Showing papers in "Journal of Nervous and Mental Disease in 1980"
TL;DR: The use of the ASI is suggested to match patients with treatments and to promote greater comparability of research findings, suggesting the treatment problems of patients are not necessarily related to the severity of their chemical abuse.
Abstract: The Addiction Severity Index (ASI) is a structured clinical interview developed to fill the need for a reliable, valid, and standardized diagnostic and evaluative instrument in the field of alcohol and drug abuse. The ASI may be administered by a technician in 20 to 30 minutes producing 10-point problem severity ratings in each of six areas commonly affected by addiction. Analyses of these problem severity ratings on 524 male veteran alcoholics and drug addicts showed them to be highly reliable and valid. Correlational analyses using the severity ratings indicated considerable independence between the problem areas, suggesting that the treatment problems of patients are not necessarily related to the severity of their chemical abuse. Cluster analyses using these ratings revealed the presence of six subgroups having distinctly different patterns of treatment problems. The authors suggest the use of the ASI to match patients with treatments and to promote greater comparability of research findings.
3,143 citations
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942 citations
TL;DR: The relationship between children's responses about themselves and mothers' responses about their children, on symptom and social functioning scales was examined, and agreement was good across the scales used when the information was derived from the same informant.
Abstract: This paper reports on the testing of self-report scales, in a pilot study of 28 children with a psychiatrically ill parent. We examined the relationship between children's responses about themselves and mothers' responses about their children, on symptom and social functioning scales. The self-report scales administered to the children included the Center for Epidemiologic Studies Depression Scale, the Children's Depression Inventory, and the Social Adjustment Scale. The mothers completed the Achenbach Child Behavior Checklist, the Conners Parent Questionnaire, and the Center for Epidemiologic Studies Depression Scale about their children. Agreement between mothers and children on the assessment of the child was poor. Agreement was good across the scales used when the information was derived from the same informant. The implication of these results for epidemiological studies, particularly concerning dual informants, is discussed.
804 citations
TL;DR: The Borderline Syndrome Index (BSI), a self-report questionnaire, was constructed to provide an assessment of the borderline syndrome that would increase the amount of information rapidly available to the clinician.
Abstract: On the basis of a selected review of some important theoretical discussions and empirical investigations of patients characterized as borderline, a self-report questionnaire, the Borderline Syndrome Index (BSI), was constructed. Its purpose was to provide an assessment of the borderline syndrome tha
173 citations
TL;DR: Impaired cognitive functioning may be a factor in the disability associated with the major affective disorders in addition to the distorted affective component usually emphasized in bipolar patients.
Abstract: Unipolar and bipolar affectively disturbed patients were administered the Halstead-Reitan category test when in an unmedicated acutely depressed phase and during recovery. Controls consisted of normal volunteers and spouses. Spouse controls were tested at intervals similar to those of the patients and were utilized to control for age, sex, education, and socioeconomic status. Results showed that depressives in the acute depressed state made significantly more errors did controls. Older bipolar patients made significantly more errors than did controls. Older bipolar patients made significantly more errors than younger bipolar or younger unipolar patients. In the recovered state the order remained the same. In spite of a decrease in error scores the older bipolar group remained in the abnormal range, whereas the younger groups scored in the normal range with few exceptions. These data suggest that impaired cognitive functioning may be a factor in the disability associated with the major affective disorders in addition to the distorted affective component usually emphasized. Furthermore, in the case of older bipolar patients, the deficit is more severe and may persist beyond the disappearance of affective signs, suggesting that factors associated with age may play an important role in conjunction with other factors associated with bipolar illness.
144 citations
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138 citations
TL;DR: The author proposes a detailed theory of the genesis of multiple personality, based on the existing ease literature and on contemporary theories of ego development, which is considered at length.
Abstract: The sudden surge of reports on multiple personality in the 1970s raises serious questions as to whether multiple personality is the rare phenomenon it has been believed to be, or whether it is a relatively common condition which is misdiagnosed with a high order of frequency. Recent research in ego psychology, particularly into the etiology of the borderline disorders, sheds considerable light on the origins of multiple personality which has traditionally, and probably mistakenly, been considered a wholly hysterical disorder. The author proposes a detailed theory of the genesis of multiple personality, based on the existing case literature and on contemporary theories of ego development. The issues of authenticity, nosology, diagnosis, personality structure, neuropathy, etiology, and treatment are considered at length.
129 citations
TL;DR: The findings suggest the desirability of a careful linguistic evaluation of all closed head injured patients because of the potential impact of verbal deficits on rehabilitation outcome.
Abstract: Fifty-six closed head injured patients referred to a rehabilitation medicine center were examined to determine the presence and nature of verbal deficits. Eighteen (32 per cent) presented classical symptoms of aphasia, 21 (38 per cent) had motor dysarthria, and 17 (30 per cent) had no discernible ap
128 citations
TL;DR: Schizophrenics, depressives, and normal controls were tested on a binaural listening task in which pairs of simultaneous continuous prose passages were presented as discussed by the authors, and the results were interpreted within the framework of Broadbent's model of selective attention.
Abstract: Schizophrenics, depressives, and normal controls were tested on a binaural listening task in which pairs of simultaneous continuous prose passages were presented. Subjects were required to shadow one passage of each pair and ignore th other. The passages in each pair, although differing markedly in content, were inseparable on the basis of their physical features. As predicted, the performance of schizophrenics on such a task was markedly worse than that of the other groups. The results were interpreted within the framework of Broadbent's model of selective attention (Broadbent, D.E. Decision and Stress. Academic Press, London, 1971). This makes a distinction between "pigeonholing" (response set) and "filtering" (stimulus set). The present findings are compatible with a schizophrenic defect at the pigeonholing stage. In contrast, the evidence for a defect in filtering specific to schizophrenia remains weak, due to the use of inappropriate control groups in a number of studies reviewed.
120 citations
TL;DR: The hypothesis that impairment on the HRB in chronic schizophrenic patients was associated with morphological abnormalities on the CT scan, and that the positive and negative CT scans of these patients could be predicted accurately, is supported.
Abstract: The Halstead-Reitan Battery (HRB), including the Wechsler Adult Intelligence Scale, was administered to 15 young chronic schizophrenic patients in an attempt to identify blindly those patients with evidence of morphological brain abnormalities on prior computed tomography (CT). The CT scan status of 12 of 15 (80 per cent) patients was correctly identified solely on the basis of neuropsychological testing. These results supported our hypothesis that impairment on the HRB in chronic schizophrenic patients was associated with morphological abnormalities on the CT scan, and that the positive and negative CT scans of these patients could be predicted accurately.
TL;DR: It is suggested that self-disclosure and parental interpersonal intimacy may be fundamental factors in marital adjustment which merit further research.
Abstract: A random sample of 50 adults in the general population received an open ended interview regarding their concepts of intimacy. A second random sample of 24 couples from the general population and 24 clinical couples received a standardized interview in which concepts of intimacy were systematically rated to develop an operational definition of the dimensions of intimacy. Self-disclosure was identified as a fundamental aspect of intimacy in interpersonal relationships and marriage. Expression of affection, compatibility, cohesion, identity, and the ability to resolve conflict were also considered important aspects of intimacy. Sexual satisfaction was considered less important than previous definitions of intimacy have suggested. The perception of his or her parents' level of intimacy was thought to influence the subject's own interpersonal relationships. Couples with marital maladjustment and/or psychiatric illness were less aware of aspects of their marriage which influence intimacy. They more frequently disagreed that sexuality influenced their level of intimacy. The study suggests that self-disclosure and parental interpersonal intimacy may be fundamental factors in marital adjustment which merit further research.
TL;DR: Performances on the Michigan Neuropsychological Test Battery revealed varying degrees of diffuse bilateral cerebral dysfunction in two thirds of Cushing's syndrome patients, and impairment was more frequent and severe in non verbal visual-ideational and visual memory functions.
Abstract: In contrast to well documented reports of medical symptoms in Cushing's syndrome (an endocrine disorder with the hallmark of corticoid overproduction), vague and infrequent references to associated mental changes reflect the subjective nature of previous clinical studies of psychological symptoms. This report presents neuropsychological test findings of 35 Cushing's syndrome patients before initiation of medical therapy, and documents the frequency, nature, and severity of deficits. Performances on the Michigan Neuropsychological Test Battery revealed equivocal or no signs of neuropsychological deficits in 13 patients. Ten other patients had few and mild deficits, eight had moderate and more frequent signs of impairment, and four had frequent and marked deficits in language and nonlanguage tests of higher (cognitive) and/or lower (sensory and/or motor) level cerebral functions. The findings thus indicate varying degrees of diffuse bilateral cerebral dysfunction in two thirds of this population. Impairment was more frequent and severe in nonverbal visual-ideational and visual memory functions. This pattern of deficits is similar to that in patients with other types of diffuse bilateral neuropathological processes such as toxicity, anoxia, and infectious cerebral disorders.
TL;DR: The evidence so far is at least consistent with, but cannot yet prove, the hypothesis that a deficiency in social bonds is a cause of neurosis, which is providing a method for identifying those elements in social relationships which, when deficient, may be causally related to neurosis.
Abstract: Psychiatric epidemiology has not until now reached the stage at which the individual's immediate social environment can be examined as a principal independent variable. That handicap may now be overcome by a recent development in social psychiatry: the systematic study of social bonds. Work in this area is providing a method for identifying those elements in social relationships which, when deficient, may be causally related to neurosis. There are considerable technical difficulties in teasing apart cause and effect. These can be tackled by designing intervention trials and by fitting structural equation models to longitudinal data. The evidence so far is at least consistent with, but cannot yet prove, the hypothesis that a deficiency in social bonds is a cause of neurosis.
TL;DR: New data, including films and videotapes of hyperstartling persons from Malaysia, the Philippines, Japan, and the United States, suggest a model capable of resolving the apparent paradox by showing how the various forms of latah are culture-specific exploitations of a neurophysiological potential shared by humans and other mammals.
Abstract: Culture-bound syndromes are forms of unusual individual behavior restricted in distribution to discrete areas of the globe. They are considered eccentricities in distribution to discete areas of the globe. They are considered eccentricities in the cultural systems of societies in which they are endemic, and psychopathologies in the reference system of Western psychological medicine. Most are episodic and highly dramatic. Because of their intrinsic interest as dramatic exotica and their implications for theories of deviance, several have been the subjects of much previous work.
TL;DR: Results indicate a 74 per cent overall morbidity, including a 28 per cent 1-month mortality rate for patients with brain tumors who receive ECT, and a positive behavioral response to ECT without complication.
Abstract: The clinical basis for the long established contraindication of electroconvulsive therapy (ECT) in the presence of brain tumor is reviewed, as is the recent literature that has questioned the absolute nature of that contraindication. A need for a specific estimate of risk is noted. Seven retrospective case reports are added to the 28 cases reported in the literature. The clinical case report data are then pooled and evaluated by outcome. Results indicate a 74 per cent overall morbidity, including a 28 per cent 1-month mortality rate for patients with brain tumors who receive ECT. Twenty-one per cent of the patients had a positive behavioral response to ECT without complication.
TL;DR: Findings from this study indicate that interpersonal communications surrounding the measurement of blood pressure can rapidly alter systolic and diastolic pressures.
Abstract: The recent development of a noninvasive automated blood pressure device has revealed a strong relationship between human conversation and blood pressure. Conventional techniques of pressure measurement such as the stethoscope and manometer, which require silence during the measurement, tended to obscure this important relationship. Findings from this study indicate that interpersonal communications surrounding the measurement of blood pressure can rapidly alter systolic and diastolic pressures. In certain situations, changes greater than 20 per cent in systolic and diastolic blood pressure and heart rate can occur within 30 seconds after the initiation of human speech. Such variance can be of critical significance in making clinical judgments concerning hypertension. These findings are discussed in the context of recent nonpharmacological treatment approaches being developed to help control hypertension.
TL;DR: For instance, this paper found that residents who scored high on an interview scale that measured a resident's level of irritability were more likely to be attacked, and most believed an incident frustrating to the patient triggered the attack.
Abstract: Thirty-one psychiatric residents at Los Angeles County-University of Southern California Medical Center were interviewed to ascertain whether they had been attacked by patients, and if so, under what conditions. Forty-eight per cent reported having been attacked, and most believed an incident frustrating to the patient triggered the attack. Personality characteristics of the residents were related to their being attacked, in that residents who scored high on an interview scale that measured a resident's level of irritability were more likely to be attacked. Implications of the findings are briefly discussed.
TL;DR: Wives of patients with Huntington's chorea revealed that none of them knew prior to marriage of the presence of a heritable disease within the husband's family.
Abstract: Huntington's chorea imposes a direct imprint on the life of the spouse of the affected patient. Interviews with 15 wives of patients with Huntington's chorea revealed that none of them knew prior to marriage of the presence of a heritable disease within the husband's family. When informed of the diagnosis, the wife reacted with disbelief and denial. As she became aware of the steady progression of the disease and the threat of transmission to her children, her response changed to resentment and hostility. The disease permeated the entire life of the unaffected spouse: her life style, family responsibility, goals, and marital relationship. In essence, the wife became inextricably involved in the disease and suffered continuous trauma from it.
TL;DR: It is hypothesized that there exists a subgroup of criminals who are unable to switch POA within a heirarchy of principles, and that they will be revealed by the already established Trail Making Test B (TMT-B), and by the new brief clinical Narratives Test (NT).
Abstract: The form of criminal actions by young adult men was analyzed for evidence of symptoms indicative of dysfunctioning of the frontal lobe system (FLS), which myelinates late. The inability to switch the principle of action (POA) appropriately during an ongoing activity, when intervening circumstances call for such a switch, is one of the most characteristic signs of FLS dysfunction. The other major sign, the inability to plan, is apparently outgrown during childhood. Some criminal persons seem to show such an inability to switch POA, according to our clinical observation. It is hypothesized that there exists a subgroup of criminals who are unable to switch POA within a heirarchy of principles, and that they will be revealed by the already established Trail Making Test B (TMT-B), and by the new brief clinical Narratives Test (NT). The test results on 30 criminals corroborate the hypothesis. On the Narratives Test, 36 per cent, and on the Trail Making Test-B, 33 per cent of young adult men charged with criminal acts (serving sentences of up to 2 years) demonstrated specifically immature action behavior indicative of FLS dysfunctioning. There is a significant positive association (π= .68, p<.001) between the performance on the two tests. Probable etiological factors include a developmental lag in the myelinization of the frontal lobes, such as is associated with deprivation of practice in their functions; however, pathology, particularly due to trauma, has yet to be ruled out.
TL;DR: The results suggest that generalized neuropsychological dysfunction characterizes groups of persons who are unemployed and/or who have held low occupational level jobs and memory and alertness and flexibility in thinking appear to be relatively important abilities with respect to these general employment variables.
Abstract: The relationship between neuropsychological abilities and employment and occupational status was examined in 108 epilepsy patients. The performances of each subject on a wide range of neuropsychological measures were grouped into six conceptually meaningful ability categories. Highly significant differences were obtained between groups of patients with epilepsy differing in employment status and occupational status across both the range of individual measures and the composite neuropsychological ability areas utilized. The relative importance of the six ability scores was then examined with respect to employment status and occupational status. The results suggest that generalized neuropsychological dysfunction characterizes groups of persons who are unemployed and/or who have held low occupational level jobs. Within this context of general impairment, however, memory and alertness and flexibility in thinking appear to be relatively important abilities with respect to these general employment variables. Implications of the results for vocational and rehabilitation efforts were discussed.
TL;DR: The literature concerning the effects of electroconvulsive therapy (ECT) upon the EEG is reviewed and possible correlations of these EEG changes with a variety of parameters are discussed.
Abstract: The literature concerning the effects of electroconvulsive therapy (ECT) upon the EEG is reviewed with respect to the degree and persistence of abnormalities. The most common electrophysiological dysfunction consists of generalized regular and irregular slow wave activity. This slowing typically disappears by a few weeks to a few months following completion of the ECT course but in rare cases may persists for longer periods. Patients given large numbers of ECT treatments tend to show more prolonged alterations. Possible correlations of these EEG changes with a variety of parameters are discussed.
TL;DR: Severity of disability was not significantly correlated with age of patient, age at onset of multiple sclerosis symptoms, Verbal IQ, Performance IQ, or Full Scale IQ, and scores on Performance subtests were lower than on Verbal subtests measuring verbal overlearned information, abstract reasoning, and vocabulary.
Abstract: Forty-eight multiple sclerosis patients were rated on the Kurtzke Disability Status Examination and tested on the Wechsler Adult Intelligence Scale. Their disability status scores, ranging from 1 to 9, with a mean of 3.98, correlated significantly only with duration of illness (r = .33, significant at the.05 level). Severity of disability was not significantly correlated with age of patient, age at onset of multiple sclerosis symptoms, Verbal IQ, Performance IQ, or Full Scale IQ. Wechsler Adult Intelligence Scale mean subtest scores ranged from average to bright normal. Scores on Performance subtests with a large motor component were lower than on Verbal subtests measuring verbal overlearned information, abstract reasoning, and vocabulary.
TL;DR: The study presents a more detailed clinical picture of the disorder, and suggests that the presence of specific antisocial behavior may be a useful criterion for dividing affected boys into two roughly equal subgroups.
Abstract: Aggressive conduct disorder, defined broadly on the basis of fighting, disobedience, destructiveness, and meanness, was diagnosed in 65 out of 136 boys and 17 of 43 girls consecutively admitted to a psychiatric clinic. Psychotic, brain damaged, and seriously retarded children were excluded from the
TL;DR: This paper presents a personal death experience viewed by the author as a “subjective reality” that is contrasted with “shared subjective reality,” i.e., commonly held beliefs among groups of individuals which do not necessarily lend themselves to scientific verification and scientifically derived objective reality.
Abstract: In recent years, there has been a marked increase in reports of the subjective experience of individuals in severe life-threatening circumstances. These have been used to suggest that scientific facts are now in agreement with religious beliefs as to the survival of the personality after physical death. This paper presents a personal death experience viewed by the author as a "subjective reality". This is contrasted with "shared subjective reality," i.e., commonly held beliefs among groups of individuals which do not necessarily lend themselves to scientific verification and scientifically derived objective reality. Subjectively real death experiences are regarded as corollary to a toxic psychosis. The content of the psychosis, which is not under voluntary control, determines the subjective experience of having entered either heaven or hell.
TL;DR: This household survey of a random sample of 713 rural adults indicated that individuals experiencing higher proportions of undesirable, unanticipated, unpreventable, and disruptive events or events having minimal social support manifested higher levels of psychiatric symptomatology.
Abstract: This household survey of a random sample of 713 rural adults (ages 18 to 60) examined the influence of event characteristics upon the relationship between life change events and impairment. Data were obtained on the occurrence of events, event characteristics, demographic characteristics, and psychiatric impairment (using the General Well-Being Schedule and the Center for Epidemiologic Studies Depression Scale). Analysis indicated that individuals experiencing higher proportions of undesirable, unanticipated, unpreventable, and disruptive events or events having minimal social support manifested higher levels of psychiatric symptomatology. Although total number of events was consistently the best predictor of impairment, it did not diminish the effects of the event characteristics on impairment. The independent effects of these event characteristics are discussed.
TL;DR: From these findings a formulation about depression is presented, and implications for etiology and treatment are discussed.
Abstract: The Kelly Role Construct Repertory Test (rep grid) was administered to 19 depressed patients, 19 psychiatric controls, and 19 normal controls. Tests were analyzed to produce measures of cognitive complexity, self-ideal congruency, negative self-construing, identification (self-other distances), and