bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Monetary Incentive on Concept Attainment in Depressed Subjects
Authors: Nutter R.W. , Cruise D.G. , Spreng L.F. , Weckowicz T.E. , Yonge K.A.
Published: April 2017

An experiment was conducted to determine whether highly depressed and non-depressed psychiatric inpatients and non-patient normal controls react differently on a concept attainment task to different reinforcement contingencies. Specifically, it was hypothesized that:

1) Depressed and non-depressed psychiatric patients and normal controls would perform at approximately the same levels on a concept attainment task when they received informational feedback only.

2) Depressed patients would show less improvement than normals and non-depressed patients when positive reinforcement (money) was given in addition to informational feedback in a concept attainment task.

3) Depressed patients would show markedly poorer performance than non-depressed patients and normals when punishment was administered for incorrect responses according to certain deductions from Freud's theory, but would be predicted to perform as well or better according to Beck's theory.

4) Following Freud's theory, depressives might initially attain concepts because of the demands of their ‘duty morality’ but would subsequently give incorrect responses to avoid positive reinforcement and/or gain punishment, since they reject ‘pleasure morality.’ This wolld not be predicted by Beck's theory.

5) If, as Beck contends, depressives are more sensitive to fear and frustration than non-depressed persons, depressed patients should have greater response latencies under punishment conditions than non-depressed persons.

A 3 x 4 factorial design was used with three diagnostic categories and four reinforcement conditions with four replications (4 Ss in each cell). The four reinforcement conditions were information feedback only, positive reinforcement only, punishment only, and positive reinforcement and punishment. The three diagnostic categories were high-depressed patients scoring greater than 24 on the Beck depression inventory (DI); low-depressed patients scoring less than 15 on the Beck DI; and normal controls.

The results did not strongly support any of the five hypotheses. In general, effects attributable to the different reinforcement conditions were weak and did not interact with the diagnostic categories as required to . support the hypotheses. Normals tended to perform better than psychiatric patients, and punishment tended to be associated with longer response latencies than positive reinforcement. Implications of these findings are discussed.
Three Types of Childhood Depression
Authors: Mcconville B.J. , Boag L.C. , Purohit A.P.
Published: April 2017

This study appears to substantiate clinical impressions regarding the three types of prime symptom depression seen in children. The affectual group occurs in younger children, and seems to give way to a mid-latency negative self-esteem type. Often such negative self-esteem is seen in multiple placement children or in others with chronic losses. Finally, there seems to be a rather uncommon type of guilt depression arising in late latency. By no means all negative self-esteem depressions merge into later guilt depressions. Most likely this latter group represents newly emerging childhood depressive symptoms in those who are old enough to experience an adult type of mourning response. This type of depression is particularly common in those with recent bereavements, and this was true of all the highest D3 scorers. Further clinical investigation of these preliminary findings is continuing.
State of the Art — 1973
Authors: Epstein Nathan B. , Bishop Duane S.
Published: April 2017

In summary, it can be said that progress is being made in the field, but slowly. The ‘art’ is vigorous, vital and exciting. The ranks of family therapists are swelling and they are coming from backgrounds of different theoretical persuasions and with varying degrees of sophistication in their training and education. This mélange does lead to excitement and turbulence but often detracts from the necessary rigour that a scientific discipline must develop in order to reach maturity.

Systems theory allows for easy conceptualization of one another's behaviour in the system, and permits a much clearer understanding of the therapeutic process based upon it, in contrast to therapeutic approaches based on other models.

The authors found negotiation to be therapeutically effective when made explicit. In addition they place the focus on the ‘here and now’ and encourage the increased labeling by family members of interactions (affective and behavioural) and their effects (affective and behavioural), according to the Family Categories Schema previously referred to. Efforts are directed especially towards dealing with the current resistances to problem solutions.

Epstein et al. have reported on an ongoing program of research which attempts to examine the process and outcome of family therapy (7,10,21,22,25,26).

What is needed now is a more rigorous approach to research and the development of a necessary theoretical base in order that a more systematic and scientific approach can be developed for treating families.
Civil Commitment and the Danger Mandate
Authors: Page Stewart , Yates Elizabeth
Published: April 2017

This paper examines the practice of involuntary mental hospitalization from the viewpoint of factors constituting effective, operating definitions of ‘dangerous’ mental disorder, as contrasted with the more narrow criteria which sanction commitment under Canadian law.

A sorting and analysis of a large sample of commitment certificates indicated that few contained evidence of involuntarily hospitalized patients as being dangerous, nor did the present sample of certificates indicate clearly that operating commitment criteria have been altered with the new and liberalized legislative formulations of such criteria. Independent of the need to commit certain people in society, possible incongruities between ideal and operating criteria for civil commitment deserve to be scrutinized by responsible professionals in mental health and law.
Life Cycle and Episodic Recidivism
Authors: Cormier Bruno M. , Boulanger Paul
Published: April 2017

Erikson a décrit les étapes psychosociales du développement, étapes qui sont concomitantes avec les étapes psychosexuelles antérieurement décrites par Freud. De même, les familles ont-elles leurs propres phases de développement, de même aussi, chacun de leurs membres vit-il ses mutations personnelles à l'intérieur du groupe.

Deux familles incestueuses ont été décrites où parents et enfants, indépendamment de leur âge chronologique, se rencontrent, soit dans les moments de régression chez les uns, soit dans les moments de progression difficile chez les autres. De ces rencontres ont résulté des comportements déviants.
Combinations of Antidepressant Drugs in the Treatment of Depressive Illness
Authors: Ray I.
Published: April 2017

Seventy-three inpatients and 11 outpatients, aged 16-76, were treated with modified sleep, combined antidepressant drugs and ECT. Every patient had treatment with psychotropic drugs prior to referral to the Yorkton Psychiatric Centre. Side effects encountered during the treatment were minimal. Concomitant ECT was also used with combined antidepressant drugs, and recovery of all patients from anesthesia during ECT was uneventful. Results of treatment on global assessment showed considerable improvement in 52 patients, 30 improved, and no change in 2 patients. The average stay in hospital was 19.5 days.
The Acquisition of Psychotherapy Skills: a Learning Model and Some Guidelines for Instructors
Authors: Berger David , Freebury D.R.
Published: April 2017

The psychodynamic pattern of acquiring psychotherapy skills can be viewed as one that exhibits regressive periods which tend towards one of two poles, ‘moving towards’, and ‘distancing’. A major block to learning, especially the learning of individual psychotherapy, is the resident's difficulties in the area of self-awareness. Pointing out psychodynamic patterns to him is essential, both to make him cognizant of the existence of the unconscious in the fullest sense and to allow the learning process to progress, possibly in a more adaptive way. Individual psychotherapy supervision is a major vehicle for such learning. Some guidelines for psychotherapy supervision are presented.
New Perspectives for Mental Health Care Delivery Systems
Authors: Thompson Michael G.
Published: April 2017

This paper describes the movement from a doctor-centred, fragmented mental health care delivery system to a system of collective responsibility on the policy level, and individualized attention on the client level. This may be achieved through the creation of a Human Services Council.
Therapy Strategies, Personality Orientation and Recovery from Alcoholism
Authors: Mclachlan John F. C.
Published: April 2017

The Conceptual Level (CL) matching model which previously predicted the immediate response of alcoholics to group psychotherapy was tested in a follow-up study of drinking behaviour. Seventy percent of patients matched to their therapist in terms of CL were found to have stopped drinking a year after treatment. By comparison, only 50 percent of the mismatched patients had stopped. Furthermore, after-care matching was related to recovery: matched patients (high CL with out-of-town care and low CL with in-town care) showed a 71 percent recovery rate, while mismatched patients showed a 49 percent rate. The overall recovery rate was 61 percent for the 94 alcoholics studied.
Trifluperidol-Induged Lactation
Authors: Sharma Shridhar , Gajwani A. K. , Sukerkar N. V.
Published: April 2017

The case is presented of a non-pregnant 19 year-old female who developed distressing lactation while being treated with trifluperidol for manic excitement. An analysis of her milk was done, the trifluperidol-induced milk was compared with breast milk in all three phases of normal lactation and differences in the constituents are discussed.
Les Potentiels Cerebraux Lents en Psychiatrie
Authors: Dongier M. , Dubrovsky B. , Garcia-Rill E.
Published: April 2017

Classical electroencephalography has brought no major contribution to psychiatric diagnosis over the last 40 years. However, new hopes have recently arisen with the introduction of new methods — the use of long-time constants together with averagers and/or computers. Cerebral electrogenesis is explored during a more or less complex task, for instance pushing a button following a visual or auditory stimulus. The amplitude and duration of potentials preceding and following the decision and the motor activity are recorded.

Many of the workers have attempted to establish psychological correlations of phenomena such as the CNV (contingent negative variation or expectancy wave) (8) and RP (readiness potential, pre-motor potential) (5). The cerebral events immediately following the decision and motor action PINV, (post imperative negative variations) are studied. These are considered to be of special interest in psychiatric patients. A minority of normal subjects (16 percent) show what is described as abnormalities of these potentials, whereas the majority of psychotics (75 percent) show these abnormalities. Neurotic patients show an intermediary percentage of abnormalities (37 percent).

In early schizophrenia, abnormal PINV are present in 94 percent of the cases, which makes the test of practical significance in doubtful cases. Studies of event-related slow potentials in more complex situations, with discriminative decisions requested from the subjests, are underway.
The Processes of Psychiatric Residency Training: Part I. Selection of Trainees and the Outcome of Training
Authors: Steiner Betty W. , Garfinkel Paul E. , Hunter R. C. A.
Published: April 2017

This paper draws attention to the problem of attrition in a psychiatric residency program by reviewing the outcome of training of all physicians accepted for psychiatric residencies at the University of Toronto over a six-year period. Of the 142 physicians no longer in training, 71 have become certified psychiatrists. Factors associated with success in training are examined. Those residents who are highly unlikely to become certified psychiatrists could be identified in each of the first three years of training. In view of these findings recommendations are made for improved screening of candidates and for dealing with residents who experience difficulties in training.
Differences between Mental Disorders of French Canadians and British Canadians
Authors: Murphy H. B. M.
Published: April 2017

A series of studies over the past decade has shown that Canadians of British origin differ from Canadians of French origin with respect to the symptomatology, frequency, course and probably the treatability of mental disorder. French Canadian schizophrenics exhibit more concern with real or imaginary disturbances of social relationships, whereas British Canadian schizophrenics and alcoholics alike exhibit a greater disregard for such relationships and for the support that goes with them. French Canadian depressives have a greater tendency towards psychomotor retardation and somatic concerns, whereas British Canadian depressives show a greater concern with guilt feelings, obsessiveness, and greater signs of thought disorder.

First hospitalizations are proportionately more frequent among British Canadians than among French Canadians in the white-collar strata, but the reverse is true in the blue-collar. The British Canadians have the higher incidence of organic disorders, but the French Canadians of the functional ones. When patients are sent to mental hospital the British Canadians tend to achieve earlier discharge than the French Canadians, but when treatment is given in an outpatient clinic there is some evidence that the French Canadians show the better recovery rate.

Connections are suggested between these findings and more general differences between the two cultures and it is suggested that clinicians may be able to put such knowledge to practical use. In particular, it is suggested that attention to maintaining social ties is more important for the French Canadian patient than for the British Canadian who conversely requires more attention to be paid to his intra-psychic ties.
Accident Neurosis: Whatever Happened to Male Hysteria?
Authors: Allodi F. A.
Published: April 2017

The role of the Workmen's Compensation Board in establishing the extent to which a disability is due to an accident, and then allocating compensation has, for half a century, been carried out with fairness and skill. However, when it comes to cases of psychiatric disability the guidelines for judging causation and assigning compensation are somewhat simplistic and inadequate. The purpose of this study was to establish more accurate and reliable criteria to assist clinicians and medicolegal experts in assessing and compensating the person with a psychiatric disability. The material studied in the present pilot project comprises 50 cases referred to the author for psychiatric consultation from the year 1967 to 1971. In terms of socioeconomic background and clinical features these findings are similar to those reported in the literature, including an outstanding prevalence of hysterical symptoms. Correlation analysis between the pre-accident and accident variables and the post-accident variables or psychiatric impairment were most significant for variables related to the circumstances of the accident (type of accident, psychological threat posed by the accident). This study has permitted clarification of a number of conceptual and methodological problems, and recommendations are given for a prospective comprehensive research project on accident neurosis.
Mourning and Depression: Their Similarities and Differences
Authors: Clayton Paula J. , Herjanic Marijan , Murphy George E. , Woodruff Robert
Published: April 2017

Previous studies have shown that bereaved people respond to their loss with a set of psychological symptoms which are in many instances indistinguishable from depressive illness, but accepted by them and their environment as normal (1,3,5). On the other hand, patients with primary affective disorder experience their condition as a “change”, “not usual self” (7), which leads them to seek help, and in this way they define themselves as patients. A comparison of frequencies of psychiatric symptoms between depressed 34, and bereaved 34, subjects matched for sex and age shows that hospitalized depressed subjects have more symptoms — 15 — than bereaved subjects (7). However, there is enough overlap that, on the basis of symptoms, the two groups cannot be differentiated satisfactorily for research purposes.

In psychiatry, most diagnostic criteria are arbitrary. If they are set narrow some patients with a mild form of illness are excluded, while if broad criteria are employed persons with other conditions or no illness at all are included. For research purposes if the symptoms of depression occur only after the death of a near relative the subjects should not be included in the group diagnosed as suffering from primary affective disorder.
Stiff-Man Syndrome
Authors: Warneke L.
Published: April 2017

A single case of Stiff-man Syndrome is presented. Some of the literature relevant to this syndrome is reviewed and the presenting clinical features and associated laboratory findings are briefly summarized. Differential diagnosis and recent views on the mechanism of the disorder are also discussed. The case was reported because of its relevance to psychiatry in that the majority of patients with Stiff-man Syndrome present with non-specific psychiatric symptoms such as depression and anxiety. They are often labeled as neurotic or hysterical and frequently come to the attention of psychiatrists long before the diagnosis is made, but once the diagnosis is made treatment is both specific and effective.
Anxiety Relief Conditioning A Critical Review and Supportive Experiment
Authors: Turnage John R. , Wenrich W. W.
Published: April 2017

An experiment was conducted to separate the effects of anxiety relief conditioning from other variables which may be operative within that paradigm. A review of the literature revealed that no definitive investigations had been conducted, and critiques of these investigations were offered. Also, the distinction between aversion relief and anxiety relief conditioning procedures was detailed.

In an attempt to offer evidence supportive of the efficacy of anxiety relief conditioning as a therapeutic technique per se, an experiment was conducted which attempted to control those variables which presumably may have confounded the findings of previous research. Two groups of snake phobic subjects were matched on the basis of an objective snake approach task, and were subjected to three, 15-min. sessions of either anxiety relief conditioning, or pseudoconditioning. It was hypothesized that the anxiety relief conditioning group would demonstrate therapeutic efficacy while the pseudoconditioning group would show no appreciable change. Analysis of the results revealed a statistically significant difference in the predicted direction. Experimental support for the effectiveness of anxiety relief conditioning as a separate and distinct therapeutic technique was thereby obtained.
Les Phenomenes Mystiques Chez le Malade Psychiatrique
Authors: Duguay Robert , Chaloult Louis , Tétreault Léon
Published: April 2017

An inquiry about mystical phenomena in psychiatric patients was done in a large French Canadian psychiatric hospital.

Four hundred and fifteen patients, taken at random, with functional psychiatric illnesses, were assessed. It was found that 19.28% of this population experienced mystical phenomena. The mystical experience was defined as an unusual psychological state in which a subject had the conviction of being in contact with God or any religious personality of the religion (angels, saints, etc…). The incidence of the mystical phenomena was studied in connection with four parameters:

1. identification characteristics of the patient

2. type of illness

3. sexual life of the patient

4. tendency of the patient to swear

Six statistically significant features were identified in mystical patients: these patients have more sexual behavioral symptoms, are more inclined to swear, are more often paranoid schizophrenics with a chronic illness, are not married and have belonged previously to a religious order.
Psychiatric Service to the Juvenile Court a Model
Authors: Chamberlain Clive , Awad George
Published: April 2017

The interface between psychiatry and the law developed unevenly and the greatest concentration has been in the area of criminal behaviour—family law and juvenile deliquency have been relatively ignored. When developing a clinical service in relation to a Family Court, the lack of literature on the subject became obvious. This paper gives an account of the historical development of the Family Court Clinic in Toronto beginning in 1920 at the time of the appointment of the first full-time Juvenile Court Judge. In terms of the problems and limitations the development of this clinic was typical of similar ventures elsewhere in North America. These problems include insufficient funding and staffing, unrealistic demands for service by the Courts, and incomplete understanding of the operation and needs of Courts on the part of mental health workers. A Family Court Clinic at the Clarke Institute of Psychiatry is offered as an example of a survivor of these and other vicissitudes, with the hope that some of its policies and practices may be useful to those involved in this work. It is felt that several ingredients are responsible for the success of the clinic, among them being attachment to a university clinical setting, a flexible appointment schedule such as evening office hours and the avoidance of a solely diagnostic approach to the work. In the past many clinics have failed because they were chiefly assessment-oriented, offering formulations of the problems but very little in the way of remedies. While unable to provide ongoing treatment for its very large clientele, the clinic operates in such a way as to provide a very broad range of service including a referral policy which treats the process of referral to other services more as a ‘service brokerage’ than the more conventional procedure of a referral letter. This is a much more active involvement which does not cease until the patient has begun receiving a service.

Other programs of the clinic in relation to the Juvenile Court are mentioned in the paper and include training programs for judges and other court staff and also research activity. Experience over the past five years with the clinic is discussed in terms of the difficulties encountered in development and the attempts to resolve these. There is a need for clinicians involved in such enterprises to share problems and solutions and to anticipate increasing demands upon psychiatrists for service in relation to family law and family courts.
Frequency and Significance of Minor Organic Signs in Elderly Depressives:
Authors: Cole M. , Hicking T.
Published: April 2017

Eighty-six elderly depressed patients were followed up for two years. Twenty-nine (34 percent) displayed minor organic signs (partial disorientation to time and/or partial disorientation to place and/or mild impairment of registration or recent memory). Minor organic signs were associated with a significant reduction in discharge rate two years following admission in patients aged 70 years plus. Among those discharged, minor organic signs were associated with a significant decline in living arrangements two years following admission.

Coincidentally, minor organic signs identified a group of elderly depressives characterized by older age, depressions of late onset, and few precipitating events.
Hyperactivity and Physical Anomalies
Authors: Firestone Philip , Lewy Fran , Douglas Virginia I.
Published: April 2017

Hyperactive elementary school boys were matched for age and IQ to a group of normal control children, and the frequency of minor physical anomalies in each group was recorded. Although hyperactives had more of these anomalies than the control children there was not a significant correlation between the degree of hyperactivity and the frequency of anomalies.
Neonaticide
Authors: Arboleda-Florez J.
Published: April 2017

This paper reports on a thirty-three year old single woman who committed neonaticide. The psychopathology of the offence is reviewed. The author warns of the possibilities of repetition of the offence, an eventuality which was most likely averted at the end of Miss H.'s third pregnancy, subsequent to the one which ended in neonaticide.
Patterns in the Delivery of Psychiatric Care in Saskatchewan 1971–72: An Overview of Service Sectors and Patient Volumes
Authors: D'Arcy Carl
Published: April 2017

For the purpose of examining patterns in the delivery of psychiatric services in the province of Saskatchewan during 1971 and 1972, a research data file was created containing data on all persons who had received medical treatment for explicitly psychiatric disorders: from PSB; from a physician paid on a fee-for-service basis under MCIC; and/or in a provincial general hospital. The resulting data file provides a history of the psychiatric care utilization behaviour of all patients who have been treated for a psychiatric illness in the province during the period January 1st, 1971 to December 31st, 1972, irrespective of the facilities in which this treatment was delivered. This data file, since it has keyed on explicitly psychiatric diagnoses and on diagnoses rather than type of service delivered, will give conservative estimates on the number of patients and patterns of contacts.

During the two-year period a total of 123,099 received some form of psychiatric treatment. There were six times as many patients seen by fee-for-service physicians as by the ‘public’ sector. In both sectors the majority of patients were seen on an outpatient basis. Patients in the ‘private’ sector were usually seen by general practitioners. There appear to be two relatively autonomous sectors involved in the delivery of psychiatric care to different population segments.

There was also a significant ‘turnover’ in the provincial psychiatric population, with patients receiving treatment in one year but not in the other.

The data could be interpreted to suggest that the majority of persons seen for psychiatric reasons by medical practitioners are suffering from relatively minor psychiatric ailments. This raises the whole question of the suitability of the service delivery system and the question of manpower substitution. Alternatively, it could be argued that these data, both the large number of outpatients and the considerable yearly turnover in the provincial psychiatric population, indicate that psychiatric problems are now essentially amenable to treatment.
The Proband-Sibling Design in Psychiatry, with Two Technical Notes
Authors: Offord D.R. , Jones Marshall B.
Published: April 2017

This paper examines the strengths and limitations of the proband-sibling design. As controls, siblings have two major advantages over biologically unrelated subjects. First, they provide better matching and, second, the sibling design is free from regression effects. Only discordant identical co-twins are stronger controls. However, discordant identical twins are not as available for psychiatric research as siblings; the design is sensitive to environmental differences only; and the conclusions reached have less external validity than those reached through proband-sibling comparisons. The limitations of the sibling design include a skewing towards larger sibships and an inability to detect between-family effects. These strengths and limitations are explored and their implications for psychiatric research discussed. Two technical problems associated with this design are examined. First, a statistical technique is presented which allows it to be determined whether the proband is different from his siblings without regard to sibship size or the form of the dependent variable. Second, it is shown how the role of geographic mobility can be clarified in follow-back studies using the proband-sibling design.
Supervision of Psychotherapy with Psychiatric Residents: One Model
Authors: Greben Stanley E.
Published: April 2017

Training of psychiatric residents should include supervised experience in psychotherapy, whatever the mode of practice the psychiatrist-to-be will later choose. individual supervision of psychotherapy on patients seen at least once a week for a year offers the best opportunity for learning in this area.

The supervisor has a teaching role which includes showing the resident how to look more objectively and insightfully at the material, serving as a partial model of a professional identity, and giving direct didactic help regarding the subject of psychotherapy.

Such an experience leads to growth and development of the resident in his professional role as psychotherapist.
The Oedipus Complex: A Critical Re-Examination
Authors: Paris Joel
Published: April 2017

The Oedipus complex no longer holds the crucial role in psychodynamics attributed to it by Freud. Attempts to distinguish between oedipal and pre-oedipal disturbances are brought into question, and it is suggested that the complex reflects many non-psychosexual issues, particularly separation-individuation. Ten views of the Oedipus complex are critically reviewed.
An Approach to the Treatment of an Adolescent with Ulcerative Colitis: Conjoint Therapy of the Parents
Authors: Maclean G.
Published: April 2017

Summary

The pertinent literature on the psychopathology and psychotherapy of individuals with ulcerative colitis is briefly summarized. A particular problem encountered in clinical practice is then described and an approach to its solution is detailed.

A 14-year-old, middle-class girl had experienced exacerbations of ulcerative colitis over two years. Without her agreement, she was referred for psychiatric assessment by a gastroenterologist when he found that she was not cooperating with medical treatment, and when she appeared depressed.

On assessment, the patient was found to be a silent adolescent whose main symptoms were indicative of immaturity, shyness and anger. This was understood in terms of the overprotective, domineering mother, a protective father and even a protective brother. The therapeutic problem was outlined on referral by her reluctance to take medication, to see doctors or to “let her friends know” of her illness. The patient and the family interactions are described.

Confronted by a girl whose denial was of such proportions it became clear that individual psychotherapy could not begin. There was no motivation and no contract to work towards this goal, and there was excessive resistance. With the girl's refusal to become involved in family therapy, it was decided that both parents should review their respective parenting roles in conjoint therapy. This had as its goal the provision of a more stimulating opportunity for the growth and development of the patient.

The author describes in detail the assessment and treatment, which was conceptualized as occurring in two stages. Stage one was an attempt at individual therapy and at developing a therapeutic alliance, both of which were unsuccessful. The second stage, conjoint therapy of the parents took place, and provided a more fruitful outcome.
A Case of Temporal Lobe Epilepsy with an Orgasmic Component
Authors: Warneke Lorne B.
Published: April 2017

A case is presented of a thirty-one year old man with temporal lobe epilepsy with probably, multiple foci of origin on the right side. His attacks included an ‘orgasmic like’ sensation which spread across his face from right to left and was followed by muscle twitching which extended into the left neck and arm. The sensations were unpleasant because of their location. Various features of temporal lobe dysfunction are discussed as well as the clinical aspects of the case.
Blindness: Some Psychological and Social Implications
Authors: Keegan David L. , Ash Daniel D.G. , Greenough Timothy
Published: April 2017

Psychiatry must increase the knowledge of adjustment to various physical disabilities if it is to act in a strong consultant role to medicine and surgery. To this end, the study of one hundred and fourteen adventitiously, declared blind subjects was carried out through structured interviews and psychological and social adjustment measures. The variables were statistically analysed, using the F test, Duncan's Multiple Range test and Canonical Correlation Analysis.

The best social function occurred in the youngest age groups, those who had the highest yearly income at the time of maximum life function and who entered rehabilitation. The best psychological and social function was found in those who had given up false hope of regaining vision. The group who had not given up this false hope did poorly on social and psychological adjustment measures and were generally unemployed, coped poorly and did not attend programs in the Canadian National Institute for the Blind (CNIB).

The onset of visual loss was found to be the time of greatest crisis, while declaration of blindness in itself led to no particular crisis with associated diminished social or psychological adjustment. Some concern is noted that the CNIB, the major caregiver for the blind, cannot offer assistance at onset because of the legal definition of blindness, and poor service may be furnished by family physicians, ophthalmologists and psychosocial helpers due to lack of understanding, shifting of responsibility and at times, neglect, assuming that the CNIB is assisting when they cannot or are not.

More research is needed in all aspects of psychosocial care for the blind. Communicating among helping groups and with the CNIB is imperative if the visually handicapped are to get better psychosocial care.
The Western Psychiatrist and his Non-Western Clientele: Transcultural Experiences of Relevance to Psychotherapy with Canadian Indian Patients.
Authors: Jilek-Aall Louise
Published: April 2017

Whenever a Western-trained psychiatrist is faced with the challenge of treating patients from a non-Western society, his responsibility is greater than when treating Western patients. He must acquire sufficient knowledge of that culture in order to distinguish between genuine psychiatric illness and culturally determined pathomorphic, that is illness-like, but not pathologic, states. He must also be able to gauge the degree of acculturation in his patient and to judge whether a therapist or indigenous healer of that very culture would not be of more benefit to this patient than Western psychiatry.
The Medical Student Therapist Treatment Outcome
Authors: Miles James E. , Mclean Peter D. , Maurice William L.
Published: April 2017

Sixty inpatients from a psychiatric ward, where senior medical students function as the sole primary physicians, were matched with 60 inpatients from two other wards in the same hospital who had been attended by psychiatric residents and certified psychiatrists. The problem-oriented medical record was used as a basis for treatment evaluation. Ratings by the patient at discharge, and the patient, a significant other and follow-up professional at three months, showed no significant difference in the treatment outcome between the two groups.
Implantation De La Therapie Comportementale En Milieu Psychanalytique
Authors: Lamontagne Yves
Published: April 2017

In French-speaking Quebec, implantation of behaviour therapy in psychiatric hospitals has been difficult because psychiatrists' training was and still is almost exclusively based on psychoanalytic theory. For this reason, many psychotherapists do not use the knowledge derived from laboratory experiments and only rely on their clinical judgement. Prejudiced by their professional identity, many psychiatrists believe that behaviorists manipulate and control patients, mechanize therapy, deny the importance of interpersonal relationships and only use punitive techniques.

After refuting these arguments, the author describes the practical difficulties encountered when implanting behaviour therapy in a psychoanalytic milieu, as well as the advantages of a better understanding between these two schools, which might lead to psychiatry becoming more scientific, more human and closer to daily reality.
Maprotiline — a Double-Blind Study of a New Tetracyclic Antidepressant in Severe Depression
Authors: Molnar G.
Published: April 2017

A double-blind study was carried out comparing the antidepressant properties of maprotiline (a new tetracyclic antidepressant) and amitriptyline. Twenty-one hospitalized severely depressed patients, selected on the basis of clinical and psychometric criteria, completed the trial period of 28 days.

The new drug was found to have an order of effectiveness similar to that of amitriptyline and both drugs were effective in agitated as well as retarded forms of depression. For both, the “day of effect”, intended as the timing of sharp clinical improvement, tended to occur during the second week of treatment. Both drugs were well tolerated by most patients but one of the maprotiline patients presented a generalized rash which resolved after discontinuation of the drug.

In conclusion, maprotiline is seen as an interesting addition to the group of major antidepressant drugs.
Psychic Trauma and Traumatic Neurosis
Authors: Maclean G.
Published: April 2017

In the introduction to a clinical example of a young boy with a traumatic neurosis, this paper reviews the phenomena of psychic trauma. Freud's contribution to the initial description of the phenomena is discussed with consideration of such factors as the “stimulus barrier”, breaks in this “protective shield” and the development of a “traumatic neurosis”. The elaboration of these concepts is followed in their later development in the literature.

The clinical example presented by the author is a description of the assessment and treatment of a four-year-old boy who had been mauled by a leopard in a suburban pet store. The presenting complaints at the time of assessment were numerous and of precise onset to the time of the mauling. The boy exhibited disturbance in sleep, clinging, fearful, apprehensive behaviour and marked separation anxiety. All such symptoms appeared as a marked regression in the boy's formerly normal development.

The child's course in play therapy is detailed. This highlighted the existence of a number of intrapsychic conflicts involving anger, guilt and the fear of retaliation. The fact that such conflicts predated the traumatic event is postulated to be a determinant of the traumatic process.
Treating the Borderline Patient in Psychotherapy
Authors: Masterson James F.
Published: April 2017

An attempt has been made to describe the contribution of maternal libidinal availability and withdrawal to the etiology of the borderline syndrome. The mother's vital contribution to normal ego development has been emphasized, and the effects of deficiencies in that contribution to the development of the intrapsychic structure of the borderline — the split ego and the split object relations unit. The latter develops from the internalization of the two major themes of interaction with the mother, produces the lietmotif of the borderline's intrapsychic structure — the rewarding and withdrawing object relations part units. The rewarding part unit becomes allied with the pathological ego to defend against the withdrawing unit, but at the cost of failure to cope with reality.

The relationship of these borderline intrapsychic structures to each other and to the therapist's intrapsychic structures, as developed in the therapeutic transference and resistance, is described and illustrated in a clinical example.
A High Prevalence of Affective Disorder Discovered in a ‘Schizophrenia Clinic’
Authors: Rapp Morton S. , Edwards Peggy
Published: April 2017

Fifty outpatients in a ‘schizophrenia clinic’ were examined, and sixteen were found to be suffering from periodic affective disorders. Nine of these were given lithium carbonate, and eight responded well. Case histories illustrate three separate reasons for incorrect diagnosis. Examination of extensive old clinical notes of five of these patients suggests that the problems of diagnosis which have been described in the literature in the past, continue to represent obstacles to correct diagnosis. Suggestions for improvement are offered.
The New Androgyny: Therapy of “Liberated” Couples
Authors: Guttman Herta A.
Published: April 2017

Under the impact of women's liberation, many couples are seeking to develop relationships in which roles are less sex-linked and more androgynous. To help such couples and their families, therapists must re-examine and modify their own sexist preconceptions. However, to be effective even the most “liberated” therapist and couple must distinguish between problems arising from sexism and from each member's personal history and psychodynamics.
Desensitization Therapy for Body Image Anxiety
Authors: Cassell Wilfred A.
Published: April 2017

A newly devised therapy technique to desensitize individuals for body image anxiety arising from conversion symptoms and psychophysiologic disorders is outlined. One application involves the projective use of inkblots with high anatomical content which provide a source of visual input to stimulate somatic images in consciousness. When these are activated in a state of relaxation the anxiety content of the pathologic anatomical imagery is reduced. A case history involving desensitization treatment for a psychoneurotic patient's psychophysiologic symptom of premature ejaculation is cited. It is primarily designed to alert interested clinical investigators to this technical innovation in treatment.
Dopamine and Schizophrenia: A Reappraisal in the Light of Clinical Studies with Clozapine
Authors: Nair N. P. V. , Zicherman V. , Schwartz G.
Published: April 2017

In this paper we review the results of our clinical evaluation of a novel antipsychotic drug, clozapine, and discuss some fundamental issues in the neuropharmacology of schizophrenia, in the light of the results. Nineteen hospitalized chronic schizophrenic patients were treated with clozapine. The drug was administered according to a fixed changing dosage schedule, ranging from 75 mg to 800 mg daily. There was a highly significant improvement as measured by the Brief Psychiatric Rating Scale. At the same time no evidence of Parkinsonism or other extrapyramidal side effects was noted in these patients during the drug administration.

For some time now, drug effect on the extrapyramidal system mediated through the nigrostriatal dopaminergic pathway was considered necessary for therapeutic effects in schizophrenic patients. But the recent discovery of the mesolimbic dopaminergic system raises the possibility that the therapeutic action of antipsychotic drugs could be mediated through this pathway without necessarily affecting the nigrostriatal pathway. This is further supported by the fact that these two dopaminergic systems have somewhat different pharmacological properties in relation to DA turnover and DA receptor blockade.

The present study clearly demonstrates the antipsychotic property of clozapine. It is equally clear that it induces no extrapyramidal effects. These findings tend to support the hypothesis that clozapine may be selectively blocking dopaminergic receptors in the limbic system. The pharmacological evidence from the literature for this selectivity is presented to support the hypothesis that schizophrenic symptoms are related to excessive dopaminergic activity in the limbic system.

In conclusion it can be stated that clozapine represents a significant advance in the investigation of the neuropharmacology and pathophysiology of schizophrenia.
Moral Judgment and Moral Conduct in the Psychopath
Authors: Link Nancy F. , Scherer Shawn E. , Byrne P. Niall
Published: April 2017

The relationship between moral conduct and moral judgment was investigated by comparing moral reasoning of a psychopathic sample from a maximum security hospital for the criminal offender with a similar inmate, nonpsychopathic sample, and a group of “normals”. Psychopaths obtained significantly higher scores on the Kohlberg scale of moral judgment than either of the other groups, for whom no differences were found. Results suggest the hypothesis that lack of guilt feelings in psychopaths facilitate the achievement of higher levels of moral judgment.
Physical Illness and Length of Psychiatric Hospitalization*
Authors: Allodi F. , Cohen M.
Published: April 2017

The authors examined physical health in relation to length of psychiatric hospitalization. One hundred and three consecutive patients admitted to an Ontario psychiatric hospital were studied for age, sex, marital status, living arrangements, previous psychiatric hospitalizations, psychiatric diagnosis and length of stay. The patients were classified as physically healthy, with minor or with major illness present.

Physical health was found to have a significant association with length of psychiatric hospitalization. Healthy patients tended to stay a shorter period of time (1–3 days) and those with major illness stayed longer (greater than 21 days). As expected, marital status and psychiatric diagnosis were also associated with length of stay; married persons stayed for shorter periods and those with functional and organic psychoses stayed longer.

The direct association between physical health and length of hospitalization has not been reported before and, in considering the role of the mental hospital, psychiatrists and administrators should be constantly aware of the physical health needs of psychiatric patients.
Sodium Amytal in the Diagnosis of Chronic Pain*
Authors: Shoichet Roy P.
Published: April 2017

The diagnosis of chronic pain cases is now an important problem for psychiatrists and many authors have presented strong evidence for the influence of psychological factors in chronic pain conditions. The author is reporting his experience with 75 consecutive out-patient consultations. Many of the patients were foreign-born and had significant language difficulties.

The main diagnostic technique described is the use of sodium amytal given intravenously over a 45 minute-period while the patient is examined physically and psychologically; his responses noted during light, midrange and deeper levels of sodium amytal sedation. Most patients fell comfortably into one of the following diagnostic groups: psychogenic regional pain, organic pain, mixed group (organic plus psychogenic regional pain), and malingering.

The author suggests that sodium amytal helps to overcome language barriers, reduces the time required for proper assessment and allows the patient and the examiner to appreciate more precisely, the level of pain and the limits of physical performance as well as permitting an effective exploration of important psychodynamic issues.
Diagnosis of Schizophrenia
Authors: Bland Roger C.
Published: April 2017

Case records of ninety consecutive first lifetime admissions with a hospital diagnosis of schizophrenia were examined for Schneiderian first rank symptoms, the Feighner diagnostic criteria, and the New Haven Schizophrenia Index. Diagnostic exclusion criteria were developed and applied. It is concluded that the hospital diagnosis of schizophrenia is likely to be too broad. Each diagnostic system can increase accuracy of diagnosis, but their exclusion criteria are too vague and the system would be improved by using those given here. Each diagnostic system selects similar groups of patients, and can be applied retrospectively to adequate case records.