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Ranieri F, Loscalzo Y. Social Withdrawal in Preschool Age: A Clinical Case in Intensive Psychoanalytic Psychotherapy. Behav Sci (Basel) 2023; 13:bs13050354. [PMID: 37232591 DOI: 10.3390/bs13050354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/14/2023] [Accepted: 04/21/2023] [Indexed: 05/27/2023] Open
Abstract
In this work, we suggest that children's social withdrawal might be a precursor of Hikikomori, a phenomenon observed among adolescents and young adults. Hence, psychotherapy interventions with preschool children showing signs of social withdrawal might play a critical role in Hikikomori prevention. This paper presents the case of a five-year-old child treated with intensive psychoanalytic psychotherapy who began therapy due to his refusing to go to school and exhibiting isolating behavior from other children. Among other symptoms were regression, emotional tension, nightmares, and nocturnal and diurnal enuresis. Moreover, the relationship in the family was difficult, both between the parents and between the parent and the child. The intensive psychoanalytic treatment involved three weekly sessions for about a year, followed by six months with one weekly session. Besides illustrating the therapeutic process through clinical vignettes taken from the sessions, this paper also provides clues on how early social withdrawal can contribute to the construction of internal personality organizations that lead to social withdrawal up to self-reclusion (or Hikikomori).
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Affiliation(s)
- Fiorenzo Ranieri
- Italian National Health Service, Department of Mental Health, UFSMIA Arezzo, 52100 Arezzo, Italy
| | - Yura Loscalzo
- Department of Health Sciences, School of Psychology, University of Florence, 50135 Florence, Italy
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Peltonen K, Kurki M, Reedtz C, Kaiser S, Rasmussen LMP, Merikukka M, Rye M, Laajasalo T, Kyrrestad H, Karjalainen P, Pettersen SD, Eng H, Breivik K, Martinussen M. Psychological tests for expectant parents and young children in the Nordic countries: A review of the evidence. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2022. [DOI: 10.1080/17405629.2022.2067141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Kirsi Peltonen
- Research Center for Child Psychiatry, University of Turku, Turku, Finland
| | - Marjo Kurki
- Department of Psychology, Itla Children’s Foundation, Helsinki, Finland
| | - Charlotte Reedtz
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sabine Kaiser
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lene-Mari P. Rasmussen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marko Merikukka
- Department of Psychology, Itla Children’s Foundation, Helsinki, Finland
| | - Marte Rye
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Henriette Kyrrestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Piia Karjalainen
- Department of Psychology, Itla Children’s Foundation, Helsinki, Finland
| | - Susann Dahl Pettersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Helene Eng
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kyrre Breivik
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Monica Martinussen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
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Pérez Martínez C, Grollemund B, Gavelle P, Viaux-Savelon S, Guedeney A. The Prevalence of Social Withdrawal in Infants With Cleft Lip and Palate: The Feasibility of the Full and the Modified Versions of the Alarm Distress Baby Scale. Front Pediatr 2022; 10:804802. [PMID: 35874558 PMCID: PMC9301039 DOI: 10.3389/fped.2022.804802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social withdrawal is a risk indicator for infant development with both organic and non-organic causes. Cleft lip and palate (CLP) impose a higher risk of physical and emotional distress in infants and alters parent-infant relationships. The ADBB scale is a screening tool to identify social withdrawal as a sign of distress in infants. The aim of this study is to evaluate the prevalence of social withdrawal behavior in infants with CLP using the full 8-item ADBB scale and the modified 5-item ADBB scale, and to examine the feasibility of both scales. METHODS 145 infants with Cleft Lip and Palate were enrolled and video recorded during a pediatric consultation. All infants were scored by two expert raters trained in ADBB scale, and subsequently scored with the m-ADBB by an independent expert. We measured the interrater agreement for the full ADBB scale and psychometric properties of both scales. RESULTS The full ADBB scale identified 15.9% of infants as having social withdrawal behavior (score above cutoff ≥5). Among the infants evaluated with the m-ADBB scale, 44.9% had a score above the suggested cutoff (≥2). For both scales, the item "vocalization" showed the higher scores. We found a good internal consistency for the full ADBB (Cronbach's alpha = 0.82) and an acceptable internal consistency for the modified ADBB (Cronbach's alpha = 0.71). The interrater agreement for the full ADBB scale was excellent (kappa = 0.837). The Spearman correlation coefficient between the total scores of the two versions was 0.88 (P < 0.001). CONCLUSION Our results indicate a relatively high prevalence of social withdrawal in infants with Cleft Lip and Palate, especially evaluated with the modified 5-item ADBB scale. We found that the full ADBB and the modified ADBB scales are feasible to use as screening tools of social withdrawal in this population. CLINICAL TRIAL REGISTRATION This trial is registered on ClinicalTrials.gov, identifier: NCT00993993. The data is the property of Assistance Publique, Hôpitaux de Paris.
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Affiliation(s)
| | - Bruno Grollemund
- Department of Dental-Facial Orthopedia, Pole of Bucco Dentaries' Medicine and Surgery, Cleft Competence Center, Strasbourg University Hospital, Strasbourg, France
| | - Pascale Gavelle
- Department of Maxillofacial Surgery and Plastic Hôpital Necker Enfants Malades, Paris, France
| | - Sylvie Viaux-Savelon
- Department of Neonatology an Obstetric, University Lyon 1 and University Hospital Croix Rousse, Hospices Civils de Lyon (HCL), Lyon, France
| | - Antoine Guedeney
- Department of Child and Adolescent Psychiatry, Université de Paris and Bichat Claude Bernard Assistance Publique - Hôpitaux de Paris (APHP) Hôpital, Paris, France
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Vaccaro SM, Tofighi D, Moss N, Rieger R, Lowe JR, Phillips J, Erickson SJ. The association of infant temperament and maternal sensitivity in preterm and full-term infants. Infant Ment Health J 2021; 42:374-385. [PMID: 33836096 DOI: 10.1002/imhj.21915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/20/2020] [Accepted: 11/24/2020] [Indexed: 01/30/2023]
Abstract
Infants who experience sensitive caregiving are at lower risk for numerous adverse outcomes. This is especially true for infants born preterm, leading them to be more susceptible to risks associated with poorer quality caregiving. Some research suggests that preterm and full-term infants differ on temperament, which may contribute to these findings. This study aimed to investigate associations between infant temperament (negative emotionality, positive affectivity/surgency, and orienting/regulatory capacity) and maternal sensitivity among infants born preterm (M = 30.2 weeks) and full term. It was hypothesized that mothers of infants born preterm and mothers of infants with more difficult temperaments would display lower sensitivity, indicated by lower responsiveness to nondistress, lower positive regard, and higher intrusiveness. Videotaped play interactions and a measure of temperament (Infant Behavior Questionnaire) were coded for 18 preterm and 44 full-term infants at 9 months (corrected) age. Results suggest that mothers of preterm and full-term infants differed significantly in responding to their infants, but these results cannot be explained by infant temperament. Preterm status and sociodemographic risk emerged as correlates of maternal behavior, such that mothers of infants born preterm and mothers with greater sociodemographic risk displayed lower levels of maternal sensitivity.
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Affiliation(s)
- Suzanne M Vaccaro
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Davood Tofighi
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Natalia Moss
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Rebecca Rieger
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Jean R Lowe
- Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico, USA
| | - John Phillips
- The Mind Research Network, Albuquerque, New Mexico, 87106, USA
| | - Sarah J Erickson
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
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The relationship between parental behavior and infant regulation: A systematic review. DEVELOPMENTAL REVIEW 2020. [DOI: 10.1016/j.dr.2020.100923] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Factors that Predict Infant Temperament: A Jordanian Study. J Pediatr Nurs 2020; 51:e45-e49. [PMID: 31421919 DOI: 10.1016/j.pedn.2019.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/04/2019] [Accepted: 08/04/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE The purpose of the study was to test the association between infant temperament and factors such as socioeconomic status, infant age, breastfeeding, and marital satisfaction. DESIGN AND METHODS A cross-sectional design was used to collect data from 278 Arabic speaking Jordanian women with infants in their first year of life from three health centers in Irbid, Jordan. The temperament of the infant was assessed using the Infant Characteristics Questionnaire (ICQ), a 20-item tool where the mothers were asked to provide a rating of infant behavior on a 5-point scale. Data were analyzed using SPSS 25. RESULTS Descriptive statistics were used to summarize characteristics of the participants. Multiple regressions showed a significant model of factors that correlate to infant temperament (F = 2.930, p = .01); having assistance to care for the infant (B = 3.058, p = .019), marital satisfaction (B = -0.127, p = .049), and infant feeding method (B = 0.147, p = .016) were the only significant predictors for infant temperament. CONCLUSION Marital satisfaction, feeding method, and assistance in caring for the infant are factors that predict infant temperament. Moreover, some aspects of these factors are modifiable. PRACTICE IMPLICATIONS Nurses should be aware of the factors that are associated with infant temperament so that they can teach the family, 'teachers' in daycare centers, and the public about potential moderators of infant temperament.
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Winberg Salomonsson M, Barimani M. MOTHERS’ EXPERIENCES OF MOTHER-INFANT PSYCHOANALYTIC TREATMENT-A QUALITATIVE STUDY. Infant Ment Health J 2017; 38:486-498. [DOI: 10.1002/imhj.21649] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Szymańska A, Dobrenko KA. The ways parents cope with stress in difficult parenting situations: the structural equation modeling approach. PeerJ 2017. [PMID: 28626606 PMCID: PMC5470577 DOI: 10.7717/peerj.3384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
The purpose of this study was to verify a theoretical model of parents’ responses to difficulties they experienced with their child. The model presents relationships between seven variables: (a) discrepancy between parental goal and the child’s current level of development, (b) parental experience of a difficulty, (c) representation of the child in the parent’s mind, (d) parent’s withdrawal from the parenting situation, (e) seeking help, (f) distancing oneself from the situation, and (g) applying pressure on the child. The study involved 319 parents of preschool children: 66 parents of three-year-olds, 85 parents of four-year-olds, 99 parents of five-year-olds and 69 parents of six-year-old children. Structural equations modeling (SEM) was used to verify the compounds described in the theoretical model. The studies revealed that when a parent is experiencing difficulties, the probability increases that the parent will have one of two reactions towards that type of stress: withdrawal from the situation or applying pressure on the child. Experiencing difficulties has no connection with searching for help and is negatively related to distancing oneself from the situation.
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Affiliation(s)
- Agnieszka Szymańska
- Institute of Psychology, Cardinal Stefan Wyszynski University in Warsaw, Poland
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Guedeney A, Forhan A, Larroque B, de Agostini M, Pingault JB, Heude B. Social Withdrawal Behaviour at One Year of Age Is Associated with Delays in Reaching Language Milestones in the EDEN Mother-Child Cohort Study. PLoS One 2016; 11:e0158426. [PMID: 27391482 PMCID: PMC4938506 DOI: 10.1371/journal.pone.0158426] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 06/15/2016] [Indexed: 11/18/2022] Open
Abstract
Objective The aim of the study was to examine the relationship between social withdrawal behaviour at one year and motor and language milestones. Materials and Methods One-year old children from the EDEN French population-based birth cohort study (Study on the pre- and postnatal determinants of the child’s development and prospective health Birth Cohort Study) were included. Social withdrawal at one year was assessed by trained midwives using the Alarm Distress BaBy (ADBB) scale. Midwives concurrently examined infants’ motor and language milestones. Parents reported on child’s psychomotor and language milestones, during the interview with the midwife. Results After adjusting for potential confounding factors, social withdrawal behaviour was significantly associated with concurrent delays in motor and language milestones assessed by the midwife or the parents. Discussion Higher scores on social withdrawal behaviour as assessed with the ADBB were associated with delays in reaching language milestones, and to a lesser extent with lower motor ability scores. Taking the contribution of social withdrawal behaviour into account may help understand the unfolding of developmental difficulties in children.
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Affiliation(s)
- Antoine Guedeney
- Univ Denis Diderot Paris - Cité & INSERM UMRS 1178, 94807, Villejuif, France
- * E-mail:
| | - Anne Forhan
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris Descartes University, Paris, F-75014, France
| | - Beatrice Larroque
- Epidemiology and Clinical Research Unit, Beaujon Hospital, Clichy, 92110, France
- Division of Psychology and Language Sciences, University College London, WC1E6BT, London, United Kingdom
| | - Maria de Agostini
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris Descartes University, Paris, F-75014, France
| | - Jean-Baptiste Pingault
- Division of Psychology and Language Sciences, University College London, WC1E6BT, London, United Kingdom
- King’s College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, WC1E6BT, London, United Kingdom
| | - Barbara Heude
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Paris Descartes University, Paris, F-75014, France
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Bornstein MH, Putnick DL, Gartstein MA, Hahn CS, Auestad N, O'Connor DL. Infant temperament: stability by age, gender, birth order, term status, and socioeconomic status. Child Dev 2015; 86:844-63. [PMID: 25865034 PMCID: PMC4428977 DOI: 10.1111/cdev.12367] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Two complementary studies focused on stability of infant temperament across the 1st year and considered infant age, gender, birth order, term status, and socioeconomic status (SES) as moderators. Study 1 consisted of 73 mothers of firstborn term girls and boys queried at 2, 5, and 13 months of age. Study 2 consisted of 335 mothers of infants of different gender, birth order, term status, and SES queried at 6 and 12 months. Consistent positive and negative affectivity factors emerged at all time points across both studies. Infant temperament proved stable and robust across gender, birth order, term status, and SES. Stability coefficients for temperament factors and scales were medium to large for shorter (< 9 months) interassessment intervals and small to medium for longer (> 10 months) intervals.
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Affiliation(s)
- Marc H Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
| | - Diane L Putnick
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
| | | | - Chun-Shin Hahn
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
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Kielbratowska B, Kazmierczak M, Michalek J, Preis K. Temperament and the mother-infant dyad: associations with breastfeeding and formula feeding with a bottle. Infant Ment Health J 2015; 36:243-50. [PMID: 25973840 DOI: 10.1002/imhj.21508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Breastfeeding supports the formation of an emotional bond between mothers and their children. The feeding method is associated with both the child's temperament and the mother's perception of herself and the child. Therefore, the present study focuses on the feeding method, mothers' reaction during feeding, and infants' temperament traits. Ninety-eight mothers with children aged 3 to 5 months participated in the study. Children were assessed with the Children Development Scale (A. Matczak et al., 2007) to measure their temperament. Mothers completed the Mother and Baby Scale (D. Wolke & I. St James-Roberts, 1987, as cited in T.B. Brazelton & K. Nugent, 1995), which measures mothers' evaluation of their children's behaviors during feeding and their overall experiences with their children's care. The results show that breastfed newborns, as compared to bottle-fed newborns, demonstrate higher vigor, which includes activity and the intensity of reaction. Bottle-fed children demonstrate higher regularity than do breastfed children. Mothers who bottle-feed their children perceive themselves to be less confident in the feeding domain than do mothers who breastfeed. Our results indicate that children's temperament might be an important factor in the decision regarding the feeding method. The study supports the idea of promoting knowledge of children's behaviors during feeding among mothers even before their children are born, such as during antenatal classes.
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