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[Combined therapy for a compulsion neurosis (author's transl)].
Within the scope of the care of mother and child arranged according to behaviour therapeutic and playtherapeutic aspects, manifest fears of separation of a 6 year old, normal talented girl, could be largely reduced after ten meetings. The repeated occurrence of the primary symptoms after a longer, exclusive stay of the patient in her family, confirms the belief, that the striking behaviour of the girl does not express a starting psychotic process but points much more to the symptom-releasing and -reinforcing effect of the family environment. It is planned to continue the treatment in a family-therapeutic way.
[Complex treatment of obsessive states of different etiology].
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[Obsessive thinking and delusion (analogies and differences)].
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Helping the hypochondriac.
Hypochondriasis can be reliably identified and requires a particular therapeutic approach by the family physician. These difficult patients are usually women over 40 with a chronic history of medical work-ups without significant findings, pride in suffering and self-sacrifice and a conviction of being ill which is essential for their self-esteem. To dismiss or confront this conviction results in a drain on medical services, while a supportive approach benefits both physician and patient.
[Prolonged exposure (flooding) in phobic and obsessive compulsive patients: 21 cases (author's transl)].
A first appraisal of 21 patients with phobic (n = 15), obsessive-compulsive (n = 5) and bereavement problems (n = 1) is carried out after a flooding procedure (prolonged exposure). One case is reported in detail. The actuarial rate of improvement amounts to 73% at a follow up between 6 and 9 months. The failures and relapses take place in the first month following the treatment. Two psychotic subjects show a significant improvement. The importance of the patient's expectations and motivation and the interpersonal aspects are underlined.
[Case of trichotillomania in a girl].
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[Some therapeutic aspects of obsessive-phobic neuroses].
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[Obsessional neurotic trends in Hieronymus Bosch's paintings].
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Use of neurosurgery for psychological disorder in British Isles during 1974--6.
All 44 neurosurgical units in the British Isles replied to a postal questionnaire asking about their use of neurosurgery during 1974--6 for functional mental illness. A total of 431 operations was reported, representing a yearly rate of 3.4 operations per million population aged over 15. The numbers of operations declined from 158 in 1974 to 119 in 1976. Four units did two-thirds of the operations. Stereotactic methods for locating the site for the lesion were used in two-thirds of procedures. Mood disorders, anxiety states, and obsessive-compulsive neurosis were the conditions most commonly treated.
Obsessive-compulsive neurosis, anancastic symptomatology and ABO blood types.
Determinations of ABO blood types was carried out in 38 patients with obsessive-compulsive neurosis, 48 schizophrenics with anancastic symptomatology, 31 depressives with anancastic symptomatology, 260 schizophrenics free of anancastic symptomatology and 65 depressives free of anancastic symptomatology. Results were compared with a representative sample of the general population. The findings of the present study provide evidence of an association between obsessive-compulsive neurosis and phenotype A, whilst a similar association between ABO blood types and anancastic symptomatology occurring in the course of psychotic disorders was not found. The significance of these findings is discussed with regard to current diagnostic and aetiological issues in obsessive-compulsive neurosis.
The Hopkins Symptom Checklist (HSCL)--factors derived from the HSCL-90.
A factor analysis of the 90-item version of the Hopkins Symptom Checklist, performed on the pretreatment self-ratings of nonpsychotic outpatients with symptoms of depression and anxiety, revealed the presence of 8 clinically meaningful factors. These eight orthogonal factors each contained at least 5 items with loadings above 0.40 and explained 4.5% or more of the matrix variance. They were labeled Somatization, Phobic-Anxiety, Retarded Depression, Agitated Depression, Obsessive-Compulsive, Interpersonal Sensitivity, Anger-Hostility and Psychoticism.
The Minnesota Multiphasic Personality Inventory in predicting response to pharmacotherapy of neurotic outpatients.
The utility of the Minnesota Multiphasic Personality Inventory (MMPI) in predicting treatment response to pharmacotherapy for a group of 54 anxious and 43 depressed outpatients was examined. Discriminant function analyses using the MMPI scales were conducted on groups of improved and unimproved patients. Several significant function, as well as zero-order, differences were found. In general, improved patients scored significantly lower on scales reflecting depression and obsessive-compulsive or schizoid tendencies. They also obtained lower scores on scales measuring interpersonal sensitivity and suggestive of character traits such as low frustration tolerance, impulsivity, and resentment toward authority figures. Additional analyses in which several different profile types were compared for treatment outcome revealed few differences among groups.
On the psychology of the aging woman. Depression in late mid-life: change or repetition? Another chance for working through.
A woman of 58 came for psychotherapy for the first time suffering from a depressive reaction precipitated by two mid-life events: the marriage of her daughter and the realization that her own cherished marital dream would never be fulfilled. She had postponed coming to terms with the disappointments of her marriage as long as she had had other objects. When these objects were lost, and the distance she had maintained to handle her feelings was threatened, she sought help. There was suggestive evidence that a collusive marital system had sustained an unsatisfactory relationship for 35 years. Her husband was described as an obsessive-compulsive character. His traits were both needed, feared, and resented by the patient, representing the rejected part of herself and aspects of her hated grandmother. Mrs. A. had character traits and a developmental history which supported a diagnosis of primitive hysterical personality. (This type has been described by Zetzel (1968) as "the so-called good hysteric.") The paucity of object relationships in her life, her poor work habits, her inability to tolerate affects were striking. The patient had identified with a pathological mother in a family dominated by rejecting and depreciating attitudes. The patient's use of the defense mechanisms of splitting, projection, and withdrawal as ways of dealing with ambivalence significantly interfered with her self-object differentiation and her capacity for intense emotional or physical intimacy. She could only love men whom she rescued or protected, a pattern consistent with the fact that she could not relate to equals or superiors. Yet she was unable to draw on a good identification with a nuturing mother, so as to really be able to give. There was too much hurt and uncontrolled anger when she was in the superior position with the kind of man who could not meet her dependency needs. Feeling unprotected, she had married a "strong" man, who she expected would meet her narcissistic and dependency demands. He was inhibited and controlled and could neither need nor be needed by her during his active work life. This led to immediate disappointment of her conflicting conscious and unconscious expectations. She wanted him to be strong and ideal, yet to need her and never oppose her. Hence, there was a failure to establish a mature or satisfying marital relationship. She turned to her children for comfort, particularly her daughter, becoming depressed when her daughter married. She found gratification by staying busy tutoring and teaching underprivileged children. In the course of treatment her depressive symptoms disappeared. She felt hopeful, capable of being believed in, and able to cope as a result of the therapist's functioning as her uncritical ally. After she resumed living with her husband she began to acknowledge an ambivalence toward her cherished, confidante daughter and in some ways reversed her previous splitting of husband and daughter. The mean husband became a kindly saint and the darling daughter became a critical, spiteful queen...
Cerebral lateralization and personality style.
Hysterical and obsessive-compulsive style subjects, as determined by a modified Rorschach test and the Wechslar Adult Intelligence Scale Comprehension subtest, were questioned in a face-to-face format where lateral eye movements were surreptitiously observed. Only right-handed subjects were used. It has been argued that lateral eye movements index immediate hemispheric activation after questions--the first such eye movement being a direction opposite to the putatively activated hemisphere. There was significantly more left-looking among the hysterical subjects than among the obsessive-compulsive style subjects.
Therapist-controlled exposure in vivo versus self-controlled exposure in vivo a comparison with obsessive-compulsive patients.
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Psychophysiological responses in obsessive-compulsive patients.
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