ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The authors studied two groups of persons who had experienced either the death of a mother or father. One group consisted of patients who had sought treatment because of pathological aspects of bereavement. The other group consisted of volunteers selected from a review of hospital death records, which indicated the recent death of their parent. The study used a nonequivalent groups design, where both groups were followed over time. The field subjects were initially seen much sooner after the death than the patients.The patient group received a time-limited dynamic therapy focused on the stress response syndrome induced by the death. At the pretherapy evaluation point, the patient sample had significantly higher levels of symptomatic distress than did the nonpatient sample. The distress declined over a 13-month period, so that patients had comparable levels of distress to that of the field subjects. After adjusting for initial values, the main difference was that patients reduced their avoidant operations more than did the field subjects. Intervening variables were assessed for the prediction of change in symptoms over time as related to the parental death. The variables that showed significant correlations to symptomatic change were cumulative negative life events from varied sources, occupation, social class, developmental level of the self-concept, identity of the deceased parent, and attribution of blame for the death. Social support did not relate to change in symptoms over time.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The author describes the phenomenology and clinical characteristics of survival guilt which can be found in many Vietnam veterans. This conflict, in its most acute presentation, typically resembles an agitated depression. The syndrome is characterized by the veterans' frequent dreams of their friends dying in battle, and by their avoidance of interpersonal intimacy because they fear the other party may abandon them or die. The section on treatment recommendations emphasizes the importance for psychotherapists to confront continuously the veterans' many self-destructive patterns of behavior. Psychotherapy should also address any false beliefs the veterans may entertain regarding the nature of their survival.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

This paper critically examines the hypothesis that chronic pain is the physical manifestation of an underlying depressive disorder, as proposed by Blumer and Heilbronn in 1982 (Blumer, D., and Heilbronn, M. Chronic pain as a variant of depressive disease. The pain-prone disorder. J. Nerv. Ment. Dis., 170: 381–406, 1982). The logic of this argument and the empirical evidence provided by Blumer and Heilbronn to support their hypothesis are discussed and their validity challenged. Alternative interpretations for the results as well as for the relationship between pain and depression are noted. Although it may be plausible to view a small subset of chronic pain patients as manifesting a “muted depressive state,” the burden of proof still lies with those theorists who adhere to this formulation.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The pain-prone disorder as a discrete psychobiological entity was defined on the basis of clinical evaluation, including observation of characteristic premorbid traits, psychological testing, inferred psychodynamic characteristics, a particular family history, and biological markers such as response to antidepressant medication. It is discussed in relation to the complaints of pain found in patients diagnosed primarily as depressive. The points made in the article by Turk and Salovey (J. Nerv. Ment. Dis. 172: 398–404, 1984) are considered item by item.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Several critics of the theory of the importance of the family environment in the etiology of schizophrenic disorders claim and have sought to prove that the disturbance of family transactions and communications demonstrated by Lidz et al. (Lidz, T., Cornelison, A., Fleck, S., et al. The intrafamilial environment of the schizophrenic patient: VI. The transmission of irrationality. AMA Arch. Neurol. Psychiatry, 79: 305–316, 1958), Wynne and Singer (Wynne, L. C., and Singer, M. T. Thought disorder and family relations of schizophrenics: II. A classification of forms of thinking. Arch. Gen. Psychiatry, 9: 199–206, 1963; Singer, M. T., and Wynne, L. C. Thought disorder and family relations of schizophrenics: IV. Results and implications. Arch. Gen. Psychiatry, 12: 201–212, 1965), and others derive from the presence of and concerns about the schizophrenic offspring. The author knows that three of his former nonpsychotic patients each had a child who later became schizophrenic. Two of the three were seen during his residency before his formulation of any hypothesis concerning the intrafamilial environment of schizophrenic patients. The cases reinforce the retrospective findings (Lidz, T., Fleck, S., and Cornelison, A. Schizophrenia and the Family. International Universities Press, New York, 1965) that the marriages of the parents and the family environments were seriously disturbed before the onset of a schizophrenic disorder in an offspring.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Two subgroups of relapsed and rehospitalized schizophrenic patients were separated on the basis of preadmission compliance or noncompliance with prescribed antipsychotic medications. Noncompliant patients had a gradual onset of episode with prominent psychotic features, required involuntary commitment, and remained in hospital longer. Compliant patients had a rapid onset of symptoms with prominent affective features (anxiety and depression) which were frequently associated with environmental stressors independent of the patient. Compliant patients were usually voluntary admissions and recovered quickly with minimal or no change in their antipsychotic pharmacotherapy. The pathogenesis of relapse among drug-compliant patients remains unknown, but likely includes aspects of environmental stress, an emergent affective syndrome, and, to some less clear extent, akinesia and akathisia. Implications for the inpatient and community treatment of these patients are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

This study tested three systems for measuring patient and therapist contributions to the therapeutic relationship. Scales with parallel dimensions were used by patients, therapists, and clinician judges to rate the same therapy hours. The sample consisted of 42 patients selected on specific criteria for their suitability for brief psychotherapy (20 sessions). They were treated by experienced psychodynamic therapists and therapeutic change was assessed by six outcome measures. Similarities and differences between the three perspectives of the alliance and their association with outcome were examined. There were significant correlations between patients', therapists', and nonparticipant judges' ratings of the patients' positive and negative contributions and the therapists' positive contributions, but no agreement between the three perspectives in their estimates of therapists' negative contributions. Within each measurement system, patients' and therapists' positive contributions to the relationship were the best predictors of outcome. In conclusion, the results suggest that the patients' and therapists' ratings of the treatment relationship, although influenced by subjective bias, agree to some extent with the nonparticipant judges' ratings and are more powerful in predicting the outcome of psychotherapy.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The authors have developed a brief rating scale to expedite the rapid screening of emergency psychiatric patients who require hospital admission from those who are suitable for outpatient crisis intervention treatment. The interviewers used this scale to assess and score the patient rapidly on the basis of three factors: dangerousness, support system, and motivation or ability to cooperate. The authors report on and discuss the use of the scale in a preliminary study of 300 cases and in a prospective study of 122 patients who were followed for 6 months after they were evaluated. They found that those who scored below a median point on the scale required hospitalization and those who scored higher were suitable for crisis intervention as outpatients.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Perceptual span was assessed in schizophrenic, bipolar affective disorder-manic, bipolar affective disorder-depressed, and nonpsychotic inpatients. Both schizophrenics and manics processed less information than depressives, and did not differ from each other. This suggests that reduced span may be a concomitant of psychoses characterized by distractibility and thought disorder, rather than a trait specific to schizophrenia.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID