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Biomedical subjects

J Birtchnell

Publications and source records attributed to J Birtchnell.

At least 37 records · Page 2Linked to original sources
PubMed1984

Dependence and its relationship to depression.

Evidence is provided that dependence, either as a trait or a state, is closely related to depression. Theories to explain this fall into two broad categories: that some individuals make excessive demands for affection and become depressed when these are not met; and that some have persistently negative attitudes to life and an inclination to self-blame. These correspond with Blatt's (1974) two sources of depression, the 'anaclitic' and the 'introjective'. Self-esteem forms a link in both theoretical approaches. It is proposed that there are three major components to dependence, which have been named affectional, ontological and differential. The first corresponds with Bowlby's concept of anxious attachment and the psychoanalytic concept of the oral personality. The last is closely related to Beck's (1967) depression-prone person. The second, originally described by Laing (1965), is concerned with a poorly established identity and causes the individual to relate to another by the imperfect process of fusion. Its part in predisposing the person to depression is less well recognized. Excessive independence, or detachment, may be as maladaptive as dependence and the opposite of both dependence and independence is autonomy. The autonomous person is truly separate and yet able to form intimate relationships.

Adolescent↗
PubMed1983

What does the MMPI dependency scale really measure?

Examined the mean DY score of various clinical and nonclinical groups (N = 855). It was significantly higher for females, whether patients or nonpatients; nonpatients with a high total score and high scores on several subscales of the Crown Crisp Experiential Index of neurotic symptomatology; psychiatric patients in general; patients and nonpatients with a high modified Zung depression score; neurotic as opposed to endogenous depressives; suicide attemptors, especially non-serious ones; Ss with early bereavement or separation particularly if followed by poor replacement care; Ss with poor quality marriages and husband dominant marriages as measured by the Ryle Marital Patterns Test. The DY Scale relates directly with the PT and D Scales and inversely with the Do Scale. Separation of the test items into those that were and were not predominantly depressive revealed that most, though not all, significant associations were due to the depressive component, which it was suggested should be markedly diminished.

Adult↗
PubMed1983

Psychotherapeutic considerations in the management of the suicidal patient.

The management of the suicidal patient is complicated by (1) the emotions expressed and the demands made by the patient, (2) the therapist's own responses, and (3) the influence of significant others. The therapist may be required to make himself available and to become personally involved to a greater extent than is usual. The suicidal patient has a tendency to involve himself in symbiotic relationships from which it is difficult for either partner to become detached without generating anxiety in the other. The degree to which the therapist indulges the patient in his dependency needs or encourages him to act responsibly is a matter of fine clinical judgment. The unwillingness of the suicidal individual to entrust himself to others causes him to become ambivalent towards both the therapist and life itself. The hostile, even murderous attitude of family members may require his temporary removal from them and necessitate their involvement in his treatment.

Aggression↗
PubMed1983

Marriage and mental illness.

Two female psychiatric patient samples were examined--240 women, aged 20 or over, from North East Scotland; and 44, aged 40 to 49, from Chichester, West Sussex. There was also a Chichester community sample of 230 women of similar age-range. The N.E. Scotland psychiatric patients with poor marriages broke down significantly earlier, and the delay between marriage and first breakdown was significantly shorter. This group also tended to have a neurotic rather than an endogenous type of depression. The poor marriages of the Chichester psychiatric patients were, in the main, similar to those of the Chichester non-patients, but the patients demonstrated significantly more disturbance of sexual relationships, and their in-laws were significantly more disapproving.

Adult↗
PubMed1982

The mental health of early mother separated women.

A community based research project was undertaken to discover whether early mother separation was related to adult mental disorder. A population sample of 73 women aged 40-49, who experienced continuous mother absences in excess of 1 year due either to family difficulties (n = 42) or external factors (n = 31), were interviewed about early life experiences and mental health. Controls (n = 69) matched for parental social class and age at father death were similarly interviewed. Three self-administered tests, the Middlesex Hospital Questionnaire, a modified Zung Depression Scale and the Navran Dependency Scale of the MMPI were also completed. It was shown that separation alone was unrelated to adult psychopathology or mental disorder. Poor preseparation maternal relationships, both alone and in combination with two or more changes of care plus unsatisfactory replacement care, contributed to an increase in psychiatric morbidity and psychopathology.

Adolescent↗
PubMed1982

Some marital and child-rearing characteristics of early mother-bereaved women.

A sample of 160 female, psychiatric patients from North-east Scotland whose mothers died before they were aged 11 was compared with 80 non-bereaved, female, psychiatric patients, matched by decade of birth, from the same area. Six subgroups of the bereaved patients classified according to the events which followed the bereavement were also examined. In addition, samples of 44 and 27 women from the Chichester general population, whose mothers died before age 11 and from 11 to 19 respectively, were paired by age, parental social class and age at death of father, with Chichester women who were not mother-bereaved. Comparisons were made in respect of age at marriage, relative age of subject and marital partner quality and fate of marriage, delay between marriage and birth of first child, total number of children, and ability to cope with the birth and subsequent child-rearing. The early bereaved women showed a tendency to marry younger men but otherwise their marriages were no different from those of the controls. The early bereaved had more difficulties with child-rearing, particularly when their children reached adolescence. Surprisingly, the findings for the six subgroups were not appreciably different from those of the total bereaved patients.

Adolescent↗
PubMed1981

In search of correspondences between age at psychiatric breakdown and parental age at death--'anniversary reactions'.

The phenomenon of psychiatric breakdown occurring when the subject reaches the age his/her parent was at death, misleadingly referred to by Hilgard as an 'anniversary reaction', is examined. It is contrasted to breakdown occurring at the anniversary of the death of a significant person and compared with the concept of nemesis as described by Chapman. An attempt is made to assess the incidence and clinical characteristics of patients breaking down at times of such age correspondence in samples of early and late mother-bereaved women from North-East Scotland. It is concluded that the phenomenon is not common and is not associated with specific clinical features. Some illustrative cases are presented.

Adolescent↗
PubMed1981

Some familial and clinical characteristics of female suicidal psychiatric patients.

The study compares 72 female psychiatric patients who had a history of suicide attempt with 122 who had neither attempted nor contemplated suicide. Of these 194 women, 128 had experienced the death of their mothers before the age of 11, but the proportions of early bereaved and not early bereaved who were suicidal were similar. Not even the events which followed bereavement affected suicidal behaviour, but the suicidal patients tended to come from larger sibships. Poor quality of the marriage and, for the early bereaved only, having three or more children related significantly to suicidal behaviour. The suicidal women were significantly more often described as dependent. Suicidal behaviour was not differentiated on the endogenous/neurotic depressive dichotomy but it was significantly related to severity of depression.

Child Rearing↗
PubMed1978

Early parent death and the clinical scales of the MMPI.

There is growing evidence that early parent death can affect the severity of adult depressive illness. It was anticipated, therefore, that early-bereaved depressed patients might score higher on certain MMPI clinical scales than non-bereaved, depressed controls matched for age and sex. This is shown to be the case, the most affected scales being Hypochondriasis and Paranoia. Hypochondriasis is shown to be more strongly associated with early father death, while Paranoia is associated equally with mother and father death. There is some suggestion that early mother death is also associated with elevation of the F score. Early parent death is shown to have no effect upon the MMPI scores of non-depressed patients.

Adult↗
PubMed1977

Seriousness of suicide attempt in relation to personality.

From a sample of psychiatric referrals who had completed the MMPI the following three groups, matched for age and sex, were derived: 42 patients with a history of a serious suicide attempt, 42 patients with a history of a non-serious attempt, and 126 patients who had neither attempted nor contemplated suicide. Non-serious suicide attempters were shown to be the most deviant group and differed to a significant extent from each of the other two groups on the Dependency, Hostility and Unconventionality scales. Male non-serious attempters showed the most disturbed personality profile. This implies that there is, for males, a higher personality threshold for making a non-serious attempt, which may account for the fact that suicide attempts, most of which are non-serious, are commoner among females.

Female↗
PubMed1976

Personality and suicidal history in psychiatric patients.

The study sample comprised 575 psychiatric referrals for whom MMPI data were available. Patients were categorized according to suicidal history. The attempted suicide and nonsuicidal patients were differentiated significantly on the D, PD, MF, DY, ES, NE, EX, HO, SD, IP, ANX, and UNC scales. Important differences between the sexes emerged; whereas for men the profiles of the suicidal ideation and nonsuicidal patients were similar, for women those of the suicidal ideation and suicide attempt were similar. Male and female suicide attemptors correspond closely in the pattern and degree of deviation from the nonsuicidal patients of their own sex. The study indicates that patients who have a history of suicide attempts constitute a more psychologically disturbed group and points to a need for further examination of the meaning of suicidal ideation for men and women.

Adjustment Disorders↗