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Results for “Paraphilic Disorders”

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At least 19 recordsLinked to original sources
PubMed1975

Psychodynamic changes in untreated neurotic patients. II. Apparently genuine improvements.

This work is part of a study of 45 neurotic patients who were seen for consultation at the Tavistock Clinic but who never received treatment, and who, by the time they were asked to come for follow-up, had never been interviewed by a psychiatrist more than twice in their whole lives. In a previous report, we described 13 patients who were at least "improved" on purely symptomatic criteria but whom we did not regard as improved on dynamic criteria. Here, we describe 11 patients who were judged to be improved on dynamic criteria. These patients are of extraordinary interest, providing not only direct evidence of therapeutic mechanisms in everyday lifeān answer to a question posed by Strupp and Bergin in 1969but also, quite unexpectedly, evidence about the therapeutic effects of single interviews.

Adult↗
PubMed1979

Sex offenders: three personality types.

Analyzed by a Q-type factor analysis MMPI profiles of 92 sex offenders institutionalized for psychiatric evaluation, which yielded three basic MMPI profile types. Altogether 88 of the 92 Ss coult be categorized into one of three types characterized by profile peaks on F,Sc; Pd,MA; or D,PD. Analysis of background information, social history items, nature of present crime, primary diagnosis, and ward observations revealed significant differences among the types. Of particular interest was the finding that the primary diagnosis for 85% of the "F,Sc" MMPI type was "no mental disorder" in spite of the fact that this group showed significantly more disturbed behavior on the ward (anxiety, depression, suspicion, and manic excitement) and had uniquely degraded their victims. The fact that two-thirds of these persons who had F scores greater than or equal to 80 and 50% denied the crime may have inadvertently affected diagnostic decisions.

Adult↗
PubMed1978

Diagnosis and chronic mental illness.

This paper describes the occurrence of chronicity in varying psychiatric illnesses. There is not an unequivocal definition of chronicity, but with the exception of the illnesses that will be described below and that lead directly or indirectly to death from CNS complications of the illness, chronicity will require a duration of a minimum of five years without a significant remission. Chronicity is further differentiated into four different kinds of chronicity: chronic--death, chronic--self-limited, chronic--remission, and chronic--recurrent. The illnesses that may be considered as possibly fulfilling the criteria for chronic will be noted and a method for deciding whether an illness qualifies will be outlined.

Alcoholism↗
PubMed1975

Hormone and hormonal agents in the treatment of aggression.

Evidence for the role of androgens in the male aggressive and sexual behavior is reviewed. Medroxyprogesterone acetate (MPA; Provera, Upjohn) has a marked antiandrogen property; it is effective in lowering the testosterone level and controlling certain otherwise intractable sex deviations. The finding in 6 patients treated for sex deviation are summarized. The effects of MPA in the treatment of 11 temporal lobe epileptics and 5 other patients with severe angry-aggressive behavior disorder are reported. Most temporal lobe epileptics responded well to MPA. Weight gain and earlier sleep were consistent side effects. The values of plasma testosterone, serum luteinizing hormone, and urinary 17-ketosteroids were decreased by the treatment. Four patients were XYY individuals with lack of control over their sexual-aggressive or angry-aggressive impulses.

17-Hydroxycorticosteroids↗
PubMed1978

Pedophilia occurring after onset of cognitive impairment.

Four married patients are reported who first manifested pedophilia and other signs of disinhibition after sustaining illnesses that led to cognitive impairments. Although pedophilia may often be related to a long-standing inadequacy of sexual functioning, the onset of pedophilia in an individual without a previous histroy of sexual perversion may indicate the presence of recently sustained cognitive impairments.

Adult↗
PubMed1976

The sexually exploited child.

Sexual exploitation of children (under 14 years of age) is a common occurrence, although actual numbers are unknown. There are three major forms of sexual abuse: (1) incest, ie, sexual activity between consanguineous family members; (2) sexual assault, such as rape or molestation by adults not related to the child; and (3) habitual sexual exploitation for purposes of financial reward or perverse sexual satisfaction. Brother-sister incest has the highest incidence in the middle and upper socioeconomic levels and is probably the least damaging, psychologically, to sexual adjustment later in life. Father-daughter incest is more common in the lower socioeconomic levels and is thought to produce major disorders in the psychosexual area. Sexual assault of children, if handled supportively and with understanding by the surrounding adults, including parents, physicians, teachers, law enforcement officers, and others, can result in minimal sequelae; however, often the situation is handled with emotional reactions ranging from disgust to hysteria which result in the child's being victimized and traumatized unnecessarily. These latter situations lead to sexual acting-out in adolescence, promiscuity, perversions, or frigidity in adult sexual life. Teachers, physicians, and child welfare workers need to be attuned to the possibility to sexual abuse in the children they serve.

Adaptation, Psychological↗
PubMed1975

Nurse therapists in behavioural psychotherapy.

Five registered mental nurses (R.M.N.s) were trained over two years to become behavioural psychotherapists for adult neurotic disorders. They achieved results comparable to those obtained with similar patients and methods by psychologists and psychiatrists. Similar results were maintained when over a third year the therapists were seconded to work in four hospitals and a general practice. Patients were satisfied at being treated by nurses. After initial teething difficulties nurse therapists became valuable members of treatment teams during both training and secondment, becoming accepted by most nurses, psychologists, and psychiatrists with whom they came into contact. The training of further nurse therapists would facilitate treatment of many disabled neurotics who would otherwise go without effective treatment. Training nurse therapists takes less time and money than training psychologists and psychiatrists because less of their education is redundant to the skills involved. The pool of R.M.N.s suitable for training is much larger than that of psychiatrists and psychologists. The nurse therapists can be integrated relatively easily into treatment teams. The present nursing structure imposes restrictions on the advancement of clinical nurse specialists and a clinical tree is badly needed parallel with present administrative and teaching hierarchies. An 18-month course in adult behavioural psychotherapy has been recognized by the Joint Board of Clinical Nursing Studies for England and Wales so that nurse therapists seem destined to be a lasting feature of future treatment teams.

Adult↗
PubMed1976

Forensic psychiatry: profiles of two types of sex offenders.

The authors examined records of 239 individuals charged with sexual offenses and referred by the courts to a forensic service. Defendants charged with rape were typically under 30 with histories of antisocial behavior that included other types of violence. Major mental illness was rare in this group. Child molesters in the sample were of no particular age, usually had no history of violent behavior, and had a low incidence of psychosis. The most common secondary diagnosis in both groups was alcohol or drug abuse.

Alcoholism↗
PubMed1979

Diagnosis of adult psychiatric patients with childhood hyperactivity.

The authors compared 48 adult psychiatric patients (27 men and 21 women) who had been hyperactive as children with two groups of patients who had not. Both comparison groups were matched for age and sex and the second was also matched for economic status. Although closer matching narrowed the gap somewhat, the formerly hyperactive subjects still showed significantly more personality disorder of all types, more sociopathy, more alcoholism, and less affective disorder than controls. Schizophrenia and drug abuse occurred no more often in these subjects than in the comparison groups.

Adolescent↗
PubMed1976

Children who are victims of sexual assault and the psychology of offenders.

Psychiatrists and others have too often discounted reports of sexual attacks upon children and ascribed the incident to fantasy. The author's experience in private psychoanalytic practice and in Philadelphia's rape victim clinics indicates that these assaults occur frequently. If the sexual attack is dealt with improperly or repressed it may cause serious psychologic problems for the victim as an adult.

Adult↗
PubMed1976

A dynamic synthesis of analytic and behavioral approaches to symptoms.

The symptom-formation process involves a complex interaction between internal symbolic expression and secondary reinforcing consequences in the patient's environment. Symptoms are considered from a practical clinical perceptive integrating behavioral and analytic approaches and the implications for diagnosis, disposition, and treatment are outlined.

Behavior Therapy↗