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Results for “Reality Testing”

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At least 595 records · Page 33Linked to original sources
PubMed2002

Being in a fragmented and isolated world: interviews with carers working with a person with a severe autistic disorder.

AIM: To illuminate the meaning of being a carer for a person with a severe autistic disorder. BACKGROUND: Carers working with people with severe autism are occasionally exposed to residents' self-injurious behaviours and violent actions and at time residents appear resistant to all forms of treatment. DESIGN/METHOD: A qualitative case study was conducted. Six Swedish carers enrolled nurses (ENs), working on a special ward in a nursing home were interviewed about their lived experiences when caring for an individual with a severe autistic disorder. Narrative interviews were conducted and interpreted using a phenomenological-hermeneutic method inspired by Paul Ricoeur. FINDINGS: Two themes were formulated which describe the carers' reality and their dream of an ideal. This ideal described carers' experiences of being trapped in a segmented and isolated care reality and their longing to achieve a sense of wholeness. The findings were interpreted and reflected on in the light of a framework inspired by the German philosopher Karl Jaspers in order to achieve a deeper understanding of the text. CONCLUSIONS: In their desperation, the carers used their empirical knowledge based on scientific knowledge, which could be understood as a substitute for their vision of a consolating wholeness. This paper shows that searching for a substitute to consolation seems to be an important aspect of the meaning of being a carer for a person with a severe autistic disorder.

Adult↗
PubMed2004

Family dynamics of postnatally depressed mothers - discrepancy between expectations and reality.

BACKGROUND: The birth of a new family member always brings changes to family dynamics. The family has to adjust to a new situation and, although the time after childbirth is happy for most families, postnatal depression affects 10-15% of mothers annually. AIMS AND OBJECTIVES: The purpose of this study was to ascertain families' experiences of family dynamics when the mother suffers from postnatal depression. DESIGN: Nine families (nine mothers, five fathers) where the mother had displayed symptoms of postnatal depression took part for the study. METHODS: Data were collected through interviews with nine families where the mother had scored 13 or more on the Edinburgh Postnatal Depression Scale, completed 6-8 weeks after childbirth. Families were offered the opportunity to volunteer for the interview while taking part in a follow-up study of postnatal depression in Finland. Interviews were analysed using the principles of grounded theory. RESULTS: The findings showed that there was great discrepancy between expectations and reality in the depressed mothers' families. Parents, especially mothers, strove for perfection, perceived the infant to tie them down and had high expectations of family life. CONCLUSIONS: Everyday family life and human relationships change, the depression and the parents' attitudes towards the infant manifest themselves in different ways, and support is of great importance. RELEVANCE TO CLINICAL PRACTICE: Women, especially those expecting their first child need a great deal of information about mood changes after childbirth and the opportunity to discuss the changes brought about by the birth of a child.

Activities of Daily Living↗
PubMed2003

[Problems in recognizing the self: a neuropsychological approach to the positive symptoms of schizophrenia].

This article present a review of recent work on cognitive neuroscience approaches of schizophrenia. Some of the symptoms displayed by schizophrenic patients can be reconsidered within the framework of disorganization of well identified cognitive functions, like self-recognition. Neuroimaging techniques can reveal in these patients disruption of neural networks normally involved in such functions.

Auditory Cortex↗
PubMed2002

Learning lessons.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1999

The biographical component of schizophrenia: a two-faced definition of relationship?

The schizophrenic's disturbed relationship with reality is generally ascribed to a mental illness of endogenous origin. Following the author's paper on a fixation disorder (1) provable in these patients, she expounds that their disturbed relationship with reality does not primarily concern their consciousness of objective reality but of their own self. As a result of contradictory definitions of relationship within his group (2,3) the schizophrenic is unable to integrate the awareness of his potentialities with the awareness of his social role. He cannot protect himself against a joker role imposed on him since his fixation disorder acts like a one-way valve impeding him from taking an active part in the definition of relationship. A hypothesis is presented as to how the schizophrenic's described fixation disorder may cause this one-way functioning of the definition of relationship.

Humans↗
PubMed2001

The loss of ego boundaries in schizophrenia: a neuromolecular hypothesis.

Virtually all genes of higher organisms have non-coding introns interspersed between the coding exons that must be spliced out in order to generate a mature messenger RNA molecule used to encode proteins. The hypothesis proposed in this paper is based on a new interpretation of molecular splicing as a primordial rejection mechanism that has evolved through time to serve as a molecular basis for other types of rejection, including rejection of thoughts and impulses in the human brain that are incompatible with environmental conditions. Psychiatrists generally explain delusions or hallucinations of schizophrenic patients in terms of 'loss of ego boundaries' or 'inner/outer confusion'. This new model proposes that the loss of the rejection function on the molecular level (non-splicing) in turn causes a loss of the boundary-setting function of glia in their interactions with the neural system. When introns are not spliced out from genes involved in neurotransmission, a variety of outcomes are possible. In some cases the production of neurotransmitters is decreased, in other cases the transmitter receptor has intron encoded sequence elements and/or premature stop codons that do not allow for proper transmitter occupancy. Because these 'chimeric' glial receptors cannot be occupied appropriately by their transmitters, the inactivating or boundary-setting function of synaptic transmission by glial cells is disturbed or lost. The inability to reject 'intronic ideas' may result in delusions and hallucinations, and could explain why schizophrenic patients are unable to test the reality of their ideas and are absolutely convinced that everything occurring in their brain is real. Finally, the concept of 'intronic ideas' from which schizophrenic patients are suffering is interpreted from an evolutionary point of view. It is proposed that many of the thoughts of schizophrenics have occurred too early in evolution and therefore cannot be realized, but in the future some of these thoughts will fit with reality as the environment changes and will no longer be considered delusions.

Ego↗
PubMed2001

[Reality and social interpretation of health].

The health profile of a human society depends upon its social development and in particular upon current social and cultural conditions. Health can be defined in many ways; both the pathogenetic and the salutogenetic approaches have their merits. Partial aspects of reality are offered for example by attempts to describe health conditions quantitatively by means of health indicators such als life expectancy, mortality, morbidity, incapacity to work, use made of medical services, and the like. The description of health must encompass the entire range of its objective and subjective experience in its somatic, mental and social dimensions. Epidemiological data must always be supplemented by the results of phenomenological observations to obtain a true picture of the experience of reality and the acceptance of the results by the group under observation.

Adolescent↗
PubMed2003

[The right of the client in geriatric psychiatry to a personal, individual world view. How can we, as caregivers, learn to share this?].

"Validation" after Naomi Feil is the name of a method which is used and recognized the world over as an appreciative way of dealing with the highly aged. Validation is based on universally valid humanist principles. A person is viewed as an individual being having a good reason for his current behavior. This is true for "still oriented" as well as for "non-oriented" persons. It is necessary to recognize and categorize the different behavioral patterns in the various phases of disorientation. Here we speak of the physical and psychological characteristics of the four phases of disorientation. The target group is persons who are just still oriented, but deny their current situation and thus react peculiaryly. The next group is the time and place disoriented persons. Subsequently the group of persons who can express themselves solely by nonverbal means, i.e. repetitive movements, follows. The last group is motionless persons who simply vegetate. In addition, there are suitable verbal and nonverbal techniques that can be used in a most sensible and appreciative way of dealing with these highly aged. The aged persons are not corrected and not oriented according to reality, but are escorted in their world. We call this: "walking in the shoes of the other person". It is necessary to take emotions seriously and to share them with others. We do not take position, we do not judge and we also do not offer hasty solutions. We are honest and do not use well-meant lies. The goal of applying validation is on the one hand the relief and improvement of the work situation of family and the people taking care of these aged persons, and on the other hand a noticeable and measurable increase of these highly aged persons welfare and quality of life.

Aged↗
PubMed1995

[In search of lost time--memory in dementia].

With the progressing loss of coherent memory the world of the demented person dissolves into a succession of fragmented and incomprehensible situations. The resulting uncertainty leads to an increased need of self-assurance: in search of familiar surroundings and personal identity, the patient escapes into his preserved memories and begins to live in his past. Reminiscence may thus become a source of continuous strain to the persons entrusted with caring for the patient; on the other hand, it may as well open avenues to a deeper understanding of the patient and his world.

Aged↗
PubMed1995

[Trans-subjective practice in schizophrenic delusions].

In schizophrenic delusion, the world of other humans is not so much the scope of events and actions; the patient rather sees himself as actually related to others, while including "the other persons" in the delusion of persecution as a crucial point of reference. Delusion, therefore, has a referential structure. When analysing the referential structure of "being persecuted", it is shown to be unilaterally transitive, the patient being, however, the ontological first reference point. The relationship to others in schizophrenic delusion cannot, however, achieve intersubjectivity; its significance is merely trans-subjective.

Communication↗
PubMed1995

[Delusions and imagination].

In this study delusion is regarded from the aspect of a phenomenology of imagination. Delusion as an experience of fictitious actualities is interpreted as the attempt of a psychotic person, to find a sense of existence in view of the threat by mental illness. After explaining the philosophical fundamentals, imagination is considered to be the dynamic origin of delusion and hallucinations. The discussion of psychopathological and clinical problems is followed by a demonstration of further phenomenological and hermeneutic approaches.

Delusions↗
PubMed2005

Brain correlates of subjective reality of physically and psychologically induced pain.

Meaningful behavior requires successful differentiation of events surfacing from one's mind from those arising from the external world. Such judgements may be especially demanding during pain because of the strong contribution from psychological factors to this experience. It is unknown how the subjective reality of pain (SRP) is constructed in the human brain, and neuronal mechanisms of the subjective reality are poorly understood in general. To address these questions, 14 suggestion-prone healthy subjects rated reality of pain that was induced either by laser pulses to the skin or by hypnotic suggestion during functional MRI. Both pain states were associated with activation of the brain's pain circuitry. During laser stimulation, the sensory parts of this circuitry were activated more strongly, and their activation strengths correlated positively with the SRP. During suggestion-induced pain, the reality estimates were lower and correlated positively with activation strengths in the rostral and perigenual anterior cingulate cortex and in the pericingulate regions of the medial prefrontal cortex; a similar trend was evident during laser-induced pain. These findings support the view that information about sensory-discriminative characteristics of pain contributes to the SRP. Differences in such information between physically and psychologically induced pain, however, could be quantitative rather than qualitative and therefore insufficient for judging the reality of pain without knowledge about the source of this information. The medial prefrontal cortex is a likely area to contribute to such source monitoring.

Adult↗
PubMed1994

Truth in memory: ramifications for psychotherapy and hypnotherapy.

In this article we address a number of issues relevant to the practice of psychotherapy and hypnotherapy: How reliable is memory? How are therapists' and clients' beliefs and expectancies related to pseudomemory formation? Are certain clients particularly vulnerable to pseudomemory creation? Does hypnosis pose special hazards for pseudomemory reports? What are the variables or factors that mediate hypnotic pseudomemories? In addition to reviewing the literature on these topics, we intend to sensitize the clinician to the potential pitfalls of critical reliance on the patient's memories, as well as uncritically accepted clinical beliefs and practices.

Fantasy↗
PubMed1996

The relationship between memory, suggestibility and hypnotic responsivity.

This study investigated the relationship between resistance to misleading information and performance on the Harvard Group Scale of Hypnotic Susceptibility (HGSHS:A), and examined the impact of obtrusive observation on subjects' hypnotic responsivity, memory, and resistance to misleading information. Eighty-five college students were administered the HGSHS:A in its standard form. Three additional bogus items were added to the HGSHS:A response booklet asking subjects to report whether they responded to suggestions that were not actually offered during the procedures. The endorsement of these items was used as an index of resistance to misleading information (suggestibility) for events occurring during hypnosis. Participants were also given a series of misleading questions related to events that occurred prior to the induction. Results indicated that performance on the HGSHS:A was not related to resistance to misleading information for events occurring during hypnosis or for events that occurred prior to the induction. As predicted, resistance to misleading information was consistent for subjects across the waking and hypnotic contexts. Also as predicted, being observed during the hypnotic procedures was related to lower scoring on the HGSHS:A.

Adolescent↗
PubMed1993

On the perception of madness.

Since the beginning of recorded history, mental illness has been recognised as being primarily in the province of the healing profession. This view has continued, despite the fact that psychiatry left the mainstream of medicine with the development of asylums during the 19th century. With the advent of deinstitutionalization however, psychiatrists, particularly in Australia, have increasingly left public practice. As a result, the treatment of the severely and chronically mentally ill, especially those with behavioural disorder, has become neglected. It is argued that moves toward the mainstreaming of acute psychiatry to general hospitals offer a new opportunity for the profession to reassert itself in this essential but difficult area of psychiatric practice.

Australia↗
PubMed1995

Does nursing theory adequately prepare psychiatric nurses to work with delusional patients?

The theory and practice of psychiatric nursing has been subjected to little serious research; consequently some nursing interventions recommended by nursing texts lack formal evaluation. This study examined one aspect of practice: the way in which nurses work with delusional patients. Registered psychiatric nurses were asked to describe the way in which they deal with patients whose delusions are a major clinical problem. The findings highlight a disparity between practice and theory.

Delusions↗