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[Adaptation mechanisms--complementary thoughts and clinical contribution].
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Social systems and psychiatry.
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[Clinical picture of "difficult" adolescents].
Some data of a comprehensive clinico-psychological, anthropological, neurological and neurophysiological study of 150 adolescents--75 "difficult ones" and 75 in the control group are presented. There were 3 main clinico-psychopathological variants of disturbed behaviour; with a prevalence of instability, affective explosiveness and desinhibition of drives. It was possible to demonstrate their pathogenetical connections with some biological traits (abnormal sexual maturation, insufficiency of the nervous system, mainly of an organic character) and environmental factors, which to a certain extent were specific for each of these variants.
[Non-psychotic mental disorders in adolescents. Problems of hospitalization and diagnosis in follow-up studies (author's transl)].
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[The allocation of maladjusted adolescents from one administrative area within the range of specialized institutions: differential care (author's transl)].
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In search of effective programs to address students' emotional distress and behavioral problems. Part I: Defining the problem.
This article discusses the prevalence and seriousness of emotional difficulties and behavioral problems in students, with a special focus on high school students and the obstacles they encounter when addressing these problems. The educational, psychological, and medical literature which addressed the problem over the past five years was evaluated, and 22 references were selected. It was determined that the lack of consensus on the terms used to describe the problem prevented accurate assessment of its prevalence. However, one fifth to one third of the students were found to be affected, leading to serious educational, psychosocial, and economic difficulties--and more are likely to be affected in the 1990s. Since the school and mental health systems have not been entirely successful in addressing the problem, adolescents' patterns of seeking help indicate that peer support groups can be part of the solution. It was concluded that the enormity of the problem requires a low-cost gate-keeping mechanism to facilitate early identification and intervention. Thus, school peer-support programs, if proven effective, may complement traditional mental health services in addressing adolescents' emotional distress and behavioral problems.
Social psychiatry in Israel.
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Beyond treatment acceptability: a comment.
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Benefit-cost analysis of community residential versus institutional services for adults with severe mental retardation and challenging behaviors.
A benefit-cost analysis was conducted to compare services in community residences versus an institution for 11 individuals with severe mental retardation and challenging behaviors who had been moved from an institution to a community setting. Effects that were not readily quantifiable in economic terms also were examined. Overall, the community-based program costs represented slight public savings over costs of the state institution. However, community living netted significant increases in variables such as resident's social networks, opportunities for integrated activities, and income.
[Nursing practice--so many walk on the wild side].
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[Relations between social defense and criminological trends from the 1930s until today].
This study is intended to analyze the historical evolution of criminological schools, in the background, wider and more articulated, of a research by the National Council for Scientific Research directed to probing the outlines of the social defence concept. The work, then, proceeds in the field of criminology and, more particularly, of the evolution of criminological currents which, without defining aims, we will name classical to tell them from the original criminology, of positivistic imprint, and from the new criminology of critical, radical or marxist inspiration, whose examination in entrusted to another research unit. The method followed was that of the historical research with reference to the selected period and with a constant relation, in text and notes, to the enunciations of the examined Authors, considered essential. For such purpose, that is to say for more accuracy in references, it was considered convenient to have the text followed, not only by an ample bibliographical index, but also by an appendix of texts considered particularly significant in the documentation field.
Special care units for persons with dementia: expected and observed effects on behavioral symptoms.
Behavioral symptoms are common in nursing home residents with dementia, and have negative consequences for the residents, their families, staff members, and nondemented residents who live in close proximity to them. Special care units are intended to provide appropriate environments and methods of care that in turn are expected to reduce the incidence of behavioral symptoms. Studies of the effectiveness of special care units in reducing behavioral symptoms have had contradictory findings. Further research is needed to identify the particular environments and methods of care that are effective in reducing specific behavioral symptoms in these residents.
Culture-fair behavioral symptom differential assessment and intervention in dementing illness.
Ethnically diverse populations are not represented in the dementia-related noncognitive behavioral symptom research arena. Some of the obstacles are structural, centering around the lack of inclusion of ethnic minority groups within existing projects. These impediments are surmountable by the systematic targeting and incorporation of ethically diverse populations in research and the deployment of a variety of research-related outreach approaches. The more formidable barriers are conceptual. They relate to the need to differentiate cultural factors from socioeconomic and social status (SES) artifacts and to include life-long exposure to various forms of prejudice and discrimination, all of which can come together in the late-life manifestation of behavioral symptoms. A culture-fair behavioral assessment and intervention model is presented. It allows researcher and clinician alike access to ethnocultural data, while differentiating SES influences. A comparative Hispanic/Anglo dementia caregiver pilot study has provided a partial test of the model with statistically significant outcomes. Two-tailed t tests (p < or = 0.05) uncovered ethnic group differences with respect to four specific dimensions of caregiving. The differences were demonstrated around reactivity to caregiving burden, caregiver health status, coping and helpseeking styles, and configuration of social support received from social network members. Further multiple regression analysis sustained the observed differences despite income, education, and mean age variance between the two ethnic groups. The model has an overall multicultural applied intent. More study is indicated.
[Treatment with psychotropic drugs in various facilities for mentally handicapped patients].
798 mentally retarded adults (> 19 years) in different types of residential care were studied with regard to psychotropic drug treatment and associated behaviour problems. The frequency of psychotropic medication amounts to 11.2% for residents of community-based group homes, 31.4% for residents of large institutions and 74.6% for long-term care patients of a Psychiatric Clinic. Neuroleptics were the most often prescribed drugs. After controlling for the degree of mental retardation, it could be shown that for persons with behaviour problems the probability of psychotropic drug treatment was 3 times as high in the group homes, and 5.7 times as high in the large institutions, as for the corresponding groups without behaviour problems.
The coming crisis of public health in the suburbs.
A process of urban decay, coupled with forced displacement and behavioral problems, affecting an increasing number of neighborhoods in large U.S. cities. The resulting social disintegration has intensified a nexus of deviant behaviors and conditions, including substance abuse, that are related to transmission of HIV and resurgence of other contagious diseases. These diseases will diffuse, or are already diffusing, along the transportation hierarchy from larger into smaller central cities, and radially from the central cities into the surrounding areas. A widespread program of urban reform is a critical precondition for the control of contagious disease in the United States. It also is important for housing, social services, housing-related public services, and public health across urban and suburban jurisdictions.
Fluoxetine-related indifference and akathisia. A case report.
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