Psychopathological differences among three groups of school children affected by the war in Croatia.

The consequences of extreme violence such as war torture affect children in different ways and may immediately manifest at the physical and/or psychologic level, or may remain hidden and unrecognized for years. The victims are usually very reluctant to speak about their traumatic experiences, and try to deny the existence of psychological disturbances. They often seek help for somatic problems. Taking these physical complaints seriously helps to progressively reach the psychological effects of violence. Therefore, identification of such children should be directed to more complete evaluation of their symptomatology and functioning. This can be done by: a) individual evaluation to get enough information on the historical events, functioning and symptoms of these children; and b) standardized instruments which may allow the children to disclose more about their psychological experiences during the war. In this study rating scales and assessment instruments for children aged < 15, such as CPRS with General Scoring Sheet (Fish, 1985), were used to assess the broad spectrum of psychopathology in this age group. These questionnaires were used in a large group of school children (N = 1888), 989 girls and 899 boys aged 7-16 years. The sample was divided into 3 groups: 843 non-displaced, 377 displaced and 669 refugee children. Results of statistical analysis (arithmetical mean and standard deviation of discriminative variables transformed in Z-values with F-ratio) showed the three groups of children (non-displaced, displaced and refugees) to significantly differ in 13 out of 15 psychopathologic clusters. Discriminative cannonic analysis of the 3 groups of children (non displaced, displaced and refugees) also showed significant differences. The first discriminative function (80.24% of total variance) indicated depression, violence and antisocial behavior to be rare in non-displaced children, more pronounced in displaced, and most pronounced in refugee children. The second discriminative function (19.76% of total variance) showed hyperactivity, anxiety and psychosomatic disturbances to be rare in non-displaced children; more frequent in refugee, and most expressed in displaced children. According to the results, the authors concluded that war is very painful for a large group of children, among whom the displaced and refugee children are most affected by psychopathologic disturbances.

Personality traits in school children with epilepsy.

An alternative way of looking at epilepsy has been restricted to the observation of personality characteristics and behavioral cognitive impairments, as these are the most important secondary handicaps. The term "behavioural disorders" is connected with the problem of the development of personality. For this reason, in clinical work a sensitive and standardized psychometric instruments for measuring personality constructs are required. One of the most frequent used instruments in our child neurowork is Eysenck's Personality Inventory (EPI--junior questionnaire), based on Eysenck's theory. In this study, EPI-junior questionnaire was given to a group of 60 boys and girls aged 10-14 years with various forms of epilepsy (single partial seizures--N = 28; complex partial seizures--N = 18; typical absence--N = 8; atypical absence--N = 6. All children were receiving anticonvulsant drugs in doses within or below therapeutic limits. The possible influence of drug administration on personality characteristics of these children was not specifically analyzed for insufficient data in their medical histories. Results of personality characteristics obtained on the EPI junior test of the children with epilepsy were compared to the results of "normal" school children matched by age, sex and social conditions. Its was found (on the "extroversion-introversion" scale) that the children with epilepsy were more introverted than the control group children, which is contrary to the common clinical experience. On the other hand, there were no statistical differences between these two groups in the category of "neuroticism". Finally, the children with epilepsy had significantly higher results on the "lie scale", which indicated greater unreliability of their results obtained on EPI-junior "lie" scale as compared to the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Hypoxic-ischemic brain damage in term neonates--the relation of neurodevelopmental handicap to cranial ultrasound findings.

This study presents ultrasound findings and neurodevelopmental follow-up in ten infants born at term suffering most severe grade of hypoxic-ischemic encephalopathy. Early ultrasound findings showed in nine of these ten neonates signs of cerebral edema accompanied in two children by intraventricular haemorrhage. Late ultrasound findings in all infants examined demonstrated severe cerebral atrophy, predominantly affecting the cortico-subcortical area. In three children multiple subcortical cysts were also present, corresponding to ultrasound findings of subcortical leukomalacia. Cranial computerized tomography was performed in six of the ten children, showing more precisely the predominant site of cortical atrophy, whereas in children with ultrasound findings of subcortical leukomalacia extensive low density areas in the subcortical white matter were present. All children had neurodevelopmental follow-up for between two and seven years. Six of the ten children have multiple disabilities suffering from spastic quadriparesis, epilepsy, mental retardation and/or visual disability. Among these six were all three children with subcortical leukomalacia. All the children demonstrated poor head growth and became markedly microcephalic. We consider ultrasonography to be very useful in the diagnosis of hypoxic-ischemic brain damage in term neonates as well in predicting the neurodevelopmental outcome in asphyxiated term infants.