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At least 19 recordsLinked to original sources
PubMed1976

Sexual attitudes and behavior patterns in a middle-class adolescent population.

Sexual activities and attitudes of a group of adolescents, who have been followed from early infancy as a part of the New York Longitudinal Study, are reported. Adolescents in the study evince a more matter-of-fact, less fearful attitude than that of previous generations, but do not seem more prone to casual sexual encounters. Sexual conflicts are seen to occur only in relation to overall psychological conflict.

Adolescent↗
PubMed1978

Hemodynamic factors and Rorschach testing in borderline and sustained hypertension.

Hemodynamic parameters and the Rorschach test were performed on 48 borderline and 64 sustained essential hypertensive patients, and compared with 33 normal subjects. Hemodynamic patterns suggested (1) in borderline hypertensives, a neurogenic hypertension, and (2) in sustained hypertensives, a volume- and renal-mediated hypertension. Repeat hemodynamic determinations were performed on 35 borderline hypertensives after a 47 +/- 3-month follow-up survey. The results confirmed that, in the same patient, hypertension was successively neurogenic and volume-mediated. The results of the Rorschach test in the overall hypertensive population pointed to an incapacity to form a structured neurosis because of the lack of a fantasy life, and an inadequacy of the mechanisms of repression of aggressive tendencies. These observations were more marked in sustained hypertensives. In borderline hypertensives, the lack of fantasy life, assessed from kinesthetic perceptions, was highly significant (p less than 0.01) and was associated with anxiety and functional symptoms suggesting an increased lability of the autonomic nervous system. In sustained hypertensives, however, there was an inability to express anxiety in a symbolic fashion (p less than 0.01). These differences in psychological findings between borderline and sustained hypertensives agree with the difference in hemodynamic patterns. The results suggest that sustained hypertensives have a predominantly somatic issue in place of the psychological conflicts observed in borderline hypertensives.

Adult↗
PubMed1977

Cyclic vomit in children: seen through the psychiatrist's eye.

Sixteen patients have been seen since 1956 at the Children's Hospital of Pittsburgh with a disgnosis of cyclic vomiting. Five of these patients were reverred for psychiatric consultation or treatment. Four of the 16 had laparotomies and no specific pathological condition was found; seven of the patients did not have surgery or psychiatric intervention. Descriptive follow-up is given for all patients, as well as various methods of handling the problem. The psychological conflicts were found to be parental anxiety, a prolonged symbiotic relationship with the mother, and the failure of the child to separate and individuate.

Child↗
PubMedDate not supplied

Ambulatory patients with medical and psychiatric illness: care in a special medical clinic.

Patients who have both medical and psychiatric illnesses often present very difficult diagnostic and treatment problems. Cross referrals by the two or more specialties necessarily involved in their management are often perceived by these patients as rejection and not only may induce in them feelings of frustration, helplessness and anger, but may also lead to a worsening of their medical and psychiatric symptomatology. This paper describes the organization and operation of a comprehensive clinic, staffed by both internists and psychiatrists, designed to provide total care for these patients. The patient population comprises patients with independent or unrelated medical and psychiatric illnesses, patients with interdependent medical and psychiatric symptoms, patients with reactive psychological problems and patients with somatizations as an expression of psychological conflicts. Case reports illustrate the approach used in patient management and some of the encouraging results that can be achieved at such a clinic. The special nature of the clinic presented a challenge to the physician's traditional role and required careful attention to specific aspects of the doctor-patient relationship, which are briefly discussed.

Adult↗
PubMed1976

[Pharmacological and psychosocial aspects of drug dependence].

Use and abuse of psychotropic drugs start with history, but toxicomania starts much later, with the discovery of morphine, in early XIXth. Century; and increases sharply after the 2nd. World War. The author reviews the general classifications of drug abuse, stressing the many differences among them, as well as the differences in clinical approaches to each one of them, and in criteria for treatment. Abuse of drugs takes many different forms roughly reduced to three: a) "traditional" addicts, with permanent and heavy intake of barbiturates, amphetamines, alcohol and narcotics; b) regular mass consumers of medicines, legally prescripted by doctors on grounds of unwise criteria or sheer complicity; c) members of the "Drug Culture" making of drug abuse a symbol of doctrinary social claims. Addictive drugs are classified, according to Lehmann, into three groups: 1. Expansive drugs: producing intense feeling and elation, according to three classes: a) Thrill drugs, causing an immediate deep pleasure, a jolt in the stomach and warm waves towards the abdomen and genitalia, with orgasmic effects; b) Easiness drugs, increasing energy and self-reliance and decreasing fatigue or ill-feelings; c) self-realization drugs, leading to deep and rich self-awareness, and heighted aesthetic and intellectual potential. 2. Reductive drugs: lowering the intensity of sensations and emotions, in three kinds: a) Releaser drugs, causing removal of inhibitions and production of phantasies; b) Sedation drugs, easing tensions and anxieties; c) Stupefying drugs, blurring all contact with the outer world. The author analyzes the patterns of intake, which include generally two or more different types of drugs, and vary in the same individual according to circumstances. Finally, several factors leading to addiction are considered, among them: biological and genetical endowment or predisposition; psychological conflicts or flaws; and social factors.

Emotions↗
PubMed1979

The dental technician and the attitude of dentists towards his role in Japan.

Historically the development of the Japanese dental care delivery system necessitated the enaction of the Dental Laboratory Technique Law. The Health Insurance Scheme, at present, is not able to operate without the collaboration of dental laboratory technicians. This means that the dental technician may introduce a possible competitive inter-relationship with the dentist who relies on prosthetic dentistry as the major source of his income. It does not mean illegal practice by dental technicians which has so far been negligible. The occupation of the dental technician, therefore, would seem to be very stable. Results obtained during the International Collaborative Study of the Dental Manpower Systems, however, showed some psychological conflict amongst the responding dental technicians.

Adult↗
PubMed1978

Evaluation of Problem Oriented Treatment Planning in outpatient psychotherapy.

The paper presents systematic evaluation of a modified problem oriented medical record approach to treatment planning in outpatient psychotherapy. By comparison with a four year period prior to the institution of problem oriented treatment planning (POTP), data from a year in which POTP was used indicated a 50% reduction in patient drop out but no change in clinician rated condition of patients at termination. Findings of the report suggest an optimistic stance on the part of the clinician regarding accomplishment of goals in six weeks when patient and clinician are in agreement as to problem and goal even if the goal entails adjustment to psychological conflict. Contrary to authors' expectations staff acceptance of POTP was good.

Attitude of Health Personnel↗
PubMed1977

The management of vaginismus.

Vaginismus may be defined as an involuntary spastic contraction of the musculature investing the outer third of the vagina. This spasm is produced by imagined or real attempts at vaginal penetration. Though vaginismus may be suspected from the history, the definitive diagnosis is made on vaginal examination. Preparation and positioning of the patient for this examination are important. Where anxiety of the patient precludes examination, the patient may be first desensitized to penetration using behavioural modification techniques. The patient is then shown how to overcome the spasm using daily digital vaginal examination. When digital vaginal dilatation can be painlessly carried out, intercourse is attempted. In some women, vaginismus appears to be a somatic manifestation of unconsious psychological conflicts. These women may benefit from more intensive psychotherapy.

Anxiety↗
PubMed1978

Psychological factors involved in request for elective abortion.

In order to understand the increasing numbers of women who are requesting a repeat elective abortion, 13 First Abortion and 13 Repeat Abortion patients were interviewed. There were no significant differences between the two groups. It was found that the failure of contraception was not because the women did not have access to adequate contraception. There was evidence of underlying psychological conflicts, sometimes in one and even both sexual partners. In 9 of the 26 patients there was material clearly suggesting that the women had an underlying conflictual wish to become pregnant. The data also suggests that many of the male partners had a strong wish to father a child. All of these situations suggest the need for adequate counselling.

Abortion Applicants↗
PubMedDate not supplied

A developmental view of identifications resulting from maternal impingements.

This paper attempts to understand in early developmental terms one of a group of patients who demonstrate a powerful identification with a conflicted aspect of their mother. In addition to the strong identification with the maternal pathology, the group is characterized by a history of maternal impingements (Winnicott) through which the infants were exposed to the conflicted psychological state of the mother. A case history of a psychoanalytic psychotherapy emphasizes the vicissitudes of the transference and countertransference. The patient presented had been exposed to premature awareness of separateness from the mother as a result of the maternal impingements. The identification with the maternal pathology is seen primarily as a defensive attempt to create the illusion that the characteristics of the impingements were actually a creation of the patient herself. This defensive identification was strengthened by the mother's inability to be responsive to the patient, except in so far as the patient entered into the "beam" of the maternal pathology. Parts of the work of Melanie Klein, Winnicott and Greenacre which make up the theoretical context for the developmental formulation of the type of identification under discussion are presented and several clinical implications of the developmental formulation are discussed.

Adult↗
PubMedDate not supplied

Studies in family-oriented crisis intervention with hemodialysis patients.

This article describes a family-oriented crisis intervention approach to help patients with chronic renal failure adjust to the unique demands of home dialysis. In particular, home dialysis necessitates a working patient-dialysis partner relationship that has very adaptive problem solving skills. A couple whose permorbid relationship is dysfunctional will soon manifest this under the stress of home dialysis. The family-oriented therapist initiates only the minimal change necessary in the relationship to achieve successful dialysis. In the home training stage the premorbidly dysfunctional couple seems best treated in individual interviews, whereas premorbidly functional couples respond more favorably to conjoint interviews which capitalize on their underlying strengths. Couples in crisis who are dialyzing at home may require a highly structured, behaviorally-oriented contractual approach which includes all relevant family members. This "band-aid" approach temporarily reinstitutes successful dialysis while purchasing more time for the couple to develop new coping mechanisms. Finally, four case studies are presented, including one in which crisis intervention efforts failed.

Adaptation, Psychological↗
PubMed1975

REM sleep and the analytic process: a psychophysiologic bridge.

Recent research on the physiology of REM sleep has supported the hypothesis that it serves processes of psychologic adaptation. This study examines the relationship between physiologic parameters of REM sleep and evidence in analytic material of the need for adaptation. Significant correlations were found between defensive strain before sleep and REM latency, and between change in defensive strain from evening to morning and total REM time.

Adaptation, Psychological↗
PubMed1979

Marriage and midlife: the impact of social change.

This paper considers the impact of social change on marriage in the midlife period. Issues which ordinarily require adaptation in midlife e.g., awareness of the finiteness of time, the limits of options and the necessity to reassess goals and deal with losses are affected by societal changes. These changes include increased numbers of dual career families and a decreased birth rate. Marital partners must integrate these changes into their lives. The process of adaptation may be stressful and result in symptoms such as depression, anxiety, somatic complaints of sexual problems. Illustrative clinical examples and treatment approaches are provided.

Adaptation, Psychological↗