Child Psychiatry

Introduction Child Psychiatry: Psychiatric disorders in children present are different from those of adults, since they arise in complex and intimate family relationships, and are influenced by the stage of child development. Children also present particular challenges for evaluation and treatment.
Psychiatric disorders present in childhood or adolescence are listed in Table

1. Pervasive developmental disorders hyperkinetic disorders specific development of neurological disorders emotional behavior of the psychiatric aspects of the elimination of child maltreatment Table 1 Classification of psychiatric disorders of childhood and early adolescence the development of some characteristics of normal normal development the child is presented in Table

2. It is essential to take into account the stage of development of the stage of the child for a psychiatric evaluation, which is accepted as normal in one stage to another will be abnormal. Early childhood experiences play an important role in determining what type of people we are as adults.
The role of parents is crucial in this. The child with the parents (or parent) who are loving and tolerant, however, able to establish and implement clear and reasonable limits likely to develop high self-esteem and a secure attachment to parents who provide a secure attachment model of others in later life. The theory of “attachment” was first described by John Bowlby in the 1950s. It stems from his study of young children separated from their mothers in the hospital. attachment behavior begins about 7 months and is clinging and unwillingness to separate from the primary caregiver, usually the mother. Serves to strengthen the bond between mother and son and has a role in the evolution of the protection of children against predators. A child is secured in position to use the mother as a secure base from which to explore the outside world can begin, and will also be able to react well to short-term separations. If the attachment is poor because the father does not meet the needs of children for care or detention, or is inconsistent, the child will be challenged to explore and separation.

This pattern of insecure attachment may persist throughout life, affecting adult relationships. Assessment of Children How psychiatric history is taken and that the child is considered dependent on age, confidence and language skills of children. Much of the story comes from parents and children who are willing to leave their parents can be seen alone. It is generally preferable to see only adolescents and their parents before establishing a relationship of trust with them. The interview should take place in a relaxed and friendly, with toys and drawing materials provided for children under 10 years. The history should include the following: Submission of complaints reported by the parent and child. It is important to take the child to ask about the complaint in a smooth, after winning their trust and talking about neutral topics. the recent behavior or emotional difficulties, including general health, mood, sleep, appetite, elimination, relationships, antisocial behavior, life and fantasy games and behavior at school. Personal history, pregnancy, birth, milestones (motor, speech, feeding, sphincter control, social behavior), medical history, separation of parents, schools attended and progress on them.

Family structure and function of construction of a genogram is often helpful. The relationships between family members should be asked about, and interactions observed during the interview. roads temperature features such as activity level, regularity of the functions (sleep, intestines, eating), the ability to adapt to new circumstances, the willingness to approach people or new situations, the quality and intensity mood, quality of relationships within and outside the family, care and persistence can be seen from a very early age. A mental status examination of the child must be completed, although often based on behavior and watch them play. The following should be considered: the future looks for any abnormalities, bruises, cuts or scratches and the appropriateness of dress. performance level of activity, interactions with parents, motor function, attention and task persistence. Tell articulation, vocabulary and language use. resentful mood happy, happy, sad, depressed, anxious, hostile. Thoughts and speech content of the fantasy life, for example by asking the three magical wishes. The evaluation should be supplemented by physical examination and talking with informants involved with the child or the family as the family doctor, teacher, school psychologist, or social services. An investigation may be made, intelligence tests and tests more frequently in the university, such as standardized tests of reading. Pervasive developmental disorder (autism) Autism is a serious disorder that begins early and out the third anniversary. It is characterized by a lack of social relationships, language development and poor resistance to change and restricted and repetitive behaviors and interests. These children do not take into account or respond to the emotions of others or of social cues. They do not adapt their behavior appropriately to new environments, and are very limited in their game, they rarely participate in “pretend play. In general, soft toys to choose not unusual and can bind to a particular object and refuse to separated from it. Some have very limited language skills, and abilities that are present are not used in social conversation with others.
Three-quarters have a serious mental disability. Autism has a prevalence of 4 to 10,000 and is three times more common in boys than in girls. It is associated with brain damage, in some cases, genetic factors appear to play an important role in the etiology. There is no specific treatment available. Families need a lot of support issues and advice and behaviors can be managed with behavioral therapy. The result is generally low, with only 15% never get an independent operation. 0-1 rapid development of motor totally dependent – on foot through a year of seven months attachment behavior for about 1-2 years begins to dry daily tantrums and separation anxiety 2-5 years to develop complex language skills departure identification of sexual identity with parents at the beginning of the formation of the consciences of living life Fantasy is considered the center of his world of 5-10 years of identity as a girl or boy able to separate and the mother’s personality attributes acquired by the end of this period of adolescence persist into adulthood puberty – 11 to 13 years in girls and 13-17 for males ADJUSTMENT personal identity of the autonomy of parents to learn to work and develop the skills necessary to become self-supporting peer relationships is very important group development Table 2 Normal small specific developmental disorders of these disorders, specific skills such as reading, spelling, knowledge of arithmetic and language interrupted.
The problems are present from early childhood. To make a diagnosis of pervasive developmental disorder Specific, acquired brain injury or disease must be excluded and that the child must have a reasonable opportunity to acquire these skills at home or at school. The causes of specific developmental disorders are not known with certainty but is believed to come of abnormal cognitive processes. All of them are much more common in boys than in girls. specific reading disorder is particularly common with a prevalence of 5-10%. The most common problems include reading distortions or additions of words or parts of words, slow reading rate and the loss of space in the project. Although the specific reading disorder is not due to insufficient enrollment, absenteeism is a common consequence of difficulties in school. disorders of conduct and specific disorders reading often co-exist. hyperkinetic disorder in the United States this is called deficit hyperactivity disorder (ADHD). The main features of the disease are hyperactivity, restlessness, attention, distractibility and impulsive behavior. These children are often clumsy , accident prone and have trouble with their parents and teachers, because they act without thinking. Other children are often avoided and may become socially isolated. The symptoms usually occur at an early age but is more frequently diagnosed in June -9 years in which there is a prevalence of about 8%. It is three times more common in boys than in girls. Several causes have been proposed, with genetic factors and parental allergies.

This is one of very few children psychiatric disorders treated with medications. stimulates amphetamines are used, such as methylphenidate, which has the paradoxical effect of reducing levels of activity and improvement of care. This translates into improvements in academic performance and development of friendship. “behavioral therapy, using a system of rewards for good behavior, it is also useful for these children. hyperactivity disorder tends to improve with age, the fourth only to the persistent problems in adolescence. Around half of them still have some features of the disorder in adulthood, which is often expressed as a behavior conduct. Conduct of the main features of the disorder conduct disorder are persistent antisocial behavior such as anti-bullying , severe temper tantrums, property damage from fire, theft, truancy, and persistent disobedience and rebellion. The child’s age must be taken into account, and the malice standard should not be regarded as a sign of conduct disorder. A third cases have a specific reading disorder, and there is considerable overlap with hyperactivity. The behavior problems are common, present in at least 4% of children with a peak between 12-16 years of age, and are three times more common in boys than in girls. There are two types of behavior disorders: behavior socialized. These children are able to make friends who usually work also behave antisocial. The bad behavior is usually more evident outside the home. Relations with adults can be good, but often there are difficulties with authority figures.
Unsocialised conduct disorder. These children have no friends, either because they were rejected by their peers, either because they deliberately choose to be isolated. Antisocial behavior occurs only. A certain degree of emotional disorder is often also present in these children. The causes of behavior disorders are a complex interaction between the biological structure of the child, family influences and environmental factors such as summersied Figure 1. The style of parenting is considered important. conduct disorders are likely to develop if parents do not set clear limits, control and manage development ineffective or inconsistent discipline. Improved parenting skills is likely to improve performance, including if other etiological factors are present. Other treatment approaches include family therapy, behavioral therapy, remedial courses and other activities to provide peer groups. The results are better for the group socialized. Two-thirds of the students unsocialised persistent conduct behavior in adulthood. The children’s emotional mood disorders are characterized by anxiety and depression. They are present in 2-3% of children and in particular for children are the most common psychiatric disorders in girls. generally have a good prognosis. separation anxiety disorder, it is normal for toddlers and preschoolers to feel some anxiety about actual or threatened separation from their parents. In anxiety disorder Separation anxiety is particularly severe or occurs in older children, and causes some problems in social functioning, as preventing children from attending school. Symptoms include persistent concerns about the separation of the attachment figure (usually the mother) and great distress if compelled to do so. Some refuse to go to sleep without his mother and nightmares about separation. parental overprotection is often present and other causes include child temperament and stressful events, especially those involving separation, such as family breakdown, loss or anxiety disorders of childhood diseases specific animal phobias, black or foreigners are normal in young children and rarely require treatment. GAD can occur and that the frequency of somatic symptoms charactersied, abdominal pain in particular. Family influences martial discord parents absent fathers violence, alcoholism, personality disorder of the brain conduct genetic parents of poor children, low IQ of temperament factors affecting the environment school care group social influences peer disciplinary code Figure 1 Performance of withdrawal symptoms, conduct disorder etiology of depressive illness with depressive illness are very similar in children than in adults – low-power mode, anhedonia, sleep and appetite changed and depressive thoughts . Fleeting suicidal thoughts are fairly common, but the suicide is rare. Moderate and severe depressive illness are rare in prepubertal children, with a steady increase in the impact on adolescents. The causes of depression and its treatment are similar to adults, although young children seem to be less sensitive to antidepressants than adults, the methods of psychological treatment that is preferred. school refusal the refusal of the child refuses to go to school because of specific concerns about school, the journey of the same or separation anxiety. This represents approximately 1% of all absences from school, and is much less frequent truancy in which the child hides his absence from school and their parents . The characteristics of children with school refusal are compared with those steers used in Table 1. Denial of the school must be addressed by returning the child to school as soon as possible that avoidance is likely to increase anxiety . a reintroduction of the quality necessary, with the support of the child and parents. Child abuse Child abuse can take the form of neglect, psychological abuse, physical or sexual abuse. It plays a role in the development of disorders psychiatric children may continue into adulthood. It is essential that all professionals who come into contact with children are aware of the possibility of abuse play a role in the problems posed by a child and his family. Table 3 Comparison characteristics of children with absences and truancy, school refusal the refusal of Absence Absence school known parents of the parents of the school day is hidden home alone or with parents may be days away from home with their pairs with the highest incidence at 11 years Increased fear of school age or separation anxiety disorders emotional n all social groups have increased in lower social classes No increase in discord parents dysfunctional marriage incidence parental overprotection severe parental abuse is difficult to measure than the majority of cases go unreported, and a definition of what constitutes abuse varies. The official figures of reported cases of abuse have increased in recent years, although this may be due to increased reporting rather than a real increase in abuse. A British study found that 12% of women and 8% of men have some form of sexual abuse before the age of 16 years. There are many factors that contribute to abuse of children. Some children are more vulnerable than others, such as those that are not desirable, an early separation from the mother, either mentally or physically disabled or have temperamental characteristics that make them difficult to handle. Some parents are more likely to be violent, especially those who were abused as children, living in poor socioeconomic conditions and have a realistic style of disciplining their children. The most common form of sexual abuse is father-daughter incest. Child sexual abuse may have a sudden change in behavior social or academic performance or behavioral problems. Some play games early and repeated sexual intercourse. It is important to give these children an opportunity to reveal their abuse, but great care must be taken to not increase their trauma. The social services must be informed any disclosure of sexual abuse by a child and start a day care procedure. The emotional effects of child sexual abuse can be addressed in individual psychotherapy with the child. Teens and adults can also be offered group therapy, which has the advantage of reducing feelings of isolation and help develop confidence and self esteem. One third of sexually abused children have no negative long-term, others are prone to depression, low self-esteem, sexual problems and tend to re- victimization in adulthood. Elimination Disorders enuresis enuresis is the involuntary emptying of the bladder occur after the age of five years in the absence of an organic cause. Bedwetting (nocturnal enuresis) is common, occurring in 10% more than 5 years, 5% of persons 10 years and 1% of 15 year olds. diurnal enuresis is less common. Enuresis is considered a principal, if there was a prior period of bladder control, and secondary if it follows a period of abstinence. It is twice as common in boys than in girls, and most cases are probably due to delayed neurological maturation that simply is corrected over time. There is often a positive family history same problem. The secondary enuresis may occur as a feature of regressive behavior in times of stress. To exclude the directors is composed of a physical cause, especially urinary tract infections, to reassure parents and encourage them to solve the problem calmly and tranquility. Implement a simple behavioral program as a graph or a wheel and the hood can be used. Encopresis Encopresis is inappropriate defecation, despite routine monitoring of the intestine. Most children are continent of faeces at the age of 3 years. At 8 years, 2% of males and 1% of girls suffer from encopresis. This may be due to inadequate toilet training or have a psychological cause of behavior that represents the child’s feelings of anger or regression to a time of stress. Constipation with overflow incontinence is the main differential diagnosis to exclude. Adolescents Adolescent social and emotional problems difficult to treat. For example, there are often disputes over the degree of independence they want and are allowed to have their parents. The peer group is very important and influential, and can provide valuable support to people to try new things away from family. You can also generate great concern by the group’s refusal , and may encourage criminal behavior. The development of sex is another potential source of confusion, anxiety and conflict. The evolution profile of psychiatric disorders such as children become teenagers. There is a marked increase in depressive disorders, especially among girls, and schizophrenia is much more common in late adolescence. Problems with alcohol and drug abuse and eating disorders tend to occur at this time. developmental disorders in general have been resolved.

Psychotherapy

An Evidence-based Treatment for Disorders of Attachment; the Empirical Support

Dyadic Development Psychotherapy (DDP) is an objective and effective treatment of children suffering from trauma and attachment disorders [1]. It is a treatment based on the evidence means that empirical research has been published by scientific journals. Craven and Lee (2006) found that DDP is a process supported and acceptable (category 3 on a system with six levels). However, the review only included the results of a partial presentation of a preliminary study of continuous monitoring, which was later completed and published in 2006.

The first study compared the development of dyadic psychotherapy with other forms of treatment, “usual care”, one year after completion of treatment. It is important to note that over 80% of children in the study had more than three previous episodes of treatment, but there is no improvement in their symptoms and behaviors. episodic treatment: a course of therapy with other mental health providers and other clinics, consisting of at least five sessions. A second study extended these results to four years after the end of treatment. On the basis of classifications Craven & Lee (Saunders et al. 2004), the inclusion of these studies have led to Dyadic Development Psychotherapy be classified as Category 2 based on the evidence, “the support and effective probably. There were two related studies the comparison of the results of empirical treatment of dyadic developmental psychotherapy with a control group. This is the basis for the rating category two.

The criteria are: * 1. The treatment has a sound theoretical basis in generally accepted psychological principles. Dyadic Development Psychotherapy is based on attachment theory (see the texts listed below * 2. An important clinical, anecdotal literature indicating the efficacy of at-risk children and foster children. View list of references. * 3. Treatment is generally accepted in clinical practice for children at risk and foster children. As demonstrated by the large number of professional development and stated dyadic psychotherapy was that many national and international conferences over the last ten or fifteen years. * 4. No clinical or empirical basis and theoretical indicating – that the treatment constitutes a substantial risk of harm to those receiving them, compared with its potential benefits. * 5. The treatment has a manual that clearly specifies the components and features of the administration of treatment that allows the application. The binding capacity building, the construction union, and the documents annexed family-focused Therapy is one kind of material. * 6. At least two studies that used some form of control without randomization (eg waiting list, the untreated group, the placebo group) have established the efficacy of treatment during the passage of time, efficiency relative to placebo, or found to be comparable or superior to already established treatment. See ref. list * 7. If multiple treatment outcome studies have been carried out, the total weight of the evidence and the effectiveness of treatment.

These studies support several of O’Connor & Zeanah [2] Conclusions and recommendations for treatment. They argue (p. 241), “The treatments for children with attachment disorders should be promoted if they are based on evidence.” Dyadic Development Psychotherapy, as with any specialized treatment, must be provided by a competent, well trained, licensed professional. Dyadic Development Psychotherapy is a treatment based on the family [3]. Dyadic Development Psychotherapy is the name of an approach and a set of principles that have proved effective in helping children with trauma and attachment disorder cure, is to develop healthy relationships of trust and reliable caregivers. The treatment is based on five basic principles. At the heart of this disorder is trauma caused by significant and substantial experiences of neglect, abuse, or prolonged and unresolved pain in the first years of life. Such experiences disrupt the normal connection to the child’s ability to form healthy and secure attachment with a caregiver distorted or not. The child has no sense of trust, security and safety. The child develops a negative working model of the world where: Ø Adults are experienced as inconsistent or hurtful. Ø The world is seen as chaotic. Ø The child feels no real influence in the world. Ø The child tries to rely only on itself. Ø child feels an overwhelming sense of shame, the child feels bad, bad, unlovable, and evil. Reactive attachment disorder is a severe developmental caused by a history of chronic abuse during the first two years of life. Reactive Attachment Disorder is often misdiagnosed by mental health professionals who lack training and experience to assess and treat these children and adults. Often, children in the system of protection of children have a variety of early diagnosis.

The behaviors and symptoms that are the basis of these earlier diagnoses is best conceptualized as the result of excessive attachment. Oppositional defiant disorder behaviors are included in the reactive attachment disorder. Posttraumatic stress disorder symptoms are the result of a significant history of violence and neglect, and the other dimension of this disorder. About 2% of the population is adopted, and between 50% and 80% of these children have attachment disorder symptoms [5]. Many of these children were violent [6] and [aggressive 7] and adults are at risk for a variety of psychological problems [8] and personality disorders such as antisocial personality disorder [9], impaired narcissistic personality, borderline personality disorder and psychopathic personality disorder [10]. abandoned children are at risk of withdrawal, social rejection, feelings of incompetence and widespread [11]. Children who have a history of abuse and neglect are a significant risk of developing PTSD in adulthood [12]. Children who have been victims of sexual abuse is a significant risk of developing anxiety disorders (2. 0 times the average), major depressive disorders (3. Average 4 times) alcohol abuse (2. Average of 5 times) drug abuse, (3 8. the average), and antisocial behavior (4. average 3 times) [13] (MacMillan, 2001). Effective treatment of these children is a public health problem (Walker, Goodwin, and Warren, 1992). Without treatment, children who were abused and neglected and have an attachment disorder become adults with the ability to develop and maintain healthy relationships is deeply damaged. Without the permanent foster appropriate and effective treatment, the disease worse. Many children with attachment disorder develop the disorder or antisocial personality disorder of personality in adulthood [14]. In the first director. Treatment should be the experience. Since the roots of this disorder is pre-verbal, treatment must create experiences that are healing. Experiences words, there are an “active” in the healing process. For example, an eight year old boy who had Reactive Attachment Disorder, bipolar disorder, and a variety of sensory disturbances in the integration has been written about his treatment and therapy last attachment in this way (More details This story can be found in the book Building Capacity for Attachment, edited by Arthur Becker-Weidman and Deborah Shell): My first treatment was with Dr. Steve. Therapy was fun! We ate lots of sandwiches. I had a bottle. We played a lot of games interesting as struggle thumb rides on the pillow, foot giant, Superman rides, guess the goodies, eye blinking contests, gifts, hide and seek. I followed the rules and play games like Dr. Steve said. Dr. Steve taught me to play and have fun with my mother. But I still did not know how to love. I still get angry and try to hurt Mom and things break. Inside, I kept thinking it was a bad boy. I was still afraid Mom and Dad get rid of me. I had a lot of tantrums at home. Sometimes, I’d still be out of control and things break down and try to hurt Mom. Was getting worse when I’m mad. Commands taught by Dr. Art MeI learned about my feeling well. Sometimes things like crazy too many feelings, fear and sadness in me feels good. Then, the well will overflow and I could explode with behaviors. But I can not allow to express my feelings. Then the property can not exceed, because I left some feelings. I also made pictures of my heart.

I was born with a heart of Nice, but then when I went to the orphanage that the cracks in my heart. My heart broke because I could not look after me. I was a baby and I needed someone to hold me and make me vibrate. But they could not because there were too many babies. Then I put 16 bricks around my heart. I was protecting my heart so do not get worse. But the bricks kept the love too. I let love in. Mom had a bunch of crazy in my heart. My work in therapy got rid of all the bricks. Then Mom’s love in. Love makes the cracks heal. Now I have a bright red heart, no cracks. I liked Dr. Art and I am proud that I am strong. He did not need therapy. I still love mom left my heart !!!!!! Sometimes I send an email to Dr. Art. I told him how I do. I started missing Dr. Art and told Mom. Mom was confused and thought I wanted more therapy. I told Mom “I do not need therapy. I just want to eat lunch with Dr. Art.” So I sent an e-mail Dr. Greg to let him know I wanted to lunch with him. Then one day, we had lunch together. Sometimes, it is still difficult. I’m still crazy and sometimes do not express my feelings well. Sometimes when Mom helps me? I can express my feelings and say, “I do not want to take my toys. It gives me courage that I owe you? But I will.” When I say it feels more crazy. It helps me to listen to mom. But sometimes when I’m angry, pouting and stomping my feet and run to my room if I forgot to express my feelings. But now I let my mother helps me so I can talk about my feelings and do what it says It was a very long time since he tried to hurt Mom or break things when I’m mad. I feel good about love now. I know my mom and my dad loves me. I know that I love you mom and dad. I do not think I’m a bad guy more. Effective therapy uses experiences to help a child experience safety, safety, acceptance, empathy and emotional harmony in the family. A number of techniques and methods are used as psychodrama, interventions in harmony with Theraplay, and other exercises. The latter. Treatment must be family oriented. Therapy helps children cope with trauma in the underlying support, a safe, secure environment “standard” and the doses administered to the parents have to offer and can come in the cure of the child. It is the ability of parents to create a safe and welcoming home that offers a healing environment. Being able to empathize with the child, accept the child, the child love, curiosity about the child, and be fun, are all part of the attitude [15] healthy. Parents are actively involved in treatment. THREE MAJOR. The trauma must be directly addressed. Therapy helps healing by providing security and protection for the child can relive the painful and shameful emotions surrounding the trauma of the child. Review of trauma is essential if the child is beginning to review the personal accounts of children and worldview. It is reviewing the distribution of trauma and anger and shame of a guarantee, an empathetic person that the child can integrate the trauma into a coherent self. FOURTH PRINCIPAL. A global security environment and security must be created. traumatized children are often hyper-vigilant, insecure and deeply suspicious. A consistent environment is safe and secure is essential to create the necessary experience for the child to heal. This medium must be present in the home and in therapy. Good communication and coordination between home, school, and therapy is another important component of effective treatment. “Compression wraps,” stimulation invasive and expensive, designed to evoke anger, “re-birth” and other provocative techniques are not part of the development of dyadic psychotherapy. These intrusives and interventional techniques are not therapy, not therapeutic, and have no place in a renowned treatment program. Fifth principal. Therapy is consensual and not coercive. In our center, we have very clear that physical coercion is not a cure and is not used in the treatment of otherwise. Treatment is provided in a manner consisted with the Association for the Treatment and Education of Children White Paper on coercion in treatment. DETAILED DESCRIPTION OF TREATMENT Dyadic Development Psychotherapy is a treatment developed by Daniel Hughes, Ph.D., (Hughes 2008, Hughes 2006, Hughes, 2003). Its basic principles are described by Hughes and summarized as follows: The emphasis on caregivers and therapists own attachment strategies. Previous research (Dozier, 2001, Tyrell 1999) has highlighted the importance of carers and therapists in the state of mind for the success of interventions. The therapist and physician are in harmony with the subjective experience of the child and take into account the child’s return. In the process of maintaining a connection with inter-works with the child, the therapist and caregiver help the child regulate affect and construct a coherent autobiographical narrative. Sharing of subjective experiences. The use of PACE and place are essential for healing. Speak directly with misattunements inevitable conflicts that arise in interpersonal relationships. Caregivers use attachment facilitating interventions. Using a variety of interventions, including cognitive-behavioral strategies. Dyadic Development Psychotherapy interventions are derived from various theoretical and empirical lines. Attachment theory (Bowlby, 1980 Bowlby, 1988) is the theoretical basis for the development of dyadic psychotherapy. Early trauma disrupts the normal development of its connection by creating distorted internal working models of self, others, and caregivers. This is one reason for treatment, and the need for sensitive care. As O’Connor & Zeanah (2003, p. 235) stated: “A most curious case is that of a nursing adoptive / that is” adequate “sensitive, but the child’s behavior has an attachment disorder, there seems little likely to improve the responsiveness sensitive parents (father and sensitive) would yield positive changes in parent-child relationship. “processing is necessary to respond directly to rigid and dysfunctional patterns internalized working with traumatized children, attachment disorders have been developed. Current thinking and research on the neurobiology of interpersonal behavior (Siegel, 1999, Siegel 2000, Siegel, 2002, Schore, 2001) is another part of the basis on which development dyadic psychotherapy. The first approach is to create a secure base in treatment (using techniques that are consistent with the continued acceptance of recovery PACE (Playful, Curious, and Empathic) and at home to provide the structure governing safety and health (Playful, Amoroso, PLACE acceptance, curious and empathetic). Develop and maintain a relationship with the listener in which communication occurs contingent of collaboration allows the child to heal. coercive intervention such as the stimulation of coastline, the security system requires the child in anger or to provoke an emotional reaction to the shame of a child, using fear to gain compliance, and interventions based on power / control and submission, etc, never used and are incompatible with treatment of its roots in attachment theory and current knowledge about the neurobiology of interpersonal behavior. The typical structure of the meeting is threefold. First, the therapist meets with the nursing staff in an office while the child sits in the treatment room. During this part of treatment, the caregiver is instructed in methods of attachment parenting (Becker-Weidman and Shell (2005) Hughes, 2006). own problems of caregivers that may create difficulties in developing an emotional bond with their children may also be explored and resolved. effective methods for parents of children with trauma-attachment disorders require a high degree of structure and consistency, with an emotional environment that shows fun, love, acceptance, curiosity and empathy (place). During this part of treatment, doctors are supported and receive the same level of responsiveness to the attention that you want the child to experience. Often, caregivers feel blamed, devalued, incompetent, exhausted and angry. parental support is an important dimension of treatment to help doctors be better able to maintain phase relationship with the connection to their children. Second, the therapist meets with the child carers in the treatment room. This usually takes from 1:00 to 1:30. Third, the therapist meets with the caregivers without the child. In general, treatment with the child uses three categories of interventions: a restructuring emotional, cognitive and psychodramatic reconstructions. Treatment with the nursing staff uses two types of interventions: parenting in the first place, and effective teaching methods to help caregivers avoid power struggles and, secondly, maintenance of the place or attitude. The treatment of non-verbal child is important because much of the trauma has occurred in a pre-verbal and is often inseparable from explicit memory. Consequently, the trauma caused by child abuse and create barriers to successful participation and treatment of these children. treatment interventions have been designed to create experiences of safety and emotional connection to the child is emotionally involved and can discuss and resolve past trauma. This emotional bond is the same process used for non-verbal communication between caregiver and child to establish to facilitate interactions (Hughes, 2003, Siegel, 2001). The therapist and caregivers results in the initiation of the child co-regulation so influential that it is manageable. cognitive restructuring interventions are designed to help school children develop mental representations of traumatic events that allow children to integrate these events and to develop a coherent autobiographical narrative. The treatment consists of multiple repetitions of the cycle of addiction caregiver rights. The cycle begins with the sharing of emotional experiences, is followed by a break in the relationship (separation or fracture), and ends with a reattunement affective states. Nonverbal communication, which involves eye contact, tone of voice, touch and movement are essential to create an emotional bond. The treatment plan often adhered to a structure with various dimensions. Is illustrated in Figure 1. First, the behavior is identified and explored. The conduct occurred or in the immediate interaction that took place sometime in the past. The use of curiosity and acceptance the behavior is studied. Second, using curiosity and acceptance the behavior is to explore and begin to feel the baby to emerge. Third, empathy is used to reduce the feeling of shame and child to reinforce the feeling that the child is accepted and understood. Fourth, the child’s behavior is normal. In other words, once the meaning of behavior and its basis of past trauma is identified, it is understandable that the symptom is present. An example of this interaction is as follows: Wow, I see you’re so angry when his mother asked him to pick up his toys. You thought it was average and did not want to have fun and like you. You thought I was going to take everything and leave you like your mom first, like when your mother first took his toys and left alone in the apartment now. Oh, I can really understand now how difficult it must be for you when Mom said to clean. I really felt angry and scared. It must be hard for you. Fifth, the child communicates this understanding to the caregiver. Sixth and finally, a new meaning for the behavior and actions that the child is integrated into a coherent narrative autobiographical experience and provide new meaning to the caregiver. past traumas are analyzed by the reading of documents and through recreations psychodramatic. Interventions that occur within a relationship of trust to listen, allow the child to integrate the traumas of the past and understand the past and present experiences that create the feelings and thoughts associated with child behavior disorders. The child develops secondary representations of these events, feelings and thoughts that result in greater impact on the regulation and a more integrated autobiographical narrative. As described by Hughes (2006, 2003), the therapy is an asset, affects the experience modulated implies acceptance, curiosity, empathy, and play. Co-regulation in children’s emerging affective states and the development of secondary representations of thoughts and feelings, the child’s capacity to engage emotionally in a relationship of trust is strengthened. Doctors take these same principles. If doctors find it difficult to participate with their children in this way, treatment is indicated for the caregiver. Children who have experienced chronic abuse and injuries are complex significant risk for a variety of other behavioral, neuropsychological, cognitive, emotional, interpersonal, and psychobiological (Cook, A., et al. Coll. 2005, van der Kolk, B., 2005). Children and adolescents with complex trauma requires a treatment approach that focuses on various aspects of disability (Cook, y., 2005). abuse and complex disorders resulting from trauma resulted in a variety of ranges, including the following: Ø Self-regulation Ø Interpersonal including the ability to secure confidence and comfort Ø Annex Ø biology, leading to somatization Diameter affect regulation * Increase the use of defense mechanisms such as dissociation Ø control of behavior Ø cognitive functions, including regulation of attention, interest and other executive functions. Ø The concept of self. Dyadic Development Psychotherapy addresses these areas of deficiency. Dyadic Development Psychotherapy share many important elements optimal social intervention and good clinical practice. For example, attention to client’s dignity, respect for the customer experience, and where the customer is, are all secular principles of clinical practice and all are also central elements Dyadic developmental psychotherapy In summary, therapy for traumatized children who have disorders of attachment should experience, consensus, and provide an environment of security, acceptance, safety, empathy, and play. [1] Becker-Weidman, A. (2006) “The treatment of traumatized children, Attachment Disorders: Dyadic Development Psychotherapy,” Child and Adolescent Social Work Journal. Vol 23. No. 2, April 2006, 147-171. Becker-Weidman, A. (2006). “Dyadic Development Psychotherapy track several years,” in the new developments in the investigation of child abuse, Stanley M. Sturt, Ph.D. (Ed.) Nova Science Publishers, New York, pp. 43-61. Becker-Weidman A. (2007) “Treatment for children to Reactive Attachment Disorder: Dyadic Development Psychotherapy,” http://www. center4familydevelop. com / search. pdf Becker-Weidman, A., & Hughes, D. (2008) “Dyadic Development Psychotherapy: An evidence-based treatment for children with complex trauma and attachment disorders, children and adolescents Social Work, 13, 329 pp. -337. Craven, P. And Lee, R. (2006) Therapeutic interventions for foster children: a systematic research synthesis. Research on Social Work Practice, 16, 287-304. [2] O’Connor, T., & Zeanah, C. (2003) Attachment Disorders: Strategies for assessment and treatment. Attachment and Human Development, 5, 223-245. [3] Hughes, D. (2008) focused on attachment of Family Therapy. NY: Norton. [4] Lyons-Ruth, K., & Jacobvitz, D. Attachment disorganization: Unresolved loss, relational violence and gaps in the strategies of behavior and attention. In Cassidy, J. And Shaver, P. (Ed.) Handbook of attachment. pp 520-554, New York: Guilford Press, 1999. Solomon, J. & George, C. (Eds.). Disorganization of attachment. NY: Guilford Press 1999. Principal, M. & Hesse, E. Parents unresolved traumatic experiences related to the status of disorganized infant attachment. In Greenberg, MT, Ciccehetti, D., & Cummings, EM (eds) Attachment in the preschool years: Theory, Research and Intervention, pp. 161-182, Chicago: University of Chicago Press, 1990. Carlson, E. A. (1988). A prospective longitudinal study of disorganized / disoriented. Child Development 69, 1107-1128. Cicchetti [5] Carlson, V., D., Barnett, D., & Braunwald, K. (1995). Finding order in disorganization: Lessons from research on child abuse attachments to their caregivers. In D. Cicchetti and V. Carlson (Eds.), Child Maltreatment: Theory and research on the causes and consequences of abuse and neglect (pp. 135-157). NY: Cambridge University Press. Cicchetti, D., Cummings, EM, Greenberg, MT, and Marvin, RS (1990). An organizational perspective on attachment beyond infancy. In M. Greenberg, D. Cicchetti, M. Cummings (Eds.), Attachment in the preschool years (pp. 3-50). Chicago: University of Chicago Press. [6] Robins, LN (1978) Longitudinal studies: childhood predictors of adult antisocial behavior robust. Psychological Medicine. 8, 611-622. [7] Prino, CT & Peyrot, M. (1994) The effect of abuse and neglect aggressive withdrawn, and prosocial behavior. Child Abuse and Neglect, 18, 871-884. [8] Schreiber, R. And Lyddon, WJ (1998) and current functioning parental psychological link between the child survivors of sexual abuse. Journal of Counseling Psychology, 45, 358-362. [9] Finzi, R. Cohen, O., Sapir, Y., and Weizman, A. (2000). (2000). (2001). (2001).

Neglect, physical violence and sexual abuse (broadly called child abuse) have profound and long-term development of a child. The long-term effects of chronic early maltreatment in a caregiving relationship (also called complex PTSD) a child can be seen in higher rates of psychiatric disorders, higher rates of addiction, and a variety of serious relationship problems. Child abuse is an intergenerational problem. Very often the perpetrators of abuse and neglect are profoundly damaged people who were abused and neglected. There are clear links between neglect and abuse and later psychological, emotional, behavioral and interpersonal problems.

The basis of this relationship is the impact that abuse and neglect in the developing brain. Daniel Siegel, medical director of the Infant and Preschool Service at the University of California at Los Angeles, has found important links between interpersonal experiences and neurobiological development (Developing Mind: Toward a neurobiology of interpersonal experience. Daniel J . Siegel, Guilford Press, 1999.) We know that a child uses the mother’s state of mind to regulate the child’s mental processes. It is through a relationship sensitive, responsive, and the care with primary care provider that the child develops the capacity for self-regulation, emotional control, regulation of behavior and cognitive skills such as cause and effect thinking, including others.

Develop the child’s ability to control their emotions and develop a coherent sense of self requires sensitive and responsive parenting. The National Adoption Center found that 52% of adoptable children are the symptoms of attachment disorder. In another study by Cicchetti, Barnett and [2], 80% of child victims of violence or abuse had symptoms of attachment disorders. The best indicator of the type of attachment of a child’s state of mind with regard to the setting of the biological mother. type of attachment to a biological mother before the birth of your child can predict with 80% accuracy for classification of attachment of the child of six years. It is a remarkable discovery. Finally, recent research by Mary Dozier, Ph.D. [3] has shown that the type of attachment to an adoptive mother has a profound effect on the type of attachment of the child. He noted that the type of attachment the child is similar to that of the adoptive mother, after three months probation.

These results strongly support a mechanism for non-genetic transmission of attachment patterns across generations. Children who have been victims of sexual abuse is a significant risk of developing anxiety disorders (2. 0 times the average), major depressive disorders (3. Mean of four times) the abuse of alcohol (2. Average of 5 times ) drug abuse, (3 8. the average), and antisocial behavior (4. average 3 times) [4]. In general, the left brain is the site of the language of motor activity in the right side of the body and logical thinking based on the language. The right hemisphere of the brain responsible for motor activity on the left side of the body, perceptions of context, facial recognition, treatment, relational and emotional perception, and in general. The orbitofrontal cortex (the brain behind the eyes) is responsible for the integration of emotional responses generated in the limbic system with higher cognitive functions such as planning and language in the prefrontal lobes of the cerebral cortex. Left orbitofrontal cortex is responsible for memory creation while the right orbitofrontal cortex is responsible for memory retrieval. operation requires an integrated right and left hemispheres. A large number of synaptic connections between neurons are formed during the first year of life in the middle of the second year of life. An integrated brain requires connections between the hemispheres by the corpus callosum. Abused and neglected children have smaller corpus callosum that children are not battered. Abused and neglected children have been integrated bit hemispheres.

This poor integration of hemispheres and underdevelopment of the orbitofrontal cortex is the basis of symptoms such as difficulty regulating emotion, lack of cause and effect thinking, inability to accurately recognize emotions in others the child’s disability express their own feelings of the child, the sense of history and autobiographical self inconsistency and a lack of awareness. The brains of abused children are not so well integrated that the brains of abused children. This helps explain why abused children have serious difficulties with emotional regulation, integrated functioning and social development. development of awareness and capacity for empathy are largely functions of the orbitofrontal cortex. When the development in this region of the brain is blocked, there are important social and emotional difficulties. Interestingly, the orbitofrontal cortex is sensitive to the recognition of faces and eyes. Abused children often have attachment disorders because of its lack of sensitivity of the biological parents of response interactions with children.

Early interpersonal experiences have a profound impact on the brain because brain circuits responsible for social perception is the same as those that integrate functions such as the creation of meaning, the regulation of states of the body, emotion regulation, the organization memory and interpersonal communication skills and empathy. stressful experiences that are overtly traumatizing or chronic cause chronic elevated levels of neuroendocrine hormones. High levels of these hormones can cause permanent damage to the hippocampus, which is essential for memory. [5] On this basis one can assume that psychological trauma can affect a person’s ability to produce and maintain the memory and prevent the resolution of trauma. Child abuse show a variety of behaviors that can lead to a number of diagnoses. However, the effect of early abuse and neglect of children can be seen in several critical areas of development. These domains include emotional regulation, regulation of behavior, attachment, biology, flexibility of response, integrated and coherent sense of self through time, the ability to participate in an impact on the lineup with significant others ( empathy and emotional connectivity), the self-concept, cognitive and learning, and development of consciousness.

The effects of abuse in early child development are profound and lasting. It is the impact of abuse on the child’s brain development that causes the effects observed in a variety of fields, including social, psychological and cognitive development. The ability to control their emotions and emotionally attuned to another depends on early experience and development of specific brain regions. In early abuse leads to deficits in the development of these brain regions, the orbitofrontal cortex, especially frontal and corpus callosum, because the toxic effects of stress hormones in the developing brain. These results suggest that effective treatment requires a significant emotional relationship to listening. Siegel said: “As parents reflect with their securely attached children’s mental states that create their shared subjective experience, which will join them in an important co-constructive process of understanding how the mind works. The inherent characteristic of a Secure attachment – contingent, collaborative communication – is also a key element in how to facilitate the integration of internal relations in a child. [6] This has implications for the effective treatment of abused children. For example, when a therapeutic relationship, the client is able to reflect on aspects of traumatic memories and experience of the effects associated with those memories without becoming dysregulated, the client developing a greater capacity to tolerate increasing amounts of concern. Customer learns to regulate itself. The tuned resonance relationship between the client and the therapist allows the client to make sense (a function of the left hemisphere) memories, autobiographical representations, and affect (right hemisphere functions.) Effective treatments, such as the development of dyadic psychotherapy, can have important positive effects on later development. [2 Cicchetti] and Barnett, 1991. [3] ‘The integration of children in foster care: the role of caregiver state of mind, Child Development, vol. 70, pp. 1467-1477, 2001. [4] MacMillan, HL, et al. al., childhood abuse and lifetime psychopathology in a community sample, American Journal of Psychiatry, vol. 158 No. 11, pp 1878-1883, November 2001 [5]. McEwen, B., “The development of the cerebral cortex XIII: Stress and brain development – II” Journal of the American Academy of Child Psychiatry, 38, 101-103, 1999. [6] Siegel, 1999. P. 333.

Well, just a mouse brain can be trained to grow, especially the human brain. The more trained, our brains must be more sharply. Memory loss in a certain amount at any age is normal, just as the changes in other organs. Just do not lazy to diligently train our brain to stay strong memory of all time.

Here’s how:
1. Practice observing capabilities. Note the surrounding environment. Record in your mind what you see, starting from the simplest and continued with a more complex observations.

2. Sharpen the senses. Can be trained to distinguish the taste of food likes and what does not.Recognizing the smell and aroma around or noises in the street or maybe feeling hot or cold air around you.

3. Memorize the name of his friends and pair the phone number. There are few who can remember? Practice in order to remember more.

4. Learn something new. Many read and acquainted with other things that may not be your field, can be a foreign language, knowledge of computers, and others.

5. Use your hands to follow the instructions of the brain. For example play the guitar, typing without looking at the keys, doing crafts of wood, or practice writing smooth.

6. Tekuni hobby. Use the opportunity to develop your hobby.

7. Learn and memorize important dates, concerned family members, friends, or a particular celebration.

8. Memorize something you like. Could be it poetry, song, words from a book or the words of someone. As much as possible also try to phrase used is a foreign language.

9. Exercise memorize a long sequence of numbers lined up, for example 32145687390282930498. This is a form of exercise to improve short-term memory. Do it by grouping or split the numbers into several parts, such as 7390282 and 3214568 then the last 930,498.

10. Remember personal travel. What are you doing an hour ago, last week on Wednesday at 10.00, for example. With whom, where, and so on.

11. Remember and thorough re daily expenses. What did you buy yesterday? How much money is in your wallet right now? When did you last get cash, and so on.

These exercises will allow the brain cells remain active and connective tissue between cells of the brain the meeting. Challenging mental activities increase the number of active circuits, or synapses in the brain. The more circuits, more and more associations, the greater the ability to remember.

Actually, you know, that some foods and drinks could actually lose the benefits of vitamins and antioxidants after exposure to air in a matter of days or weeks? Brierley Wright, MS, RD, a master’s in Nutrition Communication at the Friedman School of Nutrition Science and Policy, Tufts University, provides clues about how long should we store certain kinds of food. To be sure, certain nutrients will be lost after exposure to oxygen, heat (when cooking), and light.

Orange juice: 1 week
A glass of orange juice to meet the dose of vitamin C needed in a day. However, orange juice, packaged in a box or bottle, after opening will lose all the benefits of antioxidants after 1 week.To get her vitamin C, buy frozen juice concentrate and get a drink in a few days. Frozen concentrate can be exposed in a little light and air.

Green tea: 6 months
A study published in the Journal of Food Science in 2009 showed that the catechins (antioxidants that are often associated with reduced risk of some cancers) in green tea decreased clearly after some time. After 6 months, levels of catechin to 32 percent lower.Ensure that the antioxidant content preserved by storing the tea in the box sealed in cold and dark.

Olive oil: 6 months
Oil extra-virgin olive oil contains more than 45 heart-healthy antioxidants, but after saving for 6 months will lose its potency approximately 40 percent, according to researchers at the University of Foggia in Italy. Why does this happen? Bubbling oxygen in the bottle will destroy antioxidants.

Honey: 6 months

Researchers at the University of Illinois found that the antioxidant power of buckwheat honey and clover tree reduced 30-50 percent after 6 months. If you want to eat honey, buckwheat honey select which generally have more antioxidants. Honey is the color black, and has a very sharp smell. Meanwhile, the Journal of the American Dietetic Association, the antioxidant levels of clover honey from the tree is not so high.

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