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We report a case of an 18 year old female Turkish patient, who was suffering from psychogenic seizures. The family did not accept the disease, prohibited treatment by a medical doctor, preferred to bring her to a Hoca. She was maltreated by her father und sexually abused at the age of eight years by her brother. In this article we describe the problems of a psychiatric ill female patient within a family of Turkish origin.
Report on a 40-year-old man, born of a father-daughter union, with Werner's syndrome.
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A 3-yr-old female patient exhibited interleukin 12 (IL-12) deficiency that was associated with recurrent episodes of pneumococcal pneumonia with sepsis and other infections in the absence of fevers. The patient's peripheral blood mononuclear cells (PBMCs) exhibited normal proliferative responses to antigens. Immune responses, including in vivo production of antibodies to diphtheria, tetanus, or pneumococcal antigens, were normal. Ig levels and B cell and T cell phenotypes were also normal. In contrast, IL-12 p70 heterodimer production was undetectable by using supernatants of the patient's stimulated PBMCs when compared with control cells treated similarly. Although present, interferon gamma (IFN-gamma) was reduced. The addition of recombinant IFN-gamma to control cells enhanced the production of IL-12 by up to sixfold. By contrast, IL-12 was undetectable in supernatants of the patient's cells in the presence of recombinant IFN-gamma. IL-12 p40 subunit mRNA by using the patient's PBMCs after stimulation with Staphylococcus aureus Cowan strain 1 or lipopolysaccharide was also undetectable by reverse transcription-PCR when compared with control cells. Production of IL-2, IL-6, tumor necrosis factor alpha, or IFN-gamma of the patient's PBMCs after appropriate stimulation was observed. This patient has either a defect in Staphylococcus aureus Cowan strain 1-lipopolysaccharide- or staphylococcal enterotoxin A-induced signaling pathways for the activation of IL-12 p40 gene expression, or an abnormality in the IL-12 p40 gene itself.
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Memories of early child abuse can be read in at least two distinct ways--as true accounts of an unspeakable event or as metaphors for a wide range of boundary violations which belong to both past and present. An actual memory of an early experience tends to fade unless repeatedly rehearsed; because abuse memories are inherently shameful, it seems reasonable to be skeptical of this kind of repetition and to be suspicious of their sudden emergence. An actual memory of an early experience would be told from the child's point of view and would probably contain many false starts, internal contradictions, and all the other earmarks of a confused memory that refer to an early happening; by contrast, a seamless account with a tight narrative structure and an almost total absence of doubt or irrelevant detail is almost certainly false. An actual memory would tend to have its own flavor and style; by contrast, a memory of child abuse that sounds too much like other memories is more likely a metaphor for something else. Therapists, lawyers, and other professionals need to be trained to listen metaphorically to these accounts, to be on guard against hearing them as concrete references to a particular time and place, and to beware of reinforcing them prematurely.
A subset of the psychotherapists practicing trauma-focused therapy predicate their treatment on the existence of a newly claimed, powerful form of repression that differs from repression as used in the psychoanalytic tradition and from amnesia in any of its recognized forms. Recovered-memory specialists assist patients to supposedly retrieve vast quantities of information (e.g., utterly new dramatic life histories) that were allegedly unavailable to consciousness for years or decades. We refer to the hypothesized mental mechanism as "robust repression" and call attention to the absence of evidence documenting its validity and to the differences between it and other mental mechanisms and memory features. No recovered-memory practitioner has ever published a full specification of the attributes of this mechanism. That is, the properties it would have to have for the narratives developed during therapy to be historically accurate to any significant degree. This article reports a specification of the properties of the robust repression mechanism based on interviews with current and former patients, practitioners' writings, and reports to researchers and clinicians. The spread of reliance on the robust repression mechanism over the past 20 years through portions of the clinical community is traced. While involved in therapy, patients of recovered-memory practitioners come to believe that they have either instantly repressed large numbers of discrete events or simultaneously repressed all information about abuse they may have endured for as long as a decade.(ABSTRACT TRUNCATED AT 250 WORDS)
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Although there is a general consensus among concerned professionals that exposure to community violence is likely to be stressful and may contribute significantly to immediate and long-term mental health problems, there is virtually no empirical research on either its acute or enduring effects. In the absence of data, investigators planning research in this area must look to other studies of the impact of chronic environmental trauma on children, including the effects of war and child maltreatment. Research on child abuse provides an important source of information on the effects of trauma on children because it draws on both prospective and retrospective studies crossing a variety of theoretical perspectives and disciplines. The existence of data on both the acute impact of abuse on children and its chronic effects and outcomes in adults informs the generation of developmentally based psychological and biological hypotheses. This paper utilizes data from research on the acute and chronic effects of sexual abuse to discuss three broad hypotheses that may be relevant to the study of the effects of community violence on children.
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The Beck Depression Inventory was used to assess depressive symptoms in 178 sexual assault survivors and 50 control subjects who had never been sexually assaulted. The sexual assault survivors reported significantly more depressive symptoms than the control subjects, and further analyses strongly suggested that the depressive symptoms were caused by the sexual assault. Investigation of the relationships between depression scores and survivor and assault characteristics indicates that the nonspecifics of the assault and the use of a weapon by the assailant were most highly correlated with development of depressive symptoms.
Individuals and couples often have a desire to increase their sexuality even in the face of severe past physical and sexual trauma. Requirements for effective therapy include the establishment of a safe environment, cooperation of a partner to allow the patient to be in control, and an exploration of past sexual abuse to avoid recapitulation that may trigger flashbacks or dissociative episodes. It is also helpful if permission is given to a sexualized ego fragment to become more assertive and help the patient reconcile sexuality as ego-syntonic. The partner needs to develop ability to bring the patient back to the present when dissociating. Clinical examples demonstrate these concepts.
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