ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

In recent years reforms were instituted in the Federal Republic of Germany that were designed to facilitate the integration of psychiatric services and psychiatric patients into community life. One goal of this reform was to reduce patients' feelings of stigmatization. Because such feelings were thought to arise through patients' tenure at large, isolated state hospitals, we hypothesized that patients sent to such hospitals would feel more stigmatized than would patients assigned to a modern, integrated university hospital. Further, we hypothesized that patients in the two settings would adopt different strategies to cope with the stigma they perceived and that staff members in the two settings would share patients' views concerning these matters. Although we found that the staff in both hospitals shared our prediction that state hospital patients would perceive more stigmatization, our findings showed just the opposite. State hospital patients were significantly less likely than university hospital patients to believe that most people would devalue and discriminate against mental patients. Nor did we find strong evidence of different styles of coping with stigma among patients in the two settings. Taken together, our results suggest that in the realm of stigmatization well-intentioned efforts of reforms may have had undesirable unanticipated consequences. Given this, we suggest approaches for intervening more directly with patients in the form of “Daily Living Groups,” which are designed to explicitly discuss actual and feared stigmatization.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

One hundred ninety-five primary care patients were screened for panic disorder utilizing the National Institute of Mental Health Diagnostic Interview Schedule (DIS) as well as four additional questions that screened for core autonomic symptoms of panic disorder. A spectrum of severity of panic disorder was found. A subgroup of patients, labeled in the study as having simple panic, was found to have anxiety attacks associated with four or more autonomic symptoms, but they did not meet DSM-III recurrence criteria (three anxiety attacks within a 3-week period). Compared to primary care patients without panic attacks, patients with both simple panic and panic disorder exhibited multiple phobias, avoidance behavior, a high lifetime risk of major depression, and elevated scores on selfrating scales of anxiety and depression. The four autonomic screening questions that the authors added to the DIS interview increased the sensitivity of the DIS in identifying patients with panic disorder. Patients with panic disorder who selectively focus on their frightening autonomic symptoms may not be identified by screen questions that only focus on the cognitive awareness of anxiety.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

In order to explore fears, beliefs, and attitudes of patients with DSM-III hypochondriasis, the authors administered the self-rated Illness Attitude Scales to 21 patients with hypochondriasis, matched family practice patignts, nonpatient employees, and nonhypochondriacal psychiatric patients. Hypochondriacal patients reported more fears of and false beliefs about disease; they attended more to bodily sensations, had more fears about death, and distrusted physicians' judgments more, yet sought more medical care than other subjects. They did not take better precautions about their health. The self-report of overt attitudes suggests a characteristic syndrome, consistent with the DSM-III description of hypochondriasis. Two of the subscales of the Illness Attitude Scales yielded characteristic responses in hypochondriasis.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Somatization disorder, the presentation of multiple somatic complaints in multiple organ systems, can be diagnosed by three roughly comparable diagnostic systems: the Washington University Feighner criteria, the Research Diagnostic Criteria, and DSM-III criteria. This study evaluates diagnostic concordance for somatization disorder in these three diagnostic systems using data gathered in the National Institute of Mental Health-sponsored Epidemiologic Catchment Area Program at four sites. Data gathered through use of the Diagnostic Interview Schedule at the Duke, Johns Hopkins, Washington, and Yale University sites indicate that each criterion set identifies a somewhat different group of respondents. Feighner criteria identify the fewest number of respondents, followed by DSM-III criteria and the Research Diagnostic Criteria. Demographic, symptomatic, health utilization, and other severity indices indicate that the respondents identified by each group are very similar and that all diagnostic groups are clearly distinguishable from the normal population.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

This project was designed to test two hypotheses drawn from a new formulation explaining the exaggerated winter birthrate among hospitalized schizophrenics. The first is that the supposed exaggerated winter birthrate among process schizophrenics actually represents a reduction in spring-fall births caused by prenatal exposure to infectious diseases during the preceding winter—i.e., a high prenatal death rate in process preschizophrenic fetuses. The second is that the level of negative symptoms in survivors at risk for schizophrenia who were born after winters with high infectious disease rates is exaggerated. The findings provided some tentative support for this formulation. Compared with counterparts born after low-disease winters, schizophrenics born after winters with high disease incidences tended to show lower (more reactive) scores on a measure of the process-reaction dimension but higher anhedonia scores.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The present study is an investigation of the elicitation of auditory and visual hallucinations by brief instructions and the relationship of the report of hallucinatory-type experiences to standard measures of suggestibility. Two experiments were carried out. The first used normal subjects predisposed or not predisposed to hallucinate, as assessed by the Launay-Slade Hallucination Scale (LSHS-A). The second used hallucinating and nonhallucinating psychiatric patients. The high LSHS-A scorers and the hallucinating psychiatric patients were significantly more likely to hear suggested sounds than were their respective controls. High LSHS-A scorers were also significantly more likely to see suggested objects than were their respective controls, although this finding was not replicated in the psychiatric subjects. No significant differences on measures of suggestibility were found between the groups, although in the psychiatric group Barber Test Suggestion and Subjective Involvement scores correlated positively with LSHS-A scores.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Differential response patterns to the SCL-90R in patients with social phobia and panic disorder are presented. The differences are discussed in light of Liebowitz's distinction between primary social phobia and the secondary social fears of panic disorder patients. Treatment implications are also discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The prevalence of DSM-III-R self defeating (masochistic) personality disorder was determined on an outpatient population (N =82) and a normal population (N=40) using the Personality Diagnostic Questionnaire (PDQ). Fifteen (18.3% of the outpatients and two (5%) of normals were assessed as having the disorder. Overlap of greater than 50% with borderline, avoidant, and dependent personality disorders was found. Validation of masochistic personality disorder will require it to be of value in research and clinically in ways distinct from the other personality disorders with which it is associated.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The role of visual imagery in the symptomatology of posttraumatic stress disorder (PTSD) has not been fully appreciated. The occurrence of intrusive recollections of a traumatic event in the form of flashbacks is very common and may suggest a possible approach to treatment for many individuals with PTSD. A case is presented in which a combat veteran in psychodynamic psychotherapy for PTSD was successfully treated by capitalizing on his tendency to have flashbacks. In this instance, abreaction and subsequent working through of affective reactions to the abreaction resolved his disorder. Technical considerations and patient selection are discussed, and it is suggested that further study of the efficacy of this approach is warranted.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID