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Biomedical subjects

A M Razin

Publications and source records attributed to A M Razin.

9 recordsLinked to original sources

Suicidal behavior among inner-city Hispanic adolescent females.

Suicidal behavior is disproportionately frequent among inner-city Hispanic adolescent girls. In an attempt to generate a multifactorial set of hypotheses to explain this behavior, 33 such subjects consecutively admitted for suicidal behavior and 15 demographically identical nonsuicidal subjects were assessed by means of a structured interview. Mothers of all subjects were also assessed. Attempts were nearly always impulsive and nonlethal, though often with a stated wish to die. Nearly all were overdoses, and were precipitated by conflicts with mother or boyfriend. Mothers could usually identify the precipitants. Attempters' parents were less often born in the U.S., their mothers seemed medically less healthy, and their extended families were more often supported by public assistance, and had a higher incidence of criminal and psychiatric problems. School performance was poorer among attempters, who had suffered more and earlier losses, especially of biologic fathers, with whom fewer had ongoing relationships. They more often had boyfriends, had begun sexual activity, had recently lost friends, and expressed a mistrustful stance toward friendships. Similarly, their mothers had fewer friends and more often expressed a mistrustful stance. Relationships with mothers seemed more intense, desperate, and even violent, and attempters were much more often parentified, i.e., mothering their mothers. Although both groups often assumed caretaking roles in their families, attempters were more negatively described by themselves and by their mothers. While knowledge of suicidal models was common in both groups, attempters' mothers knew of even more models than did their daughters or the nonsuicidal subjects or their mothers. Notably, more attempters' mothers had themselves made attempts. Families of most attempters were usually mobilized by the attempt. These findings permit the construction of a putative profile of risk factors that can be tested more rigorously.

Adolescent↗

Psychotherapeutic intervention in angina: II. Implications for research and practice.

The second of a two-part series, this article draws on the clinical and research literature reviewed in the first article to formulate guidelines for research and clinical practice. In future research, the complex heterogeneity of coronary artery disease (CAD) must be recognized in more rigorous descriptive, comparative, and physiologic correlative studies of psychosocial etiology. Pseudoangina is largely unexamined by systematic study and therefore warrants research on several of its aspects. Similarly, systematic research on intervention in anginoid pain is virtually nonexistent and obviously warranted. Clinical guidelines include the emphasis of didactic, supportive approaches, detailed focus on several aspects of the pain, early and extended psychotherapeutic availability, recognition and treatment of underlying specific psychopathology, and somatic interventions aimed at presumed pathophysiologic mechanisms.

Angina Pectoris↗

Psychotherapeutic intervention in angina: I. A critical review.

This paper considers the literature on factors found to be associated with angina and pseudoangina, and attempts to delineate those psychosocial characteristics that might distinguish angina patients from either nonanginal CAD patients or from non-CAD normals. A cluster of characteristics emerges from both retrospective and prospective studies suggesting greater affective lability, "neuroticism," and perhaps physiologic reactivity than in either comparison group. The literature also suggests that learning and suggestion may play important roles in generating specific precipitants for anginal attacks. The literature on psychosocial intervention in anginal syndromes is almost entirely anecdotal, allowing few firm conclusions to be drawn, but suggesting the possible efficacy of certain behavioral, didactic, and supportive-psychodynamic interventions.

Angina Pectoris↗

Psychosocial intervention in coronary artery disease: a review.

This review attempts to provide comprehensive consideration of three phases of psychosocial intervention in coronary artery disease (CAD): preventive, acute, and convalescent/rehabilitative. Toward this end, a wide variety of literature, ranging from clinical-anecdotal reports and prescriptive exhortations to controlled systematic studies, is considered. The prevention literature is limited to the Type A behavior pattern (TABP). Despite conceptual and methodological problems. TABP modification research seems promising, though its significance for ultimate CAD-reduction remains to be demonstrated. The acute phase literature consists almost entirely of clinical lore. Systematic research is recommended on several aspects of denial and on the efficacy of the many anecdotally recommended interventions. The rehabilitative phase literature also includes a rich clinical lore, and, in addition, several systematic studies indicating psychological and perhaps physiological benefits from both individual and group supportive psychotherapy. It is concluded that the current state of knowledge in this area is promising but controversial, and that advance beyond this point requires a shift from global, clinically derived impressions to specific, tested hypotheses.

Acute Disease↗

Reduction of physiological, behavioral, and self-report responses in type A behavior: a preliminary report.

Recent reports indicate that Type A Behavior may be reducible by behavioral and other psychotherapeutic methods. To date, however, there has been virtually no demonstration of reduction of the actual, observed behavior. Furthermore, the physiologic hyperresponsiveness that seems to characterize many Type A individuals when under stress, has received relatively little therapeutic attention. This preliminary, uncontrolled report describes a cognitive-behavioral group intervention program, before and after which patients underwent assessment on physiologic, behavioral, and self-report assessments. These included heart rate and blood pressure responsiveness under stressful conditions, trained observer ratings of Type A Behavior, and a variety of subjective measures of Type A Behavior and psychological distress and symptoms. Results showed limited improvement on most behavioral and self-report indices. Relatively greater reduction of Type A Behavior was associated with higher pre-treatment levels of Type A Behavior, with the absence of coronary artery disease and with male gender.

Adult↗