Showing papers in "Australian and New Zealand Journal of Psychiatry in 1971"

Origins of Disease Phobia

Abstract: The literature on disease phobia is discussed and a controlled study of this variety of hypochondriasis is presented.There were 30 disease phobic and 30 control subjects, in-patients of a general hospital psychiatric unit in Sydney. Controls were defined as lacking the symptoms ‘disease phobia’, ‘disease conviction’, ‘somatic preoccupation’ and ‘psychogenic pain’. Matching was one-for-one and concerned sex, age and occupational prestige.In brief, the disease phobics were more anxious and self-pitying (current mental state). Before the illness they were more prone to inhibition of anger, bodily concern and low selfesteem (personality variables). As children they were more often weak, sickly and overprotected. Fifteen were youngest siblings versus only six of the controls. They gave a history of much family illness, substantiated by the findings of an excess of deaths among the mothers of disease phobics (life history characteristics). They reported an electrical current as a sensation at relatively low vol...

The diagnosis of abnormal illness behaviour.

Abstract: to pursue one’s own life, not in being a well-fed hospital patient. The strictures of Lucero and Vail (1968) may well apply to institutions. They should not nccessarily apply to the voluntary in-patient or out-patient setting. The ethics of token systems in the voluntary setting might thercfore encompass punishment schedules, provided the response rewarded has been shown to be within the patient’s repertoire and the benefit gained by producing the response is of long duration and considered by the patient to be in his own interest. REFERENCES Alford, J. and Innham. R. J . (1969). The amlication of a token reinforcement system’ to the iieatment of stuttering in children. 1. Aust. Coll. Sp. Therupisrs, 19: 58. Andrews, G. and Ingham, R. J. (1971). Stuttering: the effect of altcrations in auditory feedback with special reference to synchronous auditory feedback. J . Speech. Hearing Res. In Press. Ayllon, T. and Azrin, N. (1968). The Token Economy. Appleton Century and Crofts. New York. Ingham, R. J. (1971 1. The Role of a Token System in Stuttering. Unpublished Ph.D. Thesis, University of New South Wales, Australia. Ingham, R. J. and Andrews, J. G. (1968). The control of stuttering: an application of token reinforcement systems in a voluntary treatment setting. Paper presented to the annual conference of the Australian Psychological Society, Brisbane, August, 1968. Ingham, R. J. and Andrews, G. (1971). Stuttering: a comparison of the effectiveness of four treatment techniques. 1. Communicut. Disor., In Press. Lucero, R. J. and Vail, D. J., (1968). Public policy and public responsibility. Hosp. comm. Psychiut., 19: 232. Plomley, A., Ingham, R. J. and Andrews, G. (1971). The modification of stuttering and the token reinforcement system. 1. A ust. Coll. Speech Therapists, In Press. Premack, D. (1959). Towards empirical behaviour laws. I. Positive reinforcement. Psych. Rev., 66: 219. Winkler, K. C. (1969). Ward Management of Chronic Psychiatric Patients by a Token Reinforcement System. Unpublished Ph.D. Thesis, University of New South Wales, Australia. Yates, A. J. (1970). Behaviour Therapy. Wiley, New York.

The Epidemiology of Suicidal Behaviour in Australia

Abstract: SYNOPSISThere has been a striking rise in the suicide rate in Australia over the past 20 years. Between 1955 and 1965, the rate has risen from 15.1 per 100,000 in men to 18.8 and from 5.4 per 100,000 in women to 10.8 (W.H.O.). This rise is largely due to increase in self-poisoning. Studies of Victorian data from the last 20 years reveal that the rise is particularly evident in men between the ages of 25 and 44 and in women under the age of 35 and over the age of 55. It is much more evident in the metropolis of Melbourne, suggesting the importance of social factors.There has also been a two to three times increase in cases of attempted suicide due to self-poisoning with various commonly prescribed drugs presenting in casualty departments of general hospitals since 1955. Detailed study of 150 cases seen at the Alfred Hospital in 1969 reveals the predominance of women, the importance of interpersonal, marital and family difficulties, and of social isolation, as well as past parental deprivation.These finding...

Ethology and Psychiatry

Abstract: SYNOPSISSome of the principles underlying the science of ethology are described. Analogies are drawn between ethological and psychiatric observations in the psychiatric areas of reactions to separation, bereavement, depression, anxiety, sexual disorders and hysteria. It is suggested that in other areas also, notably obsessional states and schizophrenia, ethological concepts may be relevant. The implications and limitations of these analogies are briefly explored.

A Survey of Community Attitudes Towards Mental Illness : Part 1 the Questionnaire

Abstract: SYNOPSISSelected respondents drawn from metropolitan Melbourne (N = 318), when asked to express their opinions and attitudes in relation to four hypothetical characters, recognized mental illness in the paranoid schizophrenic, were hesitant to acknowledge it in the simple schizophrenic and the alcoholic, and denied it almost absolutely in the anxiety neurotic. Failure to diagnose a condition as mental illness did not, however, necessarily preclude recognition that the person described was in need of psychiatric help. Certain respondent characteristics and, in particular, education were related to the opinions and attitudes expressed.

Human Sexuality in Medical Education and Practice

Abstract: SYNOPSISThe work of Masters and Johnson has tremendously stimulated an interest in and understanding of human sexuality. These authors have discredited certain myths and erroneous notions about sexual problems, their causes and treatment. More and more couples are turning to their physicians for advice and treatment for sexual problems, but doctors are often in the uncomfortable position of being considered experts, when in fact they have little or no training in this field. For patient and doctor alike, this is an untenable situation which medical educators are only beginning to recognize and remedy.

Long-Term Effects of Haloperidol on Severely Emotionally Disturbed Children

Abstract: SYNOPSISA controlled, double-blind study of haloperidol in 30 children suffering from severe emotional disorders was attempted. Toxic and side-effects and reduction of symptoms were observed over a prolonged period of medication. A battery of tests was designed to study any adverse effects on development and learning processes. The conclusions reached indicated that at an overall level and in terms of diagnostic categories, no statistical significance was established when compared with placebo. However, haloperidol is significantly superior to placebo in ameliorating particular symptoms, is a relatively safe drug, and it did not impair intellectual functioning and learning tasks.

Suicide in Western Australia, 1967. An analysis of coroners' records.

Abstract: SYNOPSISThis paper reports an analysis of the police and coroners' records of all suicides in Western Australia in 1967 Where necessary, previous medical records of inpatient treatment were also scrutinized by the author. The findings are set out and discussed. It is concluded that the medical profession has much to learn in the detection of suicidal risk.

Crisis intervention: theoretical and methodological considerations.

Abstract: This paper is a theoretical and methodological dissertation on the concept of crisis intervention as an instrument of primary prevention; appropriate current literature is reviewed. The concepts of crisis are discussed briefly, and a concept emphasizing the intrapsychic state of the individual is proposed. The relevance of crisis with its period of disturbed functioning and its potential immediate and long-term sequelae for mental and physical health and social adaptation is reviewed.The concepts of crisis intervention are explored and dealt with. Each is looked at from the aspects of epidemiologically established basis, forms of intervention, both actual and hypothesized, and methodology of evaluation of effectiveness.

Aggression: instinct or symptom?

Abstract: While aggressive behaviour has undoubtedly cxisted among vertebrates for many millions of years, its scientific study is extremely recent. Thus, sustained experimental research into the aetiology of aggressive behaviour did not really begin until the 1940s and ~ O S , and the first book based on this research appeared as rccently as 1958, when J. P. Scott’s Aggression (which still remains one of the best introductions to the subject) was published under the sponsorship of the University of Chicago Committce on Publications in Biology and Medicine.‘ Since the publication of Professor Scott’s pioneer survcy, and particularly during the last decade, the study of aggressive behaviour has burgeoned as is apparent, for example, in the references listed in the course of my preparation of this present paper,2 over 80 per cent of which have been published since 1960. Again, during this period, a succession of important symposia on aggressive behaviour has been held: in London (1963), in Los Angeles (1965) and in Milan (1968);” and the naturc of human aggression has become one of the major intellectual issues of our age. The first of the symposia to which I have referred (and in which I was privileged to participate) was held at the British Museum of Natural History in October, 1963, under the auspices of the Institute of Biology, and was made memorable by the presence of the eminent cthologist, Professor Konrad Lorenz, Director of the Max-Planck-Institut fur Verhaltensphysiologie at Seewiesen in West Germany. That sanic year Konrad Lorenz’s widely discussed book On Aggression was published in Vienna, and three years later, in 1966, it

Personality Factors in Hypertension

Abstract: SYNOPSISThis paper describes a study of personality traits and psychological symptoms in hypertensive patients and in subjects with unrecognized elevation of blood pressure. The findings suggest three things. Firstly, hypertensive patients who attended an out-patient clinic showed evidence of psychological disability. Secondly, undiagnosed hypertensives were not distinguished from normotensives according to a variety of questionnaire variables. Thirdly, the existence of a hypertensive personality profile described in great detail by some writers, was not confirmed.

Facilitation of Noradrenaline Uptake by Lithium

Abstract: SYNOPSISIt has been suggested that lithium exerts its antimanic effect by facilitation of noradrenaline uptake into adrenergic neurones. Evidence in support of this hypothesis has been obtained from pharmacological experiments in which the effects of lithium were observed on isolated tissue preparations and in whole animals. The effectiveness of lithium in facilitating the uptake of noradrenaline was greater under conditions of reduced noradrenaline uptake, as in the presence of cocaine, than under control conditions.

Contemporary Challenges in Psychiatry

Abstract: One of the grcatest inhibitions against accepting an invitation to the Presidency of this College is the knowledgc that one will ultimately be obligcd to pronounce a Prcsidcntial Address. The first question onc asks in composing it is, what is the function of this ritual and ordcal? After listening to many, I am convinced that the only common feature is that they are generally responsible statements by responsible individuals on matters of which

The college arms.

Abstract: Welcome to the ninth edition of the College of Arms Newsletter. This has been created to keep interested members of the public up-to-date with the activities of the College of Arms and its officers, including matters of genealogical and heraldic significance such as recent grants of arms and recently recorded pedigrees. It is produced every three months and sent automatically and free to those who subscribe by entering their name and e-mail address in our mailing list. Other benefits for those who submit their names in this way include advance notice of College of Arms events, relevant publications, and media appearances. If you wish to remove your name from this list, to send the newsletter on to a friend, or send a genealogical or heraldic enquiry to the College, please make use of the links listed at the top of this page.

A Survey of Community Attitudes towards Mental Illness* Part 2 the Semantic Differential

Abstract: SYNOPSISSelected respondents from metropolitan Melbourne (N = 318) were required to make ratings on fifteen semantic differential scales for each of ten concepts which opposed physical medicine with psychiatric medicine, not only at the level of individual patient disability but also in terms of the facilities provided for their treatment and the medical personnel directly involved in the treatment process. Cluster scores on the factors evaluation, understandability and potency consistently favoured concepts relating to physical medicine. This relationship was maintained, independent of various respondent characteristics.

Recent Advances in the Use of Lithium

Abstract: The four major recent advances have been ( I ) the substantiation by Baastrup and Schou of their original claim (Baastrup and Schou, 1967) three years ago that maintenance lithium medication was significantly effective in preventing recurrent depressive as well as manic episodes, (2) the preliminary studies by Serry (1969) on the use of a lithium excretion test to identify probable lithium responders, (3) an increasing awareness that lithium is sometimes dramatically successful as “end of the road” medication in occasional so-called chronic schizophrenics, especially in those patients who have at some time exhibited manic features, and (4) equally necessary as adjuvant treatment in a significant proportion of young cyclothymes who are initially diagnosed as sociopaths or as suffering from a behaviour disorder.

Sociopsychiatric Study of Schizophrenia: The Follow-Up*:

Abstract: SYNOPSIS A one-year follow-up of 127 schizophrenic patients admitted to psychiatric hospitals in 1968–69, who had spent at least three months in the community during the year following their admission, revealed that regular taking of medication is the most crucial single factor leading to improvement in the psychiatric status of the patient, regardless of whether he was living in a positive or a negative environment. No difference was found between family of origin and nuclear family, but family setting tended to influence either improvement or deterioration of the patient, whilst patients living in a non-family setting remained predominantly unchanged. The progress of southern European patients was poorer than all the others, independently of their family setting and medication.

The changing tasks of child psychiatry.

Abstract: Child psychiatry in the nineteenth century was concerned with in-patient care of the mentally deficient, a population of children that contained many oddities who today would be regarded as psychotic. Gradually, as the concept of educability was appreciated, diagnosis became more refined, and psychiatrists interested themselves in rehabilitation and outpatient care. Now mental deficiency has become an independent specialty, with its own diagnostic and assessment centres, hospitals, day centres, special schools, out-patient clinics, and foster care.

Some Observations on the Epidemiology of Mental Retardation

Abstract: Unterharnscheidt, F. (1970) About boxing: review of historical REFERliNCES Cntchley, M. (1957). Medical aspects of boxing. ParticularlY from a neurological standpoint. Brft. med. J. . 1: 357 Kaplan. H . A. and Browder. J. (1954). Observations on clinical and brain wave patterns of profesional boxers. 1. Amer. med. Ass., 156: 1138. Mawdsley. C. and Ferguson. F. R . (1963). Neurological brate rigidity). Brit med. J . , 1: 364. disease in boxers. Lancet, 2: 795. Nesarajah, M. S., Seneviratne. K. N. and Watson. R. S. and medical aspects. Texas Rep . B i d . Med.. 28: 421.

Serotonin and severe affective disorders.

Abstract: SYNOPSISMonoamines have been associated with affective disorders following observations with mood elevating and mood depressing drugs. In addition, abnormalities in the metabolism of the biogenic amines have been reported in these illnesses. Experimental studies on animals have further supported the view that both catecholamines and indoleamines are important for the maintenance of normal mood states. The monoamine hypothesis of affective disorders states that severe depression is associated with a relative deficiency of brain monoamines, while clinical improvement follows correction of this deficit. The converse applies to mania and antimanic treatments. The evidence for these assertions is critically examined, and pertinent experimental observations will be discussed. The monoamine hypotheses of Brodie and of Dewhurst are examined to integrate the findings reported, and the biogenic amines will be shown to be only part of a more complex biochemical disturbance involving the hypothalamic-pituitary-adreno...

A psychiatric model for intercession in violent intergroup conflict.

Abstract: On 1st September, 1965, I rcceived a telephone call from a State Department official in the Dominican Republic. The connection was poor, but I gathered that he was asking me whcther I would be willing to come to the Dominican Republic to establish contact with young Dominican revolutionaries in order to determine whether there was any way, satisfactory to them, to open communication between them and the United States diplomatic mission in that country, and, possibly, even to reduce the violencc and killing that was taking place in the country. I accepted the invitation, provided that I would be able to act as a wholly indepcndent consultant, and thus began a real-life expcriment in psychiatric intercession in violent intergroup conflict. Before 1 report on the outcome of this particular case, it may be useful to outline some of thc considerations that went into this decision to intercede, to engage in a form of mass therapy. Lct me begin by suggesting that thc principal function, the ruison d’Ctre of the psychiatric profession, is thc reduction or elimination of human suffering that ariscs from the alienation of men from thcir fellows; that, at least, is one principal element in any definition of mcntal ill-health. Over the years, the psychiatric profession has gradually acquired and elaborated a body of knowledge and mcthods designed to rcduce alienation of the individual from his family, friends and socicty, and cven himself. We havc learned to identify, and to somc extent to correct or prevent, genetic, metabolic, and biochemical disorders, have learned to recognize and sometimes to intervene in faults of personal psychological devclopment by methods of psychotherapy, and we arc even learning to help the

The Clinical Psychologist in a General Hospital

Abstract: hypothesized to be a result of impaired communication within the family, particularly between mother and child, with the former smothering the child and the latter passively compliant. In the eating situation, this means that mother’s needs dominate over the child’s own hunger and satiety sensations. Bruch seems to make it clear, though, that obesity is not necessarily associated with severe psychopathology but the basic mechanism is aetiologically similar in all severe cases.

Psychiatry and Human Nature in Modern Society

Abstract: As a historian, 1 must confess to a certain trepidation in addressing an assembly of psychiatrists. I know of mental distress and therefore of psychiatry only by hearsay. Having thus placed my lack of credentials before you, you will agree with me that I have good reason to be apprehensive, because it is not obvious to me that I can make a sensible contribution to your discussions. But even if I decide to take my courage in both hands, it will be dificult to decide what to talk about. For instance, there are many people who believe that what we call mental disease is not really mental but organic, and in that case there is a fascinating field for inquiry into the varying degrees of tolerance offered by different societies for organic mental illness. In pre-Muslim Egypt in the 2nd century A.D., there was social acceptance of catatonic schizophrenics as well as of certain types of starvation hysteria. In most Hindu families, there is provision for serious melancholia of women, and in all medieval manors and villages there was complete acceptance of congenital idiocy. The historian has much to say on the why and how of the relativity of these attitudes and the consequent roles assigned to the psychiatrist in the treatment even of physically conditioned mental disease. But if one believes, as many psychiatrists do, that mental disease could have at least some of its roots in the mind, the historian can offer some reflections upon modern society for your consideration.

The Psychology of Crowd Behaviour: A Review of Freud's Theories in the Light of Contemporary Historical Research

Abstract: SYNOPSISThe original psychoanalytic hypothesis on the behaviour of crowds was formulated by Freud in Group Psychology and the Analysis of the Ego. Freud based his theoretical concepts on the writings of Gustave Le Bon, whose work on crowd behaviour was mainly concerned with the composition and behaviour of the crowds in the French Revolution. Modern historical research has thrown doubt on the objectivity and validity of Le Bon's descriptions. This in turn leads to a questioning of Freud's hypotheses on the psychodynamics of crowd behaviour, in particular the behaviour of socially restless and revolutionary crowds. The author examines the validity of Freud's sources and suggests modifications of his psychodynamic theories in the light of more accurate historical research. A parallel is drawn with Totem and Taboo in which Freud used data that are regarded as inaccurate by modern anthropological researches.

Obesity in Children

Abstract: The Branches were asked to express their preference for the Alum symbol, the snakes, the central circle, and the octagon and hooks. As a result of these decisions, a final badge was produced and transmitted to Bluemantle Pursuivant of the College of Arms, together with the articles and history of the Association and of the College, its membership, a statement of its funds and a description of its buildings. In January, 1965, a letter was received from Bluemantle Pursuivant of Arms to say,

Relationship Between the Psychogalvanic Reflex and the Eysenck Personality Inventory N Score

Abstract: SYNOPSISA psychogalvanic reflex (P.G.R.) study, conducted in the Department of Psychiatry, Christian Medical College, Vellore, India, is described. 20 subjects took part in this study They consisted of 10 members of the staff and 10 neurotic patients. All of them filled up the Eysenck Personality Inventory A form. A continuous P.G.R. tracing was recorded on a Grass 4-channel polygraph, before, during, and after a standard stress test (Progressive Matrices). A high N score differentiated the neurotic group from the normal group. P.G.R. changes did not differentiate the two groups. N score was significantly correlated to initial resistance change percentage (+0.568) and to initial log change conductance (—0.458). The implications of these findings are discussed.

Token reinforcement systems.

Abstract: chromosomal anomalies are employed widely; these are very suitable for epidemiological investigations. The development of tests for detecting abnormalities of function during infancy that can be reliably used by midwives, obstetricians, paediatricians and public health nurses in their routine clinical work and that will provide pointers to cases needing more intensive study is bein followed actively. The need for early diagnosis folfoowed by prompt remedial treatment, when appropriate, and by special education has now become accepted generally. From the modest beginnings of crude counting, based on predetermined observation and findings, data can accrue. From this, the source of indications as to where to look further, as to how to refine wide inquiries to provide specific answers to specific questions that are raised by exploratory study will be shown. The nature of mental retardation in different settings is a matter of importance for research because information that has been gathered already has shown that variations in patterns of morbidity and in the social relevance of these disorders exist. It is to learn where, why and how these forces operate that we must continue to apply our consideration and our research. Much of our shared interest and concern stresses the needs for provision of adequate community and hospital services for the mentally retarded and the continuing challenge of recognition and understanding of the social problem that is mental retardation. We know as well that data are needed. Facts, patterns, profiles, trends, charts, graphs and statistics, all these are vital ingredients in the pursuit of answers to questions posed by community research into mental retardation. REFERENCES Biiiik, J. A. (1953). A genetic and neuropsychiatric investigation of a north Swedish population with special regard to schimphrenia and mental deficiency. Acfa Genetica ( E a s e l ) , 4: 345. Bremcr. J. (1951). A social psychiatric investigation of a small community in northern Norway. Acta Prychiut. Scand.. Supplement 62. Essen-Moller. E. (1966). Individual trails and morbidity in a Swedish rural population. Acta. Psychiat. Scand., Supplement 100. Goodman, N. and Tizard, J. (1962). Prevalence of imbecility and idiocy among children. Brit. Med . 1.. 1: 216. Gordon, J. (1952). The twentieth century yesterday. today and tomorrow. In: F. H. Top (Ed.). The History of American Epidemiology. C. V. Mosby, St Louis. Greenwood, M. (1935). Epidemic and Crowd Diseases. Williams and Norgate, London. Gruenberg. E. M. (1966). The epidemiology of mental retardation. Int. 1. Psychiaf., 2: 78. Innes, G. and Kidd, C. B. (1967). The operational significance of regional morbidity data on mental deficiency. Healfh Bulletin (Edinburgh) 25: 55. Innes, G.. Kidd, C. 8. and Ross. H. S. (1968). Mental subnormality in northcast Scotland. Brit. 1. Psychiat., 114: 35. Kidd, C. B.. Innes, G. and Ross. H. S. (1967). The prevalence of mental subnormality in two regions: some comparisons between northcast Scotland and Northern Ireland. Ulster med. J . , 36: 139. Rushlick, A. (1961). In: A Report on the Mental Health Services of the City of Salford for the Year 1960. p. 18 Salford (U.K.) Health Department. Kushlick. A. (1964). The prevalence of recognized mental subnormality of 1.Q. under 50 among children in the south of England with reference to the demand for residential care. Proceedinm of the International Conference to r the Scientific Study o f Mental Retardation, 2: 550. Kushlick, A. (1965). Community services for the mentally subnormal. Proc. roy. SOC. Med. , 58: 373. Lemkau, P. Tietzc, C. and Coopx, M. (1941). Mental hygiene problems in an urban district. Mental Hygiene, 25: r ( 9 A

Discharging elderly patients from a psychiatric hospital.

Abstract: SYNOPSISThe community is able to tolerate discharged psychogeriatric patients by virtue of a reaction between the resources which it has to offer and the behavioural abnormalities which the discharged patient presents. Therefore, in order to maximize the potential for community care, an attempt was made to identify those factors in the community or in the patient which favoured or militated against survival in the community.It was found that only females and those patients with a diagnosis of depression showed a significant increase in their chances of re-hospitalization. No factors were found to be associated with an ability to stay outside hospital.

Sensitivity training in a psychiatric hospital.

Abstract: SYNOPSISThis article describes the establishment of sensitivity groups (T-groups) within a psychiatric admission centre handling a full spectrum of psychiatric problems. The rationale for T-groups is reviewed. Some of the factors leading up to the demand for the T-groups by the staff themselves are described. The composition of the group, and its reactions to sensitivity training are discussed. Some current and some anticipated difficulties in this type of in-service training are considered.

Aggression and Politics

Abstract: (1971). Aggression and Politics. Australian and New Zealand Journal of Psychiatry: Vol. 5, No. 2, pp. 101-105.