摘要:

The authors suggest ways to improve the classification of personality disorders by changing the way the classification is developed, evaluated, and modified. Specific proposals are intended to establish a system that can be evaluated and revised so that it successively approximates a valid system. The importance of stating the principles underlying the classification is emphasized. These principles include: the conception of personality disorder underlying each diagnosis, the structure used to define diagnoses, the nature of diagnostic items, and the model for organizing diagnostic decisions. A distinction is drawn among the theoretical, measurement, and diagnostic models underlying each diagnosis. The substantive aspects of the classification are discussed in terms of the evidence required to validate diagnostic concepts. It is argued that the first step in developing a classification is to ensure the content validity of diagnostic concepts because this is a prerequisite for other components of validity. Evaluation and revision of the classification are discussed in terms of the importance of convergent and discriminant evidence. It is recommended that the classification be evaluated and revised using criteria derived from the theoretical and measurement models associated with each diagnosis. It is also recommended that the classification be evaluated in terms of the degree to which diagnostic constructs are consistent across clinicians, different sets of diagnostic exemplars, and different samples of patients. Realization of these aims should provide a classification that may be verified, modified, or disproved in the scientific tradition.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Psychiatric epidemiological research has focused disproportionate attention on traditionally female disorders such as depression. This paper shifts epidemiological gears to elaborate and test an etiological model of a traditionally male disorder, that of alcohol abuse. We argue that social-relational deficits (narcissistic orientations) lead to abuse of alcohol for stress reduction purposes, given interpersonally oriented stressors and the incapacity to form social supports. The model was tested in the context of training for a traditionally male occupation encompassing both social-relational demands and limited social supports. A cohort of medical students was surveyed from medical school entrance through a portion of clinical training. Time 1 social-relational deficits were predictive of time 3 alcohol abuse, partially as a function of social support deficits and, to a lesser extent, patient care-related stressors. Moreover, there was an initial gender difference in social-relational deficits and a trend-level gender difference in alcohol abuse that disappeared when social-relational deficits were held constant. By time 3, women did not differ from men in social-relational deficits or alcohol abuse.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The purpose of this research was to investigate differential manifestation of depressive symptomatology among adolescents from diverse ethnocultural groups. Data from a national survey of persons 12 to 17 years of age (N=2200) were analyzed, comparing responses of Anglo, African, Mexican, and other Hispanic Americans with a 12-item version of the Center for Epidemiologic Studies Depression Scale. The results indicated minimal differences in terms of item response and internal consistency-reliability among the four adolescent groups. However, there were differences in patterns of item endorsement, as indicated by principal component factor analysis. Anglo- and African Americans exhibited similar factor structure, represented by negative affect, positive affect, and psychosomatic symptoms. The two Hispanic groups also exhibited a three-dimensional pattern, but there was a tendency among Hispanic adolescents for somatic symptoms and negative affect symptoms to cluster together. This pattern may indicate a more prominent role of somatic complaints in the presentation of depression among Mexican Americans and other Hispanics.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This study aimed to determine whether patterns of ego defense change.with short-term treatment of psychiatric illness. The subjects were 37 inpatients and outpatients with a DSM-III- R dragnosis of major depressive disorder being treated using standard clinical methods. Ego defenses before and 7 to 9 weeks after commencement of treatment were measured using a shortened version of the Defense Style Questionnaire. There was a significant decline in thejise of immature defenses with symptomatic recovery, but (no change in the neurotic or mature defenses. Patients with additional axis I diagnoses and/or abnormal personality traits (N=15) used more neurotic defenses than their counterparts with major depression alone (N=22), but this pattern did not change with time. The study demonstrates the shortterm mutability of immature defenses in relation to an episode of psychiatric illness and provides empirical support for the concept of temporary regression in the context of psychiatric illness episodes.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Observational methods were used to determine whether depressive symptoms in 20 inpatients with major depressive disorder could be observed to change during the course of treatment with antidepressant medication. Four consecutive weekly observation sessions were done using the Emotional Disorders Rating Scale, which collects information about symptoms of depression, mania, anxiety, hostility, and irritability. Only those scales indexing depressive symptoms evidenced change. Significant change was observed between the third and fourth weeks of hospitalization, thereby replicating the findings reported in the adult literature regarding depressive symptoms’ responsiveness to antidepressants.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Repeated studies suggest a relationship between winter birth and increased incidence of schizophrenia. Furthermore, there may be seasonal fluctuations in schizophrenia risk factors (e.g., influenza epidemics) and the severity of biological anomalies (e.g., enlarged cerebral ventricles in neuroimaging studies). In order to assess whether winter-born schizophrenics show greater neuropsychological impairment, 112 males meeting Research Diagnostic criteria for schizophrenia were administered the Luria-Nebraska Neuropsychological Battery, a thorough measure of higher cortical functioning deficit. Sixty-four of these 112 patients were also administered the Wechsler Adult Intelligence Scale-Revised, the Benton Visual Retention Test, and the Rey Auditory Verbal Learning Test. Despite the use of several definitions of winter and nonwinter birth, there was no evidence of elevated rates of neuropsychological dysfunction among winter-born patients on any measure. The current study contains certain limitations (e.g., variable medication status at testing), but the results suggest no strong season of birth relationship with neuropsychological impairment in a reasonably large, research diagnosed sample of schizophrenic patients.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Experimental evidence shows that many physiological processes abide by nonlinear dynamics and evidence chaos. Novel conceptual models postulate chaotic phenomena in psychological processes as well. The challenge in empirically testing these models is to develop measures that are sufficiently precise to permit nonlinear dynamical analyses and that also say something meaningful about psychological phenomena. Toward this end, we examined the spontaneously occurring autonomic activity of a patient during psychotherapy. Phase portraits were constructed of the patient's heart rate data for each of several therapy sessions. The flows within these phase spaces were visually segmented and assigned to one of four previously defined trajectory classifications. These trajectories were quantitatively analyzed, and the corresponding clinical material was assessed qualitatively. The trajectories in the physiological phase space were recognizable, recurrent, and robust; they appeared coupled to ongoing psychological processes. Possible refinements in this typology are discussed and suggestions are made for potentially using such analyses to track and navigate among psychophysiological states.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The Structured Clinical Interview for DSM-III-R diagnoses of 54 mothers who had maltreated their children were compared with those of 37 controls. The maltreatment group showed a significantly greater incidence of both current and past diagnoses. Maltreating mothers exhibited a significantly greater incidence of current mood disorder, alcohol abuse, and personality disorder than did controls. The results indicate that past abuse of cocaine, alcohol, other substances and past mood disorders were significantly more prevalent among the maltreatment sample than among controls. Mothers who had maltreated their children were significantly more likely to have histories of posttraumatic stress disorder than were controls.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID