Primary Process Content in Paranoid Schizophrenic Speech

Free speech samples given by paranoid schizophrenics, nonschizophrenic paranoids, and nonpsychotic psychiatric patients were submitted to computerized content analysis. Speech samples were searched for words belonging to the Regressive Imagery Dictionary (Martindale, 1975), which yields a well-validated measure of primary process content. Three word-concreteness dictionaries were also employed. Compared to the other groups, paranoid schizophrenics produced speech higher in primary process content as well as in transitive verb concreteness. Results are consistent with psychoanalytic theory.     

Case Studies of Two Schizophrenic Patients

A recent meta-analysis found that the Rorschach Prognostic Rating Scale (RPRS) had a strong ability to predict subsequent outcome (r = .44, N = 783; Meyer &; Handler, 1997, this issue). However, that review did not directly address questions of incremental validity. This article focuses on the ability of the RPRS to predict outcome after taking into account other sources of data. Across studies that examined both the RPRS and the MMPI Ego Strength scale, the RPRS had a strong ability to predict outcome (r = .40, N = 187), whereas the MMPI scale did not (r = .02, N = 280). Nine studies examined the RPRS along with an intelligence test and allowed direct numerical estimates of incremental validity to be calculated. Across studies, the RPRS demonstrated strong incremental validity after controlling for intelligence (incremental r = .36, N = 358). It is clear that the Rorschach can make unique contributions to understanding clinically relevant processes in ways that self-reports or measured intelligence cannot. Contemporary Rorschach scales should continue to be evaluated for their distinctive and incremental contribution to clinical practice.     

精神分裂症患者的大脑两半球关系特点

1引言 精神分裂症是最常见的精神疾病之一.多年来,大量生物医学研究成果给精神分裂症的预防及治疗带来了希望.但这些研究成果尚未就精神分裂症的病理心理学基础达成统一明确的意见.     

Depressed and Nondepressed Students: Differences in Interpersonal Perceptions

The purpose of this research was to study the patterns of interpersonal behavior of depressed students. Depressed participants rated themselves lower than non-depressed controls on assertiveness and initiation of interactions and significantly higher than controls on concern about what others think, introversion, and submissiveness. Depressed participants also scored significantly higher than controls on measures of dependency, self-criticism, and the need to please others. Ratings of depressed participants by their roommates were not correlated with depressed participants' self-reports. In contrast, most subscale self-ratings and roommate ratings for the nondepressed participants and their roommates were significantly correlated.     

The Use of Humor with Chronic Schizophrenic Patients

The use of a humorous therapeutic approach combined with drug therapy in the treatment of chronic schizophrenia patients institutionalized for protracted periods of time led to positive changes in their symptoms. The majority of the patients responded well to humorous interpretations. The patients felt that they had the option of adopting the doctor's humorous manner. This approach appealed to them and raised self-esteem; they likewise gained confidence in their own ability to form judgments. They cooperated better with the doctor in issues pertaining to treatment. The fact that humor made an impact on the patients' cognition demonstrated that patients with disturbed thought processes could be influenced in ways which improved coping. The patients' condition was evaluated according to the BPRS scale, before the treatment, on a monthly basis during the treatment, and three months upon the completion of the experiment. In the course of the experiment, pharmacological treatment remained unchanged. On the average, a perceptible reduction in the BPRS value (p < .05) was detected as a result of humor therapy. Amusing representations of affective external stimuli were incorporated into the patients' cognition and, along with a newly gained awareness of the possibility of relating to them with humor, were retained long after the termination of the project.     

Derivation and Implications of MMPI Cluster Groups in Clinically Depressed Inpatient Females

The purpose of this study was to subclassify clinically depressed patients based on a cluster-analytic examination of the MMPI. Subjects were 79 female inpatients with major depression. A cluster analysis of the MMPI validity and clinical scales resulted in three clusters labeled psychotic (287 MMPI profile), hostile (24 MMPI profile), and histrionic (32 MMPI profile) depression. The psychotic group exhibited the greatest depression as measured by the Beck Depression Inventory (BDI). The psychotic and hostile groups, however, did not differ on other associated aspects of depression, such as negative cognitions, nonassertiveness, or personality style. The hostile group reported the fewest physical difficulties and the most excessive alcohol use. The groups, however, did not differ on other aspects of depression history or presentation such as family history of depression or previous hospitalizations. A repeated measures ANOVA for the three cluster groups on the BDI at admission, discharge, and 6 months after discharge indicated that all groups showed improvement at discharge but that only the hostile depressive group continued to show improvement at the 6-month follow-up.     

Cultural Mistrust and the Clinical Diagnosis of Paranoid Schizophrenia in African American Patients

This study examined agreement between clinical diagnoses and research diagnoses of schizophrenia for a sample of African American patients recently admitted to a psychiatric hospital. It also examined the association of cultural mistrust with disagreement between clinical diagnoses and research diagnoses of the paranoid subtype of schizophrenia. Complete data was available for 118 (77%) of the 154 cases from the original sample. Agreement among the different sources of diagnoses was poor in 5 out of 6 comparisons. The lack of agreement can be attributed, in part, to the fact there were significantly more cases of schizophrenia using clinical diagnoses than those using SCID or best estimate methods. Contrary to the hypothesis, however, level of cultural mistrust did not predict the excess in clinical diagnoses of paranoid schizophrenia. Cultural mistrust was positively associated with the odds of a diagnosis of paranoid schizophrenia by the best estimate method. The implications of the results for the diagnosis and treatment of African American patients are discussed.     

Day Treatment and Psychotropic Drugs in the Aftercare of Schizophrenic Patients

Schizophrenic patients referred for day treatment at the time of discharge from ten hospitals were randomly assigned to receive day treatment plus drugs or to receive drugs alone. They were tested before assignment and at 6, 12, 18, and 24 months on social functioning, symptoms, and attitudes. Community tenure and costs were also measured. The ten day centers were described on process variables every six months for the four years of the study. Some centers were found to be effective in treating chronic schizophrenic patients and others were not. All centers improved the patients' social functioning. Six of the centers were found to singificantly delay relapse, reduce symptoms, and change some attitudes. Costs for patients in these centers were not significantly different from the group receiving only drugs. More professional staff hours, group therapy, and a high patient turnover treatment philosophy were associated with poor-result centers. More occupational therapy and a sustained nonthreatening environment were more characteristic of successful outcome centers.     

History of Religious Delusions and Psychosocial Functioning Among Mexican Patients with Paranoid Schizophrenia

The association between global functionality and religiosity among patients from developing and predominantly Catholic countries warrants attention. To compare religiosity and psychosocial functioning in Mexican schizophrenia patients with and without a history of religious delusions, seventy-four patients with paranoid schizophrenia were recruited. Patients with a history of religious delusions had more psychiatric hospitalizations and poorer psychosocial functioning compared with those without a history of religious delusions. No differences emerged between groups in the total scores of religiosity scales. A history of religious delusions rather than religiosity itself may have an influence on psychosocial functioning among Mexican patients with schizophrenia.     

Differentiating Cognitive Content between Depressed and Anxious Outpatients

Quantitative research suggests that depressed and anxious patients can be differentiated based on their cognitive content. This study used qualitative research methods to separate the specific components of open‐ended depressive and anxious thought content in 79 psychiatric outpatients. Patients with major depressive disorder (MDD; n = 36), generalized anxiety disorder (GAD; n = 10), and other psychiatric disorders (PC; n = 33) were instructed to (a) describe their most bothersome problem; (b) imagine the worst possible negative outcome followed by the best possible positive outcome; and (c) describe associated thoughts and emotions for each scenario. The content of patients' responses were coded to examine (a) the types and severity of problems; (b) the presence or absence of hopelessness, catastrophizing, hopefulness, and unrealistic positive expectations; and (c) the presence or absence of particular emotions associated with imagined worst and best outcomes. More GAD patients than MDD and PC patients indicated anticipated anxious emotions associated with imagined worst outcomes, and fewer MDD patients than GAD and PC patients indicated anticipated happiness associated with imagined best outcomes. No group differences emerged for the other variables considered. These findings suggest that depressed and anxious patients differ in their cognitive expectancies about future life events in terms of their own anticipated emotional reactions.     

齐拉西酮与氯丙嗪对精神分裂症首次发作患者心电图影响的比较研究

为了探讨齐拉西酮与氯丙嗪对首发精神分裂症患者心电图(ECG)的影响,将221例首发精神分裂症患者随机分为两组,齐拉西酮组111例,氯丙嗪组110例,分别给予齐拉西酮和氯丙嗪治疗.于治疗前和治疗后的第2、4、8周末定期进行心电图检查,并对两组患者的心电图结果进行对比分析.服药后两组患者的心电图均有不同程度的改变,以窦性心动过速和ST-T改变为主,齐拉西酮组与氯丙嗪组患者心电图异常发生率分别为24.3％、54.5％,齐拉西酮组所致心电图改变明显低于氯丙嗪组(P＜0.01).齐拉西酮与氯丙嗪治疗精神分裂症疗效相当,而齐拉西酮对首发精神分裂症患者心电图的影响显著低于氯丙嗪,临床安全性高.     

齐拉西酮与氯丙嗪对精神分裂症首次发作患者心电图影响的比较研究

为了探讨齐拉西酮与氯丙嗪对首发精神分裂症患者心电图（ECG）的影响,将221例首发精神分裂症患者随机分为两组,齐拉西酮组111例,氯丙嗪组110例,分别给予齐拉西酮和氯丙嗪治疗。于治疗前和治疗后的第2、4、8周末定期进行心电图检查,并对两组患者的心电图结果进行对比分析。服药后两组患者的心电图均有不同程度的改变,以窦性心动过速和ST—T改变为主,齐拉西酮组与氯丙嗪组患者心电图异常发生率分别为24．3％、54．5％,齐拉西酮组所致心电图改变明显低于氯丙嗪组（P〈0．01）。齐拉西酮与氯丙嗪治疗精神分裂症疗效相当,而齐拉西酮对首发精神分裂症患者心电图的影响显著低于氯丙嗪,临床安全性高。     

Social Categorization and the Perception of Groups and Group Differences

The classification of human beings into distinct groups is a fundamental feature of social perception. Problematic phenomena, such as prejudice, discrimination, and intergroup conflict, are commonly traced back to categorization. We explore the minimal conditions under which categorization occurs and the basic mechanisms by which it affects cognition and behavior. We show that comparisons between groups are not necessary for categorization, reveal the conditions under which people overestimate or underestimate differences between groups, and sketch a model showing how social categorization gives rise to differences in the evaluation of ingroups and outgroups and to differences in the accuracy of judgments of ingroups and outgroups. We conclude with reflections on intergroup conflict and the role of moral judgment in such conflicts.     

医患双方对医患关系紧张因素的认知差异

弥合医患双方对医患关系紧张因素的认知差异的关键,是加彼此的沟通和理解.沟通中主要责任在医方,作为医护人员应该以患方的利益为中心,用患方能够接受的语言和方式,向其适度介绍病情、目前国内外对此疾病的治疗现状、本医院准备采取的治疗的技术路线以及治疗费用、预后状况等详细信息,全面实施知情同意.     

Interaction of Psychosocial and Biological Factors in Marital Sexuality—Differences between Men and Women

Evaluation of intervention into marital sexuality presents problems because of the complex interaction of psychosocial and biological factors. These interactions are not the same for men and women, and various examples of such sex differences are discussed. The clinical presentation of sexual problems, the importance of sexual appetite, the effects of ageing and the effects of physical handicap on the sexual relationship, are each considered from the different viewpoints of men and women.     

Depressed mood mediates the relationship between rumination and intrusions

Research suggests that rumination is a causal factor for intrusive memories. These are disturbing autobiographical memories that pop into one's mind involuntarily, spontaneously, and repetitively. A three‐wave longitudinal study was conducted to replicate this finding and to test whether one route via which rumination leads to (an increase in) intrusive memories is via depressed affect. Secondary school students (n = 72) filled out self‐report questionnaires measuring their level of rumination, depressive symptoms (DS), and intrusive memories. These were administered at three different points, with 3 weeks in between each measurement. Two types of rumination were measured, that is, depressive rumination and rumination in response to intrusions. Both bootstrapping analyses and cross‐lagged analyses yielded evidence for DS as a partial mediator of the relationship between rumination and intrusion frequency. Both depressive rumination and rumination about the content of intrusive memories seemed to be maladaptive: They may exacerbate negative emotions, which in turn trigger intrusive memories. Ruminative thinking also directly led to (an increase in) intrusive memories. These findings might suggest that people suffering from intrusive memories may benefit not only from therapies directly aimed at reducing intrusions but also from therapies aimed at reducing rumination and DS.