Parent-reported behavioural and emotional problems in Albanian Kosovar children.

AIMS: Because no epidemiological study has been conducted of children's mental health problems in Kosova, which experienced a traumatic war in 1998-99, we conducted the first national epidemiological survey of children's mental health ever undertaken in Kosova. METHODS: Participants were 1374 Kosovar children ages 6-18 recruited through schools (60% from urban areas). Parent-reported behavioural and emotional problems were assessed using the Child Behaviour Checklist (CBCL/6-18). Kosovar findings were compared with findings from five other Central and Eastern European societies (Poland, Romania, Lithuania, Serbia and Croatia), plus the US. RESULTS: Confirmatory factor analysis (CFA) indicated that the CBCL 8-syndrome model manifested good fit to the Kosovar data. Mean item ratings and Cronbach's alphas were very similar to those of the other six societies. Kosova's mean Total Problems score fell in the middle of the range of the seven societies compared. CBCL scores were higher for adolescents (12-18), urban children, and those whose parents had limited education compared with younger (6-11), rural, and more socially advantaged children. CONCLUSIONS: Strong consistency was found between Kosovar findings and those for neighbouring countries with respect to CFA results, mean item ratings, alphas and problem score levels. Results of this epidemiological survey highlight the utility of the CBCL for identifying Kosovar Albanian children with mental health service needs.

Self-image, war psychotrauma and refugee status in adolescents.

The aim of this study was to assess how war psychotrauma, refugee status and other factors relate to self-image. Psychotherapeutic-psychiatric interview, the Offer Self-Image Questionnaire (OSIQ), questionnaires for measuring war stressors, posttraumatic stress reactions (PTS-reactions), depression and general data were administered. A total of 322 adolescents from Bosnia-Herzegovina and Croatia were included in the study. In 60.32% of the examinees, more than four war stressors were encountered. In 13.68% of the examinees, high PTS-reactions occurred. The refugees had nearly four times higher odds (aOR=3.66; 95% CI=1.63-8.2; p<0.01) of having a higher Offer score for the sexual attitudes subscale. Lower war stress had 0.28 times lower odds (aOR=0.28; 95% CI=0.11-0.71; p<0.01) of having a higher Offer score for the sexual attitudes subscale. More severe PTS-reactions had six times higher odds (aOR=6.15; 95% CI=1.7-22.2; p<0.01) of reaching a higher Offer score for the emotional tone subscale. War psychotrauma and refugee status are related to poorer adjustment only in some of the OSIQ subscales. Practical measures of joined sexually preventive/therapeutic activities are proposed, as well as educational and preventive/therapeutic psychotrauma models.

Competence and behavioral/emotional problems in Croatian children--parents' and teachers' reports: pilot study.

Achenbach's Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) were administered to school children aged between 7-11 comprising a non-referred sample (n = 349) drawn from the whole country. Those were the first data on the CBCL and TRF in Croatia. Both in the CBCL and TRF boys had higher scores compared to girls in the Externalizing and Total Problems scale (p < 0.01 and p < 0.05). Parents rated higher scores to the Internalizing and Externalizing scales and the Total Problems scale in both sexes (p < 0.01 and p < 0.05), with the exception of the Internalizing scale in boys. Parents are very important observers of mental health problems in children.

[The Croatian Society for Infant, Child and Adolescent Psychiatry: present state and proposals for improving the development of child and adolescent psychiatric services in Croatia]. / Hrvatska udruga za dojenacku, djecju i adolescentnu psihijatriju: sadasnje stanje i prijedlog za unapredenje razvoja sluzbe djecje i adolescentne psihijatrije u Republici Hrvatskoj.

The paper presents the current state of child and adolescent psychiatry in the Republic of Croatia. Thirty-seven psychiatrists practicing child and adolescent psychiatry in the entire Republic point to the lack of staff in this subspecialty profession. The subspecialty was approved by the Ministry of Health in 1994. The city of Zagreb satisfies the criteria of some European countries as regards the number of staff, but not as regards the organization of the service for child and adolescent psychiatry (e.g. lack of university hospital department as the base for medical teaching and further specialist training). In other and larger centers in the Republic the situation is well below the criteria achieved in this profession, particularly in the countries of the European Union and the USA. Still, psychiatric services in some towns tend to support the development of child and adolescent psychiatry in their environment by providing facilities and staff. There are still attempts, even in the health service itself, to overcome this lack of personnel and organization by transferring numerous cases from the domain of child and adolescent psychiatry to experts in other medical specialties or non-medical professionals, instead of improving the development of child and adolescent psychiatry. In some countries of the European Union and the USA it has already reached the monospecialty status, a tendency supported by the UEMS, which also makes efforts to coordinate programs of specialist training in the European countries. The described situation certainly has consequences in the of mental health care of children, adolescents and their families, because their treatment often begins only when a disorder has visibly developed. Its clinical manifestations can take very different forms.

Adolescent development and external influences.

There are two different approaches to the definition of "normal" in adolescence: psychoanalytic interpretation and empirical research. They are not necessarily at odds but can complement each other if normalcy is viewed as a dependent variable. Its definition depends also on cultural rules, social values and expectancies, professional orientations, personality traits and political climate, which all determine the tolerance level for aberrance. The adolescent development including biological, cognitive and psychosocial changes is related to the existing social formations and processes. It is affected by family, peer groups, neighborhood, work and wider community. The paper describes the adolescent development in particular social contexts.

The adolescents assessment of family functioning.

The aim of this study was to find out in what way adolescents assess their families and family functioning. An 34-item scale in self-report format was administered to 154 high school students and 34 patients in diagnostic procedure before entering psychotherapy in order to explore basic elements of family functioning (structure, affect, communication; behaviour control, ethic values transmission, intimacy and idealization, and elements of family dysfunction). The results showed that adolescents in general assessed their families as growth and individuation supportive. The adolescents in the clinical sample presented more dissatisfaction with their families and elements of family dysfunctions were more emphasized.