bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autocastration by a Male Transsexual
Authors: Lowy Frederick H. , Kolivakis Thomas L. 
Published: April 2017

In recent years psychiatrists increasingly have been asked to evaluate patients who demand medical and surgical sex alteration procedures. Most psychiatrists do not welcome this challenge for which they are not properly trained, and conclusions in the recent literature are contradictory and confusing. An unusual case is reported which illustrates many of the difficulties in the diagnosis and the management of transsexuals. A schizoid, thirty-five year-old man with long standing gender identity problems performed successful autocastration after he repeatedly failed to obtain adequate psychiatric and medical treatment. Like most transsexuals described in the recent literature, he demonstrated an apparently unalterable conviction that he was a feminine being trapped in a male body from which he felt alienated and which he repudiated. Dressing in feminine clothes reduced his anxiety and made him feel ‘right’ but was not associated with sexual excitement. His background reveals a chaotic childhood, characterized by a close attachment to an overly permissive, possibly disturbed mother and the absence of a stable father-figure with whom he could identify. Unlike most transsexuals this patient also shows many features which support a diagnosis of schizophrenia. Diagnostic and therapeutic considerations are discussed with reference to the relevant literature. Management is complicated by the fact that the patient is persistent and insistent in his demand for sex change while the physician struggles with ethical and practical problems. A cautious but open-minded approach is advocated which involves an initial trial of supportive psychosocial rehabilitation and then a readiness to consider medical and even surgical sex change procedures if there is good evidence that the patient cannot otherwise be helped.
Article
Authors: Lalonde Pierre 
Published: April 2017

The methods of evaluating programs, residents and teachers are all interrelated. Although this may appear to be an over-inclusive statement, good training programs designed by competent teachers will produce competent residents. These residents in turn will become good teachers and clinicians. It is therefore in the interest of both residents and teachers to constantly evaluate each other and the programs. The goal of residency training is to promote the acquisition of both theoretical and clinical skills. The final examination evaluates the resident's theoretical knowledge, but his clinical skills can only be evaluated in his day-to-day practice. Recommendations: combine these evaluations at the end of training, allowing 50 per cent for the final theoretical examination and 50 per cent for his clinical work during his training. Some steps to minimize the subjectivity of this clinical assessment follow: 1) Use the average of ratings from a number of supervisors. 2) The criteria to be evaluated should include theoretical knowledge, therapeutic abilities, interpersonal relations and initiative. 3) Periodic evaluations at regular intervals. 4) Feedback to the resident regarding his evaluation. Taking into account the right and the duty of the teacher to evaluate his residents, and considering its aforementioned difficulties, it is essential that the resident also evaluate his teachers. This is a delicate but necessary task. Criteria for evaluating teachers are: 1) Theoretical knowledge. 2) Clinical skills. 3) Interpersonal relationships. 4) Ability to communicate knowledge, both theoretical and clinical. 5) Motivation to teach. 6) Ability to inspire (‘feu sacre’). 7) Availability. This continual evaluation by the residents of the department in which they are working will act as a constant stimulus for the improvement of programs, especially if it is assumed that the resident has a choice in determining his assignment. To justify the assigning of 50 per cent of the assessment as clinical skills, a uniformity in the quality of training is necessary. This is seen as a uniformity in quality while maintaining differences in approach, and leads to the criteria for accreditation of hospitals. Recommendations: a) Formation of an autonomous committee responsible for accrediting the programs in various universities. b) Plan for continuing research.
The Present Status of Vitamin B12 and Folic Acid Deficiency in Psychiatric Illness
Authors: Shulman Ralph 
Published: April 2017

Vitamin B12 Deficiency Among the many causes of organic psychoses are a number of processes which may be cured or arrested by the right treatment and by early recognition. This includes deficiency of vitamin B12. There is, therefore, a temptation to carry out sophisticated tests for vitamin B12 deficiency in all psychiatric patients. However, until cheaper and fully-automated techniques become available, routine vitamin B12 assays cannot be justified in psychiatric patients. At the present time a hemoglobin estimation and a careful inspection of the peripheral blood film by an experienced hematologist appear to be the most economic primary screening test for vitamin B12 deficiency. Nevertheless, psychiatrists should be alert to the possibility of vitamin B12 deficiency in patients with unexplained fatigue and in those with confusional states or dementia of unknown origin. Another presentation may be impotence which sometimes precedes other neurological manifestations of the disease. Even in patients who are not anemic or have no blood film abnormalities (which is uncommon) the possibility of missing cases of hypovitamin B12 deficiency can be further diminished by doing serum B12 assays in patients who are clinically at risk. For example, this includes post-gastrectomy patients, those with a familial history of pernicious anemia and those with an associated auto-immune disorder, such as thyroid disease. Folic Acid Deficiency The available evidence linking folate deficiency with psychiatric disorders is inconclusive. It is probable that the observed excess of folic acid deficiency in psychiatric patients can be explained on the basis of malnutrition, chronic physical illness, alcoholism or other drug usage. An important exception is brain damage and mental retardation in infants with inborn errors of folic acid metabolism. Further evaluation of folate deficiency is indicated, particularly in the affective disorders and in ambulatory, non-institutionalized, epileptic patients receiving anticonvulsant medication.
Conditioned Reflex Analysis of Chronic Schizophrenias
Authors: Ananth J.V. , Ban T.A. , Lehmann H.E. 
Published: April 2017

The results of a psychophysiological (conditioning) analysis of chronic schizophrenia are presented, and a relationship between the level of psychophysiological performance and differential drug withdrawal effects is revealed.Regression from a higher to a lower level of organization, for example, from integrational to skeletomuscular or from skeletomuscular to autonomic functional systems, and dissociation within a functional system or between the different functional systems tested, were shown to be prevalent in schizophrenic patients.
Remands for Psychiatric Examination in Ontario, 1969–70
Authors: Greenland Cyril , Rosenblatt Ellen 
Published: April 2017

This study of 787 men and women remanded for psychiatric examination in Ontario, 1969-1970, was undertaken to explore the clinico-legal pathways which result in people being categorized as patients or offenders. It was also anticipated that the study would provide data on the variations between hospitals in psychiatric diagnosis and recommendations, as well as the extent to which such recommendations were accepted by the Courts. The data on the 707 men revealed that inpatient treatment was recommended by psychiatrists in 175 cases (25 per cent). This recommendation was accepted by the Courts in 84 per cent of cases. Outpatient treatment, recommended in 245 cases (35 per cent) was accepted by the Courts in only one-third. No psychiatric recommendations were made in 287 (40 per cent). It can be concluded that many of these remands to hospital were unnecessary and that the lack of understanding between some of the Courts and some of the psychiatric hospitals results in injustice to patients and misuse of scarce psychiatric resources.
Psychiatric Morbidity and Utilization of Insured Health Services
Authors: Cassell Wilfred A. , Fraser Howard N. , Spellman Anthony 
Published: April 2017

This project examined the relationship between three measures of psychiatric morbidity and the utilization of insured health services. The criteria used to define psychiatric morbidity were as follows: • Self-ratings on the Cornell Medical Index of a randomly selected sample of the population. • Medical care insurance diagnosis of psychiatric illness by the community's physicians. • Psychiatric diagnosis by a psychiatrist. In all instances psychiatric morbidity was related to ‘high utilization’ of insured services, using dollar expense as the criteria. The significance of this is discussed.
Dreams and Demography
Authors: Winget Carolyn , Kramer Milton , Whitman Roy M. 
Published: April 2017

This survey makes two contributions to the study of man. The first deals with the subject of dreams per se and the careful examination of these dreams leading to establishing norms pertinent for a generalized population. This can be seen as complementary to the earlier studies of Hall and Van de Castle which established norms for a limited population. The second contribution concerns the insights into current societal preoccupations which the dream reveals.Making a direct translation of manifest dream content into sociological factors is fraught with difficulty. Nevertheless, it is tempting to describe this middle city of the United States as reflecting the larger situation of America and perhaps of western urban culture. In this respect, human beings are seen as coping with death anxiety as they grow older, accentuated by such conditions as widowhood. Blacks and whites are seen as essentially similar in their preoccupations, aggressions and good fortunes. We see a reaffirmation that anatomy is destiny, for the single most important factor in determining dream themes is the sex into which one is born.How much this difference is biological and how much cultural is unknown. At the present time in the United States and as exemplified by a recent book (37), being a woman involves less striving for achievement, more involvement with interpersonal relations and in general a more passive role in the aggressive themes of life. Attention to inner processes and inner space would seem to be biologically based although certainly reinforced by the cultural substrate in which the woman operates.This study deals with two of the three great themes of life — birth, marriage and death. In terms of marriage it can be observed that the single person seems happier but suffers the greatest misfortunes. Women are preoccupied with marriage and personal relationships and men with work. Death overshadows both men and women and age and death are partners.
Gestational Schizophrenia
Authors: Schorer C. E. 
Published: April 2017

A group of thirty-eight mothers with an onset of schizophrenia related to gestation and delivery of a child was studied to see if the sex determines whether the onset would be during the first trimester or the puerperium, if this would be particularly true of ‘process’ schizophrenics and whether the sex of subsequent children would lead to subsequent remissions or exacerbations. No difference was found in the influence of fetal sex on precipitation, remission or exacerbation of either ‘process’ or ‘reactive’ schizophrenia. A tendency to have subsequent children either all male or all female was noted and discussed.
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.
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.
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.
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.
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.
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.