bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Burden of Personality Disorder: a District-Based Survey
Authors: Montgomery Charles , Lloyd Keith , Holmes Jeremy 
Published: March 2007

Patients with a clinical diagnosis of personality disorder (PD) often suffer prolonged distress. They are a considerable burden on psychiatric services and they are experienced as difficult to manage by their keyworkers. This paper describes the creation of a community-based case register of patients suffering from PD. It explores the relationship between psychological distress, personality dysfunction, service utilisation and keyworker stress. Mental Health workers were asked to identify those patients on their caseload whose primary problem was PD. This list provided the basis for the case register. Patients completed the revised Personality Diagnostic Questionnaire IV (PDQ 4); the General Health Questionnaire (GHQ); and the Beck Depression Inventory - 21 item (BDI). A brief, semi-structured interview was conducted by Community Psychiatric Nurses to estimate service utilisation and keyworker stress. The mean GHQ was 14.58; the mean BDI score was 28.22. The mean number of PDs per patient was 4.5. One quarter of patients (21/80) had been admitted at least once to a psychiatric ward in the previous year and 17% (13/80) had presented to casualty at least once in the previous two months. 57% of the patients had weekly or more contacts with a helping agency. The number of PD diagnoses per patient as measured by the PDQ 4 was not found to be predictive of stress experienced by CPNs, whereas high BDI and GHQ scores were strongly correlated. Similarly, the number of admissions to a psychiatric ward was associated with high BDI and GHQ scores but not with number of PDs per patient. It is feasible to establish a case register of all patients in the district with PD. There are high levels of depression and distress amorsgst patients with PD being treated as outpatients. Service utilisation and keyworker stress are not predicted by number of PDs per patient but are strongly associated with distress as measured by the GHQ and BDI, The implications of these findings are discussed.
A Delphi Approach To Characterising 'Relapse' as Used in Uk Clinical Practice
Authors: Burns Tom , Fiander Matthew , Audini Bernard 
Published: March 2007

Background: 'Relapse' is a common outcome indicator in intervention studies in schizophrenia. In community studies it is froqucntly equated with hospitalisation and in psychopharmacological studies with predetermined symptom scores. Its clinical meaning, however, remains undefined. Method: Consensus on the defining features of 'relapse' in schizophrenia used by academic and clinical schizophrenia experts in the UK, was investigated using a four stage Delphi process. A two panel, four stage, Delphi based methodology was used to investigate the implicit meanings of 'relapse' in clinical practice. A multi disciplinary panel of twelve members each listed anonymously ten indicators of relapse. A second panel, of ten experienced psychiatrists, rated the 188 submitted indicators from essential-unimportant (1-5). This panel completed a one day workshop during the remaining Delphi rounds ending with a structured discussion of the results. Results: Very strong consensus was achieved on the relative importance of potential relapse indicators. There was complete agreement about some aspects of a definition of relapse (such as recurrence of positive symptoms) and a number of the complex issues underlying the concept were clearly articulated. Conclusions: This four stage Delphi process achieved consensus on core features of relapse. The elucidation of the "softer" features at the threshold between normal fluctuations in functioning and the start of relapse require continuing investigations.
Buffers for the Bereaved: the Impact of Social Factors On the Emotional Health of Bereaving Parents
Authors: Roskin Michael 
Published: March 2007

Emotional health of bereaving parents (N = 62; control N = 56) were explored 5 years after the death of a child (age 0-12) in Israel. The Symptom Check List-90 was utilized as the primary measurement instrument. Comparisons to controls according to geographic area of birth indicated more interpersonal (over)sensitivity, obsessive-compulsiveness and anxiety among Asia/African born parents as compared to either European/American or Israeli-born. All geographical groupings of bereaving parents indicated significantly greater somatic concerns than their respective controls. The college-educated Israeli-born bereaving parents indicated significantly healthier SCL-90 scores than similarly educated European/American-born bereaving parents. This was in contrast to the trend in which European-American-born parents (regardless of educational level) exhibited scores indicating the least symptomatology. Bereaving parents are a uniquely problematic population at risk. Deaths of infants and children produce isolation and diffusion among family members. 8,18 Furthermore, the scant literature indicates that the death of a child produces higher intensities of bereavement, as well as the widest range of reactions among parents as compared to those who experience the death of either a spouse or parent. 17 Family stability and equilibrium is disturbed. Indeed, higher than average rates of marital discord occur between parents after the loss of a child. 7,3 Bereavement itself carries a considerable increased risk of morbidity and mortality.11, 12 Levav indicates that the increased risk of mortality for parents is quite high within a 5-year period after the death of their child.9 Parkes and Brown report that the bereaved differ significantly from the non-bereaved in being sicker and being admitted to the hospital more in the year following loss. They also noted increased consumption of alcohol, tobacco and tranquilizers and more disturbances of appetite, weight and sleep.11 In addition; more evidence of strain and depression was indicated among the bereaved than among the non-bereaved.11 Bereaving parents react to their loss through grief. This often manifests itself through resistance to change — a reluctance to give up possessions, relationship, status and expect ations. One approach to measuring this resistance to change is vis-a-vis levels of emotional symptomatology, e.g. depression, anxiety, obsessive-compulsiveness. In a wider sense, emotional health parameters may be utilized as a means of calibrating resistance to change and response to loss. Roskin15 in his work with bereaving parents in Israel reported that even 5 years after their child died, bereaving parents indicated less emotional health than comparable controls. Bereaving mothers were more somatic and interpersonally (over)sensitive than control mothers. Bereaving fathers indicated only more somatic complaints than control fathers.
Comparison of Depressive Symptomatology Between Saudi and American Pysychiatric Outpatients in an Eastern Province Medical Center, Saudi Arabia
Authors: West Julia 
Published: March 2007

This study compares the responses to a self-report depression inventory administered to a sample of 243 Saudi and American expatriate psychiatric outpatients of a large Eastern Pro vince medical centre in Saudi Arabia. The inventory was developed by Beck et al. (1961), and the Arabic language form was validated by West and Al-Kaisi (1982). A Kruskal-Wallis statistical analysis revealed that American male patients tended to be more depressed than American female patients, Saudi female patients reported "depression scores" higher than those of Saudi male patients, and Saudi patients overall reported higher "depres sion scores" than American patients participating in the same study. The highest and lowest significant response frequencies for Saudis were: Pessimism (H=74.26) and Hypochondria (H=17.13); for Americans: Indecisiveness (H=25.57) and Self-Image (H=7.85). (Statistical significance when H=7.82, p<.05; H=16.27, p<.001; df=3). Although explanations are offered, the appearance of psychopathology as designated by this cross-cultural scale requires further cultural examination.
Prevalence of Depressive Symptoms and Depression in Elderly Finnish Home Nursing Patients and Home Help Clients
Authors: Kivelä Sirkka-Lsa , Lehtomäki Erkki , Kivekäs Jorma 
Published: March 2007

Depressive symptoms in a population (N=419) aged 65 years or over and receiving home nursing, home help or both were assessed by postal questionnaires including the Zung self- rating depression scale (SDS). Eighty-six percent participated, and 38 percent of both men and women scored 45 raw sumpoints or more in the SDS. The mean of the raw sumpoints was 42.1 (± 9.6) for men (N = 100) and 41.4 (± 9.0) for women (N = 238, the difference being nonsignificant. Home help clients scored less than home nursing patients or patients receiving both home nursing and home help. The population scoring 45 raw SDS sumpoints or more was investigated by a general prac titioner, and the diagnosis of depression was made according to DSM III-criteria. The clinical investigations showed 26 percent of both men and women who participated to be depressive. Chronic depression was the most common class, folowed by atypical depression. About two thirds of the depressive men and half of the depressive women were 'new' cases in that it had not been realized earlier that they suffer from depression. Atypical depression was the class where underdiagnozing was most evident. Among elderly men psychomotor retardation, libido loss, anorexia and indecisiveness and among elderly women psychomotor retardation, indecisiveness, emptiness and diurnal varia tion were common symptoms of depression.
The Psychological Effects of Apartheid Psychoanalysis
Authors: Dommisse John 
Published: March 2007

The notorious governmental policy of Apartheid affects the people of that country psycho logically, as well as politically, socially, economically and medically. It does so in a variety of ways, including: the humiliating effects on blacks and arrogance inducing effects on whites; the disruption of family-life by the enforced migrant labor system; the stunted brain-development and behavioral effects that result from the inexcusably widespread childhood malnutrition in that wealthy country, (the world's 6th-largest food-exporter); the distortions and alienations in personality development, on racial lines; the mental breakdowns and suicides that result from the physical and mental torture that uncharged security-police detainees are subjected to while under interrogation. In addition, when mental health services are required they are grossly inferior for blacks, especially in the rural areas and particularly in out-patient care. The white-doctor: black-patient relationship, perforce the rule, is distinctly problematic in this socio-political climate. The World Medical Association and the World Psychiatric Association have been supportive to the South African government and silent, respectively, in the face of all the documented information on this hazardous public health situation. The United Naitons and its agencies, the World Health Organization and the Centre Against Apartheid, should be commended for their work and unequivocal stands on this issue and should be heeded in their calls for a principled response by more of the world's psychiatric, psychological and medical communities.
Admission To General Hospital Psychiatric Wards in Italy
Authors: De Girolamo Giovanni , Mors Ole , Rossi Giovanni , Grandi Lucia , Ardigo Walter , Munk-Jørgensen Povl 
Published: March 2007

Epidemiological comparisons carried out in Italian settings regarded very different areas. In this paper, we investigate the effects on the hospital activity of two different organizational models of care in two neighbouring areas in Northern Italy, Cremona and Mantua, very similar in sociodemographic features. Cremona is hospital oriented, while Mantua has well developed community services. All the patients of the catchment areas admitted during 1986 were studied. Age distribution for males, marital status, education and percentage of employed were very similar in the two samples. However, age distribution and mean age at the time of the first ever psychiatric admission for females were different, as well as the percen tage of patients living alone and the percentage of patients discharged home. But the cogent finding was the number of admissions, much higher in Cremona than in Mantua, especially for some age groups. Some explanations of this strong difference, regarding two neighbouring and similar areas, are discussed.
Prediction of Repetition of Parasuicide: With Special Reference to Unemployment
Authors: Morton Mary J. 
Published: March 2007

Economically active male parasuicides admitted to the Regional Poisoning Treatment Centre, Edinburgh in 1984 were divided into two groups - those with a previous history of parasuicide and those without. The two groups were compared on a number of psychosocial and clinical characteristics to examine which were related to repetition. A further analysis (of economically active male admissions in 1985 and 1986) tested the predictive value of these discriminating characteristics. By stratification of the population, the interaction of unemployment (a discriminator and a predictor of repetition) with certain other variables was examined. A final analysis examined the risk of repetition by duration of unemployment. Unemployment discriminated those with a past history of repetition from those with no past history and also predicted repetition within a calendar year of the initial episode. The 35-64 age group were particularly vulnerable to repetition if unemployed as were those in social classes I-III and those with a past psychiatric history (inpatient or outpatient). The relationship between unemployment and parasuicide was no longer significant when the population was stratified by presence or absence of personality disorder and history of previous parasuicide, suggesting that these might be confounding variables in the relationship. The particular vulnerability of the long-term unemployed (greater than one year) to repetition was confirmed.
Does Acculturation Influence Psychosocial Adaptation and Well-Being in Native Hawaiians?
Authors: Streltzer Jon , Rezentes William C. , Arakaki Masa 
Published: March 2007

Native Hawaiians have suffered higher disease rates and achieved lower educational and economic levels than other ethnic groups living in Hawaii. This study tests the hypothesis that cultural afifiliation protects against psychosocial pathology in Hawaiians. Subjects included 172 Hawaiians of varying blood quantum and 92 non- Hawaiians. The Na Mea Hawai'i, a rationally derived, empirically validated measure of Hawaiian acculturation was administered to all subjects in addition to psychological tests which included 19 visual analogue scales that measure both state and trait variables. The Na Mea Hawai'i proved excellent at differentiating Hawaiians from non- Hawaiians (p = .0001), and it correlated well with blood quantum (r = 0.31, p = .0001). Low acculturation scores among Hawaiians did not correlate with any measure of discontent or psychosocial pathology irrespective of blood quantum. We conclude that Na Mea Hawai'i is a valid measure of Hawaiian acculturation, and that adaptation of the Hawallans in our sample has been unaffected by level of acculturation.
Determinants of Help-Seeking Behaviour of Families of Schizophrenic Patients Attending a Teaching Hospital in India: an Indigenous Explanatory Model
Authors: Banerjee Gauranga , Roy Suparna 
Published: March 2007

A growing body of data derived from field-surveys indicate that many people with psychiatric disorders seek no professional help in any kind of health facility. These results argue for more research on barriers to help-seeking. The determinants and patterns of help-seeking behaviour of 83 families of schizophrenic patients attending a teaching hospital in India was studied in the context of their indigenous concept of health and illness. While all the families consulted any kind of health facility within two years, over 27% of them took more than five years to report to the referral centre. Those who consulted indigenous healers first took a short time to reach the referral centre. Belief in the supernatural causation of schizophrenia was very common. Most of those who believed in supernatural causation, consulted indigenous healers first and those who identified schizophrenia as a medical problem consulted practitioners of modern medicine. These findings suggest that cultural factors like indigenous belief systems about causes of illness are important determinants of patterns of help-seeking behaviour in schizophrenia.
The End Problem for a Laminated Elastic Strip —
Authors: Hess Milton S. 
Published: March 2007

A plane elasticity solution is derived for the end problem in a two- layer laminated strip. The laminae may have arbitrary elastic constants and an arbitrary thickness ratio. The solution is obtained as a series of non-orthogonal eigenfunctions, each of which varies exponentially along the axis of the strip. Each exponential coefficient is a complex root of an eigenvalue equation that results from the requirement of compatible displacements at the interface. The general solution obtained in this paper may be used to find the stress field in a two-layer laminated strip subjected to specified self- equilibrating end loading. It thus permits the determination of the stress concentration near the end which is usually neglected by invok ing St. Venant's Principle.
Measurement of Unemployment in Australia
Authors: Steinke John 
Published: March 2007

According to the Commonwealth Employment Service, 357,000 Australians were unemployed in November 1977—an increase of 283,800 since November 1973. According to the Australian Bureau of Statistics, 314,300 Australians were unemployed in November 1977—an increase of 208,900 since November 1973. Because of this divergence, and the well-documented deficiencies of CES unemployment statistics, publication of the CES series seems likely to be terminated not long after introduction of a monthly ABS unemployment series in February 1978. This article examines the background of the present situation; examines the differences in CES and ABS methods of measuring unemployment; compares the magnitude of the resulting unemployment statistics; and examines possible explanations of the change in relative magnitude of the two sets of unemploy ment statistics. The article concludes that such empirical evidence as is available suggests the change in their relative magnitudes has been caused by a simultaneous rise in coverage by CES statistics and decline in coverage by ABS statistics; that a considerable body of empirical evidence suggests the actual level of unemploy ment is greater than indicated by either CES or ABS unemployment statistics; and that the gap between actual and measured unemployment is growing.
Award Restructuring and Clerical Work: Skills, Training and Careers in a Feminized Occupation
Authors: Probert Belinda 
Published: March 2007

Clerical workers are the largest single occupational grouping in Australia, and they are predominantly female. For most women, clerical work has meant poor pay, low status, few career prospects and little recognition of their skills. This paper looks at the potential of award restructuring to improve women's employment opportunities in this occupation. In particular it examines the restructuring of the Victorian Commercial Clerks' Award, and analyzes the obstacles that lie in the way of its translation into real benefits for female clerical workers. Comparisons are drawn with developments in public sector award restructuring. The paper looks at the structure of clerical employment in the private sector, and the implications of its distribution across all industries—the predominance of small firms and the absence of industry-based career paths. It goes on to apply a feminist perspective to the key issues of skill, training and careers in clerical work, arguing that it is essential to any analysis of the actual outcomes of award restructuring in this area. The paper concludes that award restructuring is an inappropriate mechanism for improving skills and career paths in such afeminized occupation. The paper uses data from a survey of clerical employees in a wide range of workplaces to illustrate the argument. The potential of award restructuring to address unequal pay among male and female clerks through the process of reclassifying women's skills is also considered. Finally, the significance of the low level of unionization among private sector clerical employees is discussed, raising further doubts about the real benefits of award restructuring.
The Economic Consequences of Disarmament in the Netherlands
Authors: Duisenberg W.F. , Röling Bert V. A. 
Published: March 2007

General and complete disarmament in the Netherlands would result, as might be expected, in a decreasing national product and an increasing unemployment. How ever, these unfavourable consequences can be met successfully by rather simple coun ter-measures, consisting of the maintenance or even the increase of total effective de mand, provided these measures are prepared and taken in time. To make the like lihood of a smooth conversion as great as possible this preparation should be done by the Government as well as by the individual firms. This last condition is not fulfilled in reality. Detailed governmental counter-measures, meaning intervention in individual firms or industries, do not seem necessary on a large scale. Supply of labour being a bottleneck for growth in the Netherlands, the resources freed by disarmament may give new possibilities for economic growth. The effects of disarmament for Surinam and the Antillian Islands run via the markets for primary products, especially bauxite and oil. Since demand on these markets is probably determined not only by such factors as price, quality and distance, but also by national-political influences, the ultimate result cannot be predicted but can be described as non-positive for the development of these areas.
Social Position and Foreign Policy Attitudes
Authors: Halle Nils H. 
Published: March 2007

The article discusses a cross-national use of an index for social position (a center- periphery index), some hypotheses about social position and foreign policy opinion, and some selected findings from a comparative three nation study. The discussion is based upon data from a three nation survey, turn of the year 1964/65, with data from France (N = 1,209), Norway (N = 1,000) and Poland (N = 2,749); national re presentative samples. The objective of this study was to make a comparative study on 'Public Opinion and the Consequences of Disarmament' or the 'Image of a Disarmed World'. The index for social position, previously only used in Norway, proved to 'work' quite as well both in 'big power' France and 'socialist' Poland. The absolutism-gradualism hypothesis stating higher degree of gradualism in the center was confirmed and revealed some pronounced similarities between the countries. Parts of a theory for attitude and opinion propagation were tested and confirmed. Two hypotheses about 'socio-logic', stating different kinds of foreign policy 'logic' in the center and the periphery, were only partly confirmed; the difference was clearly demonstrated but not the pattern of the difference. The selected findings from the study displayed differences and similarities between the three countries, related to foreign policy on peace and disarmament, and social position. Sometimes these findings brought France and Poland more close together than Norway—France, or Norway—Poland. This was for instance particularly clear when the countries were compared with regard to relative impact, within each country, of social position on the questions used. Finally, a hypo thesis stating overselection by the center of majority views was confirmed and further discussed.