Highlights

ISAPP mourns Mike Kalogerakis, Past President

International Conference From Adolescence to Adulthood Normality and Psychopathology

09. - 12.09.2010in Larnaca, CyprusPapersubmission July 2010www.topkinisis.com

Minutes of the Executive Committee and Council of Delegates Meetings, Montreal, Canada July 2007

The ISAPP Executive Committee and Council of Delegates met July 4 and 7, 2007, in Montreal, Canada in conjunction with the ISAPP Congress. Topics discussed included the ISAPP meeting, a new version of the website, moving into online publications, and recruitment of new members.

Patricia Garel (Canada) assumed the presidency at the close of the meeting. Annette Streeck-Fischer (Germany) became President-Elect and will be organizing the next meeting, which will be held in Germany in 2011

There will be a meeting of the Balkan and Eastern European Society for Adolescent Psychiatry in Thessalonika in September 2008.

Lois T. Flaherty (USA), ISAPP Secretary

E-Mail: Lflaher770@aol.com

IACAPAP Conference in Istanbul 2008

Jon Lange (Norway), Enrico de Vito (Italy), Véronique Delvenne (Belgium), Shelley Doctors (USA), Annette Streeck-Fischer (Germany), Lois Flaherty (USA), Nikos Zilikis (Greece)

Abstracts of the two ISAPP symposia held at IACAPAP conference

Bullying and Harassment: Pathways to School Violence

Lois Flaherty (USA)

Educational Objectives

At the conclusion of this presentation, the participant should be able to recognize the biological, psychological and social factors involved in bullying behavior, diagnose psychiatric disorders in bullies and victims, and help schools develop effective intervention plans.

Target audience: Psychiatrists and other mental health professionals who work with children and adolescents and their families

Bullying, once considered a normal part of growing up, is now recognized to have serous negative consequences for both victims and perpetrators. Bullying and harassment are part of the spectrum of violent behavior and are serious problems in schools; on average about 15% of students report being bullied at some time during the school year. The perpetrators of multiple school shootings in the United States were all described as isolated loners who were ostracized by other students, often having experienced harassment or bullying at school for several years. Consequences of being a victim of bullying include depression and suicide, as well as violent retaliation after prolonged suffering. Bullies themselves are at risk for becoming more violent later on. A "conspiracy of silence" often prevails in which other students who witness bullying do not report it, providing further license for the bully to continue. Bullying affects all social classes and schools.

Effective approaches to the problem of school-related violent behavior must include interventions to address bullying and harassment. Schools must be actively involved at all levels for approaches to be effective. Effective measures include creating an emotional climate that encourages students to report bullying, a zero tolerance policy at the school, identification of high-risk students, and psychiatric assessment and intervention for victims as well as perpetrators. Psychiatrists can play an important role in diagnostic assessment, treatment planning, and treatment in conjunction with their roles as consultants to the schools.

References:

Olweus, D: Bullying in Schools: What We Know and What We Can Do. Cambridge, MA: Blackwell Publishers, Inc, 1993

Tatum, D. Herbert, G (Eds): Bullying: Home, School and Community. London: David Fulton Publishers, 1993

From Honeymoon to deadly dance - how to deal with maligne entanglments in psychotherapy of adolescents developing a borderline personality disorder.

Annette Streeck-Fischer (Germany)

In adolescents with development of borderline personality disorder you ran the risk to get into severe entanglements that repete the traumatic attachment experiences they have introjected. Several ‘art mistakes ‘ can be done which will be described.

Steps of treatment with different phases such as crisis intervention, estabilishing a secure frame, overcoming desorganised pattern, special technical interventions according to the pathological object relations, ego structural deficits and mentalization deficit will be outlined and shown in a case vignette.

First datas of a randomised controlled study of adolescents with borderline personality disorder treated under the above mentioned conditions will be presented.

A CLINICALLY USEFUL QUESTION: ARE THE ADOLESCENT'S ATTACHMENT TIES SECURE OR INSECURE

When adolescents present with extreme ambivalence toward their parents and dramatic symptoms that often contain concretized expressions of developmental needs and intersubjectively discordant responses to those needs, it is useful for clinicians to consider that they are confronting disordered attachment processes rather than normal adolescent individuation issues. This position will be considered from the point of view of theory and research and clinical vignettes will be presented to illustrate it.

Eating disorders in male adolescents

Nikos Zilikis (Greece)

Traditionally, eating disorders (ED) in adolescence are considered as "female psychopathology", and in the descriptive psychiatric approach the female model is applied to both sexes. This is not only simplifying the clinical approach and understanding of sex differences but also our understanding of the specificity of ED when considered within the particular perspective of adolescent psychopathology. The report of a number of cases of ED in male patients from the Child and Adolescent Unit of our Psychiatric Department, serves as a stimulating example for addressing crucial issues both of clinical and theoretical interest. Through their trans-nosographic character, the variety and complexity of operating mechanisms and of clinical expression, the core questions regarding dependence, aggressiveness, individuation, identifications and identity, among others, but also the integration of the disorders in the individual and family history and dynamics, altogether reveal the need for an approach which goes further than a mere descriptive and behavioural one. In this perspective, the psychodynamic approach not only allows for a better understanding of the above but, moreover, offers important implications in our therapeutic work with our young patients and their families. And in this, ED constitute a real paradigm for adolescent psychopathology.

Adolescence and attachment: factors of vulnerability and protective factors

Enrico de Vito (Italy)

Research based on the attachment theory has initially focussed on infant development and subsequently extended its field to other developmental phases. In recent years, research turned to adolescence has shown that a prevalent continuity in the organization of the Self, with regards to attachment relationships, is usually kept.

On the basis of the distinction between "secure" and "insecure" attachment patterns, it can be said that "secure" adolescents develop their identities by organizing complexes of internalized representations, whose matrix is to be found in good enough early relations.

The relevance of these secure patterns of attachment in order to promote a healthy self regulation and a balanced relatedness is discussed. The meaning of the "crisis" in adolescence is presented as an outcome of two different tracks of development (connected with the previous attachment organizations). Research data will consider the interference of other factors of vulnerability and protection in this outcome.

Interest of psychoanalytical supervision group of therapists as a

support in adolescent psychoanalytical therapy

Véronique Delvenne (Belgium)

Psychoanalytical therapies with adolescents are often situations that mobilize us a lot, because of the anguish, fears, phantasms and often acting out that invades the relational field massively. The anguish of the parents, but also often their culpability, is large. The first meeting often condenses all the tranferential issues which will be put in scene in later follow-up. It is necessary to consecutively articulate the symptoms with intra psychic, historical and relational and contextual dimensions of the youth and of all the individuals of his system at the time of the request. All around the therapy, it is important for us to be in touch with our contre-transference feelings that arouse by the narrations, but also by the interactions and nonverbal elements that developed progressively. The objective of the intensive psychoanalytical approach is to tend to reverse the psychopathological process, for example to allow the adolescent to keep in mind the reason of his breakdown and the sense of the hatred and the rejection which he expresses in regards to his mature sexual body.

Group of psychoanalytical therapists that work together with an analyst specialized in the adolescence field is a very supportive setting to understand the various levels of unconscious defence's mechanisms. It permits to highlight particular archaic mechanisms of functioning and to prevent repetition in the field of the therapy setting. The group functions as a widened psychic space where settles the various sick parts of the teenager.

While following the psychotherapeutic process of a teenager, we will shown the force of the supervision group and its utility in the maintenance of a psychoanalytical framework often put in danger in this clinical situation.