Adolescent Attachment: A Social Relations Perspective on Family Relations.

While attachment at an early age is almost exclusively determined by parental behavior, variation in the quality of attachment in adolescence seems strong to be influenced by the complex interplay between the adolescent's internal working model and its environment. To unravel the different sources of variance in adolescent attachment relationships we applied the Social Relations Model. Two parents and two adolescents from 70 relatively well-functioning families reported on their attachment relationships within a family context. In this study, attachment was conceptualized by two different dimensions of attachment, namely anxiety (for being abandoned) and avoidance (of intimacy). Our findings suggest adolescents experience little attachment anxiety throughout adolescence, but they report significantly more attachment avoidance toward their parents. The variance in the quality of adolescents' attachment relationships was mainly determined by characteristics of the adolescent and the unique adjustments they make to the attachment figure.

Si bien el apego en los primeros años de vida está casi exclusivamente determinado por la conducta de los padres, la variación de la calidad del apego en la adolescencia parece significativamente influenciada por la interacción compleja entre el modelo de funcionamiento interno del adolescente y su entorno. Para descifrar las diferentes fuentes de varianza en las relaciones de apego de los adolescentes, aplicamos el modelo de relaciones sociales. Dos padres y dos adolescentes de 70 familias con un funcionamiento relativamente bueno informaron sobre sus relaciones de apego dentro de un contexto familiar. En este estudio, el apego se conceptualizó mediante dos aspectos diferentes del apego, por ejemplo, la ansiedad (por ser abandonado) y la evitación (de la intimidad). Nuestros resultados sugieren que los adolescentes sufren poca ansiedad por el apego durante la adolescencia, pero informan una evitación del apego más significativa hacia sus padres. La varianza en la calidad de las relaciones de apego de los adolescentes estuvo determinada principalmente por las características del adolescente y por las adaptaciones únicas que hace a la figura de apego.

I won't obey!: Psychologically Controlling Parenting and (Non)-Clinical Adolescents' Responses to Rule-setting.

OBJECTIVES: This study examined associations between maternal psychologically controlling parenting and adolescents' responses to rule-setting as well as the link between both study variables and adolescents' internalizing and externalizing problems. METHOD: Both clinical and nonclinical adolescents reported upon maternal psychological control, responses to rule-setting (i.e., oppositional defiance, submissive compliance, negotiation, and accommodation) and both adolescents and mothers reported upon adolescents' problems. RESULTS: Perceived psychological control related positively to adolescents' oppositional defiance and submissive compliance and negatively to negotiation and accommodation. Further, an integrated path model indicated that psychological control related to externalizing problems via oppositional defiance and internalizing problems via submissive compliance. CONCLUSIONS: Psychological control relates to different types of problem behaviors via diverse responses to maternal rule-setting. The discussion emphasizes the importance of future prevention and intervention programs to focus on both parenting and on adolescents' active contribution to their socialization process.

Experience, Knowledge, and Attitudes of Child and Adolescent Psychiatrists in Belgium Toward Pediatric Electroconvulsive Therapy.

OBJECTIVE: The purpose of the present study was to ascertain the experience, knowledge, and attitudes of child and adolescent psychiatrists toward the use of ECT (electroconvulsive therapy) in children and adolescents in Belgium. METHODS: A questionnaire was mailed to all the members of the Flemish and Walloon Association of Child and Adolescent Psychiatrists. RESULTS: Thirty-five percent (n = 151) of the psychiatrists responded to the questionnaire. Sixty-seven percent (n = 101) rated their knowledge about ECT in children and adolescents as nil or negligible. Only one percent (n = 2) estimated their knowledge to be advanced. Fifteen percent (n = 22) were aware of a minor treated with ECT. Ten (n = 16) and thirty-one percent (n = 47) believed that ECT is a safe treatment for children and adolescents, respectively. Only six percent (n = 10) would recommend ECT for a major psychiatric disorder in a child, whereas thirty-eight percent (n = 58) for an adolescent. Fifty-three percent (n = 71) regarded ECT as a treatment of last resort. A significant correlation was identified between knowledge and attitudes toward the use of ECT in minors. Respondents with some or advanced knowledge perceived ECT as a safer and a more effective treatment option than those with negligible knowledge. Most (91%, n = 138) of the child and adolescent psychiatrists are enthusiastic to learn more about the use of ECT in minors. CONCLUSIONS: Flemish and Walloon child and adolescents psychiatrists have very little experience with using ECT in minors. They self-estimated their knowledge as negligible but are keen to learn more about this treatment option. The lack of knowledge likely explains the rare use of ECT in Belgium for children and adolescents with serious psychiatric disorders.

Atypical psychiatric presentation of relapsing anti-N-methyl-D-aspartate receptor encephalitis in childhood.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune encephalitis caused by antibodies (Ab) against the GluN1 subunit of the NMDAR. The disease typically presents with a combination of psychiatric and neurological symptoms. Presentation solely with psychiatric symptoms is rare, especially in childhood. After treatment substantial recovery with mild or no residual symptoms is seen in most cases in both children and adults. Relapse occurs in 10%-25% of patients, with recurrent episodes presenting less severe than initial presentation in most cases. We herein describe a child with a pure psychiatric presentation of anti-NMDAR encephalitis. Diagnosis and treatment was delayed because of the atypical presentation. The child relapsed several times and severe residual psychiatric symptoms persisted after recovery. This case illuminates the need to consider the diagnosis of anti-NMDAR encephalitis in both adults and children with an atypical psychiatric presentation. It also demonstrates the need for a multidisciplinary approach and brings attention to the possible severe impact of the disease on long-term psychosocial functioning.