[Behavior disorders and EEG alterations in children].
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Many authors have shown that adolescent breakdown is often associated with emotional deprivation in childhood. Psychotherapeutic intervention before the personality becomes too fixed and rigid should offer a means of improvement through the creation of substitute empathetic relationships, and prognosis should be improved to the extent to which this is successful. This hypothesis is tested through a follow-up study involving 100 adolescents, and the hypothesis is found proved in the diagnostic category of adolescent personality disorder, but of no apparent relevance in other groups.
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We studied the relationship of dispositional and process variables with outcome in 52 bereaved patients given time-limited dynamic psychotherapy. Outcomes were generally favorable in symptom relief and improvement in relationship and occupational functioning. Patients' symptoms improved more than did their social and work functioning. Pretreatment levels of impairment or distress were significantly related to outcome, but most demographic and dispositional variables did not predict outcome. Process variables examined in relation to outcome--therapeutic alliance and actions by the therapist--were not significantly related to either type of outcome. When we considered the same process variables in interaction with two dispositional variables, motivation for dynamic therapy and developmental level of the self-concept, we found significant predictions of outcome. The major findings suggest that more exploratory actions were more suitable for highly motivated and/or better-organized patients and less suitable for patients with lower levels of motivation or organization of self-concept. More supportive actions were more suitable for patients at lower dispositional levels and less therapeutic for patients at higher levels.
Investigated the personality profiles (MMPI) of 44 adolescents with progressive (Duchenne Muscular Dystrophy) and nonprogressive (mixed orthopedic) physical impairment to determine the relationship among personality correlates, disability type, functional level of impairment, and rapidity of decline in those with progressive disease. Both groups of males evidenced many similarities to severe physical limitations regardless of diagnosis or progression of their physical status. Common personality characteristics of increasing social inhibition, passiveness, and depression were identified as a response to the realities imposed on mobility and lifestyle. Little evidence was presented that supported clear and linear relationships between physical impairment and adjustment status as reflected by MMPI endorsement. Rapidity of decline in physical status in the progressive group was associated with increased report of social withdrawal and a constellation of behaviors suggestive of increased stress. Methodological problems in studying adjustment status in multihandicapped-heterogeneous disabilities were discussed.
Despite the fact that the prevalence rate for insomnia in the United States is high (35.2%), the number of patients with this condition do not represent a large percentage of patients evaluated and treated in sleep disorders clinics. On the other hand, the great majority of patients with insomnia do not seek treatment for their condition from their physicians. Several hypotheses have been created to explain this phenomenon: (1) lack of training for physicians in the area of sleep disorders, (2) pessimism in relation to treatment outcome shared by patients and physicians, and (3) time constraints and other reasons on the part of the physicians. Insomniacs, however, deserve accurate diagnosis and effective treatments for their condition. Insomnia is often the result of multiple factors converging rather than one single cause. For academic purposes, however, different disorders in difficulties with initiation and maintenance of sleep are discussed. Among them, adjustment sleep disorder, obstructive sleep apnea, periodic limb movements in sleep, circadian abnormalities, and psychiatric disturbances. Emphasis is placed on the treatment of each, along with the treatment of the other factors that are commonly found in patients with insomnia: poor sleep hygiene, use of medications that disrupt sleep, performance anxiety, deficient exposure to entrainers of circadian rhythms, diet, and exercise. A comprehensive treatment that includes a multifactorial approach is the ideal way to treat patients with insomnia. Research that will enhance our knowledge of the biological substrate of insomnia will provide clinicians with additional tools to improve the outcome of their treatments of patients with insomnia.
Long-term reactive conditions in 100 patients with traumatic cerebral lesions were studied. On the basis of the disease course, the patients were divided into two groups. In 55 cases, psychogenic disorders developed into neuroses, the latter transforming over years into neurosis-like symptomatology, with the growing frequency of vegetative and liquorodynamic impairments and also with increased asthenia. In the case of psychoses development, there was a tendency toward the alleviation of the acuity of every subsequent reactive condition. Such disorders as acute reactive psychoses, reactive depression, delirium-like fantasies showed a progressive tendency to decline, while there was an increase in the incidence of pseudodementia, reactive paranoid and verbal hallucinosis. Conditions contributing to the development of individual types of psychoses are reviewed.
OBJECTIVE: To describe the prevalence of suicide attempts and suicidal ideation in a birth cohort of New Zealand children studied to the age of 16 years; to examine the extent to which risks of suicide attempts and suicidal ideation varied with levels of adolescent psychopathology, problems of adjustment, and exposure to adverse conditions during childhood; and to examine the extent to which those attempting suicide could be distinguished from those reporting suicidal ideation alone. METHOD: Data were gathered on suicide attempts, suicidal ideation, psychiatric diagnoses, adjustment problems, and childhood factors during the course of a 16-year longitudinal study of a birth cohort of New Zealand children. RESULTS: Twelve percent of this cohort reported suicidal ideation before the age of 16 years and 3% attempted suicide. The extent to which young people expressed suicidal tendencies varied with the extent to which the young person met criteria for psychiatric disorder, the extent of adjustment problems, and the extent to which the young person had been exposed to adverse family circumstances. Those attempting suicide were distinguished from those reporting suicidal ideation by having significantly higher rates of psychopathology (p < .05), higher rates of adjustment problems (p < .005), and greater exposure to childhood and family adversity (p < .05). CONCLUSION: The results of this analysis were consistent with a dimensional model of suicidal behaviors in which those attempting suicide are distinguished from those reporting suicidal ideation alone by having a greater burden of psychosocial risk factors including psychiatric disorder, adjustment problems, and adverse childhood circumstances.
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This is a comparative clinico-epidemiological++ investigation of the rate and syndrome structure of psychopathologic states in a mobile population in a new region, and in a stable population. Investigated were also the migrational attitudes in the mobile population. Individuals with borderline psychopathology, slow-progredient mental diseases and subjects predisposed to these disorders displayed an active involvement into migration flow. Psychopathologic syndromes were detected which accumulated into the mobile population and those related with elimination from this population. The role of disadaptation of environmental impact and of the peculiarities of counter++-flow in the mobile population mental health were analysed.
The main purpose of this study was to investigate the relationship of the Beck Hopelessness Scale (BHS) with suicidal behavior and other clinical variables in 212 hospitalized suicide attempters. Another purpose was to analyze the usefulness of BHS in this particular context. Those who later committed suicide (N = 13) had significantly higher median scores than those who did not. Even though the median BHS score for the total population was above the cut-off score for future suicide risk, suggested by Beck et al., the relative ratio of correctly positive/false positive was low. Therefore the BHS does not seem to be a satisfactory instrument for predicting future suicide in hospitalized suicide attempters. Our findings rather suggest that the BHS is related to depression ratings, mood disorders and/or personality disorders.