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Biomedical subjects

I Sakinofsky

Publications and source records attributed to I Sakinofsky.

6 recordsLinked to original sources
PubMed1990

Problem resolution and repetition of parasuicide. A prospective study.

Resolution of presenting problems at three-month follow-up was studied in 228 parasuicides. 'Non-resolvers' presented with less severe problems, but prodromes were longer, prior episodes more frequent, and they experienced more powerlessness and internally directed hostility than the resolvers. At follow-up resolvers had improved more on measures of depression, externally and internally directed hostility, locus of control, powerlessness, self-esteem, sensitivity to criticism, and social adjustment. Baseline problem severity, powerlessness (negatively), and 'normlessness' 'predicted' degree of problem resolution, while baseline problem severity, the number of previous parasuicide episodes, and baseline internal hostility (the latter two variables negatively) were associated with problem resolution as a dichotomous variable. Resolvers improved more in social functioning during the follow-up than non-resolvers, but a similar proportion (16%) in each group reported repeat episodes of parasuicide at follow-up.

Adolescent↗
PubMed1990

Why parasuicides repeat despite problem resolution.

To discover why parasuicides who resolved their difficulties repeated self-harm within three-month follow-up at the same rate as those who had not resolved problems, a group of 30 repeaters was compared with 156 non-repeaters. The repeaters had a history of more frequent episodes, beginning younger. Their problems were more severe, the acts of self-harm potentially less lethal. They experienced greater feelings of externally directed hostility, powerlessness, and 'normlessness'. A constellation of nine variables correctly predicted 81.5% of the repeaters and 77.5% of the non-repeaters. At follow-up the non-repeaters had improved on several parameters but the repeaters were essentially unchanged. The resolvers among the subgroup of repeaters were more like repeaters in the overall sample than the resolvers, which may explain why some parasuicides repeat in spite of resolving their problems.

Adolescent↗
PubMed1988

Intropunitiveness and parasuicide: prediction of interview response.

A recently proposed relationship between intropunitiveness and depressive states was examined in interview intervention with parasuicidal in-patients. To test the prediction that highly intropunitive parasuicidal individuals would be most responsive to cognitive intervention, a sample of 48 parasuicidal in-patients were administered a battery of individual difference measures, including the Hostility Questionnaire. Subjects were randomly assigned to one of three interview procedures, namely a cognitive interview, an affective interview or a waiting period (control). Highly intropunitive individuals in the cognitive interview group showed the most improvements on a self-report depressive symptom change measure. In addition to supporting theoretical models of depressive state changes, the study has important clinical implications because of the need to identify parasuicidal individuals who are most likely to benefit from brief interventions.

Adult↗
PubMed1986

Suicidal patients and the ethics of medicine.

The moral values of contemporary society present a turmoil of pluralistic, often confusing values. In the face of these, what should be the proper attitude of the physician towards the suicidal patient? Should he (she) support the patient's autonomous right to make such a decision independently, or should he use his professional influence to try to sustain the patient's life? This paper discusses the social and religious roots of today's medical dilemma and tries to help the health professional to avoid the pitfalls of simplistic solutions which do not take account of clinical experience.

Ethics, Medical↗
PubMed1979

Evaluating the competence of psychotherapists.

Pressure is increasing to develop methods for evaluating the competence of psychotherapists, not only in the field of education but also in clinical practice. The skills required of a psychotherapist have not yet been defined clearly, and are probably specific to kinds of patient and types of problem. However, there is a concensus that the capacity to establish a trusting relationship and to demonstrate concern, are essential. This relationship provides a "power-base" from which to influence the patient through a variety of elements which include "interpretation", modeling, and identification. Psychoanalysts assert that the "working through" of the transference is essential, but this is disputed by others. The evidence regarding the value of experience as a psychotherapist is unclear. Again there are conflicting reports. It appears that reasonable competence in technique can be acquired (through modeling) within the first year of training. It may be that the reason why experience does not emerge more strikingly as a positive factor, is that in the published material the more experienced psychotherapists treated the more difficult patients, and therefore the outcome of their treatment suffered. This paper touches on recent approaches at McMaster University to evaluate the competence of trainees; one by setting instructional objectives in family therapy, the other by means of a process analysis of videotaped interviews, in which residents and their supervisors participated. A single simulated patient was interviewed at two points in time, to indicate change and development in the psychotherapeutic techniques of the trainees.

Clinical Competence↗