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Biomedical subjects

D W Harder

Publications and source records attributed to D W Harder.

45 records · Page 3Linked to original sources

Child Competence and psychiatric risk. VI. Summary and integration of findings.

A review of the major findings of the five previous papers in the series is presented and points of integration of the results are noted. Particular emphasis is placed on the role of diagnosis in predicting child competence as well as on differences related to whether or not the mother or the father is the patient. Also, the need to design studies to tease out the relative contributions of patient and family variables is pointed out.

Achievement↗

Schizophrenia: affect and outcome.

Considerable data suggest that schizophrenic patients with affective symptoms have a more favorable outcome than other schizophrenic patients. This may indicate that such patients are more validly regarded as having either an affective disorder or a schizoaffective psychosis. Studies of this issue have suffered from significant methodologic problems, including inappropriate sampling, unsystematic collection of symptom data, unreliable diagnostic procedures, and restricted outcome assessment. The present study, designed to surmount these methodologic difficulties, indicates that while levels of psychotic symptoms in schizophrenic patients correlate with poor outcome, affective symptoms have little prognostic power.

Adolescent↗

Child competence and psychiatric risk. III. Comparisons based on diagnosis of hospitalized parent.

The school competence of children whose parents were previously hospitalized for psychiatric disorder was studied. These children, at risk themselves for behavioral disorder, were compared to classmates as well as to each other based upon the diagnosis of the hospitalized parent. Four diagnostic groups were employed: narrowly defined schizophrenic, broadly defined schizophrenic, affective psychotic, and hospitalized nonpsychotic patients. Significant differences between the risk sample and classmates are reported along with differences among the diagnostic groups. Sons of nonpsychotic hospitalized patients were functioning most poorly and were in marked defiance of peer and adult norms. Parental and child IQ were found to have had little impact upon the data and were not considered major interactive variables. Issues concerning systems of diagnoses and the developmental implications of the findings are presented.

Achievement↗

Egocentrism in children of parents with a history of psychotic disorders.

It is known that children of schizophrenic parents have an increased risk for becoming schizophrenic, but it has been extremely difficult to determine what features may exist in such children before they become manifestly ill that might provide a key for identifying vulnerability to subsequent disorder. This study was carried out to determine whether certain types of egocentric perception exist in the children of psychotic parents that might represent a clue to vulnerability. Sixty parent-child pairs were investigated as part of the University of Rochester (NY) Child and Family Study, using standardized diagnostic assessment procedures in the parents and several methods for evaluating egocentric perception in their offspring. Results showed that severity of psychotic symptoms in a parent related significantly to the degree of persistent age-inappropriate spatial egocentrism in his or her child. All of several diagnostic approaches used for parent classification were about equally valid in this regard, except for hospital diagnosis of schizophrenia, which did not correlate significantly with offspring egocentricity.

Child↗

The assessment of ambitious-narcissistic character style with three projective tests: the Early Memories, TAT, and Rorschach.

This study describes the construction of scales designed to assess ambitious-narcissistic character style on three projective tests: the Early Memories, TAT, and Rorschach. The main aim of the study was to evaluate the reliability and validity of these scales. A secondary aim was to demonstrate the feasibility of assessing particular character styles with projective tests commonly available to clinicians and researchers. Forty male college students volunteered as subjects. The overall reliability of the three projective scales was found to be acceptable. The scales were then tested for validity in two ways. First, they were intercorrelated and found to show a pattern suggesting a common dimensionality. Secondly, the scales were found to successfully differentiate subjects rated by clinically-trained raters as ambitious-narcissistic in style from those subjects rated as non-ambitious-narcissistic.

Journal Article↗

A comparison of Rorschach developmental level and form-level systems as indicators of psychosis.

Psychotic and nonpsychotic psychiatric inpatients were tested on the Rorschach. "Reality-testing" was measured by four form-level scoring systems designed by Beck, Mayman, Becker, and Wilensky. The psychotic subjects were dichotomized on three diagnostic dimensions: schizophrenia, paranoia, and premorbid social adjustment. No significant differences were found for the Beck system. With the other systems, psychotics showed significantly poorer reality testing than nonpsychotics. No differences were found for the schizophrenic and paranoid dimensions. The Phillips premorbid adjustment score was negatively correlated with all four measures of "reality-testing." The conclusion drawn was that Rorschach measures of "reality testing" are associated with psychotic and poor premorbid functioning, but do not differentiate schizophrenic from nonschizophrenic psychotics or paranoid schizophrenics from nonparanoid schizophrenics.

Adult↗

Patterns of disorder in first admission psychiatric patients.

Are there patterns of characteristics in psychiatric patients, different from traditional diagnostic considerations, that could provide important information for understanding, treatment, and research? To pursue this question, this report describes an investigation of clinical and demographic characteristics in a representative sample of first admissions for functional psychiatric disorder. Analyzing the patterns of these characteristics showed that social class had a particularly key role relating to a larger number of characteristics than did symptom and functioning measures. Symptoms when analyzed together revealed replicated factors not corresponding to diagnostic types. The implications of these and other findings for considering a broad perspective in conceptualizing, studying, and treating psychiatric disorder are discussed.

Adolescent↗