Adolescent pregnancy is a major social issue resulting in significant risk for both the infants and young mothers. In this paper, we will describe the effects of an intervention program for adolescent mothers and their infants, including the complexities of evaluating the effects of intervention for risk groups. More than half of the teenagers in the United States are sexually active, and more than 1.1 million become pregnant each year. It has been estimated that in 1981 approximately 22% of sexually active teens 15-19 experienced a pregnancy (Hofferth 1984). Among teen pregnancies, 70-80% are unintended and unwanted (PPFA 1984). Adolescent mothers and their infants appear to be at higher risk than older mothers for a variety of medical complications that may affect subsequent infant health and may impact on infant development and parent-infant interaction. While a number of studies have indicated that the biomedical risk for teenage mothers, especially those ages 15 and older, can be decreased considerably with adequate nutrition and proper prenatal care (Carey et al. 1983; Osofsky 1968; Osofsky and Osofsky 1970), for a variety of reasons, most teens do not receive the type of prenatal care that would most likely minimize risk and optimize outcome. Adolescent mothers are more likely than their nonpregnant peers to have lower education attainment, lesser job and economic success, and less frequent marital stability (Furstenberg 1976; Simkins 1984).

Underlying the responses of 34 44-month-old children of adolescent mothers to five attachment narratives were two factors--departure and reunion. The departure factor included disorganized and insecure responses to parents' departure as well as disorganized responses to narratives about children's misbehavior and fear. Scores predicted children's externalizing behavior problems 10 months later and discriminated children in the clinical from those in the normal range for externalizing problems. Maternal depression explained significant additional variance in children's externalizing problems.

Developmental psychopathology focuses on developmental aspects of pathology as well as individual patterns of adaptation and maladaptation. Adaptation involves the resolution of earlier issues, with successful resolution facilitating adaptation and earlier developmental failures increasing the likelihood of future problems. The study of developmental psychology provides knowledge about normal processes in order to better understand psychopathology as well as groups at high risk for having problems over time. The project described in this paper focuses on applied psychoanalysis using psychoanalytic knowledge and theory in the context of an intervention project involving observational research. A case description of an adolescent mother and her child will be presented to illustrate issues about problematic development in a child first observed as part of the research project and later referred to a therapeutic nursery. The case will be discussed in relation to two questions: (1) Is it possible to define and evaluate manifestations of disturbance early in life that result in definable psychopathology at school age? (2) To what extent can the self‐righting capacity of the child or environmental intervention compensate in correcting the developmental process?

SUMMARY Medical experts have disputed whether childhood cyclic vomiting is a manifestation of epilepsy or a migraine equivalent. Quantitative EEG provides an objective measure of changes in brain activity during and between episodes. This paper reports reversible changes involving two episodes in a patient whose history included cyclic vomiting and emotional/behavioural problems. Abnormal delta activity seen during both episodes resolved at follow‐up, when the patient was asymptomatic. The brainwave changes counter the hypothesis that vomiting in these patients is psychosomatic, and support the interpretation of cyclic vomiting as a migraine equivalent. RÉSUMÉ Modifications EEG quantitatives réversibles dans un cas de vomissement cyclique: évidence d'un équivalent migraineux Des médecins spécialisés ont discuté le fait de savoir si le vomissement cyclique de l'enfant est une manifestation épileptique ou un équivalent migraineux. L'EEG quantitatif fournit une mesure objective des modifications de l'activité cérébrale durant, et entre les épisodes. L'article rapporte les modifications réversibles apparues durant deux épisodes, chez un enfant dont l'anamnèse incluait des vomissements cycliques et des troubles comportementaux ou caracteriels. Une activité delta anormale observée durant les épisodes, disparaissait au suivi lorsque la patient était asymptomatique. Ces modifications des ondes cérébrales plaident contre une explication psychosomatique de ces vomissements et favorisent l'interprétation du vomissement cyclique comme équivalent migraineux. ZUSAMMENFASSUNG Reversible EEG Veränderungen bei einem Patienten mit zyklischem Erbrechen: Migräneäquivalent Medizinische Experten haben diskutiert, ob zyklisches Erbrechen im Kindesalter als Manifestation einer Epilepsie oder als Migräneäquivalent anzusehen ist. Die quantitative EEG‐Analyse liefert den objektiven Nachweis von Veränderungen der Hirnaktivität wahrend und zwischen den Episoden. In dieser Arbeit werden reversible Veränderungen von zwei Episoden bei einem Kind beschrieben, das in der Anamnese zyklisches Erbrechen und emotionale‐bzw. Verhaltensprobleme hatte. Die abnorme Deltaaktivitat, die während beider Episoden beobachtet wurde, war bei Kontrolluntersuchungen, als das Kind syptomfrei war, nicht mehr nachweisbar. Die Veränderungen der Hirnstromkurven sprechen für die Hypothese, daß das Erbrechen bei diesen Patienten psychosomatisch ist und lassen die Interpretation zu, daß das zyklische Erbrechen ein Migräneäquivalent ist. RESUMEN Cambios cuantitativos en el EEG reversibles en un caso de vómito ciclico: evidencia de un equivalente de migraña Los expertos médicos han discutido si los vómitos cíclicos de 10s niños son una manifestación de epilepsia o un equivalente de migraña. El EEG cuan titativo proporciona una medición objetiva de los cambios en la actividad cerebral durante estos episodios y entre ellos. El presente trabajo aporta cambios reversibles afectando a dos episodios de dos niños en cuya historia habia vómitos cíclicos y problemas emocionales/cond...

The object of this prospective study was to evaluate the effectiveness of a therapeutic nursery program for troubled preschoolers attending the Preschool Day Treatment Center of The Menninger Clinic. Thirty-eight seriously disturbed preschoolers were assessed both at admission and at 9 months or at discharge (if before 9 months) in a pre-post design. Commonly used assessment instruments were collected by independent research clinicians. Significant gains were found in both internalizing and externalizing behaviors on the Child Behavior Checklist (CBCL). The Kohn Social Competence Scale showed significant improvement in learning, pleasurable play activities, and peer interactions. The socialization domain on the Vineland Adaptive Behavior Scale also indicated improvement beyond expectable maturation. In the Behavioral Observations test, both the capacities of the child and the qualities of the relationship were shown to be improved. As measured by the Epidemiologic Studies of Depression Scale (CES-D), mothers also became less depressed. Overall, the researchers conclude that a therapeutic nursery with a comprehensive program is an effective way to help seriously troubled preschoolers make gains in behavior, as well as in social and emotional growth.