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At least 19 recordsLinked to original sources

Grief-related facsimile illness.

One aspect of the grief process which is frequently mentioned in the literature on mourning but has not yet received adequate clinical attention is the tendency for the bereaved to assume symptoms and behavior of the deceased. This paper presents evidence that pathologic identificantion 1) is an important clinical syndrome that is frequently misdiagnosed and mistreated, 2) defines a population at high medical and surgical risk, 3) can be diagnosed by history alone, and 4) carries a good prognosis when identified and properly managed. Four of a series of ten clinical cases are presented and discussed. Analysis of the cases reveals a number of common features, including 1) an arrest of the normal grief process; 2) a presentation of symptoms identical or nearly identical to those experienced by the deceased; 3) previous ineffective and inappropriate treatment endeavors; 4) referral for reasons other than a recognition of an abnormal grief state; and 5) improvement or recovery during treatment aimed at facilitating the grief response. Based on a survey of the literature and the clinical material analyzed, the authors conclude that patients who present with psychologic identification with the deceased have a distinct clinical syndrome (grief-related facsimile illness) for which recognition is important to institute proper management. Contrary to the reports in the literature, it frequently presents as other than hypochondriasis. When identified, this syndrome carries a good prognosis.

Adult

Paediatrician identification of psychological factors associated with general paediatric consultations.

In a study of children 7-12 yr of age referred to general paediatric clinics, paediatricians reported psychological factors associated to somatic presentations in 47% of the children. These cases presented with a variety of somatic symptoms, but abdominal/chest/joint pains and soiling were particularly common. From research interviews with the parents we found increased rates of psychiatric disorder (abnormalities of emotions, behaviour or relationships) amongst them. The most common psychiatric symptoms were depressive mood changes and relationship problems. We also identified an excess of certain personality features in the children and of family health problems in this group. Paediatricians commonly identify psychosomatic issues in children attending general paediatric clinics and independent evidence supports the validity of their assessments.

Affective Symptoms

Adverse effects of acculturation: psychological distress among Mexican American young adults.

We examined the relationship between acculturation and psychological distress in young (20-30), middle aged (31-50), and older adult (51-74) Mexican Americans (n = 3084). The data were from the Hispanic Health and Nutrition Examination Survey (HHANES). Acculturation was measured with items on spoken and written language and ethnic identification. Psychological distress was measured with the Center for Epidemiologic Studies Depression Scale (CES-D). We found that as acculturation increased, distress significantly increased in young adults but tended to decrease in older adults. This general pattern held for males and females and was consistent for the CES-D total score and caseness rates. The effects of acculturation were independent of the effects of income and education. We discuss that alienation and discrimination may be two intervening events producing the psychological distress of the highly acculturated young adults. Further, our findings tentatively suggest a longitudinal process whereby acculturated younger Mexican Americans attempting to advance themselves economically and socially in the dominant society strip themselves of traditional resources and ethnically-based social support. Through the years, however, they may re-establish ties to their native culture which contributes to relatively positive mental health.

Acculturation

The psychoanalytic theory of change.

The concept of change by psychoanalysis has undergone an historical process related to the course and development of psychoanalytic theory. Change has changed from an effect on symptoms, to underlying etiologic conflicts, to background character, to the functioning of psychic structural systems. The psychoanalytic process does not overlap with the process of change. The former may be present without the latter. The will to recover is accompanied by the unconscious need to cover. The methodology of change is examined with regard to process, agent(s), and intrapsychic results. Every analysis is a training and supervised analysis. With increasing autonomy of the ego, the patient, identifying with the analysing functioning of the analyst, becomes his own analyst. The theory of change is related to the psychoanalytic theory of neurosis of which it is part, and differs in alternative theories extant today. The dynamic occurrences I have described as bringing about change rest upon my view of 'total composite psychoanalytic theory' as evolved to the present.

Adaptation, Psychological

Hazards of long-term psychotherapy during psychiatric residency.

When he laid the groundwork for modern standards of training psychiatrists, Freud (1937) asked, "Where and how is the poor wretch to acquire the ideal qualifications which he will need in his profession? The answer is, in an analysis of himself" (p. 248). Fromm-Reichmann (1950), an equally important influence on psychiatric education, echoed this sentiment when she professed that "any attempt at intensive psychotherapy is fraught with danger, hence unacceptable, where not preceded by the future psychiatrist's personal analysis" (p. 42). Although most psychiatric residencies do not require personal psychotherapy (Pasnau and Russell 1975), many educators and their trainees still consider psychoanalysis or long-term reconstructive psychotherapy at least a valuable experience and at most a necessary step toward becoming a complete psychiatrist. In our experience, however, psychoanalysis and related psychotherapies can have adverse effects during the turmoil of residency training.

Adaptation, Psychological

Life experiences and the decision to become a mental patient.

This research focuses upon life events influencing the decision to adopt or reject the mental patient role. Studied were 30 mental health center patients who defined themselves as mentally ill and aggressively sought treatment. These were contrasted with 21 persons who consistently denied that they were mentally disordered, and persistently resisted the treatment forced upon them. Patients in both groups had been exposed to the mental health system on the average of 7 years each. Findings showed that those identifying with the mental patient role, in contrast to those resisting it, were more likely to have received treatment in adolescence, to occupy a special sibling position in the family, to have suffered parental loss in childhood, and to have had a parent defined as mentally ill or inebriate. These results were interpreted to indicate that the decision to accept the role of mental patient occurs in the context of a crisis of personal identity to which adolescents are particularly vulnerable. The patient-candidate's fears of being mentally unbalanced are realistically affirmed by knowledge that his parent was also regarded as mentally unsound, and he has the opportunity to learn the appropriate patient role from other family members. In addition, the patient who identifies with the mental health system may be incorporating it as a love object to replace parental loss. Those resisting the patient role, in constrast, seem already to have had developed the identity of an oppressed group, and appeared to regard coercion into the mental health system as a realistic confirmation of their sense of victimization. There did not appear to be any advantages to accepting or rejecting the patient role with regard to socially acceptable conduct.

Adult

The psychological gains and losses of religious conversion.

A presentation of case material demonstrating productive identify formation and conflict resolution resulting from religious conversion with at the same time significant repression that so affected personal relatedness as to eventually lead to breakdown of adjustment.

Adult

Pseudomaturity in the developmental line of object relations.

In this work I identify pseudomaturity as a syndrome that reflects the child's image of key adult figures. In the first case, an adolescent's imitation of his high school principal maintained an internal image of this figure that shielded the boy from the experience of further hostility and from separation anxiety. In the second case, a latency-age girl's coy and servile mannerisms endeared her to adults and served as a reaction formation to her own need to be nurtured. In the third case, a preadolescent boy's cold intellectualism and disdain for peers were modeled after his mother's image of the father and also reflected the mother's image of powerful figures. Finally, an adolescent girl's intermittent runaways were patterned after her mother's premature independence, while her severe isolation of affect acted to minimize the cost of losing her mother's protection.

Adolescent

Identity.

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Christianity