IACAPAP Bulletin Supplement Donald J. Cohen Fellows’ Remarks on the 16th IACAPAP Congress Berlin, Germany – August 22–26, 2004

Section/Title Author(s) City, State, Country Page Editors’ Introduction Andrés Martin New Haven, CT, U.S.A. 2 Cynthia Pfeffer White Plains, NY, U.S.A. I. Reflections Dignified Returns: Berlin and Donald J. Cohen in 2004 Andrés Martin New Haven, CT, U.S.A. 2 Donald J. Cohen Fellowship for International Scholars in – – 4 Child and Adolescent Psychiatry and Allied Professions My Long and Arduous Journey to Berlin Olayinka Omigbodun Ibadan, Nigeria 5 (and how it was really worth it) Fellow Journeys: From Camposampiero to Berlin Leonie Boeing Edinburgh, Scotland, U.K. 7 What T-Shirt Do I Wear? Mani N. Pavuluri Chicago, Illinois, U.S.A. 8 Scientific Thinking and Thoughtfulness in Science Maj-Britt Posserud Bergen, Norway 9 “Licking and Grooming” (Affectionate Belo Mussche Antwerp, Belgium 11 Touch and Contact) in Mentorship From Generation to Generation: A Sameer Malhotra New Delhi, India 11 Fellowship Tribute to Professor Donald J. Cohen Empowering a Culture of Mentorship Worldwide Robert Vermeiren Antwerp, Belgium 12 Should We All Go Into Politics? Ine Jespers Antwerp, Belgium 12 Ukraine is Eager to Join the International Liliya Butenko, Igor Kyiv, Ukraine 14 Child Psychiatric Community: The First Martisenkovsky and Step Can Be the Hardest (But Was Not) Yana Bikshaeva Posters: Not Rockets Osman Sabuncuoglu Istanbul, Turkey 16 Creating Connections: From Berlin to Melbourne Monique Nesa Perth, Australia 16 II. Reports The Biology of Childhood Experience: Sameer Malhotra and New Delhi, India and 17 Dedicated to the Memory of Professor Leonie Boeing Edinburgh, Scotland, U.K. Richard Harrington Nature-Nurture Paradigms: From Berlin Jana Marinka Kreppner London, England, U.K. 17 versus London to Berlin and London A Place and a Time for Thinking About the Role of Stephen Collishaw London, England, U.K. 18 Place and Time in Child and Adolescent Psychiatry Primary Preoccupations for All James Swain New Haven, CT, U.S.A. 19 Listening to Sir Michael: Environmentally Zhu Yan Changsha, China 20 Mediated Risks for Psychopathology Another Look at Resilience Galit Ben-Amitay Tel Aviv, Israel 21 Quality Assurance in ADHD: The Doa Habib Alexandria, Egypt 22 European Interdisciplinary Network Brain Imaging in Psychiatry Caterina Gawrilow Konstanz, Germany 23 Gender Matters Susanne Walitza Wurzburg, Germany 23 III. Interviews Seeing the Individuality in Every Child Christoph Correll Glen Oaks, New York, U.S.A. 24 An Interview with Professor Helmut Remschmidt A Decade Editing the IACAPAP Bulletin Orlando Uccinelli and Rome, Italy and 27 Drs. Cynthia Pfeffer and Jocelyn Hattab Ramon Lindauer Amsterdam, The Netherlands IACAPAP Officers – – 28 Editors’ Introduction I. Reflections Much like kindergarten teachers, good tour guides can be enormously Recipients of the Donald J. Cohen influential on our views, yet we Fellowship for International Dignified Returns: would be hard pressed to remember a Scholars in Child Psychiatry and Berlin and Donald J. Cohen in 2004 single one by name. Thank you, Allied Professions were put to work Thomas, whatever your last name is. immediately, almost before they Andrés Martin, M.D., M.P.H. It wasn’t so much the mob of could open and enjoy their congrat- Yale Child Study Center tourists taking pictures of the ulatory letters. Specifically, they were New Haven, Connecticut, U.S.A. Quadriga on top of the Gate that let asked to contribute a piece to the next me know I had arrived to the hub of it issue of the IACAPAP Bulletin. Dig·ni·fy all. Not even recognizing in its Fellow pairings were suggested, and 1. To raise the status of (something silhouette a pictogram emblematic of assignments distributed well ahead of unworthy or lowly); to make the city. Rather, realizing that the time. One could argue that the honorable. Gate had been at the core of No exercise was a complete failure: very The American College Dictionary, Man’s Land: visible to East and few fellows turned in the ‘homework' Third Edition (Boston: Houghton West, yet out of reach for both. A they were officially assigned, and Miflin Company, 1993) colossal and painful tease, if ever even fewer of them did so working there was one. It gave me a tingling with their assigned colleagues. And Truth be told, I had some trepidation and satisfying sense of accomplish- yet, a great many of the program about going to Berlin. An unfair ment to walk under the Gate, from the participants took us up on another feeling perhaps, but one not appeased West to the East, but it was altogether offer: that to write more intimately, on finding out, through large posters chilling to walk over the bricks from their personal experiences, about pasted near its entrance, that my hotel, marking where the Wall once stood. any aspect of the Congress in all its the Sylter Hof, had a troubling history The understatement of the small magnitude and complexity. By this of its own. Early in the twentieth engraved bronze plaques strewn over second metric, the exercise turned out century, the same address, 114-116 the line every few blocks spoke to me to be, in our opinion, a singular Kurfürstenstraße, had lodged the volumes more than the dated quaint- success. The contributions that follow Jewish Brotherhood, a long-silenced ness of Checkpoint Charlie ever are divided into Reflections, Reports, institution that rings today of heated could: Berliner Mauer 1961–1989. and Interviews, but the reader will Yiddish arguments among its But not only on those plaques readily see that the distinction is members, idealistic socialists and has Berlin chosen its words thought- rather arbitrary, for it is in the inter- proto-Zionist followers of Theodor fully, proactively, tellingly: turning play between the realities of the Herzl whose dreams were not to last. left after crossing the Gate, and next Congress and the internal experience By the mid-1930’s, Adolf Eichman to the vacant lot that will soon house of its participants that the real action sullied them with the ignominy of the new American Embassy, I saw of these pieces takes place. We using the same building to house the the nearly completed Monument to appreciate the efforts of our contribu- Judenreferat IV B4 (an outpost of his the Murdered Jews of Europe. Not tors, encourage them (as every other Department of Jewish Affairs), from ‘lost’ nor ‘dead’; not even encapsu- reader) to continue engaged with where the better to tally his macabre lated under the technical jargon of IACAPAP and its Bulletin, and hope counts of racial impurity. ‘genocide’ or ‘Holocaust’: much to see all in Melbourne in 2006. Who I fully blamed jetlag for my first more plainly, much more truthfully can foresee where our field will be a night’s restless sleep. told: ‘murdered’. It struck me as short two years hence, and how that In the dreamy haze of the day brave and courageous to put it all out meeting and that place will resonate that followed, I took to the streets of there, a shingle in plain view for the with each one of us? We look the city. From an anticlimactic entire world to see. So much more forward to finding out, together. meeting point at the central Zoolo- after seeing the magnificent Jüdisches gischer Garten (in front of its Museum that Daniel Liebeskind Andrés Martin, M.D., M.P.H. Dunkin Donuts, no less) a vivacious designed years before winning the guide with a thick Irish accent led Cynthia Pfeffer, M.D. contract for New York’s Freedom me through the orderly U-Bahn grid Tower – arguably the world’s most to the Brandenburger Tor. coveted architectural trophy. At the Gate I met, and was To its critics and various quickly captivated, by Thomas, my naysayers, the Jewish Museum is too city guide for the next five hours, and refined and beautiful: more about a native Berliner through and through. (continued on page S3) S2 Dignified Returns: Three general principles helped end, many of the larger ones devoted (continued from page S2) me make sense of what surely is one to mental health have established of the richest and most fulfilling of fellowship programs specifically European cities. First, an impeccable targeted to their younger and potential architecture or itself than about memory that has refused to take the members. In the United States alone, history; its lack of graphic details a facile route of oblivion (a telling the American Psychiatric Association, sign of an elusive and slippery nature. exception to the rule being Hitler’s the American Academy of Child and As its newest admirer and champion, bunker, its exact location undisclosed, Adolescent Psychiatry, and the I celebrated its intellectual and uncelebrated, and known to but a few American College of Neuropsycho- ultimately claustrophobic appeal: I history buffs. Parenthetically —and pharmacology provide just three cannot think of a single building in all too satisfyingly— it sits today examples of institutions with thriving the world that so effectively com- under a drab parking lot and a gay fellowship programs. municates its message through the sauna club). Second, a rejection of Not surprisingly, the basic efficiency of brick and mortar alone. euphemisms in favor of short state- building block and rate-limiting step In it, the millenary history of German ments of fact: Murdered Jews, to viable fellowship programs is Jewry is reduced to three off-kilter Berliner Mauer. Third, and most money. Fellowships are costly affairs, axes of converging lines (Continuity, admirable, an embrace and incorpor- with resources rapidly spent on travel, slashed at abrupt angles by Exile and ation of the past —no matter how lodging, and registration fees. Holocaust). The museum’s archi- troubling— into a vibrant present. Additional events, such as a welcome tectural haiku is viscerally haunting To have lived through the fall of dinner or a research colloquium can and on target. The magnetic appeal of the Berlin Wall, the reunification of further stretch already preciously its underground structure would have Germany, and the erection of a allocated funds. In an attempt to likely been lost through a fully frontal museum and a monument to remem- provide a meaningful experience presentation of the horrors (as in ber, to exorcise, and ultimately to while maintaining a balanced budget, Washington D.C.’s Holocaust prevent the atrocities of the past, is a institutions have to limit their Museum): the result would have privilege of our generation. More ambitions (translating into fewer proven this geographically and emo- importantly, it is a humbling testament fellowships awarded), and explore tionally close to the source too refrac- to tremendous national and human funding streams of the utmost tive or frightening, too jarring and integrity, honesty, and courage. Risen creativity (including philanthropy, ultimately alienating an experience. and made honorable indeed. So where governmental and nongovernmental Berlin’s architectural medley better than in Berlin, in this reunified, organizations, and unrestricted appeared to me a polyphony from risen, and honorable city that reminds educational grants from industry). which to extricate an underlying us today that Holocausts and Cold By moving from a haphazard hidden tune. The gritty boxes of the Wars can and have been overcome — and small fellowship program in East’s Soviet architecture (Lenin where better than here to convene on intermittent existence during previous effigies and all) at first appeared behalf of the world’s children? meetings to a large-scale centerpiece unusual bedfellows to the majesty of of its Sixteenth World Congress in the Hohenzollern and Prussian Dig·ni·fy Berlin, IACAPAP has demonstrated buildings lining the Unter den Linden 2. To confer dignity or honor on; to its attainment of a new developmental Sraße. The perfect harmony of the give distinction to. milestone. For it takes a mature and Gendarmenmarkt at odds with the solid organization indeed to deliver a one-upmanship and pretensions of the Institutions, just like species or young program capable of attracting over obnoxiously high Fernsehturm in nations, attain a new level of develop- sixty of the brightest and most Alexanderplatz. At one level, and in mental maturity when becoming promising child and adolescent the tradition of its Potsdamer Platz capable of moving from mere survival psychiatrists and allied professionals, and its Sony Center (including a roof to the care and nurture of their young. collectively representing twenty-six fashioned after Mount Fuji) the city Fledgling organizations are satisfied countries around the globe. And a could (and to the dismay of its near to reach a large enough quorum, or to new degree of sophistication to garner empty coffers has partially already) establish a basic regularity to their the necessary resources for such a reinvent itself as a monument meetings. In contrast, mature institu- logistically massive undertaking – let embodying capitalism’s victory. I was tions worthy of commanding our alone one with as global a reach. (As trying hard to make sense of it all, respect are not content with numbers a noteworthy aside, by supporting the and could by now, in the fully alone: they focus on their futures, and attendance to Berlin of fellows from caffeinated honesty of midday, no on the transmission of their core countries of the former Eastern Block, longer blame my difficulty to do so values to a new generation. To that on jetlag alone. (continued on page S4) S3 Dignified Returns: Echoing those sentiments, with Donald J. Cohen Fellowship for (continued from page S3) Jim Leckman and Kari Schleimer, International Scholars in my partners in coordinating this Child and Adolescent Psychiatry program, we extend our own and Allied Professions the German government deserves gratitude to a dozen stellar mentors, Berlin, Germany - August 2004 special mention among the lead whose selfless dedication of time and funders of the program. Although energy are our second most precious FELLOWS planned and funded separately, the natural resource. Next of course to Eastern Program merged seamlessly our first: a promising generation of Valbona Alikaj, Albania into the overarching Fellowship). future leaders in the field. Let us all But fellowship programs are Henrik Andershed, Sweden commit to sustaining the longevity of about more than just money: they are [email protected] this most special of programs. about relationships –and about Ayse Arman, Turkey genuine care for a new generation. It [email protected] Dig·ni·fy was in this spirit that IACAPAP’s 3. From the Latin dignus, worthy. Fernando Asbahr, Brazil fellowship program was aptly named [email protected] after Donald J. Cohen, the Associa- The city of Berlin, named after the tion’s President from 1992 to 1998. Galit Ben-Amitay, Israel swamps on which it was once [email protected] The program was more than merely erected, has proven worthy not only named after Donald, it rapidly came of statehood’s capital over lowly Leonie Boeing, United Kingdom to embody his core values and talents: swamphood, but of becoming a [email protected] a combination of kindness and sobering reminder of man’s ability for Liliya Butenko, Ukraine warmth to newcomers, initiates, and evil – and for the repairing and [email protected] senior citizens alike; a legitimate ultimately prevailing good that can Stephan Collishaw, United Kingdom interest in the personal life and ensue. It has proven worthy, like few [email protected] professional challenges of others; a places could, of hosting this con- serious engagement with the details ference dedicated to improving the Ariel Como, Albania of clinical and scientific work –from welfare of the world’s children. To [email protected] the mundane to the most intricately the wonderful hosts that have been NaoufelGaddour, Tunesia complex; and perhaps above all, an this city, this country, this people, and naoufelgaddour@historique. ability to see and nurture in others our past president and dear friend zzn.com what they may not have yet been able Helmut Remschmidt, unseren Xueping Gao, China to see in themselves. herzlichsten Dank –our heartfelt [email protected] To this end, the fellowship thanks. Caterina Gawriolw, Germany required of considerable more human And to our program’s namesake, [email protected] resources than cash: it depended on we posthumously convey our sense of konstanz.de dedicated mentors. Indeed, the core of fulfillment and gratitude. This the fellowship’s activity occurred in fellowship has proven worthy of its Elen Gjevik, Norway the middle of each work day, between name. To Donald Cohen, our teacher, [email protected] the morning and afternoon sessions, our mentor, and our friend, yehi Tomi Guttorm, Finnland as groups of half a dozen or so zichrecha baruch – may your [email protected] fellows sat with their respective memory be for a blessing. Doa Habib, Egypt mentors around coffee tables in a As it has. specially designated lounge in order [email protected] to discuss their work, their science – Anke Hinney, Germany and themselves. The texture of those [email protected] small group meetings, the actual 4 Zineb Iraqi, Morroco human electricity and sparks that [email protected] flowed from them, can be readily gleaned from the essays that follow. Lucres Jansen, Netherlands Through them runs a common theme: [email protected] one of appreciation and gratitude for Ine Jespers, Belgium having been taken as seriously as [email protected] clinician-scientists and as individuals.

(continued on page S5) S4 Donald J. Cohen Fellowship Osman Sabuncuoglu, Turkey Peter Riederer, Germany (continued from page S4) [email protected] [email protected] Shella Sadigorsky, Israel Kari Schleimer, Sweden Shahi Kiran, India [email protected] [email protected] [email protected] Kapil Sayal, United Kingdom Gerd Schulte-Körne, Germany Jana Kreppner, United Kingdom [email protected] [email protected] [email protected] Maria Antonia Serra-Pinhero, Brazil Mary Schwab-Stone, USA Rejia Latva, Finland [email protected] [email protected] [email protected] Rael Strous, Israel John Sikorski, USA Ramon Lindauer, Netherlands [email protected] [email protected] [email protected] James Swain, USA Hans Steiner, USA Sameer Malholtra, India [email protected] [email protected] [email protected] Sonila Tomori, Albania Andreas Warnke, Germany Janine Marinho Dagnoni, Brazil Mannia Torppa, Finland [email protected] [email protected] [email protected] YiZheng, China Igor Martsenkovsky, Ukraine Emmanuel Tsalamanios,Greece [email protected] Dragon Mitrovic, Serbia-Montenegro [email protected] [email protected] Orlando Uccellini, Italy Diego Mugno, Italy [email protected] 4 [email protected] Robert Vermeiren, Belgium [email protected] Isable Belo Mussche, Belgium My Long and Arduous Journey [email protected] Angela Wagner, USA to Berlin (and how it was really Monique Nesa, Australia [email protected] worth it) [email protected] Susanne Walitza, Germany Alexsic Olivera, Serbia-Montenegro [email protected] Olayinka Omigbodun, M.B.B.S., M.P.H. [email protected] Ji Fen Wang, China College of Medicine, University of [email protected] Olayinka Omigbodun, Nigeria Ibadan & University College Hospital [email protected] Tjhin Wiguna, Indonesia Ibadan, Nigeria Silvia Paracchini, United Kingdom [email protected] [email protected] Maruke Yeghiyan, Armenia My journey to Berlin to attend the th Mani Pavuluri, USA [email protected] 16 World Congress of IACAPAP [email protected] Shi Ji Zhang, China began surprisingly. I was handed an e-mail with information about the Guilherme Polanczyk, Brazil [email protected] Donald J. Cohen Fellowship Program [email protected] Yan Zhu, China sent to one of my colleagues at work. Viviana Porcari, Italy [email protected] The message had been sent to a [email protected] network of psychiatrists asking them MENTORS Maj Britt Posserud, Norway to identify ‘black’ child psychiatrists [email protected] who could apply for the fellowship. I Cristoph Correll, USA immediately set out to try my luck Linda Rachidi, Morroco [email protected] and was able to put together and send [email protected] Nathaniel Laor, Israel all the necessary documents within 48 Marimilia Rodrigues Lambertucci, [email protected] hours of receiving the information. Brazil James Leckman, USA We had just completed very hectic [email protected] [email protected] but rewarding data collection on Oleh Romanchuk, Ukraine health problems in adolescents living Andrés Martin, USA [email protected] in rural southwest Nigeria, and from [email protected] Vladislav Ruchkin, USA there I was able to draw my abstract. Cynthia Pfeffer, USA [email protected] [email protected] (continued on page S6) S5 My Long and Arduous Journey history, I was told to come to the all about it. I put all arrangements for (continued from page S5) embassy as early as 6 a.m. the next my poster presentation on hold, and day, and to apply as a ‘frequent flyer.’ decided to forget about Berlin. The first time I made the 100- A few days later I got an e-mail After a patient wait, I received mile journey by road from my base to from Andrés Martin, sent to all the an e-mail congratulating me on my the embassy, I could not gain access. Donald J. Cohen Fellows. As I read selection for the fellowship. Several On the second occasion, I got to the through this e-mail, I felt a fresh zeal beautiful thoughts ran through my embassy before 5 a.m. in the morning and determination to fight on, because mind as I set out to prepare for this and joined the queue of frequent a chord struck in me as I looked at the important conference. I had a long list flyers. I stood on this queue for five list of fellows. The fact that I had of items I needed in order to obtain a hours but did not move from the point been paired up with another fellow visa to travel to Germany, including a where I started at 5 a.m.. Other gave me a sense of obligation to detailed letter of invitation from my people coming much later were being attend this conference. What did it hosts to be sent through regular mail. escorted in. I protested to the heavily was that on this list, I was the only Visa problems were least on my mind armed security guards, who simply fellow from Africa, South of the because I had been able to travel ignored my protest. Sahara. A strong need to struggle quite a bit before and never been I then discovered that you had came back to me for I now knew that refused a visa. Little did I realise that to ‘pay a price’ to get in. I was not I was an ambassador not only to my I would face a different type of ready to pay this ‘price,’ but then I country, but for the scores of situation this time. As I waited for felt silly, because getting in was easy marginalized ‘black African children’ this very special invitation letter, I so long as you were ready to pay. As with no access to mental health care. received frequent, and always upbeat I remained standing at the same Armed with this fresh burst of correspondence from the organizers, position for five hours, my emotions energy, I decided to disregard the heralding such news items as “We moved from hope, to anger, disbelief, consequences of rejection and made a now have 1400 registrations from 62 sadness and despair. After the five- phone call to a very highly placed countries,” “Your name tag is the free hour stand, those of us left standing person I know. I explained my ticket to unlimited use of the Berlin outside were told to go away, as the situation in detail, all this just one public transportation system,” “You required number of applicants for the week prior to my expected date for are invited to attend the opening cere- day had been taken. I was numb at departure. For two days I heard mony and afterwards to a special this point, and while trying to sort out nothing, but an inner voice told me to reception for fellows of this program.” my emotions, suddenly felt a choking continue with my poster preparations. All these whetted my appetite and feeling and my eyes burning. I then I made another fruitless 200 mile trip built up my enthusiasm. saw people running, children crying, that did not work out. The last try was As soon as the letter of invita- and heard shouts of “teargas, teargas.”. to go by air to another part of the tion arrived in the mail I started I immediately joined the sudden 100- country, to another German consulate. calling to book a visa interview. The meter dash. Fortunately for me, I used On Wednesday I was eventually able instruction was that we should call to be an athlete. to gain access, but was told the visa between 7 a.m. and 8 a.m. and I did When I got back to safety, would not be ready until Friday - the this meticulously for several days. I I called Professor Helmut day before I was to leave. By noon on sat by the phone calling over and over Remschmidt in Germany and Friday, my visa was ready and my again, always receiving the same explained the situation to him. I must passport arrived late that evening. I message form the answering service, mention that throughout this experi- eventually got my ticket very late at saying that all appointments had been ence, he was very supportive and did night. The last thing to arrive was my booked for the day. I called the his very best to intervene. I called poster, which was brought to me just embassy several times to report this him from outside the embassy and he an hour before I left for the airport. difficulty, but was told to keep trying reassured and encouraged me to wait. Berlin, here I come. the same number. I was later informed He called to speak to the officials I was touched by so many that the line had been jammed by a over the phone and sent fax aspects of the conference, especially group of people with whom I had to messages, but I was still not allowed meeting so many people from such make contact and pay a fee in order into the embassy for an interview. diverse cultures. And those free bus to obtain an interview appointment. I At this point I gave up all hope and U-Bahn rides through Berlin… was running out of time and became and decided that Berlin was not meant Many evenings I just hopped on a bus quite worried. I called the embassy to be. I tried to understand my experi- and went round the city. I was reception and explained the situation to ences of that 10th of August, and especially touched by the state-of-the- them. On learning about my travel returned to my base to try and forget (continued on page S7) S6 My Long and Arduous Journey Fellow Journeys: part of a living, creative memorial to (continued from page S6) From Camposampiero to Berlin. the man – passed on, in favorite Hebrew words of his, midor l’dor, Leonie Boeing, MB ChB, from generation to generation. art lectures. It was so refreshing to sit MRCPsych. We were organized into down and be nourished with excellent, Lothian NHS Young Peoples Unit mentorship groups that met daily. My well-organized lectures, coming from Royal Edinburgh Hospital group included young academics a culture where didactic and rote Edinburgh, Scotland, from China, Turkey, Germany and teaching is the norm. What further United Kingdom Israel. It was good for someone like made things so interesting and me, whose first language is English worthwhile was meeting people, My first contact with IACAPAP was (albeit with a Scottish accent, which including Dr. Sam Jolayemi from through my attendance to the ESCAP to my amusement and embarrass- Nigeria, a colleague I last saw six / Foundation Child research ment, garnered much attention) to years before the conference. He is seminar, held in Camposampiero, hear the efforts and energy that now a child psychiatrist in Australia, Italy in March of this year. Professor people from across the world make to and we spent a whole afternoon Helmut Remschmidt, who has be part in the international research talking as I was trying to get him to written much of the literature that community. help build up child psychiatry in our informed my research on early-onset Our mentor, Professor Cynthia country. I also met Professor Brian psychosis, guided delegates from Pfeffer’s account of her own work Robertson from South Africa, the across Europe through a week of with the children bereaved on person who facilitated my being able lectures and research workshops. September 11th gave us pause to to apply for the Donald J. Cohen Doing a most inspiring sales pitch at reflect on the real value of interna- Fellowship by sending out the first the time, he multi-tasked as president tional collaborations toward building e-mail. These meetings all had great of IACAPAP and encouraged us to bonds that surpass religion or meaning for me, but there was even apply for the Donald J. Cohen territorial boundaries. more to come. Fellowship, and hence onwards to As the week progressed in a Another Donald J. Cohen Berlin in August. blur of lectures and posters on Fellow, Maria Antonia Pinheiro A few weeks before the ADHD, SSRIs, and PTSD, we from Brazil, dashed up to me one conference, e-mails from Professors squeezed in time for sightseeing in afternoon as I sat chatting in the Remschmidt in Marburg and Andrés Berlin – witnessing a country reunite fellowship lounge and told me my Martin in Yale welcomed us to the and rebuild itself in stunning style. poster had won the second prize. I Fellowship and let us know of friends Professor Ernesto Caffo could not believe this and went down who would also be attending, and invited several of us to an evening at to see for myself. This was indeed paired together on writing assign- the Italian Embassy to celebrate the soothing for me as I thought of my ments for the Bulletin. Sameer work of Professor Giovanni Bollea, long and arduous journey to Berlin. Malhotra and I were given the task senior statesman and one of the My very own poster, brought to the of covering the Richard Harrington founders of Italian child and congress wrapped in bin bag liners, Memorial Lecture, thus creating a adolescent psychiatry. It was a had won second prize, bringing to a new collaborative connection between privilege indeed to attend while there climax my long and arduous journey India and Scotland. A flurry of antici- the world premier of Il Sogno di un to Berlin. My presentation, titled patory e-mails allowed us to organize Babino – A Child’s Dream– the 15- ‘Depression, depressive and suicidal accommodation and meeting places. minute testimonial film directed by symptoms among adolescents in rural Having moved into child psychiatry Marco Carniti and starring Professor Southwest Nigeria,’ had received only one year ago, my knowledge of Bollea strolling the streets of Rome notice at this international conference. Professor Donald Cohen was based alongside a cherubic ten-year-old boy Excitedly, optimistically, I wished that on his inspiring academic record, one full of big questions. this notice would bring new hope to unashamedly written with a social Glamming it up in the theatrical child mental health in ‘black’ Africa. conscience. So it was not until the and impressive setting of the Embassy That is still my fervent hope. welcome meeting for fellows, where provided a unique experience to brush academics from the U.S., Europe, and up with history: Designed with the the Middle East all spoke so warmly neoclassical grand aspirations of 4 of Professor Cohen, that I fully Benito Mussolini in mind, the realized the great privilege it was to building did not formally open as have been awarded the fellowship planned in the 1940s, but rather until bearing his name. We were all to be (continued on page S8) S7 Fellow Journeys: fellowship lounge made it instantly point home —with its urgency to cul- (continued from page S7) possible to join the discussion of tivate the serious researcher within me. young scientists with mentors Andrés Often I feel it is about believing Martin and Christoph Correll. I was in yourself and the mission of your 1991, when finally completed and at work literally five minutes after my work that leads you to seek appropri- brought up to mint condition, except arrival. In the presence of these ate funding available in your own for the notable exception of columns aspiring academics from all over the country. This relentless fundseeking left in shatters in the grand patio, a world, it was not difficult to empa- may not be a natural instinct in many reminder to the bombings it took near thize with the struggles of start-up countries. I was eager to convey this the end of the war. But the brushing research. I listened to the group, and in my group discussion when Dr. was social as much as historical, and even had the opportunity to give Martin gently pointed out that research somehow making all those hours of feedback on research methodology, is not an all-or-none phenomenon, hard slog over my data set seem ranging from career options, and there is a range of commitment worthwhile (not to mention, on behalf interpersonal issues, obstacles, the options and career lines, and that one of international collaboration, consen- choosing of mentors, recruitment, need not exclusively be in an all-out- sus-building and cultural exchange, measures, design, analysis, writing, convert-serious-researcher-mode to be witnessing a certain Professor from choice of journals, timelines, and — successful. That suddenly raised the Yale re-enact episodes of The last but not least— developing and question in my mind: Do I need my Godfather and The Sopranos to an maintaining a vision that leads to own brand of “T-shirt”? Or can I increasingly alarmed young delegate goals. settle for a local brand? Or do I go for from Sicily). Cheers to our Italian Having been brought up in national or international brand? friends! India, trained in Psychiatry in New In developing my own sense of With kneecaps intact, the week Zealand and Australia, and retrained my research career and goals, I have came to a close with feedback in the USA, I feel I had a mission at been struck by the balance of seeking sessions from the mentorship groups, IACAPAP. Having missed the head funding and bringing forward scien- giving us the opportunity to show our (with delayed entry) and tail ends (had tific ideas. To some, this could be thanks for such an inspiring experi- to leave early) of the travel fellowship construed as ambition intertwined ence. And so it was that with new forum, I am glad that I now have the with scientific pursuit. In the United ideas, collaborations and friendships opportunity to share in a larger forum States, pressure is on for various we each returned to our home this essay on my personal experience, reasons– money, publications, etc., countries, to resume with renewed as well as my two cents’ worth of but the FOCUS of scientific pursuit is energy our research and clinical wisdom. really the central anchor that dictates endeavors, and deeply touched and What I have learned in the USA a behavior conducive to making it all inspired by the enduring legacy of is the same key phrases over and over work. But then again, there is more to Professor Donald J. Cohen. again —focus on a topic, use standard focus than just what you chose. A measures, select a successful mentor self-revelation is in order here: Not who is interested in you, get prelimi- too long ago, I sounded ambitious to 4 nary data, apply for small and big others when I said I am interested in What T-Shirt Do I Wear? grants persistently, and stay on the psychopharmacology, imaging, and road, as it is not a sprint but a therapy —all at once. It was more Mani N. Pavuluri, M.D., Ph.D., marathon! All of this is meant to ignorance coupled with passion than FRANZCP develop the “T-shirt” that you wear, a just pure ambition. Then, I had to University of Illinois at Chicago metaphoric symbol of your identity match one of my critical interests Chicago, Illinois, U.S.A. that is branded with your particular with a mentor and fiscal opportunities topic(s) of interest (perhaps I can say available to me. I quickly learned that Delayed by 19 hours and having lost that my own reads “Bipolar Disorder focus is not always about only what my four research posters en route to and Affective Neuroscience”). you want to do but rather a mesh of Berlin, I told myself to go with the Honestly, people were very helpful your interests and the opportunities flow. Walking into the arena of the across other nations where I previ- around you. Single-mindedness has to ICC center to find the bold and big ously worked. They had a significant be coupled with flexibility and wise banner of “World Congress: impact in my development as an and critical choices. Therefore, it is IACAPAP,” I felt instantly welcomed academic. But somehow, for me, the for each one of us to decide and into the grand proceedings of a constant repetitive collection of individualize when we reach the meticulously organized conference. phrases after I reached the shore of crossroads of our many career The sign leading to the the USA is what finally drove the (continued on page S9) S8 What T-Shirt Do I Wear? Scientific Thinking and should act responsibly about it and (continued from page S8) Thoughtfulness in Science remain open minded and critical of what we do, particularly about our Maj-Britt Posserud, M.D. cognitive and practical paradigms. options. Most, if not all, of us, feel University of Bergen We must not believe in theories, even isolated looking for that ideal Bergen, Norway when we feel they are ‘correct’. In department and ideal team. But things fact, the wish to believe in a theory are rapidly changing as we are I went to Berlin as one of the could serve as a warning signal, one connected to our academic peers by recipients of the Donald J. Cohen to get us seriously looking for refuting emails and conferences. Networking Fellowship. This was a blessing in the instances for our theories, whether in is the key word that narrows down sense that we got financial support to our clinics or our laboratories. The these real and perceived distances. attend the IACAPAP congress, but search is a moral as well as a Another thing that struck me as even more importantly, that we got cognitive imperative, particularly I read the articles sent by Dr. Martin the opportunity to meet in small when patient care is involved. This is on the distinguished Donald J. groups with a mentor, to help us with what Professor Laor suggests Cohen, was that a script unfolded. our own research and work, and to following Karl Popper’s philosophy There are a great many scientists. get to know other researchers within of science. There are a great many organizers. the field. We were further encouraged What is the usual alternative There are a great many advocates for to share the fruits of these meetings practice we have encountered in our children. But what are the ingredients and from the whole congress with the daily academic and clinical routines? of a great leader? What seems to have rest of the field through the IACAPAP We all usually try to explain the placed him apart from others is his Bulletin. I am delighted to do this discrepancies and theoretical flaws warmth, intelligence, a mind for now. within the ruling professional business, charisma, kindness, leader- Our group mentor was Professor paradigm of the day. However, it ship, a sense of urgency in conveying Nathaniel Laor, who is not only a would be more fruitful to try and to the world what his great mind is child and adolescent psychiatrist, but juggle with alternative hypotheses, spinning, and the combined love and a card-carrying philosopher and the one among them being that a commitment to his own family, as author of papers and books in the paradigm shift is warranted. well as the extended family of the field of medicine, science, and Remember that every paradigm scientific world —all in one person. If philosophy as well. To top it all off, is a potential snare: As child mental only I had met him! But the sharing he is a published poet. Our discus- health professionals we deal with of this man and his leadership was sions started out with own work, but children and families, on whom we particularly instructive for me, as it under the guidance of Professor Laor, may have a lifelong impact. We must again contributed to my own reached a much broader picture of our remain careful lest we impose and conceptualization of my academic work as researchers. It would be cause serious harm through terribly career and identity. I am touched by impossible to justly convey the wrong paradigms. (Just think about the invaluable experience of the essence of these meetings, but I will the consequences of the theory of Cohen Fellowship at the IACAPAP try to share some of the key points autism that said the child’s disorder Congress. from our discussions. was due to its ‘refrigerator mother.’ The culmination of my experi- In addition to the sorrow of having a ence of reflecting on my own research Being a scientist - a critical lifestyle seriously disabled child, we added the agenda, coupled with personal growth, burden of guilt to these poor families, is a journey in which I hope to at least Science is respected for its harsh and to boot, made treatment research make a small contribution to the work criticism of methods and facts – impossible along the way.) Our of mental health care of children. And nothing is granted, everything could patients’ plights prescribe that we yes: whether with this or another be doubted and, therefore, has to be adopt a critical lifestyle in science and particular T-shirt. tested. Theories are preliminary, medicine. I should also note the splendor holding only until they have been of Germany. It was beautiful, and to refuted – as they more than likely will Hence, our personal insecurity do it justice would take yet another be! No theory has lasted (I take may take us and our patients into a essay. Professor Laor’s word for this), not dead end. If we are worried about even Newton’s. some limitation of our statements, be If we adopt the scientific they clinical or scientific reports, we 4 method to our lives, and develop a ought to expose and incorporate them critical lifestyle – then we need not into our future research plans. The worry about going wrong. Rather we (continued on page S10) S9 Scientific Thinking unilaterally. For example, when sociology (democratic, let us hope), (continued from page S9) criticism is offered harshly, for our and within a cognitive psychology benefit, we may want to receive it (e.g., curious and critical, we said). thing that worries us most about our neutrally. Trusting our abilities to do One must add that it constitutes a cognitive and/or practical positions so would open us up to our vocation and not only ‘on the job’ ought to be tested out. colleagues. Hence: Let your friends performance. This perhaps is why We need not adopt research and colleagues read your proposal to you may wish to exercise caution scales and protocols blindly, but get valuable comments, before you when choosing your research focus, examine critically our own contexts start your study. Don’t let the fear of your work place—peers and mentors. and apply ourselves creatively and other people ‘stealing’ your ideas stop Your research (as well as your critically to the work, without fear or you from getting help. If others steal clinical specialization) should be guilt of innovation. One may create your study and carry it out, or if you designed according to your personal one’s own protocol if one finds the read their paper of your study, try still needs and interests. It should not be ‘official’ one insufficient. One should to be happy: Consider yourself free to something you just earn a wage for. then proceed to test it, remembering critically move on to the next step, Doing something that you aren’t to be critical. find the flaws in the study, refine the happy with, being in an environment The long and the short of it is: theory and put it to the test. Science is that is not conducive to your Don’t let your loyalties to paradigms an endless search that demands the development, may eventually be (and/or mentors) stop you from collaboration of minds. Minds need incompatible with your happiness, finding out more about reality. It is the support of moral emotions. and, in the long run, will prevent you your duty to each other, to the ones When you get peer reviewers’ from achieving your life goals. The you treat and to your colleagues, just comments, they will usually help you cost is existential. So, either you as much as to yourself. write a better paper and plan a better avoid existential questions and study. But we need not confuse become an automaton of ‘success,’ or Colleagues, opponents, and critical openness with naiveté. Peer find yourself a place where you can peer reviews reviewers may be competing scien- work and thrive. Find and define Having a critical approach in all that tists, and they may have a personal anew the focus that is vital to your we do will help us be professional in interest in not having your paper interest. The day you just ‘bring your our work. If our theory is challenged, published. Here is a piece of practical briefcase’ and can no longer ‘bring if our paper is criticized, we should advice, so that you do not feel yourself’ to work, you ought, at least, see it as a compliment to our work, an incapacitated by unfair criticism and to pause for a while. Rethink your opportunity to learn and move on, still may check your feelings: If you course of life. For curious and critical rather than taking it as a personal feel that the reviewers’ comments are persons like you, there is always an insult. Remember: Our work, as well unjustified, that your work is being alternative, even to lifestyle para- as the critical statements, could all be rejected on false (or personal) digms. You may find it fun to find taken as preliminary hypotheses. All premises, then you may wish to out what they might be. evidence against them could be contact the editor and ask your work In the last part of our meeting valued as help to refine or refute in be looked at again. If you know that with Professor Laor, we exercised his favour of a better theory. As scientist competing researchers may be recommended approach, applying it we need not identify ourselves with reviewing you paper, you can always to our own research interests and the theory we offer, but let the theory add a note to the editor naming protocols. All in all, the Berlin die if it doesn’t hold, rather than stick anybody that you do not want as IACAPAP congress was a most to it at all cost (or waste energy in reviewer. There are plenty of good fruitful event for us all. We already refuting your opponent.) There is people out there to offer fair judg- look forward to the next IACAPAP much competition in any field, but ment. Do not loose trust and hope. congress in Melbourne, 2006. See comments from colleagues are valu- you there! How to avoid becoming an able to highlight possible mistakes, unhappy, unhealthy scientist by and to guide us in improving our own 45 years of age 4 hypotheses and methods. Criticism could be offered in a Science and clinical work are not friendly manner. It may be important performed in the abstract. Scientific to exercise this manner, if need be, methodology is embedded in a

S10 ‘Licking and Grooming’ ‘mentor–mentee strategy’ carries a Finally, I believe that the (Affectionate Touch and Contact) great deal of the explanation. For me, mentor-mentee relationship in the in Mentorship a parallel emerged between the fellowship program also works the ‘licking and grooming’ process seen other way round, starting a ‘sensitiza- Belo Mussche, M.D. in the rodent mother–pup dyad and tion’ process for mentorship in senior University Department of Child and the guidance of the mentor-mentee researchers. Like the squeaks of Adolescent Psychiatry relationship. In the following part I young pups setting off parenting Middelheimhospital, University of will try to illustrate this idea. behaviour of adolescent nulliparous Antwerp Two main lectures, one by Jim rats, ‘squeaks’ from junior researchers Antwerp, Belgium Leckman of the U.S., and another by were heard and picked up by inter- Ian Goodyer of the U.K., documented national researchers, and mentor-like the importance of the quality of behaviours were firmly established. I In memory of Donald J. Cohen, late parental caregiving, including licking carry this wonderful experience back director of the Yale Child Study and grooming, in the perinatal period home, and will try to establish a Center, the IACAPAP established a of rat pups. Both speakers mentioned similar kind of relationship in my own fellowship program for young a critical period in those early days, country, to the eventual benefit of the researchers. The aim of the program where the quality of care received as research community in child and was to create the opportunity for a young pup determines several adolescent psychiatry. I am confident young researchers in the field of child aspects of future development. Future that the kind of mentorship I have and adolescent psychiatry from all caregiving behaviour, anxiety regula- been fortunate to receive will allow over the world to present their tion, patterns of stress response, me to give back in kind to a younger research projects, learn about the aspects of learning and memory of generation of pups - ones just as eager interests of their peers, and establish a the pups, all seem to be influenced by for nourishment as I have been. stimulating network among a new the nature of their early caregiving generation of academics. The experiences. For example, offspring philosophy of the program was to of high licking and grooming mothers 4 achieve this aim by ‘engaging’ with seem to eventually exhibit themselves other people through presenta-tion, From Generation to Generation: high licking and grooming behaviour discussion, and self-reflection. The A Fellowship Tribute to Professor to their own pups. large group of fellows was divided Donald J. Cohen. In a metaphorical way, the into small groups of four to six ‘licking and grooming’ behaviour of a people, with a mentor assigned to Sameer Malhotra, M.D. mentor influences young researchers each group. Every group set out its All India Institute of Medical Sciences and their work. To some degree, the own schedule and pace for the New Delhi, India amount of theoretical, emotional congress. In our own group (mentor: support and guidance received in the Jim Leckman, mentees: Lucres The Donald J. Cohen Fellowship early developmental phase of research Jansen, Anke Hinney, Jana Program at the IACAPAP Congress is reflected in the future development Kreppner, and Belo Mussche) we in Berlin was an inspiring and unique of the young researcher and his or her decided to go through everybody’s experience for me. The program work. Creativity, coping capacities to present work and future plans and provided a wonderful opportunity to tackle obstacles, and the perception of careers. Our mentor asked us to fellows from around the globe to one’s own capacity are boosted by the prepare to comment on each other’s interact, to share their perspectives quality of mentorship received. What work during our working sessions. and research experiences, and to does such quality consist of? It is Hence, we attended each other’s actively participate in the conference. difficult to grasp. Drawing again a presentation or poster during the The program provided us with parallel, this time with parental congress, discussed the different insights into the inspiring life and caregiving in human studies, the research projects, and reflected on mission of Donald J. Cohen, the late quality of mentorship may be future career plans. At the end of the director of the Yale Child Study compared to the way of entering into congress it all seemed to have worked Center and past President of communication with the young out, with a new network emerging IACAPAP. Dr. Cohen was not only a researcher. It seems that the higher with goals set out for the future. committed clinician and researcher, the synchronicity of communication I was very much intrigued by but an incomparable inspirer and between mentor and mentee, the more this result, and wondered how it could supporter of young scientists. Pro- fruitful the emerging research abilities have been realised in such a short fessor Donald Cohen had a vision. He of the mentee become. time. I strongly believe that the could see, encourage, and utilize (continued on page S12) S11 From Generation to Generation: discussed at length. The mentorship Empowering a Culture of (continued from page S11) program was indeed a true reflection Mentorship Worldwide of the spirit to pass on the research experi-ences and guidance from one Robert Vermeiren, M.D., Ph.D. potentials to their optimum. His was a generation to another. Free University Medical Center, and very healthy scientific approach, All the fellows were actively University of Leiden, Amsterdam and focusing on positive aspects in human involved in the IACAPAP conference Leiden, The Netherlands, and beings and how to best utilize them proceedings. They presented their Antwerp, Belgium for the overall betterment of the scientific papers through posters and society and its future generations. He oral sessions spread during the confer- The Donald J. Cohen Fellowship believed that it was the responsibility ence period. They also shared assign- program at the IACAPAP Congress of each generation to pass on positive ments, covering various sessions of in Berlin was a most remarkable attributes and knowledge to the future importance during the conference. event last August. Although it had ones. The research presentations and delib- been announced as a subsidiary Some of his oftenused phrases erations conveyed a need to collate program to stimulate the participation echoed during the conference. Two of biological research with psychosocial of young researchers at the confer- my favorite, ‘from generation to (environmental) research. The need to ence, it turned out quite differently. generation’ and ‘just do it’, reflect his translate and apply such research into Perhaps no fellow had expected the overall commitment, and his positive, the day-to-day life also echoed across intense personal investment that scientific and humanistic approach. presentations. Man is a social being became prerequisite as part of the The mentorship program offered and cannot be reduced to mere program. Most striking perhaps was wonderful opportunities to the fellows biology. There is a need to adeuately the enthusiasm and high scientific and to discuss research endeavors and and appropriately identify, understand educational level of tutoring that was receive guidance. Twelve dynamic and best utilize biological and envi- reached. This high quality reflected mentors became actively involved in ronmental links. Such an approach the undeniably superb competencies the program, with different groups of could be applied fruitfully to the of the mentors, but also the spirit of fellows formed, each with a mentor. understanding of the human psyche the person this Fellowship program Intense training sessions followed. and thereby aid in appropriate and was named after. Professor Nathaniel Laor mentored timely prevention and management of One of Donald Cohen’s our group. Such groups provided psychiatric ailments and human principal objectives was mentoring, a ample opportunity to discuss indivi- suffering. capability he possessed like no other. dual research interests against a Overall, the Fellowship program His goal was to engage young people backdrop of professional qualifica- provided opportunities to enhance around the world, so that a new tions, and regional attributes and perspectives, develop and foster a generation of professionals working settings. Methodological issues were healthy scientific approach, as well as towards a better world for all children addressed in general, as well as speci- opportunities for exploring and could be created. The continuous fic to each fellow’s research efforts. pursuing collaborative meaningful investment to reach this goal has Some common research barriers work. Professor Donald Cohen’s given Donald plenty of disciples addressed during these sessions spirit could be felt through the scienti- around the world. Due to the included the lack of perspective/ fic growth and continuity, healthy and stimulating power that radiated from mission, ill defined research questions dynamic environment, and the tradi- him, and because he looked upon and methodology, duplication of tion of passing on positive nuggets of each of them as unique and impor- work, lack of resources (including scientific research and human wisdom tant, many became inspired in a way funding opportunities), pharmaceuti- from one generation to the next. The that is impossible to describe. cal influence, professional rivalry, fellowship program is indeed a strong Knowing that such a stimulating identification and undue holding on to positive step in this direction and atmosphere imbued the fellowship theories (identification with theories), should therefore be viewed as a program would have given Donald unwillingness to identify unexpected/ beginning, and not an end, to such a enormous pleasure. negative results of one’s research, and critical exercise. Since tutoring is a major unwillingness/resistance in addressing academic goal, many consider it a grey zones. Various methods and very usual thing. However, few healthy approaches to identify and 4 places exude an atmosphere of overcome such research blocks, successful tutoring, which implies the countering resistance and bringing involvement of stimulating yet critical about meaningful research were (continued on page S13) S12 Empowering a Culture Should We All Go Into Politics? “Caring for children exposed to war, (continued from page S12) disaster and terrorism,” chaired by Ine Jespers, M.D. Ronald Feldman, Columbia University Department of Child and University School of Social Work, teachers who guide pupils through Adolescent Psychiatry New York. In his state-of-the-art- mutual discussion. And although Middelheimhospital, University of lecture, Nathaniel Laor, Tel Aviv international congresses bear a unique Antwerp University, Israel, talked about the role in the exchange of knowledge Antwerp, Belgium psychosocial processes taking place and recent findings, they have short- in communities under war. Often war comings with regard to showing how or disaster leads to social disintegra- knowledge and experience should be During the past few decades, a tion, such as communities being split disseminated effectively, and how substantial amount of research has up, and to intergroup conflicts. Laor’s successful tutoring should be provided. been done on the impact of trauma on research shows that besides good The Donald J. Cohen Fellowship the psychological development of parenting and preparing parents on program at the IACAPAP Congress children. As stated in the Declaration how to react and what to do in case of may signal a turn of tide. A substan- of the IACAPAP’s 16th Congress, at a terrorist attack, the facilitation of tial group of young persons sensed ‘a time when the world is flooded reconciliation between groups of (and experienced) in Berlin the value with images of violence and brutal different ideologies forms the most of mentorship, and the importance of acts of aggression, we must be more effective prevention of the develop- being respected as future valuable concerned than ever with the impact ment of mental health problems in (and valued) professionals. of multiple adversities on the normal children and adolescents. To make It goes without saying that the psychological development of people see their enemy as human Donald J. Cohen Fellowship program children.’ Trauma and its link with helps the healing process. By should be continued, as a subsidiary mental health is clearly a hot topic for contrast, negative attitudes such as program and as a tutoring program. child and adolescent psychiatrists; as hate can lead to an aggravation of ‘New’ young researchers need to be expected, many of the lectures at the post traumatic stress symptoms and recruited, and ‘older’ ones need to be Congress were linked in some way to externalizing behaviors. reexposed. Pupils become teachers, trauma. The following two represent In the every day clinical situa- and there is a need to instill in both notable highlights on the topic. tion we work with one patient at a the value of tutoring. The teacher- “A new look at resilience,” time. The resiliency shown by student or mentor-mentee lines chaired by Michael Rutter. The children and adolescents is often rapidly blur, and moving from one concept of resilience tries to explain remarkable if they are given appropri- phase to the other can become one of why there is considerable variation in ate help and support. But as illus- the great joys in science and in how people respond to stress. trated, sometimes communities need clinical work. Since most of us come Resilience focuses on variation to change or be changed instead of from places where tutoring is not a between individuals who live in the only individual children or their priority, the stimulus given during same circumstances, and says families. I, too, and perhaps unbe- such a relatively short congress risks something about how they deal with knownst to me, may have been part to become extinguished. Therefore, adversity. As Suniya Luthar, from of a change larger than myself. I was ‘old’ folks need ‘booster sessions’, so Columbia University, New York lucky to participate in the first Donald that true tutoring continues to be explained in her concluding remarks J. Cohen Fellowship program at the transmitted across generations. I to the interrelated lectures, resilience 16th IACAPAP congress in Berlin. experienced the Donald Cohen has to do with healthy self-esteem, a One of its clear messages was about Fellowship as extremely valuable, perception of control, and a sense of the importance of the creative because it helped me remember and security. Two major aspects linked interaction between clinical work and relive, from a different vantage point with a sense of security are good research, and of the collaboration this time, the needs of young parenting and non-violent neighbour- between research groups from all researchers worldwide. hoods. As clinicians, we work directly over the world. In small international Let us go on with this initiative, with parents, trying to help them do a groups, we enjoyed the common and continue to empower a culture of better job on as difficult a task as is unifying experience of being child tutoring. Our final common objective parenting. But what can we do about psychiatrists, shared our problems and is clear: the creation of a better world mental health damaging our frustrations regarding research, and for children. neighbourhoods? pointed out goals for the future. Some 4 were thinking of moving to the other (continued on page S14) S13 Should We All Go Into Politics? Ukraine is Eager to Join the Ukraine, with the few available practi- (continued from page S13) International Child Psychiatric tioners trained elsewhere, typically in Community: Russia or other countries of the former Soviet block. There are also no trained side of the world to work with a The First Step Can Be the Hardest social workers in the Ukrainian child renowned research team, some pre- (But Was Not) psychiatric service structure. ferred to continue with clinical work. Liliya Butenko, M.D. Clinical psychiatric practice I am confident that the results of this Igor Martsenkovsky, M.D., Ph.D. unfortunately continues to be mired in research effort will help to improve Yana Bikshaeva, M.D. the old Soviet authoritarian traditions. clinical practice. But who will bring It is not surprising then that during the to practice the evidence that changes Ukrainian Research Institute of Social past ten years, not a single monograph in a community are sometimes more and Forensic Psychiatry and Drug or handbook appeared that was far-reaching in the prevention of Abuse, Health Ministry of Ukraine, devoted to child psychiatric practice. mental health than individual and Medical-Social Rehabilitation At medical schools, child psychiatry is therapy? An increasing effort to Department For Children, and simply absent. Faculty members in inform governments is being made. Adolescents With Behavioral and child psychiatry who taught in This has lead to developing post Mental Disorders Ukraine before the Soviet disintegra- conflict programs and to support Kyiv, Ukraine tion have gradually shifted to also institutions to foster mental health cover forensic psychiatry and drug programs independent of political Ukraine is a sovereign country of 48 abuse, in addition to the child philosophies ensuring continuity. It’s million inhabitants located in the psychiatric needs. As inheritance from a first step, but what’s next? Should center of Europe. It has most recently the former Soviet Union, Ukraine has we, as child and adolescent psychia- risen from the ruins of the Soviet a unique faculty of child psychiatry. trists be even more active on the empire, following a 350 year-long For years, it was headed by a well- political front, helping to realise struggle for independence. Ukraine known child psychiatrist, professor changes at the community level? has a large population of minors: 10.2 Lydia Bulahova. Now, the preparation As it should be, I came home million children and adolescents, or of child psychiatrists has moved from from Berlin with more questions than almost one in five inhabitants. With Kyiv to the periphery, where it is answers. I choose to share one of 2.6% of children and 3.4% of adoles- carried out by psychiatrists who do them now, namely ‘should we all go cents requiring consultative or active not have operational experience in into politics?’ I don’t really think that psychiatric intervention, the needs of child work. Training of forensic is the solution. I do think that we all our country are enormous. psychiatrists, experts in drug abuse, have the responsibility to at least Even though Ukraine has 514 and child psychiatrists in the same think about this question, put the official child psychiatric positions, program and by the same experts things we do into a bigger socio- 100 of these remain vacant. Among illustrates the government’s careless political perspective, and try to make 414 practicing child psychiatrists, attitude to child psychiatric care. As a our case on every possible occasion there are only 47 clinicians specifi- case in point, the faculty chairman with those who have the political cally trained to provide psychiatric believes that Ukraine has insufficient power to make a difference at a help for adolescents. Because of this child psychiatric needs to justify the higher level. So, let us cooperate in an shortage, adolescents often remain existence of a separate and inde- enthusiastic, openminded and honest under the supervision of general pendent specialty. way with each other, with parents, psychiatrists, especially outside of According to official medical teachers and youngsters, just as with Kyiv (formerly Kiev) – in cities like statistics, Ukraine still practices politicians. We should keep in mind Cherson or Tcherkask. In addition, widely the commitment of mentally that in the very young field of child preschoolers who require psychiatric retarded children to long-term evalua- and adolescent psychiatry, there is care are frequently treated by pediatric tion and treatment (i.e. to institution- probably not only a huge need for neurologists given the greater promin- alization and education outside of the well trained clinicians and ence of the specialty in Ukraine. mainstream). Prevalence of autism in researchers, but also for child and Children’s psychiatric care in Ukraine is low relative to the rest of adolescent psychiatrists with a large Ukraine is archaic. There are practi- the world; instead of pervasive social commitment. cally no well-trained child and adolescent psychotherapists, neuro- developmental disorders, these physiologists, and there are only a few children are frequently diagnosed with 4 clinical psychologists. Education and mental retardation or schizophrenia. certification for child and adolescent This practice skews statistics and psychotherapy is absent in today’s (continued on page S15) S14 Ukraine is Eager to Join visually impaired children; 27 for In closing, we want to express (continued from page S14) children with reduced hearing; 32 for our special thanks to Professors John deaf children; and six for blind B. Sikorski and Andrés Martin of children. the USA, and to Professors Peter provides a practical reason to In this way, a relatively Riedesser and Rainer Georg Siefen formally refuse proper rehabilitation advanced boarding school system of Germany. They were our kind and and education services, and to provide absorbs a significant part of the caring tutors and mentors during this at times unjustified neuroleptic budgetary resources available for time, and we look forward to sharing therapy. Thus, there is no government- child psychiatric care. This further much more with them in the years to supported system for the medical and promotes the isolation of mentally come, and perhaps in Kyiv in a not social rehabilitation of children with retarded children and those with too distant future. Their openness and disorders in the autistic spectrum. special needs from the rest of society. attention allowed us to make good There are some non-governmental The level of social functioning and use of such a large Congress and its organizations and one private medical adaptation among students of these many opportunities. The possibility of center in Kyiv that do provide such schools is typically much lower than being accepted into IACAPAP as a care for these children and their that of children with similar problems new member society makes us families, but it is one not available for in other countries throughout Europe. especially thankful and hopeful for the majority of patients. Child psychi- our future, and for a more productive atrists educated abroad according to In spite of these limitations, or role of child psychiatry in Ukraine. current specialization programs are especially because of them, Ukrainian We hope that the links among the still not part of the governmental psychiatrists aspire to become an colleagues from Ukraine, Germany, health care system. integral part of an international com- Poland, and the rest of the world will Children with ADHD in munity of colleagues. We aspire to help us achieve this important goal. Ukraine are also practically deprived gain new knowledge and hope to Poland is worthy of special of specialized medical and psycholog- overcome our country’s severe backlog mention in this respect. Since the time ical care. In general, psychiatrists in of psychiatric services and training. of Ukraine’s independence in 1991, a Ukraine do not diagnose ADHD. An initial step in this direction significant number of Ukrainian child Children with ADHD are usually was successfully made by two of us psychiatrists have undergone short diagnosed with behavioral disorders (LB, IM) through our recent partici- periods of training in Poland. The and are treated with neuroleptics and pation as Eastern European fellows to experience of Polish psychiatrists in sedatives. Teachers do not have the 16th IACAPAP Congress in successfully reforming children’s special education and work skills to Berlin. We were especially delighted psychiatric services after the deforma- offer to children with ADHD. These to go in as members of the Eastern tions of the totalitarian period has children are usually transferred to European Fellowship, but to come been very useful for Ukraine. In individual training sites and excluded out, and to be treated throughout, as essence, Poland became an alternative from comprehensive schooling. full-fledged members of the Donald to Russia as a source of information, At the same time, in Ukraine J. Cohen Fellowship. It was indeed a and an example of successful develop- there is a wide network of special and privilege to be part of this exciting ment and application of European boarding schools for children with group of international colleagues and traditions. We are especially grateful mental retardation and special needs. mentors. to Professors Irena Namyslovska 239 subsidiary schools are now func- It became possible first of all and Richal Wronishevsky for their tioning (214 of them boarding schools) due to the invitation and kindness of practical contributions to the for children with mental retardation. Professor and Congress President development of child psychiatry in Thirty-four of these schools are for Helmut Remschmidt, who kindly Ukraine. children with ‘psychological develop- supported us as Eastern European Let us finish with our wishes for ment retardation’ that provide inten- fellows with key membership, travel, a free, peaceful, productive, and sive remedial classes. There are 14 and financial support. We are glad to integrative collaboration on behalf of schools for children with severe have the opportunity to express here children’s welfare throughout the speech and language disorders; six for our gratitude for such important and World! children with organic brain disorders; valued help. We are also well aware 20 for children with movement that there were a great number of disorders; 11 schools and three techni- people, foundations, governments, cal training colleges for teenagers 4 and private companies who served as 14–18 years of age with behavior or sponsors and made this wonderful conduct disorders; 29 schools for project a reality for us. S15 Posters, Not Rockets in solidarity, across countries and professions represented. A number of languages, but with a shared mission, formal and informal gatherings for Osman Sabuncuoglu, M.D. we will find new ways to improve the the fellowship occurred during the Department of Child Psychiatry, the well being of children around the congress, where we formed small Marmara University School of world. groups to share our experiences of the Medicine various presentations. There were Istanbul, Turkey four different languages among the 4 members of my group — though to Back home from the IACAPAP Creating Connections: our credit we did surprisingly well! Congress, I am going through photo From Berlin to Melbourne Networks were made not only with files of children that I have occasion- each other, but with other colleagues ally collected into a notebook. A Monique Nesa from our own countries. While there smiling child, another protesting one, School of Psychology, Curtin were thousands of miles between us a very tiny baby, and finally, an old University of Technology and very different cultures to deal photograph of a genocide victim with Perth, Australia with, we found common challenges — a number tattooed on his forearm. I difficulties with funding, dealing with am upset by his face and the nature of I was very privileged to be a part of bureaucracy, and trying to fulfill the his death. the International Donald J. Cohen requirements of conducting research, I think back to my colleagues Fellowship Program at the with the responsibilities of teaching gathered for the Congress in Berlin. I IACAPAP’s 16th World Congress in and clinical work. We learned how think of the enormous power of Berlin last August. Through this others were traveling along in their constuction devoted to the betterment wonderful program I was able to respective career paths, and what their of children. And yet, so many powers share my research and work experi- hopes for the future were. operate on the world toward destruc- ences as a psychologist in Australia On our last fellowship gathering, tion, with not a single day during with fellows from all over the world. we were asked to summarize all that which innocent children don’t die. From the first round of e-mails before we had done, learned, and generally Will I, will my collegues, be able to the congress, fellows introduced experienced over the previous days. put up a fight? We don’t have themselves and made everyone feel While the spokespersons from each rockets, but rolled posters instead; we welcome. Andrés Martin partnered group did a great job of this, I think don’t have fireguns, but pens ready to us all up with a fellow from another the thing that stood out most to me write. Will our army be able to country to enrich our experience of was Oleh Romanchuk, one of our succeed in any meaningful way? attending the congress. group members, presenting each of us A harsh leader is easy to The first contact I had with my in the group with a hand-painted egg recognize. He always knows best, partner, Naoufel Gaddour, was by from his native Ukraine. He later went displays no respect for others, acts on e-mail where he was kind enough to on to explain that this symbolized behalf of millions without their introduce himself. He explained that fruitfulness, connections and consent, threatens, and if helping his he was the only psychiatrist in a longevity. survival, never abstains from war. region of Tunisia populated by two Professor Helmut Whilst his post is the most important million inhabitants. The city I live in Remschmidt’s speech later that day thing in his own mind, suffering also has just over two million people; at the closing ceremony emphasised children are inevitably normal aspects however, we have hundreds of the importance of having a network of life. However, he is clever enough psychiatrists and psychologists of people guiding you along your to show sympathy to the victims of working in the area. As everyone, at journey. His kind words and his bullying. times I feel frustrated by the gap in acknowledgement of all those who The IACAPAP Congress in our system, where some children who had supported him throughout his Berlin, and the Donald J. Cohen really need services are unable to time as President were truly touching. Fellowship I was privilleged to be a access them. Meeting Naoufel gave Returning to Perth, I was part of, have shown me how a web of me a new perspective, and a profound delighted to receive an e-mail with a connected minds, thoughts and insights sense of respect for what can be picture of our group that we took at may create hope to make our world a accomplished by some with such few our last gathering in Berlin. I have safer place for children. Many thanks resources. since returned to my university in to the organizing committee, for Never having attended such a Australia and have been able to share providing me through this program large congress before, or indeed an my experiences of the Congress with with the elements toward a strong international conference at that, I was the other students in my department. foundation that will continue. Acting amazed at the range of topics and (continued on page S17) S16 Creating Connections: was delivered by Professor Ian adversity, genetic influences on (continued from page S16) Goodyer from Cambridge Univer- biochemistry and hormonal effects sity, UK. The session was chaired by (especially the HPA axis) on mood Professor Savita Malhotra from and cognition, and how the brain is a This experience was invaluable, and Chandigarh, India. This first session, social organ, and mind states arise although the conference has finished, held on the last day of the conference, from the biology of personal experi- the friendships that we have formed was very well attended by delegates ences. Referring to the Romanian continue on. The opportunity to have from across the world. adoptee studies carried by Michael ongoing mentorship to discuss career Through the lecture, Professor Rutter and colleagues, and the directions and challenges of research Goodyer emphasized that knowing prospective studies on child devel- is much more than I had hoped for. only the strength of genetic factors is opment conducted at the Winnicott Thank you to all involved. I look not a sufficient basis for under- Research Centre in Cambridge, forward to our ongoing communica- standing the vulnerability process Professor Goodyer suggested that tions through the fellowship program toward psychopathology. He high- negative experiences in early child- and meeting up with you again at the lighted the role and sensitivity of the hood could lead to different end 17th IACAPAP World congress in gene-environment interaction, i.e. how points through different pathways. Melbourne! nature and nurture may operate to Characterizing the distal influence the liabilities for common processes of genetic vulnerabilities emotional and behavioral disorders. and early parenting adversities to 4 The impact of experience is moder- psychopathology, and relating these ated by both genetic factors, which to the intermediate biology of influence the learning process in the psychiatric disorder in childhood and II. Reports brain, as well as by epigenetic ones, adolescence, emerged as a key which are related to the nature and research area for the 21st century. The Biology of Childhood timing of the experience. Experience: The role of specific childhood Dedicated to the Memory of experiences in the individual’s devel- 4 Professor Richard Harrington opment was explained through differ- Nature-Nurture Paradigms: ent models, namely the experience- From Berlin versus London to Sameer Malhotra, M.D. expectant and the experience-adaptive Berlin and London All India Institute of Medical developmental programming models. Sciences According to the former, normal Jana Marinka Kreppner, Ph.D. New Delhi, India somatic development requires specific Institute of Psychiatry, Kings College experiences, and their absence leads London, England, United Kingdom Leonie Boeing, MB ChB, to somatic/functional damage. MRCPsych. According to the latter, normal As someone who was born and raised Lothian NHS Young Peoples Unit somatic development is shaped by in Berlin, I was especially looking Royal Edinburgh Hospital experiences, and their absence leads forward to attending the 16th World Edinburgh, Scotland, United to vulnerability, but not permanent Congress of the IACAPAP in my Kingdom damage. hometown. For the last 12 years I have Overall, these models suggest a lived in London, but Berlin never It was an honor for us to cover the critical or sensitive period in animal ceased to influence me. For me Berlin Richard Harrington Memorial Lecture development, which can be translated is a city that has shown great resili- in Berlin. Professor Harrington had a into the initial years of development ence over the last century. Berlin had reputation for a dynamic commitment in humans. The role of early human to survive many difficult periods, but to research, for strong clinical work, biological programming, as well as Berliners always managed to rebuild and for running one of the UK’s early developmental programming, is their city and were eager to learn foremost academic departments in important in this respect. Such from the mistakes that were made. In child and adolescent psychiatry, in observations explain the important short, Berlin represents a city with a Manchester. His work on depression role of parenting styles and rearing rich history of change, adaptation, and conduct disorders in children and practices during early phases of life in and integration. As such, I thought it adolescents has informed clinical determining long-lasting behaviors. was the perfect place to host a practice and service provision. The lecture illustrated examples congress that brought together The state of the art lecture on from selected geneenvironment scientists from a diversity of scientific the biology of childhood experience interactions, studies of early maternal (continued on page S18) S17 Nature-Nurture Paradigms: For me the 16th World Congress of questions about the extent and causes (continued from page S17) the IACAPAP was an unforgettable of trends over time and population and immensely stimulating experi- differences, most obviously the need ence. It was a truly interactive, mind to compare ‘like-with-like’. For perspectives, expertise, and regions of opening, interdisciplinary and multi- example, are informants today more around the world. Trancultural and cultural event. I hope that we all open about talking about mental multidisciplinary collaboration was a made new friends with whom we will health problems than they were in the strong feature of many exciting continue to stay in contact throughout past? Have certain disorders become presentations at the conference. But our working careers and beyond. more ‘fashionable’? Do variations in there were two lectures that for me social norms across different cultures were the highlights of the congress’ influence the thresholds at which program. These were the ones by particular behaviors are judged as Leon Eisenberg and Michael Rutter. 4! problematic? Training in epidemiolo- In Leon Eisenberg’s lecture we A Place and a Time for Thinking gical methods and collective thinking were reminded of the fascinating About the Role of Place and Time on how best to calibrate and validate advances that neuroscience has made in Child and Adolescent Psychiatry measures collected in different in terms of describing how biology, cultures at different points in time are inheritance and learning all act in Stephan Collishaw, Ph.D. important requirements for progress. reciprocity to determine brain Social, Genetic, and Developmental The IACAPAP meetings development and behaviour. Michael Psychiatry Centre provide an important opportunity for Rutter, in his lecture, emphasised that London, England, United Kingdom fostering collaborations to enhance we must endorse that genes and work in these fields. A variety of environment interact in important Evidence points to a substantial rise talks and posters were presented ways; especially in light of the in mental health problems amongst dealing with the issues of crosstime increasing evidence that the effects of young people over the last 50 years and cross-country differences in some genes are only expressed in the across the world (Rutter & Smith, mental health problems. A few stand presence of particular environmental 1995). Studies have also demon- out in my mind. Leon Eisenberg risk factors but not in their absence. strated considerable variation in eloquently described the interplay In my opinion, both lectures brought levels of problems between different between nature and nurture in to the point the most important devel- countries and societies (Crijnen et al, influencing child development. As opment of recent years, that is, that 1997). The implications are consider- organisms we have adapted to our we must no longer think in terms of able: time trends emphasise the environmental niche, with genes nature versus nurture but in terms of urgency in finding ‘solutions’ to providing only a general blueprint for nature and nurture standing together young people’s emotional needs; development. Michael Rutter further in reciprocity. It is this, our ever cross- cultural differences highlight highlighted the importance of growing understanding of the the potential for finding ‘solutions’ considering the interplay between interplay between environment and that make a difference at the genes and environment. However, the biology, which in my opinion holds population level. role of this interaction in explaining the key to unravel the complex Progress on understanding the differences between populations as processes involved in child and causes of population differences in opposed to within populations is adolescent psychopathology, and youth mental health depends on much less understood. One question which will, in turn, facilitate care, international collaboration. Cross- that arises is whether deterioration in treatment and prevention in child and cultural comparisons of time trends mental health over time might suggest adolescent mental health. provide a strong test of theories over that today’s societies provide less But there was a lot more to the time. For example, an association optimal environmental niches for 16th World Congress aside from the between deteriorating youth mental children to develop within. Michael exciting and rich conference pro- health and rising divorce rates in one Hong provided an extensive overview gramme. As one of the recipients of country could be mere coincidence. of the rapid social and family changes the Donald J. Cohen Fellowship, I felt Examining trends in mental health that have taken place in Asian I was given a unique opportunity to and family instability over a range of countries. These societies have been meet a great number of fellow scholars, countries that vary in these trends marked by rapid, experienced both junior and senior, with whom I allows a much stronger test of this considerable industrialization and thoroughly enjoyed exchanging views hypothesis. There are considerable urbanization. Traditional values have and experiences far beyond those methodological obstacles to providing given way to more modern and relating to the congress presentations. sound answers into relation on (continued on page S19) S18 A Place and a Time range of different disciplines, with Preoccupation: Circuits, Genes, and (continued from page S18) different perspectives and different the Crucial Role of the Environment..” skills. We all, however, shared the Jim spoke about the details of same interest in learning from one parental behavior around the birth of individualistic values. At a family another toward improving our a child and the development of the level, the birth rate has dropped research. I hope that Berlin 2004 was parent-infant bond: how much is markedly, divorce rates have a place and a time during which genetic?; how much is hard-wired increased, and more children now live international research collaborations into the brain?; and how much is in nuclear as opposed to extended were fostered that will continue long shaped by parenting and other families. Understanding which of into the future. environmental factors? Certainly, the these changes has contributed to parent-infant bond, and the nature- increased mental health problems will, References nurture debate about the development as Prof. Hong noted, only happen of our offspring has a long and when we begin to focus on underlying Rutter, M., & Smith, D.J. (1995). interesting history. This relationship mechanisms. What are the implica- Psychosocial disorders in young has fascinated scholars and artists tions of these broad societal changes people: time trends and their through the ages as well as psychia- for intrafamilial relationships and causes. Chichester: John Wiley & trists such as Donald Winnicott – who parenting? What new stresses do Sons. described the postpartum period for children experience in today’s Crijnen, A.A.M., Achenbach, T.M., mothers as an epoch of heightened changed world? From whom do chil- & Verhulst, F.C. (1997). sensitivity, almost like an illness – to dren draw their emotional support? Comparisons of problems reported Donald J. Cohen, who was fascinated Finally, Frank Verhulst talked about by parents of children in 12 by the social motivation for intimate the importance of longitudinal studies cultures: Total problems, relationships, which precedes in child and adolescent psychiatry, externalising, and internalising. cognitive development in the baby’s highlighting the persistence of Journal of the American Academy attachment to the mother. psychiatric disorder from childhood of Child and Adolescent Jim began his talk with a slide to adulthood. More generally, it is Psychiatry, 36, 1269-1277. of a Leonardo Da Vinci painting of a known that childhood maladjustment mother and child and wondered: is linked with a wider range of adult “What is this woman thinking?”, and psychosocial difficulties, affecting for 4 “How has evolution endowed us with example relationships and parenting. the capacity to become parents and Today’s children will become Primary Preoccupations for All make the tremendous adjustments in tomorrow’s parents, and we must our lives for a child?” It was just ensure that as societies we have not James Swain, M.D., Ph.D. such questions that prompted Jim and created a vicious cycle where Yale Child Study Center his colleagues to study parental increased problems in one generation New Haven, Connecticut, U.S.A. thoughts and behaviors in the peripar- lead to further difficulties in the next. tum, and show that there is an Addressing these issues requires It was an honor to attend my first increase in preoccupations and habi- lateral thinking and methodological IACAPAP meeting in the historic and tual behaviors such as checking - innovation. We need the ambition to futuristic city of Berlin – especially as somewhat similar to the symptoms of combine large-scale psychiatric a proud recipient of a Donald J. obsessive-compulsive disorder. But epidemiological approaches with a Cohen Fellowship that made it this was just the beginning of this more detailed focus on parenting and possible for me to attend. Among my fascinating tour-de-force presentation: child-centred perspectives. We also memorable experiences were visits to one that seamlessly connected the need to combine repeated cross- incredible museums, contrasted with seemingly distant dots of evolution, sectional surveys with longitudinal the incredible futuristic architecture. culture, psychology, brain circuits and and with cross-cultural approaches. At the meeting, one of the high- genes. This brings me to a final point lights was a chance to see Dr. James The lecture continued with an about the congress. It is the informal F. Leckman give a main lecture – on outline of an evolutionary approach to interactions and conversations that are a topic that has both a long historic understanding parental thoughts and perhaps most important here. I was tradition of thought in psychology, as behaviors and a review of animal fortunate enough to take part in the well as a recent rebirth of interest models of these behaviors. It is Donald J. Cohen Fellowship program, using modern and, until recently, interesting to consider that the a truly international group of futuristic techniques. The title of his symptoms that plague people with researchers and clinicians from a lecture was “Primary Parental (continued on page S20) S19 Primary Preoccupations for All international community of child many meaningful and important (continued from page S19) psychiatrists as we consider the key aspects of the Congress, I was early-life determinants of mental particularly taken by Professor health and consider future preventa- Michael Rutter’s sterling lecture, obsessive-compulsive disorder might tive health measures in children when “Environmentally mediated risks for involve the very same brain circuits they may be most effective. psychopathology.” We know that the that have evolved to help us care for Although I am fortunate to pathogenesis of most mental disorders our babies. Much is known about the know Jim from well before the Berlin rises from two interrelated areas: brain circuits, hormones and genes meeting (and to indeed be a part of genetic and environmental influences. that subserve parenting in other his research team on some of the And yet, it is difficult to distinguish species, including the importance of studies described above), I realize their respective contribu-tions, given certain midbrain regions and certain now that it sometimes takes a trip to a that they are reciprocal and interactive hormones such as oxytocin. different country and continent to with each other. How then to best Further, Jim reviewed the become fully aware of the context, study this interactive model of growing literature that supports the complexity, reach and relevance of pathogenesis? Precisely this was what notion that the intrauterine and early the work of some of our closest Professor Rutter addressed in his postnatal environment – during critical collaborators. Through my experi- lecture. In the empirical studies he developmental windows – may ences at the IACAPAP meeting, I described, he has found the “program” later parenting behavior have gained a new perspective on the environmental mediation of risk for and indeed, may set each of us up for interrelated work of colleagues from adverse psychological outcomes has a mental health risk and resiliency points throughout the entire globe, as to be preceded by risks for adverse profile. Jim also showed the first well as those from my local commun- psychological outcomes. Such risk glimpses of brain imaging research ity in New Haven, Connecticut. factors include parent-child separation emerging from his team at Yale. His and the involvement of fathers (or team has been using functional lack thereof) in childrearing. The magnetic resonance brain imaging to identification of points along the study the brain responses of parents 4 dimensions where risks arise may in the first four months after giving help in that connection, as shown by birth to infant stimuli. Listening to Sir Michael: findings on early childcare, parental Brain areas important for Environmentally Mediated Risks age at the child’s birth, and harsh or responding to alarm, determining for Psychopathology physical punishment, including overt value and performing habits are child abuse. activated in parents’ brains to “own Zhu Yan, M.D. In his lecture, he first told us baby” cries and photos compared Mental Health Institute, Central South how testing for environmental risk with control cries and photos. The University ordinarily (and artificially) requires pattern of activity appears to be Changsha, China the use of designs that pull apart different between moms and dads, variables that usually go together. between first time and veteran I am a young Chinese psychiatrist, Second, that the measurement of parents, and between scans done at participating for the first time in the within individual behavioral changes two weeks postpartum and three World Congress of the IACAPAP. I over time and is not a static function. months postpartum as the bond felt very lucky and honored to be Third, how we can use ‘natural develops. Several groups around the present as one of the Donald J. Cohen experiments’ in order to differentiate world are beginning to use such Fellowship recipients, and as one of between environmental and genetic techniques to study the brain basis of three representing the world’s most risk, as he has done in his studies the parent-infant bond, and will be populous nation. In the Congress I with Romanian orphans raised under used to study the developing affilia- met colleagues from many different adverse early conditions. Fourth, how tive systems in children’s brains in countries, and established the use of novel statistical techniques the near future. relationships that I am hopeful will can help to offset the unavoidable In this age of increasing last into the future. I welcomed the limitations introduced by measure- awareness of the critical importance opportunity of introducing and having ment error. of early life events and environment, myself be known to the international In his lecture, he provided a such as parenting, Dr. Leckman gave leaders in the field of pediatric mental range of examples to illustrate the an eloquent, state-of the art, health. This was truly a unique and success of the strategies described. multidisciplinary and moti- vational very valued experience. Finally, Professor Rutter summarized talk. It was highly relevant to the The meeting was just as scientifically important for me. Of the (continued on page S21) S20 Listening to Sir Michael: epidemiological sample, where one buffering capacity that plays a central (continued from page S20) third of maltreated individuals element in children’s resilience, as reported no mental health problems as suggested in previous research of adults. Sir Michael Rutter followed Israeli children exposed to SCUD the important of taking into account with an interesting presentation on the attacks during the first Gulf War gene-environment interactions in new frontier of gene-environment (Laor et al, 1997, 2001). relation to the novel areas of interactions in relation to resilience, My associations then led me to molecular genetics and quantitative discussing the genetic influences on a study done by another group of modeling. Large individual individual differences in susceptibility Israeli researchers in adult patients differences in response to a given to environmental hazards. Jana after myocardial infarction. They environmental risk were noted, and Kreppner, yet another fellow, found that patients with repressive the need to put together these findings presented findings from a study that coping style were better adjusted to into an overall causal model of investigates the development of traumatic stress, both in the short and developmental psychopathology. adopted children from profoundly longer term (Ginzburg et al, 2002). Professor Rutter’s stringent and depriving institutions in Rumania and Repressive coping style is defined in untiring scientific spirit was palpable the persisting negative effects of early the literature as the cognitive and throughout. His lecture helped me to adverse experiences among the more emotional effort to ignore or divert gain a better understanding of his vulnerable (or most tardily adopted) attention from threatening stimuli, thinking, and proved to be a most ones. Anne Inger discussed the whether internal or external. valuable harvest; one that energized implications of theoretical resilience Repressors are in turn defined as me to return home to and embark on concepts, and Suniya Luthar individuals who express low anxiety the many scientific and clinical summarized the symposium with an and high defensiveness (Weinberger, challenges that lie ahead. overarching commentary that inte- 1979). In yet another study, avoidant- grated the different findings into a focused coping style was found to cohesive whole. increase the risk of being sensitized, 4 I then returned to the literature compared with subjects with an Another Look at Resilience to look at the definition of ‘resilience’ emotion- or task-focused coping style again, and came across diverse (Johnsen et al, 2002). While many of Galit Ben-Amitay, M.D. descriptions – from the metaphoric these findings were described in Tel Aviv Community Mental (the ability to bend and then spring adults, what about children? Is it Health Center back in the face of adversity; Garmezy, better for them to repress, not to deal Sackler School of Medicine, 1993), to more complicated defini- with the trauma? If so, it would Tel Aviv University tions, such as the concepts of allo- certainly be different from the way Tel Aviv, Israel stasis and allostatic load that link the many of us concep-tualize the issue protective and survival values of the today. Or will avoid-ance lead to later I was privileged to participate in the acute response to stress to the vulnerability? Will the avoidance of Donald J. Cohen International adverse consequences that result if threatening emotions and cognitions Fellowship Program at the 16th the acute response persists on human impede the processing of the IACAPAP congress held in Berlin. psychological resilience on one hand, experience that is necessary to the I would like to share my thoughts and vulnerability to psychopathology integration and working through of following the symposium on the topic on the other (Charney, 2004). the traumatic contents? How is all of resilience chaired by Sir Michael Besides these different defini- this throughout development? Rutter. tions, and the historical and epidemi- I remained with all these I have to say that I was ological methods of various lines of questions, and then came across a especially interested in attending this research, I came to think about the reassuring citation reminding me that interrelated series of talks, given that children who I meet, either in the I am not to the only one pondering dealing with traumatic events is not clinic or other settings; about the such thorny questions: One day we only my personal interest, but a sadly child I once was, and wondered about may be able to say with some degree ongoing issue in my native Israel, as what provides the strength and the of confidence that factor A over a elsewhere in the world. The sympo- ability to go on in the face of certain level + factor B over a certain sium was enlightening, starting with a adversity? Concepts like sense of level + factor C over a certain level presentation by Stephan Collishaw, mastery, self-regulatory skills, will produce Y level of functioning in another Cohen fellow, who presented defense mechanisms, and family domain X, in about 80% of the cases. findings drawn from the Isle of Wight cohesion came to mind. Is it the Despite advances in our knowledge study, a thirty-year follow-up of an critical role of the maternal stress- (continued on page S22) S21 Another Look at Resilience Laor N, Wolmer L, Cohen DJ, Network for ADHD Quality (continued from page S21) Mothers’ functioning and children’s Assurance. EINAQ is an educational symptoms 5 years after a SCUD initiative of Continuing Medical missile attack. Am J Psychiatry. Education in Europe that aims to about the influence of various protec- 2001:158(7):1020-6. provide easy access to the best and tive and risk factors in development, most recent knowledge and practice health and functioning, however, we Weinberger DA, Schwartz GE, parameters for doctors involved in a still have good reason to remain Davidson RJ. Low-anxious, high- network for healthcare of children humble (Allen JR, 1998). anxious, and repressive coping with ADHD and their families. A As an international Donald J. styles: psychometric patterns and question issued was in how to be Cohen fellow at the IACAPAP behavioral and physiological certain that a child with ADHD is not Congress, I had the opportunity to responses to stress. J Abnorm just spoiled, bored, or restless, as meet fellow child psychiatrists and Psychol. 1979 ;88(4):369-80. children are not alike in expressing psychologists from all around the their emotions or social behaviors. world, to exchange ideas and thoughts, 4 Therefore, a child with ADHD must and even to start collaborating towards have severe impairment of psycholog- a transcultural research project on the ical development as manifested by al too painfully relevant subject of Quality Assurance in ADHD: high levels of inattentive, restless and posttraumatic stress disorder. I believe The European Interdisciplinary impulsive behaviors. Its onset is in that to embark on such a venture Network early childhood, before the ages of together with newly minted friends is 5-7 years; present for at least the to quite literally work toward our own Doa Habib, M.B.B.Ch. previous six months, and present in resilience. Independent Investigator, Child more than one setting (school, home, Mental Health & Psychiatry work), with clear evidence of References Alexandria, Egypt clinically significant impairment in Allen JR, Of resilience, vulnerability, social, academic or school perform- and a woman who never lived. Child It was a great opportunity for a young ance and functioning compared to Adolesc Psychiatr Clin N Am. 1998; child and adolescent psychiatrist to be other children of the same develop- 7 (1):53-71. th selected to attend the 16 International mental age. Charney DS, Psychobiological Congress of the IACAPAP in Berlin. The exact etiology of ADHD is mechanisms of resilience and I went representing Egypt, full of unknown, but recently, using struc- vulnerability: implications for enthusiasm to know not only of new tural and functional brain imaging, successful adaptation to extreme research findings and techniques, to electrophy-siological and neuropsy- stress. Am J Psychiatry. 2004 meet those leaders who provide chological studies have shown ;161(2):195-216. guidance and reference to our own abnormalities, especially in the frontal Garmezy N, Children in poverty: studies, and to meet young colleagues cortex, responsible for executive resilience despite risk. Psychiatry. from around the world struggling functioning (attention, planning, 1993 ;56(1):127-36. with challenges not too different form reasoning, problem solving and our own. Ginzburg K, Solomon Z, Koifman B working memory). Various alterations As a way to become fully & al, Trajectories of posttraumatic in higher-order cognitive functions engaged, we were given the task of stress disorder following myocardial and motivational processes have also serving as reporters for critical aspects infarction: a prospective study. J Clin been found. Molecular genetic studies of the Congress. This sounded Psychiatry. 2003 ;64(10):1217-23. have found associations with varia- intriguing and challenging, as well as tions in genes for the dopamine Johnsen BH, Eid J, Laberg JC, & al. a little scary and difficult for a non- The effect of sensitization and coping receptors 4 (DRD4 7-repeat allele) native English speaker such as me. and 5 (DRD5 148bp-allele), and the style on post-traumatic stress My own assignment was to report on symptoms and quality of life: two dopamine transporter (DAT1 10- a symposium on how Attention repeat allele). Converging evidence longitudinal studies. Scand J Psychol. Deficit Hyperactivity Disorder 2002 ;43(2):181-8. from a variety of sources suggest that (ADHD) is diagnosed and managed, catecholaminergic dysregulation is Laor N, Wolmer L, Mayes LC, & al. all while ensuring that high standards critically involved. Israeli preschool children under of medical performance are achieved Considerations on etiology also SCUDs: a 30-month follow-up. J Am in the provision of healthcare. include environmental risks, Acad Child Adolesc Psychiatry. 1997 This was the task set forth by including prenatal and perinatal ;36(3):349-56. the European Interdisciplinary (continued on page S23) S22 Quality Assurance in ADHD Brain Imaging in Psychiatry Gender Matters (continued from page S22) Caterina Gawrilow, Dipl. Psych. Susanne Walitza, M.D. University of Konstanz Department of Child and Adolescent obstetric complications, exposure to Konstanz, Germany Psychiatry and Psychotherapy, alcohol and nicotine, and the quality University of Würzburg of relationships within family Sunday morning, at the beginning of Würzburg, Germany members and at school. Constructed the 16th world congress of IACAPAP clinical interviews with both parents in Berlin, about 25 people interested ’What About Girls?’ was the and school personnel (teacher, in brain imaging met to attend a intriguing title for the lecture on ‘Sex psychologist) for evaluation of the course led by Alex Sumich from the Differences in Psychopathology’ that psychopathological symptoms, Biostatistics and Computing Institute Collette Chiland gave in honor of together with child behavior rating of Psychiatry at Kings College, the late Gerald Caplan. A great scales are useful diagnostically. London. Alex Sumich presented a number of listeners surged into the Clinically critical are interviewing the broad and absorbing range of topics: hall to hear and see Chiland, the child in order to identify the degree of starting with the early beginnings in grande dame of the Sorbonne in impairment, coping and perception electroencephalography with Hans Paris, and a IACAPAP Honorary with their disorder, coexistence of Berger in 1929, and ending with President. other developmental, emotional, examples of current studies in chil- In her lecture, Chiland summar- behavioral, vision, hearing or learning dren with ADHD. He brought many ized that children are typically con- problems. Observing the child’s graphs and examples, and encouraged sidered as gender-neutral, when in behavior while interviewing, and the auditorium to read more about fact the developmental pictures of school testing are also important. brain imaging in the literature and the young girls and boys are not the Assessment of IQ is useful to internet. After his talk he met with all same. More boys than girls are seen determine academic perform-ance of us in person to discuss ideas in in clinics. Most psychiatric symptoms versus academic potential; neuro- further detail. are more frequently seen among boys psychological assessment for testing The most important result of than girls. Boys have more difficulties executive and non-executive (timing) this Sunday morning for me, as a at school. Girls tend to be better (and functioning are of good predictive clinical, experimental psychologist, earlier) readers. potential for prognosis. was that although I didn’t know very Chiland started with a look at The persistence of the disorder much about brain imaging, I could available empirical investigations. through adulthood depends on the follow the presented issues very She reported on a study of more than severity of defining criteria and the easily and therefore feel absolutely 7,000 patients seen at the Alfred degree of a child’s perception towards prepared for running a MEG study Binet Centre in Paris over a period of symptoms, together with their level of together with the clinical psycholo- 16 years. The number of treated boys psychosocial functioning. Parental gists in our department. was higher than the number of girls training and behavioral interventions The experience with this single, (sex ratio 1:1.62). For all psychiatric in the family are essential to the first course that I have taken so far, disorders of childhood, except for psychological and educational inter- reflected very well the overall atmos- selective mutism, eating disorders, ventions for the child. Medications phere at the IACAPAP world congress ‘inhibition’, and ‘hysteric’ (somato- should be considered when psycho- and the Donald J. Cohen Fellowship: form) symptoms, boys tended to be logical treatments are insufficient throughout the entire week I obtained affected more often. During the alone. Concluding this was a a large amount of extremely helpful development from childhood to adoles- reminder of the importance of support and up-to-date information, paired cence, girls showed more eating groups for individual sufferers and with invaluable personal support from disorders, depression and suicidal their families, and for public researchers from different areas and attempts, whereas boys had more campaigning for increasing the from all over the world, with whom I antisocial and addictive behaviors awareness of how important it is that am still in contact. This experience and suicide. In adolescence, girls we recognize and treat children with was most inspiring, both personally have clearly more emotional and ADHD. and for my current and future research. I am looking forward to maintaining depressive disorders. all the established contacts (including Chiland expressed how many 4 the Donald J. Cohen fellows and investigators talk about sex mentors) and to creating and accom- differences in psychopathology, but plishing all of our planned work and largely lacking when offering research projects together. (continued on page S24) S23 Gender Matters III. Interviews of my eyes. Fortunately for me (and (continued from page S23) for all of us attending the Congress), I had not noticed any problems. plausible explanations. The well- Seeing the Individuality in Having learned about many different and meandering paths into known statistics of higher pre-, peri- Every Child: medicine and psychiatry from and postnatal mortality in boys, of An Interview with higher morbidity of boys in early colleagues and friends, I want to Professor Helmut Remschmidt childhood, and of longer life expect- know from Helmut Remschmidt what ancy in women all suggest a genetic his trajectory was into the field of advantage for bearers of double X Christoph Correll, M.D. medicine, in general, and into child chromosomes. The second X could Zucker Hillside Hospital, psychiatry, in particular. He explains: possibly prevent from certain defici- North Shore-Long Island Jewish “It started based on an illusion. I had encies. From a biological perspective, Health System, Schneider Children’s wanted to study music and German the differences in hormonal func- Hospital, literature. However, I thought to tioning and neurodevelopment have Glen Oaks, New York, U.S.A. myself that if I wanted to get to know to be taken into account. Chiland’s the human being in the most compre- talk made it seem clear, perhaps a bit Despite Professor Helmut hensive way, I had to learn three too clear: the male sex is the weaker Remschmidt’s very busy schedule, I one. things: physiology, which meant I am sitting across him at a low table in had to study medicine; the soul, What could be the possible his presidential office, located in the implications? - a concerted effort to leading to psychology; and the ideas International Congress Centrum support boys, perhaps. Since for of the world, which directed me Berlin. I am surprised how calm, example girls have a better and earlier toward philosophy. Hence, I started to grasp of language, teachers could relaxed and personable he is in the study medicine, taking up psychology support boys more in this respect at midst of the many events of this and philosophy after the preclinical school. Further, Chiland pointed out World Congress, for which he is exams in medicine. I was awarded a from a view of her philosophical ultimately responsible. I note that he Ph.D. stipend from the Volkswagen experience that there are important seems to have the gift of being able to Foundation, receiving my Ph.D. in social implications as well. At last she focus on what is in front of him at the psychology from the University of put some provocative questions on the very moment. This is truly a gift. Tuebingen for my work on person- table, such as ‘why are women Having been selected by Andrés ality changes in patients with deemed to be ‘monsters’ on making Martin to interview Professor epilepsy, comparing them to patients successful careers?’, or ‘is the depres- Remschmidt (maybe by virtue of my with non-neurological, medical sive potential of women a result of being German, having then trained as disorders and healthy controls.” suppression through men?’ a psychiatrist and child and adoles- A man of many abilities and The different points of view of cent psychiatrist in the U.S., where I broad interests, Helmut Remschmidt philosophy, psychoanalysis and work and live now) – I am given the empirical research, through the eyes received degrees in medicine, privilege of his undivided attention. I of Colette Chiland gave the lecture an psychology and philosophy. I am feel welcome. When I ask him how excellent and very charming charac- impressed by such dedication to he is doing, I am surprised again. ter. The topic was of such interest that knowledge. I want to know more one of the most frequently read news- After answering my question that he about his path into child and adol- paper in Berlin, Der Tagesspiegel, the is well, enjoying the congress, he escent psychiatry, having been led next day included a lead article on follows with a question of his own. myself by my experience with how “Girls suffer differently than “Have you noticed any problems children and adolescents during boys”. during the congress?” I register this as rotations as part of my general psy- an immediate sign that after less than chiatry residency, and by serendipi- two minutes into his conversation tously having been exposed to a with a stranger, Helmut Remschmidt research team that focuses on shows concern and compassion. He is reducing the incidence of psychotic ready to listen. He invites comments disorders through early identification about potential problems. He appears and intervention. Professor eager to search for an analysis of the Remschmidt’s experiences resonated situation and a solution right in front (continued on page S25) S24 Seeing the Individuality of mine, Dr. Walter Kast, who to explore themselves in order to get (continued from page S24) worked at a hospital for mentally a taste of some of the best poetry that handicapped children. He recom- has been written in the German with my own: “After graduation, I mended studying child psychiatry in language: Rainer Maria Rilke, Stefan started my first job as an MD. It just Marburg, rather than adult psychiatry George, Hugo von Hofmansthal, happened that my chairman assigned at the Max Plank Institute in Munich. Peter Huchel, Karl Krolow, Durs me to a 225-bed child psychiatry During my work at the hospital for Gruenbein, Sara Kirsch, Paul Celan, hospital. I was the only doctor and mentally handicapped children, I had Rose Auslaender, and poetry from the told my boss: “I can’t do this.” His an important experience with a Bukowina. He recommends a response was simple: “You are going patient. “A girl with a seizure collection of poems from that region to learn it.” “In order to get by and disorder had a troublesome, but (“Faeden ins Nichts gespannt – improve the care of my patients, I inexplicable behavioral problem. At poetry of the Bukowina”). Helmut quickly had an idea. I not only had to night, she repeatedly tore out hair Remschmidt often reads poetry before train myself, but also the nursing staff from her sleeping peers. In order to falling asleep and knows more than in order to receive the appropriate understand that phenomenon better, I 200 poems by heart. As participants help. From that time on, I trained stayed on the unit at night to observe of the opening ceremony of the nurses every Wednesday evening her behavior without her noticing me, IACAPAP congress in Berlin could about all aspects of psychiatry. The and I talked to her at length. As it not fail to notice, Helmut staff was very appreciative and turned out, she was in an omega Remschmidt also loves classical requested that the learning material be position in the group of patients on music. I was very much taken by the given to them as a written script. the unit: she was systematically fact that a chamber orchestra was Later on, they also urged me to get it neglected and abused by the other seated on the podium, weaving the published, so that nursing staff at girls. Having understood the under- fabric of the ceremony with an all- other institutions and their patients lying reason for her retalliative international language: music. Asked could benefit from the same behavior, I ventured to change it. I about his relationship to classical knowledge. When I finally contacted gave the girl special attention, tried to music, Prof. Remschmidt explains: “I the Thieme publishing company, I let her abreact her aggressive impulses, started to play the violin as a child. learned to my surprise that they were but more importantly, I worked with Later, I took up the piano and the actually in the process of putting her on increasing her self-esteem. organ. When I moved into my first together a book with two neurologists After a couple of weeks, she ceased hospital housing, I spent my first that focused exactly on training from tearing out the hair of her peers, 5,000 German marks to buy a members of the nursing professions. which was achieved without any cembalo. The apartment was almost The publisher was enthusiastic about change in her medication regimen.” devoid of furniture, but it housed a my script and put me in charge of His interest in effecting change, cembalo. I also took lessons once a coordinating the chapters with the rooted in a deep compassion and week with Hermann Werderman, who other co-authors, who to my understanding for humans and the was the cembalist of the Suedwest- advantage were not as far ahead with human condition, has propelled deutsches Kammerorchester, playing their drafts as I was. Having not Helmut Remschmidt through his a lot of Baroque music. After a ten- intended to write or publish, I had personal and professional life. He year break from playing classical suddenly become a co-author of my moved to the Department of Psychi- music, I changed to playing the viola, first book. The book, entitled atry at the University of Marburg, playing in a quartet, and I started “Neurology and Psychiatry for Germany, in 1968, building one of the playing the piano again.” As far as Nursing Professions” (edited by premier child and adolescent psychiatry composers go, we seem to share an Haupt, Jochheim & Remschmidt), has departments in the world, at a time undivided admiration of Johann been translated into Spanish, and is when child psychiatry was an even Sebastian Bach. Other favorite currently in its ninth edition. That was more neglected field than it is now. composers of his include Bruckner, my path into child psychiatry, training Having learned that he is a true Mahler, and Schubert. and medical writing. It was always Renaissance man, and being a lover Without fail, our conversation intended for practical use, not for the of German poetry myself, I want to turns to Donald J. Cohen, who is so sake of publishing.” know which authors he favors. He aptly commemorated by the Donald J. “My next steps into child psy- names many poets that are very dear Cohen International Fellowship. chiatry were influenced by a mentor to me too, and who readers may want (continued on page S26) S25 Seeing the Individuality planned to also take place in Asia and strict ethical codes that protect the (continued from page S25) South America, so as to increase the integrity of children and adolescents. level of research in child psychiatry in I am currently working on a statement Looking up at me, he asks: “Did you these countries. paper on an ethical code for research know Donald?” When I answer that I Given Professor Remschmidt’s in child psychiatry. As a field, we did not get to know him, the regretful eminent position in world child have to pay attention to the special look in his eyes is another testament psychiatry, I want to know what he situation of each child, and use to the deep impact that Donald Cohen considers the most important issues in research in the best interest of these must have made on everyone around the field; which areas he wants the exquisitely vulnerable individuals.” him. In the second of this gaze I can next generation of child psychiatrists “Finally, we have to convince see how much Helmut Remschmidt is to particularly focus on. “First, it is societal and political powers to do certain that any contact with Donald critical for the field of child more for children. We have to fight Cohen would have been transforming psychiatry to avoid the risk of being so that our societies place a high for me too, and that it is my loss not one-dimensional. Maintaining the value on positive and rich childhood to have met Donald. He goes on to plurality of methods is essential. development, and that this be seen as share with me how much he misses Concepts need to be inclusive. A a goal worth investing into. We have Donald’s sharp emotional intelligence solely pharmacological approach and to help create circumstances that are and friendship. He also expresses prescribing of medications in 15- favorable for children. It is highly how much Donald, with his deep minute appointments are inappro- problematic that societies are interest in and engagement for priate. It is crucial to continue with an reluctant and unwilling to pay for international relationships, and his interdisciplinary methodology, which conditions that are advantageous for strong sense for mentorship, is missed should include cultural, environmen- children. It is grotesque and sends a by the world psychiatric community. tal, psychological, social, pharmaco- message about our priorities that But Helmut Remschmidt has his logical and genetic factors, among stock market values are aired every own legacy of mentorship. Seven others.” day. The value of managers and of professors of child psychiatry in “Second, we must not be guided people working in the banking and Germany grew out of his department. by any ideology, such as, for example, stock market business is vastly He is a founder of the European well-meaning empiricism. We have to overvalued. This creates an imbalance Research Seminars, which train understand children in all their in our societies. It reflects an inappro- young European scientists to become aspects, paying attention to the priate estimation of money and state-of the-art investigators. These multitude of factors that are at work consumption. This situation requires a research seminars, begun in Heidelberg in their lives. It is important to change in thinking. It requires action. in 1998, are now conducted at an strengthen the self-healing powers of We all will need to work together on international level. Recent venues children, to see in a holistic way the changing this cultural atmosphere.” have included Egypt and Italy. individuality of each child, which Someone knocks at the door. Participants receive a one-week enables us to foster the potential of Prof. Remschmidt’s secretary informs training in child and adolescent each one. In all efforts of diagnosis him that someone from an Eastern psychiatry research. Half of the days, and treatment, we need to see the European country requires additional they listen to lectures by 8-10 individuality in every child. In this documentation about her attendance presenters, the other half they present regard, I was very impressed by a at the conference because her abstract and discuss projects, which have a teacher of one of my daughters who submission had arrived after the dead- clear focus on a realistic plan that can was in her 60s. After more than 35 line. She also reminds him of the be implemented and fits regional years of teaching, she still was able to tickets for the organ concert in the necessities. The young researchers see what was unique and special in Berlin Dome that will begin in one have an opportunity for close each of the children she taught. She hour. I look out of the window of this networking, and building of did not teach children according to futuristic office. Grey Berlin sky and relationships with other scientists. I general formulas, but according to a sign in neon: “Hotel Ibis–Coole can hear Prof. Remschmidt’s pride their needs and abilities. That Preise! Euro 54”. Helmut that the senior scientists presenting at impressed me and taught me a lot.” Remschmidt is looking for the CV of these meetings provide their mentor- “Third, in academic research the musician he will introduce at the ship and time without honoraria. and research conducted by industry, concert. He and his secretary agree on Furthermore, these seminars are we have to develop and adhere to (continued on page S27) S26 Seeing the Individuality In the aim of the fellowship, we newsletter reported what was (continued from page S26) wanted to meet Drs. Cynthia Pfeffer discussed at the worldwide meetings and Jocelyn Hattab, editors of the and congresses. The newsletter later the best way to get from the ICC to IACAPAP Bulletin since its inception became the current Bulletin. the Berlin Dome. He turns to me, ten years ago. But how to arrange an One of the main problems smiling: “You see, we have to come appointment with two people we had concerning the Bulletin was to reach to an end.” Rising from one of the never met at such an enormous other colleagues who were also black leather chairs, I want to know Congress and amid so many partici- interested in what is going on in the one more answer. “Professor pants? We decided to leave a note in field of child and adolescent psychia- Remschmidt, can you just leave me the hope that they would find it and try in other countries. The Internet and the readers of the IACAPAP we would be able to meet them. was part of the solution. Everybody Bulletin with three important wishes Luckily for us, this indeed turned out has now the opportunity to read the of yours?” He pauses, with curious to be the case. Both were very Bulletin through the internet. The eyes. “I have not thought about that. friendly and pleased to meet with us. Bulletin is available on line for free Well, I wish for health, for my family, We made an appointment with and appears twice a year. We hope and myself. Also, that I can complete them in the Fellow’s Lounge, a quiet that many colleagues will become my plans in the academic realm. And, part of the hall specifically set aside in engaged in writing for the Bulletin so that we can live in a peaceful time, order to meet with other fellows. We as to share their experiences in child without terrorism and war.” spoke with them about the start and and adolescent psychiatry and to We say goodbye, and I am development of the Bulletin, about the follow the development of our grateful for this hour spent with Congress, about Donald Cohen, as profession around the world. someone who has made, and well as about their work in child and The IACAPAP Bulletin was an continues to make each day, a adolescent psychiatry. effective idea to improve communica- difference on so many lives For us this was the first time to tion between colleagues of different throughout the world. participate in such a grand event. The countries and has existed now for a scientific program was so interesting whole decade. The Donald J. Cohen that it was at times difficult to choose Fellowship Program is another 4! between competing offerings. They excellent initiative to build bridges agreed, but remarked that the Congress and to bring young researchers in the A Decade Editing the is also an event to meet other people, field together. It has been an exciting IACAPAP Bulletin: to discuss your own and others’ beginning, and we hope that it will Drs. Cynthia Pfeffer and scientific work, as well as to discover continue in years to come. Jocelyn Hattab a little bit about the host city, in this We thanked the editors for their instance the reunified German capital, time, shook hands, and went home Orlando Uccellini, M.D. Rome, Italy the incomparable Berlin. with a very good and enthusiastic They told us of Donald Cohen, feeling about “our” own congress. Ramón Lindauer, M.D. of this stimulating and energetic Like Drs. Pfeffer and Hattab, we hope Amsterdam, The Netherlands person who was so engaged with to hear from you in the Bulletin, or to young clinicians and researchers see you at the next IACAPAP We will introduce ourselves. We are throughout the world, and after whom Congress in Melboune, Australia in Orlando Uccellini from Italy, and this fellowship was named. This was 2006! Ramón Lindauer from the Nether- the first time that so many fellows lands. The Donald J. Cohen had the possibility to meet each other Fellowship Program was for us a during a Congress. fantastic opportunity to meet other Meeting and establishing colleagues from different countries contact with colleagues all over the who were also interested in the field world is the major aim of the Bulletin, of research in child and adolescent which started in San Francisco in psychiatry. Therefore, our grateful 1994. The editors mentioned that the thanks to many people, especially Bulletin started as a newsletter in Professor Helmut Remschmidt, which forthcoming meetings and president and central organizer of this congresses were mentioned. The wonderful Congress. S27 IACAPAP Officers

President Vice-Presidents Myron L. Belfer, MD Ernesto Caffo, MD (Italy) Social Medicine Phyllis Cohen, EdD (USA) Harvard Medical School Kang-E Michael Hong, MD, PhD (South Korea) 641 Huntington Avenue Boston, MA 02115, USA Barry Nurcombe, MD (Australia) email: [email protected] Amira Seif El Din, MD (Egypt) Samuel Tyano, MD (Israel) Secretary-General Per-Anders Rydelius, MD, PhD Assistant Secretaries-General Astrid Lindgren's Children's Hospital Nese Erol, PhD (Turkey) 17176 Stockholm, Sweden Marie-Rose Moro, MD, PhD (France) email: [email protected] Luis Augusto Rohde, MD, MSc, DSc (Brazil)

Treasurer Adjunct Secretaries John Sikorski, MD Howard Cooper, MD (Australia) Dept. of Psychiatry, UCSF, 350 Parnassus Avenue, Suite 309, John Fayyad, MD (Lebanon) San Francisco, CA 94117, USA Sadaaki Shirataki, MD, PhD (Japan) email: [email protected] Robert Vermeiren, MD (Netherlands) Andreas Warnke, MD (Germany) Past President Yi Zheng, MD (China) Helmut Remschmidt, MD, PhD Brian Robertson, MD (South Africa) Philipps University, Hans-Sachs-Str. 6, Counselors D-35039 Marburg, Germany email: [email protected] Salvador Celia, MD (Brazil) Peter Jensen, MD (USA) Permanent Secretariat and Archivist Kari Schleimer, MD, PhD (Sweden) Kari Schleimer, MD, PhD Martin Schmidt, MD ScD(Germany) Hvilans allé 3 Kosuke Yamazaki, MD, PhD (Japan) 23251 Åkarp, Sweden email: [email protected] Monograph Editors Martine F. Flament, MD, PhD (Canada) Honorary Presidents Elena Garralda, MD (UK) James E. Anthony (USA) Gerald Caplan, MD (Israel) Bulletin Editors Colette Chiland, MD, PhD (France) Cynthia Pfeffer, MD (USA) Jocelyn Hattab, MD (Israel)

Editor Emeritus Colette Chiland, MD (France)