[Retrospective study of the cause of deafness in 60 students at the Institute for the Deaf and 33 of their deaf relatives].
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A comparison was made of the social and domestic background, prepsychotic personality and symptomatology of deaf ('hard of hearing') and non-deaf patients aged 50 or over with paranoid or affective psychoses. The deaf patients were found to be a very heterogeneous group in respect of age of onset, duration, severity and pathological basis of their deafness, but there was a substantial subgroup of paranoid patients with deafness beginning before the age of 45 in whom the personality appeared to have been less deviating than in the remainder. It was thought that the deafness in this subgroup had possibly played a relatively specific role in causing the psychosis. Some problems in identifying deafness and assessing its significance are discussed.
This study assessed the quality and quantity of social services received by deaf persons residing in Salt Lake County, Utah. It was found that although a majority of human service agencies in the county have had some contact with deaf clients, only those agencies that have made an effort to develop programs especially for the deaf and employ someone who is skilled in sign language could deliver services effectively to this population.
An electronic device for multichannel cochlear implant is now available in case of total deafness and deaf-muteness. Any surgical technic of electrodes implantation may use this prosthesis. It consists in two parts, an outside package and an implanted receptor. The external device cut the sound in eight channels, whose frequencies correspond to those of the telephon bands. These eight sinusoidal waves are changed in pulses whose frequency and duration depend on the intensity of the initial signal. All these informations are multiplexed and injected in a high frequency wave to an antenna. Electromagnetic induction supplies through the skin the implanted receptor with power and informations. This receptor is preoperatively connected to the electrodes. With this device and with phoniatric training some speech recognition, and in case of deaf-mute patients voice improvement, may be obtained in some months.
The principal facts concerning therapeutic measures in cases of sudden deafness and acoustic trauma are outlined. Experiment data concerning the pharmacology of inner ear circulation are presented. There is sufficient evidence for a critical evaluation of a few treatments whose effect seems to be proven (experimental increase of inner ear circulation in normal animals) or at least possible (in normal animals no or dubious increase; effective under pathological conditions only?). Experimental and clinical experiences concerning the dextran treatment of sudden deafness and acoustic trauma are reported.
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Cases of deafness due to Paget's disease can be separated into two types : (1) deafness of a mainly mixed type in which progressive aggravation occurs particularly in the inner ear, and (2) perceptional deafness which progresses without involvement of the transmission apparatus. Among 35 hospitalized patients with Paget's disease, 21 of whom suffered cranial involvement, 18 cases of deafness related to the bone disease were discovered by means of systematic examinations. The deafness was of the mixed type in 11 cases and of the perceptional type in the other 7. Of the 11 patients with the mixed type of deafness with an ankylosis syndrome of the ossicles, 3 were operated upon : one of them underwent an operation to mobilize the stapes, and the two others underwent total stapedectomy followed by venous interposition and the positioning of a Teflon piston. The long-term results were frankly disappointing and did not suggest that these attempts at surgical treatment should be followed up. Calcitonin was employed in 9 patients (6 with mixed deafness and 3 with perception type deafness), with comparative audiograms in 5 cases, and was also not very effective : this lack of effect was a result of the long duration of the Paget's disease and of the deafness in the patients treated. The value of hormonal treatment in cases of deafness associated with Paget's disease will probably be in the prevention of this complication.
The personality of deaf people was studied within the framework of the Eysenck concept of personality. Data gathered with the Personality Inventory AUPI could be evaluated in 66 deaf people (43 connatal or early acquired deafness, 25 late deafness, i.e. after full language development). The consistency of the AUPI Scales in the normal population about corresponds to that in the deaf people. -- Those who went deaf "early" showed a statistically significant higher degree of extraversion than the normal population. There was no significant difference in neuroticism (emotional lability). "Early" deaf people had the highest value of psychoticism; and those who developed deafness "late" also differed significantly from the normal population. Psychoticism is--according to Baumann and Dittrich reactive aggressivity and depression (reactive to frustration).
A few projective studies focusing on the impact of cognition on affect in the deaf have reported strikingly disparate results with little systematic inquiry. A new and previously unreported play situation (with the deaf) was devised to elicit a detailed story. Fantasies were obtained in a uniform fashion from four groups of five-year-old boys comprising middle-class deaf and hearing children and lower socio-economic-class deaf and hearing children. Results suggest that: (1) The impact of deafness on cognitive functioning in these children is akin to--but apparently no worse than--the cultural deprivation phenomenon experienced by low socio-economic-status children. (2) There is no paucity of fantasy life in the deaf or deprived child, despite the absence or relative lack of verbal skills. (3) A problem common to both disadvantaged children and the deaf children tested in the intrusion of anxiety into autonomous ego functions, so that practice necessary for the firm development of cognitive schemata is interfered with. (4) The clinical impulsivity secondary to these emotional pressures may perpetuate itself by interfering with cognitive decentration in time and space in relation to others.
Thirty-nine White deaf persons functioning normally within the general hearing community were surveyed on a variety of factors concerning their use of alcohol, and compared to the data from two comparable hearing samples reported previously in the literature. No significant differences were found between the deaf and hearing samples on patterns of drinking or other parameters of alcohol use. Heavier alcohol use among the deaf correlated significantly with reported frequency of driving after having drunk too much, age of having had the first drink, ever having been drunk, feeling guilt over drinking too much, and others criticizing the respondent for drinking behavior. Heavier use also tended to be correlated with attendance at an all-deaf school. Implications of the findings of similar drinking patterns for the deaf and the hearing are discussed in terms of the lack of specific rehabilitation facilities for the deaf, along with possible reasons for the lack of use by deaf clients of alcohol rehabilitation agencies in the community.
Paranoia has long been associated with deafness, but the most significant psychiatric questions in the field of deafness concern the effects of prelingual deafness on intelligence, personality, and control of aggressive drives. With intensive language training, an emotionally favorable family situation, and adequate education, prelingual deafness has little or no deleterious effect on intelligence or personality. It does not predispose to major psychotic illnesses, but probably affects character structure in such a way as to accentuate impulsivity, and weaken depressive and obsessional traits. In order to prevent psychiatric morbidity in the deaf, the primary care physician needs not only to be able to diagnose and treat deafness and its causes, but also to grasp the importance of family counseling, adequate communication and education, and vocational rehabilitation for the deaf.