Process parallels in related groups

The theoretical basis for the repetition of themes in related groups is addressed by describing similar processes in four systems: inpatient psychiatric ward, inpatient psychotherapy group, supervisory group, and group psychotherapy division. The principles of general system theory help explain process parallels in allied groups and illuminate group process.     

Peer-group affiliation and adolescent self-esteem: an integration of ego-identity and symbolic-interaction theories

To evaluate expectations derived from ego-identity theory and symbolic-interaction theories about the association between self-concept and peer-group affiliations in adolescence, we examined the self-esteem of 221 7th through 12th graders associated by peers with one of five major school crowds and 106 students relatively unknown by classmates and not associated with any school crowd. Among crowd members, self-esteem was directly related to the position of one's crowd in the peer-group status hierarchy (based on both peer-rated and self-perceived crowd affiliation). Outsiders' self-esteem differed in relation to the accuracy of their reflected appraisal of and the salience they attached to crowd affiliation. Crowd members as a whole exhibited higher self-esteem than outsiders as a whole. Differences, however, were mediated by crowd status, salience of crowd affiliation, and the accuracy of reflected appraisals. An adequate interpretation of the findings required an integration of Festinger's (1954, 1957) social comparisons and cognitive-dissonance theories, Cooley's (1902) notions of reflected appraisal, and Newman and Newman's (1976) extrapolations from ego-identity theory.     

Status of perfusion scintigraphy in the diagnostic strategy in cerebrovascular disorders and space-occupying lesions

The results of an evaluation of the perfusion scintigraphy findings of 350 hospitalised neurological patients and 55 more strictly selected neurosurgical patients with cerebrovascular complaints, revealed an accuraty of 83%, a sensitivity of 89%, and a specificity of 83%. The selection of the patients had no influence on the results as a whole. Compared with contrast-medium angiography, incorrect diagnosis must be expected in 17% of the cases. This includes erroneous negative findings in 10% of the cases. Grounds for misinterpretations are suggested, and the biological and methodological limitations of the method are set forth.     

Principles of computer-assisted classification in psychiatry

The use of computer based diagnostic decision and artificial intelligence are discussed in relation to the problems of validity and reliability of psychiatric diagnoses. The authors suggest a definition of a computer aided classificator as an existent decision system for an automatically analysis of findings.     

A view of aggression in phobic states

This article attempts to apply a theory of aggression as motivation to overcome obstacles to the understanding of phobic states and their formation. The role of aggression in the genesis of phobic conditions is discussed, and the traditional analytic view of aggression as instinctual drive is contrasted with a motivational approach. The motivational view offers the advantage of a clearer understanding of the stimulus contexts, representational connections, and both real and imaginary object connections that are lacking in the more traditional understanding of aggression as a biological drive.     

Parenting a damaged child: mourning, regression, and disappointment

This paper is an examination of the long-term parenting experiences of parents who have given birth to CNS damaged infants. In particular, the focus is on the mourning, regression, rage, and depression that frequently attend these parents throughout their lives and can become pathological and pathogenic interferences with the provision of good-enough parenting. Several clinical vignettes were presented, each of which illustrated the usefulness of different psychoanalytic clinical theories about normality and pathology of parenting and parent-child interaction. The now-classical contribution of Solnit and Stark (Mourning and the Birth of a Defective Child, 1962) is reviewed along with Benedek's and others' psychoanalytic theories about normal parenting. The thinking of these writers is within the framework of structural/libidinal theory and seems to be useful in describing certain parenting problems that concern the mourning and regressive aspects of parenting. However, it was proposed that some of the adaptive coping and pathology encompassed by Solnit and Stark's explanations is not comfortably illuminated by the structural clinical theory of conflict and drives. Freud's discussion (1917) compares mourning and melancholia, which he differentiated as related but dynamically distinct clinical phenomena. This work is briefly recalled as an earlier point in theory building where structural theory was not sufficient to explain clinical depression and rage that exceeds normal mourning (as in Freud's melancholia). It is felt that an additional theoretical perspective on parenting provided by self psychology can fill in some of the gaps left by structural theory explanations. The self psychology perspective is particularly helpful with understanding the rage, ambivalence, and chronic depression often experienced by parents of damaged children. According to this perspective, the damaged child is a disappointing selfobject for the parent, and the parent's self organization will give him the resources to cope adaptively or to develop narcissistic pathology. Three types of intrapsychic problems for a parent are described: mourning the lost object, the fantasied perfect child; experiencing and recovering from regression to early identifications with his own parents; withstanding tension and regulating one's self (experiencing chronic depression and rage) when confronted with a great disappointment in a selfobject (represented by the damaged child). It is important when designing intervention strategies in a hospital or pediatric clinic setting to clarify which type of problem is the major focus of the parent's struggle.(ABSTRACT TRUNCATED AT 400 WORDS)