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

摘要:

This paper is concerned with the kind of work that is needed in order to provide a more solid scientific foundation for the belief that life stress causes illness. Although indirect evidence from controlled laboratory studies and from extreme situations provides strong indications of the general relationship between stress and illness, the evidence concerning the effects of naturally occurring and more ordinary stressful life events is less clear. Although we have a body of research indicating that life events are associated with a wide range of disorders and distress, it does not provide a clear picture of the nature and strength of this relationship. In order to clarify our understanding of how stressful life events affect health and illness, we will need to deal with methodological issues that have emerged from research to date and to tackle a major substantive problem that has been largely neglected. The methodological issues are three: a) definition of the populations of life events to be studied; b) measurement of the magnitudes of the life events; and c) use of a research design appropriate to the question to be answered. The substantive issue concerns factors that mediate the impact of life events. Each of these issues is examined in turn in this paper.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

This paper reports on the occurrence of stressful life events prior to treatment and at a follow-up time point in a general sample of community mental health center patients. Life events scores from the patients, at both time points, are compared with scores from a non patient sample drawn from the community. Results indicate that patients before entering treatment tend to experience more events (particularly undesirable ones that could be confounded with psychological condition) than non patients. This result is no longer true at the follow-up time point. Findings regarding life events and patient hood are basically the same whether all events are used (i.e., the change score) or undesirable events alone. If, however, only events judged to be un confounded with psychological condition are considered, we find no difference between patients and non patients at either time point. Implications of the study's results for the direction-of-effect issue with respect to the stress-psychological disorder relationship are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Evaluations of social disability have been found useful in determining factors of diagnostic, therapeutic and prognostic significance in the management of psychogeriatric patients. A random sample of 100 psychogeriatric patients aged 65 or over admitted to three Toronto hospitals were studied prospectively. Standardized clinical and social interview schedules were used to assess patients' mental state, self-care capacity, social isolation, burden on the family and household contribution before admission. These assessments were carried out to determine their significance with respect to diagnosis and outcome. Self-care capacity, as measured by the Activities of Daily Living Performance Test or by informant report, was related to diagnosis and outcome measures in this sample. Social isolation was significantly correlated with length of hospital stay. Burden on the family was not found to be significantly associated with diagnosis or outcome although there was a tendency for patients with organic disorders to present more difficulties for their families. The severe burden imposed on relatives suggests the need for utilization of community social and medical services to provide relief for families of psychogeriatric patients. The implications for management are considered in the light of the above findings.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The difficulties of performing prospective psychiatric follow-up studies have recently increased due to growing concern over the ethical issues involved. In a study to determine the efficacy of different lengths of psychiatric hospitalization 235 patients were followed for 2 years after study hospitalization. Data were obtained on more than 90 per cent of the patients. The cost of performing 100 follow-up interviews ranged from $9,169 for patients living within a 6-mile radius of the study site, to $17,942 for patients living within the contiguous United States. It is concluded that through persistent effort useful data can be obtained by follow-up of psychiatric patients, while maintaining ethical standards which include respect for the rights and wishes of the patient.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The question of why addicts seek and remain in treatment has received very little attention. In the present study, 40 addicts requesting inpatient treatment for drug dependence were interviewed prior to admission about cognitive, motivational, social, and historical factors. These factors were investigated in relation to their association with certain treatment variables—whether or not the individual subsequently presented for admission, the manner in which inpatient treatment was terminated, and the length of stay. The factors most potent as predictors included the addict's evaluation of the drug unit itself, and social pressures from the family. Forensic factors were found to be positively related to length of admission; and motivation for treatment—a problematic concept which has frequently been regarded as tautologous—is also discussed. The results point to the complex interaction of factors associated with the addict's decision to seek treatment.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Studies of treatment outcome among addicts have focused on demographic factors and treatment modalities. This follow-up of treated narcotic addicts in Laos examines these two variables, plus the role of community factors in determining outcome.Three research methods were used. First, addicts readmitted within 365 days after discharge were compared with addicts not readmitted. Second, 25 addicts were selected for follow-up at 1 year post discharge; they were chosen from rural areas in order to represent addicts not likely to return to the treatment facility for readmission. Finally, 10 villages and towns were surveyed to assess the percentage of addicts seeking treatment and the percentage remaining abstinent.The study of readmitted patients and the survey of readdicted patients failed to show differences for sex, age, ethnicity, marital status, or type of opiate used when compared to non readmitted or abstinent patients. In contrast, the field survey showed that the proportion of addicts from a village or neighborhood coming to treatment was highly correlated with treatment outcome. Where more than two thirds of addicts from a given locality went for treatment, abstinent rates were high (i.e., 81 to 100 per cent). Where less than one third of addicts from a given locality went for treatment, abstinent rates were low (i.e., 0 to 25 per cent). Between these two extremes were two large towns where the abstinent rates were intermediate (i.e., 42 and 50 per cent). In these latter areas, abstinence was associated with: a) contacts with other ex-patients who were abstinent; and b) frequent contact with a person or institution interested in the person's continuing abstinence.Unexpectedly, demographic and clinical variables were not associated with treatment outcome in this study. By contrast, social variables in the addict's own community were highly correlated with outcome. These data indicate the need for study of outreach activities, including negotiation with community leaders and with groups of addicts themselves before initiating treatment activities.

ISSN:0022-3018    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A series of neuropsychological tests and an EEG examination were given to three groups of male adolescents who were inpatients in a psychiatric hospital. The groups were as follows: group 1: a group of seven patients with a diagnosis of behavior disorder, each with a history of multiple assaultive incidents; group 2: a group of eight patients with a diagnosis of behavior disorder, each with a history of zero to two assaultive incidents; group 3: a group of six patients with a diagnosis of organic brain syndrome (OBS). It was hypothesized that the repetitively assaultive behavior disorder patients would be more similar to the OBS patients than to the nonassaultive behavior disorder patients. The data revealed that several variables distinguished the nonassaultive behavior disorder patients from both OBS patients and assaultive behavior disorder patients; the latter two groups were indistinguishable from each other. The significant variables were: a) EEG abnormality; b) degree of establishment of hand dominance; c) perseveration errors in a visuomotor task; d) verbal short term memory. Paroxysmal activity, particularly in the frontal area, appeared to be the most important EEG feature related to assaultive behavior. The neuropsychological data give some support to the hypothesis that severe aggression is related to left hemisphere dysfunction. It is concluded that neuropsychological assessment can reveal organic features important in understanding repetitively violent behavior.

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