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Biomedical subjects

J Lock

Publications and source records attributed to J Lock.

At least 37 records · Page 2Linked to original sources
PubMed1998

Treatment of homophobia in a gay male adolescent.

Gay teenagers experience normal adolescent developmental processes, but need assistance negotiating the effect of homophobia on their development. Homophobia in the early phase may increase reliance upon the family. This can make it difficult to extricate oneself from family sufficiently to develop peer relationships. Supportive individual and interpretative family work can help modify these problems. Problems in the middle phase are associated with societal homophobia in the institutions where adolescents develop. High school social dynamics support homophobia and make opportunities to develop a peer network difficult. Therapeutic interventions that support a gay teen's efforts through fantasy and symbolic action are key to success in to this period. Referral to gay teen support groups are more likely to be successful during this phase. During the late phase of adolescence, homophobia complicates the quest for an acceptable social role and the need for more intimate relationships as plans for work and pairing become the focus. The therapist helps the gay teen overcome stereotypes and see themselves as individuals and as a members of a group called "gay." This makes it possible to integrate personal aspects of the self with gay-group identity.

Adolescent↗
PubMed1998

Origins of homophobia in males. Psychosexual vulnerabilities and defense development.

PURPOSE: To better understand the origins of homophobia among males. METHODS: Literature review and clinical illustration. RESULTS: Data suggest that there is a range of homophobic attitudes. CONCLUSIONS: We illustrate how homophobic attitudes can be associated with a hierarchy of defensive styles. We propose that these defensive styles are used to manage a range of psychosexual developmental anxieties in boys and men.

Adolescent↗
PubMed1995

Acting out and the narrative function: reconsidering Peter Blos's concept of the second individuation process.

The role and meaning of narratives in psychoanalytically oriented psychotherapy has begun to be explored over the past few years. Little, if any, of this material has been related to adolescent psychotherapy and it is the purpose of this paper to make some preliminary inquiries into how narratives might operate in this sphere. To explore this hypothesis, Peter Blos's ideas on adolescent acting out are related to a theory of narrative developed by the French philosopher Paul Ricoeur. Blos conceives of adolescent acting out as a part of attempts by adolescents to develop a coherent identity in what he refers to as a second individuation process. A link is proposed between adolescent acting out and Ricoeur's notion of narrative as the structure that undergirds the process of identity formation.

Acting Out↗
PubMed1995

Can experts agree when to hospitalize adolescents?

OBJECTIVE: Rates of psychiatric hospitalization and lengths of stay for adolescents have been a focus of recent controversy. With the advent of managed care, hospital systems and third-party payers are looking for ways to decide when hospitalization is indicated. The authors sought to determine whether experts could agree on the appropriateness of putative indicators for hospitalization of adolescents for conduct disorder or substance abuse. METHOD: Using a methodology developed at the Rand Corporation and previously applied to procedures in medicine and surgery, the authors developed a list of possible indications for hospitalization of adolescents with conduct disorder and/or substance abuse. A nine-member panel of experts in these areas, balanced by geography, academics/clinical practice, and whether the expert was in charge of a hospital unit, then rated the appropriateness of each indication twice under a modified Delphi procedure. RESULTS: Using prespecified definitions for agreement, after the initial rating the panel had low levels of disagreement (11%) and moderate levels of agreement (28%) on more than 1,900 possible indications for hospitalization. Despite an expanded number of indications, the panel reduced disagreement to less than 5% and increased agreement to more than 55% after the second round of ratings. CONCLUSIONS: The consensus achieved compared favorably with the results of similar panels judging the appropriateness of procedures in medicine and surgery. The methodology is applicable to studies of the appropriateness of pharmacological or psychotherapeutic interventions in both child and adult psychiatry. The results of such studies can form the basis for rational utilization review and treatment authorization decisions.

Adolescent↗
PubMed1994

Psychiatric hospitalization of adolescents for conduct disorder.

OBJECTIVE: The authors' goal was to review current published literature on the psychiatric hospitalization of adolescents with a diagnosis of conduct disorder. METHODS: The English-language literature from 1980 to 1991 cited in the MEDLINE database was searched using the key words conduct disorder, adolescent psychiatric hospitalization, psychiatric hospitalization criteria, adolescent psychiatric inpatient hospitalization, and adolescent psychiatric admissions. RESULTS: A diagnosis of conduct disorder or presenting symptoms and behaviors consistent with that diagnosis are commonly reported for adolescent psychiatric admissions. Estimates of the percentage of admissions to psychiatric inpatient treatment facilities of adolescents with conduct disorder or symptoms consistent with that disorder range from 30 to 70 percent. There are no research-based criteria for hospitalization of adolescents for conduct disorder, and systematic studies of the outcome of psychiatric hospitalization for this group have not been published. Comorbid psychiatric diagnoses and similar behavioral symptoms in conduct disorder and comorbid disorders complicate inpatient treatment of adolescents with conduct disorder. CONCLUSIONS: Studies of the outcome of psychiatric hospitalization of adolescents for conduct disorder are needed to determine the appropriate use of this modality.

Adolescent↗
PubMed1990

Balloon dilation catheters.

Catheter therapy has gained an important role in the treatment of congenital heart disease. The cumulative experience with vascular and valvular balloon dilations has demonstrated low mortality and morbidity with short-term results similar to surgery. Currently, balloon dilation is an accepted treatment for valvular pulmonary stenosis, distal pulmonary artery stenosis, recurrent coarctation, rheumatic mitral stenosis, congenital valvular aortic stenosis, and intra-atrial baffle obstruction. Except for patients at high surgical risk, balloon dilation of native coarctation is considered investigational at most institutions but accepted at others. No conclusive evaluation is yet possible for dilation of bioprosthetic valves and membranous subaortic stenosis. Individual pulmonary veins appear undilatable. Various devices are available for closure of extra- and intracardiac communications. Transcatheter closure of aortopulmonary collaterals and arteriovenous malformations is now well established at some centers. In selected patients, therapeutic embolization of surgical shunts can replace surgery. Transcatheter closure of the patent ductus arteriosus has become routine at some centers. Nonsurgical closure of atrial and ventricular septal defects has entered clinical trials, and preliminary results appear very promising. Blade atrioseptostomy and foreign body retrieval are well established. Improvement of existing procedures and implementation of new concepts will consolidate the role of catheter therapy in congenital and acquired heart disease.

Aortic Coarctation↗
PubMed1989

Cleft palate rehabilitation using a resin-bonded split-post prosthesis.

For the patient described in this report a nonprecious metal alloy that contains neither beryllium nor nickel was used. The retainers were sandblasted with 50 microns alumina and cemented by using a resin that bonds chemically to metal. With good oral hygiene and regular review the resin-bonded split-post prosthesis should provide a long period of service. In contrast to conventional fixed restorations, failure of this type of prosthesis is not highly destructive and other restorative options are still possible if failure occurs.

Adolescent↗