Ruth Easser, M.D.
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Biomedical subjects
Publications and source records attributed to M K O'Neil.
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The authors describe post-termination meetings in order to examine the controversial issue of the proper relationship between analyst and patient at this stage. In the first case the meetings facilitated the patient's re-entering treatment, leading to significant further growth. In the second and third cases, the meetings re-ignited mourning for the analyst and furthered analytic gains. The authors' overall impression was that the post-termination contacts were helpful for all three patients. Their limited data contradicted the long-standing assumption that all post-termination contact, unless specified as a course of further treatment, is harmful to the patient. The authors suggest that such meetings stabilise analytic gains, provide a joint assessment of analytic outcome from a useful later perspective and provide an opportunity for further analytic work. The consideration of any post-termination changes in the patient allows for a more inclusive evaluation of the analysis than was possible earlier. While acknowledging the need to consider such meetings thoughtfully in order to avoid any harmful enactment of wishes by the patient or the analyst, the authors encourage analysts to explore and report such meetings to replace unexamined assumptions and develop a body of clinical data about the effects of post-termination contacts.
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Inconsistent findings in studies of loss and depression arise from methodological differences, lack of common definitions of depression and loss, and the failure to consider the interaction hypothesis: the effect of early loss on depression is partly conditional on the presence of a current loss. Data were collected from 744 university students. Only 15% of subjects without loss vs. 44% with both types of loss had Beck Depression Inventory scores indicative of moderate depression. Analysis of variance confirmed this strong interaction effect. These results provide empirical support for Freud's view that a recent loss can reactivate depressive feelings associated with earlier loss.
This paper presents preliminary results of symptomatic and behavioral changes and psychodynamic observations for 9 young adult bulimic women treated with psychodynamic group psychotherapy. Pre/post group test results showed significant improvement on all measures of eating pathology, on the EDI ineffectiveness item and the Janis-Field feelings of inadequacy scale as well as on the total score of the Hopkins Symptom checklist. These results were consistent with independent clinical conclusions and with verbal reports of improvements in binging and purging behaviour. Clinical content shed light on the role of the parents, especially the father, in the development of body-image, sense of adequacy and self-esteem, life goals and feminine identification. The authors conclude that clinical observations to date have yielded interesting psychodynamic hypotheses and the initial symptomatic improvements warrant cautious therapeutic optimism.
The relationship of four psychosocial factors (family history of psychiatric illness, early loss of a nurturing relationship, stressful life events, and low social support) to depressive symptoms was investigated in university students using a cross-sectional design. A depressed group (N = 160), selected from a consecutive sample of students diagnosed depressed and attending a university psychiatric service, was contrasted with a nondepressed group (N = 206) randomly selected from the general university population within three strata (sex, academic level, and month of the year) to match the clinic group. Depression was measured by the Beck Depression Inventory. It was found that family history of psychiatric illness, stressful life events, and lack of a confidant all had a significant, independent direct effect on the occurrence of depressive symptoms, but early loss was not associated. An interaction effect among the psychosocial factors was not demonstrated.
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Depression, the most common form of psychological distress among university students, is often serious enough to warrant professional help but only a minority of depressed students seek formal help. This paper reports on the characteristics which differentiate two groups of depressed students--the help-seekers from the non-help-seekers. A university psychiatric clinic population (N = 183) was compared with a non-clinic sample (N = 55). Data about depressive symptoms, social supports, the use of medical, psychiatric and other helping services, sources of referral and the usual demographic and sociocultural information were obtained. The Beck Depression Inventory was used as the measure of depression. Severity of depression was the single most important predictor of use of the psychiatric service. In addition, being female was also an important predictor. After controlling for severity and sex, the demographic factors which distinguished help-seekers from non-help-seekers were as follows: The help-seekers were more likely to be graduate students, older, living away from family and/or to use a non-psychiatric physician. Contrary to expectation, having a confidant was not related to help-seeking, suggesting that the presence of a confidant may be preventive but does not necessarily decrease the need for professional help once a student has become depressed. A depressed student's decision to seek help may be influenced by four factors: the severity of the problem; the individual's propensity to seek help; the availability of alternate resources; and the accessibility of psychiatric services. The findings are discussed in the light of these factors.
This paper examines fluctuations in mood and symptoms associated with psychological distress during the phases of the menstrual cycle in two samples of university women. The first (Study I) sample of women (N = 162) was randomly selected from the University population. The second sample (Study II) was women (N = 138) who attended a psychiatric clinic. The subjects completed a questionnaire which included measures of depression, anxiety and general psychological distress. Information about the menstrual cycle and contraceptive pills was elicited from the subjects who were unaware that affect during the menstrual cycle was being studied. In study I there were no significant differences in depression, anxiety or psychological distress between phases of the cycle. The results of study II indicated that even in a group of women with emotional problems, it was not possible to demonstrate an increase in the average severity of mood disturbance or psychological distress during any phase of the menstrual cycle. It was concluded that in general, university women between the ages of 18-30 who are mostly single, nulliparous, with or without significant psychopathology, seeking or not seeking psychiatric help do not experience significant or disruptive fluctuations in mood and symptoms of psychological distress during the phases of the menstrual cycle. Women who are afflicted with distressing and incapacitating cyclical fluctuations are best studied as a vulnerable subgroup.
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