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The prediction of violent behavior can be an important aspect in the diagnostic work-up of a patient. Can the Minnesota Multiphasic Personality Inventory (MMPI) be of any help in predicting dangerous behavior? DSM-III disorders in which violent behavior has a high probability to occur, and the corresponding MMPI profiles are discussed.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Old people's eating habits are often idiosyncratic and unhealthy; their feeding can reflect such brain disease are dementia, depression, paranoia; poor nutrition can contribute to degenerative brain disease. The modification of nutritional requirements of the aged by genetic factors is discussed.
Quantitative electroencephalographic methods (amplitude analysis) have been used to measure the relative degree of hemispheric activation (temporal lobes) in normal subjects, mild psychopathological states, and certain mental diseases. Special tasks were used to elicit either verbal (left hemispheric) or non-verbal (right hemispheric) processes. In normal subjects, the E.E.G. data obtained are in good agreement with mental performance. Under mild to severe psychopathology they reveal functional impairments of within- as well as of between-hemispheric activities. There are also indications of disorganization in the left in the case of acute paranoid schizophrenia and in the right in the case of affective disorders.
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The paper deals with some results of experimental psychological studies of psychopathic personalities, which indicate the efficacy of using not only experimental data for verifying the existing clinical concepts. Such studies are important as well for formulating some psychological hypotheses, the solution of certain questions on the basis of the known personality theories in psychology. The possibility of using psychological examinations for the study of motivations in psychopathies are discussed. For the 4 forms of psychopathy (explosive, hysterical, inhibited, paranoidal) the prevalent motives are singled out, which in normals as a rule are not the leading ones.
BACKGROUND: Depression occurring in schizophrenia is a common problem; however, investigators have typically not studied it with the paranoid/nonparanoid dichotomy in mind. This study examines the quality as well as the severity of depression in three psychiatric groups: paranoid schizophrenia patients, nonparanoid schizophrenia patients, and nonpsychotic major depression patients. METHOD: Clinical and sociodemographic data were collected on 27 paranoid and 27 nonparanoid schizophrenia patients during their postpsychotic phase while they were at least mildly depressed, and a comparison group of 27 nonpsychotic patients diagnosed with major depressive disorder. The three groups were then assessed on various psychometric scales for severity of depression, profile of symptoms, suicidal risk, and anhedonia. RESULTS: The paranoid schizophrenia patients were more depressed and more at risk for suicide than the nonparanoid schizophrenia patients, yet their depressive profiles and levels of anhedonia were similar. CONCLUSIONS: Depressed mood and anhedonia constitute serious problems for schizophrenia patients, but particularly for paranoid schizophrenia patients during the postpsychotic phase of their illnesses. CLINICAL IMPLICATIONS: Schizophrenia patients, especially those with the paranoid features, should be routinely evaluated and monitored for depression. Apart from treatment with drugs, cognitive therapy may be considered a viable option, particularly for paranoid schizophrenia patients. LIMITATIONS: Gender was not matched for the two schizophrenia groups and extrapyramidal side effects were not measured.
Verbal interactive behavior of 10 male patients diagnosed as schizophrenic, but not acutely psychotic, and of their non-schizophrenic ('normal') and non-informed dialogue-partners are studied in dialogical conversations about political problems. A control group of ten dyads of 'normal' dialogue partners is used for comparisons. Quantitative text-properties (number of words, pauses) as well as a reconstructive hermeneutic analysis of the dialogues reveal a lack of dialogical balance, less task-oriented productivity, and markedly more strained conversation in dyads with a schizophrenic conversand as compared to those of the control group. The schizophrenic conversands we have studied manifest various interactive strategies of withdrawing from active participation in the conversational task, delegating it instead to their respective 'normal' partners who in turn attempt to stimulate more active participation of them. Furthermore, occasional strange utterances occur in nearly all dyads with a schizophrenic and lead to disturbances in the flow of the conversation. We interpret these findings as manifestations of object-relations disturbances and of corresponding deviant modes of regulating personal distance in schizophrenics.
Schizophrenia-like symptoms have been experimentally produced in humans by a single, large dose of amphetamine or by relatively low level, but continuous administration of the drug. In animal studies of the psychotomimetic properties of amphetamine, high doses and, in particular, repeated daily-injection drug schedules have often been used. However, amphetamine psychosis is not always a prominent effect of repeated intake drug schedules in humans and available clinical evidence suggests that psychosis develops more readily when the drug is taken in a continuous fashion over longer periods. The state produced by single large doses of amphetamine, although clearly abnormal, has been said to bear less resemblance to schizophrenia than the delayed paranoid symptoms developing after longer periods of continuous intake. In the present experiments we have studied the behavioral effects of 7 to 14 days of continuous administration of amphetamine to monkeys (Cercopithecus aethiops) using subcutaneously implanted silicone capsules releasing approximately .7 to 1.5 mg/kg/day of d-amphetamine base. Around-the-clock TV monitoring of the animals revealed a general biphasic sequence of drug effects, although considerable individual variation occurred: a) an "acute" phase dominated by stereotyped movements and/or prolonged staring, lasting for 2 to 5 days; b) a "late" phase peaking during days 5 to 10 after capsule implantation and characterized by highly individual, but striking sequences of: (1) Attack or sudden threat reactions directed at invisible objects; (2) rapid orienting and flight behavior without apparent cause; (3) sudden startle reactions; (4) prolonged vocalization; (5) visual tracking of invisible objects, sometimes involving coordinated patterns of "eating behavior" and (6) prolonged and rapid grooming directed at various parts of the body. These behaviors might be termed "hallucinatory" since no eliciting stimuli could be determined for their occurrence. Motor disturbances, including whole-body shakes, were often present at the same time. The animals were generally sleepless throughout the drug treatment period. Reimplantation of amphetamine capsules 2 to 8 months after the first capsule treatment produced the same effects in an individual-specific manner, but the "late phase" behaviors generally appeared sooner. The delayed occurrence of apparent hallucinatory behaviors and other abnormal "late" phase behaviors in the present experiment may be a close parallel to the delayed development of psychosis in humans induced by a similar drug regimen. Furthermore, the hallucinogenic nature of the late amphetamine state is consonant with other reports in the literature that hallucinogen-characteristic behaviors are present at this time.
The published Rorschach (Kaiser, 1970) of Sirhan Sirhan, the man who assassinated presidential aspirant Robert F. Kennedy in 1968, was studied. Psychostructural and psychodynamic analyses were conducted using reliable and valid methodology that was unavailable at the time of examination. In contrast to the defense experts at trial who diagnosed paranoid schizophrenia, the data suggest a depressed and suicidal individual organized at a borderline level of personality. Character pathology is hysterical, paranoid, and dependent. When the Rorschach findings are compared to the development history of Sirhan and the behavior around the time of the assassination, the data are somewhat consistent with the theme of psychic trauma, are very consistent with the theme of recurrent loss and pathological mourning, and validate a characterological distrust and hatred of, yet hysterical dependence on, the object world. Rorschach indices of predatory violence (Meloy, 1988a) in relation to the planned and purposeful assassination are also discussed.
OBJECTIVE: The study sought to identify basic clinical symptoms of violent inpatients and to determine the relationship between these symptoms and two outcome measures: whether violence was persistent or transient, and length of stay on a secure care unit designed to control violent behavior. METHODS: Thirty-eight patients consecutively admitted to the secure care unit were assessed using a quantified neurological scale, the Brief Psychiatric Rating Scale, and a modified version of the Social Participation Rating Scale, which measured participation in unit activities. Because there was considerable overlap among these clinical measures, factor analysis was applied to isolate underlying clinical factors. RESULTS: Factor analysis consistently identified two independent factors at different time points. The first factor, which consisted of various psychiatric symptoms and behavioral abnormalities, was indicative of general impairment. The second factor was bipolar, reflecting a positive association with neurological impairment and a negative association with paranoid symptoms. A differential association between these two factors and the outcome variables was found. Length of stay, a measure of perceived dangerousness, was best predicted by the general impairment factor, whereas persistent violence was predicted primarily by the bipolar factor. CONCLUSIONS: The data confirmed an association between persistent violence and neurological impairment. The study underscores the need for differential treatment of violent behavior in psychiatric inpatients, as different psychopathological processes might be involved.
PURPOSE: We systematically measured the associations between environmental design features of nursing home special care units and the incidence of aggression, agitation, social withdrawal, depression, and psychotic problems among persons living there who have Alzheimer's disease or a related disorder. DESIGN AND METHODS: We developed and tested a model of critical health-related environmental design features in settings for people with Alzheimer's disease. We used hierarchical linear modeling statistical techniques to assess associations between seven environmental design features and behavioral health measures for 427 residents in 15 special care units. Behavioral health measures included the Cohen-Mansfield physical agitation, verbal agitation, and aggressive behavior scales, the Multidimensional Observation Scale for Elderly Subjects depression and social withdrawal scales, and BEHAVE-AD (psychotic symptom list) misidentification and paranoid delusions scales. Statistical controls were included for the influence of, among others, cognitive status, need for assistance with activities of daily living, prescription drug use, amount of Alzheimer's staff training, and staff-to-resident ratio. Although hierarchical linear modeling minimizes the risk of Type II-false positive-error, this exploratory study also pays special attention to avoiding Type I error-the failure to recognize possible relationships between behavioral health characteristics and independent variables. RESULTS: We found associations between each behavioral health measure and particular environmental design features, as well as between behavioral health measures and both resident and nonenvironmental facility variables. IMPLICATIONS: This research demonstrates the potential that environment has for contributing to the improvement of Alzheimer's symptoms. A balanced combination of pharmacologic, behavioral, and environmental approaches is likely to be most effective in improving the health, behavior, and quality of life of people with Alzheimer's disease.