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Selected Abstracts from Pediatrics
Selected Abstracts from Pediatrics Pediatricians have a special role in helping depressed mothers and their children.
HIBBARD, R. A., ROGIIMANN, K. & HOEK ELMAN, R. A. (1987) , Genitalia in children's drawings. 79:129-137. Man y sexual abuse victims have been observed to draw genitalia on human figures. To test the hypothesis that sexually abused children draw genitalia on human figures more often than do nonabused children, drawings from 57 children. 3 through 7 years of age, who were referred to child protective services as alleged sexual abuse victims. were compared with drawings from an age-, sex-, race- , and socioeconomically matched group of 55 nonabused children receiving well-child care in medical sett ings. A standardized procedure to obtain drawings was followed by a structured interview to collect demographic, past medical, and developmental information. Five evaluators unaware of the children's backgrounds independently examined drawings for the presence or absence of five body parts; there was 94% agreement for all body parts and 93 % agreement for genitalia. Eight children were excluded from the analysis because the y only scribbled (n = 5) or because evaluators could not agree on whether genitalia were present in their drawings (n = 3). Ten percent (5/52) of the alleged sexual abuse victims and 2% (1/52) of the comparison children drew genitalia (P = .10. one-tailed Fisher exact test) . The estimated relative risk was 5.4; that is. alleged sexual abuse victims were 5.4 times more likely to draw genitalia than were comparison children. Ch ildren known to have been sexually abused were 6.8 times more likely to draw genitalia than were comparison children (P = .07, one-tailed Fisher exact test). It must be cautioned that, although the presence of genitalia in a child's drawing should alert one to consider the possib ility of sexual abuse, it does not prove it, just as the absence of genitalia does not exclude abuse. The drawing ofgenitalia should sensitize providers and influence the effort directed toward exploring the possibil ity of sexual abuse.
REMAFEDI, G . (1987), Adolescent homosexuality: psychosocial and medical implications. 79:331-337. Despite a widespread interest in the health of the gay community. the psychosocial and medical problems of gay and bisexual adolescents have not been adequately investigated. In this study, 29 gay and bisexual male teenagers participated in anonymous and confidential interviews regarding the impact of sexuality on family, employment. education, peers, intimate relationships, and physical and mental health. The majority of subjects experienced school problems related to sexuality, substance abuse, and/or emotional difficulties warranting mental health interventions. In addition, nearly half of the subjects reported a history of sexually transmitted diseases , running away from home, or conflict with the law. A minority had been victims of sexual assaults or involved in prostitution. Those less than 18 years of age experienced higher rates of psychiatric hospitalization, substance abuse, high school drop-out. and conflict with the law than did older participants. Various explanations for the prevalence of these problems and their implications for health professionals are discussed. REMAfEDI, G . (1987), Male homosexuality: the adolescent's perspective. 79:326-330. Although homosexual activity is prevalent among US teenagers, adolescent homosexuality per se has been a poorly understood phenomenon. The purpose of this investigation is to describe the meaning and experience of homosexuality from the adolescent's perspective. Twenty-nine male teenagers, self-described as gay (79 %) or bisexual (21 %), volunteered to participate in a structured interview, the purpose of which was to examine the definition of homosexuality, the acquisition of a gay identity. and the impact of sexuality on family, peers, and community. The youths demonstrated well-established sexual identities by the consistency of their sexual fantasies, interests. and behaviors over time. Homosexuality was more frequently described as a general attraction to men (48 %) and an indicator of positive personal attributes (33 %) than as an isolated sexual behavior. The subjects reported strong negative attitudes from parents (43 %) and friends (41 %) toward their sexualities. Discrimination (37 %), verbal abuse from peers (55 %), and physical assaults (30 %) were frequently cited problems. These stressors may place the boys at high risk for physical and psychosocial dysfunction.
ZUCKERMAN. B. S., BEAROSI.EE, W. R. (1987), Maternal depression: a concern for pediatricians. 79: 110-117. Maternal depression is common in clinical experience but has not been fully addressed in the pediatric literature. Depression can refer to either depressive symptoms or a diagnosable depression. Depression among mothers occurs frequentl y. is persistent, and is related to other factors such as low social class and marital disharmony. Studies demonstrate an association between a mother's depression and adverse outcomes for her child including low birth weight, behavior problems, somatic complaints, poor growth, accidents. and affective illness. Affect and child -rearing characteristics of depressed mothers seem to be important factors in mediating these poor outcomes.
RESEARCH TO PRACTICE IN CHILD PSYCHIATRY A 3-day course for specialists in child and adolescent psychiatry. on developmental perspectives on childhood psychiatric disorders and their relevance for diagnosis and treatment, will be held Sept. 30-0ct. 2, 1987, at the Institute of Psychiatry, University of London, Bethlem Royal Hospital and Maudsley Hospital. Speakers will include: Professor A. D. Cox, Dr. C. Dare, Professor P. J. Graham, Professor R. Nicol, Professor M. L. Rutter, Dr. D. Steinberg, Dr. S. Wolkind, and Professor W. Yule. Registration fee: £ 120, or $220; includes coffee , lunch, and tea. Accommodations are available at a nearby university hall of residence at £ I0.50 per night ($18 .00) including breakfast, or in central London hotels. For further information please contact: Deanna Voos, Institute of Psychiatry. De Crespigny Park. Denmark Hill. London SE5 8AF ; telephone: 0 I 703 5411.
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HIBBARD, R. A., ROGIIMANN, K. & HOEK ELMAN, R. A. (1987) , Genitalia in children's drawings. 79:129-137. Man y sexual abuse victims have been observed to draw genitalia on human figures. To test the hypothesis that sexually abused children draw genitalia on human figures more often than do nonabused children, drawings from 57 children. 3 through 7 years of age, who were referred to child protective services as alleged sexual abuse victims. were compared with drawings from an age-, sex-, race- , and socioeconomically matched group of 55 nonabused children receiving well-child care in medical sett ings. A standardized procedure to obtain drawings was followed by a structured interview to collect demographic, past medical, and developmental information. Five evaluators unaware of the children's backgrounds independently examined drawings for the presence or absence of five body parts; there was 94% agreement for all body parts and 93 % agreement for genitalia. Eight children were excluded from the analysis because the y only scribbled (n = 5) or because evaluators could not agree on whether genitalia were present in their drawings (n = 3). Ten percent (5/52) of the alleged sexual abuse victims and 2% (1/52) of the comparison children drew genitalia (P = .10. one-tailed Fisher exact test) . The estimated relative risk was 5.4; that is. alleged sexual abuse victims were 5.4 times more likely to draw genitalia than were comparison children. Ch ildren known to have been sexually abused were 6.8 times more likely to draw genitalia than were comparison children (P = .07, one-tailed Fisher exact test). It must be cautioned that, although the presence of genitalia in a child's drawing should alert one to consider the possib ility of sexual abuse, it does not prove it, just as the absence of genitalia does not exclude abuse. The drawing ofgenitalia should sensitize providers and influence the effort directed toward exploring the possibil ity of sexual abuse.
REMAFEDI, G . (1987), Adolescent homosexuality: psychosocial and medical implications. 79:331-337. Despite a widespread interest in the health of the gay community. the psychosocial and medical problems of gay and bisexual adolescents have not been adequately investigated. In this study, 29 gay and bisexual male teenagers participated in anonymous and confidential interviews regarding the impact of sexuality on family, employment. education, peers, intimate relationships, and physical and mental health. The majority of subjects experienced school problems related to sexuality, substance abuse, and/or emotional difficulties warranting mental health interventions. In addition, nearly half of the subjects reported a history of sexually transmitted diseases , running away from home, or conflict with the law. A minority had been victims of sexual assaults or involved in prostitution. Those less than 18 years of age experienced higher rates of psychiatric hospitalization, substance abuse, high school drop-out. and conflict with the law than did older participants. Various explanations for the prevalence of these problems and their implications for health professionals are discussed. REMAfEDI, G . (1987), Male homosexuality: the adolescent's perspective. 79:326-330. Although homosexual activity is prevalent among US teenagers, adolescent homosexuality per se has been a poorly understood phenomenon. The purpose of this investigation is to describe the meaning and experience of homosexuality from the adolescent's perspective. Twenty-nine male teenagers, self-described as gay (79 %) or bisexual (21 %), volunteered to participate in a structured interview, the purpose of which was to examine the definition of homosexuality, the acquisition of a gay identity. and the impact of sexuality on family, peers, and community. The youths demonstrated well-established sexual identities by the consistency of their sexual fantasies, interests. and behaviors over time. Homosexuality was more frequently described as a general attraction to men (48 %) and an indicator of positive personal attributes (33 %) than as an isolated sexual behavior. The subjects reported strong negative attitudes from parents (43 %) and friends (41 %) toward their sexualities. Discrimination (37 %), verbal abuse from peers (55 %), and physical assaults (30 %) were frequently cited problems. These stressors may place the boys at high risk for physical and psychosocial dysfunction.
ZUCKERMAN. B. S., BEAROSI.EE, W. R. (1987), Maternal depression: a concern for pediatricians. 79: 110-117. Maternal depression is common in clinical experience but has not been fully addressed in the pediatric literature. Depression can refer to either depressive symptoms or a diagnosable depression. Depression among mothers occurs frequentl y. is persistent, and is related to other factors such as low social class and marital disharmony. Studies demonstrate an association between a mother's depression and adverse outcomes for her child including low birth weight, behavior problems, somatic complaints, poor growth, accidents. and affective illness. Affect and child -rearing characteristics of depressed mothers seem to be important factors in mediating these poor outcomes.
RESEARCH TO PRACTICE IN CHILD PSYCHIATRY A 3-day course for specialists in child and adolescent psychiatry. on developmental perspectives on childhood psychiatric disorders and their relevance for diagnosis and treatment, will be held Sept. 30-0ct. 2, 1987, at the Institute of Psychiatry, University of London, Bethlem Royal Hospital and Maudsley Hospital. Speakers will include: Professor A. D. Cox, Dr. C. Dare, Professor P. J. Graham, Professor R. Nicol, Professor M. L. Rutter, Dr. D. Steinberg, Dr. S. Wolkind, and Professor W. Yule. Registration fee: £ 120, or $220; includes coffee , lunch, and tea. Accommodations are available at a nearby university hall of residence at £ I0.50 per night ($18 .00) including breakfast, or in central London hotels. For further information please contact: Deanna Voos, Institute of Psychiatry. De Crespigny Park. Denmark Hill. London SE5 8AF ; telephone: 0 I 703 5411.
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