Effect of maternal tolerance on behavioural problems in children with enuresis.

OBJECTIVE: To determine the effect of maternal tolerance on behavioural problems in children with enuresis. METHODS: The cross-sectional descriptive study was conducted from January to November 2018 at the outpatient departments of three hospitals in Lahore and Sialkot district of the Punjab province in Pakistan. The sample comprised of mothers aged 23-50 years having children with enuresis visiting one public-sector tertiary-care hospital and two private-sector secondary-care hospitals. Data was collected using the Tolerance Scale and the Children Behavioural Questionnaire and was analysed using SPSS 21. RESULTS: There were 80 mothers with a mean age of 34.53±4.89 years and as many children with a mean age of 8.16±2.36 years. Maternal intolerance was positively and significantly correlated with rule-breaking (p=0.02) and aggressive behaviour (p=0.01) in children with enuresis. Maternal intolerance was a significant and positive predictor of rule-breaking behaviour (p=0.02), aggressive behaviour (p=0.001) and attention problems (p=0.01) in the affected children. CONCLUSION: Maternal intolerance and hostile attitudes towards children with enuresis was seen to be leading to secondary behavioural and emotional difficulties.

Cognitive behaviour therapy with compulsive hoarding: a single case study.

The current case study used cognitive behaviour treatment (CBT) for the management of a 35-year-old, married man who presented with complaint of compulsive hoarding. The complaint of compulsive hoarding (excessive acquisition, difficulty in discarding saved material and cluttering) was accompanied by feeling of anger, sad mood, low confidence, decreased sleep and appetite, poor problem solving ability, indecisiveness and interpersonal conflicts. The study was approved by the institutional research committee (Departmental Doctoral Programme Committee) and followed by the university research committee (Advance Studies and Review Board) as academic requirement for the duration of 2013-2020. Written consent was also taken from the individual to publish the results of the case. Twenty-eight CBT sessions of one-hour duration were conducted, over a period of six months. Management plan mainly comprised decision-making techniques, cognitive restructuring, behavioural experiments, problem solving and social skills training. The individual was assessed on pre, mid, post and follow up levels. Assessment showed significant decrease in the symptoms. The present case report will help clinicians dealing with individuals with compulsive hoarding and its associated features, effectively with CBT.

Childhood Trauma and Alexithymia in Patients with Conversion Disorder.

OBJECTIVE: To determine the relationship between childhood trauma (physical, sexual, emotional abuse and neglect) and alexithymia in patients with conversion disorder, and to identify it as a predictor of alexithymia in conversion disorder. STUDY DESIGN: An analytical study. PLACE AND DURATION OF STUDY: Multiple public sector hospitals in Lahore, from September 2012 to July 2013. METHODOLOGY: Eighty women with conversion disorder were recruited on the basis of DSM IV-TR diagnostic criteria checklist to screen conversion disorder. Childhood abuse interview to measure childhood trauma and Bermond Vorst Alexithymia Questionnaire, DSM-IV TR Dianostic Criteria Checklist, and Childhood Abuse Interview to assess alexithymia were used, respectively. RESULTS: The mean age of the sample was 18 ±2.2 years. Thirty-six cases had a history of childhood trauma, physical abuse was the most reported trauma (f = 19, 23.8%) in their childhood. Patients with conversion disorder has a significant association with alexithymia (p < 0.05). Multiple regression analysis showed that childhood sexual abuse could predict alexithymia (F= 7.05, p < 0.05). Among the alexithymia domain, childhood physical abuse significantly predicted the difficulty in verbalizing emotions among the abused patients (F= 6.40, p < 0.05). CONCLUSION: The study highlighted childhood abuse and emotional pent up as an etiological factor of conversion disorder. Strategies should be devised to reduce this disorder among women in Pakistani society.

Psychopathology, Psychiatric Symptoms and their Demographic Correlates in Female Adolescents Flood Victims.

OBJECTIVE: To estimate the incidence of psychopathology, frequency of psychiatric symptoms, and their demographic correlates in flood affected female adolescents. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: District Muzaffargarh, Pakistan, from July to October 2011. METHODOLOGY: Female adolescent flood victims, aged 13 - 19 years, were recruited. Screening was done and Diagnostic Questionnaire for Psychiatric Disorders was administered to confirm the diagnosis according to DSM-IV-TR. Demographic information was also obtained regarding nature of personal and financial damages to the participants due to flood. RESULTS: The mean age of 205 participants was 15.78 ±2.13 years. Post-flood diagnoses of Post-Traumatic Stress Disorder (PTSD), Generalized Anxiety Disorder (GAD), and Major Depressive Disorder (MDD) had the highest frequency rates in female adolescents flood victims i.e., 4 (2%), 2 (1%) and 2 (1%), respectively. Psychiatric symptoms of GAD and PTSD were reported most by the screened-out participants; whereas participants who were still living in personal tents and received late arrival of any kind of aid, reported more psychopathology. CONCLUSION: Flood and consequent financial damages may pose a risk factor for development of psychiatric symptoms and psychopathology. Results have implications for the need of improved mental health services for female adolescent flood victims.