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Reality testing and self-reported AIDS self-care behavior.

This investigation examined the relationship between reality testing and AIDS self-care behavior for 509 urban college students. It was hypothesized that reality testing may become impaired in sexual interactions that carry the risk of HIV infection, leading to imperfect adoption of safer sex practices. Reality testing, measured by the Bell Object Relations and Reality Testing Inventory, was significantly related to AIDS knowledge as measured by the AIDS Prevention Survey of Thomas and not significantly related to self-reported safer sex behavior, measured by Bassman's HIV Infection Prevention Scale.

Acquired Immunodeficiency Syndrome

Reality testing and Rorschach perceptual regression in female patients.

In an effort to study the relationship between severity of psychological disturbances and developmental level scoring of the Rorschach, 43 female psychiatric inpatients were divided into two groups based on whether or not they were displaying behavioral evidence of poor reality testing. As expected, the poor reality testers group produced a significantly greater percentage of responses at the lowest developments level (amorphous responses). The more intact group produced a greater percentage of vague responses, as would be anticipated in patients fending off further regression or emerging from a regressive state. Findings add to the information available on the developmental system's utility within clinical settings and its applicability to female patients.

Adult

Transcendental meditation, altered reality testing, and behavioral change: a case report.

This paper presents the case of a 39-year-old woman who, several weeks following initiation into transcendental meditation (TM), experienced altered reality testing and behavior. We discuss the course of this episode, present evidence for a causal relationship between her practive of TM and altered behavior, and discuss the appropriate treatment of such phenomena.

Adult

The testing of reality from the standpoint of the body self.

Traditionally, the body self has been regarded as involved in reality testing principally in the determination of the distinction between the source of a stimulus being internal or external. The body has been closely related to instinctual drives, to urgency, and thus to conflicts that are crucial to normal and pathological development. However, the concept of the body self comprising all the psychic experiencing of body sensation, body functioning, and body image is broader than the body's connection to inner-outer reality testing and id pressures. The findings from childhood observations and from clinical research indicate that at each stage of the child's life, from earliest infancy on, the maturation and development of the body self becomes integrated with the whole group of psychic regulatory activities that contribute to the individual's sense of reality. The development of the body self at each period involves criteria by which some aspect of reality is tested. The subject of this paper has been the developmental pattern of experiences that contribute to the individual's sense of his body in particular and to the sense of reality of the self in general.

Adolescent

A first Volunteer Case Aid programme in a mental hospital. Revealing the voluntary helper's role of reality testing between staff and patients.

A pilot Voluntary Case Aid programme in an English Mental Hospital using National Health Service resources is described. The selection of ten volunteers and ten patients and the preparation of all personnel was followed by regular contacts for at least a year. Subsequent evaluation suggested high motivation with both Case Aids and patients. Changes towards improved social functioning were evident in most cases by the end of the project. A relationship starting, continuing and finishing is reported in detail and from this study it is clear that the volunteer was a reality tester for staff and patient alike, constructively disturbing and modifying their mutual projections. This was true of most of the Case Aid interventions and the implications are discussed. A method of group supervision for Case Aids is reported.

Adult

A comparison of Rorschach developmental level and form-level systems as indicators of psychosis.

Psychotic and nonpsychotic psychiatric inpatients were tested on the Rorschach. "Reality-testing" was measured by four form-level scoring systems designed by Beck, Mayman, Becker, and Wilensky. The psychotic subjects were dichotomized on three diagnostic dimensions: schizophrenia, paranoia, and premorbid social adjustment. No significant differences were found for the Beck system. With the other systems, psychotics showed significantly poorer reality testing than nonpsychotics. No differences were found for the schizophrenic and paranoid dimensions. The Phillips premorbid adjustment score was negatively correlated with all four measures of "reality-testing." The conclusion drawn was that Rorschach measures of "reality testing" are associated with psychotic and poor premorbid functioning, but do not differentiate schizophrenic from nonschizophrenic psychotics or paranoid schizophrenics from nonparanoid schizophrenics.

Adult

Dying without death: the third wish in suicide.

A hypothesis is proposed that the nonpsychotic patient in the presuicidal state may have impaired reality testing in which the act of suicide is perceived as not leading to injury or death. Impaired reality testing may be enhanced by intense affects, drugs, and sleep deprivation.

Adult

Assessment of ego functioning in multiple personality disorder.

The dissociative disorder known as multiple personality disorder (MPD) presents a diagnostic challenge to psychological assessment techniques. A case example is presented in which a new self-report, multifactorial measure of ego functioning discriminated distinct profiles for four personalities within one multiple personality organization. Interpretations of characteristics of the primary and secondary personalities based on the Bell Object Relations Reality Testing Inventory (BORRTI) are presented. The relationship between these findings and other approaches to psychological testing for dissociation and MPD are discussed. It is suggested that this approach will facilitate the clinical assessment of suspected MPD subjects and contribute to affording appropriate treatment to this population.

Adult

Object relations and self-reported AIDS self-care behavior.

This study examined the relationship between object relations and AIDS self-care behavior among 509 urban college students. The literature indicates that maturity of object relations is related to comfort in interpersonal relations and to taking responsibility for self-care. These concepts are widely accepted by psychoanalytic psychologists but have rarely been tested empirically. Object relations, measured by the Bell Object Relations and Reality Testing Inventory, was significantly related to AIDS knowledge as measured by the AIDS Prevention Survey of Thomas and to self-reported safer sex behavior, measured by Bassman's HIV Infection Prevention Scale. Knowledge about AIDS correlated with self-reported sexual risk behavior, and with a low level of self-reported social behavior aimed at preventing AIDS. Implications of these findings for public health education policy are discussed.

Acquired Immunodeficiency Syndrome

An investigation of psychological factors involved in the predisposition to auditory hallucinations.

Previous research by the author (Slade, 1972, 1973) and others has suggested that psychological stress plays an important role in triggering off the experience of auditory hallucinations. Clearly, however, predispositional factors are involved as well. The present study is an attempt to investigate some of the psychological factors which may predispose the individual to such experiences. A battery of tests involving cognitive, personality and mental imagery variables and the verbal transformation effect was administered to two small groups of psychotic patients differing only in respect of a history of auditory hallucinations and a normal control group. The main conclusion was that the results lend direct support to the proposition of Mintz & Alpert (1972) that a combination of vivid mental imagery and poor reality-testing in the auditory modality provides the basic predisposition for the experience of auditory hallucinations.

Adolescent

Psychotherapeutic schema based on the paranoid process.

A psychotherapeutic schema is proposed based on the analysis of the paranoid process. The paranoid process involves a paranoid construction of the patient's view of reality and his environment, particularly the social environment. The paranoid construction sustains and makes sense out of the patient's projective system. These projective elements reflect and are derived from the introjects--the internalized objects around which the patient's inner world and his experience of himself are organized. The schema aims at focusing the therapy on these introjects as central to the psychopathology. The following steps of the schema are outlined and discussed: establishing the therapeutic alliance, defining the projective system, testing reality, clarification of the introjects, derivation of the introjects, motivation of the introjects, mourning of infantile attachments, emergence of transference dependence, transference resolution, and termination.

Attitude of Health Personnel

Infertility: psychotherapeutic issues.

In supportive therapy with infertility patients, the clinician tries to relieve dysphoria and enhance self-esteem. Dynamically informed supportive interventions are designed to decrease guilt that may relate to past sexual activities, sexually related diseases, or abortions. These interventions should also be empathetic, promote optimism and reality testing, help with problem solving, allow catharsis and ventilation, decrease feelings of isolation and loneliness, educate and clarify, and praise and encourage where appropriate. Mental health clinicians have an important role to play in the treatment of these patients, provided they learn enough about the psychology of the experience of infertility and about the technology utilized in its treatment. As the number of people seeking treatment for infertility grows, the need for skilled therapists for this population will grow at a parallel rate.

Female