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Biomedical subjects

B A Armelius

Publications and source records attributed to B A Armelius.

11 recordsLinked to original sources

Physical and psychological health and social relations in patients with prolonged musculoskeletal disorders.

The purpose of this study was to describe and analyse the relationship between physical and psychological health and social relations in patients with prolonged musculoskeletal disorders in primary care. Seventy-eight patients--64 women and 14 men--were included in the study. Data from a semi-structured interview called addiction severity index (ASI), frequently used in psychiatric and drug abuse research and a visual analogue scale (VAS) symptom list as well were analysed using principal component analysis (PCA). The analysis gave a two-dimensional model with four poles of related variables characterizing the whole group. The first dimension consisted of one pole characterized by present psychiatric symptoms and many somatic symptoms. The second pole on this dimension was characterized by well-being, having work and feeling satisfaction with life. One pole on the second dimension was characterized by severe physical problems, related to sick leave and disability pension. The opposite pole on this dimension was characterized by severe psychiatric symptoms earlier in life and present relationship problems with family and other people. The ASI-instrument was considered to be relevant for describing important problem areas in patients with prolonged musculoskeletal disorders.

Female↗

PLS model building: a multivariate approach to personality test data.

The aim of this study was to demonstrate how personality test data can be plotted with a multivariate method known as Partial Least Squares of Latent Structures (PLS). The basic methodology behind PLS modeling is presented and the example demonstrates how a PLS model of personality test data can be used for diagnostic prediction. Principles for validating the models are also presented. The conclusion is that PLS modeling appears to be a powerful method for extracting clinically relevant information from complex personality test data matrixes. It could be used as a complement to more hard modeling methods in the process of examining a new area of interest.

Humans↗

Mental health and psychic structure: an empirical study.

Psychodynamic clinicians cite psychic structure and structural changes observed in treatment as sources of important information about unconscious psychological processes and configurations. Empirical studies have had difficulty demonstrating that psychic structure measures something different from psychiatric symptoms and everyday functioning. This study examined the relationship between psychic structure and mental health using the Health-Sickness Rating Scale (HSRS) to measure mental health and two different measures to assess psychic structure: Kernberg's personality organization (PO) and Wallerstein's Scales of Psychological Capacities (PSYCAP). Bivariate correlations and multiple regression analyses were computed based on ratings for 124 psychiatric inpatients and psychotherapy clients. Correlations showed that mental health and psychic structure are substantially interrelated, and multiple regression analyses indicated that 44% of the variance of HSRS is explained by psychic structure measured with the two methods taken together. The findings provide some support for a general factor of mental health and psychic structure and a "pure" component of psychic structure that is independent from mental health. Different factor-analytic models for understanding the relationship between mental health and psychic structure are discussed.

Adaptation, Psychological↗

The patient's contribution to the therapist's countertransference feelings.

Countertransference feelings of psychiatric milieu therapists toward their patients were studied by using a self-report feeling word checklist. The feelings were scored on subscales of feeling states in a circumplex model. By using an analysis of variance model, comparisons between reactions to patients individually and reactions to patients with different personality organizations and with different Health-sickness rating scale scores could be made. A total number of 244 therapists at 21 small treatment homes were studied. It was found that approximately 15% of the therapists' countertransference feeling reactions could be accounted for by recurrent reactions to patients individually. Surprisingly, the personality organization and the Health-sickness rating scale score of the patient accounted for almost no variance in therapists' feelings. The results are discussed, and possible explanations are evaluated.

Analysis of Variance↗

Emotional reactions to psychiatric patients. Analysis of a feeling checklist.

In psychodynamic milieu treatment, the relations between patients and nurses are the main tools for understanding and helping the patients. For this reason, it is important to construct methods to follow the development of relations and to study characteristics of helpful and nonhelpful relations. In this article, a checklist with feeling words given to nurses and aides in psychiatric treatment facilities is presented and its measurement properties are described. The analysis showed that the checklist as a whole measures the amount of emotional arousal in a reliable way. The individual feeling words have acceptable variance. A factor analysis gave a limited number of factors that are clinically understandable. The checklist seems to be well worth further study.

Countertransference↗

Linguistic characteristics of neurotic, borderline and psychotic personality organization.

Thirty patients were subjected to a Structural Interview by means of which 10 of them received the diagnosis NPO (Neurotic Personality Organization), 10 BPO (Borderline Personality Organization) and 10 PPO (Psychotic Personality Organization). About 2500 words and groups of words were extracted from the patients' utterances for analysis. The word-frequencies thus found were analyzed by a PLS discriminant analysis which yielded two significant principal components (main dimensions) explaining 57% of the variance. This analysis showed that the three groups of patients are well separated from one another and that there is a definite correlation between personality organization and linguistic variables. The main features of the BPO-patients in this study seem to be that they refer to positions outside themselves and their language is impersonal; we see this as an example of a vacillating identity. The NPO-group is characterized by an intense and rich language, signs of a more advanced symbolizing ability, deixis and high level defenses. The language of the PPO-patients is poor and its predominant feature is a lack of words; in our interpretation this indicates foreclosure and a lack of identity.

Adult↗

Reactions to DMT as related to psychotic and borderline personality organization.

Thirty-one inpatients in a psychiatric clinic were assessed with DMT and the Structural Interview. In order to assemble every relevant reaction that an individual might have to a percept-genesis, 130 DMT variables were formed. The results were first subjected to a quality control of the DMT-scores and then subjected to partial least squares in latent variables (PLS) discriminant analysis. The analysis showed that it is possible to separate patients with psychotic PO (PPO) from those with borderline PO (BPO) by means of the 130 variables. The BPO group is characterized by aggressive manifestations, sensitivity to threat, identity lability and various transformations of the Hero gestalt. The PPO group, on the other hand, is characterized by high threshold values for perception, lack of identity, denial and repression of the peripheral person at a late-phase level. There are other perceptual reactions that are important predictors of PO than the defence categories of the manual. These perceptual reactions do not correspond to the traditional psychodynamic defence mechanisms. Our conclusion is that principal component analysis (PCA) and PLS are useful methods of finding discriminating patterns of perceptual reactions to the DMT for patients with different PO.

Borderline Personality Disorder↗

Personality organization defined by DMT and the Structural Interview.

The psychoanalytic concept of Personality Organization (PO) may be operationalized by means of a Structural Interview as well as by means of psychological tests. The present study utilized the Structural Interview and a projective test called the Defence Mechanism Test (DMT) to operationalize the PO concept on a sample of 50 psychiatric inpatients. The reliability of the PO judgements were found to be acceptable for both the Structural Interview and the DMT. The validity, which was estimated as the correlation between the two methods, was also found to be substantial. The conclusion is that the concept of PO may be reliably operationalized for psychiatric patients and seems to have concurrent validity. Both the DMT and the Structural Interview may be used for differential diagnosis of PO.

Adult↗

Psychodynamic features in borderline personality disorder identified by a subliminal test, the Defense Mechanism Test.

Twenty-seven psychiatric inpatients, diagnosed according to DSM-III and the Diagnostic Interview for Borderline (DIB), and 7 healthy controls were tested with the Defense Mechanism Test (DMT), a test of subliminal perception based on psychoanalytic theory. In the test a specific stimulus is presented subliminally in a tachistoscope and the patient's perceptual distortions are registered. Patients with borderline personality disorder (BPD) were compared with patients with other personality disorders, patients with schizophrenic disorders and healthy controls. Specific perceptual distortions were identified among patients with BPD. Some individual DMT signs correlated with some deviant behaviors as identified by the DIB. The findings supported the psychodynamic validity of the concept of borderline personality disorder. It is concluded that DMT is a promising research instrument that provides an empirical approach to crucial psychodynamic phenomena.

Adult↗

Borderline diagnosis from hospital records. Reliability and validity of Gunderson's Diagnostic Interview for Borderlines (DIB).

Two trained and experienced clinical psychologists and two nontrained students rated the sections in Gunderson's Diagnostic Interview for Borderlines (DIB) on the basis of hospital records for 16 patients (DIB-R). The results showed that both reliability and validity, i.e., correlations with an actual interview, were unexpectedly high, around .80 for the trained judges and around .55 for the nontrained judges. The conclusion is that the DIB may be used for retrospective diagnosis of borderline patients from hospital records.

Adult↗