Showing papers in "American Journal of Psychiatry in 1969"
TL;DR: The author describes and emphasizes the value of a symptom and behavior rating checklist for teachers' use in drug studies with children with significant changes in all factors compared with a placebo group in a double-blind study.
Abstract: The author describes and emphasizes the value of a symptom and behavior rating checklist for teachers' use in drug studies with children. Factor analysis of the scale produced five factors that gave reliable subscales over a one-month period. A treatment study of dextroamphetamine with a group of children having learning and/or behavior disorders showed significant changes in all factors compared with a placebo group in a double-blind study.
1,748 citations
TL;DR: The author reviews 131 cases of child murder and proposes a new classification of filicide by apparent motive: altruistic, acutely psychotic, unwanted child, accidental, and spouse revenge.
Abstract: The author reviews 131 cases of child murder and proposes a new classification of filicide by apparent motive: altruistic, acutely psychotic, unwanted child, accidental, and spouse revenge. The high frequency of altruistic motives distinguishes filicide from other homicides. The psychodynamics of the filicidal impulse are explored: displacement of the murderer's original aggression from his parents, spouse, or sibling is documented. The author offers some considerations for prevention.
493 citations
TL;DR: Twenty euthyroid patients with retarded depression were studied to determine the possible role of alterations in thyroid function in the etiology and treatment of depression, and T3 was physiologically active, altering protein-bound iodine values and accelerating ankle reflex time.
Abstract: Twenty euthyroid patients with retarded depression were studied to determine the possible role of alterations in thyroid function in the etiology and treatment of depression. A battery of tests was administered regularly to measure change. Patients responded better to usual doses of imipramine when 25 µg. of L-triiodothyronine (T3) was administered daily. T3 was physiologically active, altering protein-bound iodine values and accelerating ankle reflex time. A possible explanation, based on relevant data from animal experiments, is that imipramine may elevate effective biogenic concentration, while T3 increases receptor sensitivity.
342 citations
TL;DR: In this study of the families of 59 manic-depressive, manic type probands, the predominant affective illness among the family members was depression without mania, although mania was frequent, suggesting that genetic transmission occurred by a sex-linked single or double dominant gene.
Abstract: In this study of the families of 59 manic-depressive, manic type probands, the predominant affective illness among the family members was depression without mania, although mania was frequent. The ...
203 citations
TL;DR: Variables such as diagnosis, cause of death, marital status, facility, and socioeconomic status are examined in an attempt to explain this high risk of death among psychiatric patients.
Abstract: Previous studies of mortality among psychiatric patients have dealt only with inpatient populations. This study analyzes the mortality experience of persons having received psychiatric care as inpatients or outpatients in public and private institutions. The relative risk of death for the psychiatric care group was found to be two and one-half to three times that for the comparable general population. Variables such as diagnosis, cause of death, marital status, facility, and socioeconomic status are examined in an attempt to explain this high risk of death.
196 citations
TL;DR: Using his Self-Rating Depression Scale in six foreign countries, the author found that self-ratings of depressed patients were comparable between countries and differed significantly from scores of normal subjects and nondepressed patients.
Abstract: Using his Self-Rating Depression Scale in six foreign countries, the author found that self-ratings of depressed patients were comparable between countries and differed significantly from scores of normal subjects and nondepressed patients. There was high correlation between the self-ratings and physicians' global ratings of depressed patients, and between scores on this test and other specific depression rating scales.
177 citations
TL;DR: A double-blind study of 537 patients evaluated the relative efficacy of four drugs (chlordiazepoxide, chlorpromazine, hydroxyzine, and thiamine) used in treating alcohol withdrawal symptoms, specifically to prevent delirium tremens and convulsions as mentioned in this paper.
Abstract: A double-blind study of 537 patients evaluated the relative efficacy of four drugs—chlordiazepoxide, chlorpromazine, hydroxyzine, and thiamine—commonly used in treating alcohol withdrawal symptoms, specifically to prevent delirium tremens and convulsions. Of the 55 patients who developed these symptoms, two percent were in the chlordiazepoxide group; the incidence ranged from ten to 16 percent in the other treatment groups. The authors conclude that chlordiazepoxide appears to be the drug of choice among those tested.
175 citations
TL;DR: DIAGNO II, a computer program for psychiatric diagnosis, is based on a logical decision tree model similar to the differential diagnostic process used in clinical medicine and yielded diagnoses for 100 patients which agreed with diagnoses supplied by clinicians as well as did the diagnoses provided by different clinicians on the same cases.
Abstract: DIAGNO II, a computer program for psychiatric diagnosis, is based on a logical decision tree model similar to the differential diagnostic process used in clinical medicine. In the validity study reported here, the program yielded diagnoses for 100 patients which agreed with diagnoses supplied by clinicians as well as did the diagnoses supplied by different clinicians on the same cases.
158 citations
TL;DR: Since heart surgery was first performed in the early 1950s, the incidence of postoperative emotional reactions and long-term readjustment problems has been noted to be greater and perhaps different in kind from responses to other types of surgery.
Abstract: Since heart surgery was first performed in the early 1950s, the incidence of postoperative emotional reactions and long-term readjustment problems has been noted to be greater and perhaps different in kind from responses to other types of surgery. This phenomenon has been the subject of several reviews,19 and many authors have focused their attention on one aspect or another of the surgical experience in an attempt to delineate factors involved in these responses.
152 citations
TL;DR: A controlled comparative investigation showed that temporal lobe epilepsy of the dominant hemisphere predisposes to psychotic manifestations, and in epileptic psychoses, periodicity is correlated with minimal brain damage and chronicity with maximal brain damage.
Abstract: A controlled comparative investigation showed that temporal lobe epilepsy of the dominant hemisphere predisposes to psychotic manifestations; epilepsy of the non-dominant temporal lobe is associated with manic-depressive psychotic reactions and epilepsy of the dominant temporal lobe with schizophrenic-like psychotic reactions. Also, the presence of psychomotor seizures and frequent temporal seizures is inversely correlated with psychosis; and in epileptic psychoses, periodicity is correlated with minimal brain damage and chronicity with maximal brain damage.
145 citations
TL;DR: A study covering three generations of families of abused children supports the themes that violence breeds violence and that a child who experiences violence as a child has the potential of becoming a violent member of society in the future.
Abstract: A study covering three generations of families of abused children supports the themes that violence breeds violence and that a child who experiences violence as a child has the potential of becoming a violent member of society in the future. The authors believe that the physician has a critical role and responsibility in interrupting this cycle of violence.
TL;DR: This study revealed that more than one-third of the subjects had never experienced a blackout, and that, among those who did report the experience, blackouts generally began well along in the course of alcoholism rather than at an early stage.
Abstract: In the past 25 years, numerous publications have cited "blackouts" as a major prodromal symptom of alcoholism. In contrast, this study, based on a structured interview with 100 hospitalized alcoholics, revealed that more than one-third of the subjects had never experienced a blackout and that, among those who did report the experience, blackouts generally began well along in the course of alcoholism rather than at an early stage. Blackouts were positively associated with severity and duration of alcoholism, extent and duration of alcohol consumption per drinking episode, capacity for drinking large amounts, "loss of control," neglect of meals, gulping drinks, and a history of head trauma. Only one patient had experienced blackouts after moderate drinking.
TL;DR: Four male volunteer alcoholic subjects were studied prior to, during, and following a period of experimentally induced intoxication; the anxiety reduction model was found inadequate to explain their motivation for alcohol use.
Abstract: Four male volunteer alcoholic subjects were studied prior to, during, and following a period of experimentally induced intoxication. The anxiety reduction model was found inadequate to explain their motivation for alcohol use. Euphoria was manifest only during the initial phase of intoxication; prolonged drinking was characterized by progressive depression, guilt, and psychic pain. However, termination of a drinking episode appeared to be associated with states of physical discomfort rather than with specific psychological determinants.
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TL;DR: It is suggested that the almost universal Japanese custom of ancestor worship serves an important adaptive function in the work of mourning.
Abstract: The authors examine the process of mourning in a culture whose religions sanction the implied presence of the deceased through ancestor worship, as compared to a culture where this is not acceptable or encouraged. Most of 20 Japanese widows interviewed during the acute grief phase of mourning adhered to the cultural beliefs and were less depressed and anxious and had less difficulty accepting the loss than those who did not. The authors suggest that the almost universal Japanese custom of ancestor worship serves an important adaptive function in the work of mourning.
TL;DR: The author compares flashbacks with other clinical phenomena; he believes that psychotherapy is helpful, especially if there is a focus on the traumatic and screening aspects of the imagery.
Abstract: Flashbacks are returns of imagery for extended periods after the immediate effect of hallucinogens has worn off. The most symptomatic form is recurrent intrusions of the same frightening image into awareness, without volitional control. The author compares flashbacks with other clinical phenomena; he believes that psychotherapy is helpful, especially if there is a focus on the traumatic and screening aspects of the imagery.
TL;DR: The results suggest that disagreements among clinicians may be due to actual differences in their perceptions of certain kinds of pathology rather than to semantic preference.
Abstract: To investigate the conceptual base and the factors influencing the process and current practice of psychiatric diagnosis, the authors designed six studies. Clinicians were asked to view a film of a patient interview, rate the patient on a standard set of symptom rating scales, assign a diagnosis, and answer some questions about their backgrounds and specific approach to the diagnostic decision about the case. The results suggest that disagreements among clinicians may be due to actual differences in their perceptions of certain kinds of pathology rather than to semantic preference. Suggestions are offered for methodological and technical improvements in future research in this area.
TL;DR: Consecutive admissions to a U. S. state hospital and to an English area mental hospital were compared to investigate the source of observed differences between the two countries in the frequencies of hospital admissions.
Abstract: Consecutive admissions to a U. S. state hospital and to an English area mental hospital were compared to investigate the source of observed differences between the two countries in the frequencies of diagnoses given to hospitalized patients. Although independently assigned project diagnoses for the two series resembled one another in frequency more so than did the two sets of official hospital diagnoses, indicating national differences in the use of diagnostic terms, the authors conclude that there were genuine clinical differences between the patient populations as well.
TL;DR: Emotional deprivation in the maternal relationship during early years appears to contribute significantly to the development of the symptom, with the most intense conflict between the child and the original love object.
Abstract: Trichotillomania in children is not a common occurrence. It appears to occur more frequently in girls than in boys, however, and cuts across all ages and a wide range of nosological categories. Emotional deprivation in the maternal relationship during early years appears to contribute significantly to the development of the symptom, with the most intense conflict between the child and the original love object. Trichotillomania as a symptom may take on different meanings at different levels of development, with the original meaning becoming obscured and less significant in later years.
TL;DR: This review of recent research suggests the existence of an unstable state of central nervous system hyperexcitability in depression, and possibly in mania, with an associated but disorganized intrinsic hyperactivity.
Abstract: This review of recent research suggests the existence of an unstable state of central nervous system hyperexcitability in depression, and possibly in mania, with an associated but disorganized intrinsic hyperactivity. The authors propose this concept as a possible description of the prevailing neurophysiologic state of the individual with affective disorder and as complementary to other biological hypotheses currently under investigation. They conclude that the concept warrants further study, noting the need for replication and extension of many of the studies reviewed.
TL;DR: The author describes the background and complexity of the problem and the efforts leading up to the present research project, aimed at explaining the differences between rates of first admissions to the mental hospitals of England and Wales and those of the U. S. for affective disorders, schizophrenia, and psychosis with cerebral arteriosclerosis.
Abstract: Many investigators have noted the large differences that have persisted over the years between the rates of first admissions to the mental hospitals of England and Wales and those of the U. S. for affective disorders, schizophrenia, and psychosis with cerebral arteriosclerosis. The author describes the background and complexity of the problem and the efforts leading up to the present research project, aimed at explaining the differences.
TL;DR: These aberrations are found to be very resistant to modification by a variety of maneuvers, including contact with normal social partners, drugs, and experimental manipulations, and the implications of their lack of "therapeutic" success are discussed.
Abstract: Chimpanzees reared during early life in environments with social and perceptual restrictions are strikingly different from animals reared by their mothers in a natural habitat. As adolescents they avoid social contact and display little species-typical behavior; they play and copulate infrequently and do not groom. The authors found these aberrations to be very resistant to modification by a variety of maneuvers, including contact with normal social partners, drugs, and experimental manipulations, and they discuss the implications of their lack of "therapeutic" success.
TL;DR: It is concluded that contemporary religious education does not seem to ensure healthier attitudes and the possibilities for remedying this failure are discussed.
Abstract: Reviewing a number of recent studies pertinent to the common belief that religion is a basis of sound mental health, general well-being, and humanitarianism, this author finds no empirical support for the theory He concludes that contemporary religious education does not seem to ensure healthier attitudes and discusses the possibilities for remedying this failure
TL;DR: In a large twin series the monozygotic pair concordance rate for schizophrenia was found to be 3.3 times greater than the dizygotic rate, while the difference for psychoneurosis was only 1.3.
Abstract: In a large twin series the monozygotic pair concordance rate for schizophrenia was found to be 3.3 times greater than the dizygotic rate. In contrast, the difference for psychoneurosis was only 1.3. Reanalysis of 18 earlier major twin studies revealed a similar difference in all but one instance. This consistent difference suggests the presence of a genetic factor in the pathogenesis of schizophrenia and its relative absence in psychoneurosis. However, the role of the suggested genetic factor appears to be a limited one; 85 percent of the affected monozygotic pairs in the sample were discordant for schizophrenia.
TL;DR: Experience with borderline patients leads the author to conclude that their disruptive behavior is often intensified by an intensive treatment milieu that fails to set limits on their wish for gratification.
Abstract: Experience with borderline patients leads the author to conclude that their disruptive behavior is often intensified by an intensive treatment milieu that fails to set limits on their wish for gratification. He stresses the place of therapeutic transfer to a different setting such as a state hospital and firm limit setting as essential elements of successful management.
TL;DR: The concept that delirium, at least when it occurs after operation, is a multidetermined syndrome and is not solely the product of organic brain disease is supported.
Abstract: Sixty patients who experienced postoperative delirium were compared with a group of 57 control patients, matched on the basis of type of surgery, age, and sex, who did not experience delirium. Significant differences were found between the two groups in categories of organic, social-environmental, and emotional disorders. These findings support the concept that delirium, at least when it occurs after operation, is a multidetermined syndrome and is not solely the product of organic brain disease.
TL;DR: In this author's view, an individual's wish for sexual transformation (transsexualism) does not constitute an independent diagnostic category and is a consequence of the inability to develop appropriate gender identity in accordance with anatomy.
Abstract: In this author's view, an individual's wish for sexual transformation (transsexualism) does not constitute an independent diagnostic category. It is found in association with several clinical conditions and is a consequence of the inability to develop appropriate gender identity in accordance with anatomy. The transsexual desperately seeks radical surgical procedures and endocrinological treatment. In this author's opinion, however, such surgical intervention constitutes a sanctioning of the transsexual's pathological view of reality and cannot resolve the underlying conflict.
TL;DR: It is concluded that the dramatic claims for the efficacy of LSD treatment in alcoholism are unjustified and no one treatment condition proved to be superior.
Abstract: One hundred seventy-six male alcoholic patients participated in a controlled investigation of the differential efficacy of three LSD treatment procedures and a "no therapy," or milieu treatment, condition. Half of each group was also assigned to disulfiram after discharge from the hospital to determine whether any of these techniques could be enhanced by its use. Although significant improvement was shown within all treatment groups as measured by a number of clinical assessments in the post-treatment and follow-up periods, no one treatment condition proved to be superior. The authors conclude that the dramatic claims for the efficacy of LSD treatment in alcoholism are unjustified.
TL;DR: The authors discuss the three processes—culturally sanctioned behavior, appropriation of psychotic behavior, and true psychosis—and consider their relationship to each other and to the clinical categories of conversion reaction and hysterical personality.
Abstract: Rather than being the end product of a single process, hysterical psychosis may result from three different processes. To sharpen the focus on this often elusive entity, the authors discuss the three processes—culturally sanctioned behavior, appropriation of psychotic behavior, and true psychosis—and consider their relationship to each other and to the clinical categories of conversion reaction and hysterical personality.
TL;DR: In evaluating 53 perpetrators of homicide, the author noted that a history of violent child-rearing, a severe superego, and an altered state of consciousness just prior to the act of homicide were marked characteristics of a majority of these individuals.
Abstract: In evaluating 53 perpetrators of homicide, the author noted that a history of violent child-rearing, a severe superego, and an altered state of consciousness just prior to the act of homicide were marked characteristics of a majority of these individuals. He postulates three categories of homicide, based upon the immediate psychological state of the perpetrator: dissociative, psychotic, and ego-syntonic.
TL;DR: Ten cases of battered child syndrome are reviewed from the standpoint of the assailant as the patient, and problems of early recognition and management are discussed.
Abstract: Ten cases of battered child syndrome are reviewed from the standpoint of the assailant as the patient. In certain persons with poor emotional control, aggression can be displaced and acted out upon a child. Definite significant experiences must have occurred in the patient's life before this form of release can take place. The authors discuss problems of early recognition and management.