PubMed HealthSearch

Biomedical subjects

H B Roback

Publications and source records attributed to H B Roback.

At least 19 recordsLinked to original sources

Guarding confidentiality in clinical groups: the therapist's dilemma.

This study examines the confidentiality practices of highly experienced, well-trained group psychotherapists. A provocative finding was that practitioners rarely inform prospective clients of confidentiality limitations. Their reluctance to do so appears to be based upon the belief that it might discourage persons from entering treatment, as well as having negative ramifications for the therapeutic process (e.g., members may be less likely to talk about unprotected topics). The prevalence and content of breaches in confidentiality are explored. Ethical, legal, clinical, and educational implications of these and other findings are addressed. Research recommendations are offered.

Adult

Group therapy with the antisocial spinal-cord-injured patient.

This conceptual article attempts to help health care professionals deepen their understanding of the psychological characteristics of antisocial spinal cord-injured patients that predispose them to injury, being a disruptive influence on the medical floor, oppositional acting out with physicians, and potentially thwarting effective treatment. Group techniques are described that appear to improve the adaptation of these patients to their traumatic injury and hospital environment.

Adaptation, Psychological

Psychiatric resident dismissal: a national survey of training programs.

The authors report on a nationwide survey of psychiatric residency training directors who responded to a questionnaire designed to elicit information on the magnitude of the problem of unacceptable performance by residents. One hundred six program directors reported on 5,591 internship or residency positions from 1981 to 1985. A total of 184 residents (3.3%) were prematurely terminated or persuaded to resign; departmental deliberations were held on an additional 139 residents (2.5%). Reasons for dismissal and indications during the selection process that a trainee might prove problematic are discussed. A provocative finding was that 37% of terminated residents were accepted into other psychiatry training programs.

Career Choice

Patient attrition in dynamically oriented treatment groups.

Clinical and empirical studies of premature terminators from dynamically oriented therapy groups are reviewed. While many studies focus on the personality characteristics of dropouts, the authors recommend conceptualizing such patients in terms of the interaction of patient, group, and therapist. On the basis of this model, the authors offer clinical recommendations for reducing the number of dropouts. Multivariate experimental designs for studying attrition in group psychotherapy are discussed, and the authors suggest possible directions for future research.

Attitude of Health Personnel

The female mid-life sex change applicant: a comparison with younger female transsexuals and older male sex change applicants.

This paper reports on a survey approach to the study of the aging (40 years of age and older) female requesting sex reassignment surgery (SRS). A profile of 13 cases presenting at a cross-section of gender identity clinics in North America is presented. The mid-life SRS applicant is also compared on selected characteristics with a younger female transsexual group and with the aging male sex change applicant. Findings suggest that the mid-life female SRS applicant is closely akin to the aging, conflicted homosexual, whereas the mid-life male SRS applicant appears more closely associated with the aging transvestite.

Adult

The mid-life male sex-change applicant: a multiclinic survey.

Directors of coordinators of a cross-section of North American Gender Identity Clinics provided descriptive information on 1,637 sex-change applicants and psychosocial, psychosexual, and psychiatric data on 21 middle-aged male candidates. To determine the age relatedness of the findings, the mid-life male candidates were then compared on selected characteristics with a random sample of younger biological males seeking sexual reassignment at the Vanderbilt Gender Identity Clinic. The results are consistent with previous findings highlighting the factors at mid-life that intensify the male transsexual's desire for sexual transformation. Viewing the aging gender dysphoria patient's surgical request from a developmental perspective promotes appreciation of his predicament and informed consideration of his treatment options.

Adult

Epidemic grieving at a birthday party: a case of mass hysteria.

In modern Western culture, "mass hysteria" has typically taken the form of an outbreak of a mysterious physical disorder among adolescent girls in whom no organic etiology or precipitant can be identified. If properly managed (i.e., diagnosis confirmed and publicly announced), the illness is usually of relatively short duration. This is a report of an incident of contagious hysteria among preadolescent girls, manifested as grieving reactions during what should have been a happy event--a birthday party. The complex relation between situational, developmental, physical, and personality factors in mass hysteria are discussed.

Child

The internship year in psychiatry: a status report.

The reinstitution of the "internship" requirement by the American Board of Psychiatry and Neurology resulted in the development of a 4-year residence by most residency programs. The authors distributed a questionnaire to more than 200 psychiatry residency directors to collect data concerning the new "internship" year. Their results indicate that there is considerable diversity in the content of the "internship" and general satisfaction with the quality of the experience.

Attitude of Health Personnel

Insight and hospital adjustment.

The relationship between insight and adjustment in schizophrenics was examined. Subjects who scored higher on a paper-and-pencil insight test were rated by hospital staff as better adjusted behaviourally but described themselves as more psychologically distressed than presumably less insightful subjects. Results were discussed in relation to the notion that insight in schizophrenics may intensify subjective distress while conducing to behavioural adaptation.

Adaptation, Psychological

Genital exhibitionism in women.

Historically, genital exhibitionism has usually been regarded as an exclusively male phenomenon. The authors present a case study of a female exhibitionist which is at variance with that contention. They offer a formulation of the psychodymanics of female exhibitionism, focusing on its pregenital, attention-seeking purpose. The findings from this case justify a critical reexamination of the traditional definitions of exhibitionism.

Adult

Self-concept and psychological adjustment differences between self-identified male transsexuals and male homosexuals.

Self-concept and adjustment data from anatomical males seeking sexual reassignment surgery were compared with that from a male homosexual group. Findings indicated that the homosexual group had a better self-image and was better adjusted than the sex change group. Other findings are presented that reinforce the view that the norm violations in homosexuality and transsexualism do not necessarily imply serious character damage.

Adaptation, Psychological

Sex-role related countertransference in psychotherapy.

Data from one psychological and one psychiatric agency were collected to determine if psychotherapists' treatment decisions about opposite-sex persons might be influenced by sex-role prescriptions for dealing with sexual impulses. Accordingly, male therapists were hypothesized to prolong and female therapists to avoid treatment situations likely to arouse their sexual curiosities. The results at both facilities provide some support for these notions and, if generalizable, establish sex-role primed countertransference as a factor in patient selection and termination.

Counseling