[Representation of the body through drawing in adolescence]. / Représentation du corps par le dessin à l'adolescence.

In a writing group, in hospital, teenagers' drawings help to evoke the body and its representation, at a time of life when all the changes to the body have an impact on the processes of constructing an identity. It is thereby possible to see how the teenager understands this body which expresses itself inseparably from the imaginary and the symbolic.

School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol.

BACKGROUND: Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely 'Eat Right, Be Positive About Your Body and Live Actively' (EPaL), a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13-14 years old. METHODS/DESIGN: Following quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13-14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity), body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up. DISCUSSION: It is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents. TRIAL REGISTRATION: UMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016, retrospectively registered).

[EATING DISORDERS IN PEDIATRIC AGE: A BOOM PATHOLOGY]. / TRASTORNOS DE LA CONDUCTA ALIMENTARIA EN LA EDAD PEDIÁTRICA: UNA PATOLOGÍA EN AUGE.

AIMS: to determine the characteristics of pediatric patients suffering from eating disorders that were hospitalized at Hospital Universitario de Canarias. MATERIALS AND METHODS: a retrospective study in a cohort of pediatric patients diagnosed with eating disorders and admitted in our area was developed during the last seven years. RESULTS: out of 35 patients in our study, 85.7 % were women, onset average age 13.5. 77.1% of the cases were diagnosed as anorexia nervosa- restrictive type. The most frequent analytical alterations, detected when patients were in hospital, consisted in a drop in plasma levels in retinol binding protein (RBP)- in 57.6% of the cases- and D hypovitaminosis- in 46.9 % of them: the use of high - calories supplements was required in 71.4% of patients during hospitalization. The average weight gain was higher when the body mass index (BMI) was smaller at patient's admission to hospital (p = 0,006). Conclussions: eating disorders are increasing in pediatric age: puberty is a special vulnerable period for its development, as well as medical complications secondary to malnutrition. Admission to hospital is an essential tool for handling many cases; taking the necessary monitoring leading to a weight increase, preventing complications in nutritional support and tackling the underlying psychopathology. Diagnosis and a precocious treatment are crucial to avoid an excessive weight loss and more complications.

Objetivos: determinar las características de los pacientes en edad pediátrica afectados de trastornos de la conducta alimentaria que requirieron ingreso en el Servicio de Pediatría del Complejo Hospitalario Universitario de Canarias (CHUC). Material y método: se realizó un estudio retrospectivo de una cohorte de pacientes pediátricos diagnosticados de trastornos de la conducta alimentaria e ingresados en planta de hospitalización pediátrica durante los últimos siete años. Resultados: de los 35 pacientes de la muestra, un 85,7% fueron mujeres, con una edad media al debut de 13,5 años. En el 77,1% de los casos el diagnóstico principal fue el de anorexia nerviosa de tipo restrictivo. Las alteraciones analíticas más frecuentes detectadas en el momento del ingreso consistieron en descenso de los niveles plasmáticos de proteína fijadora del retinol (RBP), presente en el 57,6% de los casos, e hipovitaminosis D, que en esta muestra estaba presente en el 46,9% de los casos. Se requirió el uso de suplementos hipercalóricos en el 71,4% de los pacientes durante la hospitalización. La ganancia ponderal media durante la estancia fue mayor cuanto menor era el índice de masa corporal (IMC) al ingreso (p = 0,006). Conclusiones: los TCA son enfermedades con incidencia creciente en la edad pediátrica. La pubertad constituye un momento de especial vulnerabilidad para el desarrollo de los TCA (así como de complicaciones médicas secundarias a la desnutrición). En muchos casos el ingreso hospitalario constituye una herramienta necesaria para un correcto manejo, instaurándose las medidas de control necesarias para la recuperación ponderal, la prevención de complicaciones del soporte nutricional y el abordaje de la psicopatología subyacente. El diagnóstico y tratamiento precoz resultan cruciales para evitar una excesiva pérdida ponderal y mayor incidencia de complicaciones.

Developmental investigation of fear-potentiated startle across puberty.

The goal of this study was to examine the association between affective development, puberty, and gender using the startle reflex as a marker of defensive mechanisms. Thirty-one male and thirty-five female adolescents aged ten to thirteen participated in a prospective study with up to five assessments. Longitudinal analyses revealed a significant effect of sex, with girls showing stronger fear-potentiation at all pubertal stages. Post hoc tests revealed that fear-potentiation increased in girls but not boys over the course of puberty. Furthermore, baseline startle decreased over the course of puberty. Because age was included as a covariate in all analyses, the puberty effect cannot be accounted for by age. To the best of our knowledge, this study provides the first evidence for a significant increase in fear-potentiated startle across the pubertal transition. Attribution of these changes to pubertal status rather than age has important implications for our understanding of the neurobiology of anxiety and affect regulation.

Delusional development in child autism at the onset of puberty: vicissitudes of psychic dimensionality between disintegration and development.

Although the psychogenetic hypotheses on child autism have been superseded, psychoanalysis can still reflect on the relational exchange and its sensory aspects in concomitance with the mental development of these patients. Without making generalizations as regards the pathogenesis, but considering the specific features of each autistic child, it may be possible to achieve an integration of those islands of competence that make up these patients' limited personal heritage. Such integration may be reached through the analysis of representational, emotional and relational transformations. The first part of this article describes the case of an autistic child in treatment from the age of four on a four-times-weekly basis who, during puberty, developed severe formal thought disorders together with delusional and hallucinatory formations. The second part develops some post-Jungian theoretical contributions, such as the concept of self as nothingness and the idea of the unsaturated archetype, so as to evaluate the function of some a-priori concepts in support of the analyst's position. These concepts are considered in relation to Bion's model of transformation, and to the formulations on dimensional awareness, especially on the shift from a two-dimensionality to three-dimensionality view, as well as to the rhythm of the object's presence and absence.

Mindfulness for adolescents: a promising approach to supporting emotion regulation and preventing risky behavior.

This article reviews the contextual and neuropsychological challenges of the adolescent period with particular attention to the role that universal prevention can play in moderating the harmful effects of stress. The centrality of emotion regulation skills to long-term health and wellness suggests their importance in prevention and intervention efforts for youth. Mindfulness has been shown to be an effective means of reducing stress and improving emotion balance in research with adults, although research on mindfulness with adolescents is limited. The authors present available data and describe one potentially effective program for adolescent mindfulness: Learning to BREATHE.

Exposure to peer delinquency as a mediator between self-report pubertal timing and delinquency: a longitudinal study of mediation.

This study examined exposure to peer delinquency as a mediator between pubertal timing and self-reported delinquency longitudinally and whether this mediational model was moderated by either gender or maltreatment experience. Data were obtained from Time 1, 2, and 3 of a longitudinal study of maltreatment and development. At Time 1 the sample comprised 454 children aged 9-13 years. Analyses via structural equation modeling supported full mediation. Gender did not moderate this mediational relationship, but maltreatment experience did. The results show that early maturing males and females are both at risk for being exposed to peers that may draw them into delinquent behavior. In addition, the mechanism linking early pubertal timing to delinquency differs depending on maltreatment experience.

Disorders of ovarian function in childhood and adolescence: evolving needs of the growing child. An endocrine perspective.

Over the past 15 years there have been changes in the care of children and adolescents paralleling increased longevity of those with chronic illnesses and increased survival after childhood cancer and organ transplantation. A broad understanding of holistic management and long-term risks is required. Optimisation of pubertal progress and normalisation of bone and hormonal health by the end of puberty will reduce the impact of later adult bone loss in chronic disease conditions. Psychosocial issues related to both precocious and delayed puberty can have profound effects on family function.

Extreme weight change behaviours: are overweight and normal weight adolescents different, and does this vary over time?

This study examined the nature of extreme weight loss behaviours among overweight and normal weight adolescents. Body mass index (BMI), body dissatisfaction, body importance, pubertal timing, negative affect, bulimic symptoms, food supplements and exercise dependence were evaluated at Time 1 and 16 months later at Time 2 among 788 adolescents. There were a large number of differences in the strategies adopted by overweight adolescents, and these remained relatively stable over time. In addition, girls engaged in more bulimic symptoms than boys; particularly overweight girls. Negative affect was also a major predictor of health risk behaviours for overweight adolescent boys and girls. Implications of these findings for the treatment of extreme weight loss behaviours among overweight adolescents are discussed.

TDAH e puberdade / ADHD and puberty

O artigo aborda a síndrome TDAH (Transtorno do Déficit de Atenção com Hiperatividade) e a probalibidade maior de um processo analítico ser bem-sucedido quando o paciente se torna púbere. A análise dos elementos envolvidos nessa síndrome conta com contribuições de Balint e Winnicott

The paper regards the syndrome ADHD (Attention Deficit Hyperactivity Disorder) and a greater probability of a successful analytical process when the patient enters puberty. The analysis of elements involved in this syndrome includes contributions by Balint and Winnicott

Prepuberal obesity (the adiposogenital syndrome): a transitional object pathology.

The adiposogenital syndrome develops during the puberal period starting from a particular family constellation, that is described. The origins of the pathological alteration are found at the first object relationships, where feeding is felt as self-feeding. Food normally plays the role of transitional object in child. In these cases, this role fails and ends by helping separation denial. Fat is laid on the intermediate space as a fetish object, a witness of the omnipotent fantasy of antistic feeding. The child develops a great ability to maintain this balance, making eating a highly pleasant activity. Difficulties encountered during treatment are commented.