Some reflections on infancy-onset XXXX .

@entity1 @entity1949 @entity146 @entity148 @entity56 @entity158 @entity11530 @entity3119
Whether infancy-onset @entity11530 is best regarded as a habit, an early sign of @entity3119 , a symptom of @entity148 , or a sign of severe @entity1949 has been a topic of continuous debate. In this paper, we describe our clinical experience with nine consecutive cases of infancy-onset @entity11530 and detail the evaluation process and treatment course in one case. A distinct psychosocial stressor was identified in all cases, often accompanied by loss in the parents' histories. Most of the @entity1 had no transitional object. In six @entity1 , the symptom resolved after treatment and did not recur, while in three others improvement was partial. Length of treatment varied from four to twenty-one sessions and outcome was unrelated to treatment duration. In all cases, mother- @entity1 interactions were characterized by a lack of maternal physical contact and warmth, sharp maternal transitions between under-involvement and intrusiveness, lack of mutual engagement, and no elaboration of symbolic play. The @entity1 's behavior during play was marked by @entity148 , @entity146 , and momentary withdrawal from the interaction. Our cases reveal an impaired affective interpersonal communication between mother and @entity1 , often masked by a fair overallfamily instrumental functioning. It is tenta- tively suggested that infancy-onset @entity11530 represents an end-point symptom of several factors, such as a disturbed parent- @entity1 relationship, a @entity158 threshold in the @entity1 , and a parental @entity56 to overt expressions of aggressive impulses and negative affects. Issues related to treatment modalities are also addressed. Discussion focused on our experience that early-onset cases of @entity11530 are often not benign or homogenous in terms of etiology, course, or response to treatment and require much further study.
