摘要:

The differential effects of an easy and difficult-to-interview patient on therapist self-reported behavioral arousal and physiological activation were observed. Eighteen experienced white male psychiatrists each interviewed two patient simulators believing they were real patients. Each actress was programed to act the part of a difficult-to-interview patient and an easy-to-interview patient. Each randomly played either part as assigned and the order of patient and role was counterbalanced. Differences in patient roles were validated by the participating therapists and independent raters. Fifteen-minute rest periods with soft music preceded each therapy session such that a complete experimental session consisted of rest 1, therapy 1, rest 2, and therapy 2. Self-reported arousal was assessed during each of the four periods by Thayer's factors from the Nowlis Mood Adjective List. Physiological activation was measured by electromyogram, heart rate, blood pressure (systolic and diastolic), and skin conductance. Therapist self-reported behavioral arousal and measured physiological activation during therapy were significantly greater than during rest. The difficulty of the patient did not appear to affect either behavioral or physiological activation level of the therapists. Several explanations for this are explored.

ISSN:0022-3018    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

In a patient with fugue states, psychophysiological parameters were studied in the sleep laboratory. Four sleeptalking episodes, which appeared to be fugues without locomotion, were recorded, identical in verbal content to some of the fugues with locomotion that occurred during the diurnal state. The episodes were temporally associated with predormescent and immediate post-rapid eye movement period (REMP) sleep. The case history and laboratory data are presented. An attempt is made to establish a psychophysiological link between fugue states and sleep-dream mechanisms. Differences between REMP and non-rapid eye movement period mentation and their relationship to fugues are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

The short term memory of schizophrenics for random dot patterns was examined by a delayed comparison procedure. In experiment 1, the 10 schizophrenics and 10 normals compared a fixed dot pattern (standard) with a variable dot pattern (comparison) appearing 2 or 8 seconds later and decided whether the comparison stimulus had “more” or “less” dots than the standard. Memory strength, indexed by the d‘ value of signal-detection theory, showed neither group difference nor decay over time. In experiment 2, the interstimulus interval was filled with an unjudged dot pattern (storage interference), and the standard stimulus followed the variable comparison stimulus (encoding difficulty). The memory strength of 17 schizophrenics and 17 normals was severely impaired, and their memory strength weakened over time, but again, no group differences were found. In both experiments, the two groups showed a strong bias (β) in underestimating the first (to-be-remembered) stimulus. It was concluded that schizophrenics' short term perceptual memory for nonverbal stimuli remains good.

ISSN:0022-3018    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

A patient's refusal to participate in recommended treatment is a problem faced in all branches of medicine. However, psychiatry faces special problems because of its authority to impose hospitalization and treatment on unwilling patients. Nowhere is this more poignant than in the treatment of patients exhibiting suicidal behavior where the potential for imminent self-destruction exists.As part of a prospective study to develop utilization review standards for the hospitalization of suicide attempters, cases were identified where there was independent agreement between both the experts' standards and the treating resident psychiatrists that hospitalization was required. Despite this agreement, the patients were not hospitalized because the patients refused. By most criteria, these patients were a high risk group. They had made repeated suicide attempts, used lethal means which eventuated in serious medical consequences, and were still suicidal when referred for treatment. The emergency room psychiatrists reported feeling confused, anxious, and annoyed in dealing with these patients, and the patients signed out against medical advice. A review of these cases indicates that discussions of social control vs. medical responsibility and clear criteria for hospitalization should be incorporated into residency training programs since the emergency room resident faces these tension-producing issues frequently with several different types of patients. Moreover, utilization review criteria may help to set standards which will assist the psychiatrist in making these difficult decisions.

ISSN:0022-3018    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

The phantom limb phenomenon (PLP) was studied in 42 patients with leprosy who had limb amputation and/or digital shortening; some of the patients also had another type of limb deformity, such as claw-hand or foot-drop, which did not involve significant loss of tissue. Thirty-eight (90 per cent) of the patients reported having at least one phantom limb (PL) for a missing or deformed part. Associated with each of the three types of limb defects, two descriptively and experientially distinct types of PLs were found: the paresthetic or typical (TPL) and the painless or natural (NPL). Descriptions of the TPL and the NPL are given. The findings were compared to various reports, particularly those of Stetter and Frederiks. The leprosy TPL was similar both to the PL of amputees as frequently described in the literature, and to what Stetter and Frederiks termed the PL sensations. A close correspondence, if not identity, was noted between the NPL of leprosy patients and the equivalent categories of Stetter's PL experience and Frederiks' PL as such. Included in these three designations are aspects of the PLP that are associated with the normal, intact limb; these aspects are thought to be usual concomitants of the PLP and to constitute manifestations of the persistence of the normal body image. From our findings, we conclude that for the appearance of a PLP, the actual loss of a part of a limb, whether slow or sudden, is not required, but the loss of its sensorimotor functions is sufficient.

ISSN:0022-3018    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

Traditional psychiatric thought has equated the inability of a female to obtain an orgasm (particularly a vaginal orgasm during intercourse) with psychological maladjustment. The research literature generally does not support this position. The present paper describes the psychological characteristics of 44 frigid women who applied for treatment of their sexual problem at two university hospital sex clinics and 26 women selected for treatment by the same criterion, but treated in private practice. Presented for comparison are 53 female neurotics from a Temple University Hospital psychotherapy study, a sample of 65 consecutive female walk-ins of mixed psychiatric diagnosis from the Psychiatric Outpatient Clinic of Temple Hospital, and a group of 35 female college student sophomores from Temple University who comprised the normal sample.A battery of psychological tests including the MMPI, the Institute for Personality and Ability Testing—Self-Evaluation Form (IPAT), the Symptom Check List, and the Eysenck Personality Inventory were given to each group. The data indicate that female patients who apply to a sex dysfunction clinic, complaining primarily of sexual inhibition, appear as a group identical to a normal control group in terms of their psychological profile and less neurotic than psychiatric outpatients, with the exception that the normals were less depressed.When women with primary orgasmic dysfunction from the above three samples were combined and compared to those with secondary orgasmic dysfunction (using Masters and Johnson's criterion), the groups were identical, at least from a global psychological perspective.We suggest that little else can be gained by assessing global personality characteristics. Without discarding the primary and secondary classifications, a potentially more fruitful approach would be to develop instruments that would measure specific dimensions, such as sexual misinformation, specific sexual anxiety or guilt, or resentment or hostility directed toward the immediate sexual partner.A scale to measure specific phobic-like sexual anxiety, in addition, would have treatment implications because of the recently demonstrated effectiveness of specific anxiety-reducing techniques, such as systematic desensitization. Specific scales can also be useful in the assessment and prediction of outcome in psychotherapy.

ISSN:0022-3018    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

The so-called problem-oriented methods for organizing and recording clinical information offer many potential benefits to users in psychiatric institutions. Beyond the mechanical aspects of implementation, incorporating a problem-oriented approach into the practices of clinical teams entails conceptual and practical readjustments of considerable magnitude. Based on an 18-month study of eight psychiatric teams with diverse characteristics, the paper discusses rationales and priorities, as well as administrative and educational considerations in the conversion process. Such a process must be studied and understood in setting objectives and channeling resources, if outcomes are to match the expectations.

ISSN:0022-3018    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

Initial interview ratings of therapist accurate empathy, unconditional positive regard, and self-congruence were correlated with nonlexical speech characteristics and outcome of individual psychotherapy. Speech characteristics of both patients (greater total speech time, shorter pause time following therapists' comments, and faster reaction times) and therapists (fewer speech units) were significantly related to improved outcome. While Rogers-Truax factors were unrelated to outcome, they were related to speech characteristics of both patient and therapist. Furthermore, patients whose therapists showed high levels of the Truax factors tended to increase their average speech durations and total speech time during the course of the initial interview.

ISSN:0022-3018    

出版商:OVID    

年代:1976

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1976

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1976

数据来源: OVID