bluuebunny/crossref_metadata_2025 huggingface dataset:
Tears of Joy
Authors: Adamson John D.
Published: April 2017

“Tears of joy” refers to crying when there has been a psychological gain, not a loss. The dynamic explanation of the phenomenon is that the need to repress sadness is lifted because of the gain; genetically the crying is over past losses. A clinical vignette illustrating the phenomenon is given here. It relieved the patient to be told that her symptoms did not mean that she was sick and requiring medication.
Cognitive Therapies: An Early Appraisal
Authors: Rapp Morton S.
Published: April 2017

Cognitive therapy embraces the theory and practice of a number of skilled and productive clinicians and researchers, and is being used increasingly. This essay has explained the core idea behind cognitive therapy, differentiated it from other standard forms of therapy, supplied some clinical examples, and attempted an early evaluation. The cognitive therapy idea is in its ascendency, and a more definitive evaluation will be possible only some years hence.
Elderly Depressives: Treatment and Follow-up
Authors: Gordon W.F.
Published: April 2017

Seventy-four depressed inpatients, 65 years of age or more, were consecutively treated in the Geriatric Unit of St. Thomas Psychiatric Hospital, during the years 1972 to 1978. Four died while inpatients and sixty-nine left hospital after an average stay of 3½ months. Ten patients had been readmitted during follow-up and within a period of between six months and two years after discharge. Five outpatients have died, two by suicide. Elderly depressives respond well to modern treatment provided medication and aftercare are maintained.
A Critical Analysis of French Psychiatric Nosology
Authors: Hooton A. , Hooton C.
Published: April 2017

The authors trace French psychiatric nosology since the turn of the century as it has developed clinical concepts not generally recognized by American psychiatrists. They claim the autonomy of three distinct (non-schizophrenic) chronic delusional psychoses is supported by clinical and statistical data, although current diagnostic practice fails to apply the same criteria to the differentiation of (non-schizophrenic) acute delusional psychoses, also recognized in France as an autonomous group. The authors suggest that French clinical findings have interesting practical implications for the study and treatment of that group of patients diagnosed in America as schizophrenics, a significant percentage of whom would be expected, on the basis of French studies, to have an early spontaneous remission without treatment.
Article
Authors: Hooton A. , Hooton Et C.
Published: April 2017

Les auteurs retracent la nosologie psychiatrique française depuis le tournant du siècle, quand elle a donné naissance à certains concepts cliniques qui ne sont généralement pas admis par les psychiatres américains. Ils montrent que l'autonomie de trois psychoses délirantes chroniques (non schizophréniques) distinctes est corroborée par les données cliniques et statistiques, bien que l'éxpérience diagnostique courante n'applique pas les mêmes critères à la différenciation des psychoses délirantes aiguës (non schizophréniques), également considérées en France comme un groupe autonome. Les auteurs indiquent que les constatations cliniques françaises débouchent sur des aperçus pratiques intéressants pour l'étude et le traitement du groupe des patients porteurs, en Amérique, du diagnostic de schizophrénie: si l'on se base sur les travaux français, on pourrait s'attendre à ce qu'un pourcentage appréciable de ces cas jourissent d'une rémission spontanée précoce, même sans traitement.
Intimacy and Emotional Illness in the General Population
Authors: Waring Edward M. , Mcelrath Debbie , Mitchell Paul , Derry Mary Ellen
Published: April 2017

Ninety married couples in the general population received a structured interview to assess their level of intimacy. The couples also completed self-report questionnaires to assess non-psychotic emotional illness and marital adjustment.

High levels of intimacy were associated with marital adjustment. Low ratings of marital intimacy were significantly associated with non-psychotic emotional illness and psychiatric help-seeking. These findings are discussed in relationship to recent studies which explore the role of lack of marital intimacy as a vulnerability fact or in the development of non-psychotic emotional illness. Implications for treatment of non-psychotic emotional illness in married individuals is briefly discussed.
Female-to-Male Transsexuals and their Partners
Authors: Steiner Betty W. , Bernstein Stephen M.
Published: April 2017

This paper reviews briefly the literature on gender disorders, that is transsexualism in fernales. Forty-one female-to-male transsexuals and twenty-one female partners of these patients were evaluated in the Gender Identity Clinic at the Clarke Institute of Psychiatry. The authors report on the type of behaviour patterns with particular reference to the kind of relationship the patients form with their partners. These seem to be stable, long-term relationships, though both the transsexual and his partner have had considerable sexual experience prior to forming this relationship. Contrary to what other workers report, these transsexuals wish to parent children and indeed frequently chose partners who already had children. The authors speculate on the reasons why a normal biological female would choose a “penis-less man” as a partner and form a long-term enduring relationship with him.
Intake Follow-Up of “No Service” Cases
Authors: Lefebvre Arlette , Weiss Elliott , Cohen Nancy , Waldron Suzanne
Published: April 2017

At The Hospital for Sick Children in Toronto, an attempt was made to bypass long pre-assessment waiting lists by referring an increasing number of patients to local community resources at the point of the initial intake call. During the pilot study, we contacted 40 families who had been redirected along these lines between January and June 1979. We found that 31 (78%)families had followed our recommendations and most were satisfied with the treatment they were receiving. This suggests that “re-referral” upon intake can often be a highly effective and useful service when provided by a central resource and consultation centre. A further systematic follow-up of all applications to children's mental health clinics, including a careful appraisal of no-show cases (families who are accepted for assessment but cancel or fail to attend), is essential so that we can tailor our services to the specific child psychiatry needs of our varied clientèle.
Body Image in Anorexia Nervosa
Authors: Garner David M.
Published: April 2017

Despite much recent interest in the objective measurement of body image in anorexia nervosa, many questions remain regarding basic mechanisms responsible for the findings as well as their meaning in the disorder. It is unclear if “whole body” measures assess the same underlying phenomena as the “body part” method, and it is unclear if body image disturbances are etiologic or a byproduct of anorexia nervosa. The possible association between self-esteem and body satisfaction and the relationship of the latter variable to actual size estimation supports the hypothesis that size perception may be closely tied to satisfaction with non-physical aspects of self. Finally it must be determined if over estimation is a function of a general psychological disturbance or of a deficit of specific interest in this disorder. Despite these questions, the way in which anorexic patients see themselves as well as the cognitive and affective responses to this perception remains an interesting and potentially fruitful area of study with this disorder.
A Practice Oral Examination Rating Scale — Inter-Observer Reliability
Authors: Mccormick William O.
Published: April 2017

Three videotaped practice clinical, oral examinations were rated by 9, 9 and 11 raters respectively. Raters were all certified specialists engaged in training residents for the certification examinations. In two of the simulated examinations considerable differences in rating scores, to the extent of pass/fail disagreement, were found. The significance of the findings, including the possibility that one examiner may “contaminate” another, is discussed. Further work is essential to develop reliable instruments for rating certification examinations, whatever their format, as the Royal College policies evolve.
Patients’ Reactions to Their Commitment
Authors: Toews J. , El-Guebaly N. , Leckie A.
Published: April 2017

The authors surveyed the reactions toward commitment of 61 respondents out of a sample of 100 patients who had been committed to hospital during a one year period. The patients reported little change in their life situation as a result of committal and most viewed committal quite neutrally. They generally felt uninformed of their rights and indicated little intent to appeal the commitments, but wished to be assured that their rights were being considered and protected. Most saw psychiatrists as the professional group best equipped to bring about a committal. The importance of consumer surveys in controversial areas such as this is underscored.
Schizophrenia and Klinefelter's Syndrome
Authors: Roy Alec
Published: April 2017

Psychiatric disorder in relation to Klinefelter's syndrome is reviewed. A well documented case report is presented of a schizophreniform illness in a patient with Klinefelter's.
Institutional Care of the Mentally Disordered in Canada — a 17th Century Record
Authors: Griffin John D. , Greenland Cyril
Published: April 2017

“General hospitals” for the care of the helpless poor, the aged and infirm, lunatics and idiots, which were developed in the mid-17th century by Louis XIV of France, soon spread to the colony in New France. Francois Charon, a wealthy businessman, built the Hôpital Général de Ville Marie, Montreal, which was opened in 1694 to care for impoverished and helpless men.

The Hospital Register, discovered in the Archives of the Soeurs Grises, Montreal, provides details of the patients’ names, dates of and reasons for admission and the dates of discharge or death. An analysis of the Register, covering the 45 years of the Charon period, reveals that among the 66 boys and men admitted, from 1694 to 1738, at least seven inmates suffered from some form of mental disorder or retardation. This suggests that the Hôpital Général de Ville Marie, together with the Hôpital Général de Québec, were the first Canadian institutions to provide care for the mentally disordered.

Pierre Chevallier, who was retarded, lived in the hospital for 44 years until his death at the age of 85. The length of stay in the hospital indicates that the early settlers of New France were men of robust constitution and that the regime provided by the Frères Charon was physically as well as spiritually sustaining.
D. Ewen Cameron's Day Hospital and the Day Hospital Movement
Authors: Goldman D.L. , Arvanitakis K.
Published: April 2017

D. Ewen Cameron founded the first day hospital in the Western World at the Allan Memorial Institute in 1946. The present article deals with the historical development of the day hospital through an understanding of Dr. Cameron's era and his pursuits. The post- World War II period was one of great advancement in psychiatry. Growing understanding of the patient from the psychosocial, biological and interpersonal points of view helped bring this discipline into the arena of the general hospital. Dr. Cameron's ability to integrate these different levels, stimulated by his earlier collaboration with Adolf Meyer, laid the groundwork for the modern day hospital.

The defining principles of the day hospital as advanced by Cameron are considered as they relate to the Allan Memorial Day Hospital of the 1950's. A setting with no beds, a daily routine that allows the patient to return home, as well as group and family interaction were developments that would set the stage for the expansion of the day hospital movement in Canada, the United States and Great Britain. This growth culminated in professional and legislative recognition of partial hospitalization as an important treatment modality. Despite underutilization, the day hospital approach remains flexible and responsive to the needs of today's psychiatric patients.
Civil Commitment: Operational Definition of New Criteria
Authors: Page Stewart
Published: April 2017

The present study is the last in a planned series of studies concerning effects of current psychiatric legislation.

Samples of ninety-seven commitment certificates (Form 3s) and seventy-nine assessment applications (Form 1s) were analyzed, following procedures validated in several previous studies. The 1978 criteria, in the author's opinion, have yet precipitated no substantive or sizeable change in “operational definition,” that is, in types of persons being committed.
Une psychothérapie psychanalytique en milieu hospitalier
Authors: Reid Wilfrid
Published: April 2017

Using a clinical case, I have attempted to demonstrate how an analytic “listening attitude” may permit a patient request which would at a manifest level, not usually require insight but, if such were given, would then influence the whole course of treatment. Thus, the fundamental concept of psychoanalysis dealing with unconscious mental mechanisms becomes operational if it is not limited simply to a technical frame of reference. The developing situation then approaches that of psychoanalysis. This process may occur if flexibility is maintained in the basic technique of psychotherapy. The views of Jean Bergeret on borderline states are briefly presented as tools of psychodynamic understanding of clinical situations.
The Teaching and Learning of Psychotherapy in a General Hospital
Authors: Greben S.E. , Berger D.M. , Book H.E. , Freebury D.R. , Silver D. , Taylor G.J.
Published: April 2017

A general teaching hospital provides an excellent setting for the teaching of psychiatric residents. The Canadian model for a teaching network, including general and specialty hospitals, allows for special interests to develop within given hospitals.

A department of psychiatry which chooses the teaching of psychotherapy as a special interest is examined. The teaching occurs in all areas of the department (ambulatory, inpatient, consultation-liaison) and is backed up by appropriate seminars. Individual supervision provides the backbone of the teaching program.

The special interest exists within a department which must answer all of the psychiatric needs of a general hospital population. From the university point of view, the network is strengthened by the existence of various areas of concentrated interest within various component units of the network.
Clinical Patterns in a Behaviour Modification Unit
Authors: Dahl G. , Merskey H.
Published: April 2017

The principles and practice of a Behaviour Modification Unit in a psychiatric hospital are described. A simple but consistent program of rewards related to privileges is employed together with attention to individual counselling and family therapy. A consecutive series of 56 patients is reported. They had a high frequency of personality disorders, behaviour disorders and past psychiatric treatment irrespective of diagnosis. Improvement was measured in terms of success, three months after discharge, in staying out of hospital and maintaining an independent existence in the community. By this criterion 42 out of 56 patients (75%) were improved. Patients who improved had had less past treatment of various types and this relationship was highly significant.

The justification for this type of program is briefly discussed.
From Sappho to Sand: Historical Perspective on Crossdressing and Cross Gender
Authors: Steiner Betty W.
Published: April 2017

This article reviews the history of crossdressing throughout history. Commencing with the Great Mother Cult through the Greco-Roman period and Judeo-Christian times followed by the Renaissance period and through to the nineteenth century, it is accompanied by fairly comprehensive references.
La psychothérapie de groupe des schizophrènes chroniques en milieu externe
Authors: Filotto Jean-FrançOis
Published: April 2017

The long term management of chronic ambulatory schizophrenic patients represents a problem in spite of the advent of neuroleptics. The most appropriate regimen seems to be group therapy combined with pharmacotherapy. In this paper we suggest that the group is more easily managed by co-therapists (usually a psychiatric nurse and a psychiatrist). This permits a transference dilution and helps the therapists to maintain a constant motivation.

We describe such a group functioning on a long term period of over six years. We also comment on the characteristics of these patients, on the criteria we use to include them in the group and on the technique we learned to use. We discuss the fact that, in our view, it is possible to induce some structural changes in these patients and that the technique is not simply supportive.
Factors Associated with Psychiatric Symptoms in Patients Undergoing Chronic Hemodialysis
Authors: Livesley W. John
Published: April 2017

Psychiatric morbidity in a sample of 85 patients undergoing chronic hemodialysis was assessed using standard questionnaires (General Health Questionnaire and Middlesex Hospital Questionnaire). Examination of the effects of demographic, illness, treatment, and history variables on questionnaire scores revealed that psychiatric symptoms were more frequent in women than in men, in those on home dialysis, in those living in rural areas, in unemployed men and in those with a disturbed nuclear family. Factor analysis of symptoms assessed by one of the questionnaires (GHQ) revealed six factors: general dissatisfaction, suicidal ideation, confidence and well-being, usefulness and enjoyment, concentration and alertness, sleep disturbance. Interview responses revealed a high incidence of general distress and anxiety and also a high incidence of sexual problems.
Klinefelter's Syndrome with Atypical Presenting Features
Authors: Yeragani V.K. , Hopkinson G.
Published: April 2017

The authors thought it would be of interest to present this case which proved to be Klinefelter's syndrome with “xxy” pattern, as the patient presented with episodes of abnormal behaviour lasting for a few minutes. He would suddenly become anxious, look perplexed, start clenching his fists and at times complain of thoughts that some persons were trying to attack him. He also felt as if he were hearing voices talking to him. Observation in the hospital and EEG recording helped to rule out temporal lobe epilepsy and a diagnosis of Klinefelter's syndrome with personality disorder and psychogenic attacks of abnormal behaviour was made at the time of discharge.
IQ and Child Psychiatric Disorder
Authors: Beitchman Joseph H. , Patterson Pat , Gelfand Bob , Minty Gillian
Published: April 2017

The WISC-RIQ scores of 85 children between 7 and 12 years of age taken from the inpatient, outpatient and day care facilities of a Regional Treatment Centre were compared with the expected IQ scores of the standard normal population. In addition, analysis of variance techniques were used to test for an association between IQ variables and seven operationally defined symptom subtypes taken from the child's chart. Significant differences between the clinical sample and the standard normal population were found for the distribution and means for full scale IQ and verbal IQ but not performance IQ. In addition, significant associations were found between FSIQ and the level of aggressive symptoms, and between VIQ and the level of hyperkinetic and aggressive symptom subtypes. The importance of IQ variables and in particular VIQ in understanding the nature of childhood psychiatric disorder is emphasized. The implications of these findings for educational policy are discussed.
Delirium Post-Chirurgie Cardiaque avec Circulation Extra-Corporelle: Aspects Cliniques et Observations dans un Centre Spécialisé
Authors: Morin Pierre , Coupal Pierre
Published: April 2017

Delirium following heart surgery with extra-corporeal circulation recently has been the subject of several studies that show a syndrome with variable diagnostic criteria and incidence which tend to confuse the entity. The diagnostic criteria proposed by the recent DSM-III of the American Psychiatric Association allow a better circumscription of the syndrome but exclude a group of patients manifesting visual hallucinations, sometimes paranoid features and cognitive functions that are less disturbed. Heller's and Kornfeld's less rigid criteria, on the other hand, have the disadvantage of including functional psychotic states that can arise after surgery without a true delirium with organic brain syndrome. We suggest the use of standard criteria that could include only delirium following cardiac surgery with E.C.C. and subdivision of the patients following the kind of surgery.

In a retrospective study of the last four years at the Montreal Heart Institute, our clinical observations show an incidence of delirium after heart surgery with E.C.C. of 3%, a finding much lower than that reported in other centres which show an incidence between 13 and 67%. The more important factors found, were the kind of surgery (valve replacement more than coronary bypass), the age of the patients, and the degree of sickness after surgery during the stay in the intensive care unit. Those risk factors were also found in other recent studies. We describe the clinical syndrome and discuss its etiology in reviewing the more common risk factors before, during and after surgery. We underline the importance of the quality of the relationship with the patient before and after surgery in discussing prevention and treatment.
Predicting the Outcome in Schizophrenia
Authors: Bland Roger C.
Published: April 2017

Current concepts of schizophrenia and recent changes in diagnostic practice, multidimensional outcome assessment, and predictive methodology are reviewed. The highly successful results of earlier studies are not borne out in recent work which indicates that only about 8–40% of the outcome variance can be predicted using multivariate analysis of symptoms or groups of symptoms. Other influences during the illness which may significantly modify the outcome include the economic situation, life events, social class, the family, extrinsic handicaps, migration and culture. These factors have been inadequately considered in prognosis research, and are probably not considered sufficiently in therapy.
Transference and Countertransference in Conjoint Couple Therapy: Therapeutic and Theoretical Implications
Authors: Guttman Herta A.
Published: April 2017

This paper reviews and illustrates the importance of transference and countertransference phenomena in the triangular situation of couple therapy, which always reawakens non-sexualized and sexualized feelings and reactions in both spouses and in the therapist. Variants of each type of reaction are presented and some possibilities for their management are discussed. The theoretical implications and difficulties presented by transference phenomena in couple therapy are discussed.
Ethical and Psychiatric Aspects of Torture: A Canadian Study
Authors: Allodi F. , Cowgill G.
Published: April 2017

In the last two decades widespread use of torture by totalitarian governments has been reported in over 60 countries. This situation concerns physicians who are sometimes called upon to see the victims. This paper reports the psychiatric findings in a group of 41 Latin American refugees who arrived in Canada from 1977 to 1979 and alleged to have been subjected to political persecution and torture under the military rulers of their own countries. Most of them, young educated men, were apprehended violently and imprisoned under conditions below the minimum international standards. Systematic physical and psychological torture was the rule, including blindfolding, beatings, electrical shocks, sexual abuse and threats of execution or sham executions. These experiences were followed by a cluster of psychiatric symptoms and physical evidence of trauma compatible with the history given. This pattern constitutes the torture syndrome included under category 308 and 309 of the DSM-III and ICD-9. The alleged professional conduct of 19 doctors who saw 21 of these patients is discussed. A list of codes of medical ethics, intended to guide and protect doctors confronted with this difficult problem, is included.
Gender Differences in Schizophrenia
Authors: Seeman Mary V.
Published: April 2017

Men with schizophrenia have an earlier age of onset, a somewhat inferior response to treatment and a generally poorer prognosis than women. These findings can perhaps be explained by the existence of two distinct forms of the illness, one with early onset, primarily affecting men, and one with later onset, primarily affecting women. There is not much evidence for this first view. Alternatively, non-specific cumulative stress factors may impinge selectively on the male, reaching the threshold of demonstrable illness at an earlier age. A third possibility is the existence of specific biological protective factors in the female, such as relatively bilateral representation of left hemisphere functions or relative dopaminergic inhibition by estrogens.
Patterns of Intellectual Functioning and Spatial Ability in Boys with Gender Identity Disorder
Authors: Finegan Jo-Anne K. , Zucker Kenneth J. , Bradley Susan J. , Doering Robert W.
Published: April 2017

Preadolescent boys with Gender Identity Disorder (N = 13), their brothers (N = 8) and boys referred for psychiatric assessment (N = 10) were administered age-appropriate Wechsler intelligence scales. Four hypotheses regarding patterns of intellectual functioning and spatial ability were tested. A previous suggestion that the development of boyhood femininity is associated with higher than average IQ was not supported, since the IQs of the feminine boys and their brothers did not differ. A report of enhanced verbal ability as compared with perceptual organization also was not replicated in these feminine boys. On Kaufman's “Freedom from Distractibility” factor, the feminine boys and their brothers obtained scores as low as the psychiatric controls; that is, all three groups were equally distractible. It was suggested that anxiety contributed to poor performance on this factor. Unlike the control groups, the feminine boys obtained low scores on a test of spatial ability (Block Design) as compared to their scores on a verbal task (Vocabulary). The association between a feminine gender role and relatively poor spatial ability was discussed.
A Comparative Trial of Home and Hospital Psychiatric Treatment: Financial Costs
Authors: Fenton Fred R. , Tessier Lise , Contandriopoulos André-Pierre , Nguyen Hung , Struening Elmer L.
Published: April 2017

The financial costs of community-based treatment, stressing home treatment, were compared with the cost of hospital-based treatment during one year. Of 155 patients destined to receive inpatient treatment, 76 were randomly assigned to home treatment, 79 to hospital treatment; the two groups were similar as to important social, demographic, and clinical characteristics. The principal differences between the two treatments concerned the focus of treatment, the locale of treatment, the degree to which continuity of treatment was maintained, and the roles of the respective treatment staffs. Manpower and operating costs, measured in dollars, were estimated in two ways. Either way, hospital-based treatment was more expensive during the year: 64.1% more expensive ($3,250 vs. $1,980 per patient) in the first instance, 108.9% more expensive ($6,750 vs. $3,230 per patient) in the second. With two exceptions during the first month of treatment, the proportions of patients and families receiving either treatment who incurred other costs of treatment were low, and the differences between groups were not significantly different. A higher proportion of patients and families receiving home-based treatment defrayed the cost of the patient's psychotropic drugs; second, a higher proportion of families of patients receiving hospital-based treatment defrayed transportation costs. The proportions of patients and families incurring costs of the consequences of illness were low, and the differences between treatment groups were not significant. We compared this study with similar studies, discussed the generalizability of the results of this study and similar studies, and identified issues for future research.
Examen psychiatrique sous ordonnance de cour à propos des patients qui refusent de se soumettre à un examen psychiatrique
Authors: Grunberg Frédéric , Moamai Nasrollah , Desmarais Gilbert , Gagné Et Esther
Published: April 2017

In this retrospective study 52 patients who had not committed any offence were examined against their will by Court order in the emergency department of a psychiatric hospital. They were compared with a control group of patients reflecting the usual clientele attending without compulsion the emergency department of the same hospital.

This research reveals it is the immediate family rather than medico-social agencies that took the initiative in arranging the Court-ordered psychiatric examination. Such patients were no different than the usual patients seen in the emergency department as to age, sex, marital status and past psychiatric history. It was at the level of symptomatology and diagnosis that such patients differed from patients in the control group.

The patients refusing to submit to a psychiatric examination not only were more agitated and aggressive, but they were more disorganized, more delusional, and had more hallucinations than the patients in the control group. They were in fact grossly psychotic patients with paranoid and manic features dominating the clinical picture.

Our study demonstrated that as far as Montreal is concerned flagrant abuse of civil rights is far more the exception than the rule. Furthermore, if society had to abandon compulsory measures in some cases, it would be the seriously mentally ill who would suffer.
Depressive Syndromes in Grossly Obese Women
Authors: Hopkinson G. , Bland R.C.
Published: April 2017

Seventy-three consecutive female candidates for intestinal bypass surgery because of gross obesity, were evaluated for the presence or history of affective disorder. Fourteen patients gave a history of depressive disorder fulfilling Feighner et al. (1) criteria, giving treated expectancy (age 15–60) of about 28%, much higher than that found in the general population.

A second syndrome of depressed moods of short duration, carbohydrate craving and weight gain was found in fifty-seven (78%) of the patients. This syndrome is similar to the carbohydrate craving and weight gain found in patients suffering from depressed mood and premenstrual fluid retention.
Teaching Individual Psychotherapy: Learning Objectives in Communication
Authors: Waiters W.W. , Bellissimo A. , Rubenstein J.S.
Published: April 2017

Communication is the essence of the process of psychotherapy. Understanding the parameters of communication conform the foundations for the development of psychotherapeutic skills in the student therapist. Using learning objectives within the context of teaching psychotherapy, the process of communication in individual psychotherapy is explored in this paper.

With the aim of offering a practical framework to assist in the analysis of the communication process involved in individual psychotherapy, the following concepts are first examined: 1) channels of communication; 2) modes of functioning; 3) interaction between channels of communication and modes of functioning.

Following this exploration, the learning objectives in communication are discussed. Using clinical examples, the relationship between the communication process and other concepts of individual psychotherapy are illustrated. Finally, some pedagogic reasons for teaching students the analysis of the communication process early in their psychotherapy training are presented.
A Comparative Psychometric Study of Anorexia Nervosa and Obsessive Neurosis
Authors: Solyom Leslie , Freeman Richard J. , Miles James E.
Published: April 2017

Similarities between anorexia nervosa and obsessive-compulsive disorder have been described by a number of authors but few empirical investigations have been reported. In the current study, 15 female anorexics were compared with 14 age-matched female obsessives on a variety of psychometric tests, psychiatrist's ratings and self-rating scales. Obsessives and anorexics obtained similarly high obsessive symptom and trait scores on the Leyton Obsessional Inventory (LOI). Both groups were rated by the psychiatrist as similarly obsessive, and there were no significant group differences in self-ratings of obsessive symptoms. Both groups were characterized by high levels of neuroticism and anxiety and low levels of extraversion. In the anorexic group the 6 abstainers had higher resistance scores on the LOI and higher extraversion scores on the MPI than the 9 bulimics. Findings are discussed with reference to the “sorcerer's apprentice” syndrome which appears to characterize both the obsessive and the anorexic.
Co-therapy in a Clinic for Schizophrenia
Authors: Seeman Mary V. , Pyke Jennifer , Denberg David , Blake Pamela , Freire Marlinda
Published: April 2017

In the outpatient treatment of schizophrenia, the routine practice of providing each patient with two co-therapists results in several benefits: reduced dependency, increased expertise, objective monitoring, added support and morale for the therapists, more obvious and therefore more reversible countertransference, more obvious and therefore more treatable “splitting” and “projecting.”

Despite these benefits, problems arise in the two-therapist arrangement. They are discussed under the following headings: loyalty conflicts; limit setting; crisis management; family work.

The authors report on techniques of co-therapy problem prevention and problem resolution. Though not always successful, co-therapy continues to be a useful model of service delivery to schizophrenic outpatients.
Group Therapy with Sexually Abused Adolescents
Authors: Lubell Derryl , Soong Wei-Tsuen
Published: April 2017

The sexually abused adolescent girl is attempting to cope with a disturbing past, threatening present, and disrupted future. She may also be feeling cut off or different from her friends at a time when, developmentally, peer contact is vital. This paper describes a group therapy experience offered to six 13 and 14 year old abuse victims in order to help them feel better about themselves, improve their social skills and reconnect with others their own age. The group focused on the girl's present, everyday functioning and the effects the family disturbances and abuse have had on them. The male and female co-therapists attempted to create an atmosphere of trust and mutual aid; discussions centered on the relationships among group members and the connections the girls make with their important others, including family, friends, and social agencies. As the sessions progressed, four main themes of concern emerged; the girls shared feelings of violation, loss, anger and, finally, hope for their future. The paper illustrates these themes, delineates some of the girls’ group experiences, and changes they underwent, and points out some organizational issues for the therapists in running this type of group.
Psychosomatic Disorders in the Elderly
Authors: Hunter R.C.A. , Cleghorn R.A.
Published: April 2017

There is no agreement on the incidence or prevalence of psychosomatic disorders in the elderly. This is due in large part to the methodological difficulties of the epidemiological studies which have not employed the same diagnostic criteria and classification. Drawing on the literature and on clinical experience, a classification is offered, and using the diagnostic criteria explicit in this classification, probable trends are identified. Pseudodementia may well be the only stress-related disorder that is peculiar to the elderly.
Patterns of Gender-Role Behaviour in Children Attending Traditional and Non-Traditional Day-Care Centres
Authors: Cole Howard J. , Zucker Kenneth J. , Bradley Susan J.
Published: April 2017

Using a sex-typed free-play task and the Draw-a-Person test, the gender-role behaviour of children attending a day-care centre whose staff adhered to a “non-sexist” child-rearing philosophy was compared to the gender-role behaviour of children attending a more traditional day-care center. Parental provision of sex-typed and neutral toys and approval of cross-sex role behaviour was also assessed. On both measures, the two groups of children showed culturally typical patterns of gender-role behaviour. The parents of the two groups of children were generally similar in terms of the kinds of toys they provided and in their attitudes toward the expression of cross-sex role behaviour. Potential explanations for the inability to demonstrate effects of the “non-sexist” child-rearing philosphy were discussed.
The Psychiatric Certification Examination in Canada and the United States: Views of Two Recent Candidates
Authors: Goldman David L. , Burnstein Michael H.
Published: April 2017

The psychiatry certification process in both Canada and the United States is compared. Three important and interrelated areas are delineated: 1) the role of mandatory certification in Canada versus voluntary certification in the United States; 2) the differing emphasis of neurology and the medical model in the two exam procedures; and 3) the effect of the speciality exam on professional development.

Compulsory certification in Canada has the potential to steer candidates in a direction that may not be immediately consonant with career plans and population needs. On the other hand, the American Board examination by its optional character does not seem to reach a large percentage of psychiatrists, an issue that has implications for the education of medical professionals. The ambiguity of the American Board's quasi-public position is portrayed. Competence in neurology appears as a distinct area for evaluation in the American Board of Psychiatry and Neurology examination. The emphasis on neurology in the Canadian Royal College exam is less marked. These issues lead to a discussion of psychiatry in Canada as a discipline in its own right as contrasted to the mixed loyalties to neurology and psychotherapy perceived in the American system.

Finally, this paper sheds light on how the certification examination of both countries plays an important role in the passage to full professional status.
The Photograph as a Catalyst in Psychotherapy
Authors: Walker Joel
Published: April 2017

This paper focuses upon the use of photographs as a projective method enabling the patient and therapist to more readily explore transferential feelings, penetrate resistance, work through conflicts, and mobilize affect. The photographs are ambiguous and abstract but have a semblance of reality. They are unstructured, which by design permits interpretation. The patient can project upon the photograph his way of seeing life, his meanings, significances, patterns, relationships, and especially feelings. I am using the photographic images for the primary purpose of therapeutics in contrast to an emphasis on diagnostic usage. What is important is the dialogue and thematic content that follows from the response. The catalytic use of photographs is an alternate strategy to explore the unconscious. It helps the patient verbalize, recognize feelings, fantasize and often to realize an untrapped storehouse of imagination and/or creative potential. Finally, this method allows the patient to become more aware of his/her unique perception of the world. “The Photograph As A Catalyst In Psychotherapy” should not be viewed as a strategy in and of itself, but rather should be utilized as an integral part of the psychotherapeutic process.
Psychologist and Physician Diagnoses of Hospitalized Patients with Similar MMPI Symptomatology
Authors: Page Stewart
Published: April 2017

MMPI profiles, including L, K, and F validity scale data, were examined for 40 hospitalized psychiatric patients, for whom diagnoses from both psychologists and physicians were available. Comparison of diagnostic patterns of the same patients, especially for diagnoses of Personality Disorders and Schizophrenics, showed relatively little agreement between disciplines. Discriminant function analyses showed also that each discipline weighted MMPI scales differently in determining diagnosis, even though the scale profiles for each patient in the sample were essentially identical. The MMPI seemingly played a nonsignificant role in determining a set of inconsistently applied diagnoses.
Women and a Changing Society: Implications for Transference/Countertransference
Authors: Roeske Nancy C. A.
Published: April 2017

The word feminism conveys a variety of definitions, attitudes, and behaviours in contemporary society. Thus, the psychotherapist must clarify the woman's definition of this term and examine personal knowledge regarding the changing roles of women and men. Three categories of factors are discussed that affect the woman's self-determination, creativity, cooperativeness in therapy and her decision about goals. These factors include female identity formation within the family, level of autonomy development, and transference / counter transference issues. Four case histories illustrate the complex interactions of these factors. The vignettes emphasize the crucial importance of the psychotherapeutic alliance in a changing society where conflict exists about appropriate ways to express authenticity.
Is Arson an Aggressive Act or a Property Offence? A Controlled Study of Psychiatric Referrals
Authors: Hill R.W. , Langevin R. , Paitich D. , Handy L. , Russon A. , Wilkinson L.
Published: April 2017

Arsonists seen for psychiatric assessment were compared to property offenders and to violent offenders on a number of clinical measures. It was found that arsonists were a mixture of the two groups but the majority aligned with property offenders in personality, diagnosis, criminal and violence history, family background, alcohol and drug use as well as in sexual behaviour. Significantly 18% of arsonists were mentally retarded.

The act of arson was examined in detail using reliable ratings. While there was no obvious motive in two-fifths of the cases, revenge with underlying anger was most frequently a recognized motive for arson. The provocateur for the act of arson was not always readily identifiable and in over half the cases more than one person or an institution was the stimulus for the fire. Direct ions for future study were discussed.
The Use of the MMPI forthe Differentiation of Suicidal and Non-Suicidal Depressions
Authors: Waters B.G.H. , Sendbuehler J.M. , Kincel R.L. , Boodoosingh L.A. , Marchenko I.
Published: April 2017

The MMPI profiles of forty suicidal and forty non-suicidal male and female depressed patients, matched for age, were compared. Significant differences between MMPI scale T scores which showed some sex specificity were found between the suicidal and non-suicidal depressives. These results replicate previous findings. However neither individual scale T scores, derived discriminant functions, nor actuarial or cluster analysis-derived MMPI profiles could completely discriminate between suicidal and non-suicidal depressed inpatients of either sex. The relevance and implications of these findings to the ascertainment of suicidal risk are discussed.
The Age of Passion Man
Authors: Millar Thomas P.
Published: April 2017

Many observers from various disciplines of thought have commented upon the relatively recent appearance of a breed of individual characterized by impatient hedonism, relative psychopathy, and unstable self image. The author, feeling these individuals to be characteristic of the declining phase of this Sensale culture, christens this individual, The Age of Passion Man.

The author describes this childhood precursor to the Age of Passion Man, the omnipotent child, and shows how such children and persons have been characteristic of the declining phase of previous world cultures. Finally, the author examines modern speculation concerning the need for a moral reformation, the construction of an ethical state, if mankind is not to be destroyed by Age of Passion Man.
Stability of Intellect and Personality in Schizophrenia
Authors: Dudek S.Z. , Kolivakis T.
Published: April 2017

A group of 52 chronic schizophrenic patients (mean age 41) currently maintained on follow-up treatment at an outpatient clinic were re-evaluated 8.5 years after initial treatment at the Allan Memorial Institute. The instruments used were the Spitzer Mental Status Schedule (MSS), the verbal WAIS, Rorschach and several thinking disorder tests. A verbal IQ finding of 1.4 points of increase (n.s.) indicates that no intellectual deterioration has occurred as measured by the WAIS. The thinking disorder tests, however, reveal considerable deficit. The Rorschach shows no evidence of personality change although there is evidence of increasing personality impoverishment, as evident in a progressive flattening of affect, and an increasing withdrawal and isolation. These inferences are supported by case history data and by the MSS psychiatric rating scale.
The Constructive Use of Envy
Authors: Smith Vivien , Whitfield Margaret
Published: April 2017

Envy has generally been seen as an undesirable, negative feeling. However, inequality is an inescapable part of life, and envious feelings are a daily experience for most people.

The authors feel that envy is a normal human feeling which if acknowledged and accepted may be dealt with constructively. Practical examples and a case history are used to illustrate this thesis.
Patient Satisfaction in a Psychiatrie Walk-In Clinic
Authors: Dyck Ronald J. , Azim Hassan F.A.
Published: April 2017

The present study examined consumer satisfaction with services provided in a Psychiatric Walk-In Clinic in order to determine not only general levels of satisfaction but also whether or not differences in satisfaction exist between different user groups. Although levels of reported satisfaction were generally high, group psychotherapy patients reported being significantly less satisfied than patients who had been assessed at the clinic or who were in individual psychotherapy. None of the demographic variables including previous psychiatric experience, diagnosis and patient visits were related to satisfaction. These data were discussed in terms of program development.
Is Incest Harmful?
Authors: Henderson James
Published: April 2017

Classically, incest has been considered from both a psychological and sociological point of view to have harmful consequences. Genetic research, though by no means lacking controversy of its own, generally supports the notion that inbreeding has untoward genetic consequences. The psychodynamics of all three parties to father-daughter incest seem to indicate that people who become involved in incestuous behaviour are often psychologically damaged before the fact, so that if they show subsequent evidence of psychological impairment the incestuous behaviour can be as plausibly viewed as a dysfunctional attempt at solving problems as it can a cause of subsequent psychopathology.

Girls involved in the father-daughter incest present in one of half a dozen frequent clinical syndromes. The presentation is influenced by the degree to which the girl may have participated in ongoing incestuous behaviour as opposed to being the presumed victim of an older adult's coercive actions or her own temporary suspension of a behavioural taboo.

Research is inconclusive as to the psychological harmfulness of incestuous behaviour, and evidence is reviewed on both sides of this complicated and controversial question. Quite apart from the general issue of the harmful-ness of incest, a number of indicators can be derived from the nature of the incestuous episode and the early response to therapeutic assessment which aid in the clinical forecasting of probable outcome.