What becomes of infantile traumatic memories? An adult "wild child" is asked to remember.

A severely traumatized child, acting like a wild animal, was removed from her parents at thirteen months of age when her three-week-old sister was found, bitten and shaken to death. (Her father was later convicted of manslaughter and imprisoned.) The older child was also covered with bite marks.

Treating childhood trauma.

This review begins with the question "What is childhood trauma?" Diagnosis is discussed next, and then the article focuses on treatment, using 3 basic principles-abreaction, context, and correction. Treatment modalities and complications are discussed, with case vignettes presented throughout to illustrate. Suggestions are provided for the psychiatrist to manage countertransference as trauma therapy proceeds.

Five analogies between a King's Speech treatment and contemporary play therapies.

Objective: Psychiatric patients frequently respond positively to play therapy, which may rely on psychoanalytic, Jungian, cognitive-behavioral, familial, school-based, or other theories. I wished to determine if there were unifying principles that tie together these various types of play treatments.

Methods: The fact-based film, The King's Speech, vividly illustrates play utilized by Lionel Logue in his speech treatment (1926-1939) of the future King of England.

Using context to treat traumatized children.

When treating childhood psychic trauma, context means "putting a perspective to the terrifying experience"--"seeing it in a new light", one might say, or understanding its magnitude and meaning. Of three essential mechanisms behind a young person's psychological recovery from a stress disorder--abreaction, context, and correction-context is the most reflective, cognitive, and conscious of these processes; while abreaction is primarily emotive, and correction is primarily behavioral (involving real or fantasied action). Because context, newly introduced by this author to the psychiatric literature (Terr, 2003), is the most recent and the least well understood of the three mechanisms, it will be the sole focus here.

Children's turn-arounds in psychotherapy: the doctor's gesture.

Unlabelled: Over the past year, a number of us have been examining the organizing principles behind dramatic turning points in the psychotherapies of children. We wondered whether any particular techniques or occurrences in therapy promoted childhood change.

Method: One of us (L.

"Wild Child": how three principles of healing organized 12 years of psychotherapy.

Methods of conducting psychotherapy in the most severe forms of childhood posttraumatic stress disorder (PTSD), especially in those traumas discovered very early in life, are rarely reported. This paper presents such a report and in the process emphasizes three elements of treatment: abreaction (full emotional expression of the traumatic experience), context (understanding and gaining perspective on the experience), and correction (finding ways personally or through society to prevent or repair such experiences). With traumatized children, all three elements may be inserted into their therapeutic play, art, and/or talk.

Children's symptoms in the wake of Challenger: a field study of distant-traumatic effects and an outline of related conditions.

Objective: The Challenger space shuttle explosion in January 1986 offered an opportunity to determine what, if any, symptoms of posttraumatic stress disorder (PTSD) and bereavement normal latency-age children and adolescents would develop after a distant, horrifying event.

Method: With a structured interview, the authors assessed the symptoms of 153 randomly selected children from Concord, N.H.

Children's thinking in the wake of Challenger.

Objective: The Challenger spacecraft explosion in 1986 offered an opportunity to study the thinking of normal children after a sudden and distant disaster, differences in thinking among children of different levels of emotional concern and different ages, and changes in their thinking over time.

Method: The authors studied six thinking patterns known to characterize childhood posttraumatic stress disorder and four additional hypothesized patterns in 153 randomly selected children of Concord, N.H.

Children's memories in the wake of Challenger.

Objective: The Challenger spacecraft explosion of Jan. 28, 1986, offered an opportunity to study the memories of normal latency and adolescent children of different emotional involvements following one sudden and distant disaster. How would children of various levels of concern express their memories? And if studied over time, how would these narratives change? Would there be developmental differences? And would there be false details of memory?

Method: The authors set out to compare the memories of 153 children from Concord, N.

Reliability of the Part II board certification examination in psychiatry: examination stability.

Objective: The aim of this study was to examine the reliability (examination stability) of the American Board of Psychiatry and Neurology (ABPN) Part II (oral) examination in psychiatry.

Method: The authors analyzed the consistency (agreement between grades given by two independent examiners) for a 1-year examination cycle using a weighted kappa statistic and compared different parts of the examination (live patient and videotape), different examination sites, different days, and different times of the day.

Results: There was no significant difference in agreement between examiners by different parts of the examination, examination site, day of the week, or time of day.

Mini-marathon groups: psychological "first aid" following disasters.

Large group counseling sessions for soldiers following battle have been commonly used since World War II. The author conceptualizes and demonstrates how these mini-marathon sessions can be adapted to support all ages and types of civilians involved in disasters. Mini-marathons take about 3 hours and are divided into three sections: story sharing, symptom sharing, and suggestions for self-help, including sharing tales of heroism and survival.

Reliability of the Part II Board Certification Examination in Psychiatry: interexaminer consistency.

Objective: The aim of the study was to examine the reliability (interexaminer consistency) of the American Board of Psychiatry and Neurology (ABPN) Part II (oral) examination in psychiatry.

Method: Grades were assigned independently by two examiners who observed the same examination in a 1-year cycle (1,422 candidates, two examinations each). The consistency between these pairs of grades (pass, condition, fail) was analyzed using a weighted kappa statistic.

Childhood traumas: an outline and overview.

Childhood psychic trauma appears to be a crucial etiological factor in the development of a number of serious disorders both in childhood and in adulthood. Like childhood rheumatic fever, psychic trauma sets a number of different problems into motion, any of which may lead to a definable mental condition. The author suggests four characteristics related to childhood trauma that appear to last for long periods of life, no matter what diagnosis the patient eventually receives.

Cochlear nucleus anatomy related to central electroauditory prosthesis implantation.

The central electroauditory prosthesis is now used to stimulate the cochlear nuclei to obtain auditory perception in patients with bilateral cochlear nerve transection who are undergoing bilateral acoustic tumor removal. In this study, we used fixed cadaver specimens to identify visible landmarks for accurate placement of the central electroauditory prosthesis through a combined suboccipital-translabyrinthine opening. Histologic features of the regions of probable implantation of the central electroauditory prosthesis were also investigated.

Who's afraid in Virginia Woolf? Clues to early sexual abuse in literature.

Virginia Woolf, by self-admission, was a victim of repeated sexual abuses. At age 5 or 6 she was sexually mishandled by her older half brother, Gerald Duckworth. In her teenage years another older half brother, George Duckworth, misused her repeatedly.

Effects of stimulation by cochlear implant on the cochlear nerve.

Degeneration of the cochlear nerve before and after placement of the cochlear implant might influence the efficacy of the device. We examined histological characteristics, including the caliber of the cochlear nerve fibers of the central segment proximal to the porus acusticus, in three profoundly deaf patients. Two of them used a cochlear implant for many years longer in one ear than in the other, and one used an implant in one ear only.

Family anxiety after traumatic events.

Victims of traumatic events--such as violent crimes, incidents of terrorism, or domestic violence--often later exhibit a variety of anxiety symptoms. The development of clinical anxiety after such tragedies may also affect the functioning of the entire family. It is vital that physicians recognize the relationship between the traumatic event and the resulting anxiety in the family.

Biocompatibility of the central electroauditory prosthesis and the human cochlear nuclei.

Previous studies from the House Ear Institute have reported the possibility of sound sensation from the central electroauditory prosthesis (CEP) implanted in patients during removal of bilateral acoustic neuromas. This study describes histologic features of tissues formed around a CEP that was removed due to infection in the area of the electrical plug on the external surface of the skull. We found a layer of compact collagen tissue around the CEP.