Reliance on statistics in psychiatric treatment.
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Biomedical subjects
Publications and source records attributed to R Morstyn.
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Statistical methodology does not provide an effective, impartial, or objective way to determine the validity of theories of psychotherapy. Furthermore, the correlations revealed by statistical studies of psychotherapy are clinically irrelevant. Nevertheless there is a growing trend to recognise only statistically "proven" techniques of psychotherapy as legitimate medical treatment. The replacement of established medical standards for psychotherapy with this bogus new scientism is likely to lead to iniquitous clinical and administrative restrictions upon psychotherapists which will cause unnecessary suffering to patients.
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Self-observation contains a paradox largely unaddressed in current psychiatric theory. It is impossible to make "objective" observations of the meaning of our own thoughts and feelings because we use those very same thoughts and feelings to make our observations. Nevertheless most psychiatric theory assumes a clear separation between the internal part of ourselves which observes and that part which forms the object of our observations. Analogies from quantum physics can be used to elucidate this paradox. Once the complexities of self-observation are understood, so are many of the enigmas of psychotherapy.
Most psychodynamic theories are based on Freud's models of mental dynamics which were significantly influenced by Newtonian physics. Freud's attempts to use the then current scientific metaphors led to theoretical and clinical dilemmas particularly in deep psychotherapy and especially with borderline patients. The author argues that as Newtonian principles are useful for describing macroscopic reality, so Freud's Newtonian constructs are useful to a certain depth of therapy. Beyond that point, scientific metaphors can be retained but the appropriate metaphors are those of quantum physics. Quantum metaphors are used to explore duality, free will and patient-therapist interaction.
The author examines some dilemmas raised by the increasing use of clomipramine in the treatment of obsessional disorders. He presents a case vignette to illustrate some diagnostic, therapeutic and ethical concerns and suggests that by asking certain questions, pitfalls can be avoided.
The spatiotemporal evolution of the P300 waveform was topographically mapped in a group of ten male chronic schizophrenics, using the technique of brain electrical activity mapping. Group-average P300 waveforms were constructed for the schizophrenic group and a group of matched controls. The control group's P300 showed a concentric development about a maximum in the centroparietal area, slightly displaced toward the left. In contrast, the schizophrenic group's P300 maximum was more anterior and to the right, with a deficiency in left temporal activity. Using the technique of significance probability mapping, it was demonstrated that the maximum between-group difference was localized to the left-middle and posterior temporal regions, where the schizophrenic group was deficient in activity.
EEG data were recorded in resting and in specific test conditions designed to activate different regions of the brain in a group (n = 10) of chronic schizophrenics and matched controls. EEG spectral energy was computed using the Fast Fourier Transform and numerical matrices representing the topographic distribution of spectral energy in a specified band were constructed and displayed as color images. Significance Probability Mapping was employed to identify regions of maximal group difference; it was found that the schizophrenic group showed increased low frequency energy (0-7 c/sec) in the frontal regions and increased fast activity (12-32 c/sec) in post-central areas and the left anterior temporal area. The different psychological test conditions were associated with different patterns of energy distribution. The consistency of our findings with other investigations suggests that topographic mapping of brain EEG spectral activity may play a useful role in the functional understanding of schizophrenia.
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Ocular pigmentation in white cats with blue and yellow eyes and in Siamese cats was examined ophthalmoscopically and histologically. Yellow-eyed white cats had entirely normal ocular pigmentation. Blue eyes of white cats had normal pigmentation of the iridial and retinal pigment epithelia but no stromal pigmentation of the iris or choroid. This deficit is apparently due to the absence of stromal pigment cells, certainly in the iris. As a general rule, the blue eye of white cats had no tapetum. Siamese cats had reduced pigmentation of the iridial and retinal pigment epithelia and no stromal pigmentation of the iris or choroid. The lack of pigmentation is apparently due to the inability of stromal pigment cells to produce pigment, certainly in the iris. We conclude that the abnormality of visual pathways previously described in the Siamese cat is not due simply to a deficiency of pigment of cells of neural crest origin.
1. Lateral geniculate neurones of the cat were studied in terms of the latency for activation by local electrical stimulation of the retina, the latency of electrical activation from the visual cortex and properties of receptive fields. Most of the units were relay cells (antidromic activation from visual cortex) but a small proportion were trans-synaptically activated from the cortex. The latter group included units with on-off, on-centre or off-centra receptive fields. 2. Direct activation of lateral geniculate neurones from local electrical stimulation of retinal ganglion cells or their axons in the retina was identified by the sharpness of timing of the elicited impulses. This procedure revealed the existence of slowly conducting axons relaying in the lateral geniculate nucleus. 3. The distribution of latencies for direct activation from the retina was bimodal with an extended tail of long values. It is similar to the distribution of antidromic latencies of retinal ganglion cells following stimulation of the optic tract. 4. There was a tendency for geniculate neurones with fast input from the retina to have fast axons to the visual cortex and correspondingly for medium-speed and slow input. 5. The previous classification of geniculate receptive fields into sustained and transient types was extended to include commonly encountered 'brisk' and uncommonly encountered 'sluggish' varieties of each. The extension was based on visual properties and latency for direct electrical activation from the retina. Units with receptive fields differing from the familiar on-centre or off-centre concentric pattern were encountered rarely; they included colour-coded fields, local-edge-detectors and one edge-inhibitory off-centre type.
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