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Paternal age, paternal presence and children’s health: An observational study
No full textIn an observational study of 31,257 children we investigated the effects of paternal age at the time of the child’s birth, paternal absence and non-biological fathers on children’s health. Results are per 5 year change in paternal age. Older fathers were associated with lower rates of unintentional injuries, odds ratio (OR)=0.966, P=0.0027. There was a quadratic association between paternal age and risk of hospital admission, β=0.0121, P=0.0109, with minimum risk at paternal age 37.7. Absent fathers were associated with increased risk of hospital admission, OR=1.19, P=0.697, P<10-3 (5 year olds). Non-biological fathers were associated with increased risk of unintentional injury, OR=1.16, P=0.0319 and hospital admission, OR=1.26, P=0.0166; lower rates of complete immunizations to 9 months, OR=0.343, P=0.0309 and higher SDQ difficulties scores: β=0.908, P<10-3
Psychopathology: Anxiety, depression and schizophrenia
No full textDuring later childhood, adolescence and adulthood a variety of mental health problems can emerge. This chapter will focus on these particular disorders. How the disorders are defined and expressed along with empirical treatments will be reviewe
An exploration of the Body Image Scale in young people: A comparison of persons with features of gender dysphoria and control samples
No full textBody image is seen as a central component to those who identify as transgender, that is, a feeling of incongruence between bodily features and assigned gender. Previous research has suggested high rates of body dissatisfaction within adolescent general population samples. Therefore, it is critical that clinicians are able to identify and disentangle distress related to gender and the body, from that of general body dissatisfaction. Furthermore, adolescent transgender persons are an understudied group in the psychological literature and many studies looking at body image in this population have been conducted using small sample sizes. The Body Image Scale (BIS) is used in gender services (GS) around the world and consists of 30 body features that the person is asked to rate in terms of satisfaction with those parts on a 5-point scale. However, there are no studies currently published where the scale has been normed in control samples within young persons populations. This is an important clinical issue as the BIS is used as part of the assessment process in GS‟s. This quantitative study is an exploration of the similarities and/or differences in body-part satisfaction in a control sample (n = 262) and in those referred to the UK Gender Identity Development Service (n= 403) using the BIS. The BIS compares primary, secondary and neutral bodily characteristics as well as differences between the sexes and ages of participants between and within the two populations. Results showed persons with gender dysphoria were significantly more dissatisfied with their bodies than the control group. In addition, this dissatisfaction increased with age during pubertal development, particularly in the clinical group. In the clinical group, natal (biological) males were more dissatisfied with their primary and neutral sexual characteristics, where as in the control group natal females were more dissatisfied than males across all sexual characteristics. Implications for research, service provision and clinical psychology practice are discussed
The complex world of hide and seek : Investigations into the use and meaning of hide and seek play and how it is related to processes of change within a looked after boy engaged in psychoanalytic psychotherapy
No full textThe aim of this study has been to investigate the significance of hide and seek play as a central feature within the intensive psychoanalytic psychotherapy of one looked after child, whose referred symptom of separation anxiety improved during the course of treatment. A mixed methods modified form of thematic analysis has been used to analyse the data and Max QDA has been introduced for data organisational purposes and to support analytic rigour. This single case study is approached from a Critical Realist stance and key findings support the argument for the validity of extending the relationship between the theoretical paradigms of Complexity Theory and Psychoanalysis,beyond the metaphorical towards the methodological with implications for efficiency, triangulation and generalisability of findings; issues which have been historically problematic in single case study research. The mixed methods analytic approach has allowed for the quantitative tracking of frequency and quality of a single marker of change, in the form of hide and seek play, across the course of the treatment. This has revealed an overall pattern in the form of a trajectory, containing properties of a self-organising complex dynamic system. Two levels of abstraction have been identified and investigated demonstrating the presence of sel-similar functioning across different levels of complexity. A ‘period of oscillation’ between variables has been identified which is associated qualitatively to a period of psychological growth and development within the child. This finding is consistent with emerging evidence in the broader field of psychology for the occurrence of a period of critical instability associated with positive treatment outcome. A key qualitative finding is the evidence for the four different sub-types of hide and seek play. This may have implications for the understanding of hide and seek play in every day life and significantly in the lives of looked after children
Constructing personal and couple narratives in late stage cancer: A narrative analysis
No full textAn increasing number of people with terminal cancer are being cared for at home, often by their partner. This study explores the identity, experiences and relationships of people caring for their partner at the end of life and how they construct their experience through personal and couple narratives. It draws upon dialogical approaches to narrative analysis to focus on caring partners and the care relationship. Six participants were recruited for the study. Two methods of data collection are used: narrative interviews and journals. Following individual case analysis, two methods of cross-narrative analysis are used: an analysis of narrative themes and an identification of narrative types.
The key findings can be summarised as follows. First, in the period since their partner's terminal prognosis, participants sustained and reconstructed self and couple relationship narratives. These narratives aided the construction of meaning and coherence at a time of major biographical disruption: the anticipated loss of a partner. Second, the study highlights the complexity of spoken and unspoken narratives in terminal cancer and how these relate to individual and couple identities. Third, a typology of archetypal narratives based upon the data is identified. The blow-by-blow narratives illustrate how participants sought to construct coherence and meaning in the illness story, while champion and resilience narratives demonstrate how participants utilised positive self and relational narratives to manage a time of biographical disruption. The study highlights how this narrative approach can enhance understanding of the experiences and identities of people caring for a terminally ill partner
Brief report: Autistic features in children and adolescents with gender dysphoria
No full textThis paper looks at the association between gender dysphoria (GD), scores on the Social Responsiveness Scale (SRS), and reported diagnoses of autism spectrum disorder (ASD). Parents of 166 young people presenting with GD (Mean age = 14.26, SD = 2.68) completed the SRS. Information concerning an ASD diagnosis was also extracted from the patient files. 45.8 % fell within the normal range on the SRS and of those 2.8 % had an ASD diagnosis. 27.1 % fell within the mild/moderate range and of those 15.6 % had an ASD diagnosis and 6.7 % an ASD query. 27.1 % fell within the severe range and of those 24.4 % had an ASD diagnosis and 26.7 % an ASD query. No difference was found in autistic features between the natal females and male
Psychotherapy with people who smell
No full textThis paper stems from psychotherapy work with patients who ‘neglect personal hygiene’ in homelessness and chronic mental health settings, and consultancy to staff groups tasked with patients’ ‘social inclusion’. Psychoanalytic theory has largely eschewed exploring internal psychic states communicated by odour and, equally, the meaning of marked societal hostility towards malodorous individuals. The paper looks at historical and anthropological notions of ‘dirt’ and the construction of the ‘unwashed’ as a social category in the formation of bourgeois society. Psychoanalytic ideas of unconscious bodily and psychic communication are described. Case examples explore how troubled relations between body and mind result from early abuse/neglect, where the internal world is suffocated by trauma and ‘dread’ which cannot be contained and processed. From a psychosocial perspective, taking up a role as ‘unacceptable’ is the paradoxical condition of belonging for many members of the social whole. The paper suggests that invasive smell confronts us with our repressed knowledge of that which is ‘rotten’ in the emotional and sociopolitical environment in which ‘the unwashed’ exist. An example from organisational consultancy traces profound disturbance in institutional dynamics that occurs when the malodorous individual seeks to claim shared social resources. The author questions the prevalent view that ‘being smelly’ is an attempt to withdraw from social and psychic contact, rather than a meaningful communication which is within the scope of psychoanalytic thought to understand
