151 選擇性緘默症 兒童焦慮障礙 一 定義 DSM-4 selective mutism Association 1994 90 1/4 1992 ICD-10 88 speech disorder Kussmaul Kussmaul aphasia voluntaria Moritz Tramer elective mutism Diagnostic and Statistic Manual of Mental Disorders (DSM-IV) (American Psychiatric Association, 1994) s mutism
152 二 症候 1. 發生時間 預後 : 3-5 90% 2. 出現率 : Bergman, Piacentini, & McCracken, 2002.71% 0.3-0.9 88 ( Wilkins,1985) 1:1.6 3. 附帶障礙 : 85%
153 Wilkins 1985 25% Wright (1968) 21% 三 病因 ( Klin and Volkmar, 1993 ; Wilkins, 1985;) 一 內在因素: 1 88 Jacobsen 1995dissociative identity
154 disorder Black & Uhde 1995 30 Jacobsen 1995 2 (Black and Uhde, 1992; Crumley, 1990; Golwyn and Weinstock, 1990; Leonard and Topol, 1993) Crumley (1990) 29 8 Black and Uhde 1992 Boon (1994) anxiety/ocd spectrum disorder Dummit III, et cl. 1997 50 50 DSM-III-R
155 48 Black & Uhde 1995 30 97 3 ( Meyers, 1984) 4 stuttering cluttering 38% disorder 5 Klin, A & Volkmar, F.R. 1993
156 6 Pavlek, 2001 四 治療策略 1 Lindblad-Goldberg, 1986; Meyers, 1984 500 2 Reed (1963) Calhoun & Koenig
157 (1973) 8 5 stimulus fading Scott (1977) 7 3 (Anstendig, 1999) (Kendall, 1994) Fung, Manassis, Kenny, & Fiksenbaum. 2002 4 inhibitors Sertraline & paroxetine Phenelzine Golwyn & Weinstock (1990) phenelzine ) ( 7 Black & Uhde (1992) fluoxetine ( 20 ) 12 Black & Uhde (1994) Fluo Boon (1994) fluoxetine Wright, et cl. 1995 10 9 12 6
158 fluoxetine treatment 5 12 Klein, Tancer, Asche & Martin. 1996 fluoxetine 21 9 8.2 5 14 76% flouxetine 5speech Smayling (1959) 6 ( 2 21 ) 5 6 school-based multidisciplinary individualized treatment plan Hechtman 1993 1 firm behavioral expectations 2
159 3video self-modeling social review Blum, Kell, Starr, Winifred, Lender, Bradley-Klug, Osborne, & Dowrick. 1998 3 15 15 4 self efficiency 5
160 6 delabeling Shvarztman., Hornshtein, Klein, Yechezkel, Ziv & Herman 1990 9 -- 7 結論
161 REFERENCES 88 69-82 American Psychiatric Association (1994), Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Washington, DC: American Psychiatric Association. Anstendig, K.D. (1999), Is selective mutism an anxiety disorder? Rethinking DSM-IV classification. Journal of Anxiety Disorder, v13, p417-434. Bergman, R.L.; John Piacentini; James T. McCracken. 2002 Prevalence and description of selective mutism in a school-based sample. Journal of the American Academy of Child and Adolescent Psychiatry, v41, n8, p938. Black, B., Uhde, T.W. (1992), Elective mutism as a variant of social phobia. Journal of the American Academy of Child and Adolescent Psychiatry, v31, p1090-1094. Black, B. & Uhde T.W. (1994), Fluoxetine treatment of elective mutism: a double-blind, placebo-controlled study. Journal of the American Academy of Child and Adolescent Psychiatry, v33, p1000-1006. Black, B. & Uhde, T. W. 1995 Psychiatric characteristics of children with selective mutism: a pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, v34, n7, p847. Blum, N. J., Kell, R. S., Starr, L., Lender, W. L., Bradley-Klug, K. L.; Osborne, M. L., & Dowrick,P.W. 1998 Case study: audio feedforward treatment of selective mutism. Journal of the American Academy of Child and Adolescent Psychiatry, Jan 1998 v37 n1 p40(4) Boon, F. (1994), The selective mutism controversy. Journal of the American Academy of Child and Adolescent Psychiatry, v33, p283.
162 Calhoun, J. & Koenig, K.P. (1973), Classroom modification of elective mutism. Behavior Therapy, v4, p700-702. Crumley, F.E. (1990), The masquerade of mutism. Journal of the American Academy of Child and Adolescent Psychiatry, v29, p318-319. Dummit,E.S. III; Klein,R.G., Tancer,N.K., Asche,B. & Martin,J. 1996 Flouxetine treatment of children with elective mutism: an open trial. Journal of the American Academy of Child and Adolescent Psychiatry, v35, n5, p615. Dummit,E.S. III; Klein,R.G., Tancer,N.K., Asche,B., Martin,J. & Fairbanks,J.A. 1997 Systematic assessment of 50 children with selective mutism. Journal of the American Academy of Child and Adolescent Psychiatry, v36, n5, p653. Dow, S. P., Sonies, B. C., Scheib, D., Moss,S. E. & Leonard, H. L. 1995 Practical guidelines for the assessment and treatment of selective mutism. Journal of the American Academy of Child and Adolescent Psychiatry, v34, n7, p836. Fung, D. S. S., Manassis, K., Kenny, A. & Fiksenbaum, L. 2002 Web-based CBT for selective mutism. (Letters to the Editor). Journal of the American Academy of Child and Adolescent Psychiatry, v41, n2, p112. Golwyn, D.H., Weinstock, R.C. (1990), Phenelzine treatment of elective mutism: a case report. Journal of Clinical Psychiatry, v51, p384-385. Hayden, T.L. (1980), Classification of elective mutism. Journal of the American Academy of Child and Adolescent Psychiatry, v19, p118-133. Jacobsen, T. 1995. Case study: is selective mutism a manifestation of dissociative identity disorder? Journal of the American Academy of Child and Adolescent Psychiatry, v34, n7, p863. Kehle, T.J., Owen, S.V. & Cressy, E.T. (1990), The use of self-modeling as an intervention in school psychology: a case study of an elective mute. School Psychology Review, v19, p115-121. Kendall,P.C. (1994), Treating anxiety disorders in children: results of a randomized clinical trial. Journal of Consulting Clinical Psychology, v64, p724-730. Klin, A. & Volkmar, F. R. 1993 Elective mutism and mental retardation. Journal of the American Academy of Child and Adolescent Psychiatry, v32, n4, p860. Leonard, H.L., Topol, D.A. (1993), Elective mutism. Child Adolescent Psychiatry
163 Clinical of North American, v2, p695-707. Lindblad-Goldberg, M. (1986), Elective mutism in families with young children. In: Treating Young Children in Family Therapy, v18, Meyers, S.V. (1984), Elective mutism in children: a family systems approach. American Journal of Family Therapy, v22, n4, p39-45. Pavlek, M 2001 Getting ready to talk: The treatment of a mildly retarded, selectively mute adult. Clinical Social Work Journal, v29, n2, p159. Reed G (1963), Elective mutism in children: a reappraisal. Journal of the Child Psychology Psychiatry, v 4, p99. Shvarztman, P., Hornshtein, I., Klein, E., Yechezkel, A., Ziv, M. & Herman, J. 1990 Elective mutism in family practice. Journal of Family Practice, v31, n3, p319. Scott, E. (1977), A desensitisation programme for the treatment of mutism in a seven year old girl: a case report. Journal of the Child Psychology Psychiatry, v18, p263-270. Smayling, J.M. (1995), Analysis of six cases of voluntary mutism. Journal of Speech Hearing Disorder, v24, p55-58. Wright,H.H., Michael L. Cuccaro, M.L., Leonhardt,T.V.; DorothyF ; Kendall,D.F., & Anderson,J.H. 1995 Case study: fluoxetine in the multimodal treatment of a preschool child with selective mutism. Journal of the American Academy of Child and Adolescent Psychiatry, v34, n7, p857.
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