Showing papers in "Psychosomatic Medicine in 1967"
TL;DR: The reaction to removal of the mother was studied in 4 group‐living pigtail monkey infants, and the data support Engel's theory of two primitive biological response systems for handling distress, each with a mediating neural organization.
Abstract: The reaction to removal of the mother was studied in 4 group-living pigtail monkey infants. All showed distress, with 3 progressing to a state of deep depression similar to the anaclitic depression of human infants following separation, as described by Spitz. The only infant not showing deep depress
305 citations
TL;DR: The study demonstrated that social groupings of nonprimates can be used in the experimental approach to the role of psychosocial stimuli and the early environment in the etiology of human hypertension.
Abstract: &NA; The increase in systolic pressure with age, which is observed in some but not all human populations, is believed to be a response to repeated symbolic stimuli arising from the social environment. An attempt was made to simulate these conditions in experimental animals by playing on their inborn drives for territory, survival, and reproduction. Meaningful stimuli were presented to CBA mice in a series of long‐term experiments. The methods involved (1) mixing of animals previously maintained in different boxes, (2) aggregation in small boxes, (3) subjecting groups to threat from a predator, and (4) inducing conflict for territory by placing equal numbers of males and females in an interconnected box system. In the experimental situations involving the most severe psychosocial stimulation, the mean arterial blood pressure rose from 126 mm. Hg to the range 150–160; it was sustained at these higher levels for 6–9 months. Those aggregated from birth showed less pressure elevation (to the range 140–150). Blood pressures in females were in the same range as those of males that had been aggregated from birth, but castrates showed minimal effects. Ether anesthesia did not abolish a sustained pressure rise, but the persistently elevated pressure of threatened animals returned to the normal range when reserpine was given. The study demonstrated that social groupings of nonprimates can be used in the experimental approach to the role of psychosocial stimuli and the early environment in the etiology of human hypertension.
221 citations
TL;DR: Studies of prevalence of psychiatric morbidity in the nonpsychiatric areas of general hospitals as well as of frequency and patterns of referrals for psychiatric consultation are critically reviewed.
Abstract: Studies of prevalence of psychiatric morbidity in the nonpsychiatric areas of general hospitals as well as of frequency and patterns of referrals for psychiatric consultation are critically reviewed. Commoner psychiatric diagnostic and management problems encountered on the medical and surgical ward
220 citations
TL;DR: It was concluded that with repeated exposure to threat, expanding gradients of activation and of inhibition develop, the latter with steeper slope, thus providing a highly adaptive mechanism for the mastery of threat.
Abstract: Continuous recordings of skin conductance, heart rate, and respiration rate were obtained from experienced and novice parachutists during a sequence of events leading up to and following a jump. While novice jumpers showed a sharp rise in physiological activity up to final altitude, experienced jumpers produced an inverted V-shaped curve--i.e., an initial rise was followed by a decline. It was concluded that with repeated exposure to threat, expanding gradients of activation and of inhibition develop, the latter with steeper slope. The early rise in activation provides an automatic signal of danger, while the inhibitory reaction prevents the arousal from becoming excessive, thus providing a highly adaptive mechanism for the mastery of threat.
205 citations
TL;DR: The scope and functions of consultation psychiatry in general hospitals are reviewed, and some of the difficulties encountered are pointed out.
Abstract: The scope and functions of consultation psychiatry in general hospitals are reviewed, and some of the difficulties encountered are pointed out. A consultation service has a vital role in contributing to improved patient care on the medical wards and to the teaching of the nonpsychiatric health professions. The value of these activities is conceptualized from the viewpoints of preventive psychiatry and applied psychosomatic medicine.
160 citations
147 citations
TL;DR: It was found that merely placing the animals in the experimental cage increased corticosterone levels, and these levels were further elevated as shock intensity and duration were increased.
Abstract: &NA; Rats were subjected to one of six intensities of electric shock administered for 30, 60, 120, or 240 sec., and then sacrificed immediately or 5, 15, or 60 min. later. Plasma corticosterone levels were determined and compared to values obtained from both unmanipulated controls and “handled” rats. It was found that merely placing the animals in the experimental cage increased corticosterone levels, and these levels were further elevated as shock intensity and duration were increased.
138 citations
TL;DR: The results indicate that investigation of relationships between variables of behavior or personality and the occurrence of symptomatic life‐threatening disease should proceed by the prospective method.
Abstract: The Minnesota Multiphasic Personality Inventory was administered at the first and fifth annual examinations of 1990 men studied in a prospective investigation of coronary heart disease. These data were used to investigate the following questions--two potential sources of error in retrospective studi
100 citations
TL;DR: These response mechanisms, conceptualized as serving significant defensive and adaptive functions, are shown to assume quite different forms in clinically differentiable schizophrenic subtypes.
Abstract: Recent researches in the schizophrenias have led to the identification of systematic relationships between sensory, perceptual, and cognitive response parameters, on the one hand, and on the other, symptom variables and their interactions with “premorbid adjustment” and length of hospitalization var
99 citations
TL;DR: In this article, the authors present a model for what psychiatric teaching should be, which is well written and well documented (there are 105 properly used references), precisely conceptualized, and economic.
Abstract: lethargy within psychiatry departments themselves; (3) remedies should be immediately forthcoming. Almost as a model for what psychiatric teaching should be, this book is well organized. It is well written and well documented (there are 105 properly used references), precisely conceptualized, and economic. In preparing the book the author traveled to a representative number of medical schools, conferred, observed, and recorded the teaching methods and thoughts. He sensed an ennui in teachers, little intellectual excitement in the fundamental courses, and much student dissatisfaction. There were, of course, exceptions, both of individual teachers and of institutions. He acknowledges these and remains sympathetic to the teaching of psychiatry, a somewhat amazing position after the evidence he presents. The causes for the present state of affairs are multiple. One of the causes is the lack of organization of basic psychiatric knowledge; another is that psychiatric departments are overdependent on part-time physicians; still another is that medical students are more and more demanding that psychiatry fall in line with other \"scientific\" courses; and finally, there is the relative isolation of the psychiatric departments from other departments in medical schools. The author's list continues and is nearly exhaustive. Even in the most comprehensive courses now taught, two necessary elements are frequently missing: (1) the teaching of psychotherapy to medical students; (2) the teaching of psychiatry with elegance, precision, and empirical data. The author argues that the first of these suggestions follows from what he considers actual need. He believes that if students do not get the proper training while in medical school, they are unlikely to receive it later either in practice or while specializing. Since psychiatry is so essential to all medical practice, the only reasonable plan is to teach this most fundamental therapeutic tool as part of the basic curriculum. The second point may be attributed to the psychiatrist's humanistic and commendable respect for the individual patient and for his students. Psychiatrists may not be intellectually aggressive outside their own circles, but such an attitude may have disastrous pedagogic consequences, at least for students interested in the \"facts.\" The author's design for a new psychiatric curriculum would include these missing elements. The book may be highly recommended for those teachers seriously concerned with the education of medical students. Although the author tends to bypass the political issues involved in curriculum planning and the immense work involved in any decent teaching program, he is aware of these, and his recommendations reflect this knowledge. If the book is to be criticized at all, it is on the grounds that its author does not advocate a more experimental attitude to the pedagogic process, for only if one is constantly trying new courses and altering curriculum, is the interest of the experienced clinician, the most valuable teacher in psychiatry, kept at its peak.
97 citations
TL;DR: Analysis of the outcome includes pre‐ and postoperative physical health; sexual behavior; psychosocial adjustment factors‐‐including marital, job, and community relationships and concern over children; satisfaction with the operation; and social behavior with regard to the operation.
Abstract: Responses to questionnaire interviews of 73 men who had undergone vasectomies are discussed. There were 70 anatomically successful operations and 3 failures. The men noted no change in their own physical health and a slight tendency toward improvement in the health of their wives. There was a significant increase in coital frequency at an age when the frequency of the general population is declining. 55 (three-fourths) of the men were more satisfied with intercourse 15 experienced no change and 3 were less satisfied. Improvement on psychosocial parameters of self and wifes tension levels relations with wife and overall happiness were reported by between one-fourth and one-half of the husbands. There was some deterioration on each of these parameters reported by some 2 to 5 men. Work relationships remained unaffected. 72 of the men said they would make the same decision again. The 1 dissenter had had 2 operative failures. The survey indicated that disagreement with the wife over the desirability of sterilization seems to favor development of later psychosocial pathology. Many of the men their friends and relatives hold stereotyped attitudes equating vasectomy with being castrated and made inferior. The good results indicated adequate coping with these psychological factors by a large majority of the respondents.
TL;DR: The very obese adults surveyed did not differ from some less obese groups reported by other investigators for frequency of family obesity, reactive eating, reported family feeding conflicts, sibship position, parental overprotection, and psychiatric diagnoses.
Abstract: Twenty-one very obese adults, with a median of 131% over actuarial average weights, were surveyed by interviews and the Minnesota Multiphasic Personality Inventory. The group did not differ from some less obese groups reported by other investigators for frequency of family obesity, reactive eating, reported family feeding conflicts, sibship position, parental overprotection, and psychiatric diagnoses. Factors which appeared homogeneous and distinctive for this group included early onset of obesity, massive weights by midadolescence, and ability to lose large amounts of weight temporarily. Two frequently assessed personality traits were overcontrol of emotions and indirect expression of hostility. Some factors, such as number of obese family members, sibship position, and reported parental overprotection, served to distinguish significantly a subgroup judged low in psychopathology from a subgroup judged high for this variable.
TL;DR: In this paper, the Committee on the College Student of the Group for the Advancement of Psychiatry proposed guidelines for college policy toward sexual behavior, with a focus on the development and integration of sexuality in the personality.
Abstract: lineation of the developmental aspects of sexuality in the individual is sensitive and clear. The authors observe that, "The continuing and periodically intense campus dialogue suggests that young people are both testing authority and searching for guidelines." With this background, the suggestion of guidelines for college policy toward sexual behavior fulfills the purposes of this report of the Committee on the College Student of the Group for the Advancement of Psychiatry. They offer a wider and more meaningful definition of sex than that of common usage, and "emphasize these positive aspects of sex in human life." The importance of relating this concept of sexuality to the total personality at the particular stage of development under consideration is explained. The section on "The Development and Integration of Sexuality in the Personality" gives a resume in plain, nontechnical language of concepts of personality development with special reference to late adolescence. In the chapter "Sexual Issues on the Campus," heterosexual and homosexual behavior, sexual deviations, contraception, pregnancy, abortion, "silent" sexual problems, and faculty-student relationships are discussed and illustrated with clinical case material. In the next section the wide range of attitudes, policies, and regulations found in different colleges is described and discussed. The prevalent principle of the college serving in the role of parent (in loco parentis) is questioned and the importance of the respect of the student's privacy is emphasized. Some general "Guidelines for College Policy Toward Sexuality" with provision for flexibility and adaptability to different individual and institutional needs are suggested. The committee's conclusion in this section, including a quotation of Anna Freud's characterization of adolescence with its vicissitudes, contradictions, and paradoxes should be helpful and reassuring to students, parents, and colleges when they are immersed in the problems of this time of life and of these times.
TL;DR: The term “psychological” was used simply to indicate that the stress aspects of the experimental situation were considered to have their impact upon the animals primarily by way of the sensory systems, rather than through direct physical or physiological trauma.
Abstract: &NA; In this study, the focus of attention was the biological response of vervet monkeys (Cercopithecus aethiops) under psychological stress to a well‐defined protein, bovine serum albumin, with plasma cortisol as an indicator of alterations in the pituitary‐adrenocortical system. The term “psychological” was used simply to indicate that the stress aspects of the experimental situation were considered to have their impact upon the animals primarily by way of the sensory systems, rather than through direct physical or physiological trauma. After immunization, 5 animals were subjected to irregular noise, light, and vertical movement, while 5 controls remained undisturbed except for periodic blood collections. The stress group showed delayed antibody formation, and the antibodies rose to a lower level than in the control group. The serum cortisol values were markedly elevated during the initial period of the experiment in the group exposed to stress.
TL;DR: “Psychogenic” may be used meaningfully to refer to causation either by a state of the organism or by an external stimulus and recognition of “linguistic parallelism” is helpful theoretically and in patient care.
Abstract: The mind-body problem is of practical importance in medicine. Current thinking about it is confused, and leads to significant errors in considering health and disease and in dealing with individual patients. “Psychological” and “physical” cannot usefully be thought of as referring to different kinds of states or events; rather, they are names of different but parallel languages that may be used for describing exactly the same events. “Functional” and “organic” are at best useless concepts and at worst seriously misleading. “Psychogenic” may be used meaningfully to refer to causation either by a state of the organism or by an external stimulus. Recognition of “linguistic parallelism” is helpful theoretically and in patient care.
TL;DR: It is concluded that psychogenic factors are of primary importance in the etiology of post‐lumbar‐puncture headaches.
Abstract: Headache following lumbar puncture is commonly thought to be due to continued leakage of spinal fluid through the dural hole and traction on pain-sensitive vascular structures. A double-blind study was performed on 100 healthy human volunteers to investigate the role of psychogenic factors in the etiology of this complication. There was no statistical difference in the incidence of headache after diagnostic and sham lumbar punctures. It was further noted that post-lumbar-puncture headaches occurred much more frequently in those subjects who expressed concern about this complication. It is concluded that psychogenic factors are of primary importance in the etiology of post-lumbar-puncture headaches.
TL;DR: It is suggested that the mechanism for drive reduction after stress is aberrant in children with recurrent abdominal pain.
Abstract: &NA; Pupillary reactivity was employed as a measure of autonomic nervous system responsivity in 12 well children and 13 children with recurrent abdominal pain. Dilatation of the pupil in darkness was measured as an index of adrenergic reactivity during experimental rest, under stress, and after recovery from stress. No significant difference between the two groups was observed at rest. In response to stress both groups showed a further increase in pupillary dilatation to a similar degree. A significant difference after stress was manifested as a small initial decrement of pupillary dilatation in the children with abdominal pain. It is suggested that the mechanism for drive reduction after stress is aberrant in children with recurrent abdominal pain.
TL;DR: Obese adolescent girls at a medically oriented camp for overweight girls were compared with normal‐weight girls at an ordinary summer camp on a number of personality and interest measures (MMPI, Strong, Semantic Differential, and Sentence Completion).
Abstract: &NA; Eighty‐eight obese adolescent girls at a medically oriented camp for overweight girls were compared with 42 normal‐weight girls at an ordinary summer camp on a number of personality and interest measures (MMPI, Strong, Semantic Differential, and Sentence Completion). Statistically significant differences were found on all measures used. The obese girls showed unusual narcissism, difficulty in impulse control, considerable social anxiety, behavioral immaturity, and depression. They were less imaginative and ambitious in their life goals and seemed to live within a pattern of ego restriction. Obesity appears to be regularly accompanied by consistent personality difficulties of a serious nature, restriction of social and occupational horizons, and faulty perception of significant concepts.
TL;DR: The cases of 7 patients who were seen in a Northern hospital and who shared a belief in hexing and “root work” are presented and the diagnostic and therapeutic implications of modern day voodoo in the Negro ghetto are discussed.
Abstract: &NA; Voodoo has evolved into a rural Southern practice in America called “root work.” The migration of the Negro has brought “root work” to the industrial North. The cases of 7 patients who were seen in a Northern hospital and who shared a belief in hexing and “root work” are presented. The diagnostic and therapeutic implications of modern day voodoo in the Negro ghetto are discussed.
TL;DR: Indices of physique, sexual and physical maturation, prior gynecological symptoms other than menstrual irregularity, and medical difficulty in general could not be related to the development of menstrual aberration.
Abstract: &NA; A longitudinal study was performed in an attempt to determine parameters which could aid in predicting the development of amenorrhea in normal females. A total freshman class of nursing students participated as subjects. It was found that psychological parameters, specifically those related to body image theory, correlated with the development of menstrual aberration. A history of significant menstrual irregularity at any time in the past was also found to correlate with menstrual disturbance during the study. Indices of physique, sexual and physical maturation, prior gynecological symptoms other than menstrual irregularity, and medical difficulty in general could not be related to the development of menstrual aberration.
TL;DR: An examination of the experimental literature lent little support to the concept of a “coronary personality,” and the lack of consistent findings was attributed to the action and complex interaction of variables such as age, sex, and socioeconomic status.
Abstract: The symbiotic phase of development is crucially involved in determing the nature of psychopathology as well as promoting psychic processes that are involved in creative activity and intimate object relationships. In a well-established object relationship, the partners relate to each other in a symbiotic fashion. From the analysis of married persons (and some clinical material is presented in this paper), the author concludes that the fundamental character structure, psychopathological or otherwise, of each spouse is identical. Exceptions to this conclusion exist, but here one is dealing with an object relationship that is superficial and transitory. Symbiotic fusion regularly occurs in creative activity and empathic intimate relationships.
TL;DR: In 2 carefully controlled studies with the same women with chronic schizophrenia, chlorpromazine was shown to raise serum cholesterol levels consistently and significantly, and cholesterol levels appeared to be related inversely to measures of withdrawal, seclusiveness, and gross psychopathology.
Abstract: &NA; In 2 carefully controlled studies with the same women with chronic schizophrenia, chlorpromazine was shown to raise serum cholesterol levels consistently and significantly. It was also a consistent finding that prior to chlorpromazine therapy cholesterol levels appeared to be related inversely to measures of withdrawal, seclusiveness, and gross psychopathology. After chlorpromazine therapy the cholesterol‐behavior relationships were no longer apparent.
TL;DR: Rats immobilized at the peak as compared to the trough in the 24‐hr.
Abstract: &NA; Rats immobilized at the peak as compared to the trough in the 24‐hr. activity cycle are more susceptible to gastric erosions. In a series of experiments designed to delineate some of the factors which may have contributed to this phenomenon, it was found that the 24‐hr. rhythm in plasma corticosterone levels is not correlated with activity and is not related to the development of erosions under 6‐hr. immobilization; plasma pepsinogen levels show a 24‐hr. rhythm which is synchronized with activity, but the magnitude of the daily fluctuations are not sufficient to account for the altered erosion susceptibility; and the increased susceptibility shown by animals immobilized during a period of maximum activity obtains even when one eliminates animals protected by the presence of food in the stomach.
TL;DR: It is contended that a solution to the general measurement of arousal will not be found by transforming single measures, by innovations in data reduction, or by combining measures, but by learning more about the unique properties of different physiological systems by establishing how they vary as a function of the parameters of stimulus input‐‐such as intensity, rate of stimulation, and time since stimulus onset.
Abstract: &NA; Empirical evidence is presented to demonstrate that there is no true relationship between such physiological measures as heart rate and skin conductance, but that (depending on circumstances) heart rate and skin conductance covary directly, inversely, or not at all. It is contended that a solution to the general measurement of arousal will not be found by transforming single measures, by innovations in data reduction, or by combining measures. Instead, the solution lies in learning more about the unique properties of different physiological systems by establishing how they vary as a function of the parameters of stimulus input‐‐such as intensity, rate of stimulation, and time since stimulus onset.
TL;DR: The sleep of a 51‐year‐old farmer with a severe psychotic depression was studied by electroencephalograph for 31 of 36 hospital days and for 2 nights 3 weeks after discharge; abrupt improvement followed the sixth session of electroconvulsive therapy.
Abstract: &NA; The sleep of a 51‐year‐old farmer with a severe psychotic depression was studied by electroencephalograph for 31 of 36 hospital days and for 2 nights 3 weeks after discharge. He was successfully treated with 9 sessions of electroconvulsive therapy (ECT); abrupt improvement followed the sixth. Before improvement his sleep was grossly abnormal with much wakefulness. REMP and Stage IV sleep were abnormally low. After successful treatment, REMP showed a compensatory increase. Stage IV sleep increased toward normal very slowly. There were changes in appetite, weight, and bowel function, as well as in mood and behavior.
TL;DR: A preclinical introduction to psychiatry along analytic lines, with emphasis on Dr. Alexander's opinions and contributions, which cannot be compared, however, in accuracy or detail, with most general psychopathologies, particularly those of Cameron or Jaspers.
Abstract: Essentially Drs. Alexander and Selesnick have written a preclinical introduction to psychiatry along analytic lines, with emphasis on Dr. Alexander's opinions and contributions. The book would perhaps be most useful during the early medical school years in the hands of an instructor who uses a broad, survey approach. In part it resembles the old general psychiatries that often preceded the discussions of syndromes in textbooks. It cannot be compared, however, in accuracy or detail, with most general psychopathologies, particularly those of Cameron or Jaspers; nor is this its goal. As with most introductions, the critical student will be hard put to know why he needs to believe much of what he is being told. Throughout, the authors* independence of mind, optimism, and broad-ranging interests are prominently in evidence.
TL;DR: Test feedings showed significant intertrial consistency and significant intrainfant reliability of repeated measures of newborn sucking for milk formula, but not ofrepeated measures of sucking for corn syrup solution.
Abstract: Neonatal sucking behavior varies as a function of the nutrient used. Test feedings showed significant intertrial consistency and significant intrainfant reliability of repeated measures of newborn sucking for milk formula, but not of repeated measures of sucking for corn syrup solution. The findings
TL;DR: Follow‐up indicated that the anxiety of both patient and doctor aroused by angina pectoris resulted in much delay in the rehabilitation of the patients in this group, even though for the period in which they were followed they had no greater mortality or morbidity than the group without anginapectoris.
Abstract: In a study on 256 patients with arteriosclerotic heart disease, a comparison was made between the patients with angina pectoris and those without it. Patients of lower socioeconomic status and with a number of specific personality characteristics, such as compulsivity, tenseness, conflictuousness, a
TL;DR: Tolerance for pain resulting from a controlled electric shock to the forearm was studied in relation to body image and anxiety and a significant positive correlation was found between pain tolerance and definiteness of body boundaries.
Abstract: &NA; Tolerance for pain resulting from a controlled electric shock to the forearm was studied in relation to body image and anxiety. A significant positive correlation was found between pain tolerance and definiteness of body boundaries. A significant negative correlation was found between Holtzman's modification of the Elizur Rorschach Content Scale and pain tolerance. However, pain tolerance was not correlated with a more focused measure of body anxiety.
TL;DR: Two cultural subgroups, thought to represent common cultural attitudes, ascribed fewer favorable characteristics to couples using vasectomy than to couples relying on ovulation suppression.
Abstract: Data from 2 groups of people - married couples who belonged to a single Protestant church and a group of students enrolled in an undergraduate college course - were collected in order to ascertain the prevailing attitudes toward people who have had vasectomies. Previous studies have indicated a postoperative increase in psychiatric symptomatology among vasectomy subjects even though they professed enthusiasm for the operations as a contraceptive method. Subjects who used oral contraceptives experienced no such reaction. The current data paralleled the results from earlier studies. It is believed that these erosive cultural attitudes substantially contribute to adverse self-conc ept change and to negative emotional reactions of couples utilizing vasectomy who may have turned to it initially in part in response to cultural pressures for birth control.