PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Psychotherapy, Multiple”

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 919 records · Page 51Linked to original sources
PubMed1985

A personal construct study of depression.

Twelve out-patients with a 'definite' or 'probable' diagnosis of major depressive disorder were treated by the author using personal construct psychotherapy (Kelly, 1955). Changes in their construct systems were monitored at intervals during the course of therapy using traditional role construct repertory grids and 'multiple perception of the self' grids. The level of depression was measured on each occasion of testing using psychiatric and self-rating depression scales. The most important findings were that high levels of depression were associated with low levels of 'conflict' and a cluster of variables to do with the construing of self, namely negative self-construing, low self-esteem and perceived self-isolation. As the depression lifted during the course of psychotherapy, there was a significant increase in the amount of 'conflict' and in the level of self-esteem, and a significant decrease in the level of self-isolation. The fact that over time the 'multiple perception of self' grids changed significantly more than the grids concerned with the construing of the self and others is interpreted as further evidence of the crucial role that the self-concept plays in depression.

Conflict, Psychological↗
PubMed1998

Atypical features and treatment response in the National Institute of Mental Health Treatment of Depression Collaborative Research Program.

Because depression with atypical features is poorly responsive to imipramine, treatment trials including a tricyclic antidepressant arm should assess depressive subtype. Sotsky and Simmens had previously reanalyzed data from the National Institute of Mental Health Treatment of Depression Collaborative Research Program (TDCRP) providing independent confirmation that imipramine is ineffective for patients with atypical features. The TDCRP was a 16-week study in which 239 outpatients with major depression were randomly assigned to cognitive behavior therapy (CBT), interpersonal psychotherapy (IPT), imipraminecase management (IMI-CM), or pill placebo-case management (Pbo-CM). We used Sotsky and Simmens' algorithm to investigate the effect of diagnostic subtype on all four treatments. Hierarchical multiple regression analyses demonstrated IMI-CM benefit relative to Pbo-CM in patients without but not in those with atypical features. These analyses did not demonstrate differential psychotherapy efficacy between depressive subtypes. In conclusion, subsequent analyses of the TDCRP study demonstrated the need to identify the subgroup of depressed patients who have atypical features. Failure to identify this subtype underestimates imipramine's benefit in the appropriately treated subgroup. Comparisons of other treatments with imipramine may be misleading if they do not account for diagnostic subtype.

Algorithms↗
PubMed1981

Multiple personality and spirit possession.

"Multiple personality" remains surrounded with a halo of the occult, and, as a rare exotic, fits uneasily into the framework of modern psychotherapy. Yet, the spirit-possession phenomena which it so closely resembles are widely distributed and commonly reported; and therefore, from the comparative perspective of anthropology, the truly interesting question is not why it occurs at all but why it occurs so seldom. This essay is an anthropologically motivated intellectual history of the perceived relation between multiple personality, possession, and kindred states. On the theoretical side, it concerns the creative role of psychological curing, the influence of theory upon the existence of the things which it is held to explain, and the influence of social and cultural factors on self-perception and the topography of the ego. I will begin by outlining the relation between multiple personality and possession, and follow with an account of how certain Western psychological theorists once tentatively allowed for the real existence of possession. Next I will examine cases of multiple personality in which possession was considered to play a literal role. As such an interpretation became increasingly suspect, decline of belief in possession was paralleled by a decline of interest in multiple personality as such and in the frequency of reported cases.

Anthropology, Cultural↗
PubMed2003

Long-term treatment of an addictive personality.

There is infrequent discussion of long-term psychotherapy of persons with addiction, particularly in the self-psychology literature. In addition, some question whether long-term psychotherapy can be helpful in severe psychiatric disorders. The author describes the treatment of a woman with multiple diagnoses, including bulimia and alcohol and drug addiction, which took place over a period of almost 7 years. These issues are addressed from a self-psychological perspective, with progression of the treatment from early facilitation of a selfobject transference to more intense selfobject transference-countertransference states. Behavioral interventions (e.g., recommendation of inpatient chemical dependency treatment) are also discussed. The author describes the patient's dramatic progress and subsequent regression. Finally, there is a discussion of the addiction from self-psychological and biological perspectives of this woman's particular developmental and treatment issues, as well as a discussion of the confrontation and limit setting in a self-psychologically oriented treatment.

Adult↗
PubMed2001

Somatization and chronic pain.

The experience of pain is related not only to tissue damage and physical illness, but also to mental phenomena including depression, anxiety and somatization. Somatization is common among chronic pain patients and presents special problems in management and treatment. Somatoform patients are often given inappropriate diagnoses, treated for non-existent depressive disorders, and exposed to multiple, superfluous investigations. Psychological models of chronic pain and somatization are presented, and treatment issues including psychotherapy and the use of antidepressants are discussed.

Antidepressive Agents↗
PubMed1986

Restraints in the treatment of a patient with multiple personality.

This paper describes a technique of voluntary, intermittent use of restraints to work through a dangerous resistance during the treatment of an angry alter personality in a case of multiple personality. A safe environment for the interpretation of the angry dynamics allowed the progress of psychotherapy.

Adult↗
PubMed2005

[Treatment and prevention for suicidal patients with severe personality disorders].

Suicide is a complex behavior of multiple, inter-related factors. The author, in this paper, discusses several issues of the psychodynamic psychotherapy for chronic suicidal patients with severe personality disorders. With regard to psychotherapy for them, the author firstly points out the treatment difficulties that stem from the training system both of psychiatry and psychotherapy where students are not systemically trained with treatment of suicidal behavior. Secondly he discusses psychodynamic evaluation, therapeutic attitude, treatment setting, counter-transference, and grief work. In terms of psychodynamic evaluation, it is suggested that a therapist needs to recognize self-maintaining function, unconscious fantasy of re-union with great pleasure, internal object relations that lead to self-destructiveness, resentment toward self, capacity for loving good aspects of personality, specific sensitiveness to certain object loss, disorganization of self representation, and ego regression. With regard to, the attitude of, the therapist and the treatment setting, the author stresses that psychotherapy should be conducted in a highly structured treatment setting with the attitude of the therapist such as active intervention, honesty (openness), awareness of treatability, and conviction. Countertransferences frequently develop based on the feelings that the therapist experiences narcissistic injury with regard to his/her own ego ideal in the psychotherapy process, in which he/she develops the various defense mechanism against the increasing aggression of his/her own. A therapist needs to be aware of the patient's dependency, make frequent interpretations of patient's destructiveness, and make effective use of the consultation at the time when he/she places himself/herself at the impasse of treatment. Finally, the author emphasizes the grief work for both therapist and family in the case when the patient unfortunately has committed suicide and open communications among therapist, other staff involved and family members should be strongly recommended. These works not only help persons concerned to work through their mourning work, but also prevent the transmission of suicides over generations.

Communication↗
PubMed1985

[Clinical picture and differentiated therapy of mental disorders in oncostomatologic diseases].

Using clinical and experimental-psychological methods, the author studied the pathogenesis of mental disturbances in patients suffering from malignant neoplasms of the maxillofacial area. Disturbances are differentiated into predominantly psychogenic and predominantly somatogenic. The article considers the mechanisms of the development of the pathological states and also possible approaches to the psychoprophylaxic and psychotherapy for each group of patients. The necessity of the participation of the psychiatrist in the multiple modality treatment of oncostomatologic patients is demonstrated.

Adaptation, Psychological↗
PubMed1988

Three group psychotherapy settings with long-term adolescent inpatients: advantages and disadvantages.

The authors describe three types of group psychotherapy settings on an adolescent service. The group setting which included all patients on the unit and employed multiple therapists and several nursing staff provided better communication, cohesiveness, and greater opportunity for staff training. Small groups provided comparatively more time for patient participation, less distraction, and better disclosure. Mixing patients from different units resulted in objective and keener observations by patients, but hall meetings became increasingly necessary to work out interpersonal issues among patients from the same unit. These observations by staff were confirmed by a patient questionnaire.

Adolescent↗
PubMed1995

Psychogenic parkinsonism.

BACKGROUND: Parkinsonism resulting from a primary psychiatric disorder has not been well characterized previously. We had been impressed that this was a rare but definite cause of parkinsonism in patients presenting to our subspecialty movement disorders clinics. OBJECTIVE: To define the clinical characteristics of "psychogenic parkinsonism" to assist in the differentiation of these patients from those with "organic" parkinsonian disorders. DESIGN: Retrospective chart reviews of patients seen at three large movement disorders centers. PATIENTS: Seven men and seven women were diagnosed as having "documented" or "clinically established" psychogenic parkinsonism after repeated assessments. RESULTS: Tremor (12 patients) was present at rest but continued without the usual transient dampening on taking up a posture and persisted with action. Tremor frequency and rhythmicity varied markedly. Tremor could often be entrained to the frequency of other movements or subsided with distraction. Rigidity (six patients) had features of voluntary resistance, often decreasing with distraction and/or activating synkinetic movements in opposite limbs. Arm swing was usually diminished or absent on the affected side; however, the arm could be held tightly to the side or cradled in front of the patient. Slowness of movement (all 14 patients) usually lacked the typical decrementing amplitude feature of bradykinesia. The slowness, ambulatory abnormalities, and postural instability (12 patients) often had bizarre, inconsistent, or incongruous features. Functional "give-way" weakness and nonorganic sensory disturbances were common (10 patients). Spontaneous remissions and remissions with placebo treatment or psychotherapy and response fluctuations related to unusual interventions were occasionally seen (five patients). Underlying psychological factors varied considerably. Most patients had been seen by several physicians and had undergone multiple unrevealing investigations. Fluorodopa F 18 (F-dopa) positron emission tomographic scanning yielded normal findings in three patients. Abnormal positron emission tomographic scanning results in a fourth patient, whose signs and symptoms had improved with psychotherapy and haloperidol therapy, emphasizes the possibility that prominent psychogenic features may be superimposed on organic parkinsonism in some patients. CONCLUSION: Psychogenic parkinsonism occurs rarely. It is a diagnosis of exclusion that should be made only by physicians with considerable experience in the care and treatment of patients with parkinsonism.

Adult↗
PubMed1980

The ethics of psychotherapy.

The author addresses the ethics of psychotherapy in terms of the interface between science and ethics, the goals of treatment, the therapeutic relationship, and special issues of confidentiality and therapist-patient sex. He considers the problems of multiple therapeutic modalities, dual allegiance of the therapist, the therapeutic use (and abuse) of power, and issues of dependency and suggests ways to maximize the clinician's exercise of ethical choices. Ethical dilemmas in psychotherapy are not entirely soluble; ultimately, the therapist, guided by his or her profession as a group, will be able to find answers to the complex problems that inevitably arise.

Confidentiality↗
PubMed1980

A multivariate analysis of long-term stay in private practice psychotherapy.

Investigated the characteristics predictive of long-term stay in private practice psychotherapy in a population of 64 "long-term" clients (remained longer than 25 sessions, mean = 47 sessions) and 88 "short-term" clients (terminated before 25 sessions, mean = 7 sessions). Data consisted of T-scores on the intake MMPI and two variables (possession of insurance coverage and use of psychoactive medication) on which long and short-term clients had been found to differ in other research. Stepwise multiple regression analysis was performed and revealed that MMPI scales 2 and 0 added to the prediction of length of stay in psychotherapy (p < .01). Insurance and medication were significant predictors only when MMPI data were not used.

Humans↗