摘要:

The present paper discusses several complications which arise in applying Dollard and Miller's analysis of conflict to the study of psychotherapy. Discussed are problems associated with recent theorizing on the nonunitary nature of fear; considerations relevant to the question of why individuals exposed to partial cues for anxiety do not show extinction of the anxiety, generalization of extinction, and increased approach behavior; the role of interpersonal feedback in maintaining neuorotic behavior; and the issue of changing goals as therapy proceeds.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Chronic neurotic encopresis (CNE), a childhood psychiatric disorder characterized by inappropriate fecal soiling, necessitates the formation of the following specific etiological factors: a) a neurologically immature developmental musculature, an organic condition which may complicate toilet training; b) premature or harsh toilet training; c) a family constellation in which the father is frequently absent and the mother erratic, emotionally inappropriate, and distant; d) the child's formation of a noncommunicative, passive, dependent personality. All of these factors are helpful in explaining the occurrence of CNE, which is thus seen as the result of a synergistic interaction among them. The complexity of etiological agents dictates a multifactorial rather than unicausal model of mental illness. Future research and tactics of psychother-apeutic intervention should focus on the interplay among these factors rather than attempting to single out one primary predisposing factor.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

During his adult life Vincent wrote more than 700 letters, mostly to his brother, Theo. Early in this correspondence he said to Theo, “Do you want me to continue writing about everything the way I have lately, telling you the thoughts that come into my mind without being afraid of letting myself go, without keeping back my thoughts or censoring them?” (15, Letter 169). These letters, written before the discovery of psychoanalysis, constitute an act of self-revelation comparable in many ways to that of the modern psychoanalytic patient. The detailed introspective data contained in them provide a unique opportunity for understanding the syndrome of episodic behavioral disorders. They suggest, in particular, how Vincent's episodic psychoses both interfered with and augmented his unique creativity.It is proposed that bursts of electrical activity within the limbic system are associated with an inspirational thought (an experience often referred to as a “brainstorm”) or a new perception of the world similar to the psychedelic experience induced by hallucinogens. If more prolonged, the behavior becomes maladaptive and includes self-defeating impulses (dyscontrol action). If still more persistent, there occurs an episodic psychotic reaction accompanied by overwhelming painful emotions, hallucinations, delusions, and confusion with a consequent loss of personal identity. This is a frightening interruption of one's life style or life flow. Vincent's letters dramatize all of these stages of limbic “seizural” activity.Such bursts of seizural activity within the limbic system can be induced not only by psychological stress but also metabolic disequilibrium, external toxins, such as alcohol, and pertinent for Vincent's situation, a convulsive constituent of absinthe (thujone). Thus, psychological and neurophysiological mechanisms are complementary and not contradictory. It is proposed that for Vincent, Limbic system sensitivity, physical neglect, absinthe abuse, and repeated psychological stress, as well as strength of character, creative temperament, innate artistic ability, and disciplined development of his artistic skills provided a rare combination of coincidences whichin partexplains why Vincent's life was a shambles and his artistic creativity unique.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Daily behavioral observations were made for several years on 10 male schizophrenic patients and on three male patients with organic brain disorders. Analysis of these data showed strong cyclic components in the five schizophrenic patients with predominantly hebephrenic symptomatology. Period lengths noted were about 2 days, 5 to 6 days, 30 days, and a longer cycle of 40 to 100 days duration. Antipsychotic medications appear to have a suppressant effect, but tricyclic antidepressants may enhance pre-existing rhythms.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Adult metachromatic leukodystrophy is a demyelinating disease due to an inherited lack of arylsulfatase A activity. The purpose of this paper is to present the characteristics of this disorder as they occurred chronologically in two siblings, prior to and subsequent to the appearance of gross neurological deficits. A deficit in spatial relationships, as contrasted with verbal abilities, was observed initially in both cases at age 13. Initial psychiatric symptoms were noted at age 16 and 18, with both patients being diagnosed subsequently as schizophrenic. Gross neurological deficits were observed 2 and 13 years, respectively, after the appearance of psychiatric symptoms. A deficit in spatial relationships may be a very sensitive early indicator of adult metachromatic leukodystrophy.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The previous 10 years of research comparing neuropsychological test performances of adults diagnosed as schizophrenic with adults diagnosed as brain damaged is reviewed. Current concepts and criteria for classifying and sub-classifying patients in terms of brain damage and schizophrenia are presented. Right hemisphere, left hemisphere, and diffusely brain-damaged patients and paranoid, reactive, and process schizophrenics may differ in neuropsychological test performances. However, not all differences among these groups are well substantiated or well understood. Few studies were found that reported consistently using the most valid criteria in forming schizophrenic and brain damaged samples. Furthermore, only a small proportion of studies included appropriate controls for age, IQ or education, length of hospitalizaton, and drug effects.Canter's Background Interference Procedure and DeWolfe's Wechsler Adult Intelligence Scale sign approach have been found to discriminate well between schizophrenic and brain-damaged groups after replicated investigation of these procedures. The Halstead-Reitan Battery provided discriminatory power equivalent to, but not superior to, many single measures. However, the use of inadequate criteria appears to have resulted in an imposed ceiling (70 to 75 per cent accuracy) on the discriminatory power of psychological tests. Recommendations for future research include: a) the use of more valid criteria for brain damage (i.e., computerized tomographic scan) and more valid and standardized assessment of schizophrenia (i.e., Inpatient Multidimensional Psychiatric Rating Scale) in classifying subjects; b) evaluating all subjects using both neurological and psychopathological criteria; c) reporting percentages of hits, false negatives, and false positives; and d) increased comparisons among schizophrenic and brain-damaged subclassifications.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Lithium is now recognized as the drug of choice for the prophylactic control of manic-depressive disease, but its mechanism of action is the nonspecific inhibition of adenyl cyclase and subsequent cAMP formation which produces many undesirable side effects. However, the effect that lithium has on the central nervous system is compatible with all three theories regarding the basis of affective disorders,i.e., the biogenic amine theory, the electrolyte theory, and the membrane theory. Fluctuations of the hormone aldosterone during the various stages of manic-depressive disease could account for an etiological mechanism, that also is compatible with all three theories. Both spironolactone and lithium can inhibit the action of aldosterone. Therefore, when six manicdepressive patients, who had been well maintained on lithium, requested discontinuance of this drug because of side effects, spironolactone was substituted. On a minimum 1-year follow-up study, five of the six patients were well maintained on this new drug regimen.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Pertinent literature concerning the pathogenicity of the primal scene is reviewed. Two psychoanalytic cases, both of whom had conscious primal scene fantasies prior to beginning psychoanalysis, are discussed. These fantasies did not represent significant ego or superego deficits. The authors suggest that conscious primal scene fantasies, in these patients, represented screen memories. Both patients were successfully analyzed.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A patient with diagnosis of manic-depressive illness, circular type, and receiving therapeutic dosages of lithium carbonate, developed papilledema that seemed to be directly related to the drug. Although this is an extremely rare complication, the authors suggest that fundal exams may be considered in patients treated with lithium.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID