The Canadian Journal of Psychiatry

Marked and consistent differences in academic performance between boys and girls were found in a longitudinal study of young school-age children. Performance, measured by objective tests administered by a psychologist, was higher in girls in all grades (Grade I to Grade V). However, tests of intelligence, perceptual maturity and conceptual ability showed no sex-linked differences — the only tests favouring the girls were those of motor ability. To explain the better academic performance of female children, personality attributes were considered (C.P.I.). Statistically significant differences were found in three personality dimensions: girls were found to be obedient and dependent, sober-minded and quiet, practical and realistic. In contrast the boys were found to be assertive and independent, excitable and happy-go-lucky, sensitive and free thinking. The significance of these findings is discussed in terms of academic achievement and also in terms of culturally-determined sex-typing of young children.

This study conceptualizes the presence of a retarded child within a family as constituting a stress which the family attempts to cope with by bringing its resources to bear on the problem. If the stress proves too great for the family's coping mechanism institutionalization may be sought.

The Institutional Sample families did not appreciably improve over the year following the removal of their child; while the Community Sample showed signs of deterioration, particularly in the areas of sibling functioning.

The follow-up findings could be interpreted in two ways to support alternate biases with regard to hospitalization. Those who are generally against institutionalization for the retarded, believing that young children should remain in their own homes if possible, may view the lack of improvement in the functioning of the institutional families after the child was removed as an indication that these families should be encouraged to remain intact. In order to achieve this goal every effort would need to be made to strengthen, shore up and assist these families to cope with their retarded member or, where necessary, to supply the child with a new home (a foster or adoptive family).

Those who generally favour institutionalization for the retarded may interpret the evidence of the decreased functioning of the community families who kept their child at home as supporting the need for the wholesale hospitalization of retarded persons. This was advocated by Goddard in his study of the Kallikaks (10).

In the former approach the focus is on the welfare of the retarded child and in the latter the emphasis is on the welfare of the family and society. Is it not possible to stop playing ‘either/or’ and consider both? There are frequent occasions when a child needs to be separated from his family for their benefit or his and where an alternate family (foster or adoptive) cannot be found. Must the choice be between forcing the family to keep him and allowing the family functioning to deteriorate, or removing the child to a large impersonal institution? Lorimer Lodge, which has cared for young retarded women for over a hundred years and also the Harold Lawson Residence for trainable retarded children aged 6–12 years (both operated by the Metropolitan Toronto Association for the Mentally Retarded), the work of Jean Vanier in France and Glen Lowther in Winnipeg on community homes for retarded adults all demonstrate viable alternatives to institutionalization. It is becoming imperative that more adequate and humane alternatives be found than the present impersonal and huge institutions for those retarded persons who require, or could benefit from, an out-of-home living arrangement. This will require a major shift in emphasis, planning and responsibility. At present in Ontario the local Association for the Mentally Retarded is the main moving force in the building of community residences. Considering the magnitude of the need, progress has been slow and such agencies as the Children's Aid Society need to set up residences, possibly in conjunction with the local Association for the Mentally Retarded. This study may be interpreted as supporting the contention that to have a retarded child in the home is an added stress on the family. Follow-up of families who responded to this stress by institutionalizing their retarded children suggests that in many instances this is not the ideal answer to the problem for the family or for the child, but that a more complex variety of solutions is needed.

The response of twenty latency-aged children to residential treatment was measured by serial child-care ratings. Those who did not respond early made no gains during the latter half of hospitalization.

A satisfactory outcome was best predicted by the total rating change within the first six months as a percentage of the treatment interval. Treatment success appeared to depend upon the extent to which the program modified the child's customary defences and behaviour within that period, irrespective of whether this resulted in an increase or reduction in disturbance. Possible reasons for lack of early change are discussed.

The incest taboo is a moral imperative; its force reflects a cross-cultural preoccupation with the incest theme. The importance of this subject in psychiatric theory and practice justifies a concerted effort to synthesize the available data into a coherent overview, drawing on the findings of a variety of relevant disciplines.

Epidemiologists have shown that almost all civilizations recognize incest, but that it is universally uncommon. The influence of sociocultural and socioeconomic variables upon the occurrence of incest is disputed, partly because of the contamination of data due to unfortunate study designs. A glance at the classical literature shows that incest is an ever-recurring theme of mythologies of many civilizations. Anthropologists have pointed out cross-cultural variations in the nature of the incest taboo but have generally substantiated its universal presence in some form.

The incest theme is an appealing area for theorists. The incest taboo is multi-determined. Freud spoke of the need to prevent the destruction of society by a band of brothers who would murder the tyrannical father, then mutilate the social order through a chain of ‘fraternal’ wars. However a variety of biological, psychological and social theories have been carefully and thoughtfully articulated to explain the incest taboo and man's pervasive preoccupation with this theme.

The occurrence of overt incest is usually in the setting of a dysfunctional family and is accompanied by drastic role shifts so far-reaching as to constitute a virtual re-programming of the familial unit. Sociocultural, socioeconomic and purely psychiatric factors may play a further part in the breakdown of the incest barrier in these situations. The psychodynamics of incest can best be conceptualized within the framework of a three-generational schema, with desertion anxiety being a recurrent theme. For example, in father-daughter incest the mother deals with desertion anxiety stemming from the maternal grandmother by casting an older daughter in the role of homemaker and sexual partner to her husband. Overt incest is but the top of the proverbial ‘ice-berg’. Incestuous behaviour appears deeply rooted in the pre-œdipal period.

Incestuous fathers have usually been rejected recently by their usual sexual partners, and they deal with the guilt arising from incestuous behaviour with flagrant and sometimes naive rationalizations. Their backgrounds are usually marginal. The wives of incestuous men collude with the incestuous liaison by rejecting their husbands sexually and by subtly encouraging their daughters to become the ‘woman of the home’. Incestuous daughters are generally felt to encourage their fathers' sexual advances or at least to refrain from resisting them. Incestuous behaviour in daughters is at least in part a function of hostile impulses toward the mother and a penis envy hypertrophied by the wish for revenge against the pre-œdipal mother.

In father-daughter incest, youth in the daughter and a relative absence of anxiety and guilt in the incestuous father or colluding mother are factors leading to a favourable prognosis, and the converse is also true.

Prevention of overt incest rests on measures to enhance the definitions of the social role and generational boundaries within the family and upon devices which serve to buttress the incest taboo. Insight psychotherapy may play a part in the treatment of discovered cases and family therapy with the aim of promoting a healthier role allocation in the dysfunctional family has proven helpful.

Fifty-six patients with chronic schizophrenia were maintained on clopenthixol for one year. Significant improvement was noted in 13 of the 18 BPRS items by the end of the study. There was also clinical improvement in approximately 71 per cent of the sample, with 27 per cent showing no change and 2 per cent slightly worse in comparison with their pre-medication condition. A number of side effects and abnormal laboratory results were noted during the first few months of the study, although these generally dropped to normal levels as the study continued. It would appear that clopenthixol is an active antipsychotic medication which maintains its activity over twelve months. One or two patients responded very well to this medication after having failed to react to other neuroleptics. Toxicity was not a problem although laboratory abnormalities were noted early in the study.

Marijuana users were divided into low and high suggestibility groups and interviewed with regard to their marijuana experiences. The two groups could be successfully differentiated in terms of whether first expectations were met and in the frequency of the occurrence of paranoid symptoms.

Videotape is factually accurate but expensive. If used to replay in a group session it interferes with group process, whereas still photographs and audiotapes are inexpensive, unobtrusive and simple to add to the standard psychotherapeutic learning experience. The technique stands as a viable accessory to group therapy treatment.