PubMed Health⌕ Search

Biomedical subjects

S K Severino

Publications and source records attributed to S K Severino.

At least 19 recordsLinked to original sources
PubMed2000

The role of attachment functions in psychotherapy.

The authors propose to clarify concepts of emotional attunement and failures of attunement in early development derived from theoretical and clinical work (Kohut) and infant psychiatry (Stern). Early attunement failures are experienced as shameful by the infant/child, and without repair they form a nidus for later destructive adult interpersonal relationships, "social blindness," and depression. The authors present a case illustrating these ideas. The role of empathic attunement experienced in the unique setting/structure of psychotherapy emerges as the single critical variable for a successful outcome.

Adolescent↗
PubMed1995

Health care reform: implications for academic psychiatric institutions.

Health care reform provides an opportunity to redefine all aspects of our health care delivery system. This article focuses on mental health services and on the implications of health care reform for academic psychiatric institutions. Questions are raised regarding the challenges that academic psychiatric centers will face in pursuing the traditional responsibilities of research, education, and clinical care. The authors propose that intersystems dialogue will create solutions to the questions. The challenge to academic psychiatric institutions rests in creating the dialogue that will inform and guide new decisions regarding research, education, and clinical priorities with the ultimate aim of ensuring that quality is preserved through reform.

Academic Medical Centers↗
PubMed1995

Premenstrual syndrome. Identification and management.

Premenstrual syndrome is a legitimate illness consisting of the cyclic recurrence of symptoms (physical, mental and behavioural) in the late luteal phase of the menstrual cycle of sufficient severity to require treatment. The syndrome has a yet unknown aetiology, an uncertain and variable course, and an unidentified family history. Methods are available for diagnosis including obtaining a reliable history, thorough physical and mental examinations, laboratory tests to exclude other possible causes of symptoms, and daily prospective symptom ratings to confirm symptom patterns. Because there is no known aetiology, treatment consists of symptom management of the specific symptoms experienced, based on prospective symptom ratings.

Affective Symptoms↗
PubMed1993

Late luteal phase dysphoric disorder: a scientific puzzle.

Late luteal phase dysphoric disorder is described as a classic biopsychosocial disorder resulting from complex interactions of biological, psychological, socioeconomic and cultural forces on women. To understand women suffering from the disorder, one must understand how the genetically designed female brain and body influence and are influenced by experience and learning. Each perspective of understanding constitutes one piece of a scientific puzzle. These perspectives are delineated and the conceptual problem of how to measure the outcome of the interactions is described.

Female↗
PubMed1992

Late luteal phase dysphoric disorder in 670 women evaluated for premenstrual complaints.

OBJECTIVE: The American Psychiatric Association's DSM-IV Work Group on Late Luteal Phase Dysphoric Disorder (LLPDD) reanalyzed existing data from prospective, daily symptom ratings to evaluate the DSM-III-R criteria for LLPDD. The objectives were to 1) evaluate the individual symptoms presently required for the diagnosis and other symptoms, 2) determine the proportion of treatment-seeking women who meet the LLPDD criteria, and 3) explore the association between LLPDD and other mental disorders. METHOD: Data from over 1,000 women seeking evaluation for premenstrual complaints at five U.S. sites were examined. The data from 670 of these women were sufficiently complete to warrant evaluation by four different methods of assessing symptom change. RESULTS: Depending on the assessment method used, 14% to 45% of the women met the criteria for LLPDD. The current DSM-III-R symptoms were classified as positive for 7% to 54% of the women. Each of these symptoms was significantly more common among women with LLPDD regardless of the assessment method used. Five symptoms not presently included were also significantly more common. Women who had had mental disorders in the past, but not present, showed a significantly greater, but very small, relative risk of LLPDD. CONCLUSIONS: The variability in the frequency of LLPDD diagnosis according to method of assessing symptom change underscores the need for a uniform assessment method. The five additional symptoms with frequencies comparable to those of the DSM-III-R symptoms should be studied further for possible inclusion in the criteria.

Data Collection↗
PubMed1991

High nocturnal body temperature in premenstrual syndrome and late luteal phase dysphoric disorder.

OBJECTIVE: Because women with late luteal phase dysphoric disorder (LLPDD) experience symptomatic affective states predictably, they can be studied to determine whether there are biological findings related solely to the clinically symptomatic state. The authors sought to answer the question, Does body temperature change with affective state? METHOD: The core body temperature and motor activity patterns of 10 women with premenstrual syndrome (PMS), six of whom also met criteria for LLPDD, and no other psychological or medical illness were compared to those of six women with chronic, noncyclic dysphoria and six asymptomatic comparison women at four phases of the menstrual cycle. RESULTS: The nocturnal temperatures of the women with PMS/LLPDD were significantly higher than those of the comparison subjects across the entire menstrual cycle, but there were no differences in nocturnal activity levels. The women with noncyclic dysphoria had a mean nocturnal temperature in the follicular phase as high as that of the women with PMS/LLPDD. The temperatures of all women were higher in the luteal phase than in the follicular phase. CONCLUSIONS: These findings suggest that in the future investigators should document menstrual cycle phase in all female subjects and, when studying body temperature, should carefully monitor symptomatic state in comparison subjects.

Adult↗
PubMed1990

Premenstrual syndrome.

Because researchers are still seeking the cause of PMS, we cannot recommend a single treatment approach that will work satisfactorily with all women who have the syndrome. Investigators have made progress, however, toward defining and diagnosing the condition. We also can help women whose lives are disrupted each month by prescribing specific approaches to symptom management.

Adult↗
PubMed1989

Frequency of reported premenstrual changes in normal and self-selected populations.

Premenstrual Assessment Form (PAF) data are presented on the prevalence of premenstrual syndrome subtypes in self-referred women (N = 60) who were requesting an evaluation for premenstrual difficulties. These data are compared to the normative data of Halbreich and Endicott (1982). The PAF offers the advantages of comprehensive symptom coverage and criteria for non-mutually exclusive subtypes of premenstrual disorder. Although the PAF relies on retrospective accounts of premenstrual difficulty, it allows the exploration of the relationships between perception of premenstrual symptoms and sample selection criteria. The present data suggest that sample characteristics such as their manner of selection for study will influence significantly the prevalence of PAF subtypes.

Adolescent↗
PubMed1989

Late luteal phase dysphoric disorder and DSM-III-R.

Text and diagnostic criteria for a new category, late luteal phase dysphoric disorder, appear in appendix A of DSM-III-R: "Proposed Diagnostic Categories Needing Further Study." The inclusion of this category in the manual was perhaps the most controversial aspect of the revision of DSM-III. In this paper the authors describe the work of the advisory committee that first proposed the category, the rationale for the category's inclusion in the manual, and the many issues that were the focus of heated debates.

Attitude to Health↗
PubMed1989

Spectral analysis of cyclic symptoms in late luteal phase dysphoric disorder.

Fifty-eight subjects self-referred for premenstrual difficulty were evaluated for late luteal phase dysphoric disorder through a spectral analysis technique applied to prospective symptom ratings. Data from the Schedule for Affective Disorders and Schizophrenia--Life-time Version were used to group the subjects according to the absence or presence of past or present psychiatric disorders. The two psychiatric groups were compared with regard to both patterns of significant symptom change and premenstrual symptom severity. Differences between the groups are used to discuss issues regarding the reliable identification of late luteal phase dysphoric disorder and the impact of other psychiatric disorders on this syndrome.

Adult↗
PubMed1989

Cyclical changes in emotional information processing in sleep and dreams.

Our scientific tools have rapidly advanced in recent decades. Urine tests and hormone assays allow us to know exactly where a woman is in her menstrual cycle and to document precisely her hormonal rhythms. Sleep-laboratory techniques allow us to know exactly when someone is dreaming so that we can obtain that communication that Freud prized so highly. Furthermore, we now have quantifiable means to measure accessibility to nonverbal mental representations, which derive from important advances in theory and method in cognitive psychology in the last several decades. None of the studies we surveyed combined these tools. The sleep-laboratory studies did not document menstrual-cycle phase with either temperature or hormone levels. Moreover, the relationship between their findings and daily functioning is still unclear. The psychoanalytic study by Benedek and Rubenstein carefully documented cycle phase, but statements about fantasy and conflict were large and sweeping and the focus was on drive-related rather than information processing effects. Careful work must be done by modern investigators before the field of medical psychoanalysis can address the basic questions of mind-body functioning that are at issue here. We have presented one approach to entering the communication network of mind-brain functioning, that is, the application of the dual-code model to dreams, in the context of the influence of hormones across the menstrual cycle. Although prior research has demonstrated cyclical fluctuations of psychodynamic themes in dream content (Baron, 1977; Benedek & Rubenstein, 1939a, b; Hertz & Jensen, 1975; Lewis & Burns, 1975; Swanson & Foulkes, 1968), the existence of a cyclical cognitive pattern as regulated by gonadal function has not previously been explored. While the findings are preliminary and limited, this is the first study to provide evidence that there are psycholinguistic styles characteristic of different phases in the menstrual cycle, and that this variation in verbal expression reflects a correspondence between hormone production and the ability to access and communicate nonverbal representations. Although the relationship between referential activity and phases of the menstrual cycle represents a statistical relationship and is hardly conclusive, the article does demonstrate how the dual-code model permits us to translate our psychoanalytic observations into operational terms. This provides one means of access to the network of communication between neuropeptides and mental representation, or in more general terms, between body and mind.

Adult↗
PubMed1988

Premenstrual syndrome and locus of control.

Seventy-six women completed a three-month prospective evaluation for premenstrual syndrome (PMS). As a part of the evaluation, they completed Rotter's Locus of Control (LOC) form in the follicular phase and premenstrually. It was found that the LOC scores of women meeting criteria for PMS rose significantly (became more "external") premenstrually, while scores of women without PMS did not show significant change. In addition, the premenstrual LOC scores of women meeting criteria for PMS were significantly higher than were scores of the non-PMS women. The results are consistent with the idea that cycle related changes in self-perception occur in women demonstrating PMS symptomatology.

Adult↗
PubMed1988

Premenstrual syndrome research: using the NIMH guidelines.

The 1983 National Institute of Mental Health (NIMH) guidelines for a premenstrual syndrome (PMS) diagnosis were applied to Daily Rating Form (DRF) data in a prospective research study. The use of two sets of criteria, each consistent with the NIMH guidelines, resulted in prevalence rates of 44% and 17%. The authors discuss other problems in defining a "syndrome": symptom patterns and the relationship between PMS and the presence of a psychiatric disorder.

Adult↗