"Note on C. Grubb's body image concerns of a multipara in the situation of intrauterine fetal death".
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A group of 20 middle-class women between 20 and 40 yr. of age and in the third trimester of pregnancy was compared with a control group of 20 non-pregnant women for cutaneous sensitivity (to a tickle) and for modifications of body schema which were hypothesized to occur during pregnancy. Latency and actual duration were considered in the perception of the tickle. Body schema were studied using two of Fisher's tests, Body Prominence and Body Cathexis. Pregnancy leads to modifications in sensitivity to tickle, specifically with regard to the right half of the body and to some extent in body schema.
Drawings of female figures made by women in their first (N = 54), second (N= 51), and third (N = 56) trimesters of pregnancy and post-partum (N = 55) women were compared with each other and with a control (N = 76) group of gynecological patients. There were no major differences in the drawings of women during the three major stages of pregnancy or between the pregnant women and those who had delivered recently. However, the pregnant women differed significantly from the gynecological controls in that they made more nude drawings, emphasized the genitals, distorted the drawn figures, and made the drawings smaller in size. It was concluded that somatic and psychological changes associated with pregnancy are reflected in the human figure drawings.
The authors studied a group of young ballerinas through responses to a questionnaire and intensive interviews. The young women described a life characterized by complete dedication in which academics, social life, and pleasures were sacrificed and a program of intensive exercise and practice became their main activity. They tended to feel overweight in spite of being thin and continued to diet or to employ other means to become even thinner. Two heuristic conclusions were reached: (a) the goal of thinness was in part a flight from conflicts about adult sexuality that arose at puberty; and (b) repetitive practice was engaged in for its own sake, not for career advancement, in an attempt to lose themselves in a transcendental quest for perfection. A comparison was made between this group and girls of the same age with anorexia nervosa. Several similarities but many more differences were found. Findings are based on a very small sample and must be interpreted cautiously, but directions for further studies are implied.
In a difficult and delicate clinic for adolescents, the author attempts to demonstrate, from new concepts such as "Family Body", the importance to reevaluate classic psychiatric nosography, to differently formulate etiology, pathogenesis, prognosis and treatment of the adolescent crisis. The adolescent in crisis, as a symptom offered by the family, can be heard as a metaphore in the familial communication, as a symptom of the "Family Body": uncomfortable position and very fructuous, because in between epistemological approaches, the psychoanalytic approach and the systemic approach.
Preliminary, exploratory studies examine self-perceptions of the stigma of overweight in relatiopship to weight-losing patterns of female and male children of different ages. It is suggested that the concept of stigma may be a viable analytical tool in studying overweight as: an exclusive focus in interaction, related to a negative body image, overwhelming others with mixed emotions, clashing with other attributes of the person, an equivocal predictor of activities, and related to one's sense of responsibility for one's overweight. Female adolescents in the Slimnastics class in a high school and children and adolescents in an obesity clinic in a hospital were studied. Male children and female adolescents had more trouble losing weight than did female children and male adolescents. Youth who viewed overweight as both one's responsibility and as an illness that required the joint efforts of oneself and others, especially professional experts, were more successful in losing weight than those youth who believed that overweight was solely their responsibility or not at all their responsibility. Intensive focusing on one's overweight and one one's negative body image seemed to inhibit or deter weight losing for some youth.
Extinction and synesthesia were studied in 50 patients with spinal cord injury with various levels and extents. Extinction was found in 20 (40 per cent) and synesthesia in 6 (12 per cent) of the 40 males and 10 females. No correlations were found between either of the two phenomena and parameters of patient's age, lesion's age, lesion's level and extent, or accompanying head injury. The latter occurred in 22/50 patients (44 per cent), diagnosed by a history of amnesia. Extinction was tested by synchronous double stimulation unilaterally and bilaterally, symmetrically and asymmetrically. It was more frequent unilaterally than bilaterally. The modalities of superficial sensibility were prone to be extinct but those of deep sensibility (pallesthesia from bone conduction and kinesthesia) were not. Extinction of tactile responses did not imply that all other skin modalities (pain, temperature, pressure, skin pallesthesia) will also be extinct in an all or nothing fashion. Modalities could become extinct either singly or in combination. Extinction in spinal man was presumed to be caused by a reduction of perception in hypesthetic areas and was of diagnostic value insofar as its segmental distribution suggested the longitudinal extent of a cord lesion. This concept is in accord with the results of monkey experiments by Eidelberg and Schwartz (1971). Synesthia in spinal man is not identical with synchiria of the monkey. It is not in a reciprocal relationship with extinction and both phonemena co-existed in four of the six patients. Synesthesia is elicited by a stimulus delivered to the normesthetic skin above the level of the lesion with two responses: one well localised at the site of stimulation and the other unilaterally or bilaterally in anaesthetic parts of the body. Five of the six patients reported volitional phantom movements of somatic (toes) and/or visceral (micturition-defaecation) structures. Such sensations are elicited by remembering the engrams of pre-traumatic experiences in areas of the body image connected with motor function. Synesthesia could be understood as a sensory counterpart in areas of the body image when ascending impules of actual perception are mixed with impulses modulated at the artifical synapse of the rostral cord stump creating a phantom sensation.
Patients with anorexia nervosa have previously been shown to display disturbances in visual self-perception and interoception. In the present investigation we wished to determine the stability of these disturbances and the effects of weight gain on them. We studied 29 females, 16 patients with primary anorexia nervosa and 13 controls, who had also been studied one year previously. Each subject took part in investigations of body image, using a distorting photograph technique, and interoception, using a satiety aversion to sucrose test. We found that some anorexic subjects tend to overestimate body size and have an absence of aversion to repeated sucrose tastes. Moreover, these disturbances were stable over the year and were not affected by weight change.
A case is reported of a former woman astronaut candidate who withstood the rigors of the preliminary physical examinations for this position. Some years later, she sustained a subarachnoid hemorrhage from an arteriovenous malformation in the right parieto-occipital area, which was successfully excised. Postoperatively, she had a marked visual deficit, from which she completely recovered within 3 months. The development of psychomotor seizures 5 months later was due to probable scarring in the right parieto-occipital region of the cerebral cortex, the interpretive area for orientation of body image in space, which had been supplied by the clipped right anterior and posterior cerebral arteries feeding the arteriovenous anomaly. These seizures have been well controlled on anticonvulsants. A lesion in the temporoparieto-occipital region due to a hemorrhage from a ruptured arteriovenous anomaly, resulting in the disabling symptoms of disorientation or loss of body image due to impairment of the interpretive cortex, could be devastating to the pilot and a mission. This case raises the question of an automatic use of the CT brain scan in screening potential space candidates, and even the consideration of a percutaneous femoral four-vessel arteriogram in all, or possibly selected, candidates. Most neurosurgeons and neuroradiologists probably would consider the risks of the latter procedure too great to justify its use for fear of permanent complications to the space candidate.
Functional overlay is not a recognized psychiatric diagnosis. Evaluating functional overlay and differentiating between this concept and organic conditions is important in medicolegal areas in which financial values are placed on pain and disability. Functional overlay is not malingering: the former is based on preconscious or unconscious mechanisms, the latter is consciously induced. In considering psychologic reactions to pain and disability, a gradient of simulation, malingering, symptom exaggeration, overvaluation, functional overlay and hysteria is useful. The dynamics of overlay are a combination of anxiety from body-image distortion and depression from decreased efficiency of the body, as well as the resulting psychosocial disruption in a patient's life.
A longitudinal study of body image change during pregnancy was conducted to test what aspects of body perception are sensitive to psychological change. Fifty-five black and 30 white women who were primiparous, less than 4 months pregnant and at least 17 years old, were interviewed during their first and third trimester as well as 6 weeks post partum. Awareness of one's stomach as measured by the Stomach Focus score of the Body Focus Questionnaire was sensitive to body changes which accompany pregnancy. However, the black women did not change in awareness of their stomachs following delivery as the white women did. The Body Distortion Questionnaire revealed that the black women felt most distorted at 9 months of pregnancy but the white women declined in body distortion. Both groups reported less distortion following parturition. Thus, cultural as well as psychological and physiological factors influence the way in which the body is perceived and experienced during pregnancy.
We have compared bone images from a number of patients using three instruments. In 38 patients, Cleon body images were compared with whole-body rectilinear scans. Cleon images were also compared with scintillation camera images of the trunk or extremities of 31 patients and of the skull of 70 patients. The Cleon was superior to the rectilinear scanner in resolution, lesion detectability, and speed of scanning. The Cleon and gamma camera were comparable in lesion detection, but the Cleon was consdierably faster. Clinical studies and comparative evaluation are presented.
Investigated the relationship between self-esteem and the pupillometric response. Because a positive correlation has been established between pupillary dilation and positive interest in an observed stimulus, it was hypothesized that self-esteem would be correlated positively with the pupillometric response when Ss (N = 82) viewed photographs of themselves. Results indicated that self-esteem was related to the pupillometric response only for females. The relationship, however, was opposite to that predicted. The greater the pupillometric index, the poorer the self-esteem. It is suggested that in a situation in which implicit anxiety states are involved, sympathetic nervous system activity predominates over the interest value of the stimulus. It may be that females more than males are constitutionally prone to exhibit this sympathetic reaction and/or are more responsive to the body image properties inherent in the stimulus photographs.