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Biomedical subjects

S Eth

Publications and source records attributed to S Eth.

At least 37 records · Page 2Linked to original sources

Patient psychopathology and expressed emotion in schizophrenia.

The relationship of a full range of psychiatric symptoms to EE was examined in 40 men with BPRS and SANS diagnoses of schizophrenia or schizoaffective disorder. Patients from high-EE families had significantly higher ratings of positive symptoms, anxious depression, and overall psychopathology, but not negative symptoms, than did those from low-EE families. In predicting relapses of schizophrenia, account may need to be taken of an interaction between subtle differences in symptoms and relatives' attitudes.

Adult↗

Can schizophrenia cause posttraumatic stress disorder?

Theories about schizophrenia have viewed stress and anxiety as both predisposing factors and associated features of the disorder. But these theories ignore a possible fundamental interaction: Terrifying psychotic experiences might act as traumatic events and precipitate a posttraumatic stress syndrome. We present a case of schizophrenia complicated by posttraumatic stress disorder and discuss the implications of this comorbidity for theory, research, and practice.

Adult↗

Behavioral science and the juvenile death penalty.

Behavioral science data included in an amicus brief has been introduced into a recent Supreme Court decision (Thompson v. Oklahoma) involving the juvenile death penalty. However, a close examination of the data fails to provide support for either the pro- or antijuvenile death penalty position.

Adolescent↗

The child victim as witness in sexual abuse proceedings.

The psychiatrist working with a child witness in a sexual abuse case is at an intrinsic disadvantage. Most of the activities take place in a legal system where the psychiatrist may feel like a stranger in a strange land. Further, a major area of concern to the courts is cognitive development and memory, which unlike phenomenology, dynamics, and therapeutics, are somewhat remote from the psychiatrist's core expertise. It is not surprising, then, that the stress associated with the role of child advocate or expert witness often produces anxiety for the psychiatrist or may result in a frank avoidance of forensic tasks. This paper is intended to militate against such a reaction by familiarizing the psychiatrist with the salient issues of the sexually abused child as a witness.

Child↗

Life threat and posttraumatic stress in school-age children.

One hundred fifty-nine children (14.5% of the student body) were sampled after a fatal sniper attack on their elementary school playground. Systematic self-reports of posttraumatic stress disorder (PTSD) symptoms were obtained by use of a child PTSD Reaction Index. Analysis of variance revealed significant differences by exposure but not by sex, ethnicity, or age. Additional analyses were conducted of individual item response, overall severity of PTSD reaction, symptom grouping, and previous life events. The results provide strong evidence that acute PTSD symptoms occur in school-age children with a notable correlation between proximity to the violence and type and number of PTSD symptoms. Sampling at approximately one month after the trauma provided adequate delineation among exposure groups. The symptom profile of highly exposed children lends validity to the diagnosis of acute PTSD in childhood.

Acute Disease↗

Protecting third parties: a decade after Tarasoff.

The authors discuss current public policy concerning the treatment of potentially violent psychiatric patients and outline some legal and ethical precedents of the current policy. Therapeutic interventions before and after the Tarasoff decision are compared. The authors make specific recommendations for clinicians, who they believe tend to interpret laws too restrictively. They suggest that courts need to rethink current liability standards so that legal decisions can be more clinically informed. Finally, they believe that legislative interventions which specify that warning the potential victim and notifying the police absolve psychotherapists from liability may lead to reflexive rather than reflective management of violent patients.

California↗

Consent and liability: special problems with anxiolytics.

The use of benzodiazepine anxiolytic therapy has sometimes been associated with certain adverse reactions. The authors discuss the extent to which the clinician is responsible for warning patients that benzodiazepine therapy may result in addiction, withdrawal problems, and/or impaired cognitive and motor skills. The development of new anxiolytics such as buspirone, which seem to exert less effect on cognitive and motor skills and lack addiction potential (and thus withdrawal problems), presents the clinician with a treatment alternative. The authors review two legal cases involving benzodiazepine-induced driving impairment and discuss whether the clinician is obligated to prescribe the agent that generally demonstrates the least interference with such common activities as driving. Primary issues that arise in the discussion of physician responsibility are informed consent (both verbal and written) and the documentation of all treatment decisions. The authors recommend quality care and individualized treatment to avoid liability.

Anti-Anxiety Agents↗

Legal liability with psychotropic drug use: extrapyramidal syndromes and tardive dyskinesia.

The use of medication has become essential to the practice of modern psychiatry. Despite the enormous benefits associated with the administration of psychotropics, these drugs also carry the risk of significant adverse reactions. The legal implications of side effects of antipsychotic agents are explored. The particular focus is on the potentially serious liability confronting the psychiatrist whose patient develops delayed neuromuscular complications. Whenever neuroleptic medication is used, it is crucial for all psychiatrists to be cognizant of the need to obtain voluntary informed consent in the context of clinically appropriate treatment.

Basal Ganglia Diseases↗

Death notification.

Death notification--informing the deceased's family of an unexpected death--is a singularly stressful task common to medical personnel, clergy, and police. We surveyed by questionnaire a group of 50 Los Angeles Police Department homicide detectives, 21 of whom were subsequently interviewed by telephone. The detectives stated that their initial apprehension stemmed from feeling unprepared. Identification with victims' families was common and compounded the stress. One prevalent worry concerned the possible reactions of the family upon hearing the news, especially the risk of a violent attack on the police officer. Several coping styles were recognized. Our findings suggest that the repetitive performance of this continuously stressful task may be a prominent and underappreciated contribution to occupational burnout.

Death↗

Mental health consultation to a preschool following the murder of a mother and child.

The murder of a five-year-old boy and his mother disrupted the entire small community of the pre-school he had attended. A two-stage mental health intervention consisting of separate group sessions with the preschoolers, teachers, and parents was initiated to help them work through their grief and fear and to reverse their increasing isolation from one another. The reassuring presence of adults who were not struggling with the crisis and the creation of a supportive milieu relieved the children's anxiety, enabling them to discuss their fears and fantasies about the deaths, and alleviated the anxious mistrust and sense of lost personal security of the teachers and parents. The teachers were able to resume their professional functioning, and the parents were better able to assist their affected children.

Attitude to Death↗

An unusual case of self-inflicted death in childhood.

The authors report the details of the case of a ten year old boy whose self-inflicted death by gunshot featured the involvement of a nine year old companion. The authors examine the material from the viewpoints of a possible case of suicide, of a certain case of violent death, and of a case with repercussions on the other child and the community.

Adaptation, Psychological↗