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Showing papers in "Social Psychiatry and Psychiatric Epidemiology in 1973"


Journal ArticleDOI
TL;DR: The “prediction of further suicidal behaviour rating scale” proved an effective instrument in determining which female patients were at high risk, but not so for males, and the social circumstances of the treated group were significantly improved when compared with the controls.
Abstract: An experimental after-care programme was provided for patients who had repeatedly attempted suicide (parasuicide) and had been admitted to the Edinburgh Regional Poisoning Treatment Centre. This programme was an extension of the regular after-care service provided by the Centre. Its special features were domiciliary visits and a 24 hr. emergency service in addition to out-patient clinics. In order to evaluate the programme, patients entering the study were allocated alternately to a treatment group, who were offered the facilities of the experimental service, and a control group who received conventional care. All patients were assessed for risk of further repetition of parasuicidal acts by a predictive rating scale. Those rated at high risk were all offered the same facilities in the treatment group and hence were excluded from the comparison with the controls. — Psychiatric and social assessments of all cases were carried out on identification before discharge from the Centre, and again at the end of six months. Further admissions to the Centre of patients from both groups were recorded. The programme was evaluated by making comparisons between the treatment and control groups of (a) the number of further parasuicidal acts within six months of discharge from the Centre and (b) changes during that period in the patients' psychiatric and behavioural states and in their social circumstances. — One hundred and ninety-seven patients were identified as repeaters. Forty-two of these were rated as at high risk of further repetition. Of the non-high risk patients, 71 remained in the treatment group and 84 in the control group. The treatment and control groups did not differ significantly in terms of sex, age, civil status, social class, psychiatric diagnosis, personality assessment, alcohol and drug abuse, or social disintegration. All were predominantly from Social Classes IV and V. The commonest diagnosis was of personality disorder with no additional circumscribed or formal psychiatric illness. Over 50 % of the subjects had problems in the use of alcohol or drugs. The majority of the patients had serious social difficulties. — No significant difference was found between the treatment and control groups in the proportion of patients with further acts of parasuicide during the follow-up: 24 % and 23 % respectively. Patients with problems in the use of alcohol were over-represented among these further repeaters. No significant difference were found in the follow-up assessments of psychiatric and behavioural states between the treatment and control groups. — The social circumstances of the treated group were significantly improved when compared with the controls. This difference was most marked among the female patients. The high risk patients were older than the others and the majority came from Social Class V. Severe personality disorders and abuse of alcohol and drugs were very common among the high risk patients. Fifty-six per cent of the high risk group repeated parasuicidal acts during the six months follow-up. All these patients were dependent on either alcohol or drugs. Women more commonly repeated than men in the high risk group. — The “prediction of further suicidal behaviour rating scale” proved an effective instrument in determining which female patients were at high risk, but not so for males. — The after-care provided may have been of too short duration to permit full evaluation, and further programmes of this kind might yeild more positive results conducted for a longer period. Alternatively, a completely different approach may be necessary.

113 citations


Journal ArticleDOI
TL;DR: In this article, the authors found that the risk of committing an act of violence, which had to be calculated on the basis of inexact data, is about 6 in 100 000 approximately, and is one-tenth of that for schizophrenia (5 in 10 000).
Abstract: The essential result of our study is that crimes of violence committed by mentally ill and by mentally retarded are quantitatively proportional to the number of crimes of violence committed by the total population. In affective psychoses and mental retardation, the risk of committing an act of violence, which had to be calculated on the basis of inexact data, is about 6 in 100 000 approximately, and is one-tenth ofthat for schizophrenia (5 in 10 000). Factors which do not depend on the disorder, especially family and personality factors, seem to be relevant for the disposition to criminality. The disorder itself has different consequences. It generally seems to postpone the manifestation of the act of violence and thus raises the average age of the mentally-ill offenders. The closest connection between the crime motives and the disease can be assumed in depressed and schizophrenic offenders. The personality of the depressed seems to suppress the disposition to commit aggressive offenses with the exception of extended suicide as a combined act of violence and self-destruction. In schizophrenia, certain disturbances which can be found in chronic systematized paranoid syndromes seem to co-determine the motive of the offense, and are likely to favour its manifestation.

56 citations


Journal ArticleDOI
TL;DR: A review of studies from Great Britain, Australia and Israel revealed remarkably similar findings as to the increase in attempts over the past decade and the characteristic of the attempters suggest that the New Haven findings are representative of an urban trend.
Abstract: A comparison of in and outpatient hospital admissions for suicide attempts in an urban community in 1955 and 1970 revealed an 11 fold increase in attempts. The increase in suicide attempts exceeds the growth or changes in the structure of the population, the utilization of the emergency room by psychiatric or non-psychiatric patients and cannot be explained by changes in the health delivery during that time period. The suicide rate in the same community during that time period decreased slightly. The suicide rate in 1970 for the community studied was 7.3/100 000 and the crude suicide attempt rate was estimated at 183.4/100 000. — The characteristics of the attempts were examined. Most attempters were under 30 years of age, females outnumbered males 2∶1, most were single or divorced persons, social classes 1 and 2 were underrepresented reflecting the use of private doctors by this group. The racial distribution was representative of the area primarly served by the hospital. The majority of attempts were impulsive with little intent to kill oneself and by ingestion of pills. — A review of studies from Great Britain, Australia and Israel revealed remarkably similar findings as to the increase in attempts over the past decade and the characteristic of the attempters. These similarities suggest that the New Haven findings are representative of an urban trend. One population change noted which has an effect on the suicide attempt rate is the marked increase in-the high risk age group, persons 15–24, reflecting the rising birth rate following World War II. A rise in the suicide rate may occur as these young attempters mature and enter the age of risk for suicide. The current rate of suicide attempts in young persons, both in the United States and in other parts of the Western world, constitutes a significant public health problem.

32 citations


Journal ArticleDOI
T. Harding1
TL;DR: There were 51 people on a single day with psychosis severe enough to lead them to be away from their homes in West Africa with a population of 140 000, whose help was almost exclusively sought in preference to allopathic medicine.
Abstract: In a rural community in West Africa with a population of 140 000, there were 51 people on a single day with psychosis severe enough to lead them to be away from their homes 43 of these were under treatment by traditional healers, whose help was almost exclusively sought in preference to allopathic medicine One traditional healer, a herbalist, admitted 24 psychotic patients in a 6 month period for treatment which included physical restraint, drug therapy and rehabilitation 6 months after their discharge, one patient had been re-admitted and 4 appeared severely incapacitated; 8 patients appeared completely recovered

31 citations


Journal ArticleDOI
Birgitta Rorsman1
TL;DR: A comparison was made between suicide psychiatric patients and randomly selected psychiatric patients from the same original patient group, concerning factors that on the basis of earlier knowledge about causes of suicide could be expected to differentiate the two groups.
Abstract: Many factors held to be associated with suicide also apply to mental illness in general. An important question is whether psychiatric patients who commit suicide are distinguishable from other psychiatric patients. — In this study, a comparison was made between suicide psychiatric patients and randomly selected psychiatric patients from the same original patient group. The patients were compared concerning factors that on the basis of earlier knowledge about causes of suicide could be expected to differentiate the two groups. The variables chosen for comparison were mainly objective social and medical data. Information was collected from the psychiatric hospital records. The analysed sample consisted of 45 suicide patients and 276 controls. — The major difference in the comparison of suicide patients versus control psychiatric patients was a high frequency of previously attempted suicide in both sexes in the suicide group. In this study, 56% of all suicides had a history of previous attempt. Other factors found to be of special importance in psychiatric suicide patients were recent object loss by death in men, and living alone in women. Less prominent findings with slight significance were: more patients with affective disorder in the male suicide group and more divorced patients among the female suicides compared to controls. — The suicide patients had in many respects received similar psychiatric services to the control patients. The most interesting difference was a higher occurrence of “no treatment” in the male suicide group. Female suicide patients were more often hospitalised.

28 citations


Journal ArticleDOI
TL;DR: It appears that once in civil mental hospitals, the release of the criminally insane is less influenced by any special emphasis on dangerousness than by those factors previously suggested as influencing therelease of other civil mental patients.
Abstract: To determine how various indicators of dangerousness might effect decisions for the community release of patients defined as criminally insane, a sample of 176 male patients transferred against psychiatric recommendations to civil mental hospitals were studied. Even though these patients were seen as some of the most dangerous patients in state institutions, there was little relationship between criminal histories or incidents of hospital assaults with their release into the community. Of the other variables examined, the most important was the length of hospitalization and its association with the availability of persons in the community willing to sponsor the release of individuals. It appears that once in civil mental hospitals, the release of the criminally insane is less influenced by any special emphasis on dangerousness than by those factors previously suggested as influencing the release of other civil mental patients.

13 citations


Journal ArticleDOI
TL;DR: The authors found that aggression is adjustive, motivated behaviour that holds a complex relationship to the personality and environment of the young people studied, and that this action is a by-product of adjusting to the lower-class style of life.
Abstract: Some results from a recently completed study into aggression among English working-class adolescents in a depressed neighbourhood are used to examine contrasted perspectives of this behaviour that are prevalent in the field: 1. the view which sees aggressiveness as pathological and 2. the position arguing that this action is a by-product of adjusting to the lower-class style of life. Yougsters judged as aggressive or non-aggressive by their peers were depth interviewed with a schedule probing the images they held of themselves and their environment, the activities they valued and self-reported aggressive behaviour. The results support the argument that aggression is adjustive, motivated behaviour that holds a complex relationship to the personality and environment of the young people studied.

13 citations


Journal ArticleDOI
Birgitta Rorsman1
TL;DR: The suicides occurred fairly evenly throughout the 1962–67 period, there being no significant decreasing tendency with the passage of time.
Abstract: The study concerns mortality by suicide among psychiatric patients. The sample consisted of all patients, 20 years and over, who were treated at the Psychiatric Department in Lund, Sweden during the year 1962. The Swedish Central Bureau of Statistics publishes annual lists on mortality with coded data concerning causes and date of death for all deceased persons registered in Swedish parish registers. By examining these mortality lists for the years 1962 to 1967 the psychiatric patients, who had died by suicide during this period, could be located. Out of the total number of 3.006 patients, 46 died by suicide during these years. The expected number of suicides for a corresponding sample from the general population was 4.34. The suicides occurred fairly evenly throughout the 1962–67 period, there being no significant decreasing tendency with the passage of time. In 8 out of 29 male suicides and 10 out of 16 female suicides, the suicide occurred within three months after the last contact with the department. The sex-difference was significant. Hanging was the most frequent method in men and poisoning in women.

13 citations


Journal ArticleDOI
TL;DR: In this article, the attitudes toward mental illness of the people of two rural communities belonging to the same mental health district in Finland are analyzed on the basis of Durkheim's and Allardt's theories of social structure.
Abstract: The attitudes toward mental illness of the people of two rural communities belonging to the same mental health district in Finland are analysed on the basis of Durkheim's and Allardt's theories of social structure. One community was mainly agricultural (community A) and the other was industrialized (community I). Use was made of a Likert-type attitude scale created for the purpose, and the personal interview technique was employed. The sample consisted of 200 individuals and the response percentage was 94. The main hypothesis of the study, introduced on both sociological and psychiatric grounds, was that attitudes in community A would be more negative than in community I, but the results failed to confirm this. On the other hand, men's attitudes were more positive than those of women in both communities, but to a statistically significant extent so only in community I. Moreover, age and sex correlated with attitudes in this community: attitudes were more positive, the older a man and the younger a woman. When age was considered singly and as a continuous variable it did not, however, correlate with attitudes. A positive association between attitudes and educational level was observed in both communities, and the same was true of the number of sources of information about mental illness and attitudes. In the Conclusions section the writers state that attitudes may be considered as intervening variables and that no far-reaching conclusions concerning causal relationships can be based on them.

13 citations


Journal ArticleDOI
TL;DR: In this paper, the relationship between the ability to recognize behavior as pathological and attitudes, whether positive or negative, towards the mentally ill was tested and no relationship was found, and the data strongly supported the proposition that the persons who attached the label of mental illness to the previously described behaviors do not differ significantly from persons not using this label in terms of their willingness to interact at various levels with the mental ill.
Abstract: Star and Cummings findings that in 1950 and 1951 only a small minority of the public was able to identify symptoms of mental illness other than those of paranoid schizophrenia are at variance with the findings of the major studies carried out in the 1960's. In most studies, substantial numbers of the public were able to recognize case descriptions as mentally ill. Therefore, hypotheses and policies based on the assumption of public's inability or unwillingness to identify mental illness are no longer supported empirically. The relationship between the ability to recognize behavior as pathological and attitudes, whether positive or negative, towards the mentally ill was tested. No relationship was found. Bentz and Edgerton studying predominantly rural populations and using different techniques have arrived at similar findings. They state “our data strongly supports the proposition that the persons who attached the label of mental illness to the previously described behaviors do not differ significantly from persons not using this label in terms of their willingness to interact at various levels with the mentally ill.” (13). Our study confirms this.

12 citations


Journal ArticleDOI
TL;DR: In this paper, a case study of a group relations seminar comprised of high school students in a compensatory education program is presented, where an attempt is made to inter-relate a group member's dream, the leaders' roles, an episode involving the total institution, and various staff reactions.
Abstract: Concepts of authority relations and boundary maintenance and crossing, developed at the Tavistock Institute, which have been found useful for understanding group and organizational dynamics, are presented. This conceptual viewpoint is then utilized in a case study of a group relations seminar comprised of high school students in a compensatory education program. Since this seminar had an unanticipated impact on the larger organization, of which it was a part, this perspective is also invoked to analyze this phenomena. Specifically, an attempt is made to inter-relate a group member's dream, the leaders' roles, an episode involving the total institution, and various staff reactions. Finally, some organizational aspects of resistance to change are highlighted.

Journal ArticleDOI
TL;DR: The individual and interaction effects of race, race, education, and age on self-derogation were investigated in this paper, and the individual effects of social positions on self derogation are generally statistically nonsignificant and/or not uniform throughout the population.
Abstract: The present study investigates the individual and interaction effects of sex, race, education, and age upon self-derogation. Data were collected by survey research methods from a sample (N=500) of the adult population of Harris County (including the city of Houston), Texas. Self-Derogation was measured by a factorially derived index. The individual effects of the social positions upon self-derogation were generally statistically nonsignificant and/or not uniform throughout the population. However, strong interaction effects were observed. Self-derogation was relatively great among: less educated white females; more educated Negro males; and less educated white males, aged 50–59. It was suggested that systematic consideration of the interaction effects of social positions would account for much of the inconsistency apparent in the related literature and would lead to further hypotheses regarding the genesis of negative self-attitudes.

Journal ArticleDOI
TL;DR: In this paper, the authors describe the characteristics of girls referred to a consulting psychiatrist by the Young Mothers Clinic, part of a comprehensive service program for school-age mothers in New Haven, Conn.
Abstract: This paper describes the characteristics of girls referred to a consulting psychiatrist by the Young Mothers Clinic, part of a comprehensive service program for school-age mothers in New Haven, Conn. This program provided obstetrical, educational, and social services to the study group, which consisted of 180 patients who entered the clinic over a two year period. All of the study group were under 18 years of age and unwed when they registered for the clinic, and most were nonwhite. — Twenty-five of the 180 girls were referred to the psychiatrist. Common reasons for referral included lack of attention, delinquency, learning difficulties at school, withdrawn behavior, depression, suicidal threats, and chaotic home situations. Those referred were found frequently to have 1. a history of contact with juvenile court and/or 2. low scores on the Wechsler intelligence scales and poor scores on the Bender Gestalt test. — White girls were more likely to be referred than were nonwhite girls. Girls 15 years of age or under were more likely to be referred than older girls. These two groups (i.e. the younger group and the white group) tended to come from extremely disorganized homes. — Clinically, the psychiatrist was impressed by the repeated history of maternal deprivation among the referred patients. She hypothesized that the girls' unfulfilled yearning for closeness with their mothers may have driven them toward early physical relationships with boys, resulting in the pregnancies. Therapeutic recommendations were difficult to implement primarily because the girls, for various reasons, did not follow through with referrals to other sources of care.

Journal ArticleDOI
TL;DR: In this paper, the authors investigated the relationship between nurses' ratings of patient behaviour, nurse intervention and patient behaviour on a ward for chronic psychotic patients and found that nurses' rating relate mainly to ward management and not to such behavioural indices as social interaction or variability of behaviour.
Abstract: On a ward for chronic psychotic patients the relationships between nurses' ratings of patient behaviour, nurse intervention and patient behaviour is investigated. The ward was observed during the morning hours of a normal working day, and the observational data were correlated with the nurses' ratings. It was found that the nurses' ratings relate mainly to ward management and not to such behavioural indices as social interaction or variability of behaviour.

Journal ArticleDOI
TL;DR: It is suggested that in this type of service one deals more with adaptational vicissitudes than with “pathology” in the conventional sense.
Abstract: Les auteurs presentent une etude statistique et epidemiologique d'un echantillon representatif de la clientele d'un service de guidance infantile, selectionne sur une periode de 4 ans. — Les parametres utilises (sexe, âge, nationalite, domicile, niveau socio-professionnel, mode de venue, motif de consultation, milieu familial) permettent de degager des resultats dont les plus interessants semblent: a) l'importance de la categorie socio-professionnelle des parents, qui se traduit par des differences significatives dans les comparaisons en fonction du sexe des consultants, de leur mode de venue et du motif de consultation — b) La surrepresentation d'enfants delinquents dans les milieux familiaux desunis — c) la faible motivation des milieux modestes pour consulter le pedo-psychiatre — d) le role marginal joue par la distance comme facteur influencant la decision de consultation. — Les versants diagnostic et therapeutique ne sont pas pris en consideration.

Journal ArticleDOI
TL;DR: Analysis of the data from neurotic patients shows higher rates for the upper class in the incidence and point prevalence groups, and lower class patients have the highest rates in all three components of prevalence.
Abstract: Data from 2374 urban Lebanese patients who were under psychiatric care between February 15, 1964 and August 15, 1964 are presented in terms of components of prevalence. In the incidence group a significant association is shown to exist between social class and the rate of illness with the upper class showing the highest rate. In the patient population under care at the onset of the study, lower class patients predominate, and the same is found to be true for patients readmitted to care during the study period. Analysis of the data from neurotic patients shows higher rates for the upper class in the incidence and point prevalence groups. Among psychotics, lower class patients have the highest rates in all three components of prevalence. This data is further analyzed individually for affective disorders, schizophrenic reactions, and brain disorders.

Journal ArticleDOI
TL;DR: A statistically significant inverse relationship is found to exist between educational level and the prevalence of illness for both sexes and this pattern is shown to persist for new cases, cases that were under care at the onset of the study, and readmissions into care during the study period.
Abstract: Data from 2256 urban Lebanese patients who were under psychiatric care during a period of six months are presented in terms of educational level and the prevalence and types of psychiatric illness. The data are examined for the entire patient population as well as for each component of prevalence. A statistically significant inverse relationship is found to exist between educational level and the prevalence of illness for both sexes. This pattern is shown to persist for new cases, cases that were under care at the onset of the study, and readmissions into care during the study period. There are additional detailed analyses for the various types of psychiatric diagnoses.

Journal ArticleDOI
TL;DR: A brief survey of the organisation in the United Kingdom of existing facilities for rehabilitation, training and sheltered employment precedes a description of five years work in a voluntary, non-profit making organisation (Bristol Industrial Therapy Organisation) as mentioned in this paper.
Abstract: A brief survey of the organisation in the United Kingdom of existing facilities for rehabilitation, training and sheltered employment precedes a description of five years work in a voluntary, non-profit making organisation (Bristol Industrial Therapy Organisation (Bristol) Limited). The classification of patients referred during this period is reported and the outcome of attendance. The success and failure, according to sources of referral and diagnosis, is commented on and a two-year follow-up is given. A summary of outcome for the first eleven years of the Organisation is recorded. — The present state of industrial therapy is discussed and the need for research and for workers in the field to become more highly specialised is stressed. — The change in clientele is noted with an increase in referral of patients suffering from subnormality. A likely increase in persons with personality disorders is anticipated. — The different methods of approach by I. T. O. to the problem of reemployment are enumerated and the applicability of the I. T. O. principle to other groups, for example, ex-prisoners, prisoners, physically handicapped, etc. is suggested. The strength accruing to the Organisation from close links with the hospital and community is noted and the Organisations view that there should not be separate rehabilitation services for the psychiatrically ill and for the physically ill is stated. The continuation of voluntary organisations such as I. T. O. is considered desirable but not in the continuous provision of services which are clearly the responsibility of statutory authorities. These authorities must give fresh thought to the problem of providing services appropriate to modern needs.

Journal ArticleDOI
TL;DR: Goldberg, Bennett, Wing et al. as discussed by the authorsuhrten 8 Wochen lang eine einfache industrielle Papierarbeit aus Two Gruppen wurden nach 3 verschiedenen Bezahlungssystemen entlohnt: Pauschale, wochentlich ausgezahlter Stucklohn, and Sofortbezahung in Hohe des Stuck-lohns Untersucht wurden die Leistungen der Versuchspersonen unter
Abstract: 30 chronisch Schizophrene, aufgeteilt in 2 Gruppen, fuhrten 8 Wochen lang eine einfache industrielle Papierarbeit aus Die Gruppen wurden nach 3 verschiedenen Bezahlungssystemen entlohnt: Pauschale, wochentlich ausgezahlter Stucklohn und Sofortbezahlung in Hohe des Stucklohns Untersucht wurden die Leistungen der Versuchspersonen unter den verschiedenen Bezahlungsmodi und die Korrelation zwischen objektiver Leistung und der mit Hilfe des Beurteilungsbogens von Personal subjektiv geschatzten Leistung — Die zeitliche Abfolge der Bezahlungsmodi erfolgte bei den Gruppen nach zwei verschiedenen Versuchsmustern So bildete jede Gruppe ihre eigene Kontrolle, konnte andererseits aber auch mit der anderen verglichen werden — Bei dem Versuch ergab sich, das Stucklohn im Vergleich zur Pauschalbezahlung einen signifikanten Leistungszuwachs von 19% in Gruppe A und 10% in Gruppe B bewirkte Sofortbezahlung steigerte die Leistung in Gruppe A gegenuber wochentlich ausbezahltem Stucklohn um weitere 20% — in Gruppe B um 17% Damit kann von uns die oft geauserte Vermutung (Goldberg, Bennett, Wing u a), das die Moglichkeit zu hoheren Verdiensten von wesentlicher motivierender Kraft fur die Leistungsfahigkeit Schizophrener ist, experimentell bestatigt werden — Die individuelle Leistungsbewertung mittels ublicher Arbeitstherapieformulare, die nach subjektiver Beurteilung durch das Pflegepersonal erfolgte, ist verglichen mit der objektiven Messung der Leistung unzuverlassig Durch die subjektive Bewertung gelang nur eine annahernde Einschatzung der allgemeinen Leistungsfahigkeit eines Patienten, ohne das individuelle tagliche Schwankungen berucksichtigt wurden Solange, bis geeignetere Instrumente zur Beurteilung entwickelt worden sind, sollte demnach moglichst auf die Messung der objektiven Leistung zuruckgegriffen werden — Aus dem Versuch ergibt sich insgesamt, das die Einfuhrung einer regelrechten Bezahlung anstelle der wenig adaquaten Belohnung fur Arbeiten von industriellem Charakter einen gunstigen rehabilitativen Einflus erwarten last

Journal ArticleDOI
TL;DR: In this article, a pilot-study of the Reliabilitat psychiatrischer Diagnosen was conducted, in which 52 Mediziner und psychologen were asked to evaluate the charakteristischen characteristics of zehn diagnostischen Symptomen.
Abstract: Es wird uber eine Pilot-Study zu der Untersuchung “Reliabilitat psychiatrischer Diagnosen” berichtet. Ziel dieser Arbeit war es, Hinweise auf die Beantwortung der folgenden Fragen zu erhalten: — Welche der zehn Diagnosen aus den Bereichen endogene Psychose, Neurose und Personlichkeitsstorung (Psychopathie) werden ubereinstimmend mit charakteristischen Symptomen gut beschrieben? — Welche Symptome, Verlaufskriterien, anamnestische und atiologische Daten sind zur differentialdiagnostischen Abgrenzung der zehn psychiatrischen Krankheitsbilder geeignet? — Welche der zehn Diagnosen werden nicht oder unzureichend unterschieden? — Bei Erhebungen in drei psychiatrischen Landeskrankenhausern und zwei psychiatrischen Universitatskliniken beteiligten sich 52 Mediziner und Psychologen, die gebeten wurden, funf bis zehn diagnostische Stereotype, z. B. “die Schizophrenie”, an Hand der von uns vorgegebenen Symptomlisten zu charakterisieren. Hinter jedem Symptom war eine 10 cm lange Skala von “uncharakteristisch” bis “sehr charakteristisch”, auf der die Einzelentscheidung, z.B. wie charakteristisch sind “Halluzinationen” bei der “Schizophrenie”? durch einfache Markierung festgehalten wurde. — Die Auswahl der zur Charakterisierung brauchbaren Symptome erfolgte auf zwei Wegen. Zum einen wurde gepruft, ob die Beurteilungen jedes Items folgenden Kriterien genugten: — 1. Verteilungssymmetrie der Beurteilungen eines Items bei jeder Diagnose. — 2. Der Mittelwert der Beurteilungen eines Items mus mindestens bei einer Diagnose im Bereich “sehr charakteristisch” liegen. — 3. Der Abstand zwischen hochstem und niedrigstem Mittelwert eines Items bei den Diagnosen mus etwa die Halfte der theoretisch moglichen Differenz erreichen. — Auf der anderen Seite wurde eine Rangfolge der Items nach deren Eignung zur Abgrenzung der Diagnosen voneinander mit Hilfe einer schrittweisen Diskriminanzanalyse errechnet. Durch die Kombination dieser beiden Auswahlverfahren war eine sinnvolle Selektion moglich; von den ursprunglich 98 Symtomen erwiesen sich nur 52 als ausreichend brauchbar zur Charakterisierung der zehn Diagnosen. — Die Ergebnisse einer Faktorenanalyse zeigten die unterschiedliche Abgrenzbarkeit der ausgewahlten Diagnosen. Eine Trennung der drei verschiedenen Depressionsformen lies sich nicht nachweisen. Von den zehn Diagnosen fanden sich in der Faktorenanalyse nur funf als Symptomgruppierungen wieder. Es bleibt abzuwarten, ob diese vorlaufigen Ergebnisse sich in der Hauptuntersuchung bestatigen lassen.

Journal ArticleDOI
TL;DR: The NCCC was indicated to be an open adaptive system, since it continued to incorporate agencies into the referral network while keeping abreast of the new developments and changing needs of the community.
Abstract: The present study employs an open adaptive systems model to analyze the referral network of the Nashville Crisis Call Center (NCCC) in Nashville, Tennessee. The analysis focuses on the development of the NCCC referral network over a two year period. Results indicated that the NCCC progressively and adaptively increased agency contacts within the community. The NCCC was thus indicated to be an open adaptive system, since it continued to incorporate agencies into the referral network while keeping abreast of the new developments and changing needs of the community. The use of such systems methods in analysis is considered to have significant potential for future evaluation of functional services.

Journal ArticleDOI
TL;DR: The authors investigated the relationship of language, attitudinal, and socioeconomic factors with behavior representative of cultural change and in particular the effect of American teachers and cultural values on cultural change in a cross-cultural small group setting involving Thai medical students and American and Thai teachers.
Abstract: This is a field study of cultural change in Thailand in a cross-cultural small group setting involving Thai medical students and American and Thai teachers. Its purpose is to investigate the relationship of language, attitudinal, and socioeconomic factors with behavior representative of cultural change and in particular the effect of American teachers and cultural values on this change. This study attempts to go beyond the usual subjective anecdotal description of cultural change by careful observation of a discrete behavior operationally defined as representative of cultural change in a natural setting offering an unusually high degree of control over environmental variables. Results indicate that cultural change as measured by this behavior (student verbal assertiveness with the teacher) is significantly correlated at a moderate level with English language ability but not course grades. It is related to certain attitudes toward the learning process and future plans having to do with anticipated study in the United States. It is not related to a wide variety of socioeconomic background variables thought to be related to cultural change. The student's verbal assertiveness with the American teacher was significantly correlated at a high level with his verbal assertiveness with the Thai teacher. The implications of this for environment and personality as factors in cultural change are discussed.

Journal ArticleDOI
TL;DR: This paper discusses these important social psychiatric issues in the light of the newly developing concept of child advocacy and discute données socio-psychiatriques importantes à la lumière of the nouvelle conception du soutien à l'enfant.
Abstract: The recent report of the Joint Commission on the Mental Health of Children concludes that the state of mental health services for children has deteriorated in the past forty years. This is a paradoxical finding as there has been a steady growth of child psychiatric services during this time. The explanation appears to lie partly in the existence of structural or system defects which have impaired the growth and adaptation of child mental health services, and partly in societal ambivalence towards children. This paper discusses these important social psychiatric issues in the light of the newly developing concept of child advocacy.

Journal ArticleDOI
TL;DR: The authors decrit les interactions statistiquement significative retrouvees entre certain caracteristiques factuelles du malade mental hospitalise and l'intensite des liens existant entre lui et le monde exterieur.
Abstract: Cette etude decrit les interactions statistiquement significatives retrouvees entre certaines caracteristiques factuelles du malade mental hospitalise et l'intensite des liens existant entre lui et le monde exterieur. Elle met en evidence l'influence nefaste de la nature carcerale de l'institution psychiatrique et de la maladie mentale elle-meme sur l'integrite des relations entre le malade mental et le monde presume sain. — Une des phase de l'etude tendait a rechercher des indices de la deterioration des liens entre le malade mental et sa famille, dans la structure meme de celle-ci et sa maniere d'y repartir les roles. L'analyse de cette phase s'est revelee non significative. — Des commentaires d'ordre methodologique et operationnel sont formules.