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Biomedical subjects

A M Jacobson

Publications and source records attributed to A M Jacobson.

At least 55 records · Page 3Linked to original sources
PubMed1987

Psychologic predictors of compliance in children with recent onset of diabetes mellitus.

A group of 57 children with recent onset of insulin-dependent diabetes mellitus was studied over 18 months. Compliance with the prescribed diabetic treatment deteriorated over this period. Adolescents (aged 13 to 15 years) were less compliant than preadolescents (aged 9 to 12 years). Initial patient reports of self-esteem, perceived competence, social functioning, behavioral symptoms, and their adjustment to diabetes predicted subsequent compliance behaviors. The findings highlight the linkage of child personality and adjustment with self-care of diabetes, and suggest that psychosocial assessment soon after diabetes is diagnosed may help identify patients at risk for later compliance problems.

Adaptation, Psychological↗
PubMed1987

Interaction sequences in families of psychiatrically hospitalized and nonpatient adolescents.

A KEY theme running through competing views of family influences upon adolescent development is that of directionality, on two levels: influences within the flow of family interaction; and influences from family processes to individual adolescent development. In this paper our focus is upon the first level, intrafamilial sequences within families. More specifically, we study links between psychiatric impairment in adolescence and developmentally relevant parent-child and parent-parent sequences. This report extends a previous investigation (Hauser et al. 1984), which described our new family coding system and first correlational findings. We now study the flow of interactions within these families. Although there has been much recent empirical research in adolescent psychosocial development (e.g., Redmore and Loevinger 1979; Loevinger 1976; Adams and Fitch 1982; Hauser et al. 1984), one important area has received less attention--the relationship between developmentally relevant family processes and psychiatric disturbance during adolescence.

Adjustment Disorders↗
PubMed1986

Evaluating ego defense mechanisms using clinical interviews: an empirical study of adolescent diabetic and psychiatric patients.

Ego defense mechanisms were studied in three groups of early adolescents: diabetic patients, non-psychotic psychiatric patients, and healthy high school students. Defenses were assessed from ratings of open-ended, in-depth interviews. High levels of denial and low levels of asceticism were found in all three groups. Comparisons between groups indicated that psychiatric patients had a distinctive profile of defense usage, in comparison to adolescents from the other two groups. An independent measure of ego development was positively correlated with the defenses of altruism, intellectualization, and suppression, while it was negatively correlated with acting out, avoidance, denial, displacement, projection, and repression. The findings of substantial differences in defense usage between the psychiatric and non-psychiatric samples, and the size and directions of the correlations with ego development level, lend support to the validity of the defense codes.

Acting Out↗
PubMed1986

Children with recently diagnosed diabetes: interactions within their families.

Cross-sectional findings drawn from the first year of a 4-year longitudinal study of preadolescent and early adolescent insulin-dependent diabetics and their families are presented. Using direct observation techniques and a specially designed coding system, the family interactions of 56 families with a recently diagnosed diabetic child are compared with those of 49 families with a child of similar age and sex, who has had a recent, serious acute illness. The two samples are contrasted in terms of each family member's (mother, father, and child) enabling and constraining interactions, controlling for social class differences. The findings reveal that the diabetic children and their parents expressed significantly more enabling (e.g., focusing, problem solving, active understanding) speeches than comparable members of the acute illness group. In addition, there are indications of particular constraining interactions (devaluing) occurring between fathers and diabetic children. Several alternative interpretations are offered to account for these results, together with plans for future research directions to investigate these hypothesized explanations.

Adolescent↗
PubMed1984

Ego development and psychopathology: a study of hospitalized adolescents.

This paper explores the relationship between ego development and psychiatrically relevant behaviors in a group of hospitalized adolescents. Building on Loevinger's model of ego development, we administered the Sentence Completion Test to 114 adolescent girls and boys. To study psychiatric symptoms, Achenbach and Edelbrock's Child Behavior Checklist was used. With these procedures, the Achenbach and Edelbrock factor scores were compared to ego stage using correlational and multiple regression analyses. Findings indicate significant negative correlations with the externalizing and internalizing factors as well as a variety of behavioral subscales. A significant relationship also exists between the total number of symptoms and ego development. Ego development is found to be an important predictor for the externalizing factor and 2 subscales after the background variables of age, sex, and SES are partialed out. Our discussion addresses the question of the relationship between stages and transitions in ego development in relation to psychopathology. In addition, "age-stage dysynchronies" are discussed as ways of understanding psychopathology from a developmental perspective.

Acting Out↗
PubMed1984

Familial contexts of adolescent ego development.

In this paper we describe our newly constructed Constraining and Enabling Coding System (CECS). This scheme was constructed to identify family interactions that are conceptually relevant to adolescent ego development. First, we discuss the theoretical rationale and reliability properties of the codes. We then present results of applying the scales to observations of 61 families, consisting of 2 parents and an adolescent, drawn from matched high school and psychiatric populations. All families are upper and (predominantly) upper-middle class. Each member completed the Loevinger Sentence Completion Test and then participated in a revealed-differences task, using responses to Kohlberg Moral Dilemmas as discussion stimuli. Transcripts of these audiorecorded discussions formed the data base for the family analyses. After controlling for patient status and adolescent age, adolescent and parent ego-development scores still contributed to explained variance in family interactions. Adolescent ego development was positively associated with adolescent enabling behaviors (e.g., problem solving, empathy). In contrast, there were negative correlations between constraining behaviors (e.g., devaluing, withholding) and adolescent ego development. Parental behaviors were significantly associated with (a) parent ego development, and (b) adolescent ego development. The third dimension of our system, discourse change, also showed theoretically expected strong correlations between progressive discourse change and ego development. In our discussion we comment on the importance of now proceeding to sequence analyses in order to explore questions of directionality.

Adolescent↗
PubMed1983

Ego development and self-image complexity in early adolescence. Longitudinal studies of psychiatric and diabetic patients.

Ego development and multiple self-images were studied in nonpsychotic psychiatric patients, diabetic patients, and healthy high school students. The results reported are drawn from the first year of a four-year longitudinal project investigating the psychosocial development and family interactions of impaired and at-risk adolescents. Both groups of patients, especially the psychiatric group, were significantly lower in their ego development and showed less self-image complexity than the high school students. These findings are discussed both in terms of understanding developmental deviation in these two chronically ill groups, and as a strategy for investigating formulations being proposed in the new self-psychology framework.

Adjustment Disorders↗
PubMed1982

Experience with penile prostheses in the treatment of impotence in diabetic men.

Increasing use of penile prostheses to treat impotence in diabetic men warrants a detailed assessment of functional and subjective outcomes within this group. This study uses record review and patient-partner questionnaire techniques to examine this population and evaluate postoperative satisfaction in terms of changes in patterns of sexual activity, health status, and complication rates. The satisfaction rates among patients and partners were 81% and 83%, respectively. Frequency of sexual activity was increased, and physical enjoyment was improved among satisfied recipients. Most postoperative complications were treatable and led to dissatisfaction only if they were irreparable. Most prostheses are therefore being used successfully. We recommend that impotent diabetic men be informed of the availability of prosthetic implants.

Adult↗
PubMed1980

Diagnosed mental disorder in children and use of health services in four organized health care settings.

The authors present comparative data on the extent, nature, and impact of diagnosed mental disorder among children under 18 years of age seen during 1975 in four organized health care settings. Between 3.3% and 10.1% of the children seen were diagnosed as having a mental disorder in the study year, representing an annual prevalence of between 2.2% and 8.2% of the "covered" child populations. Transient situational disturbances, behavior disorders, and special symptoms were the most common diagnoses; the more severe disorders (organic brain disease, schizophrenia, and affective and other psychoses) accounted for less than 4% of all diagnosed mental disorder. Patients with diagnosed mental disorder used non-mental-health services (except those of pediatricians) appreciably more often than did patients without such a diagnosis.

Adolescent↗
PubMed1980

Utility of electromyographic biological feedback in chronic stuttering: a clinical study with follow-up.

A systematic case study is presented in which eight chronic adult stutterers underwent an electromyographic (EMG) biological feedback training program designed to reduce masseter muscle tension in an effort to improve fluency. All subjects mastered the program within 10 30-min. sessions. Measures of muscle tension and fluency indicated improvement at the end of treatment that were maintained at 3- to 6-mo. follow-up.

Adult↗
PubMed1979

Neighborhood health center patients who use minor tranquilizers.

Thirty-four ambulatory medical patients who had used minor tranquilizers for varying lengths of time were interviewed to determine their medical and psychiatric statuses, and to learn their own perspective of their medical care. The population was elderly of lower socioeconomic status, and chronically ill (a significant minority with serious and disabling illness). Depressive equivalents, depression, and anxiety were prominent, but clinical states requiring psychiatric care were not. Slightly less than one-half were alcoholic. Forty-one percent took the medications for target symptoms other than anxiety, and 76% believed these agents were efficacious. Chronic users had significantly more chronic medical illness, and significantly more somatization, anxiety, and fatigue.

Acute Disease↗
PubMed1978

Treatment of Raynaud's disease: evaluation of a behavioral approach.

Eight patients with Raynaud's disease were treated with a behavioral program which included skin temperature biofeedback, relaxation training and protocol individualization based on the investigators' psychological understanding of each patient. Three patients improved clinically, although only one learned self-control of skin temperature. Anxiety reduction, brought about by relaxation or changes in the program to suit individual needs, appeared to be an important aspect of the treatment program.

Adult↗