The effect of chronic caffeine consumption on urinary incontinence in psychogeriatric inpatients

Abstract

Urinary incontinence is a common problem in psychiatric settings, particularly among psychogeriatric patients. In view of the known diuretic action of caffeine, the present study assessed the effect of tea and coffee consumption on level of incontinence in selected psychogeriatric inpatients. A total of 14 patients participated in the study which employed a combined “withdrawal” and “multiple-baseline across subjects” design to examine the effect of alternating phases of caffeine exposure and abstinence on frequency of daytime and nighttime incontinence. Incontinence levels were significantly reduced during periods of caffeine abstinence relative to periods of chronic caffeine exposure. The hypothesis that observed reductions in incontinence may have been due to accompanying reductions in fluid intake was examined but not supported.     

Brief report: Relativism and identity crisis in young adulthood

This study investigated the relationship between epistemological world views and identity formation. Forty college students, aged 17 to 23 years, were presented with a paradigm belief scale (Social Paradigm Belief Inventory; SPBI), an identity status questionnaire, and an indepth interview about a conflict they had recently experienced. It was hypothesized that a relativistic world view would be related to a moratorium identity status because relativistic thought processes involve a questioning of the objectivity of knowledge and authority structures and hence an awareness of the variety of alternative and potentially conflicting roles and choices. Results indicated that relativism was the most common world view used when responding to questions about a personal conflict and that relativistic scores on the SPBI were predictive of the moratorium status. Relativistic scores on the SPBI were also negatively related to identity achievement, as were mechanistic scores. Females experienced moratorium to a greater extent than males but were not more relativistic. Results are discussed in terms of linkages among cognitive development, psychosocial development, gender, and the type of measures used to assess world view status.     

Determinants of object choice in adulthood: a test case of object-relations theory

A clinical example of the effects of the absence of the father during the early childhood of a male analysand and its consequences for his later object choice is presented. This patient's biological father left the household when the patient was only a few months old, and his mother did not remarry until he was five years of age. Unconscious fantasies of the lost father, with whom the patient had no contact in reality, and longing for him organized the patient's drives and determined his self-identity as well as his later object choice. The patient developed both a positive and negative identification with the lost father. The identification was with a fantasy object not a real one. The case highlights the need to use a precise term in talking of the object, namely the mental representation of the object which may or may not be built up out of experiences with the real object.     

Relation of urinary incontinence, menopausal symptoms, and life satisfaction in middle-age Korean women

Associations of urinary incontinence, menopausal symptoms and life satisfaction of 235 middle-age Korean women (40 to 59 years) were investigated, based on responses to a self-report questionnaire. Urinary incontinence was positively correlated with menopausal symptoms (r =.24) and negatively correlated with life satisfaction (r=-.11). Life satisfaction was negatively correlated with menopausal symptoms (r = -.28). All rs indicate weak associations and account for small common variables. Even so, results suggest effective treatment of urinary incontinence and menopausal symptoms could enhance life satisfaction through promoting healthy behavior and emotional health in such middle-age women.     

Time-based and event-based prospective memory across adulthood: underlying mechanisms and differential costs on the ongoing task

The authors investigated the phenomenon that performance in an ongoing task declines when individuals must carry out a prospective memory (PM) task. This effect is referred to as the PM interference effect. The authors examined whether the PM interference effect differs between event-based and time-based PM tasks and whether it is increased among the elderly. The authors also investigated adult age differences in PM performance and the potential underlying mechanisms of the age deficits in PM. They found that the PM interference effect was greater in event-based than in time-based tasks. However, aging was not associated with an increase in PM interference effects. Age differences in PM performance were more exaggerated in time-based than event-based PM, but they were not mediated by age differences in traditional cognitive ability measures. In time-based PM, age showed a unique adverse effect even after controlling for the ability to externally monitor the time, leading to the possibility that aging disrupts time-based PM because of deficits in internally processing the time.     

Family timing in late adolescence and early adulthood: The case of southern males

Social science research and theory about familial orientations and reproductive ideals have largely neglected males' attitudes. Drawing on demographic and status attainment perspectives, this study applies a model of processes underlying marriage and family timing to longitudinal data on 288 young adult males from the Southern Youth Study. Several posited influences of family of origin factors, significant others, and adolescent status and familial aspirations on marital timing and early family growth are assessed.Development of this report was sponsored in part by the Texas Agricultural Experiment Station and contributes both to TAES Project H-2811 and to USDA (CSRS) Regional Research Project S-81, and in part by the Maxwell Policy Center on Aging and the All-University Gerontology Center, Syracuse University through Title IV-C Grant #90-A-1054101 from the Administration on Aging, Department of Health, Education, and Welfare. Information for analysis was obtained by pooling data collected under grants provided by the Agricultural Experiment Stations of Alabama, Georgia, South Carolina, and Texas. Appreciation is expressed to John Womack, Paul D. Mader, and G. David Curry for their advice at various stages of this research.     

Systems measures of word use and differential diagnosis

This paper presents findings on the power of two systems measures of word use to discriminate four patient groups. The first is the slope of accumulated entropy or complexity of the sample (known to be logarithmic over time). The other is the average Poisson rate for the use of new words (known to be a Poisson process). The four groups consisted of cancer, depressed, paranoid, and somatization patients. The two word measures discriminate the first three groups from the fourth. There is evidence that larger samples will identify a similar discriminator for each of the first three groups from one another. The results are discussed in terms of how these methods may offer fresh insight into the relationship between language use and psychopathology.     

Diagnosis and differential diagnosis of myasthenia gravis]

The author describes the possibilities of diagnosis and differential diagnosis of myasthenia gravis. The data is based on the literature and on case reports of personal observations of more than 270 patients with myasthenia. He inaugurates his own classification of myasthenia comprising of 8 types, among which there is one particular clinical type, described first by the author. The different problematic types of myasthenia are discussed together with the most important diagnostic tests and the principles of differential diagnosis. The clinical and pathological study is completed by illustrations.     

Some suggestions on epileptic psychoses, their differential diagnosis and therapy

From a present point of view, some clinical suggestions are put forward concerning the symptomatology, differential diagnostics, and therapy of psychotic states in epileptic patients (twilight states, states of emotional deterioration and epileptic psychoses proper).     

The Bender-Gestalt test in differential diagnosis of adolescents with learning difficulties

This study assessed the efficiency of the Haine and Koppitz scoring systems used with the Bender-Gestalt Test (B-G) in terms of their ability to differentiate between adolescents with and without central nervous system (CNS) impairment who were achieving below age-expectations. Utilizing a population of 84 adolescents enrolled in a residential treatment center, both the Haine and Koppitz systems with the Bender-Gestalt differentiated 25 Ss with CNS impairment from 59 Ss wihout such impairment. The results indicated, however, that neither scoring system was useful in individual classification when the B-G was used alone or in combination with intelligence test results.     

A case report on the use of flooding in stuttering therapy

The last several years have seen the development and use of anxiety-reduction procedures in stuttering therapy. Among these types of methods, systematic desensitization and reciprocal inhibition have been employed almost exclusively. Emotional de-conditioning by means of flooding or implosive techniques has been attempted far less often. This article presents a case report on the utilization of the flooding tactic. Results are offered and discussed relative to the question of whether the elimination of anxiety is a realistic goal in therapy. The suggestion is offered that what many stutterers may really need to develop is the ability to generate fluency-enhancing behaviors in spite of the presence of heightened emotionality.