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Biomedical subjects

M J Horowitz

Publications and source records attributed to M J Horowitz.

At least 37 records · Page 2Linked to original sources
PubMed1993

Psyclops: an exploratory graphical system for clinical research and education.

We present Psyclops, an interactive computer graphic system designed to help address a growing information dilemma in the examination of individual psychiatric cases. Ever more information is needed to better understand conscious experience, interpersonal behavior, and the formation of psychiatric signs and symptoms, yet the information load already exceeds our usual methods of handling it. Psyclops consists of a suite of software modules, manual sections, and standards that have been developed according to guiding concepts intended to help one collect, organize, access, and explore complex data about a single subject for research, education, and ultimately, clinical care purposes. This document provides background in clinical information science and a description of the system; the reader interested in its application in clinical research theory development is referred to the companion paper in this issue (Horowitz et al., Pathological Grief: An Intensive Case Study).

Arousal↗
PubMed1990

A model of mourning: change in schemas of self and other.

The mourning process may serve an evolutionary purpose, one that has allowed maximum survival characteristics. By passage through the phases of grief, the bereaved person prepares to make new commitments to others and to accept new personal roles. This passage involves an unconscious change in mental structures of meanings about the self and other people. This paper examines mourning in terms of such person schemas.

Grief↗
PubMed1989

Relationship schema formulation: role-relationship models and intrapsychic conflict.

Recurrent maladaptive interpersonal relationship patterns are a central characteristic of the personality disorders and the main focus in dynamic, cognitive, and family psychotherapies. In dynamic formulations the emphasis is on examining conflict in terms of opposing wishes, fears, and defenses. Such formulations can take place at various levels of information, involving ideas, emotions, self and objects. This paper presents a system for formulating intrapsychic conflicts at the level of person schemas (Horowitz 1988a). It uses units called Role-Relationship Models (RRM).

Adult↗
PubMed1989

Clinical phenomenology of narcissistic pathology.

The phenomenology of some persons with narcissistic personality disorders has been discussed in four categories: phenomena (signs and symptoms), recurrent distressing states of mind, recurrent maladaptive views of self and others, and irrational or hyper-defensive processing of emotional themes. Although no one person will fit the prototype described the overall gestalt may help the clinician recognize variations in individual cases.

Arousal↗
PubMed1988

A controlled trial of brief psychotherapy and mutual-help group treatment of conjugal bereavement.

Sixty-one women who sought treatment for unresolved grief reactions 4 months to 3 years after the death of their husbands were randomly assigned to either brief dynamic psychotherapy with experienced clinicians or mutual-help group treatment led by nonclinicians. Women in both groups experienced a reduction in stress-specific and general symptoms as well as improvement in social and work functioning. Women in the brief psychotherapy group showed a greater decline in one measure of general symptoms, and there was greater attrition in the group treatment condition. When two subgroups who had completed the majority of sessions were compared, treatments were found to be equally effective.

Adaptation, Psychological↗
PubMed1988

Formulation of states of mind in psychotherapy.

A patient in psychotherapy may vary in his ability to understand the therapist, and to express this thoughts, as he moves from one state of mind to another. Analysis of states of mind is useful, not only in understanding these variations while the patient is in treatment, but also in helping him to understand his shifting moods in external situations.

Adult↗
PubMed1988

Narcissistic rage in leaders: the intersection of individual dynamics and group process.

Power corrupts in terms of both grandiose inflations and threatened narcissistic injuries. This paper deals with the rage states that may ensue in leaders. After explaining the individual psychodynamics of self-righteous rages in executives, this paper describes inferences about the group processes set in motion by such leaders and the reactions of subordinates. Independent thinkers in subordinate groups are both especially vulnerable to harm and especially important to preventing disasters within the group. The variable action of such persons leads to a sequence of possible phases. In bad scenarios the last phase is one containing institutional ruin, bloodbaths, or mutinies. Understanding the inference of individual and group dynamics on a theme of narcissistic injury may help prevent such disasters.

Anger↗
PubMed1986

Comprehensive analysis of change after brief dynamic psychotherapy.

This report provides data on symptom levels by using group means as well as categories of clinical relevance as they change over the course of treatment and also examines change "beyond symptoms" as levels of adaptive functioning. This approach allows a more comprehensive analysis of change in a series of patients with pathological grief reactions treated with brief dynamic psychotherapy. The different perspectives on outcome of the patient, the evaluating clinician, the treating clinician, and independent judges are compared. The findings from all perspectives indicate that major symptom relief occurred in the majority of patients, with less change in adaptive abilities.

Adaptation, Psychological↗
PubMed1986

Stress-response syndromes: a review of posttraumatic and adjustment disorders.

The signs and symptoms of response to a stressful life event are expressed in two predominant phases: the intrusive state, characterized by unbidden ideas and feelings and even compulsive actions, and the denial state, characterized by emotional numbing and constriction of ideation. In this review of stress-response syndromes, the author outlines those phases, discusses the DSM-III diagnoses for stress-response disorders, and considers the mutual etiologic effects of stressful life events, psychiatric disorders, and preexisting conflicts or functional deficits. Guidelines for brief dynamic psychotherapy for patients who need more than transient support are presented.

Adaptation, Psychological↗
PubMed1985

A proposed method for measuring change beyond symptoms.

The initial report of the Patterns of Individual Change Scales battery presented the rationale, development, and conceptualization of this measurement package. Empirical data supported the reliability and validity of the scales as measures of patient characteristics that extended beyond the symptomatic domain. This article presents more extensive reliability and validity data. Ratings on two new samples were collected, and the interrater reliability coefficients for the scales were again of appreciable magnitude. Discriminant validity was examined, as was the factor structure of the battery. The results suggested that the scales tap three distinct sources of variance. Comparisons with symptom measures and case illustrations indicated that the measurement of changes in patients' functioning beyond symptoms is necessary and viable.

Adult↗
PubMed1985

Brief psychotherapy with vulnerable patients: an outcome assessment.

The outcome of brief therapy with psychologically vulnerable patients is uncertain, and some clinicians, anticipating negative effects, recommend exclusion of such patients from time-limited treatment. We had the opportunity to explore the results of time-limited dynamic therapy with eight vulnerable patients, a subsample within a larger series of 35 persons treated for pathological grief reactions precipitated by parental death. These cases included three poor outcomes, four good outcomes, and one fair outcome. Examination of each case individually suggests that for the majority, brief therapy was useful in stemming a downhill course. In some cases, it also provided a bridge to an indicated longer-term psychotherapy.

Adult↗
PubMed1984

Brief psychotherapy of bereavement reactions. The relationship of process to outcome.

We studied the relationship of dispositional and process variables with outcome in 52 bereaved patients given time-limited dynamic psychotherapy. Outcomes were generally favorable in symptom relief and improvement in relationship and occupational functioning. Patients' symptoms improved more than did their social and work functioning. Pretreatment levels of impairment or distress were significantly related to outcome, but most demographic and dispositional variables did not predict outcome. Process variables examined in relation to outcome--therapeutic alliance and actions by the therapist--were not significantly related to either type of outcome. When we considered the same process variables in interaction with two dispositional variables, motivation for dynamic therapy and developmental level of the self-concept, we found significant predictions of outcome. The major findings suggest that more exploratory actions were more suitable for highly motivated and/or better-organized patients and less suitable for patients with lower levels of motivation or organization of self-concept. More supportive actions were more suitable for patients at lower dispositional levels and less therapeutic for patients at higher levels.

Adjustment Disorders↗
PubMed1984

Reactions to the death of a parent. Results from patients and field subjects.

The authors studied two groups of persons who had experienced either the death of a mother or father. One group consisted of patients who had sought treatment because of pathological aspects of bereavement. The other group consisted of volunteers selected from a review of hospital death records, which indicated the recent death of their parent. The study used a nonequivalent groups design, where both groups were followed over time. The field subjects were initially seen much sooner after the death than the patients. The patient group received a time-limited dynamic therapy focused on the stress response syndrome induced by the death. At the pretherapy evaluation point, the patient sample had significantly higher levels of symptomatic distress than did the nonpatient sample. The distress declined over a 13-month period, so that patients had comparable levels of distress to that of the field subjects. After adjusting for initial values, the main difference was that patients reduced their avoidant operations more than did the field subjects. Intervening variables were assessed for the prediction of change in symptoms over time as related to the parental death. The variables that showed significant correlations to symptomatic change were cumulative negative life events from varied sources, occupation, social class, developmental level of the self-concept, identity of the deceased parent, and attribution of blame for the death. Social support did not relate to change in symptoms over time.

Adaptation, Psychological↗
PubMed1984

Relationship testing after the loss of a parent.

In this study of adults presenting with symptoms of pathological grief after the death of a parent, there was a frequent pattern of strain on a current love relationship. The attempt to master negative views of the self, precipitated by loss of the parent, through reenactment with the significant other was prominent. Psychotherapy offered an opportunity to rework the feared representation of the self.

Adult↗