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The molding of personality: a newborn's innate characteristics in interaction with parents' personalities.

This report describes a girl who was studied by means of the Brazelton Neonatal Behavioral Assessment Scale from her 1st until her 28th day of life, observed at the age of 1 year, and, at the age of 1 1/2 years, was seen in a psychiatric family interview. The examinational data and history (obtained from the parents) present a picture of deviant development with exceptionally low orientation responsiveness and high excitability from the first hours of life. Carmel showed little ability to quiet herself and little response to soothing attempts. Motor development was normal throughout, physical health and growth were satisfactory, and intellectual development (assessed on the Vineland scale) was average. Carmel's continuous, inconsolable crying and lack of responsiveness led to a family adjustment with the passive, somewhat disorganized mother moving into the background and the anxious father taking over. He developed a way of keeping activity. This physical stimulation, coupled with overprotection (the father's tendency to interpose himself between the girl and other people) as well as controlling all frustration, resulted in a precarious balance at the price of Carmel's reduced autonomy, delay in adaptive ego functions, and severe stranger anxiety. The case illustrates the interaction between innate characteristics and parental attitudes, and the need for preventive counseling based on understanding a child's idiosyncratic behavior patterns.

Anesthesia, Obstetrical↗

[Personal biography in the aging process and attitude to personal biography in social work with the elderly].

In old age, individualization processes also simultaneously effect the opportunity and necessity to shape one's life. Societal orientation dissipates, and the certainties of earlier times disappear. Plurality and option appear as an increasing twofold challenge to coping with life. These ambiguities characterize modern old age. Or in other words: the biographization of old age has begun. Against this background, the orientation to biography in social work with the elderly is redefined as the reflective handling of the various selfthematizations, which arise, in order to again gain security in unclear circumstances and to reposition oneself. Implied in this, too, is that the orientation to biography requires an scientific foundation and that the naive treatment of narrative life-history in the past is to be overcome.

Adaptation, Psychological↗

[Evaluation of the attitude towards disabled persons of 3rd and 4th year medical students using the "Attitude towards disabled persons" questionnaire. Effect of courses and rotations in physical medicine and rehabilitation departments].

UNLABELLED: Modifications of the medical curriculum have included a compulsory course on disability. OBJECTIVE: To determine whether attendance in a course on disability and/or rotations in physical medicine and rehabilitation departments modify the attitude of medical students towards disabled people. METHODS: All third- and fourth-year students completed a translated version of the ATDPb. This questionnaire rates items evaluating attitude towards disabled people on a 6-point scale (minimum 0; maximum 180). Retro-translation was performed to control the translation. During the second year, all students had attended a general course in ethics. Fourth-year students had attended a 17 hours course on disability, and 21 of 78 had spent 9 weeks in the physical medicine and rehabilitation department. The study compares fourth-year students to third-year students, considered as controls, and students having spent a rotation in the physical medicine and rehabilitation department to others. RESULTS: The mean score of all students was 108.86+/-15.84 (73-160) on the ATDP scale. Males and females did not differ significantly, and the score did not change from that before the course on disability (109.95+/-14.98 vs 107.6+/-16.65, P=0.23) nor after a rotation in the physical medicine and rehabilitation department (113.52+/-11.42 vs 108.54+/-16.03, P=0.14). CONCLUSION: Development and validation of scores that would fit better to the European cultural context would be useful. The present method of theoretical courses and rotations do not improve the attitude of students towards disabled people and should be modified if this objective is to be achieved.

Attitude to Health↗

Dialectical behavior therapy in the treatment of persons with borderline personality disorder.

Highly suicidal, borderline patients are difficult to treat within the hospital and the community. The institution of managed care necessitates that care for these and other chronically hospitalized populations take place in the community. Psychotherapy has shown moderate success for some borderlines, however, treatment attrition is a significant problem. Without an intervention that successfully maintains suicidal borderline patients in therapy, either more costly methods of treatment must be used or death will result. A form of cognitive-behavioral therapy called dialectical behavior therapy has shown a high rate of effectiveness in reducing inpatient hospital days, suicide attempt frequency, and therapy attrition.

Borderline Personality Disorder↗