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Biomedical subjects

A Stravynski

Publications and source records attributed to A Stravynski.

28 records · Page 2Linked to original sources

[Implications of biological models on psychiatric clinical practice.].

The explanatory models of a biological nature are growing in popularity in psychiatry. The reason for this ideological tendency is studied and contradictory evidences are underlined. It seems that an exclusively biological conception of psychiatric disorders is more prescriptive than descriptive of the facts. Biological models, seemingly more "scientific" are particularly of interest to the professionals with a bio-medical training, and, in this sense, bear important implications for the practice of psychiatry. Their influences on clinical practice, professional training and research are reviewed and discussed.

English Abstract↗

Patients who complain of social dysfunction as their main problem: II. Comparison with other outpatients seen for behavior therapy.

Forty socially dysfunctional patients (avoidant personality disorder, DSM-III) and 76 other patients also seen for behavioral psychotherapy rated 30 items from the Social Situations Questionnaire on dimensions of distress and frequency of involvement. A discriminant function analysis showed that socially dysfunctional patients formed a distinct group as compared with other patients on ratings of distress. The main characteristics were over initiating social contact and carrying on a conversation with people one does not know. The separation between groups on the rating of frequency of involvement was less clear cut with some degree of overlap. The differences were in interactions with relative strangers and making decisions affecting them. A subsequent classification of cases using the derived discriminant function validated the above findings.

Adult↗

The influence of two different sets of information and suggestions on the subjective effects of relaxation.

The study compared the subjective effects of different relaxation techniques and their susceptibility to influence by information and suggestions provided by the trainers. Two groups of twelve subjects each were trained in autogenic training and in progressive relaxation successively. On three occasions during their training, each group was given one of two contrasting sets of information and suggestions concerning the subjective effects to be expected. At the end of training, differences in the subjective effects accompanying the two relaxation techniques were found but no significant effect of the contrasting sets of information and suggestions emerged. These results suggest that the subjective effects of relaxation were resistant to simple suggestions and, being more robust and real than often thought, could constitute a basis for differential indications of various relaxation methods.

Adult↗

Behavioral treatment of psychogenic vomiting in the context of social phobia.

A case of psychogenic vomiting in the context of social phobia was treated by a combination of exposure in vivo, social skills training, and cognitive modification. The intervention was not directly aimed at the vomiting, but at aspects of the patient's behavior hypothesized to be instrumental in maintaining it; deficits in prosocial behaviors and associated anxiety. Change was assessed on the basis of patient's records of daily frequency of: vomiting; performance of treated behaviors; and associated anxiety within a single-case multiple baseline design. Change occurred only with the introduction of treatment and not before it, ruling out effects of time or mere contact. Clinically, the vomiting was virtually eliminated after 7 weeks, and the anxiety was substantially reduced in most previously feared (and avoided) social situations; except for a 2-week depressive spell, this outcome has been maintained for an available 2-year follow-up. A general improvement in the patient's personal, social, and vocational life has also occurred.

Adult↗

The treatment of social dysfunction in nonpsychotic outpatients. A review.

A sizable proportion (7 to 16 per cent) of psychiatric outpatients suffer from social dysfunction, either as the main complaint or in conjunction with other psychiatric problems. Social skills training is a newly evolved treatment regimen that involves teaching patients new forms of social behavior by their rehearsal within sessions and their practice in real life between sessions. In an overview of controlled studies, social skills training was found to have been useful for up to 16 months follow-up in mainly nonpsychotic socially dysfunctional outpatients. Its effects supersede "no-treatment" periods and it appears a more potent treatment of social dysfunction than contrasting methods such as short term psychotherapy, systematic desensitization, sensitivity training, etc. The adjunct use of an anxiolytic or cognitive modification has not enhanced outcome. Social skills training is recommended as the treatment of choice for patients with social dysfunction, especially when no other major psychiatric disorders are present.

Ambulatory Care↗

Social phobia.

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Humans↗

Social skills problems in neurotic outpatients. Social skills training with and without cognitive modification.

Twenty-two "socially dysfunctional" outpatients had 12 1 1/2-hour sessions of social skills training either alone or combined with cognitive modification (each, n = 11). Two raters who were blind to the treatment regimen significantly differentiated the two treatments, as judged from audiotapes of treatment sessions. Measurement was by an independent assessor in a structured interview, by self-monitoring of several activities and of anxiety felt during them, and by self-rated questionnaires. In each treatment regimen, patients' conditions improved significantly and equally on reported behavioral and cognitive measures both during and after treatment, and at six-month follow-up. Outcome did not differ significantly between the two treatment conditions at any time on any measure. Patients reported increased levels of social activities and less anxiety during these, less isolation, better relations with their colleagues at work, less depression, and loss of many irrational social beliefs. During multiple baseline monitoring for up to nine weeks, no improvement occurred. Performance of each social task or "target" increased significantly after training was begun for it, and subjective anxiety decreased similarly during social performance. Untreated targets improved much less, and more slowly. Social skills training was followed by lasting and worthwhile improvement that was not enhanced by the addition of cognitive modification.

Adult↗

Social phobia viewed as a problem in social functioning: a pilot study of group behavioral treatment.

Available treatments of social phobia reduce anxiety and avoidance of social situations. Social functioning however, remains relatively unaffected. This study piloted a behavioral group treatment that aimed at improving patients' individual difficulties in social functioning. Five patients fulfilling DSM-IV criteria for social phobia were selected for treatment by a 16-session behavioral group treatment focusing on improving interpersonal functioning both in specific phobic situations as well as in different spheres of social life in general. Four out of 5 patients completed treatment and showed individual patterns of clinically significant improvement. Their individual test-score results and case-histories are presented. Three patients no longer fulfilled to the diagnostic criteria at the end of treatment; the fourth--at 6 month follow-up. This was maintained at a 2 year follow-up.

Adult↗