Showing papers in "Journal of Nervous and Mental Disease in 1976"

On the methods and theory of reliability.

Abstract: This paper reviews the most frequently used and misused reliability measures appearing in the mental health literature. We illustrate the various types of data sets on which reliability is assessed (i.e., two raters, more than two raters, and varying numbers of raters with dichotomous, polychotomous, and quantitative data). Reliability statistics appropriate for each data format are presented, and their pros and cons illustrated. Inadequancies of some methods are highlighted. The meaning of different levels of reliability obtained with various statistics is discussed. This critique is intended for the reading professional and the investigator who has an occasional need for reliability assessment. Statistical expertise is not required and theoretical material is referenced for the interested reader. Necessary formulas for computations are presented in the appendices. A summary table of some suitable reliability measures is presented.

A model to replace psychiatric hospitals

Abstract: A comprehensive system of community treatment in southwest Denver has reduced the need for adult psychiatric inpatient beds to less than 1/100,000 population. Six small, community-based therapeutic environments, crisis intervention, home treatment, social systems intervention, and rapid tranquilization comprise the essential components of this total community care system. The system operates within a framework of citizen participation and community control, the elimination of formal staff offices, and a focus on working in the real-life setting of the client and his family. To evaluate the effectiveness of community care, patients about to be hospitalized were randomly assigned to a psychiatric hospital or to community alternative treatment. Outcome measures at discharge and at follow-up completed by the client himself, treatment staff, and family members indicate that community treatment was more effective than psychiatric hospitalization.

Impact of the seclusion room experience.

Abstract: The seclusion room is a repository of intense feeling and strongly held opinion for members of psychiatric inpatient units. Patients, nurses, and doctors often find themselves in intrapsychic and/or interpersonal conflict over its use and misuse. Perhaps because of general discomfort, relatively little is known about what a patient actually experiences while secluded. In this report, we utilized an unexpected source of information on the meaning of the seclusion room experience for our patients: their art productions. The observations are based upon our therapeutic and research experience with acutely schizophrenic patients hospitalized on an NIMH clinical research unit located in NIH's Clinical Center. On this unit, pharmacotherapy was not used during investigation periods and, in keeping with the unit's treatment philosophy, was used sparingly or not at all during noninvestigative periods. As a result, the seclusion room was used frequently for severe management problems. Systematic collection of art productions was a routine part of the research protocol. Patients attended three individual art therapy sessions: during drug-free periods 2 to 3 weeks after admission, 2 to 3 weeks before discharge, and at follow-up 1 year after admission. The patient was asked to use pastels to draw the following pictures: a free picture (patient's choice), a self-portrait, a picture of his/her psychiatric illness, a picture of any hallucination experienced, and a picture of any delusion experienced. After completing each picture, the patient was encouraged to discuss it. Sixty-two patients were evaluated with this methodology. Particulary noteworthy is the fact that in no instance was a patient requested to draw a picture about a seclusion room experience. Nevertheless, over one third of the patients did so, underscoring the prominence of the experience for them. Furthermore, these pictures did not emerge from a large array of patient art, but from only threee art sessions per patient. The nature of the pictures fell into the following patterns: a) pleasurable hallucinations occurring while in seclusion; b) frightening delusions connected with the experience of seclusion; c) strong nondelusional feelings about being in seclusion (often the picture of the psychiatric illness was a representation of the seclusion room experience); d) special focus on the staff member in attendance outside the seclusion room door. The implications of these graphic expressions are discussed, with particular emphasis on the impact of the seclusion room experience for the patient.

Recent life events and acute schizophrenic psychosis: a controlled study.

Abstract: In this case control study, first admission schizophrenic patients were found to report more recent life events overall and more events categorized as undesirable, familial, relocation, and legal than controls. Interpretation of the observations should be ventured cautiously given the small differen

A 2-year follow-up of 72 hyperactive boys. Classroom behavior and peer acceptance.

Abstract: A 2-year, prospective follow-up of 72 hyperactive boys (94 per cent of the initial sample) examined classroom and home behavior, academic achievement, peer status, and depressive symptomatology for patients and a matched control group. Sixty-five per cent of the sample was still on medication at fol

Identity of emotional triggers in epilepsy.

Abstract: This communication describes a technique of stimulated recall and video replay which has reduced the frequency of seizures in five epileptic patients. Each of the patients had long standing partial epilepsy with complex symptomatology of the psychomotor type. It was generally acknowledged that emoti

The New Sex Therapy: Active Treatment of Sexual Dysfunctions

Abstract: Algebra: An Introduction , Thomas Hungerford, Jul 27, 2012, Mathematics, 616 pages. Abstract Algebra: An Introduction is set apart by its thematic development and organization. The chapters are organized around two themes: arithmetic and congruence. Each themeCapitols Webster's Quotations, Facts and Phrases, , Nov 26, 2008, , 113 pages. Use in Literature CapitisCapitis huius partis diuisio.ndash;Richard Hakluyt in The Principal Navigations, Voyages, Traffiques and Discoveries of the English Nation, vol 1 Cats With Hands , Joe Martin, Jan 1, 2006, Humor, 108 pages. Imagine a universe where felines have the upper hand, as if they didn't already. This volume is the first compilation of the popular \"Cats With Hands\" comic strip by Joe Martin More than fifty photos capture the beauty and spirit of Greyhounds and Italian Greyhounds. Be they Iggies (Italian Greyhounds) or Greyts (Greyhounds), these elegant dogs have. This book provides essential text explaining how differing business cultures of nations influence management decisions, and what is both common and unique to these societies. http://iberyw.files.wordpress.com/2014/07/nu-dao-no-hoa.pdf The Ghost That Closed Down The Town , Arthur Goldstuck, Oct 2, 2012, Body, Mind & Spirit, 344 pages. Arthur Goldstuck made the world of South African urban legends his own with four bestsellers during the 1990s. Now he returns to this landscape, but from a very differentThe Children's Hour , Mathilda Schirmer, Dorothy Short, 1953, Children's literature, . A selection from the great children's literature of all time Helen Singer Kaplan http://iberyw.files.wordpress.com/2014/07/craftworkers-year-book.pdf In Dewey's Wake Unfinished Work of Pragmatic Reconstruction, William J. Gavin, Feb 1, 2012, PHILOSOPHY, 255 pages. Leading scholars evaluate the importance of Dewey's work for our timesI See , Rachel Isadora, Sep 16, 1991, Juvenile Fiction, 24 pages. A baby responds to all of the things she sees. On board pages Helen Singer Kaplan Penguin, 1974 Clinical virology the evaluation and management of human viral infections, Robert DebrГ©, Josette Celers, 1970, Medical, 871 pages. VirologieBlueberries for Sal , Robert McCloskey, Jan 1, 1948, Juvenile Fiction, 54 pages. Little Sal and Little Bear both lose their mothers while eating blueberries and almost end up with the other's mother The evolution of national insurance in Great Britain the origins of the welfare state, Bentley B. Gilbert, 1966, Political Science, 497 pages Mouse Development Patterning, Morphogenesis, and Organogenesis, Janet Rossant, Patrick T. Tam, Mar 21, 2002, Science, 712 pages. This book represents a classic compilation of current knowledge about mouse development and its correlates to research in cell biology, molecular biology, genetics, andModern English a self-tutor or class text for foreign students, Neile Osman, 1964, Foreign Language Study, 240 pages Nobody's Mother Life Without Kids, Lynne Van Luven, Oct 31, 2006, Social Science, 226 pages. Statistics say that one in 10 women has no intention of taking the plunge into motherhood. 'Nobody's Mother' is a collection of stories by women who have already made this Offers an introduction to the life and thought of five 17th century spiritual writers, explores the links between them, and looks at the ways in which their influence is seen. Communication in Legal Advocacy integrates work in legal theory, communication theory, social science research, and strategic planning to provide a comprehensive analysis of. http://iberyw.files.wordpress.com/2014/07/north-american-airlines-handbook.pdf The Discovery of Teaching , Cole Speicher Brembeck, 1962, Teaching, 333 pagesA satanic affair Salman Rushdie and the rage of Islam, Malise Ruthven, 1990, Biography & Autobiography, 184 pages Calloway's Crossing , I. J. Parnham, 2007, Fiction, 235 pages. Saloon owner Trip Kincaid and his bartender Grace Theroux face trouble from Ryan Trimble's protection racket. Will a mysterious gunslinger prove to be help or an even more The author of Writings on an Ethical Life reflects on the life and work of his Viennese grandfather, a classical scholar and critic of Sigmund Freud who died at the hands of. This revised edition of the Cherrytree Children's Atlas provides an ideal introduction to the countries of the world, providing maps and up-to-date information on each place. 13,500 Secret Codes Codes from Aero Elite Combat to Zone fo Enders and 850 games in between! Invincibillity, Level Skip, Infinite Lives, Unlimited Ammo, Secret Characters. Getting Started in Property Flipping , Michael C. Thomsett, Jan 6, 2007, Business & Economics, 256 pages. A NON-TRADITIONAL APPROACH TO REAL ESTATE GETTING STARTED IN PROPERTY FLIPPING The concept of property flipping is not new; in fact, it has been around for a very long timeSins of the Wife , Jeanette M. Williams, Jul 17, 2007, Fiction, 168 pages. Julia Jones is a married woman who is living the best of two worlds. She has a successful job on one hand, and at the same time, she is living the life as a woman who was in http://iberyw.files.wordpress.com/2014/07/roy-livesey-into-evangelicalism-25-years-encouraging-biblical-discernment-warning-of-doctri.pdf The Complete Idiot's Guide to Paint Shop Pro 7 , Nat Gertler, 2001, Computers, 361 pages. PLEASE PROVIDE COURSE INFORMATIONPLEASE PROVIDEEPHEMERIS --The Book of Time --2 , Red Jordan Arobateau, 2010, Transgender people The New Sex Therapy: Active Treatment of Sexual Dysfunctions Penguin, 1974 http://avaxsearch.com/?q=The+New+Sex+Therapy%3A+Active+Treatment+of+Sexual+Dysfunctions This Jesus , Markus Bockmuehl, Oct 27, 2004, Religion, 256 pagesMass Action in the Nervous System , UNKNOWN. AUTHOR, Walter J. Freeman, Oct 28, 1975, Medical, 496 pages. Mass Action in the Nervous System The Story of the Stone: The dreamer wakes , Xueqin Cao, 1986, Fiction, 383 pages. The Story of the Stone (c. 1760), also known as the Dream of the Red Chamber, is one of the greatest novels of Chinese literature. the fifth part of Cao Xueqin's magnificent http://is.gd/QqDMXe The Compassionate Mind Approach to Recovering from Trauma Series editor, Paul Gilbert, Sophie James, Deborah Lee, Jul 19, 2012, Self-Help, 300 pages. Terrible events are very hard to deal with and those who go through a trauma often feel permanently changed by it. Grief, numbness, anger, anxiety and shame are all very commonThe Far East Comes Near Autobiographical Accounts of Southeast Asian Students in America, Lucy Hong Nhiem Nguyen, Joel Martin Halpern, 1989, Biography & Autobiography, 213 pages. Collects the personal accounts of twenty-six college students who were refugees from Cambodia, Laos, and Vietnam http://iberyw.files.wordpress.com/2014/07/the-tales-of-uncle-remus-the-adventures-of-brer-rabbit.pdf The perilous journey of the Donner Party , Marian Calabro, 2000, Donner Party, 192 pages. Uses materials from letters and diaries written by survivors of the Donner Party to relate the experiences of that ill-fated group as they endured horrific circumstances onThe fictional technique of Scott Fitzgerald , James Edwin Miller, 1957, Fiction, 116 pages http://www.amazon.com/s/?url=search-alias=stripbooks&field-keywords=The+New+Sex+Therapy%3A+Active+Treatment+of+Sexual+Dysfunctions http://iberyw.files.wordpress.com/2014/07/coercion-capital-and-european-states-ad-990-1992.pdf download The New Sex Therapy: Active Treatment of Sexual Dysfunctions created: 28th January 2013

The influence of patient's personality on adjustment to chronic dialysis: A predictive study.

Abstract: The aim of the present study is to gather data on the influence of certain personality factors on adjustment to chronic hemodialysis. One hundred thirty-six patients underwent predialysis personality assessment by clinical evaluation and all those who survived at least 6 months on dialysis were foll

Predicting individual responses to drug treatment in schizophrenia: a test dose model.

Abstract: The literature and the findings from the Camarillo Schizophrenia Research Project reported in this paper indicate that a satisfactory method for predicting the response of an individual schizophrenic patient to antipsychotic drugs has yet to be devised. A test dose procedure is described which offers promise of a practical approach to selecting the most appropriate drug and dosage for a particular patient and tailoring blood concentrations to the needs of the individual case. Preliminary findings indicate that the test dose procedure is feasible; that detectable changes occur after a single test dose; and that measurements made during the test dose period may be predictive of eventual outcome. These findings are, of course, only a report of a preliminary pilot experiment, subject to important caveats about small number of cases, interpretation of large numbers of correlation coefficients, and need for cross-validation. Nevertheless, they are encouraging and suggest that the test dose approach has considerable potential for further research.

Loose associations and disordered speech patterns in chronic schizophrenia.

Abstract: The present research involves the development and utilization of a method to evaluate the free speech of chronic schizophrenic patients to measure aspects of thought disorder. Using this technique, two samples (one chronically hospitalized, the other nonhospitalized) of 15 chronic schizophrenic subjects each studied and compared. Severe types of looseness of association were not a prominent finding in the patients studied. On several of the other categories of speech patterns in investigated, multiyear hospitalized chronic schizophrenics were found to have significantly higher scores than a sample of chronic schizophrenics living in the community. This included a measure of paucity of speech, of perseveration, of repetition, and a measure of overally deviant verbalizations. The chronic schizophrenic patients generally showed high degrees of perseveration and paucity of speech, variables which may be related to impoverished thinking. The significance of these results is analyzed and discussed, with several aspects of the data suggesting that the differences may be due to severity of illness. The phenomenological scoring system developed and utilized is found to be reliable and seems to represent a useful tool for the study of many aspects of the schizophrenic patient.

Asymmetry of information processing in hallucinators and nonhallucinators.

Abstract: In previous work we had developed evidence suggesting that hallucinating schizophrenics differ from nonhallucinators in the pattern of errors made in a shadowing task. Non hallucinators appeared to be less willing to guess when they were unsure. The errors of the hallucinators seemed more semantically elaborate. The experiment had not been designed to study these factors and the current experiment was conducted using a technique reported by Pisoni et al. These workers had studied normal Ss in an immediate recall task, using semantically well integrated (SWI) or poorly integrated (SPI) sentences. Pisoni et al. had shown that right ear presentation produced more accurate recall of SWI as compared to SPI sentences, whereas left ear presentation failed to discriminate these sentences. Utilizing the methods of Pisoni et al., we replicated their findings in a normal control group. The results from our hallucinating and nonhallucinating groups were different from each other, the nonhallucinators being less accurate, discriminating semantic integration level on left rather than right ear input, and making more fragmented errors. Little support could be found for attributing this pattern of performance to nonspecific aspects of the procedures. It appears that the nonhallucinators process information differently from hallucinators. These differences may reflect alterations in language development. It is speculated that such differences might be consistent with interference with the development of brain asymmetry.

Marital discord, sexual problems, and depression.

Abstract: Systematic studies of relationships among depression, sexual function, and martial discord in hemodialysis patients and their spouses arelacking; existing studies focus upon only one of these three topics, or deal with patient or spouse as individuals rather than as a couple. We studied 17 chronic, medically stable hemodialysis patients and their husbands or wives. Although couples rated their degree of marital discord as low, the investigators rated it as high, based on the number and type of specific problems reported by the couple. The couples' evaluation may not represent denial, as has been commonly assumed. Instead their evaluation may imply that the disease and its treatment overshadow marital problems, even though couples recognize and react to these problems. Couples showed a high prevalence of sexual problems--in terms of overall satisfaction, frequency of intercourse, and specific dysfunctional symptoms (difficulty becoming excited, maintaining excitement, or having orgasm). We found a strong relationship between severity of depression and severity of sexual dysfunction in patients, but not in their mates. No strong relationship existed between a patient's depression score and marital discord, although spouses showed a trend toward correlation between severity of depression and martial discord. Younger couples, especially, seem not to want intercourse when severe martial discord exists. Patients' depression scores were comparable to thoseof psychiatric patients, while spouses' depression scores resembled those of normals. While psychosocial phenomena such as marital discord, sexual dysfunction, and depression are clear, causal chains are not. Despite disadvantages inherent in using questionnaires, short, self-administered, easily scored instruments may elicit problems with sex, marriage, and mood which might otherwise be overlooked by caretaking personnel.

Evoked response and kinesthetic measures of augmenting/reducing in schizophrenics: replications and extensions.

Abstract: This study represents an attempt to replicate the central results of earlier work on stimulus intensity control. It uses a diverse sample of 40 hospitalized schizophrenic subjects, both chronic and acute. Two measures of stimulus intensity control were used: the Petrie kinesthetic figural aftereffects procedure (KFA), and the EEG method of average evoked response (AER). Finding the earlier results generally applicable, it presents a model of the function of stimulus intensity control in schizophrenia, which suggests that acute schizophrenics are particularly vulnerable to being inundated by stimuli, and therefore, that in order to protect themselves, they tend to reduce the perceived intensity of stimuli. Chronic schizophreniics have higher AER amplitudes and reduce less than acutes, suggesting that among chronics, the reducing mechanism either never was present or failed, whereas paranoid schizophrenics tend to be augmenters--a response style consistent with vigilant scanning.

Evaluation Of The Initial Interview In A Walk-in Clinic: The Patient's Perspective On A “customer Approach”

Abstract: There have been different models on how to conduct the initial psychiatric interview in a walk-in clinic. A "customer approach" has been developed which stresses: a) eliciting and understanding the requests that patients have regarding how they hope to be helped; and b) negotiating a treatment plan with the patients. We evaluated this customer approach from the perspective of the patient. The first hypothesis was supported. The patient's perception of the clinician's utilization of the customer approach correlated positively and substantially with measures of outcome, especially feeling satisfied and helped. The second hypothesis was also supported. Utilization of the customer approach continued to correlate positively and substantially with outcome even when patients did not get the disposition originally wanted. We discussed the clinical significance of the customer approach especially in regard to patient objectives in the initial interview--a treatment plan vs. symptom relief.

Treatment of chronic post-traumatic organic brain syndrome with dextroamphetamine: first reported case.

Abstract: In view of its therapeutic efficacy in the treatment of children with minimal brain dysfunction syndrome, dextroamphetamine was administered to a young adult with a chronic organic brain syndrome secondary to cerebral trauma. That D-amphetamine was critical to the resulting marked diminution in confusion, paranoia, and deficit in short term memory was confirmed by the occurrence of a relapse coincident with placebo administration as part of a double blind evaluation. Amitriptylline appeared to potentiate the therapeutic effects of D-amphetamine. The results achieved, although observational and subjective in nature, warrant replication in controlled, quantitative clinical studies.

Depressive disorders in Vietnam returnees.

Abstract: A random sample of 470 Army enlisted men who served tours of duty in Vietnam and returned to the United States in September, 1971 was selected from military records. Between May and September, 1972, these servicemen were located and personally interviewed. Additional information was obtained from their military records and from Veterans Administration files. Interviews were obtained for 95% and military records for 99%. Veterans Administration records were available for 22% of the sample. Depressive disorders appeared to be a significant problem in these enlistees after their return. Twenty-six per cent of the total sample reported at least some symptoms of depression, and 7 per cent reported a full affective syndrome. A third of those with depressive syndromes have had psychiatric care since their return. The association of depression with combat, use of illicit drugs, and other pre- and post-Vietnam variables is discussed.

A comparison of the effectiveness of primidone versus carbamazepine in epileptic outpatients

Abstract: Prior to the release of carbamazepine for the treatment of patients with psychomotor and grand mal seizures, primidone was regarded as the drug of choice for these disorders, especially when combined with diphenylhydantoin (DPH). It was, therefore, of interest to compare the effectiveness of carbamazepine against primidone when added to a therapeutic dose of DPH. Forty-five patients completed a 6-month study with each patient serving as his own control. The patients were initially stabilized on therapeutic doses of DPH and one of the test compounds, while all other medications were withdrawn. After 3 months of treatment, they were transferred onto the other drug for a second 3-month period. Extensive laboratory testing, including anticonvulsant levels, electroencephalograms, and neuropsychological evaluations, was performed. For the most part, the patients remained on outpatient status, returning for reports of seizure frequency, side effects, and laboratory studies every 14 days. The study was conducted in a single blind fashion by the treating neurologists; double blind by the electroencephalographer and psychologists. The results indicated that the two drugs did not differ in their effectiveness on seizure control. There were somewhat more side effects--none serious--with carbamazepine than with primidone. The EEG showed increased fast activity with primidone and increased theta activity with carbamazepine. There was no difference in regard to decrease of electroencephalographic seizure discharges. The patients showed more impairment on a repeatable neuropsychological test battery with primidone than with carbamazepine, and they also showed an increase on the psychopathic deviate scale of the Minnesota Multiphasic Inventory. Depressive feelings, when present, lessened while under treatment with carbamazepine. The results suggest that patients with the seizure types under consideration and who do not respond to DPH alone or to a DPH-phenobarbital combination can be placed on either carbamazepine or primidone while phenobarbital is discontinued. A patient who is intellectually and emotionally intact with no past history of behavioral disturbances may do better on primidone than carbamazepine, because this drug gives fewer side effects. On the other hand, those patients who have a past history of emotional and/or intellectual disturbances may profit more from carbamazepine.

The neuropsychological, psychiatric, and physical effects of prolonged and severe stress: 30 years later.

Abstract: This study investigates the long term or residual effects resulting from severe and extended exposure to stress. The samples were prisoners of war who were intended in Japan (high stress group) or Europe (low stress group) during the Second World War. They were examined in the following three areas: neuropsychological, psychiatric, and physical/neurological. Significant differences were found in all three spheres between the two groups. Second, to examine further the effect of length of internment on these variables, the low stress group was divided into long term and short term internment duration groups, and then the three groups were compared. Significant differences were found among these three groups. These results are discussed in relation to a traditional model of explanation.

Suicide following psychiatric hospitalization.

Abstract: The hypothesis was tested that following psychiatric hospitalization, those subjects who subsequently completed suicide would be distinguished from those who did not by the interaction of two circumstances: a state of defenselessness at the time of hospitalization, and experience of adverse life events following release from hospital. Subjects were 40 male VA psychiatric inpatients: 20 who completed suicide following release, and 20 controls matched on age, race, and time at risk in the community. Defenselessness (the incapacity to defend against distressful negative self-feelings) was defined in terms of scores derived from the extended Brief Psychiatric Rating Scale administered shortly after the patient's hospitalization. Adverse life events were eight events characterized simultaneously as undesirable, unlikely to have been initiated by the subject, and having a score of 30 or above on the Social Readjustment Rating Scale. In confirmation of the hypothesis, it was found that completed suicide subjects were significantly and appreciably more likely both to have had high defenselessness scores at the time of hospitalization and to have experienced adverse life events during the posthospitalization period, whereas neither circumstance in the absence of the other was predictive. The findings support the position that suicide is a response to experiences with self-threatening implications, in the face of personal incapacity to defend against, adapt to, or cope with such experiences. Language: en

The History of mental retardation : collected papers

Abstract: a military engineer, published in Paris his Le diverse et artificiose machine, a work that became one of the outstanding examples of Renaissance book production. It was written in Italian and French and with its remarkable sequence of 194 illustrations it is the most elaborate and one of the earliest pictorial technical works to be printed. Its very extensive influence lasted into the nineteenth century and machines of today have pieces in common with those of Ramelli. In this superbly produced volume the text explanatory to the drawings has been translated by the late Martha Teach Gnudi, into English for the first time, and all of the original 194 engraved plates are faithfully and elegantly reproduced. Dr. Gnudi also supplied a scholarly biographical study of Ramelli, together with notes on his preliminary material and on linguistic and bibliographical matters. There is also a helpful analysis of the principal elements of the machines in a \"Pictorial glossary\" compiled by E. S. Ferguson. Living at a time of almost continuous warfare, Ramelli as a military engineer obviously specialized in machines of war: military bridges, military screwjacks and breaking devices, military hurling machines, and appliances to breach defences, cross rivers, moats, etc. However, these constituted only about one-sixth of all his mechanical inventions. There were also mills, cranes, machines for dragging heavy objects, machines for raising excavated earth, cofferdams, and fountains. As far as the technological aspects of the history of medicine are concerned, grain mills and water-raising devices are of special interest. The latter consist of piston and rotary pumps, bucket-filling, and other ingenious devices. As well as the practical public health issues, such as the provision of drinking, bathing, and irrigation water, and the draining of swamps with the reduction in the mosquito population and thus of malaria, there are also the analogies made between machines and parts of the body. Thus we are aware of the influence of the pump on developing concepts of heart action and blood flow, but others exist, which are less well known, or at present unsuspected. A detailed analysis of the interactions between technology and medicine is needed, and when this is carried out Ramelli's book will be of great importance. The present edition of it can be awarded high praise as an outstanding, scholarly contribution to the history of technology and a masterpiece of publishing. Wishing to learn from the lessons of history in …

MDA-assisted psychotherapy with neurotic outpatients: a pilot study

Abstract: Ten neurotic patients (five males and five females) were treated over a period of 2 to 6 months (mean, 4.1) as outpatients. The study allowed for a maximum of 75 hours of psychotherapy (mean, 51.55 hours). During the course of treatment, two to four (mean, 3.5) administrations of MDA (3,4-methylenedioxyamphetamine) were employed as adjunctive aids in an effort to enhance the psychotherapeutic process. The mean duration of the drug sessions was 8 hours (range, 6 to 14 hours). The first administration of MDA took place when, in the therapist's judgment, sufficient rapport had been established with the patient. All patients received an initial dose of 75 mg of MDA; subsequent dosage was allowed to range up to 200 mg. On these occasions, the drug appeared to be well tolerated with no serious side effects or complications observed. Psychometric assessments were obtained pre- and post-treatment, employing the Minnesota Multiphasic Personality Inventory (MMPI), Wittenborn Psychiatric Rating Scales (WPRS), and Brief Psychiatric Rating Scale (BPRS). In addition, follow-up evaluations were obtained 6 months after the termination of therapy by the use of the MMPI, WPRS, BPRS, and a Social History Questionnaire (SHQ) which had also been administered before treatment was initiated. Clinically, the impression was obtained that psychotherapy and the adjunctive use of MDA appeared to facilitate improvement in these patients. This impression was substantiated by significant reductions in scores on the psychometric assessments measuring depression, anxiety, and obsessive-compulsive traits. The meaures evaluating the sense of well-being and self-actualization also were encouraging. Although some of the patients were not as responsive as others, there were no observations to suggest that the condition of any of these patients had become worse.

On the bimodality of the distribution of electrodermal orienting responses in schizophrenic patients.

Abstract: Data are presented from four of the author's studies on the electrodermal orienting responss which fail to confirm the findings of Gruzelier and Venables of a markedly bimodal distribution of ORs in schizophrenic populations. A review of the findings of other earlier studies, none of which confirm the bimodal hypothesis although some used patients taking phenothiazines, shows that differential effects of drugs, although probably an important factor, by itself cannot account entirely for the discrepancies in results. It is hypothesized that due to changes in hospital discharge policies, the groups of patients tested by Gruzelier and Venables, compared to those tested in earlier studies, were more heavily weighted with patients whose symptoms were resistant to phenothiazines. These patients may either have come from the extremes of the responsivity distribution or have atypical reactions to neuroleptic drugs.

The fate of the untreated alcoholic. Toward a natural history of the disorder.

Abstract: Eighty-three male alcoholics were administered a structured interview when they appeared at a large general hospital for treatment of a variety of disorders. These represent 83 consecutive cases. None received treatment aside from brief “drying-out” but all were accepted as participants in a researc

Measuring psychoneurotic behavior in cross-cultural surveys.

Abstract: In recent years, a number of studies have appeared which attempt to measure neurotic disorders among population samples in different cultural settings. The problem of how to define and measure psychiatric disorders in untreated groups, and especially in cultures to which the investigators are not native, is, however, far from resolved. The present report describes an effort to study psychological stress among the Serer of Senegal. We describe a method we used to develop a questionnaire to tap symptoms of psychiatric distress, and which would be geared to the realities of place and setting. By means of a factor analysis of the responses to this questionnaire by more than 400 subjects, we identify four dimensions by which the Serer express neurotic disturbance. Further analyses presented in the report demonstrate that these are not merely ways of expressing symptoms based on physical illness, that they are able to discriminate between ill and well people in the Serer frame of reference, that they possess domain validity, and that they demonstrate important similarities and differences with factors obtained using similar techniques in different cultural settings. From a methodological point of view, we illustrate the importance of using a multidimensional approach in such studies.

Skin conductance responding/nonresponding and pupillometrics in chronic schizophrenia a confirmation of gruzelier and venables

Abstract: In a number of reports, Gruzelier and Venables have demonstrated that about 50% of the schizophrenic population do not show the skin conductance orienting response (S.C.O.R.), while those that do respond, do not show normal habituation. Zahn (Orienting response in schizophrenics. J. Nerv. Ment. Dis., 162: 195-199, 1976) has questioned the bimodality of the S.C.O.R. in schizophrenia and suggests that responding/nonresponding could well be due to differential effects of phenothiazine medication. In two experiments (with equally medicated patients), in two different hospitals, the present report confirms the finding of a large proportion of nonresponding in schizophrenia but also suggests that both normal and nonhabituation are seen within schizophrenics and normals. Differential pupillary dilation and constriction parameters are seen in responders and nonresponders although both of these patient groups show tachycardia (the most usual effect of phenothiazines) in comparison to the normal group. The results do not fit easily into the differential effect of phenothiazines hypothesis proposed by Zahn.