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The parents of school phobic adolescents - a preliminary investigation of family life variables.

Parents were interviewed at home in a preliminary study of family life variables. Forty-eight had children admitted to an adolescent in-patient unit, 19 of them for school phobia and the remainder because of other psychiatric conditions. Difficulty in obtaining a comparable group from the normal school population resulted in only 12 such families being studied in addition. The psychiatric cases were reliably separated into school phobic and other problems. Practically all the school phobics had neurotic disorders. Contact of parents with relatives and friends, their leisure activities outside the home, their patterns of work and their management of domestic affairs, were looked at. It was thought that these aspects of family functioning might be distinctive where there was a school phobic youngster and that an abnormal pattern of family life might predispose a child to this disorder. In fact, no evidence emerged to suggest that parents of school phobic adolescents participate in, or make decisions about, family life activities in any way different from parents of other psychiatric cases or normal controls.

Adolescent↗

[Querulous patients].

Querulousnes is no uniform psychiatric phenomenon and no disease entity. Causes and occasions are of the most various types, difficult to compare between persons, often moulded by the currents of the day, inherited ways of thinking, experiences and environment. Querulants are personalities, who, after colliding with the legal system and having had their own claims dismissed, suffer from an often chief and irremediable feeling of being victim of an injustice. They cannot understand that, what is in due form valid can, when, scrutinized with the greatest sense of justice and practical common sense, impress upon someone as injustice. The submission to the unattainable, the parting from hopes, expectations and claims do not materialize. The step by step stiffening readiness for action can be confined to the lawsuit matter, it comes however about, that it extends to further spheres of life. Escalations occur in particular then, when the authorities course of action, courts of justice and opponents are felt as tyrants or mortal threat. A person deriving a meaning from his entire life or events, which he interprets for himself, makes his relations to the community and Law fragile [90]. Are presented within the framework of differential diagnostic distinctions, manifestations of querulous behaviour among abnormal personalities, neurotic disorders and schizophrenic psychoses under psychiatric aspects. Brought into sharper focus are the psychogenic psychoses, which became manifest in the USA, GUS and scandinavian countries in connection with serious querulous evolutions. Hints to decision of the supreme court and forensic psychiatric expert opinion conclude the article.

Expert Testimony↗

Personal and social factors associated with the remission of psychiatric symptoms.

Most studies of "spontaneous remission" involve samples of untreated psychiatric patients. This selection process limits the generalizability of findings to the population of persons with neurotic disturbances. This report concerns a community sample of people with neurotic disorders. Fifty subjects were followed up for five years, using both clinical and quantitative techniques. Almost half lost their symptoms during this time. Various sociodemographic factors, personality assets, and liabilities contribute to the process through which such remissions occur.

Adolescent↗

[Clinical hypnosis. Current status of theory and empirical aspects].

Hypnosis as a traditional healing method, in its more recent development, has generated a multitude of techniques. These serve as practical tools which can be combined with other therapy techniques for the treatment of medical, psychosomatic and neurotic disorders. Based on 80 group studies (to date) the empirical evidence for the effectiveness of hypnosis is considerable and proves its clinical impact in various areas of application. As a theoretical foundation a number of hypotheses have been formulated, which describe hypnosis as a complex phenomenon with biological, cognitive and social aspects.

Humans↗

[Typology of affective disorders on the neurotic level in essential hypertension].

A study of 123 hypertensive patients in conditions of a specialized department of a cardiological Institute has shown the predominance of depressive disorders with a certain prevalence of the anxiety affect at the first stages and the melancholical affect at the subsequent stages. States with the leading affects of dysphoria and hyperthymia are observed less frequently and only at advanced stages of the disease. The authors outline the role of personality and situational-psychological characteristics as well as the stage and the course of the vascular process itself in the formation of affective disturbances.

Adolescent↗

Measuring psychoneurotic behavior in cross-cultural surveys.

In recent years, a number of studies have appeared which attempt to measure neurotic disorders among population samples in different cultural settings. The problem of how to define and measure psychiatric disorders in untreated groups, and especially in cultures to which the investigators are not native, is, however, far from resolved. The present report describes an effort to study psychological stress among the Serer of Senegal. We describe a method we used to develop a questionnaire to tap symptoms of psychiatric distress, and which would be geared to the realities of place and setting. By means of a factor analysis of the responses to this questionnaire by more than 400 subjects, we identify four dimensions by which the Serer express neurotic disturbance. Further analyses presented in the report demonstrate that these are not merely ways of expressing symptoms based on physical illness, that they are able to discriminate between ill and well people in the Serer frame of reference, that they possess domain validity, and that they demonstrate important similarities and differences with factors obtained using similar techniques in different cultural settings. From a methodological point of view, we illustrate the importance of using a multidimensional approach in such studies.

Adolescent↗

Nurse therapists in behavioural psychotherapy.

Five registered mental nurses (R.M.N.s) were trained over two years to become behavioural psychotherapists for adult neurotic disorders. They achieved results comparable to those obtained with similar patients and methods by psychologists and psychiatrists. Similar results were maintained when over a third year the therapists were seconded to work in four hospitals and a general practice. Patients were satisfied at being treated by nurses. After initial teething difficulties nurse therapists became valuable members of treatment teams during both training and secondment, becoming accepted by most nurses, psychologists, and psychiatrists with whom they came into contact. The training of further nurse therapists would facilitate treatment of many disabled neurotics who would otherwise go without effective treatment. Training nurse therapists takes less time and money than training psychologists and psychiatrists because less of their education is redundant to the skills involved. The pool of R.M.N.s suitable for training is much larger than that of psychiatrists and psychologists. The nurse therapists can be integrated relatively easily into treatment teams. The present nursing structure imposes restrictions on the advancement of clinical nurse specialists and a clinical tree is badly needed parallel with present administrative and teaching hierarchies. An 18-month course in adult behavioural psychotherapy has been recognized by the Joint Board of Clinical Nursing Studies for England and Wales so that nurse therapists seem destined to be a lasting feature of future treatment teams.

Adult↗

[A clinical study on non-verbal psychotherapy in childhood and adolescence: a proposed classification and psychopathological considerations].

The author examined the therapeutic sequence of 37 child and adolescent cases of neurotic disorder in whom the non-verbal approach was successively taken for more than 6 months. The cases could be classified into two types, according to their choice of non-verbal methods: "simple type" cases, who chose only one method at all their therapeutic sessions and "mixed type" cases, who took various combinations of non-verbal methods during the period of psychotherapy. In "simple type" cases, premorbid character was usually introverted and emotionally stable. As for their family situations, their fathers were rather asthenic and their mothers often lacked emotional communication in child-rearing. Patients showed one or only few clinical symptoms. The therapeutic relationship with them was superficially calm and stable, and it was often difficult to deepen the emotional commitment further. In "mixed type" cases, on the other hand, premorbid character was emotionally often unstable. Their fathers tended to be away from home, and mothers were conspicuously overprotective and meddlesome. Their clinical symptoms were varied. In the therapeutic sessions, they often became dependent on therapists and, at the same time, ambivalent and unstable in certain conditions, showing dissatisfactions and reacting strongly against their therapists. The characteristics of these two types can be observed in relation to other clinical disorders. Regarding the development of interpersonal relationship and personality, it can be seen that the two types is derived from the different quality of the "sense of basic trust" of each patient acquired in early childhood. Based on the above findings, the author discussed a few psychopathological issues on his proposed classification.

Adolescent↗

The relationship between alcoholism and neurosis: evidence from a twin study.

The twin register of the Maudsley Hospital was used to select a series of monozygotic (MZ) and same-sexed dizygotic (DZ) twins who had been given an ICD8 diagnosis related to alcoholism. They and their co-twins were traced. Medical and drinking histories were compiled (from records and by interview) for 56 twin-pairs, to permit current and retrospective diagnosis of any neurotic disorders. RDC diagnoses of panic disorder, generalised anxiety disorder, obsessive-compulsive disorder and phobias were more common in the alcoholic probands and the co-twins who were also alcoholics than in the normal-drinking co-twins. The Eysenck Personality Questionnaire (EPQ) and the Severity of Alcohol Dependence Questionnaire (SADQ) were completed by 54 individuals. Neuroticism scores were significantly higher for both male and female alcoholics than for their normal-drinking co-twins; and intra-pair differences in neuroticism were significantly correlated with intra-pair differences in severity of dependence. These results suggest that both clinically diagnosed neurotic illness and high neuroticism scores are more often a consequence than a cause of alcoholism.

Alcoholism↗

[Health problems of school education reform].

The paper deals with impact of educational load in pupils at present general educational establishments on their health. The great total educational load in them was found to violate the schoolchildren's routine. This more frequently forms inadequate physiological responses, develops neurotic disorders. The incidence of chronic diseases is higher in children going to new-type schools. The findings provide evidence for some medical and organizational measures to promote schoolchildren's health.

Adolescent↗

Changes in the patient's perception of his therapist in the process of group and individual psychotherapy.

The patient's perception of his therapist seems to be one of the major components of the therapeutic relationship. The different psychotherapeutic setting seem to influence the dynamics of the therapeutic relationship along with some other therapist and patient variables. Two groups of patients treated in the Department of Neurotic Disorders of the Institute of Psychiatry and Neurology (Warsaw) were investigated 2 times during their course of psychotherapies (individual, group). The perception of the therapist was measured by the Adjective Raging Scales constructed for the purpose of this research. These data were correlated with the results of the ACL (Gough) as a measure of personality traits and with the intensity of the clinical symptoms.

Adaptation, Psychological↗

Neuroticism in patients with irritable bowel syndrome.

Employing a Hindi adaptation of the Middlesex Hospital Questionnaire (MHQ), neuroticism level was assessed in 133 subjects with irritable bowel syndrome and compared with that in patients with organic bowel disease (33), healthy population (140) and known neurotics (110). Compared with healthy controls and patients with organic bowel disease, significantly higher scores were found among irritable bowel syndrome patients in all the subscales except obsession. The total of scores was midway between those of the normal population and known neurotics. Neurotic disorder was detected in 51% of irritable bowel syndrome patients compared to 24% of organic bowel disease subjects (P less than 0.05) and 7.8% of the healthy population. Cut-off points, calculated as mean + 2 SD of scores in the healthy population, were found to be reliable as shown by clinical interview.

Adult↗

[Characteristics of the development and mental status of siblings of neurotic children].

150 children were examined. They were divided into two groups. The first group was composed of the children hospitalized with the diagnosis of neurotic disorder, the second one of their brothers and sisters of similar age (7-13) nontreated psychiatrically. There were statistically significant differences between these two groups in the following ways: 1) pathology of the pre- and postnatal periods, 2) psychomotor development and somatic state during the infantile age, 3) emotional development during the preschool period.

Adolescent↗

Analytic abstinence and preoedipal disturbance.

Analytic abstinence entails a technical frustration that may have different meanings for those with primarily neurotic disorder and those with significant preoedipal pathology. It is posited that the greater the degree of preoedipal disturbance, the greater will be the tendency to experience the frustration of the technique itself as transference-laden: conflicts related to frustrating experiences in early childhood are revived owing to the abstinent form of psychoanalytic treatment. Ramifications regarding the analyst's work-ego, countertransference, general strategic considerations, and technical difficulties are discussed.

Countertransference↗

[Psychological aspects of diet therapy of children and adolescents suffering from digestive system diseases].

Clinicopsychological investigations of 361 patients, aged from 6 to 17 years, suffering from diseases of the gastrointestinal tract, have revealed in 60.7% of them negative psychological attitude to the dietotherapy they received. Among children and adolescents with concomitant neurotic disorders such attitude was noted in 79.6%. A system of special measures has been developed including three main elements: 1) psychotherapeutic mediation of dietotherapy before its administration and in the process of the therapy; 2) creation of the psychologic attitude to the diet adherence; 3) alteration of the patient's taste stereotype. Realization of such measures has been conducive to higher effectiveness of the dietotherapy.

Adolescent↗

[Aortocoronary bypass: methods of group psychotherapy and instruction and the rehabilitation potentials].

In a large number of patients aortocoronary shunting often leads to persistent neurotic disorders' development. Taking into account the biological, psychological and social factors contributing to the disease pathogenesis, the authors tend to introduce some methods of active involvement of patients into a rehabilitation-prophylactic process to restore their mental health balance, behavioral standards, communicative habits etc.

Adaptation, Psychological↗

[Proof of complex theories regarding conflicts, neuroses and their therapy, exemplified by Mjasiscew's theory of relations].

Most psycho-dynamic theories emphasize the role of intra-personal conflicts in the aetiology and therapy of neurotic disorders, but very few can be empirically tested. The social psychological and psychodynamic "pathogenetic" theory of the "Leningrad School" of psychotherapy according to Mjasiscew (Lauterbach, 1984) maintains that conflicts between a person's relations with his social, material and cultural environment may be the cause of his neurosis. This theory is used to demonstrate that psychodynamic hypotheses about the role of intra-personal conflicts can be empirically tested with the help of "tests of conflict" (Lauterbach, 1987).

Conflict, Psychological↗

[Diagnosis of ego functions and object relations based on rating scales].

This study investigated rater-agreement and the factorial structure of the Rating-Scales for the assessment of object-relations and ego-functions developed by Bellak and coworkers. A subset of the original scales with the modifications and translations performed by Streeck was used, altogether 19 scales consisting of sub-components of seven functions. These were applied in assessing patients with neurotic disorders, alcohol addiction and Crohn's disease (n = 25 each). Rater-agreement was not satisfactory: In almost all scales there were significant differences in central tendency; only in seven scales rater-agreement was adequate, it's height varying for diagnostic groups and functions. Results of factor-analysis showed a two-dimensional structure. Implications for further research with these scales are discussed.

Adult↗