial clinical use has suggested repeated administrations of the NSSI Assessment Tool have been useful in monitoring client progress in treatment.