Reflections during a study on family therapy with drug addicts

This article presents ideas and reflections emerging during a project on family therapy with drug abusers. Initially inspired by the writings of Stanton and Todd on the subject, the project developed into a recursive and self-reflective process, characterized by increasing doubts about the usefulness of categorization of families, of pre-planning therapy, and of the therapist as an "expert." The limitations of approaches that emphasize the importance of understanding the family structure as the basis for changing it are discussed, particularly with respect to how they decrease therapist flexibility and may block the family's finding their own solution. Alternative approaches to practice and research are also discussed, bearing on ideas particularly formulated by theoreticians and practitioners inspired by second-order cybernetics.     

Effects of sleep deprivation on performance and EEG spectral analysis in young adults

Nine totally sleep deprived (TSD) and nine control subjects were evaluated with a complete battery for attention and memory performance. Frontal and temporal EEGs (5 min, eyes closed) were also recorded before and after the night. TSD subjects exhibited three performance deficits: learning the Pursuit Rotor Task, implicit recall of paired words, and distractibility on the Brown-Peterson Test. Relative to evening recordings, control subjects showed decreased morning absolute powers in all electrodes for all frequencies except for Frontal delta; TSD subjects showed increased Frontal and Temporal theta and Frontal beta. These results show that motor procedural, implicit memory, and working memory are sensitive to one night of TSD, and that Frontal and Temporal theta spectral power seem to discriminate between a night with sleep from a night without.     

Power spectral density changes in the EEG during mental arithmetic and eye-opening

Summary The effect of mental arithmetic (standard multiplication, with eyes closed) and eye-opening on the power spectral density of the EEG (recorded bipolarly from occipital and parietal regions) have been compared. The EEG was recorded on magnetic tape from normal subjects, (medical students) in a constant environment and subsequently analysed by an analogue computer (Noratom Instrument for Statistical Analysis and Computation, ISAC).Absolute measurements made from 15 subjects with eyes closed have shown that peaks of power at 10 Hz vary from 9 to 46 V² per Hz. Qualitatively, suppression of power at 10 Hz is greater due to eye-opening than mental arithmetic.Analysis of pooled power spectral density functions from 11 subjects showed that the effect of eye-opening differed significantly from the effect of mental arithmetic at 2.5 and 12.5 Hz. Suppression of lower frequency alpha activity was more pronounced during calculation than during eye-opening. Compared with the eyes closed condition, eye-opening showed a highly significant suppression at 10 and 12.5 Hz (alpha activity) and from 15 to 25 Hz (beta activity). Mental arithmetic induced significant suppression at 7.5 and 10 Hz and from 15 to 30 Hz. Eye-opening enhanced lower frequency activity which calculation suppressed.Variation was greater between first, second and third calculations in pooled power spectral densities than between corresponding eye-opening epochs. It is suggested that these differences in effects of eye-opening and mental arithmetic reflect differences in underlying cerebral activity, rather than that an underlying factor common to both effects may be orbital in origin.     

Group analytic therapy with schizophrenic outpatients

This paper describes a model for group analytic psychotherapy with patients who have been psychotic, namely, schizophrenics and manic depressives. The groups are run on the group centered principles of S. H. Foulkes. They are continuous, slow-open groups, in line with these patients' needs for long-term therapy. A theory is proposed which justifies treating these patients in group-centered groups despite their great dependency needs. The paper also describes the task of the therapist in building and running such a group.Acknowledgments to Geoffrey Elkan, Marcia Levene, Noa Rotem, Aya Levi-Posnanski, Yossi Ezrati, S. Littman, Tamar Sternberg, E. Danilowitz, and C. Kauffman.     

Group therapy with schizophrenic patients: a short-term, homogeneous approach

The author presents a short-term, homogeneous model for treating schizophrenic patients in discussion-oriented therapy groups. Typically, patients attend nine sessions in the open inpatient groups and 12 sessions in the closed outpatient groups. The two goals of this co-therapy approach are to help patients cope with psychotic experiences and improve their interpersonal relationships. Discussions focus on hallucinations, delusions, loose associations, and maladaptive relationships, and anxiety-producing topics are avoided. The format is interaction-oriented and emphasizes the here and now. Empirical evidence supports the value of this short-term group therapy approach when it is used in conjunction with antipsychotic medications and long-term follow-up.     

An 8q21 deletion in a patient with comorbid psychosis and mental retardation

Systematic investigations indicate that some of the recognized psychiatric disorders can be identified among those with mental retardation due to chromosomal abnormalities. We report a psychotic patient with mild mental retardation (intelligence quotient: 68) and minor anomalies that had a chromosomal aberration not previously described in a psychotic patient. Our patient highlights the importance of the cytogenetic study in psychiatric patients with comorbid mental retardation or minor anomalies. In addition, her psychosis symptoms may be helpful to propose a new candidate gene for psychosis.     

Initial experiences with cognitive therapy of schizophrenic patients

Based on earlier experiences of various groups of authors, we developed and modified a programme of cognitive therapy for schizophrenic patients. The aim of the application of the therapeutic programme to subacute patients was to decrease subjectively perceptible basic disorders and to improve the functions of performance. The present results and experiences with 4 groups consisting of a total of 31 patients encourage us to continue applying cognitive procedures of therapy. Problems of the ascertainment of measuring values and fundamental questions of therapeutic efficacy are discussed.     

Bright light therapy in schizophrenic diseases

20 patients with schizophrenic disorders, displaying a depressive syndrome, were given bright-light therapy, and compared with 11 patients treated by means of partial deprivation of sleep. Against a figure of 27% in the case of sleep-deprivation, syndrome remittance was 55% in the case of bright-light therapy. Psychometric data were obtained by use of three external-assessment schemes (HAMD, BPRS, and NOSIE) and two self-assessment procedures (TSD, POMS). As depressive syndromes improve under bright-light therapy, schizophrenic symptoms also recede, which suggests close syndromatologic links in the sense of a universal genesis of psychoses.     

Attentional network task performance in schizophrenic patients

Several studies have researched the attentional functioning of schizophrenic patients by means of the Attentional Network Test. The present work reviews these studies and assesses the clinical relevance of their results. Both the reviewed data and our own results suggest that the Attentional Network Test does not provide a clear-cut discrimination of the attentional profile of schizophrenic patients from a clinical point of view. However, after classifying patients according to their psychotic symptoms, it became evident that positive syndrome patients are less efficient at tasks that tap the orientation network.