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PubMed2004

Taijin Kyofusho in university students: patterns of fear and predispositions to the offensive variant.

Taijin Kyofusho (TKS), a disorder characterized by a fear of interpersonal relations, and regarded as a culture-bound disorder in Japan, is related to social anxiety disorder (SAD). A variant of TKS, the 'offensive type' involves fear of offending others by one's inappropriate social behavior or appearance. Reports of offensive-type TKS have hitherto been limited to a small number of case reports. To delineate the characteristics of offensive-type TKS and to determine the patterns of fear and factors involved, we investigated 111 Japanese university students who reported feeling tense or nervous in social or interpersonal interactions. We analyzed subjects' responses to items on a scale for TKS, and isolated five factors. Cluster analysis of the factor scores revealed a group (N = 25) with symptomatic profiles that fit 'offensive-type TKS.' Despite this group's high TKS scores, their scores on the Liebowitz Social Anxiety Scale-Japanese version were relatively low. Our results suggest that the symptoms of some TKS sufferers do not fall within the SAD spectrum.

Adolescent↗
PubMed2000

Contributions of object relations theory and self psychology to relational psychology and group psychotherapy.

Object relations theory and self psychology are psychoanalytic perspectives that are especially concerned with interpersonal relations and their mental representations. Object relations theory began as an intrapsychic "singleton" psychology with the work of Freud and Melanie Klein. It subsequently evolved into a multi-person psychology with the work of Bion on groups, as well as the clinical and theoretical contributions of Winnicott and Fairbairn. Kohutian self psychology, which emerged later, has been interested in the relations between the self and significant others as mirroring and idealizing "self-objects." Stolorow's "inter-subjective perspective" emerged from self psychology as a full-fledged multi-person point of view. This article considers the significance of contemporary object relations theory and self psychology as relational, multi-person perspectives in terms of their application to group psychotherapy, focusing upon the group-as-a-whole, projective identification, transitional space and object, and self/self-object relations as particularly useful constructs. A clinical vignette is provided.

Humans↗
PubMed1999

Cognitive and behavioral sequelae of closed head injury in older adults according to their significant others.

This study examined the neurobehavioral effects of closed head injury (CHI) in older adults according to their significant others. Informants of 17 mild and moderate CHI patients > or = 50 years old when injured completed the Geriatric Evaluation of Relative's Rating Instrument, a questionnaire inquiring about the patient's cognition, affect, interpersonal relations, and daily activities. The significant others provided retrospective ratings of preinjury functioning and completed the same instrument an average of 4 and 13 months post-injury. The significant others of 10 community-residing, normal control subjects completed the questionnaire at comparable intervals between each rating. Compared with their preinjury functioning, and unlike the control subjects, patients showed declines in cognition and mood. The possible impact of these changes, including their effect on subjective burden in caregivers, is discussed.

Aged↗
PubMed1995

Beyond posttraumatic stress disorder: object relations and reality testing disturbances in physically and sexually abused adolescents.

OBJECTIVE: To evaluate posttraumatic stress disorder (PTSD) symptom severity, object (interpersonal) relations disturbances, and reality testing disturbances in a sample of physically and sexually abused adolescents. METHOD: Subjects were 37 students, 16 boys and 21 girls, enrolled at a private, residential school for children with various conduct problems. Students completed several psychological tests, including the Child Post-Traumatic Stress Disorder Reaction Index (CPTSD-RI) and the Bell Object Relations and Reality Testing Inventory. RESULTS: Of the 37 students, 22 (59.5%) had CPTSD-RI scores in the severe and the very severe ranges. The most common object relations and reality testing disturbances were insecure attachment and uncertainty of perception, respectively. CPTSD-RI scores were positively correlated with two of the four object relations scores (insecure attachment and egocentricity) and with all three reality testing scores (reality distortion, uncertainty of perception, and hallucinations/delusions). Mean CPTSD-RI scores were higher for students whose abuse had involved sex (sexual and physical abuse, sexual abuse only) than they were for students whose abuse had been physical only. Alienation and social incompetence, the two object relations disturbances not correlated with PTSD symptom severity, were associated with having experienced abuse at an early age and having been abused by a parent or stepparent (versus a nonparent). CONCLUSION: To address more effectively the long-term difficulties associated with child maltreatment, clinicians and clinician-investigators ought to evaluate interpersonal and reality testing disturbances, as well as PTSD symptom severity.

Adolescent↗
PubMed1991

Problem-based curriculum: outcome evaluation.

The College of Medicine and Medical Sciences of the Arabian Gulf University (CMMS-AGU) in Bahrain is, in its innovativeness, unique in the region in that a problem-based strategy is used in the planning and implementation of the curriculum. The first batch of graduates have completed their internship programme in the different countries of the region. This paper presents an evaluative study of the outcome of the programme in relation to the institutional goals. Assessment of the intern's performance in clinical competence, interpersonal relations, self-directed learning, and their relative standing vis-à-vis graduates from other schools was done by supervisors. The findings of the study confirm the relative merits of the problem-based curricular strategy in medical education.

Bahrain↗
PubMedDate not supplied

[Social anxieties in a clinical sample].

Under the label of social phobia a complex of ailments was introduced into the syndromal diagnostic classification system of ICD-10 and DSM-IV, which is characterized by fear of embarrassing and humiliating experiences in relation to other persons. According to our experiences, however, social phobias and other problems in interpersonal relations are not yet paid the clinical attention that these problems deserve, when the severity of impairments subjects affected by social phobias suffer from is taken into account. There is a considerable lack of research of the psychodynamic aspects of social phobia as well. For this reason, we studied the frequency and extent of social anxieties in a sample of patients requiring psychiatric-psychotherapeutic inpatient treatment suffering from social anxieties (N = 930). This sample was compared to another sample of patients without social anxieties. We applied standardized diagnostic and psychometric instruments in order to collect information about anamnestic and social data as well as data about symptom severity, interpersonal impairments and comorbid disorders. The results do not only show the high frequency of social anxieties (45 %), but also the severe impairments in various domains of personal functioning of patients suffering from social anxieties compared to the patients without severe social anxieties. According to our clinical experiences and to the results presented here, the construct of social phobia as it is currently used in the psychiatric classification systems is an syndromal additive description that falls short of a form of suffering that is characterized by the facts that it is interwoven with the complete social existence of an affected person. For this reason, the term social phobia should be replaced by the more appropriate term of social anxiety.

Adult↗
PubMed2003

Williams syndrome: 15 years of psychological research.

Williams syndrome is a rare genetic disorder caused by a microdeletion of about 20 genes on chromosome 7q11.23. The importance of this syndrome for theories and models of cognition became apparent about 15 years ago, when Bellugi, Sabo, and Vaid (1988) argued that Williams syndrome was a paradigm case of the independence of language from cognition. In particular, it was argued that individuals with Williams syndrome have "intact" language despite severe mental retardation. More recent findings indicate a more complex relation between language and characteristics associated with this syndrome. The articles in this special issue form 3 overlapping clusters: articles concerned with language development relative to cognitive development, articles concerned with other aspects of cognition, and articles concerned with interpersonal relations and personality. Together, these articles provide strong evidence of the importance of the study of neurodevelopmental genetic disorders for enhancing understanding of the complex manner in which initial genetic differences impact both behavior and processing strategies from infancy through adulthood. Our hope is that this issue will motivate further studies, informed by the genetic-developmental approach, on both Williams syndrome and other neurodevelopmental genetic disorders.

Cognition Disorders↗
PubMed1991

The Karolinska Psychodynamic Profile. I. Validity and dimensionality.

The Karolinska Psychodynamic Profile (KAPP) is a new rating instrument based on psychoanalytical theory that is intended to assess relatively stable modes of mental functioning, as they appear in self-perception and in interpersonal relations. The 18 subscales of the KAPP and their scale steps are described in detail. The information needed for assessment is obtained through a structural interview procedure. The KAPP can discriminate between patients with and without a DSM-III diagnosis. It does not appear to be sensitive to the strain of a major life event. Comparison between interview-based ratings and projective test-based ratings shows satisfactory agreement and similarities in factor structure. The KAPP appears to possess both discriminative and construct validity.

Adjustment Disorders↗
PubMed1991

The Karolinska Psychodynamic Profile. II. Interdisciplinary and cross-cultural reliability.

The Karolinska Psychodynamic Profile (KAPP) is a rating instrument based on psychoanalytical theory, that is intended to assess relatively stable modes of mental functioning, as they appear in self-perception and in interpersonal relations. The 18 subscales of the KAPP and their scale steps are described in detail and kept close to clinically observable phenomena. The information needed for assessment is obtained through a structural interview procedure. The interrater reliability was tested with different Swedish raters with varying psychodynamic training and experience. It was also tested with a non-Swedish rater with psychoanalytic training. The interrater correlations were generally high, suggesting that the KAPP has interdisciplinary and cross-cultural reliability.

Adjustment Disorders↗
PubMed2004

A questionnaire to examine food service satisfaction of elderly residents in long-term care facilities.

The purpose of this study was to develop a survey tool for assessing the satisfaction of elderly long-term care (LTC) residents with the meals and food services they receive, as well as to assess quality of life issues related to eating. Food service delivery should be provided in an environment that fosters autonomy, interpersonal relations, and security. The questionnaire was administered as face-to-face interviews with 205 residents (> or = 65 years of age) of 13 LTC facilities in Saskatoon, Saskatchewan, Canada (participation rate = 67%). Residents expressed some concern with food variety, quality, taste, and appearance, and with the posting of menus. Quality of life issues were mostly positive; however, residents were less satisfied with areas related to their autonomy such as food choice and snack availability.

Aged↗
PubMed2003

[Violent relationship in young people and STD/AIDS risk].

To verify whether affective relationships involving violence are associated with increased risk of sexually transmitted diseases (STDs), including AIDS, we conducted a survey among youth 14 to 22 years of age residing in two low-income communities in Rio de Janeiro, Brazil. We used a qualitative methodology with focal groups and individual interviews. Violence is part of the routine among these youth in both their community and families. The following factors were associated with violence in interpersonal relations: lack of money, unemployment, drug and alcohol use, jealousy, and infidelity. The young people reported that condom use is not negotiated with violent partners, resulting in increased risk of STD/AIDS. The results indicate that violence is multi-factorial, and when present in interpersonal relationships it intervenes negatively in relation to protection against STD/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Preattentive bias for emotional information in panic disorder with agoraphobia.

A combined emotional Stroop and implicit memory (tachistoscopic identification) task with 3 types of words (panic-related, interpersonal threat, and neutral words) and 2 exposure conditions (subliminal, supraliminal) was administered to 35 patients with panic disorder and 35 age- and sex-matched controls. The patients showed Stroop interference for panic-related words both sub- and supraliminally and a similar but not equally robust effect on interpersonal threat words. On the tachistoscopic identification task, the patients identified more panic-related words than the controls did but showed no implicit memory bias effect. The patients' subliminal Stroop interference for panic-related words was found to correlate with trait anxiety and depression, although not with anxiety sensitivity.

Adult↗
PubMedDate not supplied

A synthesis of qualitative home visiting research.

Over the past decade, a body of qualitative research has been developed which describes the home visiting practice of public health nurses (PHNs) to maternal-child clients. This article reports a synthesis of these studies. The purpose of the synthesis was to identify common elements and differences between the research reports that would lead to theory development or support of existing theories. Methods were based on Miles and Huberman's (1994) text on qualitative data analysis. Results of the synthesis indicated that building and preserving relationships with the client is the central focus of home visiting and provides a foundation for problem identification and problem solving. Clients control access to their homes as well as the information they are willing to share with the nurse. The goals of home visiting relate to empowering mothers, supporting their independence and decision making. Similarities to Peplau's theory of Interpersonal Relations and Cox's Interaction Model of Client Health Behavior (IMCHB) are noted.

Community Health Nursing↗
PubMed1975

Development of a reaction inventory to measure guilt.

The Reaction Inventory-Guilt was developed to isolate, in individuals, the specific stimulus situations which result in guilt. The 50-item inventory was administered to 96 subjects. The estimate of the internal consistency coefficient was .94. The inter-item correlations were factor analyzed by the principle axis method, and rotation to oblique simple structure was accomplished by the Promax method. Four oblique factors were obtained: intentional behavior disrupting interpersonal relations; self-destructive behavior; behavior contrary to moral or ethical principles; and unintentional behavior disrupting interpersonal relationships.

Adolescent↗
PubMed1991

Gynecologic factors in sexual dysfunction of the older woman.

Older women may experience sexual dysfunction due to many different causes. Some problems related to menopausal hormonal change may be easily treated with estrogen supplements. Other problems involve intricate interpersonal relations between the woman and her sexual partner and may require a combination of medical therapy and sexual counseling. Gynecologic cancer and cancer treatments are often accompanied by problems in sexual functioning. These problems may then impair relations and self-image, leading to a vicious circle of deteriorating social function. Some recommendations for the clinician follow. The clinician should maintain an attitude of openness to the possibility of sexual concerns in older women. Such concerns should be taken seriously and should not be dismissed as part of aging. Routine periodic health examinations can include a question such as "Do you have any concerns about your sexual life that you would like to discuss?" In follow-up visits for procedures with a high likelihood of causing sexual dysfunction, questions that would open the door to a discussion of sexuality should be asked. Sexual dysfunction should be recognized as a couple-oriented phenomenon. A woman's anxiety about her appearance, postoperative depression, or dyspareunia may be perceived by her partner as a sexual rejection and may initiate a cycle of decreasing contact or may even lead to erectile dysfunction. Sexual counseling should include both partners. When a surgical procedure that will probably have an impact on sexual function is contemplated, provide the patient and her partner with advance counseling. Descriptions of surgery should not be simply a statement of body parts to be removed but should specifically address the anticipated sexual effects. Counseling should include a description of basic anatomy and function of the genital organs. Illustrations and appropriate demonstration during the physical examination should be used to ensure the patient's understanding. Descriptions should be accurate without being either frightening or falsely reassuring. The patient should be counseled about the benefits of including her partner in discussions. Then, when possible, the sexual partner of the patient should be invited to sessions of advance counseling on contemplated procedures. Clinicians should remain open to the possibility that the sexual partner will be a nontraditional one, e.g., an unmarried male partner or another woman. The clinician should be alert to remediable causes of dysfunction. For example, decreased vaginal lubrication may be managed with use of water-soluble lubricants.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1995

[The social psychological adaptation of patients with borderline mental disorders].

Social Interview Scale (SIS) elaborated by A. Clare and V. Cairns was applied. The principal information concerning adaptation and reliability of the method was presented. Two groups of patients with borderline disorders and control group (120 cases at all) were examined. The patient's groups were distinguished by the severity of the illness: the 1-st group included 30 continuous sluggish schizophrenic patients with pseudoneurotic symptoms (ICD-10: F 21) registered in mental health dispensary, the 2-nd group consisted of 50 neurotic patients who attended a psychiatrist in a district out-patient clinic (ICD-10: F 4). Social adaptation was estimated in terms of the basic areas of the man's life: housekeeping, professional occupation, material conditions, entertainments and leisure, microsocial relationships, matrimonial and family relations. It was found that schizophrenic patients were characterized first of all by severe complications in the interpersonal relations exactly with close relatives and in matrimonial sphere. Meanwhile neurotic patients were preoccupied mainly by social functioning problems as well as by job or housewife role dissatisfaction.

Adaptation, Psychological↗
PubMed2003

The relation between coordinated interpersonal timing and maternal sensitivity in four-month-old infants.

The relation between mother-infant coordinated interpersonal timing, an automated microanalytic measure of dyadic vocal coordination, and maternal sensitivity was explored. Thirty-five mothers and their developmentally normal 4-month-old infants were audio-recorded during a 20-min laboratory vocal interaction session, that was later analyzed for degree of vocal coordination. Maternal Sensitivity ratings (Ainsworth & Bell, 1969) were based on a video-taped 45-min unstructured laboratory interaction period. A significant curvilinear relation between the degree to which mother coordinated her noninterruptive co-occurring speech to that of her infant was found and revealed that mothers highest in sensitivity were characterized by moderate levels of coordination. Examining mother-infant interaction at the specific behavioral level, while incorporating tests of nonlinear trends, may provide important information about the nature of sensitive parenting.

Adult↗