[Writing process, PPmP and I in the middle of the word].
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Female↗
Biomedical subjects
H Speidel
Publications and source records attributed to H Speidel.
[Psychosomatic disorders in the elderly].
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Aged↗
[Psychogenic hand dystonia and hereditary polyneuropathy with liability to pressure palsies. A contribution to etiology of dystonias].
We report on a case of a female who had developed a fixed flexion contracture of the 4th and 5th fingers of the right hand which was painless and at-rest right in the beginning at the age of 19. By means of neurographical examinations a hereditary neuropathy with liability to pressure palsies was established in her and her mother, which had clinically manifested with symptoms of the ulnar nerve at the affected hand. The dystonic symptoms did not show any progression within ten years follow-up. A remarkable feature of the course was the twice repeated occurrence of short, sudden and complete remissions immediately following invasive diagnostic procedures. The thorough discussion of differential diagnostic aspects and the analysis of the familiar situation and psychodynamics of the patient resulted in the diagnosis of a psychogenic hand dystonia.
Adult↗
[Contemporary thoughts of a psychoanalyst. On some hidden consequences of "coping with the past" in relation to the national socialism era].
Many incidents awake the old suspicions about what kind of people the Germans really are, but the media are always poised to pounce on anything which looks like a reemergence of Nazi attitudes. So from this angle Germans seem to be a society which as a whole disapproves of violence and destructive behaviour. Both these images prove to be misleading. A kind of collective reaction formation has developed in Germany: intellectuals automatically assume that one can only speak about the Germans as a whole in critical and derogatory terms. Their views have developed a collective identity in which the Nazi past and the Holocaust play a central role. This deep-rooted distrust against one's own people reveals a more or less well concealed hatred directed against oneself. In the book of Alexander and Margarete Mitscherlich "The Inability to Mourn", which became a kind of credo for a whole generation of thoughtful young Germans, the authors prescribed a diet of restricted perceptions and collective self-hatred. The result is: German moral thinking shows signs of a aggressive, negative ego-ideal, and one aspect of this is collective self-castigation in the sense of a latent melancholic mechanism punishing the internalised father, because the bad past seems to have been his fault.
Adaptation, Psychological↗
[Adolf-Ernst Meyer as researcher and teacher. Psychoanalysis and empirical research 8 December 1995 symposium on the 70th birthday of Adolf-Ernst Meyer].
This speech, delivered to celebrate the seventieth birthday of Adolf-Ernst Meyer, fifteen days before he died, pays tribute to his achievements as a researcher and teacher. His most important scientific projects included investigations into hirsutism, anorexia nervosa, brief psychotherapy, the way psychoanalysis functions and a pychoanalytic questionnaire on personality trait. He was influential in amongst other things founding a new field of research for the German Research Association and publishing expertises for it, and as dean of his faculty, chairman of the German College for Psychosomatic Medicine and co-editor of the extensive survey behind the new law on psychotherapy commissioned by the Federal Ministry of Youth, Family, Women and Health. In recent years he received several international honours. The textbook, "jores: Practical Psychosomatics" which he coauthored appeared only after this death.
Germany↗
[Psychophysical stress reactions during a psychoanalytic interview].
In 37 young volunteers analytically oriented interviews were taken and their effects being compared to those of conventional stressors using mental arithmetic. Because of their similarity to day-to-day stressors we expected higher cardiovascular reactions (blood pressure, heart rate and catecholamines) under interview situations than in mental arithmetic. Conforming this hypothesis, we found higher reactions in blood pressure regulation, while heart rates were not higher under interview situations compared to laboratory stressors. Epinephrine showed a qualitative difference: Only in interview situations we found a significant rise of 27%. Plasma cortisol also showed a rise in interview situations, however, smaller. We therefore suggest, that analytically oriented interviews are an adequate method to investigate cardiovascular reagibility in young hypertensive-prone persons.
Adult↗
[The physician's cognition during cardiopulmonary resuscitation of the human].
The cognitions of 20 emergency-physicians while working on a mobile resuscitation unit were examined by means of questionnaire in over 260 situations of resuscitation. A pattern of cognitions could be detected: Emergency physicians appear not to think very much during resuscitation. If there are thoughts, these usually concern the obvious, or what is immediately present in the situation, i.e. the patient or the patient's relatives; repression may also play a role. Cognitions which are reflective of self are rare and only develop late in the situation, depending on the surroundings and the amount of stress. The cognitions concerning the relatives are frequent in those situations with direct physician-relative contact. The physicians often report in retrospect having felt compelled to a decision for resuscitation by the presence of the relatives; nevertheless, the decision itself appears to be a result, rather, of their cognitions of the relatives. Distancing by means of cognition was ubiquitously employed as a coping strategy by physicians when in situations which were perceived as not having a positive outcome. Thoughts about "own death" or "about the patient" are specific, however, for certain groups of doctors. Results of the present investigation suggest that physicians have cognitions about relatives during the process of decision making, and cognitions about the patient during the resuscitation manoeuvre.
Adult↗
[Today's taboos--tomorrow's problems].
Societies need common taboos for their self-preservation. They can be regarded as social defence mechanisms and are therefore unconscious or dissociation phenomena. These qualities may explain many social incompatibilities and, as well as this, the inability of societies to introduce rationally-founded social changes. From this perspective, the decline of ethnic entities can be understood. Marking taboos may therefore be seen as a key to understanding social processes and social standstills. Here the present political developments in Germany serve as an example.
Cultural Characteristics↗
Psychosocial, neuropsychological and neurological status in a sample of heart transplant recipients.
The sample for this psychosocial follow-up study was formed using the 71 surviving patients from a total of 100 who underwent heart transplantation up until March 1990 at Kiel University Hospital. Forty of these could be investigated comprehensively. The neurological investigation comprised EEG and auditory and visually evoked potentials. The psychological investigation started with several neuropsychological tests; additionally all patients were interviewed and they completed questionnaires concerning anxiety, depression, ways of coping, personality characteristics and life satisfaction. Within the entire sample, there were few indications for specific psychological impairment. The psychosocial status of the patients was not significantly related to the time which had elapsed since they underwent transplantation. There were few associations between neuropsychological and psychosocial data, and several indicators of early postoperative complications which are described in the literature (e.g., length of stay in the intensive care unit). Clinically relevant subgroups (formed on the basis of neuropsychological test results, anxiety and depression) did not differ in terms of these indicators. Nevertheless, a considerable proportion of the patients (25%) were characterized by having a higher level of affective and neuropsychological impairment. Although based upon retrospective investigations, the results of this follow-up generally correlate with those gained from Anglo-American countries. In interpreting the results one needs to consider the possible influence of premorbid personality characteristics as well as denial which may be typical for patients undergoing heart transplantation.
Adaptation, Psychological↗
Preoperative and late postoperative psychosocial state following coronary artery bypass surgery.
In a prospective study of psychological and neurological reactions to coronary artery bypass surgery, 45 patients were examined preoperatively, postoperatively, and 21 to 27 months after, using a variety of neurological, psychiatric, and psychological investigations. Within the follow-up sample, three subgroups of patients could be identified by cluster analysis who differed with respect to their emotional status and life satisfaction. One group (24% of the total sample) was characterized by high levels of anxiety, depression and life dissatisfaction and appears as a risk population. The other groups could be described as either average (42%) or stable (33%). At the follow up, the risk group further indicated a preference for depressive coping styles, a slightly higher degree of cognitive impairment, more neurological and psychopathological symptoms (specifically giving-up and hostility), a considerably lower return-to-work rate, more subjective physical complaints and a poorer attitude toward the outcome. While postoperative measurements (obtained 2-3 and 6-8 days after surgery) as well as intraoperative parameters did not reveal significant group differences, the analysis yielded an increased impairment within the risk group already prior to surgery, especially emotional problems, specific health-related cognitions and a more fatalistic attitude. The results are in line with those of other studies investigating the late postoperative psychological status with regard to the proportion of patients showing psychological impairments as well as to their specific psychological characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)
Adaptation, Psychological↗
[A study of the psychosomatic aspects of endometriosis].
Based upon existing psychological studies of endometriosis, the hypothesis was tested if patients suffering from this disorder differ from other infertile females with respect to psychological characteristics. Using questionnaires as well as a semi-structured psychotherapeutic interview 38 patients with endometriosis and 18 females with tubal sterility were investigated. A comparison of both groups indicated a higher level of anxiety and some evidence for a somatic preoccupation in the endometriotic patients. The analysis of the interviews (which were judged by several independent raters) confirmed the hypothesis of gender role conflicts in combination with endometriosis. This conflict seemed to be characterized by a negative experience of menarche and puberty, early gynecological problems and negative sexual experiences. This constellation is illustrated using a typical case. Based upon these results, further studies of endometriosis using a psychosomatic perspective seem to be promising.
Adaptation, Psychological↗
[Time-limited contacts with psychosomatic-psychotherapeutic ambulatory care. I. Retrospective evaluation by patients].
Despite of the relevance of psychosomatic-psychotherapeutic outpatient services there is a lack of empirical studies concerning their effectiveness and compliance from the patients' point of view. This study describes the retrospective judgements of a maximum of three outpatient consultations, given by 125 patients after a mean follow-up period of 14 months. These patients completed a comprehensive questionnaire, comparable with instruments used in follow-up studies of longterm psychotherapies. The questionnaire covered demographic data, a detailed description of the consultations (including the atmosphere of the contact and the therapeutic alliance), their consequences as well as the present life situation and -quality. The results first indicate that patients who refused their participation in the study received more unspecific recommendations by the therapist, and were more commonly referred by other clinics. The judgements of the consultations were predominantly negative. Patients criticized for example a lack of activity by the therapist and of practical advice. The overall rate of compliance (i.e. number of patients who followed the therapist's recommendations) was 49%. Compliance was higher with respect to individual therapy and lowest with respect to inpatient psychotherapy. As far as the present life situation was concerned, the patients answers indicate a slight decrease of their complaints as well as an increase of life quality as compared to the time of the consultation. Potential reasons for the negative view of time limited contacts with a psychosomatic outpatient unit are finally discussed.
Adolescent↗
[Time-limited contacts with psychosomatic-psychotherapeutic ambulatory care. II. Potential determinants of compliance with therapeutic recommendations].
In a detailed analysis of the data from a follow-up study with 125 patients of a psychosomatic outpatient unit, possible determinants of the utilization of therapeutic recommendations (which was seen as an indicator of compliance) have been analysed. The overall compliance-rate in the sample was 49%. Comparisons of the patients who were compliant or noncompliant (61 vs 37) revealed that demographic as well as diagnostic characteristics hardly differentiated between the two groups. The compliance-rate seems to be higher in patients who had been judged as motivated by their therapist during the time of their contacts with the unit. Besides that, the perception of the atmosphere of the contacts as well as the therapeutic alliance during a maximum of three consultations differed between both groups. Patients who were compliant assessed their life quality more positively at the time of the follow up than the other group. In a second step of the analysis, an attempt was made, by means of cluster analyses, to investigate the relationship between the compliance-rates, and the mode of referral as well as diagnostic characteristics on the one, the judgement of qualitative aspects of the consultations on the other hand. The analysis of the first relationship indicated a tendency for noncompliance in older patients and those suffering from addictions, whereas compliance seemed to be high in younger patients who came to the consultation of their own accord. Multivariate analyses further confirmed the significance of the therapeutic alliance for the prediction of compliance-rates and the importance of several other qualitative aspects of the contacts.(ABSTRACT TRUNCATED AT 250 WORDS)
Adaptation, Psychological↗
[Stress: a treatable cardiovascular risk factor?].
The study of psychosomatic factors in the pathogenesis of ischemic heart disease has followed three directions, a clinical-phenomenologic, physiologic-behavioral and a curricular-psychodynamic one. From the sixties onward Type A behavior has been prevailing as concept for the investigation of prospective importance of psychic factors in ischemic heart disease. Such a behavior-oriented view alone proves however to be inadequate. For a comprehensive approach to psychic risk factors and their treatment and prevention anxiety, depression, important experiences in life and individual biographic constellations are equally important. They represent factors only approximated by the conventional term "stress".
Coronary Disease↗
[On the way to a pre-oedipal society].
A quarter of a century after the publication of A. Mitscherlichs "Society without father" we have to state that his diagnosis should be extended and specified based upon a critical look at the moral theory of A. MacIntyre and the feminist anthropology of E. Badinter the thesis is developed that the decay of patriarchal social structures is connected with a regression towards a pre-oedipal society.
Female↗
[Management of hospital per diem insurance in inpatient psychotherapy].
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Adult↗
[Psychoanalysis, age and chronic disease].
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Age Factors↗