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Treating Suicidelike Behavior in a Preschooler

Ruth P. Zager, MD
JAMA. 1990;264(20):2683-2684. doi:10.1001/jama.1990.03450200091042.
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This book records the case of Alexi, a very emotionally disturbed boy, seen from age three years and four months as a patient at the clinic where the author is a child psychiatrist.

Alexi attends a preschool program where he has often behaved disruptively and aggressively and had withdrawn episodes. Trad, understandably quite concerned by Alexi's self-destructive fantasies and behavior, worries about Alexi's safety should he become more preoccupied with his destructive fantasies. Moreover, Alexi comes from a chaotic, unstable, disrupted, abusive environment, peopled with insensitive, psychologically immature, aggressive and depriving relatives. Recognizing that Alexi's parents were probably deprived, not very well—nurtured individuals during their own childhoods, Trad clearly assesses their difficulties and inabilities to parent adequately. Showing that events affecting Alexi and his family are probably multifaceted, and that Alexi's behavior is obviously multi-determined, Trad wisely elects not only to work with Alexi, but also to involve his parents


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