ISSN:0022-3018    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

This paper presents the main issues in the diagnosis and treatment of psychiatric sequelae in torture victims. The concept of post traumatic stress disorder is used to organize literature on psychiatric casualties resulting from massive psychic trauma, e.g., the Nazi Holocaust, the Vietnam and Israeli wars, and the current world epidemic of torture. Torture is a unique humanmade stressor resulting in category-specific diagnostic symptoms. Medical assessment can be complemented with photographs, x-rays, electroencephalograms, and sleep studies. Individual psychotherapy and group techniques focus on the issues of denial and trust, loss, survivor guilt, and reparation. Programs of psychological and social rehabilitation and treatment with benzodiazepines, tricyclic antidepressants, and other compounds are reviewed. Future research needs include the conceptualization of the trauma of torture and its sequelae in broader terms, the application of standardized measurements to facilitate international comparisons, and the testing of various approaches to intervention in an experimental design. An ethical physician must resist the pressures of totalitarian governments to assume neutrality in the presence of human rights violations affecting his/her patients.

ISSN:0022-3018    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Narcolepsy in which the hallucinatory component is unusually prominent may lead to the development of an illness indistinguishable from the schizophrenic syndrome. Psychotic symptoms dominate the symptomatology, so that the primary illness is obscured. Five patients are described for whom conventional antipsychotic drugs were ineffectual, but for whom treatment with stimulants produced substantial improvement. The diagnosis of narcolepsy was confirmed by Human Leukocyte Antigen typing and sleep laboratory testing. These results support the “REM intrusion” hypothesis of the causation of schizophrenia in as many as 7% of a series of schizophrenic patients. Implications for diagnosis and treatment are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The place of culture in psychiatric nosology is explored through the example of taijin kyofusho (TKS), a common Japanese psychiatric disorder characterized by a fear of offending or hurting others through one's awkward social behavior or an imagined physical defect. Although variants of this disorder have been described in other cultures (e.g., dysmorphophobia), the full spectrum appears to be confined to Japan. TKS can be understood as a pathological amplification of culture-specific concerns about the social presentation of self and the impact of improper conduct on the well-being of others. Both social interaction and constitutional vulnerability may contribute to the cognitive processes that underlie TKS. The salience of cultural differences for psychiatric nosology then depends on whether the clinical focus is on disordered biology, individual psychology and experience, or the social context of behavior. Any attempt to include cultural variation in psychiatric diagnoses must begin by making explicit the intended use of the classification because different social contexts and clinical goals demand alternative diagnostic schemes.

ISSN:0022-3018    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The role of loneliness, irrational beliefs, and deficient reasons for living in predicting vulnerability to hopelessness under conditions of negative life stress was examined. Subjects (N = 178) completed the UCLA Loneliness Scale, Rational Beliefs Inventory, and the Reasons for Living Inventory at the beginning of the semester. Then, at midterm, measures of negative life stress, depression, and hopelessness were obtained from the same subjects. It was hypothesized that the vulnerability factors would interact with negative life stress to predict hopelessness, independent of depressed mood. The results of multiple regression analyses supported this hypothesis. Implications for research, prevention, and treatment are noted.

ISSN:0022-3018    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The purposes of this study were the following: a) to determine the prevalence of combatrelated posttraumatic stress disorder (PTSD) symptoms among veterans seeking assistance at a Veterans Administration medical center substance abuse treatment facility, b) to examine the relative contribution of Vietnam war zone variables to PTSD symptom development, and c) to study psychosocial adjustment problems associated with Vietnam combat exposure and with PTSD symptoms among help-seeking substance abusing men. Of 489 male veterans presenting for treatment, 10.7% had significant Vietnam combat-related PTSD symptoms as measured by the Mississippi Scale for Combat-Related PTSD. Clinically significant PTSD symptoms occurred among 46% of the subsample of combat-exposed Vietnam veterans with substance abuse problems. Degree of combat exposure was the most important military stressor that distinguished Vietnam veterans with PTSD from those without PTSD, but the groups also differed on age of war zone duty, duration of war zone duty, and whether they were wounded. Veterans who served in Vietnam did not differ from veterans who had no war zone duty on various parameters of psychosocial adjustment. However, the subgroup of Vietnam veterans with PTSD symptoms reported significantly greater psychosocial adjustment problems than their counterparts who did not have PTSD. The deleterious effects associated with combat-related PTSD appeared to be confined to adjunctive psychiatric difficulties and unemployment and did not increase risk of arrests for antisocial conduct beyond that found for veterans without PTSD. Methodological and clinical implications of these findings are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Absorption (a trait capacity for total attentional involvement) was reported to increase during episodes of marijuana intoxication. Several subsets of the absorption scale items specifically characterized marijuana intoxication, and groups of users and nonusers showed differential affective involvement with these experiences. Additionally, within the drugusing group, a positive correlation between frequency of marijuana use and affective ratings of these experiences was found. The findings support the hypothesis that a specific type of alteration in consciousness that enhances capacity for total attentional involvement (absorption) characterizes marijuana intoxication, and that this enhancement may act as a reinforcer, possibly influencing future use.

ISSN:0022-3018    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

We examined the clinical data for 230 depressed inpatients who had completed a dexamethasone suppression test (DST) to determine whether those with an elevated post-DST serum cortisol level exhibited any of the classic physiological stigmata of Cushing's syndrome. Hypertension was significantly more frequent among DST nonsuppressors (21.2%) than among normal suppressors (11.3%). Percent blood lymphocyte count was significantly lower among nonsuppressors. Confounders such as gender, age, body weight, and use of antihypertensives did not account for the findings. Implications for morbidity and mortality rates among patients with affective disorder are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1991

数据来源: OVID