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PubMed1986

Stimulus processing during apparent unconsciousness in anesthetized volunteers.

Return of motor-responses upon request as an indicator of stimulus processing during apparent unconsciousness in general anesthesia was studied in 8 healthy, male volunteers during prolonged inhalation of nitrous oxide. First the minimal effective concentration of nitrous oxide was established for each volunteer, based upon continued absence of motor-responses to repeated verbal commands. One week later this concentration of nitrous oxide was administered for a 3-hr. period; return of motor-responses after at least 30 min. of absence was considered a sign of so-called unconscious perception. Four volunteers showed return of motor-response within the 3 hr. of exposure, but two of these had been rather restless throughout the session. Results indicate that unexpected processing of information by patients may occur during presumed unconsciousness after a prolonged inhalation of nitrous oxide in general anesthesia.

Adult↗
PubMed1997

Reported prevalence of unconsciousness from mechanical impact to the head in university populations during a fifteen-year period.

The prevalence of at least one episode of unconsciousness during childhood due to a mechanical impact to the skull was inferred by the response to one item embedded within a questionnaire of 140 items. 50% of the 633 university men and 33% of the 863 university women reported such unconsciousness; the prevalence did not change significantly between samples over a 15-yr. period. Multiple regression analysis indicated that the 10 items most strongly associated with the report of childhood unconsciousness did not explain more than about 10% of the variance. The majority of the items were those associated with complex partial epileptic-like signs and included (adult) episodes of memory blanks, mystical experiences, dissociation, and sudden meaningfulness.

Adolescent↗
PubMed1992

Conscious and unconscious perceptions of self in children of alcoholics.

The conscious and unconscious self-concept was examined in three groups of children: 23 children of alcoholics (COA), 19 children from nonalcoholic but dysfunctional families, and 23 children from normal families without alcoholism or family dysfunction. Self-concept was assessed both objectively, using the Piers-Harris Children's Self Concept Scale, and subjectively, using the Draw-A-Person Test and the Thematic Apperception Test from rating systems designed to tap unconscious dimensions of self. The COAs and normal controls were also compared for behavioral problems with the Achenbach Child Behavior Checklist. We found that COAs made more positive self-statements on objective measures of self-concept than children from families without alcoholism, whether or not the families were dysfunctional. Subjective analyses of projective test responses revealed unconscious differences in self-concept among the COAs, though this was not corroborated with objective scores, probably due to the crudeness of the rating instrument in failing to tap these dimensions. Also COAs had significantly more behavior problems, based on parental reports, which contrasts with their objective reports of self. Implications of these findings were discussed.

Alcoholism↗
PubMed1980

Prolonged posttraumatic unconsciousness: therapeutic assets and liabilities.

Prolonged coma following severe head injury is a serious condition because it implies a poor prognosis. In order to assess the magnitude of this phenomenon, the authors have reviewed 135 cases of posttraumatic unconsciousness lasting more than 2 weeks, from among the entire propulation of patients with severe head injury managed in 10 years in their neurosurgical intensive care unit. The incidence of prolonged coma was 4% of all patients with acute traumatic coma, and 0.6% of all hospitalized patients with head injury. By 1 year after trauma, 30% of the patients had died, 8% survived in a vegetative state, 31% survived with severe disabilities, and 31% had made a satisfactory recovery. The early clinical picture of prolonged unconsciousness has no predictive value as to further evolution. Patients emerge from unconsciousness in consecutive steps representing the restoration of increasingly complex neurological functions; the timing of these steps is very variable and sometimes covers several months. The time distribution of recovery steps in individual cases is of limited predictive value as to outcome. The most frequent state during the recovery process is the condition of wakefulness without awareness, which should not be pronounced "permanent" earlier than 1 year after injury.

Brain Injuries↗
PubMed2004

Valid distinctions between conscious and unconscious perception?

In this commentary, we discuss the strengths and limitations of Snodgrass, Bernat, and Shevrin's (2004) theory of unconscious perception. Our commentary centers on the value of signal detection theory (SDT) to understanding the unconscious perception controversy, a value that Snodgrass et al. for the most part agree with (i.e., that most approaches to studying unconscious perception are invalid because they have confounded the criterion for detection with the criterion for awareness). However, we believe that their model relies on a somewhat restricted application of SDT. We discuss how SDTcan be better applied to provide the necessary tests to validate their model.

Humans↗
PubMed2003

Adult age differences in unconscious transference: source confusion or identity blending?

Eyewitnesses are known often to falsely identify a familiar but innocent bystander when asked to pick out a perpetrator from a lineup. Such unconscious transference errors have been attributed to either identity confusions at encoding or source retrieval errors. Three experiments contrasted younger and older adults in their susceptibility to such misidentifications. Participants saw photographs of perpetrators, then a series of mug shots of innocent bystanders. A week later, they saw lineups containing bystanders (and others containing perpetrators in Experiment 3) and were asked whether any of the perpetrators were present. When younger faces were used as stimuli (Experiments 1 and 3), older adults showed higher rates of transference errors. When older faces were used as stimuli (Experiments 2 and 3), no such age effects in rates of unconscious transference were apparent. In addition, older adults in Experiment 3 showed an own-age bias effect for correct identification of targets. Unconscious transference errors were found to be due to both source retrieval errors and identity confusions, but age-related increases were found only in the latter.

Adult↗
PubMed2001

[Influence of intubation maneuver with or without premedication for intracranial hemorrhage with unconsciousness].

PURPOSE: To clarify the influence of intubation maneuver with or without premedication for intracranial hemorrhage with unconsciousness. METHODS: Between May 1995 and May 2000, we analyzed retrospectively 46 patients who had received intubation for unconsciousness and were found non-traumatic intracranial hemorrhage by head computer tomography at the Trauma and Critical Care Center, National Defense Medical College. They were divided into two groups, Drug group in which drugs were used before intubation and Control group which were intubated without drugs. Physical findings on admission, head CT findings, Glasgow Outcome Score(GOS) at discharge were analyzed between the groups. RESULTS: There were no significant differences for background of subjects between the groups. In the Drug group, diazepam, pentazocine, lidocaine, nifedipine and nicardipine were used before intubation. GOS in the Control group was significantly greater than in the Drug group(p < 0.01). CONCLUSION: In case of intubation for unconscious patients who may suffer intracranial hemorrhage, using premedication leads to favorable outcome.

Adult↗
PubMed2001

How important is history of unconsciousness in head injury patients?

A total of 100 patients of head injury were studied. They all underwent thorough clinical and neurological examination, skull radiography and CT scan of head. And with the help of all these parameters an evaluation was done to find out the importance of history of unconsciousness on risk of intracranial complications. A lot of controversies exist about detection of factors that make a patient of head injury a high risk candidate for developing intracranial complications. Young active population was the most commonly affected group in head injury with male preponderance at all ages. Roadside accident found to be the main cause of head trauma in adults while fall from height in paediatric age group. Although Glassgow Coma Index (GCI) was found to be a good predictor for intracranial complications as well as final outcome in patients with total score of 12 or less but it was not equally good in patients of minor head injury (GCI = 13-15). Similarly history of unconsciousness was not found to be correlating well with risk of intracranial complications but longer duration of unconsciousness was found to be a poor prognostic index.

Adult↗
PubMed1991

Shame in psychoanalysis: the function of unconscious fantasies.

The conceptualization of shame as an emergent affect in the clinical situation gains clarity by linking it to unconscious fantasies. The author suggests that shame appears when an individual fails in his efforts to obtain from another person, in reality or in imagined scenes, an expected similar affect or a complementary message, or both. A self-evaluation emerges of being undeserving of the desired response. In this respect shame is related to the narcissistic component of any experience or fantasy, be it pre-oedipal, oedipal, or post-oedipal. In cases where there is a pathological predisposition to shame, the predisposition is linked to unconscious fantasies portraying the individual as the desiring and frustrated subject of an unresponded to affective message. After its formation the unconscious fantasy itself, and all its unrepressed derivatives, become a source of shame. A clinical example illustrates these points.

Adult↗
PubMed1989

The permanently unconscious patient, non-feeding and euthanasia.

Some sources condemn judicial decisions which authorize the withdrawal of artificial nutrition from permanently unconscious patients. These critics assert that withdrawal of nutrition from a preservable unconscious patient amounts to intentional killing of a helpless human being. Grave implications are seen for helpless patients. This article confronts these critics and their assertions. The author contends that the judicial approach which allows withdrawal of artificial nutrition is fully consistent with traditional medico-legal doctrines. The article articulates a standard--respect for human dignity--which justifies withdrawal of artificial nutrition from a permanently unconscious patient. The implications of this formula for other incompetent patients facing a protracted dying process is discussed. Finally, the article explains why active euthanasia can and ought to be distinguished from withdrawal of life-preserving medical intervention.

Attitude to Death↗
PubMed1989

Crisis intervention through early interpretation of unconscious guilt.

The author describes an approach to crisis intervention based on the assumption that a crisis reconfirms a patient's unconscious pathogenic beliefs and increases unconscious guilt. The nature of the psychopathology can be understood in terms of the patient's history, current life problems, and testing of the therapist. Treatment involves offering the patient a dynamic evaluation that includes interpretation of the role of pathogenic beliefs and guilt in the crisis. This approach provides symptomatic relief and may lead to incipient personality change. Improvement may be due in part to the greater openness to change characteristic of persons in crisis. However, this approach seems effective primarily because patients are enabled to disconfirm their pathogenic beliefs and thereby reduce unconscious guilt.

Adult↗
PubMed1989

The role of unconscious guilt in psychopathology and psychotherapy.

Using a new psychoanalytic perspective, the author explains how irrational unconscious guilt originates, how it produces psychopathology, and how it is mastered in psychotherapy. According to this perspective, unconscious guilt is a product of repressed irrational beliefs derived from traumatic childhood experiences. The author emphasizes the role of guilt as a source of resistance and transference, and he explains patients' unconscious efforts to master problems with guilt through an ongoing process of testing the therapist. Therapeutic outcome significantly depends on the degree to which therapists pass patients' tests and accurately analyze patients' guilt-based resistances and transferences. The author briefly describes an empirical study based on these concepts.

Guilt↗
PubMed1987

The relationship of repression to the unconscious.

I try to formulate the simplest topographic model that embodies current theoretical understanding. The repression mechanism is under the control of a single censorship located on the border of consciousness. I argue that neither the operation of the repression mechanism nor the decision process of the censorship, which controls the repression mechanism and other defence mechanisms, can be considered dynamically unconscious. I discuss the distinction drawn by Wallerstein, Sandler & Joffe between the experiential and the non-experiential, concluding that much of the non-conscious id, ego, and superego is non-experiential rather than dynamically unconscious. Within the experiential realm I present the reasons why the censorship is located on the edge of consciousness and the implications of this location for the distinction between the preconscious and the dynamic unconscious.

Defense Mechanisms↗
PubMed1983

[Work of the so-called phantom in the unconscious and psychosomatics. Apropos of psoriasis].

The theory of "ghost" in the heart of the unconscious relates the precocious psychic legacy of mental misfunctioning through the unconscious to unconscious relationship with a relative inhabited by a mourning that has not been worked through. These misfunctionings can express themselves thanks to various psychopathological demonstrations, but through psychosomatical illnesses as well. As shown by the authors in some cases of psoriasis: determinism that could associate--a genetical predisposition of the future patient,--a notion of family or personal history having to do with events such as burns, fire.

Adult↗
PubMedDate not supplied

[The collective unconscious: from image to symbol].

With the help of clinical examples, the author tries to show how the therapeutic process works in Jung's theory of Unconscious: in the course of transference, the Unconscious generates Images which are coming from the Archetypes of Collective Unconscious. The interpretation of these Images and dreamer's associations trough transference, leads the patient to elaborate Symbols as carriers of a new sense for himself.

Dreams↗
PubMed1993

[Conscious, unconscious and not conscious in coma].

In this work, the relation between the consciousness and the unconsciousness was studied in patients presenting a neurosurgical coma state. The study includes 29 patients with clinical observations during their hospitalisation period and a follow up for one year after the emergence from the state of coma. The psychoanalytic methods were used, taking in consideration the emotional and personal history of each patient. We attempted to demonstrate the persistence of the unconscious psychic life during coma and the early period after awakening from the coma. In addition, we felt the existence of a sort of direct confrontation with the unconscious psychic life in some patients emerging from a comatose state. The question is also what are the effects of such experience and how would they affect the life of the patients in the future?

Coma↗
PubMed1995

[What is not revealed in the telephone call reporting "unconsciousness"].

Medical documentation of the Zagreb Emergency Medical Center was reviewed in the period between January 1 to December 31, 1994. 1352 telephone calls received by physician in charge related to the state of unconsciousness were processed. The state of unconsciousness was verified in 602 patients (44.52%). 315 patients (23.30%) were not unconscious. Insufficient evidence of the state of consciousness was provided in the case of 395 patients (29.22%). In the case of 40 calls, patients were not found on the spot. Vasovagal syncope, death, acute alcoholism, epilepsy, trauma, stroke, hypoglycemia, psychoneurosis and intoxication represent the most usual diagnosis made by physicians who examined the patients.

Emergencies↗
PubMed1995

Unconscious activation of motor responses in a hemiplegic patient with anosognosia and neglect.

Unconscious processing of environmental stimuli has been convincingly demonstrated for a large number of neuropsychological syndromes. However, only few studies have successfully recorded on-line the activation of the autonomous or the motoric nervous systems. The activation of the motor system by unconscious stimuli would be a strong argument that information processing in the brain is not organized into two serial steps (stimulus identification first, response selection second). This would argue for parallel processes of stimuli identification routines and response selection mechanisms on the basis of only provisionally worked out stimulus features. Investigating an anosognostic patient we found electrodermal activity (EDA) and electromyographic responses (EMG) to bimanual tasks, mental imagery, and to the request to execute specific actions. But overt behavior remained hemiplegic and the patient was unable to feel any kind of control of her paralyzed left arm and hand. Generally, the data can be interpreted along the lines of a theory of two different routes to action, leaving the unconscious selection of action patterns intact, whereas the intentional triggering of overt behavior with the left hand and arm was impossible for the patient.

Brain↗