摘要:

The convergence between the demystification of psychiatric diagnosis and the increasing professional awareness of a cultural viewpoint offers the opportunity for research to systematically address issues of culturally valid diagnosis. To organize such research, a three-level hierarchical framework is developed which integrates hypotheses about the role of culture, beginning with symptom assessment, then the configuring of symptoms into disorders, and finally the interpersonal situation of the diagnostic interview. An examination of cross-cultural research and research on cultural minorities shows how errors accumulate from the first to the third level because of the neglect of culture or through misconceptions of the concept. The framework is premised upon the need to make programs of research the driving force behind long-range efforts to culturally sensitize psychiatric diagnosis.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This study examined the relationship between stress, appraised control, and coping and depressive mood in 425 human immunodeficiency virus-positive and -negative gay men in San Francisco. Depressive mood was assessed by self-report in 1988 and 1989. Participants were also surveyed in 1989 on the stress in their lives, their appraised control over the stress, and the ways they coped. Depressive mood in 1988 and symptoms of human immunodeficiency virus disease in 1989 accounted for 50% of the variance in 1989 depressive mood; stress, appraised control, and coping accounted for an additional 10% of the variance in depressive mood in 1989. Path analysis indicated: stress appraised as controllable was associated with involvement coping, which in turn was associated with diminished depressive mood; stress associated with detachment was associated with increased depressive mood; and stress was also directly associated with increased depressive mood.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Forensic experts have focused more on the psychological profile of a serial killer rather than on the pronounced effects on the community at large. Coping with a stressful event is thought to influence emotional states. However, little empirical understanding of this process exists. The present study examined changes in psychological factors 9 days after the occurrence of serial killings in a college community. Multivariate analyses of variance conducted on the variables of stress, anxiety, physical symptoms, and depression revealed a significant difference between the group tested after the murders and a cross-sectional cohort group. Univariate analyses revealed that the study class was significantly more depressed compared with the cohort group. The study class was also significantly more depressed compared with their own responses 1 year before the killings. For both classes, depression was significantly correlated with certain coping styles, including escape-avoidance and accept responsibility. Results have implications for certain coping behaviors (i.e., avoidant behaviors), such as that leaving the community may have been maladaptive and perhaps diverted attention from the more necessary active problem-solving behaviors (e.g., increasing security) in addition to increasing depression.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Traditionally, an excess of interpersonal dependency has been used to characterize disturbed interpersonal relationships in adults. This approach stands in sharp contrast to that of attachment theorists who conceptualize attachment as functionally distinct from dependency. Attachment theory focuses on anxious attachment in the definition and dynamics of disturbed adult interpersonal relationships.The purpose of this study was to examine the relevance of anxious attachment to the differentiation of psychiatric outpatients from nonpatients.Empirically, three scales (feared loss of the attachment figure, proximity seeking, and separation protest) measure the components of anxious attachment as defined by Bowlby. The scales were administered to two research samples. Sample 1 was composed of 136 respondents to a survey within the Calgary community. Sample 2 consisted of 110 psychiatric outpatients drawn from the psychotherapy clinic of the Calgary General Hospital. The results indicate that the three components of anxious attachment offer a clinically relevant system for differentiating between psychiatric outpatients and nonpatients. Of these three components, feared loss has the predominant effect. The implications of this finding for the delineation of disturbed interpersonal relationships in adults is discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

An experienced, analytically trained psychotherapist was physiologically monitored while conducting a 28-session exploratory psychotherapy with a patient suffering a pathological grief reaction. The therapist's autonomic responses, as manifested by perturbations in heart rate, were subjected to nonlinear dynamical analysis, yielding a series of characteristic “trajectories” representing the flow of these responses in time. We report interrater reliability and present descriptive statistics resulting from classifying these trajectories into four types. Interesting but preliminary clinical correlates of these autonomic trajectories were obtained by having the therapist review videotaped excerpts of the sessions and complete a self-report questionnaire. In conjunction with a previous report focusing on autonomic responses in the patient, this study further demonstrates the application of nonlinear dynamical methods to investigations of psychophysiology in the setting of psychotherapy, and perhaps in dyadic interactions more generally.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We evaluated rates, reliability, internal consistency, factor structure, and clinical and predictive validity of antisocial personality disorder (ASP) across three diagnostic systems which varied in emphasis on a) core sociopathic traits and b) independence of antisocial behaviors from substance use in 399 cocaine abusers. Rates of ASP ranged from 7% (Research Diagnostic Criteria) to 53% (DSM-III-R). The DSM-III-R diagnosis of ASP was more reliable at 1 month and 1 year than the Research Diagnostic Criteria. Items assessing core traits of sociopathy had very low reliability and were poorly correlated with other criteria. Across all systems, cocaine abusers with ASP had earlier onset of drug dependence, more psychosocial dysfunction, and higher rates of other psychiatric disorders. Finally, only the DSM-III-R diagnosis of ASP was associated with treatment retention and short-term prognosis. These findings suggest that current diagnostic systems which require core sociopathic traits and independence of criminal behaviors from substance use may be more unreliable and of weaker prognostic significance than less restrictive systems.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Interictal depression is common among epilepsy patients and may have a relationship to seizure variables. Among 1339 epileptic outpatients, we identified 101 (7.5%) patients who had a depressive disorder that required psychiatric evaluation, compared with only 105 (5.3%) of 1991 migraine patients from the same clinic (p= .01). The 101 epilepsy-depression patients were compared retrospectively with 202 seizure patients without depression on six seizure variables. The epilepsy-depression group had significantly fewer patients with generalized tonic-clonic seizures, a decreased frequency of generalized tonic-clonic seizures, and more patients on multiple anticonvulsant medications. We conclude that interictal depression in epilepsy may result from the use of more anticonvulsant drugs resulting in the prevention of secondary generalization from a seizure focus.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Verbal memory and performance on a number of tests known to be sensitive to lesions that disrupt frontal lobe functioning were studied in patients with schizophrenia or schizoaffective illness. Both patient groups were severely and equally impaired on verbal and design fluency and on the Wisconsin Card Sorting Test, measures that are sensitive to dysfunction of frontal-striatal circuitry. Both patient groups exhibited impaired recall but nearly normal recognition memory, a pattern that is typically observed in frontal and subcortical diseases. Accelerated forgetting was evident on delayed recall tests; the magnitude of this impairment was greater for schizophrenic than for schizoaffective patients. These results suggest that frontal and/or subcortical dysfunction is common to schizophrenia and schizoaffective disorder. A subgroup including the majority of schizophrenic patients, however, exhibit a mild amnesia-like disorder which may result from pathological changes in the structure and function of the temporal lobes or the medial diencephalon.

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1993

数据来源: OVID