[Historical perspectives of child psychiatric research in the tension field between natural and psychological sciences]. / Die historische Perspektive kinderpsychiatrischer Forschung im Spannungsfeld zwischen Natur- und Geisteswissenschaft.

Child and juvenile psychiatry first came to be regarded as an independent clinical field after the second world war. Up to that time, research had been concerned with confirming the findings of adult psychiatry among children and juveniles. From the time of Kraepelin, adult psychiatry had made an effort to establish an immediate relationship between pathological anatomical findings and psychopathology based on close observation of the individual. In contrast to this were efforts to overcome subjectivity by using statistics or by defining "types" (Kretschmer), which led to the concept of syndromes. In the field of child and juvenile psychiatry, this doctrine brought to the fore the study of the consequences of low-level brain damage during early childhood in the 1950's. In research in both adult and child and juveniles psychiatry there is a constant alternation between a more organic and a more psychically oriented approach to observation. But there is a fundamental limit to any effort to objectify psychic phenomena, one that is mirrored in microphysics and related borderline areas. Individual case study and statistical, mathematical methods must be used to supplement one another. One main area for future research in child and juvenile psychiatry relates to the application of the insights of developmental psychology to general psychopathology and how to integrate related fields from the social sciences. Child and juvenile psychiatry cannot be limited to "psychiatry" in the narrower sense of the term, either in clinical practice or in research.

[Intelligence structure of hyperkinetic children: comparative study of 2,229 profiles of the Hamburg Wechsler Intelligence Test for Children]. / Die Intelligenzstruktur hypermotorischer Kinder: Vergleichende Untersuchung an 2229 HAWIK-Profilen.

A retrospective evaluation of the HAWIK (Hamburg-Wechsler Intelligence Test for Children) test profiles of 2229 children with hyperkinetic syndrome and/or minimal brain dysfunction (MBD) was used in a group comparison in order to contribute to the question whether the hyperkinetic syndrome can be regarded as an autonomous syndrome apart from MBD or not. A total collective of 3 groups were compared: a) hyperkinetic children without MBD, b) hyperkinetic children who were found to suffer from MBD, c) children admitted with the diagnosis of MBD with no symptoms of hyperactivity. The mean values and graphics showed differences in the test profiles of groups a) and c). As for the boys, there were clear differences between hyperkinetic boys with MBD, and boys with MBD without hyperactivity; the mean values were significantly lower in this group. The test results confirm the supposition that hyperkinesis does not increase the disabilities ("Leistungsschwäche") caused by MBD but to a certain extent rather affords a certain means of compensation- at least in the test situation. We can also assume that the incidence of minimal brain dysfunction differs in boys and girls.

[Is minimal brain dysfunction really only an empty phrase? A scientific theoretical problem]. / Ist die MCD tatsächlich nur eine Leerformel? Ein wissenschaftstheoretisches Problem.

The book Die minimale cerebrale Dysfunction-Eine Eine Leerformel (Minimal Cerebral Dysfunction-An Empty Phrase) by Esser and Schmidt is critically reviewed, with reference being made to numerous clinical studies that have confirmed the existence of the syndrome minimal cerebral dysfunction (also called frühkindlich exogenes Psychosyndrom in German). The reviewer's fundamental objection is to the "exact-science" methods used in the study: Such methods are inappropriate for confirming or disproving the existence of a psychosyndrome that has grown out of clinical experience. The reduction in the number of items that is dictated by an exact-science approach is diametrically opposed to the overall assessment of the psychopathological picture common in clinical practice. In many areas of psychology and psychiatry, restricting oneself to a study of only those factors that can be counted or measured also places limitations on the amount of information that can be gained.

To the diagnostic of "incomprehensible" offences of adolescents and juveniles.

Diagnostical and forensical problems of "incomprehensible" offences of adolescents and juveniles are discussed, which lack any motive and even a "repressed" conflict is not there to analyse. Here unacceptable parts of the personality are split in the sense of a borderline-structure of personality; the described offenders belong to those people, who are lost for a short time in day dreams and borderline-realities and in this situation are unable to get back to the common reality of their environment. An exact analysis of such cases could change our ideas about the nosology of schizophrenia and give it a development-psychological foundation.

[Development of nosological conceptions of child psychoses]. / Die Entwicklung der nosologischen Vorstellungen über die kindlichen Psychosen.

A study of the historical development of nosological conceptions of schizophrenia of children in parallel with the development of pedopsychiatry shows that these conceptions closely follow the lines of adult psychiatry. The description of psychosis-like conditions such as infantile dementia and autism also did not yet lead to a fundamental change in pathogenetic conceptions. There is then described the heuristic approach to considering schizophrenia of children and schizophrenia-like pictures of childhood as a disturbance of adaptation to reality, the development of which can be due to dispositional factors, minimal cerebral lesions acquired in early childhood, and environmental conditions in the sense of a constellatory genesis.

[Psychoses and borderline cases in puberty and adolescence and their importance in criminal law (author's transl)]. / Psychosen und "Grenzfälle" in Pubertät und Adoleszenz und ihre strafrechtliche Bedeutung.

Juvenile psychoses are on the whole rare, at any rate rarer than psychoses in adults. The former commonly used conception of the disease, hebephrenia, as a pubertal form of schizophrenia has largely lost its significance. The cardinal symptoms are delusions and disordered mental processes in addition to anxiety and states of excitement. The particular importance of this disease lies in the individual experience of this disturbance of the reference environment which is an existential threat to a newly formed personality and its relation to the environment. The difficulty in classifying it among the psychoses on the one hand and as a neurosis on the other has produced a term "borderline" for it, characterized by an infantile incompatibility with positive and negative tendencies in himself and in reference persons and through the lack of a stable reality of reference.

[Can the family continue to guarantee the rights of children?]. / Kann die Familie weiterhin das Recht des Kindes Gewährleisten?

The legal position of children is based essentially on the assumption that the family can always safeguard the child's welfare in confrontations with a third party. Therefore children have not been granted autonomous legal status; their interests are protected by the term "the child's best interest", which although incorporated into law is not defined. In recent years more attention has been paid to the legal status of children, and a certain amount of autonomy has been granted, although not without contest. This tendency is an expression of a change in family structure, which until recently conformed to the ideal of the nineteenth century bourgeois family. Our own limited investigations show, in addition to already well known demographic changes, that in the course of our century young children have become more and more limited in their opportunities to form strong emotional bonds. Only since then has the dual bond of early childhood been recognized as being of primary importance. The family is becoming increasingly inadequate. Children are therefore increasingly endangered by the death or divorce of their parents. As a result it is essential that better legal provision be made to ensure that they are regarded as autonomous individuals.

[Emotional development - what determines it - what disturbs it?]. / Die psychische Entwicklung. Was prägt und was stört sie?

By asking for the determining factors in developmental psychology we exemplify the vicissitudes of scientific perspectives during the past century, in which the factors viewed as primarily responsible (for development) changed several times - depending on the "zeitgeist". In actual fact one must assume a continuous interaction of genetics, externally caused alterations and milieu effects. To this science can only contribute by means of statistical probability, which in a single case would have to be translated into no more than a statement of risks and chances.

[Consultation, pedagogy and therapy]. / Beratung, Pädagogik, Therapie

In child psychiatry the discrepancey between the diagnostic and therapeutic possibilities can often be disappointing, and thus, especially the young people involved demand education in approved psychotherapeutic techniques. This seems to be more important than education in common diagnosis and consultation, but the term psychotherapy is much too restricted and its possibilities not as practical as assumed. On the other hand the importance and possibilities of parental consultation and of orthoeducation is underestimated as an aid in decisions envolving changing the environment. Classical psychotherapy and family therapy have to be restricted to severe child neuroses - mostly for financial reasons - although the knowledge thereof in addition to clinical experience and routine is important. Training in these therapeutic techniques thus can not be the main goal in education in child psychiatry. Experience in diagnosing, consulting and pedagogy make effective aid possible and are available to more children and families.

[Relationships between cerebral organic and reactive disorders in childhood and adolescence]. / Die Beziehungen zwischen hirnorganischen und reaktiven Störungen im Kindes- und Jugendalter

The causes of psychic disorders must not only be discerned either reactive or organic. The perception of stimuli from the environment, the experiences a child makes, are worked up in the brain, which functions can be divided into a lot of singular abilities. The observation of their organic conditioned disorders shows, how behavioral disorders and mislearning may develop and also, how they will be misunderstood and disapproved by the environment. This fact is as well an explanation for the formation of neuroses on the bottom of an organic brain disfunction as also for the origin of psychoses being secundary disturbances of the relation to reality, considered from a new point of view. Both, neuroses and psychoses originate in constellative interaction of brain organic and reactive factors.