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Biomedical subjects

J H Kleiger

Publications and source records attributed to J H Kleiger.

13 recordsLinked to original sources
PubMed1997

Rorschach shading responses: from a printer's error to an integrated psychoanalytic paradigm.

Beginning with a review of the historical development, the current status, and the empirical foundations of Rorschach shading responses, I then explore how the 4 psychologies of psychoanalysis can help generate inferences about clinical issues suggested by these responses. The contributions and limitations of this theory-based approach to understanding shading responses are demonstrated and discussed through clinical examples and a review of theoretical concepts and empirical findings.

Adult↗
PubMed1994

Re-integration stress for Desert Storm families: wartime deployments and family trauma.

Because the war was relatively brief, casualties relatively light, and the Nation sanctioned the war socially, veterans of Desert Shield/Storm and their families were not anticipated to suffer symptoms of trauma or re-entry stress beyond that expected in routine peacetime military deployments. However, the authors argue that the stress imposed on families by Desert Shield/Storm was not analogous to that of routine deployments. The call to duty was unexpected, disruptive, and "hazardous" (i.e., highly dangerous) which places it in the category of a "catastrophic" stressor as defined by McCubbin and Figley (1983). The deployment was a call to war, which creates unique stress beyond those experienced during peacetime deployments. The deployment also carried with it prolonged "anticipation of trauma." For these reasons, the authors argue, the deployment to Desert Shield/Storm created a situation of "family trauma" for veterans and their families. Suggestions are offered for education, prevention and treatment for families undergoing unexpected wartime military deployments.

Adaptation, Psychological↗
PubMed1993

Toward a conceptual understanding of the deviant response in the Comprehensive Rorschach System.

We examined the scoring criteria, subtypes, and interpretative nuances of the deviant response (DR) special score of the Comprehensive Rorschach System. To augment the usual understanding of the DR score, we review the concepts of fabulizing and confabulation in Rorschach literature and discuss the traditional meaning of and the confusion surrounding these terms. By equating a subtype of DR, the excessively embellished DR response, with Rapaport's (Rapaport, Gill, & Schafer, 1968) "affect-laden fantasy" type of confabulation response, we set the stage for an examination of the unique clinical diagnostic implications of this special subtype of DR. We conclude by recommending slight modifications to some of the special scores categories (DR in particular) of the Comprehensive System so that these scores can not only be assigned with more internal consistency and precision but also become more useful in identifying a broader range of unusual Rorschach responses.

Borderline Personality Disorder↗
PubMed1993

The enduring Rorschach contributions of David Rapaport.

David Rapaport's contributions to the Rorschach are highlighted and placed within the context of his significant impact on psychological testing and psychoanalytic theory. After a brief biographical sketch, I examine the essence of Rapaport's lasting Rorschach contributions and summarize some of the strengths and limitations of the Rapaport Method.

Journal Article↗
PubMed1987

Clinical observations concerning active duty veterans with post-Vietnam adjustment problems.

Clinical observations by Navy psychiatrists and psychologists who concurrently conducted therapy groups at three separate military treatment facilities between 1981 and 1984 were recorded. The reasons they returned to active duty or remained in the service, how and why they were referred to therapy, issues that arose in group therapy, and factors that were believed to have influenced the successful outcome are summarized and discussed.

Adult↗
PubMed1980

Characteristics of alexithymic patients in a chronic respiratory illness population.

Alexithymic characteristics in 100 chronic respiratory illness patients were assessed by means of the Beth Israel Psychosomatic Questionnaire (BIQ). The study was designed to explore the relationship of alexithymia to various demographic variables and three disease categories (asthma, tuberculosis, and chronic obstructive respiratory disease). The BIQ was found to yield a high inter-rater reliability when the interviews were conducted and rated in a systematic manner. Significant relationships were found between alexithymia and age, marital status, and disease categories; however, the latter two relationships appear to some extent to be artifacts of the age differences of the subjects among categories. More research is needed to understand the nature of the relationship between alexithymia and age, but it should also be profitable to examine the relationship of this variable to medical outcome.

Adolescent↗
PubMed1980

The development of an MMPI alexithymia scale.

A 22-item MMPI alexithymia scale was derived from the Beth Israel Psychosomatic Questionnaire (BIQ). The new MMPI scale yields an 82% hit rate when predicting to BIQ alexithymia scores and has been shown to have impressive stability over time. The new scale should provide a rapid, standardized means of assessing alexithymia in a variety of populations.

Humans↗
PubMed1980

Psychomaintenance aspects of alexithymia: relationship to medical outcome variables in a chronic respiratory illness population.

MMPI alexithymia scores and MMPI panic-fear personality scores were calculated for 202 adult asthmatic patients. Both sets of scores were shown to be related to the number of days rehospitalized. In addition, patients who scored high on both the alexithymia and panic-fear personality scales were judged by their attending physicians as being more severely ill than other patients. Both of these relationships were independent of the objective severity of the patient's asthma as indexed by longitudinal pulmonary functions. The study highlights the fact that alexithymia and panic-fear are two dimensions which may contribute to medical intractability in chronic asthma.

Adolescent↗
PubMed1979

Medication compliance in chronic asthmatic patients.

In an attempt to assess patient and physician behavior patterns which interfere with effective medical treatment, 100 chronic adult and adolescent asthmatics were asked about the frequency and the nature of their medication non-compliance. The nature of the patient's medication abuse was also related to underlying personality characteristics, as measured by the MMPI Panic-Fear scale. Finally eleven physicians were asked about the frequency with which they asked their patients about over abuse and under abuse of prescribed medications. The results are impressive, showing that 54.0% of the patients reported some type of medication abuse, and that the nature of the abuse may be predicted from the patient's MMPI Panic-Fear score. Perhaps the most important finding was that while over 50% of the patients reported medication non-compliance (under abuse, over abuse, or cyclical abuse), only 27.3% of the physicians said that they routinely inquired about medication abuse. Such a discrepancy suggests one area in which patient and physician characteristics may have a bearing on the effective delivery of medical treatment. The findings underscore the need for physicians to include in their diagnostic procedure a routine inquiry into the patient's patterns of medication non-compliance.

Adolescent↗
PubMed1979

Panic-fear in asthma. Symptomatology as an index of signal anxiety and personality as an index of ego resources.

Clinical observations and studies of asthmatic patients have often concluded that therre is a strong relationship between the degree of the patient's anxiety and the medical intractability of his illness. However, psychotherapeutic interventions designed to alleviate patient anxiety have been noticeably inconsistent in achieving meaningful alleviation of the patient's asthma. The present paper addresses this apparent paradox by positing the existence of two types of anxiety: a) asthma-specific anxiety, as indexed by Panic-Fear symptomatology scores of the Asthma Symptom Checklist; and b) characterological and pervasive anxiety, as indexed by Panic-Fear personality scores of the Minnesota Multiphasic Personality Inventory. In this study, long term medical outcome was found to be influenced by the combination of these types of anxiety. Wehn high asthma-specific anxiety coexisted with high characterological anxiety, medical outcome following intensive long term medical treatment was exceptionally poor. In contrast, when high asthma-specific anxiety coexisted with average levels of characterological anxiety, medical outcome was exceptionally good. These results are discussed relative to the theoretical distinctions between signal anxiety and anxiety concomitant with a lack of basic ego resources.

Adolescent↗