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The aim of this research was to study individual development along with the epigenesis of family relations in an eight-year follow-up of schizophrenia. The five epigenetic phases described by Wynne are attachment/caregiving, communicating, joint problemsolving, mutuality, and intimacy. Results showed that the critical level of epigenesis was the communicating level; its resolution was statistically significantly connected to good prognosis concerning individual parameters. The mother-child dyad was usually epigenetically the most developed dyad in the family. We think this study gives a new paradigm for understanding connecting interconnections between individual and family dynamics in schizophrenia and valuable information for planning the integrated and need-specific treatment of schizophrenia and evaluating the course and prognosis of schizophrenia.This study was carried out at the Clinic of Psychiatry of the University of Turku, Finland, and financially supported by the Academy of Finland. The head of the project was Professor Yrjö O. Alanen. We have also been in cooperation with and received valuable constructive criticism from Professor Lyman C. Wynne, whose theoretical model we applied in this study. Ms. Birgitta Nolvi's secretarial work was greatly appreciated. 相似文献
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Incidents involving the authors' twin 10-year-old daughters illustrate that guilt is well established in normal children of 10. The incidents suggest how the expectation of parental blaming triggers guilt and shame. Guilt and shame are compared. While they may coexist in the 10-year-old, guilt clearly is assuming a dominant position. Mental health professionals have emphasized the psychopathology of guilt and many forget that it is essential for normal socialization in that the guilty person feels a need to repair damage allegedly done. Guilt presumes that at least a primitive mutuality has been established in the person; and mutuality is the hallmark of human maturity. Terms are defined here with some variation from their usage by mental health experts: shame, guilt, blame, and counterblame. 相似文献