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Biomedical subjects

J Westermeyer

Publications and source records attributed to J Westermeyer.

At least 145 records · Page 8Linked to original sources
PubMed1978

A review of the relationship between dysphoria, pleasure, and human bonding.

A model is presented which links up recent findings regarding the biochemical substrates of neurological networks mediating pleasure states with the concept of animal behavior relating to bonding. The forms of human bonding (parent-child, kinship, friendship) have analogies in the animal world and appear to be based on a combination of fixed action patterns, learning behaviors supported by endogenous secretion of "pleasure-producing" endorphines, and social reinforcement. The implications of this model for psychiatric treatment and rehabilitation are discussed.

Affective Symptoms↗
PubMed1978

Incest in psychiatric practice: a description of patients and incestuous relationships.

Patients reporting incest resembled the author's other patients in age, sex marital status, education, residence and social class. Both initiating and receptive partners were represented among these patients. In two-thirds of 32 patients, incest had occurred more than 1 year previously. No one clinical picture predominated. Thirty-two patients had been involved in 42 incestuous relationships. Initiating partners, always older, included 32 men and 10 women. Coitus was the most frequent sexual activity; homosexual relations were present in 4 instances. Adults initiating incest had usually lost access to adult sexual partners by death, divorce, illness, or marital partners' refusal to cohabit.

Adolescent↗
PubMed1977

Cross-racial foster home placement among native American psychiatric patients.

In Minnesota, about 0.5 percent of the general population are raised outside of their biologic homes. However, it has been estimated that 25 to 30 percent of all Indian children under the age of 18 years are currently living outside of their biologic homes. Clinical experience with adolescent and adult Indian psychiatric patients bears this out: about half of them have been raised in foster or adoptive homes.Seventeen American Indian patients who had been raised in non-Indian foster and adoptive homes were interviewed for five to ten hours each. Data were collected from the patients and social agencies regarding demographic characteristics, social coping, and current clinical problems. In addition, information obtained regarding their out-of-family placement included: age at placement, reason for placement, number of subsequent placements, and interracial and intraracial relationships during placement and subsequently during adulthood.This clinical sample shows a low rate of psychosis and neurosis, but a high rate of alcohol-related disorders, suicide attempts, and behavioral problems. While their education is average, their employment and marital status shows marked social disability. Most have had numerous childhood placements over a long period, all in white homes, and none have subsequently returned to their family-of-origin.These unfortunate human beings have been described by both whites and Indians in Minnesota as "apples": racially "red" or Indian on the outside, but culturally white on the inside. White groups do not accept them as whites because they are distinctively racial Indians, but they do not feel at ease in Indian communities since they were raised with white values and attitudes. While some of these people do indeed make successful adjustments in Indian or white society (or both) the results of this study show that many apparently do not.

Acculturation↗
PubMed1977

Narcotic addiction in two Asian cultures: a comparison and analysis.

Our current knowledge regarding the effects of open access to narcotic drugs is limited. This study was undertaken to clarify issues regarding availability of these drugs. Two ethnic groups in Laos were compared: the Hmong (or Meo), a tribal group with access to opium in their homes; and the Lao, a peasant people with more limited access, usually in opium dens. Of 15 demographic and clinical variables studied, 10 showed significant differences between the two cultures. Eight of these 10 could be readily accounted for by differences in drug availability. Only two differences could be ascribed to socio-ecologic factors not related to drug availability. Similarities between the two groups appeared due to (1) pharmacologic effects of narcotic addiction and (2) low social opprobrium toward addiction in both cultures. In this study, open availability of narcotic drugs appeared to favor the following: a greater proportion of female addicts; younger age of opiate usage and addiction; use of the more intoxicating route of administration; earlier onset of problems related to addiction; and shorter duration of addiction before seeking treatment.

Adult↗
PubMed1977

Opium and heroin addicts in Laos. I. A comparative study.

Students of narcotic addiction have believed that heroin addiction is more debilitating than the "traditional" opium addiction. Access to both opium and heroin addicts in a Laotian treatment facility provided an opportunity to test this hypothesis. All subjects were volunteer narcotic addicts seeking treatment at an inpatient detoxification facility over a 12-month period. The research format consisted of five demographic characteristics, four aspects of past narcotic usage, and three aspects of current narcotic usage. Fifty-one heroin addicts were compared to 438 opium addicts. Many of the demographic differences in the two groups reflected the urban residence of most heroin addicts and the mixed urban-rural residence of opium addicts. Heroin addicts had more frequent daily doses of drug, spent considerably more money for their drug, and required higher initial methadone doses for detoxification. It also appeared that heroin addicts might have "deteriorated" faster and thus sought treatment earlier than opium addicts. Since the heroin and opium addicts in this study differed significantly on most demographic characteristics, it was difficult to know whether these observed differences were due to drug factors or demographic factors. Thus, a study of pairs matched for age, sex, and ethnicity was subsequently undertaken to test the hypotheses generated by this study.

Adolescent↗
PubMed1977

Opium and heroin addicts in Laos. II. A study of matched pairs.

Fifty-one Asian heroin addicts in Laos were matched for sex, ethnicity, and age with 51 opium addicts. All subjects were voluntary patients at a treatment facility for addicts. The two groups were compared for demographic characteristics, past narcotic history, current narcotic use, and readmission within 1 year following discharge from treatment. Heroin addicts took more doses of drug per day, spent more money per day on narcotic drugs, required higher detoxification doses of methadone, and sought treatment much sooner than did opium addicts. The two groups did not differ for duration of narcotic use prior to becoming addicted, or for rate of readmission following treatment. Demographic differences in occupation and employment reflected the urban distribution of heroin addicts, and the mixed urban-rural residence of opium addicts. These data suggest that heroin is not per se more or less apt to produce addiction (i.e., is not more "addictogenic") as compared to opium. The type of narcotic drug also does not appear to be an important factor in determining treatment outcome. However, heroin does appear to be more "pathogenic" than opium, since heroin addicts sought treatment much sooner than did opium addicts. This may have been due to economic factors (i. e., heroin addicts took more doses per day, spent more time in phases of intoxication and withdrawal, and spent less time in the middle phase with work and other coping behaviors). Opium addiction is not a "benign" or "social" form of addiction. In comparison to heroin, however, opium does cost less, requires fewer doses per day, and has a less toxic withdrawal (at least in the initial phase). Moreover, opium apparently takes longer to produce life crises that motivate the addict to seek treatment.

Adolescent↗
PubMed1977

A heroin "epidemic" in Asia.

Heroin "epidemics" have been reported in North America but not in Asia. Following passage of an anti-opium law in Laos, heroin use suddenly began in one area during 1972. Initially heroin use prevailed among indigenous Asian addicts, mostly older addicts who gradually switched from opium to heroin. In addition, there evolved a new group of indigenous addicts: young, single, unemployed males in urban areas whose first narcotic drug was heroin. After the appearance of heroin in Laos, increasing numbers of younger Americans and Europeans were soon attracted to heroin use in Laos.

Adolescent↗
PubMed1977

"World Traveler" addicts in Asia: I. Demographic and clinical description.

Fifty-six addicted "world travelers" were studied at a treatment facility for opium addicts in Laos. They were primarily in their twenties (80%), male (80%), and single (70%). Most had begun narcotic use away from their own country during their travels. A majority were traveling alone, currently living alone, and using narcotic drugs alone. Their addiction at the time of seeking treatment was well established: narcotic drugs comprised their main daily expenditure, they had numerous problems associated with narcotic use, and high doses of methadone were necessary for detoxification.

Adolescent↗
PubMed1977

"World Traveler" addicts in Asia: II. Comparison with "Stay at home" addicts.

Demographic and clinical characteristics of "world traveler" addicts in Asia have been described in a previous paper. In order to understand more about this group, the 56 American and European addicts seen in Laos were compared to 100 American addicts from Minneapolis matched for age, sex, and year of admission to treatment. "World traveler" addicts tended to be older, better educated, and more apt to be single than this sample of "stay at home" addicts. In comparison to the latter, "travelers" began using narcotic drugs at an older age, became addicted more rapidly, and sought treatment earlier. They were also exposed to more inexpensive, readily available narcotic drugs than the "at home" addicts. These data suggest that exposure to inexpensive, readily available narcotic drugs can result in addiction among a group of people who had previously been refractory to narcotic addiction in their own culture. Loneliness and sociocultural isolation appeared to accelerate the rate at which the average "traveler" moved from nonaddictive use to addiction. Further comparisons to other samples of "at home" addicts will be needed to demonstrate whether these findings are due to "travel" per se or to demographic factors.

Adolescent↗
PubMed1976

The pro-heroin effects of anti-opium laws in Asia.

Over 25 years anti-opium laws were enacted by three Asian governments in countries where opium use was traditional. Within months, heroin use suddenly appeared; and within a decade, heroin addiction surpassed opium addiction. The laws led to (1) increased price of narcotic drugs, (2) a heroin "industry," (3) corruption of the law enforcement system, and (4) major health problems involving parenteral drug use. The Asian experience indicates that antinarcotic laws can be effective only with careful preparations: (1) changing society's attitude toward the traditional drug from ambivalence to opposition; (2) mobilizing resources to treat and rehabilitate all addicts within a short period of time; (3) developing the social will to incarcerate all "recidivist" addicts for a prolonged period; and (4) preventing narcotic production or importation.

Drug and Narcotic Control↗
PubMed1976

Use of a social indicator system to assess alcoholism among Indian people in Minnesota.

A social indicator system was used to assess alcohol-related problems among American Indian people in Minnesota. Instead of counting "cases," the method involved using "events" that were recorded by various social institutions in the course of their work. The system showed that Indian people commonly encountered alcohol-related "events" that led to death or to social institutions with a poor record of problem resolution (foster homes, jail, prison, welfare agencies). However, they infrequently appeared in psychiatric facilities with alcohol-related "events."

Accidents↗
PubMed1976

Clinical guidelines for the cross-cultural treatment of chemical dependency.

Clinicians should be skilled in work with their ethnic peers before attempting cross-cultural treatment. Acquiring cross-cultural sensitivity involves regression to childlike openness for new values, attitudes, and behaviors. Members of the ethnic group can orient the clinician by discussion, suggested readings, and invitations to their homes and ritual events. Work should begin slowly, with regular consultation from ethnic peers of the patient. Special transference issues involve parent-child transactions and the "Messianic countertransference." Clinicians must maintain their primary commitment to the patient and to the patient's social resources, rather than to an institution not responsible to the patient population.

Asia↗
PubMed1975

Socioathy and drug use in a young psychiatric population.

Recent studies have consistently demonstrated a higher-than-expected proportion of heavy drug users among young psychiatric patients. Careful reading of these reports fails to adduce what might account for this constant finding. In order to examine this question more closely, one hundred young psychiatric inpatients (aged 15 to 25 years) were studied in detail. The following extensive data were obtained for each patient: demography (sex, age, race, marital status occupation), clinical characteristics (prior psychiatric care, presenting complaint, duration of hospitalization, diagnosis, treatment, disposition), prior social problems (truancy, runaway, pregnancy out of wedlock, divorce or separation, vehicular accident while intoxicated, felony), and social resources on admission (employment, friends, family-of-origin). An extensive drug history consisted of types of drugs, duration and frequency of usage, and pattern of use over the previous twelve months. Based on specific criteria patients were divided into abstainers, occasional users, regular users, and heavy users. Forty-nine of the patients were tabulated as heavy users. Compared to the other patients, heavy users were found to have more unemployment, more divorce and separation, more characterological and fewer neurotic diagnoses, more problematic prior social events, and fewer social resources at the time of admission. Unexpectedly, the two groups did not differ significantly for all other demographic and clinical parameters. The implications of these findings for our psychopathologic categorization and for our management of young in-patients are noted.

Adolescent↗