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At least 19 recordsLinked to original sources

Negativism and countertransference.

The purpose of this work is to explore the phenomenon of negativism and the analyst's response to it during the course of analytic work with a patient in whom negativism is a central behavioral pattern. Melville's short story, "Bartleby the Scrivener," describing in telling detail the response of a sympathetic lawyer to profound and pervasive negativism in his legal scribe, is discussed as a literary analogy to the analyst-analysand dyad. Aspects of the concept of negativism within psychoanalysis are discussed. The potential usefulness of understanding certain unexpected countertransference responses to pervasive negativism is explored, as this is a relatively neglected area of psychoanalytic technique. A case is presented describing the analysis of a patient whose character, like Bartleby's, is a mixture of profound negativism along with schizoid, obsessional, and masochistic elements.

Countertransference↗

[Survey of the negativation of bacteriologic tests in patients with active pulmonary tuberculosis: how long should the isolation be?].

The risk of contamination by contact with patients with tuberculosis is reduced by isolation of patients until negativation of direct sputum analysis for the research of tuberculosis bacilli. To evaluate the efficacy of this isolation, we compared, in 32 patients with active tuberculosis, the results of direct examination and culture of the sputum and the clinical outcome. Thirty-two successive patients hospitalized in the same internal medicine unit, received antituberculosis drugs and had 3 sputum examinations per week with direct analysis and culture until negativation of the 3 direct examinations. Then, isolation ended. At the time of direct-negativation, 14 of the 32 patients kept positive cultures. In the 18 remaining subjects, the cultures became negative, about seven days before direct-negativation. Patients with negative cultures had more frequently weight increase (83% versus 71%), were more rapidly without fever (11 days versus 19 days), had less cough and had less severe radiologic disease (50% versus 75%) compared to patients with positive cultures but these differences were not statistically significant due to the small sample size. In tuberculosis patients, 3 successive negative direct sputum examinations do not eliminate the risk of tuberculosis transmission, specially to hospitalized or immunocompromised patients. The risk of contamination in these cases, although unknown, may be weak. Terminating isolation should not be based on sputum examination alone, but also on other factors such as the clinical course (resolution of cough and fever, weight), the initial number of bacilli, and the severity of the radiological lesions.

Adult↗

[Trazodone for the treatment of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease: a retrospective study focused on the aggression and negativism in caregiving situations].

Behavioral and psychological symptoms of dementia (BPSD) includes anxiety, depression, hallucination, delusion, aggression, irritability, agitation and wandering. BPSD often causes a deterioration of activity of daily living (ADL) and worsens caregiver burden. Trazodone, an atypical antidepressant, is used for the treatment of BPSD, but the effectiveness is controversial. In this study, we retrospectively analyzed the medical records of the 13 AD patients who were rated as having the aggression and negativism in caregiving situation and were treated by trazodone. The BPSD of the per-treatment stage of the patients was assessed with Neoropsychiatric Inventory(NPI). Improvement of BPSD after trazodone was observed in 9 patients, and the aggression and negativism in caregiving situations were improved in 6 patient. Trazodone may be effect for the treatment of a certain type of BPSD such as aggression and negativism in caregiving situations. Prospective studies of this issue are recommended in AD patient.

Activities of Daily Living↗

Neurotic negativism and negation in the psychoanalytic situation.

Negativistic phenomena in the treatment of neurotic children and adults are examined and distinctions are made among negativism, negation, and denial. Clinical vignettes exemplifying various forms of negativism are presented and viewed as expressions of developmental, defensive, or characterological aspects of the personality. Hartmann's seminal concepts of the genetic fallacy, change of function, and secondary autonomy are employed. The addition of a developmental view provides a broader context within which to view the patient's behavior and on the basis of which to formulate interpretive interventions.

Adult↗

[Psychodynamic aspects of schizophrenic negativism in individual psychotherapy].

This is a report of the individual psychotherapy of a schizophrenic woman who has been cured after years of treatment. The report deals mainly with psychodynamic problems such as resistance and negativism. It shows that only a common view of such phenomena, which includes the therapist as well as the patient and establishes a symmetry of experience, can lead to those processes of identification and counter-identification which ultimatively are helpful to both the patient and his therapist.

Aggression↗

A lesson on negativism in the toddler. Preceded by some considerations on the teaching of general pediatrics.

This study presents observations about certain preliminary conditions necessary for the practicing physician's teaching ambulatory pediatrics. The author's practical experience is cited in the transcription of a lesson about 'negativism in the toddler', and a sensorimotor psychodynamic concept is proposed to explain the child's oppositional behavior: the unusual energy potential at this age, the immediacy of an act, an object concept different from that of the adult. The pediatrician's role as 'health counselor' is evoked in the therapeutic considerations.

Child Behavior↗

Spontaneous negativation of serum hepatitis C virus RNA is a rare event in type C chronic liver diseases: analysis of HCV RNA in 320 patients who were followed for more than 3 years.

BACKGROUND/AIMS: The natural course of hepatitis C virus (HCV) replication in type C liver diseases has not yet been elucidated. The aim of the study was to investigate the spontaneous outcome of the viremia by examining the changes in HCV RNA in patients with chronic type C liver diseases. METHODS: Among patients who visited our liver clinic between June 1981 and December 1993, 320 patients with chronic type C liver diseases were followed for at least 3 years and had no history of interferon treatment. HCV RNA was examined by a highly specific reverse transcription-polymerase chain reaction method in paired serum samples obtained from these patients at the beginning and end of follow-up. RESULTS: Among the 320 cases, HCV RNA was seropositive in 310 (97%) cases at the beginning of follow-up. Of these 310, HCV RNA remained seropositive in 304 (98%) and became seronegative in six (2%) cases by the end of follow-up. All of these six patients had liver cancer. HCV RNA became seronegative after the patients entered the state of liver failure because of the development of tumors or portal thrombosis. The remaining 10 cases who were seronegative for HCV RNA at the beginning were seropositive at the end of follow-up. Among the 320 cases, serum alanine aminotransferase normalized and remained normal for more than 12 months until the end of follow-up in 11 cases (0.6%/year/case), but none became negative for HCV RNA. CONCLUSIONS: Thus, during the natural course of chronic HCV infection, spontaneous negativation of serum HCV RNA seems extremely rare, at least in patients with chronic active hepatitis or cirrhosis of the liver, and may occur primarily at the terminal stage when tumors cause liver failure.

Aged↗

Lymphocyte T helper-specific reactivity in sustained responders to interferon and ribavirin with negativation (seroreversion) of anti-hepatitis C virus.

BACKGROUND: Seroreversion, negativation of anti-hepatitis C virus previously positive, is sometimes found in some chronic hepatitis C-sustained responders (SRs) to antiviral therapy. AIMS: To determine the probability of seroreversion in SR treatment with Interferon and Ribavirin, and lymphocyte T helper (CD4+) reactivity to HCV antigens. METHODS: Thirty SR were followed on average for 54.8 months. Anti-HCV was tested by third generation test. Peripheral blood mononuclear cells (PBMCs) were isolated from venous blood and cultured to evaluate CD4+ proliferation in response to 2 microg/ml of eight HCV recombinant antigens from core, NS3, NS4, NS5 regions. RESULTS: Seroreversion was verified in 23% of patients (7/30), appearing at 47.5+/-24.0 months. The probability of anti-HCV loss in this group was 25% at 56 months after ending therapy. In 57% (4/7), anti-HCV returned to positive. These 7 SR patients with seroreversion also showed weaker CD4+ reactivity in 5% of tests (3/56) than the remaining 23 anti-HCV-positive SRs who showed stronger reactivity in 18% of tests (33/184), P=0.036. CONCLUSIONS: One-quarter of the SR showed seroreversion of anti-HCV and weaker CD4+ specific HCV proliferation than those who remained anti-HCV positive. The data suggest that complete viral eradication is a possible and achievable clinical objective.

Adult↗

The anal personality: self-disclosure, negativism, self-esteem, and superego severity.

Psychoanalytic implications of anal characterology were operationalized, and an experimental situation devised to test hypotheses of various aspects of interpersonal behavior. Subjects selected for the study had been found to score either high or low on Kline's (Ai3) Anality Scale. Self-disclosure and disclosure reciprocity were shown to be negative functions of anality: productivity and superego measures were also shown to be functions of anality. Self-esteem and socio-economic status did not relate to anality levels, while the hypothesis linking anality with negativism was only partially confirmed. Implications for psychoanalytic and social psychology research are discussed.

Journal Article↗

Predictors of tilting test negativization during beta-blocker treatment in patients with neurocardiogenic syncope.

BACKGROUND: The cardioinhibitory and/or vasodepressor reflex, always preceded by adrenergic activation, has recently been accepted as the main mechanism of neuromediated syncope. The aim of this study was to verify if efficacy of beta-blockers, in the treatment of neuromediated syncope, may be predicted on the basis of clinical variables and data derived from tilting test. METHODS: We retrospectively analyzed 23 patients with recurrent or traumatic unexplained syncopal episodes, with a positive tilting test, who repeated the test during beta-blocker therapy. According to the second tilting test results, patients were divided into Group 1 (19 patients) with a positive second test, and Group 2 (4 patients) with a negative second test. RESULTS: No difference was found between the two groups in age, gender, number of syncopal episodes before observation, and period (days) between the two tests. Moreover, there was no difference between the two groups in the kind of positive response to tilting test, in heart rate at tilting (minimum, maximum, delta and slope of increase), and in the minimum, maximum and slope of heart rate increase before syncope. Delta heart rate before syncope was 15 b/min in Group 1, and 28 b/min in Group 2 (p = 0.011). Taking a discriminant value of 20 b/min, 100% sensitivity and 68% specificity were found. CONCLUSIONS: Heart rate increase before syncope identifies patients with negativization of tilting test on beta-blocker therapy. However, the clinical value of the second test for driving therapy is controversial.

Adrenergic beta-Antagonists↗

A persistent severe autoimmune hemolytic anemia despite apparent direct antiglobulin test negativization.

BACKGROUND AND OBJECTIVE: Not all cases of autoimmune hemolytic anemia (AIHA) are diagnosed by the direct antiglobulin test (DAT). We present and discuss a simple method of enhancing the sensitivity of the standard DAT. DESIGN AND METHODS: We report the case of a five-month-old child diagnosed with a severe IgG-mediated AIHA, characterized by quick DAT negativization despite clinical worsening. Warm AIHA with negative DAT, possibly due to a low affinity autoantibody, unresponsive to conventional therapy, was hypothesized. RESULTS: The DAT resulted strongly positive with anti-IgG serum using a 4C saline for erythrocyte washing, to reduce the dissociation of the supposed low affinity autoantibody. Very intensive cytoreductive treatment was administered twice until clinical remission was obtained. INTERPRETATION AND CONCLUSIONS: The clinical course of AIHA can be dissociated by the DAT. Since autoantibody-mediated hemolysis with negative DAT rarely occurs, once other causes of high reticulocyte count anemia have been ruled out, the DAT after ice-cold saline washing could be a useful and easy means of corroborating the diagnosis of AHIA, when traditional methods fail.

Anemia, Hemolytic, Autoimmune↗

Negativism in evaluative judgments of words among depressed outpatients with borderline personality disorder.

This study contrasted the frequency of negativistic evaluative judgments to words of various emotional content between two groups of patients with Major Depressive Disorder (MDD) (20 patients with a comorbid diagnosis of Borderline Personality Disorder (BPD) and 20 patients without BPD) and a group of 20 community adult Controls. BPD patients made more "dislike" judgments with neutral words than MDD patients and Controls. The performances of the MDD patients were more similar to the Control group than to the BPD group, despite negligible differences between the two patient groups in the severity of depressive symptoms and overall psychopathology. As a whole, these data indicate that the presence of borderline features in patients with MDD can be an important qualifier in terms of patients attitudinal dispositions.

Adult↗