Variability of mood and hysterical traits in normal women.
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Biomedical subjects
Publications and source records attributed to P R Slavney.
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The authors describe a case of Briquet's syndrome in a man and discuss the relationship of that condition to personality features. They view Briquet's syndrome as a set of behaviors arising from personality traits and suggest that examination of the genesis and treatment of the condition be shifted to a characterological approach.
We attempted to validate the DSM-II diagnosis of hysterical personality and the depression often experienced by such patients by comparing mean Minnesota Multiphasic Personality inventory (MMP) scores of hysterical personality patients with those of paranoid schizophrenic patients and a group with mixed psychiatric diagnoses. Index patients had significantly higher scores than either control group and could be distinguished on individual scales from the paranoid schizophrenics. However, the mean MMPl profile of hysterical personalities was similar to that of depressed controls. Therefore, the MMPl alone could not differentiate these two groups nor could it confirm or refute the validity of the diagnostic concept of hysterical personality, but it did support the clinical observation that depression is a major risk for individuals given this diagnosis and that the experience of depression by these patients is genuine.
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Eugen Bleuler formulated schizophrenia as a disjunctive category based on universal, dimensional phenomena that were regarded as pathognomonic of the disorder. In consequence, schizophrenia came to dominate diagnostic practice in American psychiatry. This report suggests that affective disorder has been formulated in a similar way, and with a similar result. The nature of disjunctive categories is examined and their replacement by conjunctive categories for schizophrenia and affective disorder is anticipated.
Most psychiatrists assume that belief is a basis for behavior. The validity of this assumption has been challenged by certain philosophers who assign the concept belief to the domain of "folk psychology." These philosophers contend that the discoveries of neuroscience will eliminate the ideas of folk psychology from scientific discourse and that behavior will eventually be accounted for in terms of brain states. In order to examine the relationship of belief and behavior, examples of self-mutilation by normal and abnormal individuals are reviewed. It is concluded that belief is a basis for behavior and that neuroscience, like folk psychology, is valid only within certain limits.
It has been proposed that pseudoseizures are a symbolic expression of having been sexually abused. Such reasoning is hermeneutic in nature and potentially damaging if uncritically used. Sexual abuse is one of several risk factors for pseudoseizures, but it should not be deduced simply from the occurrence or form of the conversion disorder.
Demoralization, a normal response to adversity, is commonly seen in medical and surgical patients referred for psychiatric consultation. Demoralization should be distinguished from adjustment disorders and other pathological conditions--a process that would be facilitated if demoralization, like grief, were given a V code in DSM. Although the primary responsibility for treating demoralization rests with the patient's physician, the consulting psychiatrist must make an accurate diagnosis and begin the process of supportive psychotherapy.