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K B Schmaling

Publications and source records attributed to K B Schmaling.

14 recordsLinked to original sources
PubMed1995

Clinical features of vocal cord dysfunction.

Vocal cord dysfunction (VCD) is a respiratory condition characterized by adduction of the vocal cords with resultant airflow limitation at the level of the larynx. Previously, this condition was described in case reports and in small series. This study reviews all patients hospitalized from 1984 through 1991 in whom VCD was diagnosed. Demographic, historical, physiologic, laboratory, and psychiatric factors were statistically analyzed. Ninety-five patients met the criteria for proved VCD; of these, 53 also had asthma. All patients had laryngoscopic evidence of paradoxical vocal cord motion, with inspiratory and/or early expiratory vocal cord adduction. The patients with VCD without asthma were predominantly young women. In these patients, asthma had been misdiagnosed for an average of 4.8 years. Their medications were identical to those of a control group of patients with severe asthma. Thirty-four of the 42 patients with VCD without asthma were receiving prednisone regularly at an average daily dose of 29.2 mg. Medical utilization was enormous with the VCD group, averaging 9.7 emergency room visits and 5.9 admissions in the year prior to presentation. Also, 28% of the patients with VCD had been intubated. We conclude that VCD can masquerade as asthma and that it often coexists with asthma. This study helps to define the historical and clinical features of VCD.

Adult↗
PubMed1991

Transference.

Explore the source record for details and available documents.

Humans↗
PubMed1991

Marital therapy as a treatment for depression.

The purpose of this study was to compare cognitive-behavioral therapy (CT; n = 20), behavioral marital therapy (BMT; n = 19), and a treatment combining BMT and CT (CO; n = 21) in the alleviation of wives' depression and the enhancement of marital satisfaction. BMT was less effective than CT for depression in maritally nondistressed couples, whereas for maritally distressed couples the two treatments were equally effective. BMT was the only treatment to have a significant positive impact on relationship satisfaction in distressed couples, whereas CO was the only treatment to enhance the marital satisfaction of nondistressed couples. On marital interaction measures CO was the only treatment to significantly reduce both husband and wife aversive behavior and to significantly increase wife facilitative behavior.

Adaptation, Psychological↗
PubMed1991

Childhood sexual abuse in patients with paradoxical vocal cord dysfunction.

We present three prototypical cases of paradoxical vocal cord dysfunction. The symptoms of this functional disorder mimic those of bronchial asthma attacks. These patients typically have experienced extensive medical intervention including intubation and corticosteroid use. We identify a history of childhood sexual abuse as an important factor contributing to the development of this psychosomatic disorder. We discuss the severity of psychopathology in patients with paradoxical vocal cord dysfunction and how this physical symptom may have developed to express psychological difficulties.

Adult↗
PubMed1990

Marital interaction and depression.

In this article, patterns of marital interaction as a function of depression and marital satisfaction are examined. The purpose of the study was to separate dysfunctional marital interaction patterns that were unique to depression from those that were associated with marital distress. The presence or absence of a depressed wife was crossed with level of marital satisfaction (distressed or nondistressed) to produce four groups of subject couples. Couples in which the wife was depressed exhibited more depressive behavior than did nondepressed couples, but only during discussion of a high conflict (as opposed to neutral) topic. Sex X Depression Level X Marital Satisfaction interactions were found for aggressive behavior: Depressed women in nondistressed relationships exhibited behavior that was characteristic of maritally distressed couples (high rates of aggression). In contrast, the husbands of these women exhibited behavior that one would expect in happily married couples (low rates of aggression). We failed to replicate previous findings that depressive behavior served a coercive function, although distressed couples, regardless of depression status, exhibited all the usual signs of negative dysfunctional interaction. In general, the findings suggested that marital distress rather than depression per se may be responsible for the dysfunctional interaction patterns frequently observed in depressed couples.

Adult↗
PubMed1990

Personality styles of patients asserting environmental illness.

Case reports and chart reviews of patients asserting environmental illness suggest that they suffer from psychiatric difficulties, typically somatization disorder. We assert that viewing these patients solely as somatizers or hysterical characters searching for a nurturant relationship will undermine the doctor-patient relationship. Rather, many of these patients are obsessive/paranoid characters searching for a medical explanation to their physical symptoms. This distinction is highlighted by contrasting the clinical presentations of hysteric/somatizing patients with those environmental illness patients demonstrating an obsessive/paranoid style. Further illustration is provided by a case report with psychological test data. Finally, treatment recommendations based upon this distinction are delineated.

Adult↗
PubMed1989

Research-structured vs clinically flexible versions of social learning-based marital therapy.

The purpose of this study was to compare our structured research-based version of marital therapy from a social learning perspective with a clinically flexible version of the same treatment where treatment plans were individually-based and there was no specific number of treatment sessions. Thirty distressed married couples were randomly assigned to one of these two treatments. Assessment of outcome was based on global marital satisfaction, spouse reports of functioning in specific areas, and direct observational measures of communication. At posttest there were no differences in efficacy between structured and flexible treatments, although both treatments led to significant improvements. At a 6-month follow-up couples treated with the structured format were more likely to have deteriorated and flexibly treated couples were more likely to have maintained their treatment gains.

Adult↗
PubMed1989

Marital therapy and spouse involvement in the treatment of depression, agoraphobia, and alcoholism.

This article examines the literature on marital therapy and spouse involvement as treatments for major psychopathology. The focus is on three disorders that have attracted a sufficient number of empirical findings: depression, agoraphobia, and alcoholism. For each of these disorders, we first examine the relation between marital dynamics and the disorder and next discuss empirical efforts to evaluate the impact of marital therapy or spouse involvement on the disorder. In addition, we summarize trends and suggest methodological refinements for future research.

Agoraphobia↗
PubMed1985

The utility of differentiating between mixed and pure forms of antisocial child behavior.

This study examined the utility of classifying boys on the basis of a typology of antisocial behavior. A group of 195 boys, aged 10-17, was divided into four mutually exclusive groups based on their pattern of antisocial behavior. Stealing and fighting were chosen as criteria to define the four groups: boys who fought but did not steal (Exclusive Fighter Group), boys who stole but did not fight (Exclusive Theft Group), boys who stole and fought (Versatile Antisocial Group), and boys who did neither (Remaining Group). A multimethod-multirespondent study of these boys showed that the Exclusive Fighter Group tended to score high on a range of overt antisocial behaviors and were relatively little involved in delinquency; the Exclusive Theft Group tended to score high on some overt antisocial behaviors and were much involved in delinquency; Versatile Antisocial youths scored highest among all groups on almost all overt and covert antisocial behaviors, and in terms of delinquent acts. The Versatile boys came from families with the most disturbed child-rearing practices.

Adolescent↗
PubMed1985

Empirical evidence for overt and covert patterns of antisocial conduct problems: a metaanalysis.

Twenty-eight factor- and cluster-analytic studies of child psychopathology were examined for patterns in antisocial behavior. A multidimensional scaling analysis yielded one dimension that was labeled overt-covert antisocial behavior. One end of this dimension consisted of overt or confrontive antisocial behaviors such as arguing, temper tantrums, and fighting. The other end consisted of covert or concealed antisocial behaviors such as stealing, truancy, and fire setting. Implications derived from the present findings are discussed as they apply to the diagnosis, prevention, and treatment of antisocial behaviors in children.

Adolescent↗
PubMed1982

A signal detection approach to social perception: identification of negative and positive behaviors by parents of normal and problem children.

The present experiment was designed to investigate differences in the perception of social behavior between parents of normal and problem children and to relate these differences to behavior observed in the home environment. Subjects were brought into the laboratory and asked to identify positive and negative behaviors on a written script portraying family interactions. Correct and incorrect responses were analyzed using signal detection procedures to produce measures of sensitivity and response bias for positive and negative behaviors. These analyses revealed that parents of normal children were better able to discriminate positive behavior than were parents of problem children. Correlations between these responses and data obtained for a subset of the subjects from 1-hour home observations, using a newly developed home observational coding system, revealed a number of relationships between these sets of variables.

Aggression↗
PubMedDate not supplied

Descriptive validity and stability of diagnostic criteria for dysthymic disorder.

The goal of this study is to examine different criteria for the diagnosis of dysthymic disorder (DD). Using a two-stage design, records of 37 subjects diagnosed with DSM-III-R DD were systematically reviewed. Seven of these patients met criteria except for having depression less than 50% of the time. The initial evaluation involved a comparison of the diagnostic assessments using symptom criteria of DSM-III-R and ICD-10, proposed DSM-IV criteria for DD, DSM-III-R major depressive disorder (MD) criteria, and the Columbia criteria for atypical depression (AD). A subsample of 16 subjects who were assessed at least twice several months apart was then extracted. Agreement between the assessments with the proposed DSM-IV symptom list was determined. In the initial assessment, all 37 subjects (100%) met DSM-III-R and ICD-10 criteria, proposed DSM-IV criteria for DD, and DSM-III-R MD criteria, with percentages of mean positive items on the four criteria being 77%, 84%, 89%, and 77%, respectively. In addition, nine subjects (24.3%) also met diagnostic criteria for AD. All 16 subjects (100%) of the subsample again met proposed DSM-IV criteria for DD when assessed 75 to 145 days after their initial assessment. Items with the highest agreement between each two assessments were pessimism and low self-esteem, whereas social withdrawal and decreased activity had lower agreement. The proposed DSM-IV criteria for DD had good sensitivity and reliability in assessing core symptoms of DD. The use of different criteria for DD is discussed.

Adult↗