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Biomedical subjects

Paul R McHugh

Publications and source records attributed to Paul R McHugh.

8 recordsLinked to original sources
PubMed2006

PTSD: a problematic diagnostic category.

Since the publication of Diagnostic and Statistical Manual of Mental Disorders (DSM)-III, posttraumatic stress disorder (PTSD) has become a remarkably dominant theme in mental health discourse and diagnostic practice. This development has been encouraged by the diagnosis being officially presumed to exist in acute, chronic, delayed, complex, subdromal, and even "masked" forms. Here, we present an historical and clinical review that indicates how, since 1980, the term PTSD (along with its dubious embellishments) replaced established views on mental responses to trauma to the detriment of patient care and psychiatric investigation. From this historical perspective, we review and evaluate the natural course of emotional and behavioral reactions to traumatic experiences, and as well their assessment, formulation, and therapeutic management in both civilian and military situations. From this we conclude that the concept of PTSD has moved the mental health field away from, rather than towards a better understanding of the natural psychological responses to trauma. A return to prior standards of diagnostic practice and therapeutic planning would greatly benefit patient care, rehabilitative services to veterans, and epidemiologic research.

Diagnosis, Differential↗
PubMed2004

The adventures of a "different" pair.

Gerry Smith had been a fellow in the Neuropsychiatry Division at the Walter Reed Army Institute of Research. There, he and Paul McHugh first worked together. This is the story of the formation of their two companion careers in physiology and behavior and the issues they confronted at this early stage.

Behavioral Medicine↗
PubMed2004

From refusal to reconciliation: family relationships after an accusation based on recovered memories.

In following families who reported to the False Memory Foundation between 1992 and 2001 that a member had charged them with incest, a survey questionnaire (with a 42% return rate) was sent to some 4,400 families. These data demonstrate that 99% of these accusers were white, 93% were female, 77% were graduates, 86% were in psychotherapy, and 82% accused their father. Such accusations were rare events before 1985 but then grew exponentially in frequency, peaking in the 2-year period from 1991 to 1992, with 579 accusations. Thereafter, such accusations steadily declined so that in 1999 and 2000, only 36 accusations occurred. The accusers can be differentiated in the manner with which they reconciled with the situation: 56% refused all family contact, 36% returned but did not discuss the accusation, and 8% retracted completely. These data give evidence of a time-limited craze of therapy-induced incest accusations that has now dissipated.

Adaptation, Psychological↗
PubMed2004

Where's the wisdom?

Explore the source record for details and available documents.

Advisory Committees↗
PubMed2003

Academic psychiatry and health care reform: strategic initiatives for sustaining the clinical mission.

Health care reform has posed special challenges for departments of psychiatry in academic medical centers. This report describes one department's strategic responses to a marketplace with high penetration by managed care and provides examples of the kinds of faculty concerns that can arise when major departmental reorganizations are attempted. The department's successful adaptation to a radically altered professional environment is attributed to the following five initiatives: vertical integration and diversification of clinical programs, service line management, outcomes measurement, regional network development, and institutional managed care partnerships Although the authors did not design their adaptive efforts as a research study, they offer objective data to support their conclusion that the viability of their overall clinical enterprise has been sustained despite an external environment inhospitable to academic psychiatry.

Academic Medical Centers↗