摘要:

The internal consistency of the Beck Depression Inventory (BDI) is assessed in 335 randomly selected medical inpatients, and in another sample of 101 depressed psychiatric inpatients with 104 interviewed normals. The data for the two samples were analyzed separately using a latent trait model. The analysis confirms that the BDI measures a single underlying dimension of depressive severity for both patient samples. Fourteen symptoms discriminate well for severity of depression in the psychiatric-normal sample, seven symptoms in the medical sample, and six symptoms in both samples. The latter six symptoms (suicidal ideation, sense of failure, sense of punishment, loss of social interest, indecision, and dissatisfaction) may represent criteria for depressive severity that are not confounded by the presence of physical illness or the attendant distress.

ISSN:0022-3018    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The dexamethasone suppression test (DST) has performed well as a diagnostic test for depression in many specialized research settings. Clinical epidemiological methodology enables prediction of its diagnostic value in a variety of clinical settings different from those in which the DST has been studied. We reanalyzed the published data on the test's performance as a confirmatory diagnostic test for endogenous depression or major depressive disorder and modeled target populations, taking into consideration available data on the epidemiology of depression and variations in the test's performance according to clinical characteristics of the patients evaluated. The problems with which patients present in different settings will contribute to lower prevalence of the disorder and lower sensitivity and specificity of the test on general psychiatry wards, in psychiatric office practices, and in medical outpatient departments. As a result, the positive predictive value of the test, which is high on research wards (92 per cent), is likely to be lower on general psychiatric wards (82 per cent) and much lower in psychiatric office practice (52 per cent) and in general medical settings (29 per cent). Clinicians who use the DST in the diagnosis of depression should be aware of clinical and epidemiological variables that will affect its diagnostic value in different settings.

ISSN:0022-3018    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

A sizable proportion (7 to 16 per cent) of psychiatric outpatients suffer from social dysfunction, either as the main complaint or in conjunction with other psychiatric problems. Social skills training is a newly evolved treatment regimen that involves teaching patients new forms of social behavior by their rehearsal within sessions and their practice in real life between sessions. In an overview of controlled studies, social skills training was found to have been useful for up to 16 months follow-up in mainly nonpsychotic socially dysfunctional outpatients. Its effects supersede “no-treatment” periods and it appears a more potent treatment of social dysfunction than contrasting methods such as short term psychotherapy, systematic desensitization, sensitivity training, etc. The adjunct use of an anxiolytic or cognitive modification has not enhanced outcome. Social skills training is recommended as the treatment of choice for patients with social dysfunction, especially when no other major psychiatric disorders are present.

ISSN:0022-3018    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Pain is a complex phenomenon which is influenced by multiple factors; likewise, assessment of chronic pain patients' response to treatment is influenced by many variables. A physician, psychologist, physical therapist, and occupational therapist rated the extent of recovery of 40 chronic pain patients who had spent 4 to 6 weeks in an inpatient chronic pain treatment program. Each patient also rated his/her own degree of improvement. In addition, therapists and patients reported which factors were the primary determinants of their outcome ratings. Although therapists rated the patients as significantly more improved than the patients rated themselves, there was still a high degree of similarity between therapists' and patients' view of recovery. Therapists and patients were in high agreement concerning which patients were classified as treatment successes or failures. Furthermore, activity level and ability to cope with pain were frequently endorsed by therapists and patients as important determinants of recovery rating. Contrary to a previous report, the results of this study suggest that pain patients are not necessarily poor judges of (their own) treatment results. Perhaps more importantly, this study supports the use of a broad-based multidimensional approach to assesssing treatment outcome for chronic pain patients.

ISSN:0022-3018    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Thirty-three intact families consisting of an adolescent referred for psychotherapy, and a sibling adolescent, were classified according to the Reiss Card Sorting Test. All the families fit two of the types described by the theory of Reiss, the consensus sensitive and the distance sensitive; none were from the environment sensitive.Significant differences were found to exist between the adolescents in these two family types on personality measures. The adolescents from consensus-sensitive families showed a higher level of psychological differentiation, a higher self-concept, and more mature object relations than adolescents from the distance-sensitive families. The results verify and broaden aspects of Reiss' theory and are discussed in consideration with the development that has taken place in family therapy and research. They suggest that the relationship between the family and the adjustment of its children can be better understood and predicted on the basis of the family type.

ISSN:0022-3018    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

An unknown number of American children claim to remember previous lives. In this paper data of 79 such children are analyzed and compared with data from a larger number of cases in India.Few American children of these cases make verifiable statements, and those who do nearly always speak about the lives of deceased members of their own families. In this feature, American cases differ from Indian ones, in which the children usually speak of the lives of deceased persons in another family and often in another community. Indian children also frequently make verifiable statements about the lives of such persons.In some other respects, however, such as the age of first speaking about the previous lives, the content of the statements they make, and related unusual behavior, American subjects closely resemble ones in India.Although many of the American cases may derive from fantasies, a wish-fulfilling motive or obvious gain for the child is not discernible in most of them. Nor do the cases resemble in their form fantasies of imaginary playmates.Some American cases of this type occur in families already believing in reincarnation, but many others do not. In these families the child's statements about a previous life are often puzzling and even alarming to his or her parents. The child is sometimes involved in conflict over the apparent memories with members of his or her family. In turn, the family members immediately involved often fear that other members of the family or other persons in the community will consider the child abnormal.Many American cases are first reported years after the child's first speaking about a previous life; and it seems probable that many other cases are never reported. One purpose of this paper is to alert psychiatrists and pediatricians to the occurrence of such cases and to encourage their reporting them for further study.

ISSN:0022-3018    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

An adult nonreader, in therapy for serious emotional problems, began to read, at first during the therapy sessions, and then on his own, following treatment that involved a mix of psychodynamic exploration and behavioral interventions. The inability to read was addressed directly, first by having him imagine reading, and then by having him attempt to read, after achieving a state of increased relaxation through the use of muscle and breathing exercises. This result suggests that relaxation exercises should be tried in cases of reading disability at least whenever they are associated with emotional problems. Furthermore, inasmuch as anxiety and stress do not always manifest themselves in ways that are obvious to an observer, the case raises the possibility that relaxation exercises might be helpful even when there are no obvious symptoms of emotional disorder.

ISSN:0022-3018    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1983

数据来源: OVID