ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

This review of the relationship between frontal lobe pathology and sequelae of closed head injury (CHI) emphasizes the variety of neuropsychological disturbances that may be present and factors that influence symptom presentation. First, the mechanisms of injury in CHI are briefly summarized with an emphasis on frontal involvement. This summary is followed by an overview of frontal lobe structure and function including behavioral and cognitive sequelae associated with frontal damage in other patient populations. Next, findings specifically related to frontal dysfunction in CHI patients are presented. These studies, although few in number, indicate that CHI patients frequently exhibit deficits indicative of frontal damage. The clinical implications of frontal dysfunction following CHI and potential avenues for future research are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In the process of developing a two-part therapist rating scale, we obtained questionnaire responses from a large sample of subjects who had undergone one of a variety of psychotherapies. Our data support the importance of perceived therapist care as a strong correlate of patient satisfaction, and patients seemed able to discriminate clearly between psychodynamic and cognitive-behavioral therapies. In the first (nonspecific) questionnaire, we derived five dimensions (Care-Concern, Directive-Control, Critical-Confronting, Understanding, and Charisma) from principal-components analyses, with the first two dimensions being relatively independent of each other. A multiple-regression analysis revealed that combined scale scores accounted for 50% of the variance of patient satisfaction ratings, with the Care dimension accounting for most of this effect. In the second questionnaire, data were analyzed from respondents who had undergone therapy with known cognitive-behavioral or psychodynamic therapists; but, in a minority of subjects who were recruited through the media, we depended on detailed descriptive vignettes to allocate them to one or another of these “specific” types of psychotherapy. Six scales emerged, three characterizing cognitive- behavioral therapies (Behavioral Task Orientation, Organization, and Cognitive Focus) and three representing psychodynamic therapies (Transference, Inner Conflict, and Relationship). Subjects' ratings on all scales strongly discriminated between the two broad modalities of therapy, suggesting that patient reports may provide valid measures of therapist styles. We conclude that questionnaires such as the one we are developing may provide economical measures for assessing therapist consistency when comparing different modalities of psychotherapy.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Although the mental health of recently employed persons has been well studied, the mental health of welfare recipients is not well understood. Among our increasing refugee population, many receive welfare benefits at some point. The Hmong are among those who are highly represented among welfare recipients in several areas of the United States.Do psychiatrists have anything to contribute toward the resolution of high welfare rates? This question is especially relevant in refugee populations who are at increased risk for several psychiatric disorders, including depression, paranoia, and adjustment disorders. This study was undertaken among 100 Hmong refugees who had been in the United States for 8 years. Indices of mental health included two rating scales (the Zung Depression Scale and the SCL-90), five-axis DSM-III diagnoses, Hamilton Anxiety and Depression Scales, Global Assessment Scale, Brief Psychiatric Rating Scale, Inpatient Multidimensional Scale, and Mini-Mental State Exam. These indices were compared with current welfare status and the duration of time on welfare. Other comparisons with welfare included demographic characteristics, material possessions, acculturation characteristics, health and social problems, and nonoccupation avocations. Results indicate that welfare recipients show lower acculturation and elevated psychiatric symptom levels. Suggestions for ameliorating this situation are extrapolated from studies in the literature on chronically unemployed persons.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

By DSM-III-R criteria, patients may be diagnosed as having panic disorder without reporting the experience of intense fear. However, if such patients do not report subjective fear, they may be less likely to receive a panic diagnosis. The authors studied 32 subjects with angiographically normal coronary arteries who fit panic disorder criteria. A total of 13 (41%) reported no fear during their last major attack. These subjects were contrasted with those who did report fear. Pew differences were found in group demographic data or responses to self-report questionnaires. We conclude that there appear to be few differences between the nonfear panic disorder subjects and those who do report fear. This conclusion awaits further support using challenge tests, medication trials, biological indices, alexithymia inventories, and family studies. The recognition of the existence of this subtype is likely to increase the number of patients receiving the panic disorder diagnosis in cardiology settings, in psychiatric settings, and in research projects using structured clinical interviews.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Due to their prevalence and relationship to agoraphobia, panic attacks are receiving considerable attention. The DSM-III requires that they include at least four associated symptoms and occur at least weekly for a diagnosis of panic disorder. This study of panic symptoms and frequency in 68 panic sufferers addresses the validity of these DSM-III requirements in terms of symptom patterns and phobic avoidance. Using chi-square, Fisher, and t-test analyses, this study found no clinical distinction between frequent (occurring at least weekly) and infrequent panic attacks. When comparing limited-symptom attacks (associated with less than four symptoms) with full-blown panic attacks, as expected, symptom frequencies were greater (p<.05) in full-blown attacks, with the exceptions of feelings of unreality and fear of dying, going crazy, or losing control. Phobic avoidance did not differ between limited-symptom and full-blown attacks. This study not only demonstrates the arbitrary nature of the DSM-III requirements for a diagnosis of panic disorder but recognizes the importance of limited-symptom attacks to the development of agoraphobia.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The present study explored the validity of the unipolar-bipolar distinction in the characterological mood disorders. Thirteen cyclothymic and 32 primary early-onset dysthymic outpatients, diagnosed according to DSM-III-R, were compared on demographic, clinical, personality, and family history variables. The cyclothymics exhibited significantly higher levels of depressive symptomatology and extraversion and had a higher rate of bipolar I disorder in their first-degree relatives than the dysthymics. In addition, a significantly greater proportion of cyclothymics than dysthymics had a family history of drug abuse. The groups did not differ significantly on gender, overall rates of affective disorders in relatives, or a number of symptoms which have been reported to distinguish unipolar and bipolar depressives. Although these data require replication due to the small sample and large number of analyses conducted, they provide at least partial support for extending the unipolar-bipolar distinction to the characterological mood disorders.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Patients who have bulimia nervosa and are overweight have received little attention in the medical literature. The authors identified 25 patients who weighed ≥130% of their ideal body weight out of a series of 591 patients with bulimia nervosa. This subgroup was contrasted with a sample of 25 patients with bulimia nervosa who were 90% to 110% of their ideal body weight. Members of the overweight bulimia nervosa group were binge-eating and vomiting less frequently than the comparison group but were more likely to be abusing laxatives, and to report a history of self-injurious behavior and suicide attempt(s). Both groups reported frequent binge-eating.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Prevalences of Diagnostic Interview Schedule/DSM-III psychiatric disorders for male veterans and nonveterans from four war eras were estimated using data from over 7500 male community respondents interviewed by the Epidemiologic Catchment Area program at five geographic areas across the country. Veterans serving after Vietnam (Post-Vietnam era) had greater lifetime and 6-month prevalences of psychiatric disorder than their nonveteran counterparts, whereas the reverse tended to be the case for the Vietnam, Korean, and World War II war eras. Comparisons across war eras revealed a trend for more psychiatric disorder, especially substance abuse, in younger veterans and nonveterans than in older respondents.

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1990

数据来源: OVID