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Preadolescent boys with Gender Identity Disorder (N = 13), their brothers (N = 8) and boys referred for psychiatric assessment (N = 10) were administered age-appropriate Wechsler intelligence scales. Four hypotheses regarding patterns of intellectual functioning and spatial ability were tested. A previous suggestion that the development of boyhood femininity is associated with higher than average IQ was not supported, since the IQs of the feminine boys and their brothers did not differ. A report of enhanced verbal ability as compared with perceptual organization also was not replicated in these feminine boys. On Kaufman's “Freedom from Distractibility” factor, the feminine boys and their brothers obtained scores as low as the psychiatric controls; that is, all three groups were equally distractible. It was suggested that anxiety contributed to poor performance on this factor. Unlike the control groups, the feminine boys obtained low scores on a test of spatial ability (Block Design) as compared to their scores on a verbal task (Vocabulary). The association between a feminine gender role and relatively poor spatial ability was discussed.

The lack of a universally accepted definition of body image has impeded our understanding of body image disturbances in children and adolescents. This paper examines the evolution of body image as a multidimensional construct and the difficulties associated with the use of human figure drawing to measure body image. Directions for future research are considered.

Since its development from general psychiatry, child psychiatry has been influenced by its close involvements with the child guidance movement and pediatrics and by the age of its patient population. This has led it to evolve in ways quite distinct from adult psychiatry, so much so that at times the understanding and relationship between the two disciplines has been somewhat strained. This paper relates the development of child psychiatry to its history, its tasks and its patient population, highlighting some of the major differences between child and adult psychiatry. It then looks at why research in child psychiatry has lagged behind research in adult psychiatry. It concludes by discussing tensions between the two disciplines, and why it serves the interests of both professions as well as those of our patients, that a better understanding and collaboration between them be established.

Objectives: To test the hypothesis that adoptees are overrepresented among a sample of clinic-referred boys with gender identity problems (N = 238). To compare the adoptees and nonadoptees on demographic, behaviour problem, and gender-typed measures.Method: The percentage of clinic-referred boys with gender identity problems adopted in the first 2 years of life (“early adoptees”) was compared to the base rate of boys adopted in Ontario. Parent-report and behavioural measures were used to compare the early adoptees with “late adoptees” (adopted after the second year of life) and nonadoptees.Results: The percentage of boys with gender identity problems who were early adoptees (7.6%) was significantly higher than the base rate of males adopted in Ontario in the first 2 years of life (1.5%). Both the early and late adoptees were significantly less intelligent than the nonadoptees. The early adoptees also had significantly higher externalizing T scores on the Child Behavior Checklist than did the late adoptees and the nonadoptees. The 3 groups did not differ in the percentage who met the complete Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for gender identity disorder and on 4 other measures of gender-typed behaviour.Conclusion: Adoptees are overrepresented among clinic-referred boys with gender identity problems. The reasons for this finding are not clear but may be accounted for by general risk factors that increase the likelihood of clinical referral or by psychosocial and biological factors associated with adoption.

The outcomes after 8 months treatment for mildly delayed, behaviorally disordered preschoolers in a therapeutic preschool were compared with outcomes for similar children integrated into daycare centres on measures of development, language and behaviour. The results provide a measure of the gains achievable in a well resourced and specialized program.

Using a sex-typed free-play task and the Draw-a-Person test, the gender-role behaviour of children attending a day-care centre whose staff adhered to a “non-sexist” child-rearing philosophy was compared to the gender-role behaviour of children attending a more traditional day-care center. Parental provision of sex-typed and neutral toys and approval of cross-sex role behaviour was also assessed. On both measures, the two groups of children showed culturally typical patterns of gender-role behaviour. The parents of the two groups of children were generally similar in terms of the kinds of toys they provided and in their attitudes toward the expression of cross-sex role behaviour. Potential explanations for the inability to demonstrate effects of the “non-sexist” child-rearing philosphy were discussed.

This article provides a selected overview of the literature on gender identity disorder and psychosexual problems in children and adolescents, with a focus on diagnosis, clinical course, etiology, and treatment.

A failure of affect regulation is put forward as central to the development of psychopathology. Giving affect regulation this pivotal role allows one to explain how the various theories of intervention (for example, dynamic, behavioural, medical) can all have relatively similar results. As well, it provides an explanation for the common findings of brain and language dysfunction in psychopathology, the co-occurrence of anxiety disorders in various other mental disorders and the responsiveness of individuals with severe pathology to the affect in their environments. A model is presented linking the reticular, limbic and frontal systems of the brain with the conceptual frameworks used by mental health workers in their efforts to intervene. To illustrate how the model may be used, it is applied to various disorders.