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[The many-colored picture of endocrine crisis in clinical practice--psychological symptoms in hormonal emergencies].

Four case reports from a general practitioner's daily work illustrate the problem of endocrine crises hidden by psychiatric symptoms. Psychologic and psychiatric problems in a GP's office are very frequent; endocrine crises are very rare, but with high consequences for the patient. Optimal coordination and cooperation between psychiatric and somatic clinicians and investigation are necessary for optimal education of future physicians.

Addison Disease↗

Dysthymia in clinical practice :psychological therapies.

Psychological therapies for depression may have several different targets: symptom amelioration, relapse prevention, and improving social adaptation. For cognitive therapy the targets are mainly the first two of these, for dynamic psychotherapies particularly the third. In dysthymia, provision of a coping repertoire for a long term illness may also be important. There have been few controlled trials of psychological therapies in dysthymia, but one study has found benefit from marital therapy, and uncontrolled studies, suggest some benefit from cognitive therapy. Controlled trials in other forms of depression of specific targeted psychotherapies, most commonly interpersonal psychotherapy, but also group, marital and family therapy, and social work, show benefit on social adjustment and some benefit on symptoms. Controlled trials of cognitive therapy show symptom benefit in milder depression, and strongly suggestive evidence of relapse reduction.

Adaptation, Psychological↗

Practicing school psychology. A turn-of-the-century perspective.

Contemporary school psychology is more than an extrapolation of its early circumstances. However, several aspects remain intact despite changes in child classification, technology and instrumentation, regulation, and professionalization of the field. A snapshot is presented of school psychology practice during its origin period at the turn of the 20th century.

Child↗

Practicing professional psychology.

The practice of professional psychology generally has consisted of assessment and intervention. This article describes the functioning of one practitioner's activities. For assessment, the model described emphasizes point predictions and actuarial approaches whenever those are available. The discussion includes descriptions of specialization and expansion of practice areas, as well as the need for involvement in advocacy activities and professional associations.

Humans↗

Neuropsychophysiology during relaxation in generalized, universal 'allergic' reactivity to the environment: a comparison study.

Comparisons were made among a group of patients presenting with universal 'allergic' intolerance to environmental chemicals (universal reactor, n = 58), a group of control subjects without psychologic symptoms (control, n = 55) and a group of outpatients from a psychology practice (psychologic, n = 89) on neuropsychophysiological measures during relaxation. The measures were electroencephalographic (EEG) spectral category for frequencies below 15 Hz, EEG beta activity, scalp electromyography (EMG), peripheral temperature (TEMP), and skin resistance level (SRL). The distributions of subjects in each group across eight EEG spectral categories were significantly different, with the distribution for universal reactors the same as that of the psychologic patients (p = 0.22), and both different from the distribution of controls (p less than 0.001). High levels of EEG beta activity were observed in more universal reactors and psychologic patients than in controls (p = 0.04). High levels of EMG scalp activity were observed in a greater number of universal reactors than in subjects in the other two groups (p less than 0.001). The three groups did not differ in TEMP and SRL. Implications of neuropsychophysiologic stress profiling for the diagnosis and treatment of psychosomatic illness are discussed.

Adult↗

Psychologic assessment technology for geriatric practice.

Psychologic assessment is an integral aspect of the comprehensive functional assessment of geriatric patients. Medical areas in which psychologic testing and evaluation can be of significant service in the diagnosis and formulation of treatment plans include psychiatric and neurologic disturbances, psychosomatic disorders, circulatory diseases (especially hypertension), diabetes, chronic pain, sexual dysfunctions, and gastrointestinal problems. In the effort to gain an understanding of the total patient, it is important to clarify the effect of physical condition on a person's psychologic reactions as well as the impact of psychologic states on his/her biologic status. This orientation is particularly important in dealing with elderly patients because the interaction between the physical and the psychologic in this age group is exceedingly strong and significant. Despite the fact that research in the psychology of the aged is of long standing, the attention given by clinical psychologists to the provision of services to geriatric patients has been quite limited until recently. Many psychologic tests have been developed during the past 70 years, but relatively few of them have been standardized for use with the aged. Of late, however, this has been changing. Several tests have been adapted, and some new ones have been organized with the needs and characteristics of the aged in mind. Closer attention has been paid to psychometric principles in the development of the tests, leading to the organization of useful norms and the demonstration of proper levels of reliability and validity. Accordingly, the state of the art of psychologic assessment of the aged is currently rather limited, but the outlook for the near future appears encouraging. In evaluating the condition of a geriatric patient, the clinical psychologist normally generates data through observations, testing, and interviewing. The resulting report covers the following areas: 1) adaptation to the examination and behavioral characteristics during the procedure, 2) cognitive functioning, 3) visual motor coordination and perception of spatial relationships, and 4) personality characteristics and mental health status. Data for the first area are normally derived by the examiner from observations and subjective impressions of the patient's behavior. For each of the other areas the information is obtained through standardized tests. In this discussion, some of the principal assessments that are currently available are reviewed and evaluated for their usefulness with the aged.

Aged↗

Evidence-based practice in psychology.

The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes psychology's fundamental commitment to sophisticated EBPP and takes into account the full range of evidence psychologists and policymakers must consider. Research, clinical expertise, and patient characteristics are all supported as relevant to good outcomes. EBPP promotes effective psychological practice and enhances public health by applying empirically supported principles of psychological assessment, case formulation, therapeutic relationship, and intervention. The report provides a rationale for and expanded discussion of the EBPP policy statement that was developed by the Task Force and adopted as association policy by the APA Council of Representatives in August 2005.

Evidence-Based Medicine↗

Comparison of counseling and clinical psychology graduates on the examination for professional practice in psychology.

Doctoral recipients in clinical psychology scored higher than doctoral recipients in counseling psychology on the national licensing exam, the Examination for Professional Practice in Psychology. The largest discrepancies between the 2 groups were on Subtest I (diagnosis), Subtest II (intervention), and Subtest III (research). The differences were less large for Subtest IV (professional/ethical/legal issues) and for Subtest V (social application). The authors recommend that both counseling and clinical psychology graduate students take more course work in the department of the other discipline.

Counseling↗

Community psychology as a model for the new private practice of psychology.

The continuing increase in graduates from training programs in psychology when coupled with the decline of publicly supported mental health facilities or funds will lead more psychologists to offer services privately. At the same time, the private practice of psychology is changing, and a community psychology model may be useful in the development and offering of services. The community concepts of prevention, crisis intervention, and consultation can be related to family, work, and health in the development of some of the services that will become more prevalent in private practice.

Community Mental Health Services↗