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[Psychoses and borderline cases in puberty and adolescence and their importance in criminal law (author's transl)].

Juvenile psychoses are on the whole rare, at any rate rarer than psychoses in adults. The former commonly used conception of the disease, hebephrenia, as a pubertal form of schizophrenia has largely lost its significance. The cardinal symptoms are delusions and disordered mental processes in addition to anxiety and states of excitement. The particular importance of this disease lies in the individual experience of this disturbance of the reference environment which is an existential threat to a newly formed personality and its relation to the environment. The difficulty in classifying it among the psychoses on the one hand and as a neurosis on the other has produced a term "borderline" for it, characterized by an infantile incompatibility with positive and negative tendencies in himself and in reference persons and through the lack of a stable reality of reference.

Adolescent↗

Developing Brief Versions of the Suinn­Lew Asian Self­Identity Acculturation (SL­ASIA) Scale for Counseling Research.

PURPOSE. The goal of the present article is to create two five­item brief forms of the Suinn­Lew Asian Self­Identity Acculturation Scale (SL­ASIA), compare the forms for reliability and validity, and make a recommendation as to which form is better and/or more appropriate for use. METHODOLOGY. Data from two data sets (University of Illinois and University of Washington) were used in this study. The ITC brief form (Item­Total Correlation Form) and the CFL brief form (Cross­Factor Loading Form) were created for each data set. Reliability analyses (i.e. Cronbach's alpha) were conducted for the forms in each of the two studies. Differential construct vailidity was examined by comparing each brief form to target variables in each of the data sets. PRINCIPAL FINDINGS. Reliability analyses of the SL­ASIA administered at the University of Illinois indicated that the SL­ASIA, ITC brief form, and CFL brief form were all internally consistent. The three scales were also shown to be highly correlated with each other. Differential concurrent validity was assessed by comparing the ITC and CFL forms to target variables (negative social­network orientation, individualism, and attitude toward seeking professional psychological help). It was found that both versions of the brief SL­ASIA had similar correlations to the target variables as the full scale SL­ASIA. Reliability analyses of the SL­ASIA administered at the University of Washington indicated that the SL­ASIA, ITC brief form, and CFL brief form were all internally consistent. The three scales were also shown to be highly correlated with each other. Differential constuct validity was assessed by comparing the ITC and CFL forms to target variables (counseling orientations: behavioral, client­centered, existential, gestalt, Freudian, rational­emotive, and trait factor). As with the University of Illinois data set, both versions of the brief SL­ASIA had similar correlations to the target variables as the full scale SL­ASIA in this data set, providing even further evidence of their concurrent validity. CONCLUSIONS. It is possible to develop two reliable and valid brief versions of the SL­ASIA in order to encourage more research to use the acculturation variable. We recommend that researchers who need a short form of an acculturation scale for Asian Americans use either version of the brief SL­ASIA. Both have adequate levels of reliability and are highly correlated to the full scale. Neither version has a clear advantage over the other. RELEVANCE TO ASIAN AMERICAN AND PACIFIC ISLANDER POPULATIONS. This article is particularly relevant to Asian American college student populations. KEY WORDS. Acculturation, Mental Health

Journal Article↗

[Human cloning, as ideological construction of technology].

The article treats the issue of cloning as a part of the dominant ideology of the so-called technical progress. The author shows that the notion of "technical progress" is an ideological construction full of hidden valuation. The whole class of technicians is simply materially interested in disseminating this ideology. According to the author the so-called technical progress doesn't improve the quality of life as far as psychological satisfaction is concerned. The cult of technology is rooted in the crisis of humanistic values and civilization. It implies avoiding serious existential questions and civilization challenges. Technology itself appears in this statement only as a result of concrete conditions in concrete historical moment, but not as an independent process. Cloning can be only the contemporary answer to the collapse of the art of breeding and educating consecutive generations. It can be only the next step of the fall of western civilization or the so-called revolt of the masses.

Biomedical Technology↗

The use of music therapy to address the suffering in advanced cancer pain.

Pain associated with advanced cancer is multifaceted and complex, and is influenced by physiological, psychological, social, and spiritual phenomena. Suffering may be identified in patients when pain is associated with impending loss, increased dependency, and an altered understanding of one's existential purpose. Comprehensive pain management aims to address problematic symptoms in order to improve comfort, peace of mind, and quality of life. Music therapy is a treatment modality of great diversity that can offer a range of benefits to patients with advanced cancer pain and symptoms of suffering. Music therapists perform comprehensive assessments that include reviews of social, cultural, and medical history; current medical status; and the ways in which emotions are affecting the pain. A variety of music therapy techniques may be used, including vocal techniques, listening, and instrumental techniques. These techniques provide opportunities for exploration of the feelings and issues compounding the pain experience. Case examples are presented to demonstrate the "lifting", "transporting", and "bringing of peace" qualities of music that offer patients moments of release, reflection, and renewal.

Adult↗

[A study on bactericidal/permeability increasing protein (BPI) as a natural inhibitor of endotoxin].

OBJECTIVE: To investigate the existential status of BPI as a natural defensive factor in human polymorphonuclear leukocytes (PMNL). METHODS: The abilities of porcine BPI to combine endotoxin (lipopolysaccharide, LPS) and inhibit the release of TNFalpha from hepatic Kupffer's cells were examined. And the expression of BPI in PMNL after stimulation by LPS was determined by flow cytometry. RESULTS: The ability of porcine BPI to combine LPS was increased along with the increment of BPI concentration. The effects of the BPI on the inhibition of the release of TNFalpha from hepatic Kupffer's cells were dose-dependant. The expression of BPI in PMNL was enhanced obviously within 30 mins of LPS stimulation. But there was no immediate release of BPI into blood. CONCLUSION: BPI possessed potential power of neutralizing LPS. It might be beneficial to supplement exogenous BPI in case of Gram negative bacterial infection.

Animals↗

Being a child with asthma.

This study aimed to illuminate what it is like being a child with asthma. Unstructured interviews were conducted with 14 children with asthma in Sweden. The data were analyzed using a phenomenologic hermeneutic method. The results showed that the children strived to live normal lives. Sometimes they felt that they were participants in everyday life; other times they felt like outsiders. As participants, they felt confident in their own knowledge, in other people's wish to help, and that medicine would help. As outsiders, they felt deprived, guilty, lonely, anxious, and fearful. Results were interpreted from an ecosophic as well as an existential perspective.

Adaptation, Psychological↗

Optimizing well-being: the empirical encounter of two traditions.

Subjective well-being (SWB) is evaluation of life in terms of satisfaction and balance between positive and negative affect; psychological well-being (PWB) entails perception of engagement with existential challenges of life. The authors hypothesized that these research streams are conceptually related but empirically distinct and that combinations of them relate differentially to sociodemographics and personality. Data are from a national sample of 3,032 Americans aged 25-74. Factor analyses confirmed the related-but-distinct status of SWB and PWB. The probability of optimal well-being (high SWB and PWB) increased as age, education, extraversion, and conscientiousness increased and as neuroticism decreased. Compared with adults with higher SWB than PWB. adults with higher PWB than SWB were younger, had more education, and showed more openness to experience.

Adaptation, Psychological↗

[Diagnostic and therapeutic guidelines for posttraumatic stress disorders].

Posttraumatic stress disorder (PTSD) presents an important medical and social problem in the Republic of Croatia with prevalence of 10-30% depending on the population. On the basis of our 8-year clinical experience in treating PTSD and detailed analysis of related literature a special team of the Department of Psychological Medicine, Zagreb University Hospital, compiled the proposed guidelines for diagnostics and treatment of PTSD. The established guidelines are independently developed, clinically proven at our Clinic and in terms of custom made procedure world wide unique. Their essential feature is psychoanalytic comprehension and approach to etiopathogenesis of PTSD, although it also applies to other psychotherapeutic techniques (cognitive-behavioral, relaxation, existential). The diagnostic model is based upon structured clinical interview (DSM-IV, ICD-10), but it also complies with the principles of psychotherapeutic interview. Therapeutic interventions as proposed are divided according to therapeutic goal into symptomatic and etiological.

Clinical Protocols↗

Validating a measure of religiousness/spirituality for Native Hawaiians.

Religiousness and spirituality are integral to the human experience. There is emerging literature that shows that religiousness and spirituality are associated with various mental and physical health outcomes. Yet, the development of measures to accurately assess these phenomena in health settings is still in its early stages. The difficulties in developing standardized definitions and measures relate to varying interpretations of religiousness and spirituality, a reluctance to utilize a scientific approach to understand an existential and personal experience, and multicultural distinctions. The potential for designing health interventions in which religiousness and spirituality are integrated rests upon the development of measures that are psychometrically sound. This paper reports on preliminary research that empirically assesses one measure of religiousness and spirituality for Native Hawaiians--a group besieged with an array of health problems. The measure is the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) developed by the National Institute on Aging and the Fetzer Institute. This instrument has shown to have appropriate reliability and validity scores. A modified BMMRS was administered to 15 Native Hawaiians who underwent a cultural intervention of exercise, diet, and education in a program called Uli'eo Koa (warrior fitness). The BMMRS was slightly modified based on the literature and earlier research to be more specific to Native Hawaiians. Overall, measures of internal consistency supported the reliability of the BMMRS. The strongest subscales included the domains of "daily spiritual experiences," "religious and spiritual coping," and "religious support." Low internal consistency estimates for the items, "watches/listens to religious programs," "family makes demands," and "significant loss in faith," suggest that these items do not measure the same concept for participants. Although the intercorrelations among the subscales were generally low and with wide variability, 10 of the 17 subscales/single items were moderately to highly correlated with one another, indicating concurrent validity. These subscales, some of which assessed, "daily spiritual experiences," "religious and spiritual coping," and "organizational religiousness," suggest that core ideas on spirituality and religiousness for these participants, broadly reflect both "personal" and "organizational" viewpoints. Caution should be used in interpreting the results of the study because of limitations in the study's design. However, despite these limitations in design, this study provides empirical support for future research on religiousness and spirituality for Native Hawaiians.

Adult↗

Without discrimination for religion, race, or gender.

The transplantation of organs, which at first sight appears to be just a technical medical procedure, is, first and foremost a sociocultural action that gives expression to existential perceptions. In Israeli society, as in most western societies the donation of the body or parts of it, is interpreted as possible at a societal level, and not as a gift from one individual to another. The medical achievement inherent in organ transplantation brings forward the relationship between the body, death and society. The moment the body ceases to function biologically, its position within the social entity is examined. The donation of organs evinces the acceptance of the idea that the personal body belongs to the society which sanctions the transition of the private body into organs that become national assets. This research is a first attempt to study the motives of people from Muslim society, who donated organs of their dear ones. The ability of these people to enter into a system of exchange flows from a tacit assumption by all of them that the action is approved by their social group. This paper presents the concepts of death and of the body that enable donation in general and the donation of the Muslim population in particular.

Humans↗

[End-of-life sedation--definition and clinical guidelines needed].

End-of-life sedation is not well defined in clinical medicine. The Swedish Society of Medicine, Delegation for Medical Ethics, arranged a Nordic expert workshop to discuss issues of terminology, indications, information and consent, follow up and teaching. It was concluded that the following issues must be part of the decision-making process: the diagnosis and prognosis must be correct, all other treatment options including psychological and existential support must have been tried, there must be consensus between the patient, the family and the staff about the situation and the proposed treatment. These discussions will be followed by clinical guidelines issued by the Society.

Advance Directives↗

Quality of life in patients with traumatic brain injury-basic issues, assessment and recommendations.

INTRODUCTION: Traumatic brain injuries (TBI) are one of the most common consequences of traffic accidents. Patients with mild, moderate or severe brain injuries suffer from physical, cognitive, behavioral, emotional and social problems. Most of these problems have been a long standing focus amongst practitioners and researchers. Only recently a development has started that took interest in the quality of life outcome of TBI patients. The international members of this consensus meeting reviewed the literature on Quality of Life assessment after TBI and discussed the applicability of different measurements to this specific patient group. TIME POINTS: During the acute phase (T1; < 3 month after trauma) QoL it is difficult to assess due to the reduced consciousness of TBI patients. In the phase of rehabilitation (T2; < one year after trauma) and in the post-rehabilitation phase (T3) repeated assessment of QoL is recommended. INSTRUMENTS: Several generic and disease-specific instruments possibly relevant to TBI patients or specifically developed for this group were assessed according to the existing evidence in the literature. Criteria for the evaluation of these instruments were: feasibility, specificity, validity, comprehensiveness, international availability, existence of norms, and psychometric quality. The cognitive impairment and the existential dimension were not sufficiently considered in most of the reviewed instruments. GROUP CONSENSUS: The family's and relatives' view of the patient's QoL should not be used as a proxy but provides an additional source of information in the acute phase. At T2 and T3, assessment of the patient's quality of life should include a generic as well as a disease specific instrument. Among the generic instruments the SF-36, the EuroQol and the WHO-QoL should be considered. The literature about specific instruments for patients with TBI like the EBIC is scarce. Therefore, the group could hardly give an empirically based recommendation. The need for further investigation on QoL instruments in TBI patients is strongly emphasized.

Brain Injuries↗

[Etiology of adult insomnia].

In the article, the author develops an analysis of external and intrapsychic factors related to adults' insomnia. First she undertakes a literature review to describe semiological, evolutive and etiological levels of insomnia. From a semiological point of view, it is usual to differenciate initial insomnia (associated to the first phase of sleeping), intermittent insomnia (related to frequent awakenings) and final insomnia (related to early morning awakenings). From an evolutive point of view, we can identify transitory insomnia (characterized by frequent awakenings) and chronic insomnia. On the other hand, we are allowed to distinguish organic insomnia (disorder where an organic cerebral injury is demonstrated or suspected) from insomnias related to psychiatric or somatic disease or idiopathic one. Then, the author makes a literary review to identify various insomnia causes and points out. Social factors: insomnia rates are higher by divorced, separated or widowed people. Percentages are higher when scholastic level is weak, domestic income is less then 915 O a month, or by unemployed people. Besides, sleep quality is deteriorated by ageing. Sleeping and waking rhythm is able to loose its synchronization. Complaints about insomnia occur far frequently from women than men. Environmental factors: working constraints increase sleep disorders. It is possible to make the same conclusion when we have to face overcharge of external events, deep intrapsychic conflicts (related to grief, unemployment, damage or hospitalization) or interpersonal conflicts' situations where we are confronted to stress related to socio-affective environment, lack of social support or conjugal difficulties. Medical and physiologic causes: legs impatience syndrome, recurrent limbs shakings syndrome, breathe stop during sleep, narcolepsy, excessive medicine or hypnotic drugs use, some central nervous system injuries, every nocturnal awakening (related to aches.), surgical operation. Chronobiological factors: night working or day-night shift produce insomnia by desynchronization. It is the same for time lag related to jet-lag flights. Significant gaps between the internal biological clock and environmental synchronizators, such as phase delay sleep, phase advance sleep, sleep-waking cycle longer than 24 (25) hours, or variations in sleep-awakening cycle, are of less importance. Toxic factors are numerous: amphetamines, antidepressors, medication against anorexia and tubercular disease, caffeine and alcohol excessive use, chronic alcoholism. Behavioral factors: enduring insomnias are related to poor nightroutines (to go to sleep too early, to read or to look at T.V. when going to bed). The same effect is produced by regular intellectual activities close to bedtime or by a late meal in the evening, by an noisy or unhealthy environment, by physical hyperactivity or sleeping after each lunch. Psychiatric factors: insomnia often appears with psychiatric disorders such as a major depressive episode, an anxiety disorder or schizophrenia. Insomnia also is able to open a delirious disorganization or a manic access. Psychological factors: overstimulation of waking system (related to stress overdose or intellectual hyperactivity), conditioning phenomena, fear of not falling asleep, intrapsychic and interpersonal conflicts. Third, the author put hypothesis about psychodynamic etiology of chronic insomnia. Following a first assumption, insomnia should be a result of anguish excess related to intrapsychic (and not interpersonal) conflicts which can't lead to a mental elaboration. These conflicts run over dream protective function, generating a breakdown of dream symbolization function. At a clinical level, we are in some cases in front of people enduring sleeping insomnia but more often, we are confronted with an intermittent or early waking insomnia sometimes associated with nightmares. Following a second assumption, insomnia should be a result of psychic functioning invalidation. Here, failure of dream protective and symbolization function is related to anguish excess associated with an amount of external conflicts. Overwhelmed by concretude, insomniac patients present an alexythimic intrapsychic functioning forbiding dream realization. These persons have no possibility to elaborate conflicts especially external overcharge, using dreams or imagination to escape from an intrusive reality and regress to sleeping. Here we are in front of initial sleep insomnia. Following a third hypothesis, some insomnias are related to wakings associated with repetitive nightmares. This type of insomnia should be related to a past traumatic event or activated by actual existential context and produces a too important anguish charge to follow a mental elaboration process and lead to mental symbolic representation. Following a fourth hypothesis, some insomnias are in relation with an impossibility to accept passive position. The last one will expose to a danger consisting either of castration or loneliness and death. To conclude, the author suggests some preventive perspective to face insomnia. Especially, she points out limits of pharmalogical treatments. She underlines the necessity to promote no medical methods to facilitate sleep induction and maintenance, including sleep hygiene measures, relaxation, psychotherapic approach and behavioral methods. She emphasizes the danger of a reductive approach of insomnia which would be focused on a single medical, psychological or environmental dimension. Last but not least, she makes methodological propositions to test from a clinical point of view the four psychodynamic exposed hypotheses.

Adult↗

Hiding in the crowd: can mortality salience promote affiliation with others who oppose one's worldviews?

The present research highlights affiliation defenses in the psychological confrontation with death. In 3 experiments, it was found that mortality salience led to increased affiliation strivings, as indicated by a greater preference for sitting within a group as opposed to sitting alone. Mortality salience actually led to increased affiliation with a worldview-threatening group (Experiments 1-2), even when affiliation with the group forced participants to attack their own worldviews (Experiment 3). Taken together, the findings support a distinct role of affiliation defenses against existential concerns. Moreover, affiliation defenses seem powerful enough to override worldview validation defenses, even when the worldviews in question are personally relevant and highly accessible.

Adult↗

[Parasuicide and violence: criminological aspects from a study of 21,314 male army recruits in Switzerland].

Suicidal behaviors are not uncommon, but rarely admitted in the families and in society at large. Violence is a public health and social problem of growing concern. Research on the relationship between violence and suicidal behaviors is scarce for the last decades, perhaps because suicide is no longer considered an offense. The present study is based on a sample of 21,314 valid interviews with 20 year old Swiss men, representing over 70% of this cohort. The questionnaire contained over 900 variables, addressing issues such as previous history of parasuicide, self-reported violent acts and injuries, during childhood and adolescence, as well as over the last year before recruits training. The questionnaire also contains various items about mental health, familial and social conditions and situational factors. We used an ordinal scale for measuring violence and operationalisations of mental disturbances according to theoretical and empirical concepts such as conduct disorder and antisocial personality disorder according to DSM IV, the dissocial syndrome according to Rauchfleisch's (1981) definition; 2,6% of the recruits reported at least one suicide attempt during the last year, one third even multiple attempts. Life-time prevalence at age 20 was 3,9%. Suicide attempters often showed signs of psychiatric disorders, especially for a dissocial (OR=6,9) or an antisocial (OR=5,8) syndrome. Other studies have shown that the rate of suicide in France and Switzerland is very high compared to other European countries. Our study confirms the existence of a real behavioural and existential problem among young Swiss men. Half of the suicide attempters had a history of physical violence against others and 20% were themselves victims of violent acts during the previous year. Suicide attempters who were victims were also more violent than those who were not victimized. A suicide attempt during the previous year is a marker for violent behaviours (OR=2,1) and victimisation (OR=1,9) during this same year. We also found a positive link between multiple attempted suicides and the commission of serious violence. It is concluded that parasuicide among young men is related to other violent acts and should be considered as a positive marker of violent behavior in general and victimisation by crime. It seems that suicide is a transgression of social and cultural values because of the amount of aggression behind it, even if it is not a criminal offense. Suicide attempts of young men should receive more attention by professionals in the field of medicine, psychology and social work. Treatment of these men not only prevents an individual mental health problem but also contributes to crime prevention at the community level. Criminological theories could inspire further studies in suicidology, in order to improve the multidisciplinary knowledge of the phenomenology and etiology of parasuicide. In the same way, criminologists as policy makers should attach more attention to parasuicide given its many theoretical and practical connections with crime.

Adult↗

[Overt and latent restlessness and the awareness of the meaning of life in patients with valvular heart disease].

By means of R. B. Cattell Self-Knowledge Sheet and Crumbough and Miholick Scale of the Awareness of the Meaning of Life, 25 patients were examined, prepared for surgical correction of valvular heart disease. By means of R.B. Cattell Self-Knowledge Sheet a group was isolated of patients showing high overt restlessness (OR) and high latent restlessness (LR). It was shown that the personalities of these two groups of patients demonstrated numerous common features, but very significant differences also existed. The patients with high latent restlessness (LR) demonstrated strong emotional tension caused by frustration, feeling of inferiority with low self-estimation, as well as many conflicts at super ego level, but they had strong defensive mechanisms of own personality. The patients with high overt restlessness (OR) revealed high degree of intensification of the feeling of isolation, loneliness, and existential emptiness resulting from the lost feeling of the meaning of further existence with the progress of disease. The results of our studies are guidelines for the choice of psychotherapeutic management of patients qualified for operation of valvular heart disease.

Adult↗

[Depression and aging].

Old age is a qualitative state during which depression frequently occurs. This illness presents particular features which should be considered in the course of both normal ageing and senility. Viewed as an existential crisis, ageing may be considered as a depression promoting factor. Rich in depression promoting factors, this period of life is a sequence of crises which result in reorganizations heavily dependent on the adaptive capabilities of the aged person. During ageing, depression exhibits particular features that one should be able to recognize and distinguish from the consequences of deficits that are the normal adjuncts of the ageing process. The same is true of alterations occurring in the cognitive sphere and which might result from demential alteration. During ageing, depression should be identified among the other decompensation patterns occurring in the aged patient by viewing the situation in terms of overhelmed mechanisms. Depression exhibits a pattern whereby it relates closely with the risk of dementia. Therapeutic management should take into account such a perspective, that one might call transnosographic, when considering the depressiveness of aged patients as a high-risk situation requiring long-term follow-up of their biological, psychodynamic, social and cognitive functions.

Aged↗

[Problems of occupational paedagogy in rehabilitation (author's transl)].

Within the framework of a work science focusing on the disabled, occupational paedagogy (Arbeitspädagogik) offers- from its methods and objectives- useful approaches to the industrial resettlement of the disabled. The different models of occupational paedagogy and the experience gained from then (Taylor, Münsterberg, Moede, Baumgarten, Twi-methode, Riedel) can be easily adapted to and integrated with special requirements of vocational rehabilitation. In the light of human work valuation as an existential dimension of "Being-in-the-world", resettlement in open industry with the help of occupational paedagogy and the related measures for a job organisation suitable for the disabled, are discussed from a human ecological viewpoint. Possibilities of on-the-job-training are formulated in recommendations which are in accordance with the Johannes Riedel model of occupational paedagogy. The influence that inadequacies of general vocational training have on an invalidism before retirement emphasises the necessity of obviating the danger of excessive work demand caused by modern industrial conditions, by preventive measures of occupational paedagogy.

Persons with Disabilities↗