PubMed HealthSearch

SEARCH · PubMed Health

Results for “Reality Testing”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

Measurement and modification of delusional beliefs.

It has been proposed that delusional thinking may be on a continuum with normal behavior and can be assessed by taking account of factors such as the client's degree of belief conviction or the extent of preoccupation with the belief. In our research a number of measures were used to assess the delusional thinking of people diagnosed as schizophrenic. Two interventions were used: (a) a structured verbal challenge and (b) a reality test in which the belief was subject to an empirical test. We used a multiple-baseline, across-subjects design. Of the 6 clients, 2 completely rejected their beliefs, and 3 others significantly reduced their belief conviction. Maintenance was good, and there was evidence that the intervention had enabled 5 of the 6 clients to effectively regulate their delusional thinking.

Adult

Object relations and self-reported AIDS self-care behavior.

This study examined the relationship between object relations and AIDS self-care behavior among 509 urban college students. The literature indicates that maturity of object relations is related to comfort in interpersonal relations and to taking responsibility for self-care. These concepts are widely accepted by psychoanalytic psychologists but have rarely been tested empirically. Object relations, measured by the Bell Object Relations and Reality Testing Inventory, was significantly related to AIDS knowledge as measured by the AIDS Prevention Survey of Thomas and to self-reported safer sex behavior, measured by Bassman's HIV Infection Prevention Scale. Knowledge about AIDS correlated with self-reported sexual risk behavior, and with a low level of self-reported social behavior aimed at preventing AIDS. Implications of these findings for public health education policy are discussed.

Acquired Immunodeficiency Syndrome

An investigation of psychological factors involved in the predisposition to auditory hallucinations.

Previous research by the author (Slade, 1972, 1973) and others has suggested that psychological stress plays an important role in triggering off the experience of auditory hallucinations. Clearly, however, predispositional factors are involved as well. The present study is an attempt to investigate some of the psychological factors which may predispose the individual to such experiences. A battery of tests involving cognitive, personality and mental imagery variables and the verbal transformation effect was administered to two small groups of psychotic patients differing only in respect of a history of auditory hallucinations and a normal control group. The main conclusion was that the results lend direct support to the proposition of Mintz & Alpert (1972) that a combination of vivid mental imagery and poor reality-testing in the auditory modality provides the basic predisposition for the experience of auditory hallucinations.

Adolescent

Psychotherapeutic schema based on the paranoid process.

A psychotherapeutic schema is proposed based on the analysis of the paranoid process. The paranoid process involves a paranoid construction of the patient's view of reality and his environment, particularly the social environment. The paranoid construction sustains and makes sense out of the patient's projective system. These projective elements reflect and are derived from the introjects--the internalized objects around which the patient's inner world and his experience of himself are organized. The schema aims at focusing the therapy on these introjects as central to the psychopathology. The following steps of the schema are outlined and discussed: establishing the therapeutic alliance, defining the projective system, testing reality, clarification of the introjects, derivation of the introjects, motivation of the introjects, mourning of infantile attachments, emergence of transference dependence, transference resolution, and termination.

Attitude of Health Personnel

Infertility: psychotherapeutic issues.

In supportive therapy with infertility patients, the clinician tries to relieve dysphoria and enhance self-esteem. Dynamically informed supportive interventions are designed to decrease guilt that may relate to past sexual activities, sexually related diseases, or abortions. These interventions should also be empathetic, promote optimism and reality testing, help with problem solving, allow catharsis and ventilation, decrease feelings of isolation and loneliness, educate and clarify, and praise and encourage where appropriate. Mental health clinicians have an important role to play in the treatment of these patients, provided they learn enough about the psychology of the experience of infertility and about the technology utilized in its treatment. As the number of people seeking treatment for infertility grows, the need for skilled therapists for this population will grow at a parallel rate.

Female

Though disorder in high-functioning autistic adults.

Examined thought disorder in a sample (n = 11) of high-functioning autistic young adults and older adolescents (mean IQ = 83) utilizing objective ratings from the Thought, Language and Communication Disorder Scale (TLC Scale) and projective data from the Rorschach ink blots. Results from the TLC Scale pointed to negative features of thought disorder in this sample (e.g., Poverty of Speech). Rorschach protocols revealed poor reality testing and perceptual distortions in every autistic subject, and also identified several areas of cognitive slippage (e.g., Incongruous Combinations, Fabulized Combinations, Deviant Responses, Inappropriate Logic). Comparing TLC Scale and Rorschach results to schizophrenic reference groups, autistic subjects demonstrated significantly more Poverty of Speech and less Illogically on the TLC Scale, and on the Rorschach they evidenced features of thought disorder that are encountered also in schizophrenia. Results are discussed in relation to the measures employed, and to areas of similarity and difference between autism and schizophrenia.

Adolescent

Self-esteem and perceptions of conveyed impressions: is negative affectivity associated with greater realism?

Two studies examined the notion that negative affectivity (Watson & Clark, 1984) is associated with more accurate perceptions of conveyed impressions in social interactions. In Study 1 (n = 160), low self-esteem (LSE) and high self-esteem (HSE) subjects were paired with either an LSE or an HSE partner. After a 15-min interaction, they rated themselves, their partners, and how they believed their partners would rate them on 20 adjectives related to social competence. Study 2 (n = 40) was identical except that each interaction was observed by 2 observers who rated each participant, and participants also rated how they believed an observer would rate them. LSE subjects exhibited greater accuracy only with respect to the elevation component of observers' ratings; HSE subjects overestimated the positivity of observers' evaluations, whereas LSE subjects were relatively accurate. However, LSE subjects exhibited less overall accuracy with respect to their partners' ratings. We argue that when these results are considered with earlier research, there is no support for the notion of depressive realism in assessing conveyed impressions.

Adult

Rorschach structure of a hospitalized sample of Vietnam veterans with PTSD.

Rorschach structural summary data are presented for a group of 41 posttraumatic stress disorder (PTSD) patients who were being treated in a specialized inpatient PTSD treatment program. Results suggest that patients suffering from PTSD exhibit impaired reality-testing abilities and tend to utilize ineffective coping strategies. The group's structural summary factors are presented as incipient normative data for the Exner Comprehensive System on patients with PTSD. Implications that these protocols suggest a more severe and pervasive level of psychopathology than would be expected from theoretical descriptions of the disorder are discussed.

Adult

Representation of interpersonal interactions on the Rorschach and level of psychopathology.

Recent theoretical formulations emphasize the importance of the quality of interpersonal relationships in personality development and psychopathology and have resulted in the construction of methods for assessing the representation of interpersonal experiences. The Urist Mutuality of Autonomy (MOA) Scale is one of the most frequently used methods for assessing the quality of interpersonal relationships by evaluating interactions portrayed on the Rorschach between people, animals, and/or things. This study of the relationship of the MOA scale to independent assessments of interpersonal relationships and clinical symptoms in a group of seriously disturbed adolescents and young adults recently admitted to a long-term, open, residential treatment facility revealed that the average quality of interactions portrayed on the Rorschach relates significantly to the severity of clinical symptoms and the presence of thought disorder, but not to the quality of interpersonal relations. In addition, the portrayal of at least one intensively malevolent and destructive interaction on the Rorschach is correlated primarily with measures of thought disorder and impaired reality testing, whereas not giving at least one mutual and benevolent interaction response is correlated with impaired capacity for social adaptation (e.g., inappropriate interpersonal behavior and unmodulated affect). The relative failure to give at least one mutual and benevolent response is also correlated with the severity of clinical symptoms. Though the MOA scale was developed to assess object relations, it seems more consistently to assess aspects of psychopathology, such as the severity of clinical symptoms and the extent of thought disorder, and only secondarily the quality of interpersonal relationships.

Adolescent

Assessing object representations as a continuous variable: a modification of the concept of the object on the Rorschach scale.

Current methods for assessing the quality of internalized object representations have not provided a continuous variable that simultaneously includes both an accuracy and a maturity component. A modification of Blatt, Brooks, Brenneis, and Schimek's (1976) Concept of the Object on the Rorschach scale that would combine the two components by weighting the quality of each response according to its form level was proposed. Initial discriminant and convergent validity of this modification was checked through correlations and multiple regression analyses using behavioral, diagnostic, and demographic data from 84 adolescent inpatients as dependent variables. Results indicate the modified score was directly related to measures of peer relatedness, intelligence, psychological health, and reality testing, and indirectly related to measures of psychosis and hostile, unmanageable behavior. The results support the utility of the modification for providing a continuous score that assesses both developmental maturity and accuracy, the two dimensions on which the concept of object representation is based.

Adolescent

Rorschach characteristics of mothers of incest victims.

Investigated the Rorschach characteristics of 28 mothers of incest victims, using the Rorschach Comprehensive System. Their characteristics were compared to those from a control group of 28 women, matched with the target group for socioeconomic status (SES), age, education, marital status, and the presence of children. Chi-square, analysis of variance, and a stepwise linear discriminant function analysis were used to evaluate Rorschach differences between the control and target groups. Major findings indicate that mothers of incest victims demonstrated significantly greater weaknesses in reality testing, more frequent signs of depression, and greater interpersonal guardedness than control group mothers. Discriminant function analysis, based on scores from the schizophrenia index (SCZI), conventional form (chi + %), and texture responses (t), yielded an overall accurate classification rate of 87.5% for placement of women into the target and control group categories.

Adult

Time and Schizophrenia.

It is possible, albeit reductionistic, to consider the many dysfunctions of reality testing found in schizophrenia as manifestations of a defective time sense. This perspective on schizophrenic discourse, for instance, permits a new grasp of "schizophrenic logic" and a novel approach to therapeutic interpretation. The present paper describes the use of time-related interventions in the psychotherapy of a schizophrenic patient. Several aspects of time sense are outlined. Under each heading are examples from the psychotherapy of Carrie, demonstrating her idiosyncratic notion of that particular temporal concept. Interpretations are aimed at clarifying the cognitive assumptions underlying the patient's expressions.

Female

Frontal lobe influences on delusions: a clinical perspective.

The presence of delusions, a significant feature of many schizophrenic patients, implies a disturbance of reality testing. Through descriptions of a number of organic delusion syndromes featuring frontal damage, and a theory of prefrontal functions, a correlation of schizophrenic delusions and prefrontal malfunctions is postulated.

Adult

Visual hallucinations during hallucinogenic experience and schizophrenia.

The visual hallucinations experienced by a 26-year-old woman under the influence of hallucinogens and during schizophrenia are described. Three types of hallucinations are delineated: (1) superimposed hallucinations, (2) spatial and depth distortions, and (3) animations. These three types of hallucinations appear to represent consecutive gradations on a continuum of the ego function of reality testing, with superimposed hallucinations revealing the least and animations the greatest degree of disorientation. The findings of the present study indicate the need for a research design that compares the hallucinations of schizophrenics to the toxic hallucinations of nonschizophrenics.

Adult

Psychological effects of mastectomy on a woman's feminine self-concept.

Previous literature on mastectomy indicates that the operation may be perceived by the patient as a threat to her feminity. Accordingly, the present study attempted to measure changes in body image, self-concept, and total self-image in mastectomy patients and two control groups (biopsy and surgical controls). Patients were given a questionnaire measuring the concepts in question three times: 1 day before surgery; 6 days after surgery; and 6 to 11 months later. There were distinctly different patterns of results for the three groups. Mastectomy patients did indeed evince a decline in body image and total self-image, but not until months after surgery. This was not unexpected in light of previous findings of massive denial in mastectomy patients. Immediately after surgery, this denial would be at its strongest, and it is feasible that it would take some months of reality testing until the denial is no longer a necessary defense. Biopsy patients showed a decline in body image and total self-image immediately after surgery, when their denial was no longer needed. Surgical control patients showed little overall change. Thus, mastectomy patients do appear to react to the operation with a decline in self-image, although this does not appear until some time after the operation.

Adult

The concepts: Disturbed state of consciousness and psychosis.

A theoretical analysis is made of the two concepts: "disturbed state of consciousness" (DSC) and "psychosis", and these concepts are defined in ways which are consistent with actual clinical psychiatric work on the Continent. Concerning DSC's two points are emphasized: Whether we, as psychiatrists, are conscious of it or not--one of our premisses for classifying a state as a pathological DSC is an evaluation of the client's ability to change the state voluntarily. Furthermore, stating that a DSC was present in the time interval tl0tn implies stating that all experiences were abnormal in some way during the interval--when the word "experience" is taken in the broad sense, including William James' "fringe" and "embeddedness" in the stream of consciousness. Reality testing may remain the cardinal point in the definition of "psychosis"--if we make the distinction between theoretical, "fullblown", syndromes and concrete syndromes with fewer symptoms clear to ourselves.

Alcoholic Intoxication

Diagnosis of schizophrenic borderline states.

The aim of this paper is to contribute to the clinical description of the group of schizophrenic borderline patients. In the first place important clinical features pointed out in older, basic papers will be restated. Secondly, additional observations, not used in clinical practice before, at least not explicitly, are described, data which are believed to be useful for the diagnosis of the states in question as well as for the differential diagnosis from other conditions, neuroses in particular. In the latter regard the following points are considered to be of outstanding importance: the presence or absence of a primary gain; the presence or absence of strivings to obtain an emotional secondary gain; the nature of the interpersonal relationship; the composition of the single symptoms. Pseudonormal, pseudoneurotic and pseudopsychopathic states are characterized. Micro-psychotic and overt psychotic states are described. Clinical differences from schizophrenic psychosis as observed in patients in the nuclear group of the schizophrenias are pointed out.

Adult