Treatment environment and treatment outcome.
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The individual is encased in an existential, phenomenological space that has the capacity to contract or expand, to isolate itself, or to join with others. An analysis is provided of how this individual space capsule functions under varying circumstances, such as depression, schizophrenia, sociopathy, divorce, child-battery, aging, death, overpopulation, cultural disruption, and execution.
In northern Alberta, the Aboriginal (native) female population appears to be overrepresented in the HIV statistics. A qualitative research study was designed to explore the cultural factors that relate to the high HIV infection rate in these women. Eight HIV-positive women were interviewed for the study, representing about one third of the population. A model was developed to explain the relationships that exist between the women's formative years, their self-esteem, and the survival techniques they used prior to becoming HIV-positive. These survival techniques may have placed them in situations that increased their risk of infection with the HIV virus.
The present case illustrates the application of behavioral modification methodology with a traumatically brain-injured adult. Such a treatment regime utilizing a report-card system and a response-cost procedure was implemented to decrease behaviors of using foul language and biting staff members. Dramatic improvement was demonstrated.
A comparative clinical and psychological study of 96 adolescents of either sex with preponderant aggressive forms of behavioral disorders and 47 with other behavioral changes was performed within the framework of either nonpathologic personality changes or borderline mental disorders. Aggression developed through different mechanisms which could be preferentially involved in shaping its nonpathologic or pathologic forms. Differential diagnostic, therapeutic and preventive methods are recommended taking into account the aggression genesis.
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OBJECTIVE: To examine pathways leading to specific types of early externalizing disorders. METHOD: Longitudinal data were collected on 310 low-income, male subjects followed from infancy until age 6 years. RESULTS: Support across informants was found for the importance of the caregiving environment during infancy in relation to the development of externalizing disorders at school entry. Support was also found for the significance of early child factors, but this was limited to child behavior at home. CONCLUSIONS: The results are consistent with social learning and attachment models, which suggest that severe conduct problems in early childhood are the result of deficits in the caregiving environment. Support was also found for Moffitt's hypothesis that children with the comorbid attention-deficit/hyperactivity disorder-oppositional defiant disorder/conduct disorder pattern experience multiple child and psychosocial risk factors that begin during infancy.
Asperger's Syndrome is one of the diagnostic subcategories of pervasive developmental disorders. It is characterized by a defect in reciprocal social interaction, lack of empathy for others and poor non-verbal communication. Antisocial acts, including aggression and sexual offense, are not considered to be common in this disorder. We describe an adolescent with Asperger's Syndrome whose main problems are his violence and sexual offenses. We assume that these symptoms are secondary to his diagnosis of Asperger's as a manifestation of his difficulties with the "theory of mind" of others. This atypical case report is in contrast with the low prevalence of aggression and sexual offense in Asperger's, as reported in the literature. We discuss the reasons for this low prevalence. Our conclusions are based on one case history and a literature review. We call for further research in this field.
Utility of the Vineland Adaptive Behavior Scales-Expanded Form to discriminate among areas of adaptive behavior was substantiated by comparing profiles of scores obtained by three groups of individuals with mental retardation and either a communication, social behavior, or motor abilities disorder with those of matched individuals with mental retardation but no other disorder. Individuals with social behavior disorders obtained lower scores only in the Socialization domain; those with motor disorders, in the Motor domain and in the Personal and Domestic subscales that require motor competencies; and those with communication disorders, lower scores in the Communication domain and in the Community and Interpersonal Relationships subscales requiring expressive competencies. The utility of the Vineland Scales in obtaining an ecological evaluation of individuals with mental retardation is discussed.
OBJECTIVE: To examine the full spectrum of psychiatric comorbidity in juvenile obsessive-compulsive disorder (OCD) in a naturalistic manner when no exclusionary criteria are used for sample selection. METHOD: Consecutive referrals to a specialized pediatric OCD clinic were evaluated by means of structured diagnostic interviews and rating scales. No exclusionary criteria were used for sample selection. Findings were compared with those of previously published reports of juvenile OCD. RESULTS: Compared with previous studies, our sample of juveniles with OCD had high rates of comorbidity not only with tic, mood, and anxiety disorders but also with disruptive behavior disorders. CONCLUSIONS: Our findings indicate that in the naturalistic setting, juvenile OCD is heavily comorbid with both internalizing and externalizing disorders. The presence of such a complex comorbid state has important clinical and research implications and stresses the relevance of limiting exclusionary criteria in studies of juvenile OCD.
Psychiatric and behavioural disorders were found to be relatively common in a sample of 318 individuals with a mental handicap living in the community. Many of those referred for psychiatric assessment had other non-psychiatric problems. The presence of these other needs has been recognized, and had led to the emergence of a distinct group of professionals, therapists and support staff with whom psychiatrists need to liaise to devise an adequate and effective care plan. This study also highlights the need for the development of a methodology for assessing psychiatric disorders in people with a mental handicap.
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