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Biomedical subjects

H Pinsker

Publications and source records attributed to H Pinsker.

At least 19 recordsLinked to original sources
PubMed1999

Interpersonal change in brief supportive psychotherapy.

As a substudy of a manual-based outcome study of the Beth Israel Brief Psychotherapy Program, the authors studied the efficacy of supportive psychotherapy in personality change, with particular attention to changes that outlast the period of treatment. They examined results from the Inventory of Interpersonal Problems (IIP) at intake, 40th-session termination, and 6-month follow-up in the first 20 subjects randomized to the supportive group. Eight subjects (40%) dropped out, but their initial IIP scores did not differ from those of follow-up completers. Six of 10 subjects with complete 6-month follow-up data showed significant improvement in interpersonal problems (4 cases P < 0.001; 2 cases P < 0.05). In a case method design, using the IIP mapped to an interpersonal circumplex model, the authors graphically demonstrate lasting positive changes in interpersonal functioning in subjects treated with supportive psychotherapy.

Adult↗
PubMed1998

A randomized prospective study comparing supportive and dynamic therapies. Outcome and alliance.

The authors report preliminary results of Brief Supportive Psychotherapy (BSP) in the Beth Israel Brief Psychotherapy Program for a sample with primarily Cluster C Axis II disorders. This study compares 24 patients treated with BSP with 25 patients treated with Short-Term Dynamic Psychotherapy (STDP). STDP was chosen because its confrontational methods contrast dramatically to BSP, which emphasizes building self-esteem, reducing anxiety, and enhancing coping mechanisms. Videotaped therapies were based on manualized 40-session protocols. Similar degrees of improvement were seen in BSP and STDP at termination and at 6-month follow-up. A study of therapeutic alliance in BSP showed stable and high levels of alliance in good-outcome cases and more variability in poor-outcome cases. These preliminary findings are consistent with other studies and suggest supportive psychotherapy may be effective for many patients, leading to significant and lasting change.

Adult↗
PubMed1994

The role of theory in teaching supportive psychotherapy.

Because supportive therapy is not based upon a theory of mind or personality or psychopathology, it should not be thought of as a unique modality of treatment but rather as a body of techniques or tactics that function with various theoretical orientations as a "shell program" functions with a computer's operating system. The therapist's operating system is the theoretical orientation gives direction to his/her interventions. In the past, supportive therapy has generally been explained in terms of its departures from the model of expressive therapy. The techniques and rationales of supportive therapy have now been articulated so that they can be taught along with the techniques and rationales of expressive therapy. It is important that students not absorb the tenets and tactics of expressive therapy as a monolithic model for all therapy. Supervision of psychotherapy should pay ample attention to the "coaching" function aimed at mastering technique, which is as important as teaching about psychopathology or encouraging personal growth.

Education↗
PubMed1994

The mock trial in psychiatric staff education.

The mock trial is an important educational technique that has seldom been reported in the medical literature. In this paper we describe the evolution of mock trials as a regular component in the educational program for our multidisciplinary staff. The mock trial is not only an excellent strategy for teaching about the interface between psychiatry and the law, but also for teaching about malpractice, documentation, and medical reasoning. The most effective presentation used an actual case from our facility, practicing attorneys, and an experienced judge in a condensed version of a trial.

Forensic Medicine↗
PubMed1986

A review of supportive psychotherapy.

Although supportive psychotherapy techniques are more widely used than expressive or insight-oriented techniques, particularly with hospitalized or chronically ill patients, supportive treatment strategies have been underrepresented in the literature and not adequately taught to therapists in training. The authors review the diverse definitions and goals of supportive therapy as related to two major types of objectives. They stress the distinction between the supportive relationship, which is present to some extent in all psychotherapy, and supportive treatment, and they examine the inverse relationship between expressive and supportive therapy. Finally, selected elements and techniques of the conduct of supportive therapy, such as style of communication, respect, praise, advice, self-disclosure, and interpretation, are discussed.

Combined Modality Therapy↗
PubMed1984

Use of benzodiazepines in primary-care geriatric patients.

From a sample of 257 elderly patients, 93 subjects who had received benzodiazepine (mainly diazepam) prescriptions for one or more years were interviewed about their subjective perception of the drug's effects and their attitudes regarding its use. The subjects were predominantly women: mean age was 72 years. All subjects had begun use of benzodiazepine more than two years earlier, although some had since stopped using the drug; more than a third had used it for more than six years. About half of the subjects said they took no more of the drug than had been initially prescribed, and three quarters reported they took the medications only when a need was felt. The principal indication for use of benzodiazepines was described as tension. Those who were still taking the drug at the time of interview were more likely to live alone and to say that they had the same problems as when they began its use. None of the subjects who had discontinued use of the drugs had been aware of withdrawal symptoms, and there was no evidence that any subject had become addicted, although several expressed a fear of this. It appears that in this age group, prolonged use of benzodiazepine at low doses, with the patients regulating the quantity, is safe and may be helpful. Most subjects, even if not helped, always kept some of the drug at home in case they might need it.

Aged↗
PubMed1982

Panic and generalized anxiety disorders. Developmental antecedents and precipitants.

Seventeen subjects with panic disorder (PD) and 16 subjects with generalized anxiety disorder (GAD) were interviewed to obtain their developmental and psychiatric histories. The groups reported a similar incidence of early separation, separation disorder in childhood, and separation causing exacerbation of symptoms. The groups differed significantly in that those with PD had a higher incidence of a grossly disturbed childhood environmental and major depressive episodes. The results of this preliminary study support the validity of the DSM-III distinction between PD and GAD.

Adolescent↗
PubMed1982

Swimming in Aplysia brasiliana: analysis of behavior and neuronal pathways.

Swimming of Aplysia brasiliana was analyzed using time-lapse video and computer graphics techniques to quantify the cyclical movements of different regions of the parapodia. Both the speed of swimming and the period of oscillation are temperature dependent, whereas the metachronal offset is not. The parapodial arterial supply is described; ligation of parapodial arteries does not affect the parapodial motions. Peripheral and central lesions indicated that (1) the anterior parapodial nerve plays the major role in parapodial flapping, (2) a separate neuronal oscillator resides in each pedal ganglion, (3) bilateral coordination is mediated via the pedal commissure, and (4) the swimming "command" pathway is the cerebro-pedal connective. During regular parapodial flapping the speed of level midwater swimming is constant throughout the cycle, suggesting that swimming is not produced by jet propulsion. An alternative propulsion model is advanced.

Animals↗
PubMed1981

The allegedly suicidal patient in a general hospital.

Of 50 emergency room admissions of patients believed to need protection against imminent suicide, the admission decision was, in 74% of the cases, solely on the patient's allegation (i.e., assertion without proof) that he was suicidal. Over half of the allegedly suicidal patients were chronic schizophrenic, and 20% were individuals with substance abuse problems. Only those allegers with affective disorders manifested any behavior or thinking after admission that could cause staff concern about suicide. Assuming that the suicidal thoughts and impulses described were products of intense, although transient, feeling and were in no instance feigned, extended hospital care did not appear indicated. Concern about possibility of suicide, if not based upon consideration of risk factors, diagnosis, and clinical judgment, may distract from attention to the patient's needs for long-term outpatient rehabilitation or psychotherapy, and may encourage episodic rather than continuous care for the chronically ill.

Adult↗
PubMed1981

The treatment of involuntary patients in the general hospital psychiatric unit.

In response to pressure to assume more responsibility for chronic patients, many general hospitals have asserted that they should limit care to those suitable for voluntary treatment on an open ward. This assertion appears to be based primarily on political and symbolic arguments. The limitation of admission to voluntary patients would serve to exclude many acutely psychotic patients with excellent prognosis best treated in a general hospital. The locked ward appears to offer the maximum flexibility in dealing with illnesses which in varying degrees affect the individual's judgment and impulsivity. The limitation of psychiatric units to voluntary patients in open wards would preclude psychiatry from joining in the mission of the general hospital - the best possible care for the community it serves.

Chronic Disease↗
PubMed1980

Neuroethological studies of freely swimming Aplysia brasiliana.

Recently developed neurophysiological and behavioural techniques were used to study swimming in the marine gastropod Aplysia brasiliana. Aplysia swim by bilateral parapodial flapping with an anterior to posterior metachronal wave. Parapodial oscillations are measured from video records. Population recordings from nerves innervating the parapodia during normal swimming in intact Aplysia reveal synchronous phasic activity in large efferent units associated with parapodial opening. Isolated brain studies and stimulation of central pathways in intact animals suggest a central pattern generator. We conclude that the output of the neuronal oscillator that controls parapodial flapping radiates synchronously from each pedal ganglion. The putative command to swim originates within the cerebral ganglia.

Animals↗