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PubMed2000

[Not Available].

The intention of the study is the empirical differentiation between "mature" and "immature" (borderline-) hysterics. 366 inpatients of the Department of Psychoso-matic Medicine of the Central Institute of Mental Health in Mannheim (university of Heidelberg) were diagnosed with regard to the existence of hysterical personality traits. 146 patients shared the criteria of the DOPSY-system for hysteria. This group was divided by assistance of the Bordcrlinc-Syndromc-Index (BSI) into a subgroup of n = 79 "mature" and a subgroup of n=67 "immature" Borderline hysterics. The distri-bution was validated by the Freiburger Personality inventure (FPI). Both groups are similar referring to age, gender and schooleducation. On the level of symptomatology we found the same feature of diagnoses in the area F40-45 in the ICD-10. Two third of the patients with hysterical personality traits have got an additional classification of personality disorder, but only 48% in the group of mature hysterics and 37% in the group of immature hysterics were classified by experienced psychoanalysists as his-trionic personality disorder (F60.4, ICD-10). With respect to risk factors in the life history we found that mature hysterics much more often were characterized by a loss of father in the first three years and the position of the eldest (and sometimes only) child. The results pointed to distinct developmental lines, which suggest, that the two hysterical groups can be differentiated by the style of coping and defense.

Biography↗

PubMed1988

Characteristics of fatal gunshot wounds in the home in Oklahoma: 1982-1983.

Children are a unique group at risk of injury from firearms because of their immaturity, curiosity, and imitative behavior. All unintentional firearm deaths in persons younger than age 20 years that occurred in Oklahoma in 1982 and 1983 were reviewed. There were 32 unintentional deaths from firearms in children from birth to age 19 years. The death rate in rural counties was four times that of urban counties. Twenty-seven deaths (85%) occurred at home, with an adult present in only two cases. The home death rate for males was 5.2 times that of females, with 15- to 19-year-old males most at risk. The rates among whites and Native Americans were similar, at 1.5 and 1.2 per 100,000, respectively, with no deaths among the black population. This review concurs with previous studies that firearms are a significant cause of mortality in the pediatric age group. Counseling parents about the hazards of firearms may prevent deaths through better supervision and more responsible gun care and storage.

Accidents, Home↗

PubMed1978

Hepatitis A virus infection: new insights from seroepidemiologic studies.

The prevalence of exposure to hepatitis A virus (HAV) increases with increasing age; decreases with increasing socioeconomic class; increases with increasing serologic evidence of prior hepatitis B virus (HBV) exposure but is much more common than HBV exposure; is independent of sex and race; varies in different parts of the world as a function of hygienic, developmental, and unrecognized geographic factors; and is not affected by immune deficiency or immaturity. Transmission of type A hepatitis is enhanced by poor personal hygiene such as that seen in institutions for the mentally retarded. On the other hand, there is no increased exposure to HAV among homosexuals, who have frequent and intimate contact with multiple sexual partners; among hemodialysis patients and staff; or among multiply transfused individuals, all of whom are at significantly increased risk of exposure to HBV. No epidemiologic evidence has confirmed the existence of viremic or intestinal carriers of HAV, and the virus is rarely, if ever, spread by parenteral mechanisms. Finally, HAV appears to play no role in chronic liver disease and a very minor role in fulminant hepatitis; however, HAV is responsible for a sizable proportion (approximately 20%--40%) of sporadic hepatitis among urban adults.

Age Factors↗

PubMedDate not supplied

[Psychological aspects and essential arterial hypertension].

UNLABELLED: In addition to organic and hereditary factors, psychological variations among individuals are also known to play an important role in the etiology of essential arterial hypertension. OBJECTIVE: To investigate in detail the psychological processes possibly involved in the etiology of essential arterial hypertension. METHODS: A group of 20 subjects, all of whom where diagnosed as suffering from essential arterial hypertension, was studied using psychological interviews and the Rorschach Test. The results obtained were compared with those gathered from normal (non-hypertensive) individuals represented by the Rorschach Test for the Brazilian population. RESULTS: In terms of personality structure, the hypertensive group presented signs of subjective and immature mechanics which prevailed over more mature and adult traits. These characteristics lead the patients to emotional withdrawal as a defense inadequate affectivity. CONCLUSION: The blocking of emotional expression, as well as simultaneous anxiety, may affect the autonomic nervous system and lead to periodic transitory hypertensive crises which, with time assume a permanent nature.

Adult↗

PubMed1976

Human figure drawings by children with Duchenne's muscular dystrophy.

Seventy-two human figure drawings by forty-three patients who had a diagnosis of Duchenne's muscular dystrophy were examined. The study includes a description of these human figure drawings according to eleven emotional indicators and according to directionality quadrants. When the human figure drawings were used as a projective tool, four personality traits of some of the children were identified: physical inadequacy, immaturity, body anxiety, and insecurity. Both the emotional indicators and the quadrant in which the figures appeared were examined in relation to stages of the disease process to see if the human figure drawings of the children might reflect more stress and anxiety at a particular stage of the disease. Suggestions for improvements and recommendations for future study are given.

Adolescent↗

PubMed1992

Narcissism and object relations.

Questionnaire measures of the narcissistic personality disorder can predict healthy and unhealthy self-functioning. That this outcome might support Heinz Kohut's psychoanalytic psychology of the self was tested in a sample of 354 undergraduates. In canonical correlations, factors from the Narcissistic Personality Inventory were associated more strongly with grandiose than with idealizing immaturities in Kohut's bipolar self, while difficulties in interpersonal relationships (i.e., poor object relations) were associated more strongly with idealizing deficits. Zero-order and partial correlational data were congruent with Kohut's hypothesis that self-grandiosity can include elements of both "pathology" and relative mental health, but canonical correlations did not support Kohut's claim that narcissism can be described in a bidimensional self-structure.

Adolescent↗

PubMed1976

Psychological adaptation to jejunoileal bypass for morbid obesity.

Psychological adaptation to jejunoileal bypass procedures in 34 morbidly obese patients was evaluated preoperatively and followed postoperatively for an average of 23 months. Preoperative emotional disturbances were mainly those of mild personality disorders with passive-aggressive, passive-dependent, and emotionally immature traits. Following discharge from the hospital, nine patients (or 24 per cent) developed psychiatric difficulties, characterized by either increased neurotic symptoms and interpersonal problems, or the emergence of psychosis. Male patients and those with the greatest weight loss were statistically more likely to have psychiatric complications. The remaining patients expressed satisfaction with the operation, noted relief from the burden of dieting, experienced less excitement associated with eating, and felt more self-confident and hopeful.

Adaptation, Psychological↗

PubMed1992

Psychological appraisal and emotional response to physical injury: a clinical, phenomenological study of 109 adults.

We studied the cognitive, emotional and behavioral responses at four points of time in a random sample of 109 accidentally injured adults via audio taped semistructured interviews and self-assessment rating scales. Neither the subjects appraisal of death or disability, nor the emotional responses corresponded strongly to the severity of the physical injury sustained or the "objective" threat to life but, instead, reflected, to a large extent, the personal meaning of the injury or the accident. Dissociative responses reported by 17 persons were of short duration and associated with young age and immaturity, and did not predict or a poor longterm post-traumatic psychiatric course. Ratings of intrusion, avoidance and anxiety were more strongly associated with psychopathology than "objective" danger or injury severity. This study indicates that following civilian trauma, the cognitive, emotional and behavioral responses are strongly related to preaccident and accident-independent life circumstances. The findings question the validity of the DSM-IIIR criterion of stressors of PTSD in civilian accidents, and suggest that post-traumatic mental disorders should be evaluated in much the same way as psychiatric disorders after physical illness.

Accidents↗

PubMed2001

[Psychological aspects of treatment of patients with head and neck cancer].

One of the basic components that describe treatment success in contemporary oncology is patients' quality of life (QL) depending on specificity of the disease, treatment method, side effect of treatment, the medical prognosis and patient expectations. In reality, the QL is determined by the difference between patients' expectations and the actual health condition. The bigger the difference, the worse the evaluation of QL. Solving the crises, stress situation and starting life in a new way are strictly connected with the reshaping of personality and formation of adequate skills. It means it is necessary to create a new "picture of oneself", "self image" appropriate to the actual health condition and find the optimum way of activating personality protecting system (defence mechanisms). This task is not easy to realise; it is often necessary to introduce the psychotherapy to make it work. The main aim of defence mechanisms is the reduction of fear and other negative emotions, typical for oncological patients. However, the immature and poor defence system of "ego" can, at the same time, protect the personality unity and result in harmful behaviours. But when the "new self image" is made real, the newly learnt personality defence mechanisms are more mature, the patient becomes able to fight with the disease, is able to face the reality, which constitutes the main factor in the increase of QL assessment. To estimate the influence of psychotherapy on QL of head and neck cancer patients we have planned the introduction of psychological intervention (meetings of therapeutic groups).

Defense Mechanisms↗

PubMed1981

A predictive approach to the study of manifest content in suicide notes.

Involved the deduction of 30 protocol sentences; 10 each for the theories of Binswanger, Freud, and Kelly. Naive judges noted the incidence of contents that corresponded to the protocol sentences in 33 genuine and 33 simulated notes. A coefficient of concordance of .70 indicated adequate interjudge reliability. Only the protocol sentences derived from Freud discriminated as a set in favor of the genuine notes. Statements that indicated loss and an identification with a lost person were found more frequently in genuine notes. Statements of isolation, immaturity and desires for freedom more frequently characterized the simulated notes. Implications of the results are discussed.

Humans↗

PubMed1998

The relationship between defense styles and personality disorders.

The relationships between personality disorder clusters and defense mechanism factors were evaluated in 31 female and 24 male psychiatric inpatients from an urban hospital, who ranged in age from 19 to 57 years. The degree to which defense factors predicted personality disorder psychopathology was assessed, with gender entered as a covariate. The degree of borderline psychopathology had the strongest relationship with the Immature defense style (F(1,54) = 9.83, R2 = .54, p < .05). The results support previous research demonstrating a stronger link between Borderline personality disorder and defense styles relative to other personality disorders.

Adult↗

PubMed1996

[Study of the role of parents' occupation in children's mortality].

This study have been carried out to: a) investigate the prevalence of such occupational factors in parents which could be fatal to their children, and b) evaluate quantitatively the risk of mortality in infants caused by some leading diseases developed as a result of harmful occupational factors to which their parents had been exposed. During this work the data bank on infant mortality in Tallinn based on deaths registration in city archive for period 1968-1992 has been created. This bank includes the data on parents' occupation. The prevalence of parents' occupational risk factors has been analyzed in infants who die due extreme immaturity and other prematurity cases, congenital anomalies neoplasias and control group persons. To evaluate the death risk in children the case-control epidemiological study with the individual group selection has been performed. This pilot analytical epidemiological study allows to suppose involving of possibly harmful occupational factors which are playing a certain role influencing mortality in whole contingent investigated, but not concerning individual nosologic forms. For the final judgement concerning the role of occupational risk factors the additional special fundamental study including the extended number of observations and the data, on interrupting nonoccupational risk factors prevalence should be carried out.

Adolescent↗

PubMed2005

Psychological distress and personality traits in early rheumatoid arthritis: A preliminary survey.

OBJECTIVES: To investigate psychiatric manifestations, personality traits, and ego mechanisms of defense involved in early rheumatoid arthritis (RA). METHODS: Twenty-two unselected early RA outpatients with disease duration less than 1 year participated in the study. The majority of participants were females (72.7%), married (81.8%), aged 51.0+/-14.6 years. Thirty-four subjects matched for age, sex and educational level served as "healthy" controls. General Heath Questionnaire, Symptom Distress Checklist, Defense Style Questionnaire and Hostility and Direction of Hostility Questionnaire were used; disease activity was estimated by disease activity for 28-joint indices score. RESULTS: Seven patients (31.8%) presented psychological distress scores indicative of possible psychiatric caseness, expressing obsessive-compulsive symptoms and depression, as compared to six (17.6%) of controls. Social dysfunction distress and somatization were prominent psychiatric manifestations in early RA group. Early RA patients tend to adopt a less adaptive defense style than controls. Although disease activity was not correlated to psychological distress, a significant association between disease activity and patients' defensive style was observed: as the disease is exacerbated, there was a shift from "non-adaptive" to "immature image distorting or borderline" defense style, suggesting a rather fragile underlying personality structure. CONCLUSION: Psychological distress is a relatively common experience in early RA. Social dysfunction, along with the less adaptive defense style, which under the stress of the disease exacerbation turns to "borderline", underlines the importance of a careful assessment and consultation in early RA patients in order to face the distress shortly after diagnosis and highlights potential risk factors for future adaptation to exacerbations of the disease.

Adaptation, Psychological↗

PubMed1995

Defense style in personality disorders. An empirical study.

Do patients with DSM-III-R axis II diagnoses use defenses thought to be specific to personality disorders, such as omnipotence, devaluation, splitting, and projective identification? Thirty-one psychiatric outpatients with personality disorders, 42 neurotic outpatients, and 353 community controls completed the 88-item Defense Style Questionnaire. Factor analysis yielded four factors (defense styles). One of them consisted of omnipotence, devaluation, splitting, denial, isolation, and projective identification, defenses considered as typically "borderline" (Cronbach's alpha = .72). The personality disorder group scored significantly higher on the borderline defense style than did the other two groups. The other defense styles (mature, immature, and neurotic) did not differentiate between the patient groups, but the mature and immature styles did distinguish between patients and healthy controls.

Adult↗

PubMed2004

Vulnerability to post-traumatic stress disorder and psychological morbidity in aged holocaust survivors.

OBJECTIVE: Although high rates of post-traumatic stress disorder (PTSD) and psychological morbidity have been consistently reported in Holocaust survivors (HS), reports are inconsistent about which factors are associated with psychological morbidity. In a study of the oldest HS cohort yet reported, we aim to clarify why this variability exists by examining factors associated with PTSD and psychological morbidity, including for the first time measures of personality and defense mechanisms. METHODS: One hundred HS randomly selected from a convenience sample of 309 respondents to a survey of Jewish persons aged 60 years and older living in the community in Sydney were assessed using the following instruments: demographics, severity of trauma experienced, General Health Questionnaire (GHQ-28), PTSD diagnosis (DSM-IV), Brief Psychiatric Rating Scale, Impact of Events Scale, Defense Style Questionnaire, modified Eysenck Personality Inventory. RESULTS: Older age, experience of more severe trauma, use of immature defense mechanisms and higher neuroticism were associated with significant PTSD and psychological morbidity; severity of trauma was associated with PTSD and with more severe psychological morbidity. CONCLUSIONS: A profile of survivors at-risk can be identified that may have application to survivors of more recent holocausts. Late life may be a period of vulnerability in the aftermath of severe trauma.

Female↗

PubMed1999

Personality, personality disorders, and defense mechanisms.

The prototype approach was used to assess the presence of personality features associated with borderline, narcissistic, histrionic, and psychopathic personality syndromes in a sample of 91 young adults from the Block and Block (1980) longitudinal study. These personality prototypes were found to be related to the use of denial and projection, and especially to the immature manifestations of those defenses, in ways consistent with theory.

Adult↗

PubMedDate not supplied

Lifetime comorbidity of alcohol dependence in women with bulimia nervosa.

To determine how women with comorbid bulimia nervosa and alcohol dependence differed from those with bulimia nervosa alone, 114 women with DSM-III-R bulimia nervosa were assessed at intake for a randomized clinical trial with structure diagnostic interviews and psychometric instruments. The sample was divided on the basis of the presence (47%) or absence (53%) of lifetime alcohol dependence. Axis I and Axis II disorders, clinical features of bulimia, and personality and temperament characteristics were then compared. Women with comorbid alcohol dependence and bulimia nervosa reported a higher prevalence of suicide attempts, anxiety disorders, other substance dependence, conduct disorder and personality disorders (especially borderline and histrionic), and higher scores on novelty seeking, impulsivity, and immature defenses. There were few differences in the severity of bulimic symptoms. Findings revealed that women with comorbid bulimia nervosa and alcohol dependence bear a greater burden of Axis I and Axis II psychopathology and display greater symptoms of impulsivity and novelty seeking.

Adolescent↗

PubMed1995

[Cognitive and affective characteristics of children with malformation syndrome].

The aim of this paper is to study the psychological and relational aspects in children suffering from specific malformative syndrome and precisely Down s., Sotos s., X-Fragile s. and Williams s. Indeed literature provides much data related to the phenotype, to the organic-biological characteristics, but little or nothing is known about the affective structure, the episodes and to the particular dynamics that emerge in he relation between the parents and the malformed child. A protocol was applied to our sample group (16 subjects). This protocol includes laboratory and instrumental tests (chromosome test, neurometabolic screening, EEG, CT or cranial MRI, cardiac and abdominal ultrasonography, ear and eye test) aspects. This evaluation is carried out through the proposal of standardized situations (psychometric tests) and a use of a freer observational setting. This permits us to understand how the child perceives himself the awareness and the image he has of himself and how able he is to integrate his illness experiences and his way of relating with the environment. The data of our observations are thus used to compile a grill for the structural diagnosis of the personality. Besides, this evaluation is flanked by the observation of the family in order to explore the psychological image that parents have of their child, his character, his good points, his bad points, his similarities, how he relates to them, any educational problems and the emotional reaction that the communication of the diagnosis has raised in them. The videotaped observations are subsequently evaluated through the application of a grill for the study of the mother-child relationship. The results obtained from the psychological research underline a reasonable heterogeneity both of the intellectual level and of the metapsychological profile. Twelve subjects were mentally retarded (5 with mild mental retardation, 7 with moderate mental retardation); the remaining 4 had a normal cognitive development (3 with Sotos s., 1 with Williams s.). Psychological disturbances are present and thus divided: light disturbances (affective immaturity, neurotic-depressive organisation) in 11 subjects. Average disturbances (dysharmonious structure, and borderline personality) in 4 subjects; severe disturbances (psychosis) in 1 subject. Besides, above all in the group of subjects with X-Fragile s. and Down s., the tendency to assume behaviour of a regressive type, also postural, emerges. Among the 4 groups it is frequent to resort to defence mechanisms of hypomaniac type, accompanied by the denial of the patient's "sick parts". Another common characteristic concerns the quality of imaginary life which is shown to be repetitive and stereotype in content. Indeed these children's play activity characterized by a limited capacity of symbolization. Instead, when the symbolic process is more developed, contents concerning a deteriorated and destructive image of the Self emerges. Through the evaluation of family dynamics what is more noticeable is that the parent-malformed child interaction appears to be quite nonstimulating and noninvolving or incoherent, lacking in harmony and empathy towards the child's inner world. Indeed we can notice a lack of both verbal and extraverbal exchange of communication and brief interactive sequences which do not usually take into account the child's proposals and an affective tonality of depressive and nonaffective type. Therefore it may be concluded a certain smoothness in the clinical expression of the syndromes considered, both as far as the cognitive deficit entity and the psychic problems are concerned. Referring to the interactive dynamics between parents and children with dismorphic syndrom it seems that the child's pathology becomes the organizational summit of the above-mentioned relational dynamics among most of the patients examined...

Child↗