Showing papers in "Journal of Nervous and Mental Disease in 1971"
TL;DR: The symptoms of restlessness, distractibility, impulsiveness, excitable, excitability, and aggressiveness seemed to persist in most of the children, and were associated with poor performance in school and low self-esteem.
Abstract: We studied 83 children between the ages of 12 and 16 who had been diagnosed as having the hyperactive syndrome 2 to 5 years earlier. About half of the children were markedly improved, one-quarter remained unchanged, and the remaining quarter lay in between. The symptoms of restlessness, distractibil
295 citations
TL;DR: Certain cultural and social factors, particularly role expectations and values, are discussed as possible factors helping to account for the relationships found between life crises and psychiatric impairment.
Abstract: This is a report on relationships between life crises and psychiatric impairment in a community sample of 938 adults in New Haven, Connecticut.It is part of a longitudinal study of the population of a community mental health center catchment area. The theoretical framework for the paper finds its roots in two bodies of socio-medical literature, namely, stress research and epidemiological field studies of mental illness. The specific research question is to determine whether or not there is a relationship between the occurrence of life events, the patterning of such events and the degree of psychological impairment. As in other field studies, we discovered a significant amount of psychiatric impairment in the community. Eighteen per cent of the adults interviewed were classified as having a high symptom level (very impaired), 47 per cent as a medium symptom level (moderately impaired), and 35 per cent as a low symptom level (unimpaired). More important, we found significant relationships between these scores and the occurrence of life events in the year previous to our interview. First, the greater the degree of impairment the more likely is the individual to have experienced at least one of 62 life events for which we gathered information. Equally important, there is a very strong association between the number of events experienced and the individual's mental status: the greater the number of events reported by respondents, the greater the proportional difference between the percentage of unimpaired and the percentage of very impaired who experienced that number of events. When events are categorized according to type of social activity, changes in the respondent's social field and degree of desirability impairment are strongly and positively related to the experiencing of life crises. Finally, similar patterns are found for each of the individual life events with the exception of several biopsychosocial situations associated with the family developmental cycle.Certain cultural and social factors, particularly role expectations and values, are discussed as possible factors helping to account for the relationshipsfound above between life crises and psychiatric impairment.
198 citations
TL;DR: The factor dimensions provide an alternative conceptual framework for describing the social maladjustment of depressed patients which may be more suitable for observing patterns of change and measuring the effects of psychotherapy or other treatments.
Abstract: There have been relatively few empirical investigations of the dimensions underlying rating of social and interpersonal functioning. Most social adjustment scales have evaluated functioning in terms of role areas such as work adjustment, marital adjustment, social and leisure adjustment. These ignor
131 citations
TL;DR: Among the clinical implications of this study is that concrete, favorable feedback regarding specific performance not only improves the depressed patient's pessimism and level of aspiration but can also increase his productivity.
Abstract: Previous clinical observations have suggested that the tangible demonstration to a depressed patient that he can successfully attain a stated goal may ameliorate his pessimism, low self-esteem and loss of motivation. An experiment was devised to test the proposition that the depressed patient is so
101 citations
TL;DR: The English language literature on disulfiram treatment of alcoholism since the drug's introduction in 1948 is critically reviewed.
Abstract: The English language literature on disulfiram treatment of alcoholism since the drug's introduction in 1948 is critically reviewed. The complications of and contraindications to disulfiram treatment are discussed. Changes both in the administration of and attitudes toward disulfiram are noted and th
94 citations
TL;DR: The view is advanced that increases in alpha density during feedback training arise from a diminution of those factors which block this rhythm, and some implications of such a view are discussed.
Abstract: The recent attention given to the feedback control of human brain-wave activity and the implications of such control prompts a careful analysis of this phenomenon. Particular emphasis is placed on the learned control of the alpha rhythm. A review of possible factors that might influence the density of alpha rhythms led to the differentiation of three general sources of influence: constitutional, physiological, and cognitive-attentional factors. Each of these factors is discussed as a possible mediator of the learned control of the alpha rhythm. The view is advanced that increases in alpha density during feedback training arise from a diminution of those factors that block this rhythm, and some implications of such a view arc discussed. Several of the issues raised appear generalizable to the whole question of the operant control of autonomic activity.
89 citations
TL;DR: Two experiments were designed to determine conditions under which moderate drinking could be maintained for 5 days in succession, and demonstrated that it was the absence of reinforcement contingencies for moderation, rather than living in an impoverished environment, which resulted in excessive drinking.
Abstract: Healthy chronic alcoholics were hospitalized and given access to substantial quantities of ethanol in an effort to limit their drinking by the application of contingency-management procedures. Two experiments were designed to determine conditions under which moderate drinking could be maintained for 5 days in succession. The reinforcer for moderation was participation in an enriched environment. Excessive drinking resulted in the subject's withdrawal from this environment. The first experiment demonstrated that moderate drinking could be maintained by this strategy. The question arose then whether drinking during the noncontingent weeks occurred because of the absence of contingencies or whether it resulted from the aversive nature of the impoverished environment in which the subjects were required to live. The second experiment demonstrated that it was the absence of reinforcement contingencies for moderation, rather than living in an impoverished environment, which resulted in excessive drinking. These results are discussed in relation to the feasibility of moderate drinking as a therapeutic goal for the chronic alcoholic and contingencies which might be used to manage alcoholism.
78 citations
TL;DR: Correlations between verbal and spatial intelligence tests were significant for controls and short term alcoholics but nonsignificant for longterm alcoholics, suggesting differential hemisphere sensitivity to the effects of chronic alcoholism with a consequent dissociation in factors related to intellectual functioning.
Abstract: Chronic alcoholics (N = 30) and hospital controls (N = 30), matched on age and education, were tested on a verbal and spatial intelligence test. Chronic alcoholics performed significantly poorer than controls on the spatial but not on the verbal intelligence test. Alcoholic history was demonstrated
77 citations
TL;DR: Sleep data from chronic alcoholics have indicated that sleep disturbance represents an important aspect of alcoholic detoxification, and previous studies have been complicated by problems of poor diet, uncertain time for onset of withdrawal, or a limited time schedule for controlled withdrawal.
Abstract: Sleep data from chronic alcoholics have indicated that sleep disturbance represents an important aspect of alcoholic detoxification. Previous studies have been complicated by problems of poor diet, uncertain time for onset of withdrawal, or a limited time schedule for controlled withdrawal. This stu
71 citations
TL;DR: Attempters were younger, had a previous history of suicide attempts, evidence of underlying personality disturbance suggestive of character disorder, and a clinical pattern of neurotic rather than endogenous depression.
Abstract: A sample of 189 depressed patients, previously studied in detail, was followed up 10 months after initial treatment contact. Thirteen of these individuals had made suicide attempts, one fatally, during the period. Sociodemographic variables, previous history, personality dimensions, and symptom rati
69 citations
TL;DR: Frequent nightmare sufferers when compared with their less frequent and non-nightmare counterparts demonstrated greater manifest anxiety, lower ego-strength, heightened conscious concerns about death, and significantly more sleep disturbances.
Abstract: The relationship between the self-reports of the occurrence of nightmare dreams and a number of personality characteristics was examined for a hospitalized sample. Frequent nightmare sufferers when compared with their less frequent and non-nightmare counterparts demonstrated greater manifest anxiety
TL;DR: The patients with multiple sclerosis showed relatively mild impairment in tasks requiring abstract reasoning and logical analysis, an area that has been shown to be more seriously deficient in many studies of patients with other types of cerebral disease or damage.
Abstract: Thirty subjects (25 males and 5 females) with definitive diagnoses of multiple sclerosis were matched in pairs for race, sex, age, and education with 30 subjects who had normal brain functions. An extensive battery of psychological tests was individually administered to each subject. The measures we
TL;DR: Alcoholic and nonalcoholic Ss were tested using verbal learning procedures that included multiple trial free-recall learning of random and related words; 2) multiple trial serial learning; and 3) the production and reproduction of discrete free associations.
Abstract: Alcoholic and nonalcoholic Ss were tested using verbal learning procedures that included 1) multiple trial free-recall learning of random and related words; 2) multiple trial serial learning; and 3) the production and reproduction of discrete free associations. The Ss were tested while sober and whi
TL;DR: Patients were older, had a relatively long history of heavy drinking, were less likely to be depressed, and were more likely to have had delirium tremens and Alcoholics Anonymous contact and to rate high on motivation.
Abstract: Three groups of outpatient alcoholics treated with disulfiram (group 1: high abstinence clinic attenders; group 2: low abstinence clinic attenders; group 3: clinic dropouts) were matched to control nondisulfiram patients with respect to variables thought to influence outcome in all kinds of alcoholism treatment. Only group 1 patients did better while on disulfiram than controls. Compared with group 2 and 3 patients, they were older, had a relatively long history of heavy drinking, were less likely to be depressed, and were more likely to have had delirium tremens (DT's) and Alcoholics Anonymous (AA) contact, to be abstinent on admission, and to rate high on motivation
TL;DR: Some insights on the psychology of schizophrenia are provided by David Shakow and his colleagues.
Abstract: SOME OBSERVATIONS ON THE PSYCHOLOGY (AND SOME FEWER, ON THE BIOLOGY) OF SCHIZOPHRENIA DAVID SHAKOW; The Journal of Nervous and Mental Disease
TL;DR: Problems with the reliabilities of and intercorrelations among the various process-reactive scales are discussed, indicating the need for replication of the above findings using other scales and for the continued development and refinement of process- reactive measuring devices.
Abstract: Earlier studies have suggested that the scales used to distinguish process from reactive schizophrenics may be sensitive to differences in sex, race, and socioeconomic status (SES). Social histories of psychiatrically diagnosed schizophrenics served as a basis for evaluating the above variables as well as that of social mobility and for dividing Ss into process (N=150) and reactive (N=150) groups using the Symptom Check List. X2 analysis revealed that Ss receiving process schizophrenia ratings were over-represented among males (p<.005), blacks (p<.005), and the lower SES (p<.05). When race and SES were examined simultaneously, lower SES white Ss were more often rated as process than upper SES white Ss (p<.025), while no difference in process-reactive ratings was found in the analogous comparison for blacks. No relationship was found between social mobility and process-reactive ratings. These findings may reflect correlates of the process-reactive dimension or they may be artifacts of possible scale and rater bias. Problems with the reliabilities of and intercorrelations among the various process-reactive scales are discussed, indicating the need for replication of the above findings using other scales and for the continued development and refinement of process-reactive measuring devices.
TL;DR: The results indicate that when one controls for either age of first psychiatric treatment contact or premorbid asocial adjustment marital status has no prognostic utility.
Abstract: The 3-year incidence of rehospitalization of a group of 81 previously hospitalized schizophrenic patients was determined. A significant relationship was found between their incidence of rehospitalization and age of first psychiatric treatment contact (p<.001), premorbid asocial adjustment (p<.001) a
TL;DR: It was suggested that an overall model of consensual experience remained a plausible explanation of family performance but that an individual information processing model was equally plausible.
Abstract: A selective review of the literature permitted us to predict that normal families would experience their environment as patterned, logical and masterable (environment-sensitive); that members in families of delinquents would experience themselves in their own universe where others' behavior and opinion was irrelevant (distance-sensitive); that families of schizophrenics would experience the environment as confusing and hostile and would strive toward shared, stylized and distorted notions of it as a means of mutual protection and support. An array of experimental findings, using objective measures from a card-sorting procedure, confirmed most of these predictions. It was suggested that an overall model of consensual experience remained a plausible explanation of family performance but that an individual information processing model was equally plausible. Three distinctive contributions of the present methods and concepts were discussed: their provision of a typology of families based on objective classificatory techniques, the possibility of bypassing notions of the ideal and defective in family life and the study of families' interaction with their communities.
TL;DR: It was shown that phenothiazines reduce SC level, elevate HR and restrict frequency of specific and nonspecific reactivity in SC and range of variability in HR are linearly related to daily dosage level.
Abstract: The effects of chronically administered phenothiazine medication upon aspects of skin conductance (SC) and heart rate (HR) in 32 schizophrenic patients were assessed in two ways. Skin conductance scores obtained during rest and during the performance of a series of span of apprehension tasks were correlated with a phenothiazine dosage index (PDI), representing chlorpromazine equivalent daily dosage. For 15 schizophrenics withdrawn from medication for 3 months and for nine normal controls pre- and postwithdrawal rest and performance scores were obtained and compared by repeated measurement analyses of variances. Results, congruent with other studies, indicate that phenothiazines reduce SC level, elevate HR and restrict frequency of specific and nonspecific reactivity in SC and range of variability in HR. Moreover, it was shown that several of these effects are linearly related to daily dosage level. The implications of these findings for past and future uses of autonomically mediated psychophysiological variables in the study of phenothiazine-treated schizophrenic disorders are discussed, as well as the applicability of the PDI in controlling statistically drug dosage-contaminated psychophysiological variance.
Journal Article•
TL;DR: A 17-year-old dual personality was treated with techniques derived from hypnotherapy and adapted for use without hupnosis induction, thought to be identical with that of dissociation in multiple personality.
Abstract: A 17-year-old dual personality was treated with techniques derived from hypnotherapy and adapted for use without hupnosis induction. The mechanism of hypnotically induced dissociation is thought to be identical with that of dissociation in multiple personality. Like the hypnotic subject, the second personality usually has access to material not available to ordinary consciousness. Therapists are cautioned against showing too much interest in the dissociated personality as this subtly reinforces the dramatic aspects of this condition. Hypnosis, while commonly used in such cases for contact with the dissociated personality, is thought to be counterindicated for the same reason, and also because it may be interpreted by the patient as a sanction of the dissociative process. The result tends to be a further splitting off of personality fragments. However, a working knowledge of the dynamics of hypnosis and of hypnotherapeutic techniques can make a unique contribution to the therapy of dual or multiple personalities
TL;DR: While brain damage alone, resulting from birth complications, may not explain the unique symptoms of childhood schizophrenia, it is considered possible that in families already predisposed genetically for the development of this disorder, the addition of reproductive complications, especially perinatal factors, may be enough to tip the balance between health and disease, and profoundly disrupt the child's later development.
Abstract: Evidence has accumulated during the past decade linking pregnancy and birth complications to later disorders of function. In 1956 Pasamanick et al. postulated that these complications might produce a “continuum of reproductive casualty…extending from fetal and neonatal death through cerebral palsy, epilepsy, mental deficiency, and behavior disorder.” Prenatal and perinatal complications have also been associated with childhood schizophrenia, although only two of the studies summarized used the patients' siblings as controls. Since siblings represent the best controls of environmental and hereditary variables (short of studying monozygotic twins discordant for childhood schizophrenia), they were used in the present study as controls. Accordingly, 33 childhood schizophrenics and their 83 siblings were analyzed with regard to prenatal and perinatal complications. Information was obtained from the patients' case records and from the hospital birth records and birth certificate records of both patients and their siblings. The childhood schizophrenics had a higher rate of prenatal complications than their siblings, but the difference was not significant. With regard to perinatal complications, however, the patients had a significantly higher rate than their siblings (p There was also a clear association between the schizophrenic child's ego status on admission to the hospital and his IQ and age of hospital admission. The schizophrenic children with poorer ego development compared to those with better ego development are admitted to the hospital earlier (p While brain damage alone, resulting from birth complications, may not explain the unique symptoms of childhood schizophrenia, it is considered possible that in families already predisposed genetically for the development of this disorder, the addition of reproductive complications, especially perinatal factors (e.g., breech presentation, placenta previa, midforceps, induction of labor for complication, newborn distress, etc.) may be enough to tip the balance between health and disease, and profoundly disrupt the child's later development.
TL;DR: By using a soliloquy technique to re-evoke subjective experiences that occurred immediately prior to the suicide attempts of 15 patients, it is found that suicidal ideation was associated with a hopeless and helpless outlook on a foreshortened personal future.
Abstract: By using a soliloquy technique to re-evoke subjective experiences that occurred immediately prior to the suicide attempts of 15 patients, we found that suicidal ideation was associated with a hopeless and helpless outlook on a foreshortened personal future. The soliloquy technique may become useful
TL;DR: Those subjects who reported the most negative affects immediately after the stress film were the subjects highest on intrusive thought during the following performance periods.
Abstract: In experimental studies of stress, the focus has been largely on psychophysiological reactions or global defensive styles. This study focused on cognitive responses after a stress film, as compared with responses after a neutral film and in a base line condition. Thirty-one subjects in a counterbalanced design had significantly more intrusive thoughts and recollections of film scenes after the stress film (p
TL;DR: Social and situational stressors were categorized for 172 patients who received one of the following diagnostic labels: schizophrenic reaction, depressive reaction, personality disorder, or transient situational personality disorder and found that specific diagnostic patterns were unrelated to specific antecedent stressors.
Abstract: Social and situational stressors were categorized for 172 patients who received one of the following diagnostic labels: schizophrenic reaction, depressive reaction, personality disorder, or transient situational personality disorder. The frequency of occurrence of these stress factors were evaluated for a 2-year period prior to the request for psychiatric intervention. The results indicated that there were no differences among diagnostic groups with respect to the average number of stressors experienced during this period. It was also found that specific diagnostic patterns were unrelated to specific antecedent stressors. It was suggested that social and situational stressors have generalized effects which may be expressed in varying symptomatology depending on the characteristics of the individual under stress.
TL;DR: The qualities found in this study to be characteristic of pictures produced during depression seem to be the result of a paucity of pictorial development which is congruent with the total image of the severely depressed individual.
Abstract: Despite the prevalence of the syndrome of depression, there are few observations in the literature on the art expressions of depressed patients compared with an abundance of data on schizophrenic art. Where observations appear, there is not evidence of systematic investigation. This study is an attempt to delineate characteristics of depressive art expression tested by a blind rating procedure. The sample studied is composed of pictures produced by 10 hospitalized depressed patients. Pictures made on days when depression was high are compared with pictures produced by the same patients when depression was low. Patients served as their own controls in order to eliminate variables of artistic ability and experience, intelligence, age, etc. Blind raters compared the pictures for characteristics hypothesized to be associated with depression. The results indicated that during increased depression, patients' pictures revealed less color used, more empty space, less investment of effort or less complete, and more depressive affect or less affect than when less depressed. Though not of statistical significance, there was a trend toward the pictures being more constricted and more meaningless than when less depressed. The hypothesis that they would also be more disorganized was not supported. Examples of three of the pairs studied are illustrated, along with descriptions of the patients' appearance and behavior at the art therapy sessions at which they were produced. The rating results for each of these pairs are discussed. The discrepancies between the findings reported here and elsewhere appear to be due to two variables in particular: a difference in the setting giving rise to a different sort of population of depressed patients who made pictures; and a different manner of investigation, i.e., a blind methodology as opposed to generalized impressions. In conclusion, the qualities found in this study to be characteristic of pictures produced during depression seem to be the result of a paucity of pictorial development which is congruent with the total image of the severely depressed individual.
TL;DR: Various disturbances of sexual activity can occur in men undergoing phenothiazine therapy, including diminished libido, erectile impotence, and ejaculatory inhibition.
Abstract: Various disturbances of sexual activity can occur in men undergoing phenothiazine therapy, including diminished libido, erectile impotence, and ejaculatory inhibition. The latter side effect has been encountered during treatment with thioridazine (Mellaril) and much more rarely with chlorprothixene