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Biomedical subjects

P F Dell

Publications and source records attributed to P F Dell.

11 recordsLinked to original sources
PubMed1998

Axis II pathology in outpatients with dissociative identity disorder.

Forty-two outpatients with dissociative identity disorder (DID) and 16 outpatients with dissociative disorder not otherwise specified (DDNOS) were administered the Millon Clinical Multiaxial Inventory-II (MCMI-II), the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), and the Dissociative Experiences Scale (DES). DID patients manifested severe personality pathology (BR > 84) on a mean of 4.0 MCMI-II scales: avoidant (76%), self-defeating (68%), borderline (53%), and passive-aggressive (45%). DDNOS cases had severe personality pathology on fewer MCMI-II scales (mean = 1.69): avoidant (50%) and self-defeating (31%). The DID and DDNOS groups differed in their scores on the DES (means = 54.9 vs. 25.9), the PK-PTSD scale of the MMPI-2 (means = 33.6 vs. 21.7), and in the incidence of severe borderline pathology (53% vs. 6%). These data on personality pathology in DID patients are virtually identical to those of seven previous studies of personality pathology in chronic PTSD patients (i.e., avoidant, self-defeating, borderline, and passive-aggressive). Such robust convergence of findings supports the construct validity of DID as a form of posttraumatic disorder and suggests that there is a quite predictable personologic core to the clinical picture of severely traumatized individuals.

Adult↗
PubMed1990

Adolescent multiple personality disorder: a preliminary study of eleven cases.

The diagnostic features and treatment histories of 11 adolescents with multiple personality disorder (MPD) are presented. Clinical evaluation revealed that the majority of these adolescents manifested extremely variable school performance, disruptive behavior, trances, amnesias, mood swings, sharp changes in personality, apparent lying, voices heard in the head, and depression. All had a history of childhood trauma: Sexual abuse (73%), physical abuse (73%), and emotional abuse (82%). Seventy-three percent had a parent with a diagnosable dissociative disorder; 36% of the mothers had MPD. These adolescents had a mean number of 24.1 alter personalities and appear to have become multiple at a mean age of 3 years, 1 month. All patients had angry protector alters, depressed alters, scared alters, and child alters. Fifty-four percent of these cases have integrated during treatment or are progressing toward integration. The remaining cases dropped out of therapy.

Adolescent↗
PubMed1989

Violence and the systemic view: the problem of power.

Violence is a strikingly lineal concept that is difficult to address from a systemic perspective. Bateson's epistemological disqualification of the concept of power is often understood to imply a corresponding systemic disqualification of the concept of violence. This position is examined in light of recent feminist criticism. It is argued that (a) violence and power belong essentially to the domain of human experience and (b) human experience cannot be invalidated by theory. Accordingly, it is suggested that the (appropriate) invalidation of power and violence in the domain of systemic explanation should probably be understood both as a deliberate choice that necessarily follows from adopting a systemic perspective, and as a fundamental limitation of that perspective. In neither case, however, should the systemic view be considered to be a valid disqualification of the human experience of violence and power.

Behavior↗
PubMed1988

Professional skepticism about multiple personality.

Therapists who have treated patients with multiple personality disorder (MPD) were surveyed about professional skepticism regarding the existence of MPD. Of these therapists, 78% reported that they had encountered intense skepticism from fellow professionals. Much of this skepticism appears to be explainable in terms of a) the lengthy decline of psychiatry's interest in dissociation, b) underappreciation of the prevalence of individuals with dissociative ability, and c) misconceptions about the natural clinical presentation of patients with MPD. These factors, however, could not explain the behavior of those skeptics who deliberately interfered with the clinical care of patients and who engaged in repeated acts of harassment against the patient and/or therapist. Half of the survey respondents reported that they had encountered these latter forms of extreme skepticism.

Attitude of Health Personnel↗
PubMed1986

Why do we still call them "paradoxes"?

The fact that therapists label some events "paradoxical" may suggest that our current beliefs or theories are limited in their ability to adequately account for those phenomena. It is argued that our underlying belief in objectivity surrounds therapeutic "paradoxes" with a persistently paradoxical aura, and leads to confusion in our understanding of a variety of phenomena. Maturana's ideas regarding structure determinism, instructive interaction, and phenomenal domains are used to suggest an answer to these difficulties. It is claimed that the problematic status of many theoretical concepts (for example, communication, information, resistance, homeostasis, and pathology) is revealing of something quite important--that the experiential validity of instructive interaction repeatedly leads us into implicitly or explicitly employing instructive interaction in a domain where it can never be valid: the domain of theory and explanation.

Communication↗
PubMed1986

In defense of "lineal causality".

It has often been said that ideas about lineal and circular causality may be theoretically profound, but that the reputed impossibility of lineal causality seems to fly in the face of our experience and our common sense. The above humorous jibe at theory goes straight to the heart of the matter. Bateson's epistemology of lineal and circular causality does not describe our everyday experience. Bateson's epistemology explains our experience.

Adult↗
PubMed1982

Beyond homeostasis: toward a concept of coherence.

The concept of homeostasis has served as a major building block, if not the cornerstone, of family theory and family therapy. Designed to account for the perceived stability of systems (and symptoms), homeostasis is an epistemologically flawed concept that has repetitively been used in the service of dualistic, animistic, and vitalistic interpretations of systems. Accordingly, homeostasis has led to quirky clinical formulations and a great deal of fuzzy theorizing. This paper contends that the notion of homeostasis is fundamentally inconsistent with systemic epistemology and should be replaced with the more compatible concept of coherence. Whereas homeostasis is a heuristic concept that is not part of a more encompassing theory, the concept of coherence is inseparable from the epistemology in which it is embedded.

Cybernetics↗
PubMed1981

Some irreverent thoughts on paradox.

There is currently great interest in the use of paradox in psychotherapy. Unfortunately, there is also considerable confusion and misunderstanding of paradox, owing, in part, to the lack of a comprehensive theory that explains the role of paradox in human problems. This paper does not address itself to such theory but explores some cultural and epistemological components of therapists' misperceptions and misattributions of "paradox."

Child↗
PubMed1980

Researching the family theories of schizophrenia: an exercise in epistemological confusion.

some, but not all, of the family theories of schizophrenia entail a shift from the Aristotelian/Cartesian/Newtonian epistemology of individual psychology to a systemic epistemology of pattern. Perhaps the most significant (and underappreciated) aspect of this epistemological shift pertains to etiology: The family theories of schizophrenia espoused by Bateson et al. and by Wynne and Singer do not claim that parents or families cause schizophrenia. The persistent failure of researchers to appreciate this has led to many fruitless studies that have sought to discover a causal link between the thought disorder and communication deviance of parents and the schizophrenia of their offspring. This paper reviews from an epistemological viewpoint the empirical literature that has attempted to assess the validity of the family theories of schizophrenia. Particular attention is given to restating and extending the epistemology of pattern within which schizophrenia occurs. The conventional psychiatric approaches to schizophrenia are shown to play an active role within the schizophrenic pattern.

Adolescent↗