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Biomedical subjects

K Z Altshuler

Publications and source records attributed to K Z Altshuler.

At least 19 recordsLinked to original sources
PubMed1990

Whatever happened to intensive psychotherapy?

Of 163 residency programs responding to a survey about training requirements in long-term psychotherapy, more than 100 did not require that any patients be seen more than once a week. Among 41 psychotherapy protocols representing outcome-related research that were reported at an annual meeting of the Society for Psychotherapy Research, the studies employing more than once-a-week treatment for 6 or more months were rare. Intensive psychotherapy is clearly on the wane in training programs and in psychotherapy research paradigms.

Appointments and Schedules↗
PubMed1989

Will the psychotherapies yield differential results? A look at assumptions in therapy trials.

Differential results in psychotherapy should be both clinically substantial and attributable to the differences alleged in various treatments. This paper reviews the nonspecific elements of psychotherapy, and inspects cognitive, interpersonal, and analytically oriented therapies to see whether claimed differences are, in fact, sufficient to make differential results likely. It also calls attention to assumptions implicit in most clinical trials about the effectiveness of once-a-week, short-term treatment, and how these assumptions limit the likelihood that research will discriminate differential outcome.

Cognitive Behavioral Therapy↗
PubMed1986

Perspectives on patient noncompliance.

Patient noncompliance can sabotage the best clinical efforts to provide effective treatment. Psychiatrists consulting in a medical setting can promote patient compliance by using insights from four conceptual models of psychiatry: medical, psychodynamic, behavioral, and social. The authors describe the models and illustrate their clinical application with examples from their work with diabetic patients.

Adolescent↗
PubMed1985

Anorexia nervosa and depression: a dissenting view.

The frequency of depressive symptoms in anorexic patients, the response of some anorexic patients to antidepressants or ECT, the occurrence of comparable physiologic abnormalities in major depression and anorexia nervosa, and family studies of incidence increasingly link depression and anorexia in the literature. A review of the problems in making this linkage shows that the possibility of anorexia nervosa as a depressive equivalent or a depressive spectrum disorder must be seriously questioned.

Anorexia Nervosa↗
PubMed1984

Psychoanalytic and cognitive therapies: a comparison of theory and tactics.

The theory and tactics of psychoanalytic and cognitive therapies for depression are explored. Tactics developed from either theoretical base are often similar, though described in different terms. Analytic therapies, being derivative from psychoanalysis, are broader in the possibilities prescribed, and therefore less rigorous in the application of several active techniques. In part because of this, there are differences between analytic and cognitive therapies in session structure, in history taking, in dealing with transference and countertransference, and with paranoid patients. A paradigm is offered regarding the reasons for success or limited success with either method.

Cognition↗
PubMed1984

On the question of bisexuality.

If the homosexual-heterosexual range is a continuum, individuals at the midpoint should be characterized by equal frequency, equal pleasure, and relatively random sex choice of their partners. A small sample of bisexuals, self-identified according to these criteria, was interviewed. If these individuals are typical, sexual choice is dichotomous, rather than continuous, and inferences based on a continuum are untenable.

Adult↗
PubMed1983

The genetics of affective disorder: data, theory, and clinical applications.

A genetic factor in the etiology of the affective disorders has been a subject of considerable interest and investigation during the last five decades. Data from twin studies, family studies, and adoption studies strongly support three major findings: genetic factors are significant in the etiology of both bipolar and unipolar affective disorder; bipolar and unipolar affective disorder tend to breed true and are genetically distinct diseases; and both bipolar and unipolar affective disorder are genetically distinct from schizophrenia. While the mode of transmission for the affective disorders remains unclear, the genetic data already afford clinical applications pertinent to diagnosis, prognosis, treatment response, and both immediate and longitudinal clinical course. Pharmacogenetic factors unrelated to the illness are also relevant to the management of antidepressant pharmacotherapy.

Adoption↗
PubMed1982

The effect of dosage on the dexamethasone suppression test in normal controls.

A sample of 23 drug-free, normal adult subjects, aged 23 to 50 years, received 1 mg dexamethasone p.o. at midnight. Serum cortisols were obtained at 0800h, 1600h, and 2330h pre- and postdexamethasone. Only 1 of these 23 subjects (4.3%) evidenced nonsuppression, as defined by any postdexamethasone serum cortisol value of greater than 4.0 micrograms/dl. A dose of 0.75 mg dexamethasone was administered to 23 drug-free, normal adult subjects, 20 of whom participated in the above 1 mg trial. Six of these 23 (26.1%) showed nonsuppression at a threshold of 4.0 micrograms/dl. Another 11 normal adults who were taking various prescription medications (e.g., sympathomimetics, nasal decongestants, birth control pills, thyroid hormones) or who were suffering from untreated upper respiratory infections, venereal infections, or allergies were tested with 1 mg of dexamethasone. In this sample, 7 of 13 (53.8%) showed nonsuppression. These findings suggest that: (1) 1 mg of dexamethasone is the lowest effective dose that can be used in diagnostic testing for melancholic depression; (2) a false-positive response to the dexamethasone suppression test (DST) may occur with infections, allergies, or possibly with certain prescription medications. Further studies of the effects of illness and/or medications on DST responses are needed.

Adult↗
PubMed1978

On the inter-relationship of cognition and affect: fantasies of deaf children.

A few projective studies focusing on the impact of cognition on affect in the deaf have reported strikingly disparate results with little systematic inquiry. A new and previously unreported play situation (with the deaf) was devised to elicit a detailed story. Fantasies were obtained in a uniform fashion from four groups of five-year-old boys comprising middle-class deaf and hearing children and lower socio-economic-class deaf and hearing children. Results suggest that: (1) The impact of deafness on cognitive functioning in these children is akin to--but apparently no worse than--the cultural deprivation phenomenon experienced by low socio-economic-status children. (2) There is no paucity of fantasy life in the deaf or deprived child, despite the absence or relative lack of verbal skills. (3) A problem common to both disadvantaged children and the deaf children tested in the intrusion of anxiety into autonomous ego functions, so that practice necessary for the firm development of cognitive schemata is interfered with. (4) The clinical impulsivity secondary to these emotional pressures may perpetuate itself by interfering with cognitive decentration in time and space in relation to others.

Affect↗
PubMed1978

Toward a psychology of deafness?

A large scale study comparing Yugoslavian and American adolescents with normal hearing and with early profound deafness suggests that a relative tendency to impulsivity is a notable characteristic of the deaf group. Despite the conclusiveness of the study overall, there was little intercorrelation among individual subjects on the several test measures employed. A stereotype should be avoided therefore, and the tests viewed as perhaps tapping different personality aspects or avenues of development for what clinically becomes a final common pathway. Comparable and comparative studies of deaf children of deaf parents and of children whose hearing parents have learned manual language early may define how much the tendency is based on qualities of parental discomfort with a deaf child, on the unavailability of language, or on the absence of sound alone.

Adolescent↗
PubMed1977

Lithium and aggressive behavior in patients with early total deafness.

Patients with early total deafness frequently present with impulsive, aggressive behavior. Nine such inpatients were treated with Lithium. Two acting out adolescents showed a response to medication and a third personality disorder was dropped for side reactions. Of six schizophrenics, five responded in terms of aggressive behavior, while requiring continued medication with phenothiazines at notably lowered doses for their schizophrenic pathology.

Adolescent↗