| Adolescent Psychiatry
ISSN: 2210-6766
Adolescent Psychiatry
Volume 1, Number 1, January 2011
Contents
In Memoriam
Remembering Michael Kalogerakis (1927–2010) Pp. 1-2
Lois T. Flaherty
Michael Kalogerakis, Greek Reminiscences Pp. 3
Nikos Zilikis
Editorial
Adolescent Psychiatry—Past, Present, and Future Pp. 4-5
Lois T. Flaherty
Special Article
Treatment Outcome of Three Female Adolescents with Borderline Personality Disorder Pp. 6-19
Max Sugar and Irving H. Berkovitz
[Abstract] [Full
text article]
Borderline Personality Disorder in Adolescents Pp. 20-22
Lois T. Flaherty
Perspectives
The Shame Ethic in Adolescent Psychotherapy Pp. 23-27
John E. Meeks
[Abstract] [Full
text article]
Keeping it Real: Overcoming Resistance in Adolescent Males Mandated into Treatment Pp. 28-34
James G. Barrett and Nancy Rappaport
[Abstract] [Full
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“When Can I See You Again?”: The Immigration Experience, Insecure Attachment and Psychotherapy Pp. 35-45
Anjana Rajan and Nancy Rappaport
[Abstract] [Full
text article]
A Psychiatric Perspective on Narratives of Self-Reflection in Resilient Adolescents Pp. 46-54
Ayelet R. Barkai and Nancy Rappaport
[Abstract] [Full
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Reviews and Overviews
A Selective Review of the Research on Juvenile Bipolar Disorder: Implications for Struggling Clinicians Pp. 55-60
Jennifer Harris
[Abstract] [Full
text article]
Conflict of Interest as a Possible Factor in the Rise of Pediatric Bipolar Disorder Pp. 61-66
Edmund C. Levin and Peter I. Parry
Cyber Cruelty: Understanding and Preventing the New Bullying Pp. 67-71
Ruth Gerson and Nancy Rappaport
[Abstract]
[Full
text article]
Identity and Acculturation in Immigrant and Second Generation Adolescents Pp. 72-81
Eugenio M. Rothe, Andres J. Pumariega and Diana Sabagh
[Abstract] [Full
text article]
Albert Ellis’ Rational-Emotive Behavior Therapy Pp. 82-87
Richard Rosner
[Abstract] [Full
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Research Article
Effects of Self-Image on Identity Status Among Turkish Adolescents Pp. 88-93
Füsun Çuhadaroglu Çetin and Halime Tuna Ulay
[Abstract] [Full
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Abstracts
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Treatment Outcome of Three Female Adolescents with Borderline Personality Disorder
Max Sugar and Irving H. Berkovitz
This paper presents a follow-up of the psychoanalytic psychotherapy of three female adolescents who met DSM III criteria for borderline personality disorder (BPD). A questionnaire was offered to them 15-30 years after their initial psychotherapeutic contact in an effort to assess the effects of the psychotherapy and their current status. Although all patients came from a White, privileged background, they had very chaotic, disturbed families with absent parent(s), sexual and physical abuse, and few supportive adults during their teenage years. The findings were that all of them had 1) completed the developmental tasks of adolescence; 2) met requirements for being in remission; and 3) had fulfilling, successful adult lives, despite not being entirely free of psychopathology. While not discounting the fact that other influences in their ecosystems were also helpful, we conclude that psychoanalytic psychotherapy with adolescents with borderline personality disorder may be very beneficial.
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The Shame Ethic in Adolescent Psychotherapy
John E. Meeks
The shame-ethic, which emphasizes courage, disregard of personal safety and maintenance of one's social image, probably goes back to early human history. It tends to arise in social systems that view themselves as under attack and that lean toward combative, aggressive or even militaristic solutions. Cultures operating with this ethic place great importance on appearing strong and invincible; losing face and being shamed are to be avoided at all costs. In our era, the “Code of the Streets” is a modern version of this ethic, to which many inner city teenagers subscribe. This code values self-protection, self-aggrandizement, and the capacity to dominate others. It is fragile and must be continually maintained by actions that demean and victimize others. The behavior that characterizes many adolescents who come into treatment settings can be understood in terms of the shame ethnic. Treatment approaches for these young people need to take this dynamic into account and frame interventions in ways that support self esteem while suggesting pro-social behavioral alternatives. This article discusses ways that therapists can be effective with adolescents who subscribe to the shame ethic.
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Keeping it Real: Overcoming Resistance in Adolescent Males Mandated into Treatment
James G. Barrett and Nancy Rappaport
Teenage boys who are mandated into mental health treatment through either probation or juvenile diversion are often reluctant to engage in treatment. These young men typically adhere to both rigid masculine gender norms and the code of the street, both of which discourage men to talk about their feelings or display any sign of vulnerability. However, if these young men fail to connect to supports they are at-risk for school dropout, incarceration and possibly significant injury or death. This article identifies barriers to engaging in treatment for systems-involved adolescent males as well as practical techniques for clinicians to help facilitate buy-in to treatment by reframing the treatment process for this population.
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“When Can I See You Again?”: The Immigration Experience, Insecure Attachment and Psychotherapy
Anjana Rajan and Nancy Rappaport
Adolescent immigrants need to navigate typical adolescent challenges while also struggling with the impact of immigration. Mastering the developmental tasks of adolescence is even more daunting for those teenagers who have underlying psychopathology. Intensive psychotherapy with these troubled teens provides a rich opportunity to better understand their struggles and to examine how best to provide necessary support for them. In this paper we explore how the task of engaging adolescents and their families warrants an approach that provides a space that is both flexible and responsive, addressing the underlying loss and behavior secondary to insecure or disorganized attachments. A case study of an immigrant teen in long-term treatment at a school-based health center (SBHC) highlights the importance of utilizing an attachment based model when intervening with this rewarding and highly vulnerable population. The case example illustrates the long term, therapeutic work which is reflective of the complicated patients in our caseloads, and also illuminates how the attachment framework shapes the therapeutic work. The advantages of the SBHC for utilizing this model are discussed.
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A Psychiatric Perspective on Narratives of Self-Reflection in Resilient Adolescents
Ayelet R. Barkai and Nancy Rappaport
Self-reflection is a developmental competence that fully emerges in adolescence. In this paper, self-reflection development is explored from the perspectives of developmental psychology, resilience studies, and developmental psychopathology as a way to deepen clinicians’ understanding of the clinical relevance of self-reflection development. Literature on narrative identity formation in normative adolescence is reviewed, and research on self-reflection in narratives of high-risk adolescents participating in a 30+ year ongoing longitudinal study of adolescent developmental psychology and psychopathology is presented. A theoretical synthesis is proposed to account for the relations between self-reflection, competence and resilient outcome.
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A Selective Review of the Research on Juvenile Bipolar Disorder: Implications for Struggling Clinicians
Jennifer Harris
The diagnosis of juvenile bipolar disorder (JBD) has been the subject of much controversy and confusion. There have been well documented increases in the application of this diagnosis, at least in the United States. This has led to concerns about overdiagnosis. At the same time, juvenile bipolar disorder presenting in adolescents can be difficult to detect, with symptoms being perceived as normal, if exaggerated, adolescent behavior. Two cases, one mistakenly diagnosed as JBD and the other in which the diagnosis was missed, illustrate the difficulty in making an accurate diagnosis. Recent refinements in diagnosis have the potential to clarify and improve clinical diagnosis and treatment. The three main diagnostic approaches to JBD (the so-called “narrow phenotype” approach, the “cardinal symptoms” and brief frequent cycles approach, and finally the persistent, impairing irritability approach) are reviewed. The author then reviews the longitudinal data examining continuity between juvenile and adult bipolar disorder. Returning to the cases, the author reviews her treatment decisions, and how they could have been improved with better diagnostic precision. Finally, some thoughts are shared about why the diagnosis of JBD has become both so much more frequent and controversial, and what practicing clinicians should focus on.
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Cyber Cruelty: Understanding and Preventing the New Bullying
Ruth Gerson and Nancy Rappaport
As adolescents increasingly adopt cell phones, smart phones, and the Internet as tools for communication and social networking, they can become victims of the growing trend of cyberbullying – targeted harm inflicted through such technology. These forms of technology are often strange and unfamiliar to parents, teachers, and medical and mental health providers. This review article provides an introduction to cyberbullying, tools for screening, and opportunities for prevention
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Identity and Acculturation in Immigrant and Second Generation Adolescents
Eugenio M. Rothe, Andres J. Pumariega and Diana Sabagh
The experience of immigration presents developmental challenges to adolescents that can lead to negative mental health outcomes, or can result in resiliency, psychological growth and enrichment of the personality structure. This article reviews the most recent demographics and research findings of the first and second generation immigrant adolescents in the United States. It explains the psychodynamic processes of migration and acculturation, and the risk factors and protective factors that affect these adolescents. Finally, it offers some suggestions regarding treatment approaches with this population.
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Albert Ellis’ Rational-Emotive Behavior Therapy
Richard Rosner
Rational emotive behavioral therapy (REBT) is a form of cognitive behavioral therapy developed by Albert Ellis. Developed in the 1950s, REBT was one of the earliest forms of what became known as cognitive behavioral therapy. It was successfully adapted for children and adolescents in the 1980s (Barnard & Joyce, 1984) and has been studied extensively and shown to be effective in this population (Gonzales, Nelson, & Gutkin, 2004). This article provides a selective review of the literature, and brief overview of REBT, and discusses its advantages and disadvantages.
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Effects of Self-Image on Identity Status Among Turkish Adolescents
Füsun Çuhadaroglu Çetin and Halime Tuna Ulay
The concepts of identity and self-image are realms of two different theories, but both are frequently used and are very helpful in understanding adolescents. The present study explores the relation of the self-image with identity status among 364 Turkish adolescents of varied socioeconomic status. The results show that adolescents from low socioeconomic status have more negative self-images on all measures and those from upper socioeconomic status are differentiated from those of middle and lower SES by having a more positive sense of identity. The main effects of sense of identity are seen in the emotional tone, body-image, social relations, family relations, and vocational-educational goals aspects of self-image.
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