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PubMed1993

[Psychopathology in nunneries].

The psychiatric observations of female adepts and nuns of Christian monastic congregations, seen as in- or outpatients of a mental hospital of an order, are reported, mainly focussing on schizophrenic and schizophreniform psychoses and severe personality disorders. The patient statistics and sketches of psychopathology and the dynamics of the disorders are presented. The selection process for adepts for the monastic profession and the need for education of the responsible leaders in psychological, psychotherapeutic and psychiatric issues are considered.

Borderline Personality Disorder↗
PubMed1997

[The psychopathological differentiation of pathological body sensations].

The special group termed as "somatic fantasies" (SF) was distinguished among pathological somatic sensations of heteronomous character. Psychopathological structure of SF differed from senestopathias in some signs: objectiveness--the sensation achieved the level of the real perception of physical phenomena and objects; formal-geometrical organisation--the possibility of their parametric estimation (in form, volume, size, etc.); space location--the clear correlation of feelings with certain organ or physiological process; dynamic characteristics-- variability, mobility. The description of somatic sensations was characterized by allegory image as well as by metaphorical, affective saturation as compared with senestopathias. SF were observed in patients with borderline mental disorders in accordance with the 1CD-10 diagnostical headings: schizotypic disorder (F21), anxious phobic disorders (F40, F41), dissociative disturbances (F44), somatoform disorders (F45). 19 patients (6 males, 11 females; mean age 32.6 years) formed the group examined. Two variations of SF were recognized which correlated with hysterical or schizotypic disorders of personality.

Adult↗
PubMed1993

Language in differential diagnosis of a teenage schizophrenic girl with aspects of multiple personality.

Diagnosis of a teenage schizophrenic girl showed many features of her language and behavior mimicked the presentation of a Dissociative Personality Disorder. These aspects were secondary to the primary schizophrenic disorder and treated via a multimodal approach combining pharmacotherapy, individual, family, and milieu therapy. Implications are drawn for tailoring verbal interventions to such overdetermined conditions.

Adolescent↗
PubMed2006

Selective preservation of memory for people in the context of semantic memory disorder: patterns of association and dissociation.

A number of single cases in the literature demonstrate that person-specific semantic knowledge can be selectively impaired after acquired brain damage compared with that of object categories. However, there has been little unequivocal evidence for the reverse dissociation, selective preservation of person-specific semantic knowledge. Recently, three case studies have been published which provide support for the claim that such knowledge can be selectively preserved [Kay, J., & Hanley, J. R. (2002). Preservation of memory for people in semantic memory disorder: Further category-specific semantic dissociation. Cognitive Neuropsychology, 19, 113-134; Lyons, F., Hanley, J. R., & Kay, J. (2002). Anomia for common names and geographical names with preserved retrieval of names of people: A semantic memory disorder. Cortex, 38, 23-35; Thompson, S. A, Graham, K. S., Williams, G., Patterson, K., Kapur, N., & Hodges, J. R. (2004). Dissociating person-specific from general semantic knowledge: Roles of the left and right temporal lobes. Neuropsychologia, 42, 359-370]. In this paper, we supply further evidence from a series of 18 patients with acquired language disorder. Of this set, a number were observed to be impaired on tests of semantic association and word-picture matching using names of object categories (e.g. objects, animals and foods), but preserved on similar tests using names of famous people. Careful methodology was applied to match object and person-specific categories for item difficulty. The study also examined whether preservation of person-specific semantic knowledge was associated with preservation of knowledge of 'biological categories' such as fruit and vegetables and animals, or with preservation of 'token' knowledge of singular categories such as countries. The findings are discussed in the context of a variety of accounts that examine whether semantic memory has a categorical structure.

Adult↗
PubMedDate not supplied

Advances in the diagnosis and treatment of children with serious mental illness.

As a nation, we are becoming aware that a significant number of children develop severe neuropsychiatric disorders. Unfortunately, knowledge of DSM-IV criteria does not always help the child and family social worker identify children with these disorders. Early onset schizophrenia, bipolar disorders, and severe depression can cause child behaviors that differ markedly from symptoms manifested by adults with serious mental illness. This article provides specific information for screening and treating children who develop long-term neuropsychiatric disorders.

Adolescent↗
PubMed1993

Characteristics of a child inpatient population with hysteria in India.

OBJECTIVE: This study examined the rate, correlates, and clinical outcome of childhood hysteria in a sample of inpatients in India. For comparison, the rate of this disorder among outpatients was computed. METHOD: Data were derived from case records of inpatient (n = 143) and outpatient admissions (n = 640) during a 1-year interval at the Child and Adolescent Psychiatry Unit of the National Institute of Mental Health and Neurosciences, Bangalore, South India. RESULTS: The diagnosis of hysteria was made in 30.8% (n = 44) of the inpatient and 14.8% (n = 95) of the outpatient samples. The inpatients with hysteria were mostly postpubertal, their gender distribution was approximately even, and pseudo-seizure was the most frequent presentation. These inpatients had a brief duration of illness at admission and short-term outcome was generally positive. CONCLUSIONS: Children with hysterical symptoms form a notable proportion of cases in child guidance and psychiatry clinics in India. It could be that, in this culture, having a "medical" illness is one of the more acceptable means of seeking psychiatric help. The use of a structured and intensive inpatient treatment package appeared to bring about rapid symptom remission. Some of the present findings could be the basis to explore subtypes of childhood hysteria.

Adolescent↗
PubMed2001

Effects of gender and ethnicity on duty-related posttraumatic stress symptoms among urban police officers.

We studied 655 urban police officers (21% female, 48% white, 24% black, and 28% Hispanic) to assess ethnic and gender differences in duty-related symptoms of posttraumatic stress disorder (PTSD). We obtained self-report measures of: a) PTSD symptoms, b) peritraumatic dissociation, c) exposure to duty-related critical incidents, d) general psychiatric symptoms, e) response bias due to social desirability, and f) demographic variables. We found that self-identified Hispanic-American officers evidenced greater PTSD symptoms than both self-identified European-American and self-identified African-American officers. These effects were small in size but they persisted even after controlling for differences in other relevant variables. Contrary to expectation, we found no gender differences in PTSD symptoms. Our findings are of note because: a) they replicate a previous finding of greater PTSD among Hispanic-American military personnel and b) they fail to replicate the well-established finding of greater PTSD symptoms among civilian women.

Adult↗
PubMed2005

Children's adjustment 15 years after daycare abuse.

This follow-up study of 42 children abused in daycare suggests that even very small children confirm through their behavior and/or language that something distressing happened to them. Interviews with parents 15 years after the abuse suggest there are periods when children's recollection is persistent as well as times when it is unclear how much the child remembers. Results showed after 15 years, 40% of the children had made a satisfactory adjustment, 40% had made a marginal adjustment, and 20% had made a problematic adjustment.

Acting Out↗
PubMed2005

From mimesis to agency: clinical steps in the work of psychic two-ness.

In this paper, through the study of the clinical process of a girl starting treatment at the age of 3 years 10 months, who was thought of as a 'dummy' by her family and who came for consultation when the assumed genetic aetiology was questioned, the authors build upon Tustin's contributions on the context of togetherness and the crisis of two-ness, and upon Eugenio and Renata Gaddini's on the precursor object. The mimetic phenomena enacted with an older brother and at the kindergarten are found to result from cumulative trauma at her contacting a loving but mind-blind mother. After an initial stage of transference autism, enactment in the session of the traumatic situation was the ?rst step in surmounting her autistic pseudo-stupidity. Mimetic transference dynamics took place principally at the level of the gaze, leading to the unfolding of the work of two-ness to a differentiation from the analyst as psychic breast, on the road to symbol formation and personal agency.

Autistic Disorder↗
PubMed1998

Homeostasis, stress, trauma, and adaptation. A neurodevelopmental view of childhood trauma.

All experiences change the brain, but not all experiences affect the brain equally. Because the brain is developing and organizing at such an explosive rate in the first years of life, experiences during this period have more potential to influence the brain in positive and negative ways. Traumatic events disrupt homeostasis in multiple areas of the brain that are recruited to respond to the threat. Use-dependent internalization of elements of the traumatic experience can result in the persistence of fear-related neurophysiologic patterns affecting emotional, behavioral, cognitive, and social functioning. A neurodevelopmental view of childhood trauma can help future clinical and research efforts to define and use child-specific and developmentally informed models to guide assessment, intervention, education, therapeutics, and policy.

Adaptation, Psychological↗
PubMed1999

Deconstructing DID.

The author contends that a psychoanalytically informed approach to the patient with dissociative identity disorder (DID) can be very useful. However, there are difficulties in conceptualizing this condition without extending existing theory or applying in new ways what is already known. It is also difficult to put DID in a proper context relative to all the other disorders known to occur in the human mind. Depending on one's clinical experience, level of skepticism, and appreciation of history, DID may be seen as either: a) the psychological "missing link" that realizes Freud's goal of uniting the psychology of dreams with psychopathology, or b) a fraudulent condition that is wittingly or unwittingly manufactured in the therapist's office or c) a population of disturbed and disturbing patients, once the subject of great scientific interest, which, exiled like a "Lost Tribe," is now back in the fold of legitimacy. The author has had extensive clinical experience with psychic trauma, and bases his own views of DID on three assumptions: 1. that dissociation may be seen as a complex defense; 2. that DID may be thought of as a "lower level dissociative character"; and 3. that there is a unique psychic structure, the "dissociative self" whose function is to create "alter personalities" out of disowned affects, memories, fantasies, and drives. This "dissociative self" must be dissolved in order for integration of "alter personalities" to occur. A clinical vignette is offered to illustrate how he addresses some of the challenges of developing a therapeutic alliance at this end of the dissociative-character-pathology continuum, and how he grapples with the difficulty of integrating clinical phenomena, such as the appearance of "alters," with the psychoanalytic model of the mind.

Adult↗
PubMedDate not supplied

Peritraumatic dissociation as a predictor of post-traumatic stress disorder: a critical review.

In psychiatric literature, dissociative reactions at the time of a traumatic event (i.e., peritraumatic dissociation) are considered to be risk factors for the development of post-traumatic stress disorder (PTSD). In this article, we critically review research concerned with the link between peritraumatic dissociation and PTSD. Our main point is that studies in this area heavily rely on retrospective reports of dissociative reactions during the trauma. We argue that this methodology has important limitations since people in general and PTSD patients in particular find it difficult to give accurate descriptions of past emotional states. Restrictive factors that play a role in this context have to do with forgetting, attribution, and malingering.

Dissociative Disorders↗