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Biomedical subjects

D Bakal

Publications and source records attributed to D Bakal.

10 recordsLinked to original sources
PubMed2006

An experiential mind-body approach to the management of medically unexplained symptoms.

This article outlines an experiential mind-body framework for understanding and treating patients with medically unexplained symptoms. The model relies on somatic awareness, a normal part of consciousness, to resolve the mind-body dualism inherent in conventional multidisciplinary approaches. Somatic awareness represents a guiding healing heuristic which allows for a linear treatment application of the biopsychosocial model. The heuristic acknowledges the validity of the patient's physical symptoms and identifies psychological and social factors needed for the healing process. Somatic awareness is used to direct changes in coping styles, illness beliefs, medication dependence and personal dynamics that are necessary to achieve symptom control. The mind-body concept is consistent with and supported by neurobiological models which draw on central nervous system mechanisms to explain medically unexplained symptoms. The concept is also supported by a recent hypothesis concerning the role peripheral connective tissue may play in influencing illness and well-being. Finally, somatic awareness is described as having potential to enhance understanding and conscious use of inner healing mechanisms at the basis of the placebo effect.

Humans↗
PubMed1992

Agoraphobic avoidance and panic frequency as predictors of laboratory induced panic reactions.

This study examined the importance of agoraphobic avoidance and frequency of panic as predictors of psychological and physiological responses of panic sufferers to a laboratory based provocation procedure. Psychophysiologic comparisons were made between 22 panic disorder patients and 15 controls, at baseline and across three periods of carbon dioxide gas inhalations (1, 3, 5%; balance oxygen). Subjective measures of anxiety, frightening cognitions and body sensations were obtained across the phases. Physiological measures of minute ventilation, breathing rate, tidal volume, end tidal CO2 and heart rate were also obtained. Between group comparisons revealed significant differences between the groups on the subjective measures with no significant differences occurring on the physiological measures. Within group analyses revealed that pre-session questionnaire measures of agoraphobia avoidance and panic frequency predicted the degree of anxiety, frightening sensations and cognitions during baseline and 5% CO2 inhalation. The results indicated that both self-reported agoraphobic avoidance and panic frequency are strong clinical predictors of psychological reactions of panic sufferers during laboratory provocation.

Adult↗
PubMed1989

The clinical significance of pain and cognitive activity in latent labor.

We examined the relationship between pain and cognitive activity during the latent (less than or equal to 3 cm), mid-active (5-7 cm), and transition (greater than or equal to 8 cm) phases of labor and the concomitant efficiency of the latent, active, and descent phases in 115 nulliparous women. Patients provided subjective pain ratings and described their thoughts during each of the three phases. Higher levels of pain during the latent phase of labor were predictive of longer latent (r = 0.58) and active (r = 0.50) phases of labor. Distress-related thoughts during latent labor were predictive of longer latent (r = 0.31, P less than .01), active (r = 0.67), and second-stage (r = 0.61) labor. We found no relationships between pain and cognitive activity measured during active labor and efficiency of active labor or second stage of labor. Pain and cognitive activity assessed during the latent phase were also prognostic of obstetric outcome. Thirteen of 19 women (68.4%) who reported "horrible" or "excruciating" pain required instrumental delivery, compared with eight of 27 women (29.6%) in the "discomforting" pain group. Subjects in the "distress-related" cognitive group had 2.6 times the incidence of instrumental delivery, five times the incidence of abnormal fetal heart rate patterns, and four times the requirement for pediatric assistance for the neonate than subjects in the "coping" group. We conclude that latent labor is a critical phase in the psychobiology of labor and that pain and cognitive activity during this phase are important contributors to labor efficiency and obstetric outcome.

Adolescent↗
PubMed1982

Solitary intracranial plasmacytoma: two patients with extended follow-up.

Solitary neoplastic proliferation of plasma cells (plasmacytoma) rarely occurs in the central nervous system. The longest follow-Up in nine previously reported patients was 5 years. We have followed two patients with solitary intracranial plasmacytoma for 8 and 13 years, respectively. At the time of biopsy diagnosis, neither showed involvement of the adjacent calvarium or evidence of a systemic plasma cell dyscrasia. The first patient underwent partial excision of a mass in the right occipital lobe that showed no gross or microscopic involvement of the dura. The second patient had partial resection of a mass arising from dura and invading the left temporal lobe. Postoperative irradiation was given to both patients. No clinical or radiological sign of recurrent brain tumor has developed in either patient during the extended follow-up period. Neither patient has had laboratory or clinical evidence of a systemic plasma cell dyscrasia. Solitary intracranial plasmacytoma may be a "curable" brain tumor.

Adult↗
PubMed1975

Stimulus generalization and anxiety in schizophrenic and normal subjects.

Sixty schizophrenics and 60 normal subjects were compared on a test of stimulus generalization. The generalization stimuli were lines differing in length. Both schizophrenics and normals were divided into two groups (30 subjects each) and trained either on a short line or on a long line. In addition to the generalization stimuli, subjects were presented with an irrelevant stimulus (circle). Although there was a significant difference between the generalization gradients of the groups, this difference was limited to generalization stimuli away from the negative training stimulus. The concept of peak shift was invoked to interpret these data. That the groups did not respond to the irrelevant stimulus is inconsistent with interference theory and gives some support to the differentiation between conceptual overinclusion and perceptual overinclusion. The relationship between stimulus generalization and scores on the Manifest Anxiety Scale was inconsistent.

Anxiety↗
PubMedDate not supplied

Variability in breathing patterns during latent labor. A pilot study.

This study examined the breathing patterns of a small sample of women (n = 21) during latent labor. The study also examined the different thoughts or cognitions the women experienced during their early contractions and assessed whether these cognitions, when classified as associative or dissociative in orientation, were related to breathing styles and length of labor. Respiration rate and tidal volume were monitored during and between contractions using a noninvasive plethysmograph system. The breathing results indicated considerable variation among women in individual respiration rate and tidal volume both between and during contractions. In addition, marked variability was found in both the direction and degree of change in breathing frequency and tidal volume in response to contractions. Women who relied predominantly on associative strategies during early labor had lower breathing rates and higher tidal volumes than did women who employed dissociative strategies.

Adult↗