摘要:

Numerous studies have shown evidence of cerebral ventricular enlargement in schizophrenia and its relationship to severity of clinical symptoms and psychosocial dysfunction. In this large prospective study, 88 noninstitutionalized DSM-III-R schizophrenic patients were administered a CT scan and rated for positive and negative symptomatology and premorbid adjustment. The CT scans from 14 healthy controls were used for comparison of cerebral ventricular measures. Patients had an enlarged ventricle to brain ratio of the anterior portion of the lateral ventricles, the frontal horns, compared with controls. Patients with larger frontal horns had more severe negative symptoms and poorer premorbid childhood adjustment. The area of the main body of the cerebral lateral ventricles, though not elevated in patients, was correlated with the total number of prior hospitalizations. These results support the hypothesis of a structural and functional “frontal” deficit in schizophrenia.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Stuctural brain abnormalities have recently been discovered using magnetic resonance imaging in infantile autism, a neurodevelopmental disorder of unknown etiology. However, functional neuroimaging studies in autism using positron emission tomography have had conflicting results and have not explained how the known structural brain abnormalities in autism act in a functioning brain to produce autistic behavior. Using a new technology, highresolution brain single photon emission tomography, we studied and scanned four young adults with infantile autism and four age-matched controls using the labeled ligand99mTc-D,Lhexamethyl- propylene amine oxime (99mTc-HMPAO). Total brain perfusion was significantly decreased in autism subjects (range, 58% to 72% of controls,p≤.02). In addition to the globally decreased perfusion, the autism group also had regionally decreased flow in the right lateral temporal and right, left, and midfrontal lobes compared with controls (p≤.02, Mann- Whitneyt-test).

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The neuropsychological and clinical correlates of extreme violence were examined retrospectively in young and older inpatients of a forensic psychiatric hospital. The young group exhibited significantly higher rates of both a learning disability and a history of childhood conduct disorder, whereas the older group had a significantly higher rate of psychosis. The older individuals charged with murder were also more likely to have acted alone and to have had an intimate relationship with the victim. These results suggest that age, specific clinical and neuropsychological variables, and the characteristics of the violent act may represent important variables for risk models of violence.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Log-linear %2 analyses were conducted to examine potential interactions between the presence of precrime axis I psychiatric diagnoses and differential levels of crime stress in association with posttraumatic stress disorder (PTSD) in a community sample of 295 female crime victims. High crime stress was defined as crime that included either perceived life threat, actual injury, or completed rape. Crime stress level was significantly associated with PTSD after the crime. Thirty-five percent of subjects with high crime stress exposure met criteria for PTSD, as opposed to 13% of those with low crime stress exposure. Precrime diagnosis was not associated with high crime stress exposure, indicating that this is not a vulnerability factor for exposure to crime characteristics associated with increased rates of PTSD. There were no significant independent associations between precrime axis I diagnoses and PTSD after the crime. However, a significant interaction was observed among crime stress level, precrime depression, and PTSD such that the rate of PTSD was substantially higher in association with precrime depression only in the high crime stress exposure group. Major findings are consistent with previous results implicating trauma exposure as the primary factor in development of PTSD. However, the results indicate that precrime depression may constitute a vulnerability factor for development of PTSD under conditions of high crime stress exposure.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The “personal characteristics” and “extreme event” hypotheses have been proposed as alternative explanations for the development of posttraumatic stress disorder (PTSD) among combat veterans. The person-event interaction model attempts to integrate both perspectives by hypothesizing that premilitary individual vulnerability characteristics play a greater role in influencing risk of PTSD or PTSD symptom severity at lower than at higher levels of exposure to traumatic combat stressors. Focusing on a sample of 57 Vietnam veterans undergoing inpatient treatment for diagnosed PTSD, we assessed this model by examining interactions between negative parenting behaviors in childhood (e.g.-test), inconsistent love) and degree of combat exposure in predicting PTSD symptom severity. Hierarchical regression analyses supported the model, indicating that the father's negative parenting behaviors were more predictive of PTSD symptom severity at relatively lower levels of combat exposure. Implications of the findings for further research on multivariate, interactional models of PTSD etiology among Vietnam combat veterans are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Longitudinal data from 290 firefighters who had completed questionnaires 4, 11, and 29 months after exposure to a natural disaster were used to examine the role of intrusive and distressing memories in the etiology of posttraumatic stress disorder. At 42 months, all those who were at risk of having developed a psychiatric disorder (N=113) and a randomly selected comparison group (N=34) who had never developed symptoms were interviewed using the Diagnostic Interview Schedule.The intrusion subscale score of the Impact of Events Scale accounted solely for the etiological link between the disaster and posttraumatic disorders. Avoidance had no direct relationship with the onset of symptoms and appeared to be a defensive strategy to contain the distress generated by the re-experiencing of the disaster, indicating the importance of separating these phenomena from disorder mood and arousal in posttraumatic stress disorder. An information processing model was validated using three different data sets, which suggests its robustness. Using cross-lagged panel correlations, a bidirectional relationship was demonstrated between disorder and intrusive recollections, suggesting that the intensity of recurring memories of a traumatic experience is as indicative of a disturbance of mood and arousal as the exposure to the trauma.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

We applied an operational definition of neurotic depression to 185 hospitalized patients who met Feighner and DSM-III-R criteria for unipolar depression. Based on a systematic chart review, 37 patients met the criteria for neurotic depression. As a group, these patients differed from nonneurotics in symptoms, clinical course, outcome, and family history. The neurotic depressives were younger and more likely to identify precipitating factors. They were less likely to meet criteria for melancholia and to have delusions. They were more likely to be ill 3 years later and more likely to have familial alcoholism. These differences help to confirm the validity of the neurotic depression concept.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

No pharmacological treatment protocol has proven generally useful for all patients who stutter. Various medications, behavior therapy, relaxation, suggestion, and social-based therapies have been used. For this drug treatment study, two groups of adult stutterers were followed in an 8-week open label protocol. All subjects had in the past received speech therapy; none had been treated previously with medication for stuttering. The first group (N=12) received a maximum dose of 800 mg of carbamazepine; the second group (N=8) received a maximum dose of 400 mg of carbamazepine. Each patient served as his or her own control. A series of systematic speech tests was given weekly to determine the variability of fluency for each subject.A statistically significant change occurred for a number of “expectancy to stutter” characteristics. Subjects felt that they stuttered less often while taking carbamazepine. Subjective effects began before medication and continued after patients discontinued the medication. Struggle characteristics also subjectively decreased. However, no objective improvement was found. No change was found in percentage of words stuttered, reading improvement, or improvement in spontaneous speech rate. Interrater reliability showed a correlation of .996. Three carbamazepine serum level therapeutic windows were inspected with negative results. Interestingly, naive listener ratings did show a statistically significant improvement on carbamazepine versus placebo. Future anecdotal reports of pharmacological improvement of stuttering should be subjected to rigorous objective testing before general acceptance

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The aim of this research project was to develop an instrument to measure acknowledgment and denial of illness in hospitalized psychiatric patients.The investigators developed a 23-item, 4-point self report scale, the Patient's Experience of Hospitalization (PEH), and collected validity data from a sample of inpatients. A total of 29 subjects completed the PEH, the Marlowe-Crowne Social Desirability Inventory (MCSD), the MMPI, and a Global Assessment Scale (GAS) report. The patients' psychotherapists also provided GAS scores.Kuder Richardson split-half reliability and point biserial correlations of 18 items were adequate. The PEH total score correlated significantly and positively with the difference between the GAS scores assigned to the patient by the patient and by the therapist, with the patient's self-report GAS score, with MCSD scores and with the MMPI L and K scales, considered to assess crude and subtle defensive denial. Correlations with MMPI clinical scales (symptom reports) were negative, further supporting the idea of the PEH as a measure of denial.

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1992

数据来源: OVID