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Biomedical subjects

R Plutchik

Publications and source records attributed to R Plutchik.

At least 55 records · Page 3Linked to original sources
PubMed1986

A comparison of psychopathology in child psychiatric inpatients, outpatients, and nonpatients. Implications for treatment planning.

A total of 308 preadolescents who were either psychiatric inpatients, psychiatric outpatients, or nonpatients were studied with semistructured interview research instruments that have been described previously. The three groups of children included 106 children consecutively admitted to a voluntary hospital psychiatric inpatient unit, 101 consecutively admitted children to the same voluntary hospital center psychiatric outpatient clinic, and 101 randomly selected nonpatients. The research instruments included a Spectrum of Suicidal Behavior Scale, a Spectrum of Assaultive Behavior Scale, a Precipitating Events Scale, General Psychopathology (recent and past) Scales, a Family Background Scale, a Child's Concept of Death Scale, an Ego-Functioning Scale, and Ego-Defense Scale, and a Medical-Neurological Assessment Scale. The results of the study indicated that the presence of recent depression and recent and past aggression, the use of such ego defenses as projection, displacement, and regression, and the experience of parental separation were significantly different for the three groups of children. Impulse control and reality testing were best in the nonpatients and poorest in the inpatients. The variables that best predicted the need for psychiatric hospitalization were suicidal behavior, recent depression, recent aggression, poor reality testing, and such ego defenses as projection and regression. Implications of these findings are discussed.

Aggression↗
PubMed1986

The serotonin hypothesis of (auto)aggression. Critical appraisal of the evidence.

Based on the relation found to exist between low CSF 5-HIAA and suicide attempt, in particular violent suicide attempt, both in depressed and in so-called nondepressed suicide attempters, the conclusion was drawn that decreased central 5-HT metabolism is related to (auto)aggression, rather than to depression. We challenged this conclusion and that for three reasons: Violent suicide attempt accumulates in certain types of depression making it impossible to conclude whether the biological variable relates to (auto)aggression or to that type of depression as such. Nondepressed suicide attempter is a diagnosis that should be based on presuicidal not on postsuicidal data, in order to avoid false-positive diagnoses. Suicide method is not a reliable index of seriousness of the attempt. Risk/rescue ratio should be used instead. Next the data are discussed that do support the hypothesis that diminished 5-HT metabolism in the brain is related to disregulation of aggression. Finally, the hypothesis is launched that both mood and aggression disorders are related to decreased 5-HT metabolism in the CNS. This would provide a biological explanation for the clinical observation that disorders in mood and in aggression often go hand in hand. Biological research of psychiatric disorders gains in informative value as the psychopathological analysis of the phenomena one studies is more comprehensive. Biological suicide research is no exception to this rule.

Aggression↗
PubMed1986

Suicidal behavior in child psychiatric inpatients and outpatients and in nonpatients.

One hundred one child psychiatric outpatients were assessed using a standard battery of measures to identify factors associated with suicidal behavior. Data on these outpatients were compared to those for psychiatric inpatients and nonpatients previously studied. The frequency of suicidal behavior among the outpatients (24.8%) was less than for a comparable group of inpatients (78.5%) but more than for a comparable group of nonpatients (12%). Four variables--recent general psychopathology, preoccupation with death, and recent and past depression--were significantly associated with suicidal behavior in the three groups of children.

Aggression↗
PubMed1985

An empirical study on the "cathartic effect" of attempted suicide.

A cathartic effect of attempted suicide has been suggested, but few data are available to validate the concept. In this study we report on the relation between presuicidal and postsuicidal mood conditions in a group of 25 hospitalized suicide attempters and 50 control patients who were depressed but not suicidal. A significant decrease in depression was demonstrated to occur in the suicidal patients within a few days of hospitalization. This was not the case in depressed patients without prior suicide attempts. The drop in depression ratings can, therefore, be attributed to the suicide attempt. Possible explanatory factors are discussed. These findings indicate that the diagnosis of a suicide attempt in the absence of depression can only be reliably made on the basis of data pertaining to the presuicidal mood condition.

Abreaction↗
PubMed1984

Depression type and depression severity in relation to risk of violent suicide attempt.

Low levels of cerebrospinal fluid 5-hydroxyindoleacetic acid and a blunted thyroid-stimulating hormone response to thyrotropin-releasing hormone have been reported in depressed patients--in particular in those who have made violent suicide attempts. There are at least two conceivable explanations for these findings: The biological abnormalities relate to (1) disturbed aggression regulation or to (2) disturbed mood regulation (either type or severity). The second alternative presupposes that violent suicide attempts occur differentially in a particular depression type or differentially in severe depression. This study demonstrated that violent suicide attempts are "depression-specific," i.e., they relate to a particular depressive syndrome, that of vital depression, but not to the severity factor. Therefore, it is impossible to decide whether the biological abnormalities in depressed, violent suicide attempters relate to a particular type of mood disorder or to a distorted regulation of aggression.

Depressive Disorder↗
PubMed1984

Psychodynamic variables as predictors of psychotherapy outcome.

Predicting the outcome of psychotherapy is a central concern in psychiatry. Twenty-one medical students seeking psychotherapy were evaluated on a number of psychodynamic and process variables using self-report scales and scales completed by the therapist before, during, and after psychotherapy. There were significant differences between patients and a comparison group on eight variables before therapy. Ten psychodynamic variables (six representing ego defense mechanisms) and four process variables were found to be highly correlated with outcome measures; the process variables were the best predictors of outcome. The data support the use of psychodynamic and process variables as predictors of outcome in psychoanalytically oriented psychotherapy.

Adult↗
PubMed1983

Predictors of assaultiveness in latency age children.

The authors evaluated the presence of assaultive behavior in 103 children, aged 6-12 years, seen in the psychiatric inpatient and outpatient services of a municipal hospital. No racial or ethnic differences were found. Boys were significantly more assaultive than girls and used fire setting and hitting with objects more often. Inpatients were significantly more assaultive than outpatients. Children with conduct disorders, specific developmental disorders, and mental retardation were more assaultive than those with neurotic disorders. Multiple regression analysis showed that the child's past aggressive behavior, absence of anxiety and depression, and parental assaultive behavior were the best predictors of assaultive behavior.

Ambulatory Care↗
PubMed1983

Suicidal and assaultive behavior in children: classification, measurement, and interrelations.

In 102 children aged 6 to 12 years who were in a municipal psychiatric inpatient or outpatient clinic, the authors identified four groups of suicidal and/or assaultive behaviors. Logistic regression analyses showed that neurosis, intellectualization, and low levels of aggression predicted membership in the nonassaultive-nonsuicidal group; intense aggression, parental suicidal behavior, parental assaultive behavior, and compensation predicted it in the assaultive-suicidal group; depression, a minimum of aggression, and adjustment disorder predicted it in the suicidal-only group; and intense aggression and absence of depression predicted it in the assaultive-only group. Two clearly distinct types of suicidal children were delineated.

Acting Out↗
PubMed1982

Measuring death anxiety: conceptual, psychometric, and factor-analytic aspects.

This study was undertaken to construct a brief, reliable, and valid questionnaire for measuring attitudes toward death and dying. In Stage 1, four groups of individuals ranging in age from 30 to 82 years completed the Death Anxiety Questionnaire (DAQ), a brief anxiety scale (MAS), and a depression scale (DP). During Stage 2, results on these scales were cross-validated on a new sample of subjects, and the Templer and Dickstein measures of death anxiety were also completed. Internal consistency of the DAQ as determined by coefficient alpha was .83 (n = 230) and test-retest reliability was .87 (n = 30). No significant sex or age differences were found for any of the groups tested. Results provided evidence for both construct and concurrent validity of the DAQ and for discriminant validity of the items. A principal-components factor analysis suggested four independent dimensions of death anxiety: Fear of the Unknown; Fear of Suffering; Fear of Loneliness; and Fear of Personal Extinction. Recommendations for future research include an investigation of the degree to which scores on these four dimensions might differentiate among different sex, age, personality, affective, and diagnostic groupings.

Adult↗
PubMed1982

Psychopathology of latency age children. Relation to treatment planning.

One hundred three children, ages 6 to 12 years, who were evaluated in a psychiatric outpatient clinic and an inpatient unit of a large municipal hospital, were compared with regard to suicidal and assaultive behaviors, recent and chronic affects and behaviors, recent environmental stresses, family background, and ego functioning. The hospitalized children showed multiple deficits in ego functioning, more dangerous acting out behaviors, disabilities in regulation of affect states, and more severe psychopathology of the parents, primarily the mother. Multiple regression analyses showed that the child's assaultive behavior, suicidal behavior, antisocial behavior, reality testing, parental separation, and parental pregnancy complications accounted for 51.2 per cent of the variance in the prediction of psychiatric hospitalization. Recommendations are made concerning indications for psychiatric hospitalization.

Aggression↗
PubMed1982

Learning dynamic psychotherapy: a longitudinal study.

The authors investigated the evolution of psychotherapeutic skills over time in a group of psychiatric residents in their third year of training. A 29-item Supervisors Evaluation Scale measuring psychotherapy skills was developed. Each resident who began his or her clinical experience in conducting individual analytically oriented psychotherapy was rated by his or her supervisors on this scale toward the beginning of training and again 8 months later. Statistically significant changes were found for 7 of the skills measured. The authors feel that these may reflect those aspects of psychotherapy which the beginning therapist can readily learn with supervision and experience.

Attitude of Health Personnel↗
PubMed1981

Psychotherapy skill profiles of psychiatric residents.

A survey of experienced clinicians has suggested that negative outcomes of psychotherapy may be related to misapplications or deficiencies of technique. The present study was, therefore, concerned with two questions: a) does the more competent psychiatric resident have a different profile of therapeutic skills from the less competent resident; and b) are the more competent residents more aware of their own behavior with patients than less competent residents? To answer these questions, a Supervisors' Evaluation Scale and a parallel Psychotherapy Self-Evaluation Scale were developed, and their reliability, content, and discriminant validities were established on the basis of their use with a group of psychiatric residents being supervised in an outpatient clinic. Results demonstrated that the more and less competent trainees, selected on the basis of global ratings, differed significantly on almost every item of the Supervisors' Evaluation Scale, but did not differ on most of the items of the Psychotherapy Self-Evaluation Scale. Residents reported it to be particularly difficult to deal with patients' aggression and acting out behavior, fee setting and collecting, and understanding the patients' defensive structures. The rating scales can be used to assist in supervision by assessing the level of acquired skills in psychotherapy, and can also be used to help identify special areas of strengths and weaknesses.

Ambulatory Care↗
PubMed1980

Expectations of hospital treatment. Conflicting views of patients and staff.

A 40-item therapeutic community questionnaire, developed from a survey of experts, was used to assess the treatment needs and expectations of a group of 30 hospitalized psychiatric patients. The patients' attitudes regarding an ideal ward atmosphere were compared to those, as measured previously by the identical instrument, of the treating staff. The results indicated that psychiatric inpatients found the therapeutic community modality consistent with their needs and expectations. However, staff and patients were divided in attitude toward the therapeutic community concept. The staff's definition of therapeutic community was broad and exceeded the principles of the therapeutic community experts. The patients desired a more conservative approach which combined respect and responsibility with a ward structure that was unambiguous and less democratic. Studies of ward atmosphere as well as premature termination in psychotherapy indicate that such conflicts in viewpoint between patients and staff might have detrimental effects on hospital outcome. A negotiated approach to inpatient treatment is suggested as a means to establish greater autonomy, growth in self-esteem, sense of responsibility, and increased trust on the part of hospitalized patients.

Attitude↗