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At least 1,153 records · Page 64Linked to original sources
PubMed2000

A double-blind comparison of fluvoxamine versus placebo in the treatment of compulsive buying disorder.

Nondepressed outpatients with a compulsive buying disorder were recruited by advertisement and word of mouth for inclusion in a controlled treatment trial. Following a 1-week single-blind placebo washout, subjects were randomly assigned to fluvoxamine (n = 12) or placebo (n = 11). Subjects received fluvoxamine (up to 300 mg daily) or placebo for 9 weeks. There were few dropouts. Outcome measures included the Yale-Brown Obsessive-Compulsive Scale--Shopping Version (YBOCS-SV), three Clinical Global Impressions (CGI) ratings, the Hamilton Rating Scale for Depression (HRSD), and the Maudsley Obsessive-compulsive Inventory (MOI). At the conclusion of the trial, 50% of fluvoxamine recipients and 63.6% of placebo recipients achieved CGI ratings of "much" or "very much" improvement, while 33% of fluvoxamine recipients were "very much" improved compared with 18% of placebo recipients (by endpoint analysis). Subjects in both treatment cells showed improvement as early as the second week of the trial, and for most, improvement continued during the 9-week study. There were no significant differences between fluvoxamine- and placebo-treated subjects on any of the outcome measures, with the exception that fluvoxamine recipients achieved greater improvement than placebo recipients on the MOI (p = .02). Adverse experiences were more frequent in the group receiving fluvoxamine, particularly nausea, insomnia, decreased motivation, and sedation. We conclude that in a short-term treatment trial of compulsive buying, subjects receiving fluvoxamine or placebo respond similarly.

Adult↗
PubMed2000

Psychophysiological assessment of compulsive gamblers' arousal to gambling cues: a pilot study.

Psychophysiological assessments measuring heart rate, systolic and diastolic blood pressure, and skin resistance level were conducted on 7 male compulsive gamblers and on 7 age and gender matched controls while both groups performed mental arithmetic and listened to individualized tapes of the gamblers' preferred form of gambling and an individualized fear tape. Heart rate responses of the gamblers to the 2 gambling audiotapes were significantly greater than those found for the controls whereas the groups did not differ on mental arithmetic or the fear provoking scene, confirming some degree of cue-specific arousal in gamblers. The other physical responses did not yield such strong results. If physiological arousal provides the motivational basis for gambling and is maintained on an intermittent schedule of reinforcement, the findings may have implications for the treatment of compulsive gambling.

Adult↗
PubMed2001

Why do people stay in hateful relationships? The concept of malignant vindictiveness.

Why do couples remain in hateful relationships? This article defines theoretically rigorous ways of viewing partners who stay together despite severe strife. A case presentation shows how a relationship of two people, each with his or her character structure and idealized image, creates interpersonal conflict because of opposing demands each makes on self and other. Such conflict requires radical defensive measures including alienation, idealization, and externalization that increase tensions. A vicious circle of malignant vindictiveness cements the relationship. Increasing implacability in the relationship is understood through Horneyan categories of interlocking idealized images, hurt pride reactions, and the externalizing process.

Compulsive Behavior↗
PubMed2002

Making sense of repetition phenomena by integrating psychotraumatology and psychodynamic psychotherapy.

Psychotherapy and psychotraumatology share a preoccupation with repetition phenomena, manifested as transference, compulsions to repeat, or intrusive reexperiencing. Terminological diversity obscures compelling similarities between these repetition phenomena and discourages speculation about processes involved in their genesis. This paper remedies these oversights by integrating recent empirical evidence pertaining to memory with European intellectual traditions embraced by its pioneering dynamic psychotherapists. Using dreams as a prototype repetition, the phenomenological diversity of repetition phenomena is shown to be reconcilable with current evidence about memory encoding, storage, and retrieval. Differences in persistence, intensity, pervasiveness, and treatment resilience of repetition phenomena are explained using concepts derived from psychological and biological sciences. Implications for psychotherapeutic theory, practice, and evaluation are considered.

Compulsive Behavior↗
PubMed1998

Treatment refractory schizophrenia: how should we proceed?

A substantial portion of schizophrenic patients demonstrate suboptimal response to conventional antipsychotics. These agents are primarily effective in the treatment of psychotic symptoms; their efficacy in other domains of psychopathology such as negative symptoms, chronic aggressive behavior, and cognitive deficits, is limited or non-existent. In this group of refractory patients, the novel atypical antipsychotic clozapine has demonstrated robust efficacy, with response rates approaching 60% after twelve weeks of treatment. Efficacy of clozapine extends to symptom domains other than psychosis, including negative symptoms, mood stabilization, aggressive behavior and compulsive water drinking. Several novel agents, each of which shares some, but not all, of the preclinical and clinical characteristics that make clozapine so unique, have been introduced in the last 4 years. These agents demonstrate a broader spectrum of efficacy and an improved side effect profile in non-refractory patients. Initial data on their efficacy in refractory patients suggests that olanzapine does not achieve overall superior efficacy in this patient population compared to conventional agents although there is some evidence of relatively greater efficacy in negative symptoms and aggressivity. Several studies suggest that the efficacy of risperidone is superior to that of conventional agents in refractory patients. Preliminary conclusions are not possible for quetiapine because of a paucity of data in the literature. The literature supports a risperidone trial prior to a clozapine trial in a treatment algorithm for refractory patients because of its more favorable risk/benefit profile.

Antipsychotic Agents↗
PubMed1997

Perfectionism, perceived weight status, and bulimic symptoms: two studies testing a diathesis-stress model.

Among a total of 890 women from 2 separate nonclinical samples (1 collected in 1982 on college undergraduates, n = 435, and 1 collected in 1992 on women who were in college in 1982, n = 455), the authors tested a diathesis-stress model of the interrelations of perfectionism, perceived weight status, and bulimic symptoms. The authors predicted and found that perfectionism served as a risk factor for bulimic symptoms for women who perceived themselves as overweight but did not serve as a risk factor for those who did not perceive themselves as overweight. Perceived weight activated perfectionism as a predictor of bulimic symptoms; actual weight did not serve the same role. These findings are discussed in the context of recent clinical and social psychological theory regarding development of bulimic symptoms.

Adult↗
PubMed2006

A cluster analysis investigation of workaholism as a syndrome.

Workaholism has been conceptualized as a syndrome although there have been few tests that explicitly consider its syndrome status. The authors analyzed a three-dimensional scale of workaholism developed by Spence and Robbins (1992) using cluster analysis. The authors identified three clusters of individuals, one of which corresponded to Spence and Robbins's profile of the workaholic (high work involvement, high drive to work, low work enjoyment). Consistent with previously conjectured relations with workaholism, individuals in the workaholic cluster were more likely to label themselves as workaholics, more likely to have acquaintances label them as workaholics, and more likely to have lower life satisfaction and higher work-life imbalance. The importance of considering workaholism as a syndrome and the implications for effective interventions are discussed.

Adult↗