Siblings of retarded children: a population at risk.
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Three hundred and sixty-six university students (158 males and 208 females) completed a three-part questionnaire. The first two parts consisted of self-report inventories to assess psychological adjustment (Eysenck's Neuroticism Scale and Lanyon's Alienation Scale). The third part assessed gender role (Bem's Sex Role Inventory). Androgyny was scored as per both the Bem (1974) system and the Spence et al. (1975) system, and the groups obtained by these two systems were separately analyzed for differences in psychological adjustment scores. Feminine individuals (regardless of biological gender or system of classification) obtained less adjusted scores, and this was especially significant for males. It was also found that the Spence et al. system had more predictive power than the Bem system for classifying individuals.
A sample of 11 male gender-dysphoric patients meeting DSM-III criteria for transsexualism was seen over a 3-year period by a military psychiatrist. Eight patients had extensive military experience, including combat duty in some cases. At the time of evaluation three were on active duty, one was a Department of Defense employee, and four were veterans. Evidence is presented for a hypermasculine phase of development that coincides with the age of enlistment in nearly all cases. The psychodynamic underpinnings of the choice to enlist in transsexual males are discussed. Outcome of military service was premature discharge in over 60%. The military's management of gender-dysphoric servicemen is described. Current military policies, in association with the proposed hypermasculine phase of transsexual development, may actually result in a higher prevalence of transsexualism in the military than in the civilian population.
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Knowledge of psychosocial risk factors and psychosomatic problems of pregnancy, childbirth, and childbed is still rather poor among obstetricians, midwives, pediatric nurses, and pediatricians. This means that psychosocial risk factors and psychosomatic disturbances during pregnancy, childbirth, and childbed are not always and not thoroughly enough discovered and thus they are not treated properly. The necessity of a psychosomatically oriented care of the pregnant woman is pointed out with discussion of basic and advanced psychosomatic treatment.
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Quite generally, psychotherapy and psychoanalysis are under great pressure today to account for what they are doing, to prove their scientific validity and their therapeutic efficacy. Those of us who use clinical experience in conducting their practice in ways which seem optimal, as judged both by them and by their patients, are increasingly challenged to respond to a canon of scientific method and validity that claims its brief for truth. What I am going to say will not live up to such high standards of proof, but will simply reflect my clinical experience: what helps and what fails with most patients that come to me, often after a string of previous treatment failures. What I am going to say claims practical usefulness, not ultimate scientific truth. I would like to highlight a number of issues that have proven themselves as of special importance for the long term treatment of substance abuse dependent patients. The first is the role various forms of denial play and how these might best be approached. Multiple layers of denial entail usually some form of split identity--rapid alternations from one part identity to the other. Then I shall briefly study the role of impulsivity and of various forms of impulsive action. These topics of denial, split identity and impulsive action dictate some reflexions on attitude and technique necessary for the long term psychotherapy of patients with prominent problems of substance abuse and impulsivity. I shall conclude with some more general recommendations for the future of psychotherapy with substance abusers.
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When a patient has a myocardial infarction (MI), all aspects of marital function are affected. Soon after the MI, patients' wives experience psychological distress that decreases with time. Illness behaviors among the MI patients' wives increase, and aggressive and sexual impulses are often inhibited. Many families experience changes in members' work status after the husband has an MI, and wives are faced with increased chores. Marital interaction also changes. Dysfunctional marital relationships are associated with a poor psychosocial outcome. Additionally, spousal factors such as dependency are also likely to affect patients. Intervention strategies are best directed to wives at risk for problems.
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Advances an evolution-based model of strategic conflict between men and women. Conflict is predicted to occur whenever the reproductive strategy adopted by one sex interferes with that adopted by the opposite sex. Three empirical studies tested hypotheses based on this model. Study 1 (N = 528) examined sex differences in sources of anger and upset (e.g., about sexual aggressiveness or withholding) among 2 samples of Ss differing in age and martial status. Study 2 (N = 60) assessed the perceived magnitude of upset each sex would experience when confronted by each source. Study 3 (N = 214) tested predictions within married couples about sex differences in sources of marital and sexual dissatisfaction. These studies provide modest support for the strategic conflict model and implicate the negative emotions of anger and upset as proximate mechanisms that alert men and women to strategic interference. The diversity of upset elicitors discovered here, such as being condescending, possessive, neglecting, abusive, inconsiderate, moody, and self-centered, point to the limitations of this evolutionary model and the need to develop more comprehensive models of conflict between the sexes.
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