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Biomedical subjects

E K Silberman

Publications and source records attributed to E K Silberman.

At least 19 recordsLinked to original sources
PubMed1997

Research without external funding in North American psychiatry.

OBJECTIVE: The authors investigated the extent and characteristics of published psychiatric research from U.S. and Canadian medical schools that was carried out without external funding. METHOD: They reviewed reports of unfunded research in 14 psychiatric journals, tabulating methodological factors and topics of study. They surveyed first authors about their academic duties and resources used in the studies. RESULTS: Unfunded studies represented 26% of research reports, were usually prospective, most commonly dealt with phenomenology/epidemiology or psychopharmacology, used low levels of technology, and were accomplished on a modest budget of time and money. CONCLUSIONS: Unfunded studies make a substantial and economically efficient contribution to psychiatric research. Future investigations should detail the institutional conditions necessary to sustain this type of research productivity.

Authorship↗
PubMed1997

Gloria revisited.

Explore the source record for details and available documents.

Holistic Health↗
PubMed1997

A survey of state and VA policies on psychiatrists as primary care providers.

Fifty-five state and territorial commissioners of mental health and chiefs of psychiatry at 158 Department of Veterans Affairs medical centers were surveyed about current policies related to psychiatrists' roles as primary care providers in state and VA facilities. About half the respondents indicated that psychiatrists provided primary medical care or indicated interest in having psychiatrists provide such care. Less than half of this group limited such care to specific patient populations, and less than 25 percent required specific training for providers. The survey results indicate that opportunities for psychiatrists to provide primary care exist in many state and VA facilities but that no generally accepted guidelines or training standards for such practice have been developed.

Attitude of Health Personnel↗
PubMed1989

Psychiatric responses to trauma.

Controlled studies examining the relationship between psychiatric disorders and war and other traumatic events are reviewed. Several studies have found a correlation between the severity of posttraumatic stress disorder symptoms and the degree of trauma. Other disorders associated with trauma include depression, substance abuse disorders, adjustment disorders, psychosomatic disorders, and antisocial behavior. No relationship has been found between trauma and subsequent violent behavior. The authors identify areas for further research, including examination of why the majority of persons exposed to trauma do not develop psychiatric illness.

Depressive Disorder↗
PubMed1986

Hemispheric lateralization of functions related to emotion.

We have reviewed the evidence that processes and functions related to perception and expression of emotions are represented asymmetrically in the cerebral hemispheres. The literature describes three possible aspects of emotional lateralization: that emotions are better recognized by the right hemisphere; that control of emotional expression and related behaviors takes place principally in the right hemisphere; and that the right hemisphere is specialized for dealing with negative emotions, while the left is specialized for dealing with positive emotions. Evidence for the three hypotheses derives from methodologically diverse studies in unimpaired, brain-lesioned, and mood-disordered populations. Relatively little of the work has been precisely replicated, and conclusions rest on parallel lines of evidence from diverse sources. The present level of knowledge suggests a model of emotional control based on interactive inhibition between a right negatively biased and left positively biased hemisphere. However, the details of such a model, including the precise conditions under which emotion-related functions are lateralized, and the mechanisms of such lateralization have yet to be elucidated.

Brain↗
PubMed1986

The clinical phenomenology of multiple personality disorder: review of 100 recent cases.

The clinical syndrome of multiple personality disorder (MPD) is an unusual dissociative condition that has been poorly characterized. In an attempt to better delineate the clinical phenomenology of MPD, 100 recent cases were collected on a 386-item questionnaire completed by clinicians involved in the treatment of MPD patients. This study documents the existence of a clinical syndrome characterized by a core of depressive and dissociative symptoms and a childhood history of significant trauma, primarily child abuse.

Acting Out↗
PubMed1985

Cognitive functioning in biological subtypes of depression.

This study describes a method for investigating clinical correlates of biological subtypes of depression, using cognitive functioning as the principal behavioral variable. Dexamethasone Suppression Test (DST) escapers were compared to DST suppressors and healthy controls on a battery of learning and memory procedures designed to investigate cognitive functioning in detail. DST suppressors, but not escapers, were cognitively impaired on our tasks. The performance of controls and DST escapers was related to depth of semantic processing, whereas performance of DST suppressors varied inversely with degree of felt hopelessness. Examination of cognitive functioning in future studies may provide useful insights into the clinical significance of biological markers of depression.

Adult↗
PubMed1985

Dissociative states in multiple personality disorder: a quantitative study.

Multiple personality disorder (MPD) patients may experience themselves as several discrete alter personalities who do not share consciousness or memories with one another. In this study, we asked whether MPD patients are different from controls in their ability to learn and remember, and their ability to compartmentalize information. MPD patients were not found to differ from controls in overall memory level. Learning of information by MPD patients in disparate personality states did not result in greater compartmentalization than that of which control subjects were capable. However, there were qualitative differences between the cognitive performance of patients and that of controls attempting to role-play alter personalities. Our results suggest that simple confabulation is not an adequate model for the MPD syndrome, and we consider a possible role for state-dependent learning in the phenomenology of MPD.

Adult↗
PubMed1985

Clinical observation of high-risk children.

Systematic observations of the behavior of high-risk and control children were made during the clinical interview, the neurological examination, psychometric testing, and the experimental psychological test battery. Children were unaware that observations of them were being made and recorded. In all four examination settings, index children were seen as impaired relative to control children in their communication skills, ability to relate to the examiners, and motor behavior. There were no consistent differences between town and kibbutz subjects, and no interactions with genetic background. However, index boys showed a general trend toward greater pathology than index girls.

Child↗
PubMed1985

Clinical-subjective evaluation of high-risk children: integration and discussion.

Clinical evaluations of index and control children from the point of view of the clinical interview, observations of the subjects during testing, the subjects' parents, and their teachers were compared. There was general agreement that index children showed more psychopathological symptoms, poorer ego development, poorer interpersonal relations, and poorer use of leisure time than their controls. By contrast, behaviors related to aggression, phobias, shame, sleep pathology, eating disorders, frustration tolerance, sexual behavior, and verbal communication skills failed to show consistent group differences. Index boys showed greater anxiety than their controls, while there were no such differences among the girls. Rearing environment exerted no apparent effect on the psychosocial functioning of the children. Factor analysis disclosed that a general factor, accounting for 32.6 percent of the variance, discriminated between index and control children, while several special factors, which represented rarely seen traits, did not discriminate. Group differences, therefore, appeared to stem from global impairment of psychosocial functioning rather than from several distinct patterns of deficit. The present results are in general agreement with previously reported evaluations of children at risk for schizophrenia.

Adaptation, Psychological↗
PubMed1985

The Israeli high-risk study: statistical overview and discussion.

We have attempted to provide an overview of the initial evaluation of high-risk and control children. Summary measures of pathology were calculated for each clinical evaluation and objective test of the subjects. Correlational analysis revealed a pattern of intercorrelations among clinical subjective measures of pathology, and among objective measures, with no significant cross-correlations between the two types of measures. The one exception was the presence of neurological soft signs, which tended to correlate with both clinically and objectively measured pathology. Cluster analysis revealed three groups of subjects: a small group of index subjects who performed poorly on both clinical and objective measures; a larger cluster, predominantly index subjects, who showed clinical but not objective pathology; and a third group, including most of the controls, who functioned relatively well on both types of measures. Index subjects tended to show more consistent pathology across both clinical-subjective and objective examinations than controls. We hypothesize that our results stem from underlying deficits in attention, motor function, and perceptual-motor integration in offspring of schizophrenic patients. The finding of an inverse relationship between degree of pathology and age among the index children raises the possibility that developmental lags also play a part in the pathology of our high-risk subjects.

Age Factors↗
PubMed1985

The NIMH-Israeli schizophrenia project: the history of a high-risk study.

We have reviewed some of the difficulties encountered in bringing this study to completion. Among our special problems were the necessity of collecting large numbers of measures on a relatively small study population, the need to recruit and maintain a staff over long periods of time, the wide geographical separation between staff members responsible for design and those responsible for execution of the study, and the difficulties of conducting longitudinal research in a politically unstable part of the world. Centralization of data and data analysis proved a crucial step in bringing the study to its present level of completion.

Child↗
PubMed1985

Adult outcomes of high-risk children: differential effects of town and kibbutz rearing.

We conducted a followup study 15 years after the initial examination of 46 of the Israeli children at risk for schizophrenia (index cases) and 44 of the control children. Thus, we were able to contact and examine 90 of the surviving 99 subjects of the investigation. Half of the subjects had grown up in the communal child-rearing setting of a kibbutz, and half had been raised by their own parents in cities in Israel. The kibbutz-index cases, at average age 25, show the highest incidence of psychiatric disorder. Environmental factors that may have led to this outcome are discussed.

Adult↗
PubMed1985

Transient sensory, cognitive and affective phenomena in affective illness. A comparison with complex partial epilepsy.

Behavioural changes have often been noted in patients with epilepsy. This study investigated the converse phenomenon--the occurrence of transient sensory, cognitive and affective changes resembling those described by epileptics, in affectively ill patients. Forty-four patients with affective illness, 37 with complex partial seizures, and 30 hypertensive controls were interviewed to determine the lifetime occurrence of these phenomena. Such symptoms occurred frequently in association with episodes of affective illness and epilepsy, but were rare in controls. Visual, auditory, olfactory and epigastric symptoms, illusions, jumbled thoughts and amnesia were common to both epilepsy and affective illness. Greater numbers of symptoms were associated with better response to lithium and tricyclic antidepressants. Transient sensory, cognitive, and affective phenomena may be more common in affective illness and other psychiatric conditions than is generally recognised, and may be clues to the underlying pathophysiology of these conditions.

Adult↗
PubMed1984

Atypical depression.

Atypical depressions are those characterized by high levels of phobic anxiety or by reversed vegetative symptoms such as hypersomnia and hyperphagia. Patients with such depressions may present overtly for treatment. However, they may also present within other diagnostic categories such as personality disorder or somatic complaints. The comparative roles of monoamine oxidase inhibitors, heterocyclic antidepressants, and other biologic treatments for atypical depressions are discussed.

Alprazolam↗