A predictive approach to Freud's formulations regarding suicide

This study of suicide notes involved the deduction of 25 protocol sentences that reflected important specific aspects of Freud's formulations regarding suicide. Independent judges noted the incidence of contents corresponding to the protocol sentences in 33 genuine and 33 simulated notes. Comparisons between genuine and simulated notes revealed that the protocol sentences discriminated significantly as a set in favor of the genuine notes. Individual statements found significantly more frequently in genuine notes indicated loss and/or rejection, preoccupation with a lost person, ambivalence toward a lost person, identification with a lost person, communicating feelings of anger toward oneself but appearing to be angry toward someone else, turning back upon oneself murderous wishes or impulses, and seeing the act as a fulfillment of self-punishment. A frequency count of the sentences in the notes indicated that these statements occurred quite frequently (i.e., at least one-third of the time) in the genuine notes. Implications of the results are discussed.     

An innovative approach to clinical communication in schizophrenia: the approaches to schizophrenia communication checklists

Side effects from antipsychotic medications can have a profound effect on patients' lives and may adversely affect their willingness to comply with treatment. Identification of side effects through improved communication between psychiatrists, other members of the healthcare team, and their patients might increase treatment compliance. The Approaches to Schizophrenia Communication (ASC) Steering Group developed two simple, practical checklists for use in the busy clinical setting. The ASC-Self-Report (ASC-SR) checklist is completed by the patient and comprises a list of the more common or clinically important side effects of antipsychotic treatment. The ASC-Clinic (ASC-C) checklist is completed by both clinician and patient together, being used as the basis for a semi-structured interview. In a multicenter pilot study set up to evaluate the utility of checklists, 86% of patients responding considered the ASC-SR to be useful in communicating their problems to psychiatrists and other members of the healthcare team. All healthcare team respondents found both checklists to be helpful when discussing side effect problems with their patients. Moreover, 41% and 47% of healthcare team respondents reported that the ASC-SR and ASC-C, respectively, had assisted them in identifying side-effect problems not previously acknowledged. Preliminary evaluation of the ASC-SR and ASC-C in this multicenter pilot study suggests that both tools were user-friendly, encouraged communication between patients and healthcare professionals about antipsychotic drug side effects, and could readily integrated into everyday clinical practice.     

Primitive drive-dominated thinking: relationship to acute schizophrenia and sociopathy.

To investigate primitive drive-dominated thinking in schizophrenic disorders and sociopathic behavior, responses on the Rorschach and other personality tests of 171 acute psychiatric patients were assessed using Holt's system. Results suggested that: (a) Acute schizophrenics were high on primitive drive content, but this was also characteristic of some nonschizophrenics, and other types of disturbed thinking were even more prominent in schizophrenics. (b) There were no significant differences between process and reactive schizophrenics in expression of primitive drive content. (c) Males showed more drive-dominated thinking than females (p less than .10), although sex was not a powerful variable. (d) Depressives showed less drived-dominated thinking than nondepressive (p less than .05). (e) Patients high on sociopathic or rule-breaking behavior tended to show more primitive drive-dominated thinking (p less than .01).     

A community survey of psychological symptoms: evaluating evolutionary theories regarding shamanism and schizophrenia

Evolutionary theories regarding shamanism and schizophrenia provide hypotheses testable through analysis of survey data. A questionnaire, administered to a predominately African-American sample in North Carolina (N?=?965), surveyed schizotypal experience and other psychological symptoms, absorption and related psychological variables, childhood and adolescent difficulty, and incidence of unusual experiences (apparitions, paranormal dreams, waking ESP, out-of-body experience, near-death experience, sleep paralysis, UFOs, spiritual healing, and religious experiences). Study findings replicated Mirowsky's results regarding overlapping boundaries between psychiatric diagnoses. Findings also supported evolutionary hypotheses regarding correlations between schizotypal experiences, psychological variables related to shamanism, unusual experiences, and childhood/adolescent difficulty. Findings suggest use of religion-based cognitive behavioural therapy for distressed people reporting frequent unusual experiences.     

Attachment and spiritual coping in patients with chronic schizophrenia

Many studies on spirituality in psychosis have shown that, compared to a nonclinical population, patients make more use of spiritual beliefs/religious practices to deal with their problems. Our research question was to test whether attachment to spiritual figures could be a good explanation for religious coping strategies in patients with psychosis. First, adult attachment was investigated in 28 patients with chronic psychosis and 18 controls, using the Adult Attachment Interview. Diagnostic evaluations were performed with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) Axis I disorders and symptomatic evaluation with the Brief Psychiatric Rating Scale. Results also show a high prevalence of insecure avoidant attachment in patients, and suggest that a significant part of religious coping might be explained by the theory of attachment (64% of the patients, 78% of controls). The implications of these results are interpreted in light of correspondence and compensation hypotheses.     

The enactive approach and disorders of the self - the case of schizophrenia

Phenomenology and the Cognitive Sciences - The paper discusses two recent approaches to schizophrenia, a phenomenological and a neuroscientific approach, illustrating how new directions in...     

众善之首:健康权析论

健康权是获得一种提供公民享有可能达到的最高健康水平的均等机会的健康保护体制的权利;政府应承担以确保民众平等获得基本卫生保健为基点的诸项积极义务.各国宪法日益将健康权列为基本人权,并不断明确和完善.健康权具有可诉性,尽管在"逐步实施"方面存在难题.我国应在法律上进一步明确和促进健康权.     

A multi‐component approach to the treatment of chronic rumination

A multi‐component intervention was used to treat chronic rumination exhibited by an adult female diagnosed with a developmental disability. The intervention consisted of: (a) interruption of precursor behavior, (b) the alternation of 10‐min periods of continued instruction that involved walking and working with (c) 10‐min periods in which instructions were not delivered but a variable time 5‐s schedule of noncontingent attention was programmed, and (d) a 1‐min differential reinforcement of other behavior (DRO) schedule. During the intervention, rumination decreased by 82% relative to baseline. Next, components of the multi‐component intervention were systematically removed to evaluate their individual contribution. Results suggested that each individual component contributed to the overall treatment effects. Copyright © 2010 John Wiley & Sons, Ltd.