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PubMed1995

[Some medico-psychological perspectives on sexual homicides. Three cases].

While sexual murders are widely reported in the media, there are almost no reports on these major crimes in the French medico-psychological literature. After a brief historical and legal overview, the author discusses the forensic definition of sexual homicides, parent-to-child transmission of sexual violence, the distinction between paraphilic and non-paraphilic sexual offenders, criminal affects, and the classification of aggressors in violent homicides. He confirms that particularly violent murderers may be divided into two psychiatric and behavioral categories. Next, the six main causes of sexual homicide are presented together with three clinical observations of such cases: 1) one with homosexual connotations; 2) another through hate for women; 3) and a third where rage was not specifically directed. Finally, the author concludes that there should be systematic criminologic research in France into sexual murders.

Female↗
PubMed2003

Associations of weight-based teasing and emotional well-being among adolescents.

BACKGROUND: Verbal harassment, such as bullying and hate speech, has received considerable attention recently, but less is known about weight-based teasing and its potential harmful effects on young people's psychosocial well-being. OBJECTIVE: To determine the associations of weight-based teasing and body satisfaction, self-esteem, depressive symptoms, and suicidal ideation and suicide attempts using a large sample of adolescents. DESIGN: Secondary analysis of survey and anthropometric data. SETTING: Ethnically and socioeconomically diverse communities in the urban and suburban school districts of the Minneapolis/St Paul metropolitan area. PARTICIPANTS: A school-based sample of 4746 adolescents in grades 7 to 12 at 31 public middle schools and high schools. MAIN OUTCOME MEASURES: Weight-based teasing from peers or family members, body satisfaction, self-esteem, depressive symptoms, and suicidal ideation and suicide attempts. RESULTS: Of the eligible students, 81.5% participated; 30.0% of adolescent girls and 24.7% of adolescent boys were teased by peers, and 28.7% of adolescent girls and 16.1% of adolescent boys were teased by family members. Approximately 14.6% of adolescent girls and 9.6% of adolescent boys reported teasing from both of these sources. Teasing about body weight was consistently associated with low body satisfaction, low self-esteem, high depressive symptoms, and thinking about and attempting suicide, even after controlling for actual body weight. These associations held for adolescent boys and girls, across racial, ethnic, and weight groups. Furthermore, teasing from 2 sources was associated with a higher prevalence of emotional health problems than either teasing from a single source or no teasing. CONCLUSIONS: Physicians and other health care providers should recognize the importance of weight-based teasing for young patients. Policy, programs, and education should focus on increasing awareness of what constitutes weight-based teasing, its potentially harmful effects on adolescents' emotional well-being, and reduction of this behavior.

Adolescent↗
PubMed1996

Dubowitz syndrome: review of 141 cases including 36 previously unreported patients.

We review clinical information on 141 individuals with Dubowitz syndrome, 105 reported since 1965, and 36 previously unreported. We define the Dubowitz syndrome phenotype on the basis of clinical descriptions. The facial appearance is characteristic and present in most patients with Dubowitz syndrome. The phenotypic spectrum is quite variable and ranges from normal growth and head circumference with mild psychomotor retardation and lack of eczema to a condition of severe growth retardation, mental retardation, microcephaly, and eczema. Overall, the condition may involve the cutaneous, ocular, dental, digestive, musculoskeletal, urogenital, cardiovascular, neurological, hematological, and immune systems. Characteristic behavior patterns which have not been cited previously are present in our cases; most patients are hyperactive, shy, hate crowds, and like music, rhythm, and vibrations from music speakers, tape recorders, or transmitted through floors. Dubowitz syndrome is an autosomal recessive disorder with possibly increased frequency of parental consanguinity. Heterogeneity cannot be excluded at this time.

Abnormalities, Multiple↗
PubMed1997

Interpersonal guilt: the development of a new measure.

We describe the development of a new measure to assess guilt related to concern about harming others. The two versions of the Interpersonal Guilt Questionnaire, a 45-item and 67-item version, include theoretically-based and clinically relevant categories of guilt: survivor guilt, separation/disloyalty guilt, omnipotent responsibility guilt, and self-hate guilt. Preliminary reliability and validity studies for both versions are presented, based on clinical and nonclinical samples of subjects. Subscales on both versions show good internal consistency; however, the second version, which expanded on the first, is more psychometrically sound overall. Both versions demonstrated predicted correlations with previously published measures of guilt and related affects, such as shame and depression, and with attributional style. Differences between clinical and nonclinical samples are reported and the relevance of survivor guilt and shame to psychopathology is noted.

Adult↗
PubMed2006

The aftermath: aspects of recovery described by perpetrators of maternal filicide committed in the context of severe mental illness.

Mentally abnormal maternal filicide is a rare and horrifying event. Clinicians are unlikely to develop broad experience with this and there is little information available about recovery. This paper presents a range of descriptions of recovery experiences derived from a qualitative study of mentally abnormal maternal filicide perpetrators. Transcripts from a qualitative, semi-structured interview study of six women who committed filicide in the context of major mental illness were reviewed. Descriptions related to rehabilitation issues were grouped and themes extracted. The women described patchy but horrific memories they avoided thinking and talking about. They described intense self-judgement and self-hate. They valued ongoing relationships with surviving children and were distressed by perceptions that they might be a danger to other children. Managing illness was not described as a major challenge. Acknowledgement of illness was described as important in coming to terms with what they had done. Surviving children and relationships with family and other support networks were described as important in their rehabilitation. We conclude that optimizing treatment and rehabilitation for mental illness, supporting the woman to acknowledge the role of illness in the offence, maximizing support from personal networks, and enabling her to regain some aspect of the mother role may be more efficacious than debriefing with respect to the offence.

Adaptation, Psychological↗
PubMed1999

On the therapist's reverie and containing function.

Containment and interpretation are two inseparable aspects of the psychoanalytic technique. This is better understood by Bion's clinical metaphors of "container-contained" relationship and the capacity for reverie. Bion, continuing and expanding Klein's concept of projective identification, has transposed this from what happens to an infant to what happens in the link between mother and infant; until now he laid emphasis on the mother's (or therapist's) ability to contain the primitive anxieties which the infant (or the patient) experiences. He described three types of links--love, hate, and knowledge-- and proposed two metaphors which laid the foundation of a new and efficient frame of reference of the analytic process and technique, namely, the container-contained relationship and the reverie. Two clinical vignettes will illustrate the pivotal function of the therapist's reverie within the therapist-patient interaction. In the first case, a dead (internal) object of the patient was contained in the context of the session, enabling the patient to contain and sustain the psychic pain and her self-destructive tendencies; the second case stresses how the therapist's reverie, during a silence, revealed a bad part of the patient's self, which was lost through projective identification.

Adult↗
PubMed2000

Sadomasochistic relating: what's sex got to do with it?

The sexuality in sadomasochistic relating is most often viewed as defensive, functioning to erotize the repetition of earlier trauma, as a defense against painful affect, or as masking early, nonerotic needs for recognition and autonomy. However, this emphasis on the nonerotic dimension of so-called sexualized experience leads to symbolic interpretations of sexuality; this "deliteralization of sexuality" requires some embodiment in the concrete and literal, or metaphor is delinked from that which it is derived. Without discounting the validity of such formulations, this paper aims to put the drive (libido) back into formulations of sadomasochistic relations, and discusses the erotic dimension in sadomasochistic relations as an irreducible, hidden structure that both threatens and sustains the destructive attachment. It is suggested that sexuality is a driving force behind sadomasochistic interplay, while aggression may be recruited for defensive, concealing purposes. Through a case illustration, this paper demonstrates how sadomasochistic relating is symbolically penetrating, teasing, withholding, and intensifying in hate-inducing ways, all of which are designed to gratify and simultaneously harden the other. In many cases, sadomasochistic sexuality may be viewed as aggressivized, paradoxically, to maintain safety under the regressive pull of sexual and preoedipal longings.

Defense Mechanisms↗
PubMed2002

Flaubert's Madame Bovary: a study in envy and revenge.

Flaubert's Emma Bovary is one of the most convincingly realized characters in modern literature. Her husband, Charles, a rural doctor, loves her dearly, but he is dull, ineffectual, and boring. Emma seems to hate him with a fury that knows no bounds. She betrays him sexually, ruins him financially, and ultimately destroys his very life. What drives her to such unmitigated rage? The authors identify evidence in the novel suggestive of a dynamic thrust for revenge along the lines described by Freud (1918) in "The Taboo of Virginity." Elements of narcissistic rage and a sense of entitlement intensify Emma's anger and vengefulness.

Emotions↗
PubMed1993

The conflict and process theory of Melanie Klein.

This article depicts the theory of Melanie Klein in both its conflict and process dimensions. In addition, it outlines Klein's strategic place in psychoanalytic history and in psychoanalytic theory formation. Her major contributions are seen in light of their clinical imperatives, and aspects of her metapsychology that seem negligible are differentiated from these clinical imperatives. Klein's role as a dialectical fulcrum between drive and object relations theories is explicated. Within the conflict theory, drive derivatives of sex and aggression are reformulated as object-related passions of love and hate. The process dimensions of Klein's theory are outlined in terms of dialectical increments of depressive position process as it alternates with regressive paranoid-schizoid-position mental phenomenology. The mourning process as a developmental process is particularly high-lighted in terms of self-integrative progression within the working through of the depressive position.

Aggression↗
PubMed1976

Psychoanalytic treatment of the obese person. Part III.

This paper is an attempt to clarify some of the issues which face the psychiatrist in his efforts at treating the obese patient through analytic means. A thoroughgoing bias in Western culture impairs the psychiatric and non-psychiatric medical care of the obese person. Inconclusive evidence concerning the causal relation between obesity and chronic disease does not deter this cultural bias from exaggerating the role that obesity is thought to play in disease process. Whatever contribution it makes to physical illness, obesity remains a substantial social disability that is frequently associated with self-hate and feelings of ineffectiveness. Scientific investigations indicate that adiposity is determined by interactions of genetic and environmental influences acting at different levels of complexity within the organism. Hence, the adipocyte itself may influence existing fatness and retard weight reduction. Constitutional factors affecting the hypothalamus may contribute to obesity in certain individuals. Also, cortical effects determine maladaptive eating behavior and excessive adiposity. Poor eating habits which are associated with emotional conflict seem to strongly affect the development and continuance of obesity in most fat persons. The interaction among adipocyte, hypothalamus, and cerebral cortex remains unclear. The various treatments of obesity have been shown to be of little impact in helping overweight persons to sustain weight loss. Diet control, exercise, group psychotherapy, and behavior modification show slight benefit. Recent controlled studies dispute earlier claims that behavior modification is effective in achieving meaningful and lasting weight loss. Claims that intestinal bypass procedures are a useful treatment also require further supporting evidence. Psychoanalytic or intensive sustained psychotherapeutic treatment of the obese person emphasizes exploration of the entire personality. As long-neglected constructive forces are stregthened, weight loss may proceed. Psychoanalytic treatment is not indicated for obesity uncomplicated by neurotic distortions. In the presence of interpersonal problems and personal ineffectiveness, psychoanalysis has real utility. It is not clear that obesity is a major determinant of impaired physical or emotional health. Rather, the medical indictment of obesity seems to stem from the need to justify an intensely negative cultural bias. Casual disregard of this fact and of the complexity involving issues of etiology and treatment may signify inadequate appreciation in the psychoanalyst of the extent to which he participates in this cultural bias. The continuing failure of medical science to devise a means to help fat persons sustain weight loss to any meaningful degree has prevented the development of studies which would show if weight reduction truly does provide uniformly enhanced physical and emotional well-being...

Dreams↗
PubMed1994

Interpersonal conflict and emotions in an Iranian cultural practice: qahr and ashti.

qahr (not to be on speaking terms with someone) and ashti (to make up) represent a complex culture-specific fusion of emotional dynamics, cognitive evaluations, and behavioral tendencies, which both codes negative and "distancing" emotions and initiates a set of social actions and gestures that lead to amelioration of that emotional state. The causes, experience, and expressions of qahr and ashti were studied in the context of parent-child as well as inter-adult relationships. Of the ninety-two participants, forty-six mothers and 5 fathers (aged 25 to 52) constituted the Parent Sample, and 27 females and 14 males (aged 17 to 39) the Adult Sample. Qahr is a brief temporary rupture in the relationship of parent-child that is followed by ashti. The duration of qahr increases drastically in the inter-adult experience of qahr, yet it is a temporary rupture and not a break-up. Qahr is typically expressed in the form of a non-verbal ritualized sign system that indicates a lack of desire for any further interaction between the initiator and another person. The fusion of an emotional element of "being hurt," cognitive element of "being criticized," and being punished for "wrongdoing" constitute the core meaning of qahr for the child in her/his early experience of this cultural practice, which is internalized as an emotional-cognitive-behavioral cultural script by the child and later re-enacted in his/her relationships to siblings, parents, close relatives, and friends. Interpersonally, qahr has an expressive as well as instrumental function. Qahr is an indirect expression of a cluster of negative emotions such as hate, anger, dislike, and hurt. Qahr also evokes feelings of guilt, shame, regret, compassion, and love in others so that they are motivated to "correct" the "wrong-doing," and it sends a signal to the concerned others to intervene and bring about reconciliation. Ashti is the last stage of qahr. Ashti is reconciliation and mediation plays an important role in the process of ashti.

Adolescent↗
PubMed2004

[On the 150th birthday of Paul Julius Möbius (1853-1907)].

In memory of Paul Julius Möbius (1853-1907) on the occasion of his 150th birthday Among his profession Leipzig neurologist and psychiatrist Paul Julius Möbius made a name for himself by clinical studies on singular neurological topics. Several of these contributions have been acknowledged until today by giving his name to these symptoms or illnesses (cf. 'Möbius sign', 'Möbius syndrome', 'Möbius disease'). It was also him who divided nervous illnesses into endogenous and exogenous ones. Furthermore, Möbius made significant contributions towards the understanding of the causes for some mental illnesses, e.g. it was him who postulated a psychogenic development of hysteria. Through his pathographies as well as his work as a major reviewer and editor of 'Schmidt's Annals of Domestic and Foreign Entire Medicine' Möbius became known to a greater public. Even more well-known, if not infamous, Möbius's name is for his pamphlet on 'The Physiological Mental Weakness of Woman'. As a result of it's repeated republication he was accused to be hating women and his major contributions towards the progress of the neurosciences have been neglected.

Germany↗
PubMedDate not supplied

Identifying the body-dysmorphic patient in aesthetic surgery.

Body dysmorphophobia (BDD) is a psychiatric illness experienced by up to 20% of patients requesting cosmetic surgery. Because of its diverse presentations, BDD should be searched out and recognized by the plastic surgeon. Otherwise, the unwary operator will invariably have to deal with a profoundly dissatisfied patient. Patients with BDD hate their bodies and may seek out cosmetic surgery as a solution. However, they invariably are not satisfied despite the objective result. Many eventually fall into the cosmetic surgical victim category of "overoperation." These patients need psychological counseling and referral to psychiatrists with a special interest in body image. Recognition and deferral of surgery for BDD patients is advised because findings have shown the propensity of these patients to litigate, threaten, and even harm or kill their surgeon.

Adult↗
PubMedDate not supplied

Applicability of the Chinese Beck Depression Inventory.

Using a sample of 329 currently depressed patients from 24 hospitals across China, this study assesses the reliability and validity of the Chinese version of Beck Depression Inventory (CBDI). Even though the internal reliability and the concurrent validity were good (Cronbach alpha = 0.846; r = 0.566), the results showed that the item of Loss of Libido was most weakly correlated with the CBDI's total score; the items of Sense of Punishment, Sense of Hate, Self Accusations, Crying Spells, Irritability, and Somatic Preoccupation were poorly associated with the intensity of depression measured by the total score of the Chinese version of Hamilton Depression Rating Scale (CHDS). The CBDI's construct validity was rather poor by principal component analysis: three of six factors were unexplainable in terms of clinical features of depression. The results demonstrated that CBDI, even though it was semantically translated into Chinese language, still could not be effectively applied in clinic and research settings in China. Using the theory and methods of psychometrics to develop China's own culturally sensitive self-report inventory is the correct way to eliminate cultural bias and make cross-cultural research more valid. This is the most rigorous scientific approach to cross-cultural comparisons.

Adult↗
PubMed1988

The role of the right hemisphere in the production of linguistic stress.

Recent research has proposed a general prosodic disturbance associated with right hemisphere damage (RHD), one encompassing both affective and linguistic functions. The present study attempted to explore whether the ability to produce linguistic prosody was impaired in this patient population. Productions of phonemic stress tokens (e.g., Re'dcoat vs. red coa't) as well as examples of contrastive stress, or sentential emphasis (e.g., Sam hated the movie), were elicited from eight male speakers with unilateral right hemisphere CVAs and seven male control subjects. Two types of analyses were conducted on these utterances. Acoustic analysis focused on the correlates associated with word stress, namely changes in amplitude, duration, and fundamental frequency. The perceptual saliency of emerging cues to stress was also examined by presentation of test tokens to phonetically trained listeners for identification of stress placement. The patients as a group produced fewer acoustic cues to stress compared to the normal subjects, but no statistical differences were found between groups for either stress at the phrase level or at the sentence level. In the perceptual analysis, stress produced by the patient group was judged to be less salient than that for the normal group, although a high degree of variability was evident in both populations. The data suggest a spared processing mechanism for linguistic prosody in RHD speakers, thus mitigating against the view of a general dysprosody tied to RHD.

Adult↗
PubMed1983

The child sexual abuse accommodation syndrome.

Child victims of sexual abuse face secondary trauma in the crisis of discovery. Their attempts to reconcile their private experiences with the realities of the outer world are assaulted by the disbelief, blame and rejection they experience from adults. The normal coping behavior of the child contradicts the entrenched beliefs and expectations typically held by adults, stigmatizing the child with charges of lying, manipulating or imagining from parents, courts and clinicians. Such abandonment by the very adults most crucial to the child's protection and recovery drives the child deeper into self-blame, self-hate, alienation and revictimization. In contrast, the advocacy of an empathic clinician within a supportive treatment network can provide vital credibility and endorsement for the child. Evaluation of the responses of normal children to sexual assault provides clear evidence that societal definitions of "normal" victim behavior are inappropriate and procrustean, serving adults as mythic insulators against the child's pain. Within this climate of prejudice, the sequential survival options available to the victim further alienate the child from any hope of outside credibility or acceptance. Ironically, the child's inevitable choice of the "wrong" options reinforces and perpetuates the prejudicial myths. The most typical reactions of children are classified in this paper as the child sexual abuse accommodation syndrome. The syndrome is composed of five categories, of which two define basic childhood vulnerability and three are sequentially contingent on sexual assault: (1) secrecy, (2) helplessness, (3) entrapment and accommodation, (4) delayed, unconvincing disclosure, and (5) retraction. The accommodation syndrome is proposed as a simple and logical model for use by clinicians to improve understanding and acceptance of the child's position in the complex and controversial dynamics of sexual victimization. Application of the syndrome tends to challenge entrenched myths and prejudice, providing credibility and advocacy for the child within the home, the courts, and throughout the treatment process. The paper also provides discussion of the child's coping strategies as analogs for subsequent behavioral and psychological problems, including implications for specific modalities of treatment.

Adaptation, Psychological↗
PubMed1991

Synthesis of gamma-[4-(benzoylphenyl)methylamido]-7-methylguanosine 5'-triphosphate, a photoaffinity-label for cap-binding proteins.

An easy and rapid method for the synthesis of the photoreactive cap analogue gamma-[4-(benzoylphenyl)methylamido]-7-methylguanosine-5'-triphosp hate (BP-m7GTP) has been developed. Synthesis of [gamma-32P]BP-m7GTP was carried out as a two-step procedure. The first step included the phosphorylation of GDP with [32P]orthophosphate to [gamma-32P]GTP and its methylation to [gamma-32P]m7GTP. After purification, [gamma-32P]m7GTP was condensed with 4-aminomethyl-benzophenone-HCl to [gamma-32P]BP-m7GTP. Using this probe, specific labeling of nuclear cap binding proteins is demonstrated.

Affinity Labels↗
PubMed2004

Snake care and husbandry.

The snake has long been a contradictory species; you either love them or hate them. In the United States, these reptiles are popular pets. There is also a significant amount of energy placed into developing captive breeding programs to produce different color morphs for many species. In some cases, such as the ball pythons (Pythonregius), these color morphs can sell for 20,000 dollars to 30,000 dollars each. In comparison to domestic mammals, snakes are long-lived. It is not uncommon for corn snakes (Elaphe guttata guttata) to live for 15 to 25 years and for ball pythons to live 35 to 45 years. Because of the longevity and value of these animals, more snakes are being presented to the veterinarian to manage medical and surgical problems,as well as for routine medical care. Veterinary personnel working with snakes should familiarize themselves with the specific husbandry and medical requirements of these animals so that they can make informed decisions regarding their management.

Animal Husbandry↗