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At least 1,009 records · Page 56Linked to original sources
PubMed1997

General principles of self psychology: a position statement.

In the more than twenty-five years since Kohut formulated a psychology of the self, the basic theory has undergone many revisions and additions. In the course of broadening from a focus on narcissism and empathy into a general theory of normal and pathological development, self psychology has taken so many different directions that the question can be asked, Does self psychology remain essentially a single theory with different descriptors--a theory of a self-selfobject matrix, a theory of intersubjectivity, a theory of motivational systems, and so on? A concise statement of general principles is intended to contribute to a dialogue between advocates of the views presented here and those who hold different views of theory and practice, within and withoutself psychology.

Adolescent↗
PubMed1997

Determinants of general practitioner recognition of psychological problems in a multi-ethnic inner-city health district.

BACKGROUND: With few exceptions, evaluation of the capacity of general practitioners (GPs) to recognise psychiatric disorder in their patients has failed to consider the role of ethnic diversity in the consultation process and whether such knowledge can improve understanding of the degree to which psychiatric morbidity is recognised within GP settings. METHODS: This research was completed in five general practices representative of all those within an inner-city health district. Psychiatric morbidity in patients consecutively attending the practices was then assessed using the General Health Questionnaire; in addition, GPs were asked to complete a checklist of current problems identified during each consultation. RESULTS: Analysis suggested that Asian and Black patients were less likely than White patients to have psychological problems identified; that social problems and a psychiatric history facilitated recognition; and that current physical illness hindered recognition. CONCLUSIONS: GP recognition of psychological problems varies according to patient ethnicity but can be substantially masked by both the physical and social circumstances of patients at consultation.

Adolescent↗
PubMed1999

Links among theory, research, and practice: cornerstones of clinical scientific progress.

Discusses how explicit links among clinical theory, research, and practice are necessary if a clinical discipline is to survive in the managed care marketplace of today. Robust links among theory, research, and practice enable the elaboration of a systematic body of clinical knowledge that is practical in its deployment, effective in its methods, and compelling in its rationale. Moreover, theoretical advances are increasingly necessary, in that they allow scientists to categorize and prioritize the growing amount of empirically derived information, determine how pieces of multilevel data fit together, identify knowledge gaps, and set priorities for future studies. As shown by some of the articles in this special section, evolving theories of behavior have several characteristics in common; namely that they are developmental, transactional, contextual, adaptational, multilevel, and multidetermined. Concerns may be raised, however, as to whether current research methods are fully adequate to test these newer, more complex, multilevel theories or the clinical phenomena they seek to characterize. To address these difficulties, as well as to increase the pace of scientific advances that may result from propitious links among theory, research, and practice, I offer several recommendations to clinical psychology in general and to clinical child psychological research in particular.

Adolescent↗
PubMed1995

The clinical boundaries of posttraumatic stress disorder.

Three sets of clinical boundaries exist for posttraumatic stress disorder (PTSD), as for all concepts of psychiatric disorder. The first involves the border with normal psychology in general, and with the normal psychology of stress response in particular. This boundary can be surveyed from a number of vantage points and the maps which result will not necessarily correspond. The second boundary issue involves internal boundaries between psychiatric disorders, specifically between PTSD and other concepts of disorder. The high level of comorbidity documented in PTSD has ensured that this aspect of boundary setting is particularly contentious. The third set of boundaries is concerned with subtyping within the global construct of PTSD. The validity and extent of subtyping would be based on the degree to which phenomenological differences exist in relation to PTSD syndromes occurring in the wake of certain types of traumatic events. Such clinical subtyping might however need to be buttressed by external validity indicators such as differential treatment responses or outcome. A final boundary issue of major significance to therapists involves the need to place oneself unambiguously on the side of the trauma survivor in the struggle to resolve the traumatic experiences. The pivotal position of PTSD in the psychopathological arena is discussed.

Adaptation, Psychological↗
PubMedDate not supplied

General hospital suicides--a psychological autopsy study in Finland.

Although both severe medical disorders and mental disorders are established risk factors for suicide, it is not known if patients who commit suicide in general hospitals differ from others. This study investigated current mental disorders and other clinical characteristics among general hospital suicide victims and compared them with other suicide victims in an unselected nationwide population. Drawing on data from a psychological autopsy study of all suicides (N = 1397) in Finland during one year, all suicides committed by patients in a general hospital setting were identified. Retrospective DSM-III-R consensus diagnoses were assigned and general hospital suicide victims were compared with other suicide completers in terms of clinical characteristics. Twenty-six general hospital suicide victims, 1.9% of all suicides, were identified. Subjects who completed suicide during general hospital treatment were older and used more violent suicide methods than other suicide victims. One or more diagnoses of psychiatric (Axis I) disorders were assigned for 88% of the general hospital suicide victims. Overall, the most prevalent disorder was major depression, which was more common among the general hospital suicide victims, even when age was controlled for. The findings of this study suggest that most people who commit suicide during a spell of general hospital treatment suffer from current mental disorder, as do suicide victims in general. The recognition and treatment of major depression in particular should be improved in order to prevent suicide in general hospitals.

Diagnostic and Statistical Manual of Mental Disord↗
PubMed1963

PREDICTION OF DISCRIMINATION FROM GENERALIZATION AFTER VARIATIONS IN SCHEDULE OF REINFORCEMENT.

The relationship between generalization and discrimination is explored in the present study by utilizing the results of systematic changes in the generalization gradient to predict changes in discrimination behavior. In the first of two experiments, differing groups of pigeons were trained to respond to a wavelength of 550 mmicro under conditions of varying schedules of reinforcement. Generalization gradients were then obtained and the ratios of the responses to selected discriminative stimuli calculated. These were used to predict discrimination behavior in a second experiment using the same stimuli. Both the number of trials to a discrimination criterion and the ratio of response indicate the plausibilty of an inverse hypothesis, and the applicability of the generalization model to related behavior such as discrimination.

Animals↗
PubMed2006

Psychological effects of repeated general anesthesia in children.

BACKGROUND: Although methods for reducing preoperative anxiety have been a major interest of pediatric anesthesiologists, there are no reports of the effects of repeated anesthesia on psychological development of children. METHODS: To determine the overall effect of multiple anesthetics on the psychology of children, we undertook to compare the children undergoing repeated anesthesia (Group S) for the treatment of corrosive esophagitis with a control group (Group C) with chronic renal disease and frequent hospital admissions. Psychological tests and diagnosis of children Group S (n = 23) were compared prospectively with Group C (n = 20). All children had been appropriately treated over the previous 5 years and 50% of patients in Group C had general anesthesia once and those in Group S underwent at least 5 GAs. Parents completed a child behavior checklist (CBCL) and Marital Conflict Questionnaire; the children were evaluated by a child psychiatrist using DSM-IV criteria and completed the Child Depression Inventory (CDI). RESULTS: The children in Group S underwent a total of 251 (11 +/- 7) GAs over 4-60 months. The incidence of psychopathology was nine and 10 children in groups S and C, respectively. The CBCL and CDI scores were parallel with a psychiatric diagnosis. Marital conflict scores were higher in Group S. CONCLUSIONS: Both chronic disease states affect psychology of children. Repeated anesthesia in addition to chronic disease does not seem to disturb the child's psychological health further when tentative and precautious approach modalities are undertaken.

Adolescent↗