Philosophy of medicine in the Netherlands

This report explores the relationship between philosophy and medicine in the Netherlands. In Section 1 we outline the ups and downs of medico-philosophical research in our country: pre-war flourishing, post-war decline, and modern renaissance. In Section 2 we review recent Dutch literature in the philosophy of medicine. The topics dealt with include methodology of medical science, alternative medicine, the basic concepts of medicine, anthropological medicine, medicalization, medicine and culture, and health care ethics.     

An information processing system for the psychiatric emergency room

An information processing system for a psychiatric emergency room is described. Several studies are presented that show the utility of the system. In the first study, variables involved in diagnosis are explicated. The second study attempts to determine the characteristics that distinguish recidivists from nonrecidivists at an emergency room. The third study attempts to find patient variables related to success in short-term treatment programs. The final study is aimed at discovering whether there are psychopathological effects related to the use of inhalants. Together, these studies show the potential of a mental health information system for learning more about the nature of mental disorders and their treatment.     

Component analysis of the type A coronary-prone behavior pattern in male and female college students

Two studies investigated the psychological dimensions encompassed by the Rosenman Structured Interview (SI) method of assessing the Type A behavior pattern. In Study 1, female students completed the SI and Jenkins Activity Survey (JAS). Factor analysis of the verbal stylistic and answer content components of the SI yielded a 5-factor solution, with one factor--Clinical Rating--accounting for most nonerror variance in Type A ratings. The remaining factors were derived from answer content and correlated more substantially with JAS Type A ratings than with SI Type A ratings. In Study 2, male and female college students completed the SI and JAS and a battery of questionnaires that tap trait dimensions implied by the conceptual definition of Type A. For both males and females, SI ratings of Type A could almost be completely predicted by scores on the Clinical Rating factor. For both sexes, content dimensions of the SI related to other measures of Type A and to Type A-consistent traits, whereas the Clinical Rating factor was only modestly associated with such traits. Moreover, sex differences were observed in the trait constellations composing SI and JAS definitions of Type A. These results suggest that a discrepancy exists between conceptual and operational definitions of the Type A pattern.     

The EPPI family therapy outcome study

Information was evaluated from 1014 families seen in an eight-year period by therapists connected with the Department of Family Psychiatry at Eastern Pennsylvania Psychiatric Institute in Philadelphia. Statistical analysis revealed several factors that had some predictive value in relation to outcome of therapy; these were race, past psychiatric hospitalization, type of presenting family problem, and number of sessions held. There was a rather good chance of improvement being noted by the therapist if the family stayed in treatment for eight or more sessions. About 90% of the cases were seen for less than 20 interviews. Only about 3% were seen for longer than 35 interviews. The vast majority of EPPI cases were short-term. Black families tended to present different problems from white, and therapy was terminated with blacks sooner than for whites. About 35% of families terminated after one to two interviews, and another 30% after three to seven sessions. Since families tended to benefit most after eight or more sessions, the need for better methods or techniques to engage families is highlighted.The research was supported in part by a Career Development Award from the University of California, San Francisco, to the first author.     

A case report of pathological rule-governed syllable intrusion

A detailed analysis of a unique speech disturbance, marked by the frequent appearance in the speech stream of a meaningless intrusive syllable, is presented. Following a lengthy thoracic surgery, an American English speaking patient began to speak with non-English prosodic patterns, which evolved to a conspicuous intrusion in his speech of the syllable /sis/. This syllable and its variants were attached to words in a manner which conformed to the regular phonological rules in English (for formation of plural, possessive, and third person singular morphemes). The distribution and frequency of the intrusive syllable are described, and possible explanations for the abnormal occurrence of this particular syllable are discussed.     

Programmed stuttering therapy for children: Comparison of four establishment programs

Four different establishment programs (programmed traditional, delayed auditory feedback, pause, and gradual increase in length and complexity of utterance) for improving the fluency of school-age children who stutter were compared. The programs were carried out by eight public school clinicians with 16 children (eight elementary and eight junior-senior high school) in their respective schools. All four programs produced important improvement in the speech fluency of the 16 children. All the children demonstrated transfer of fluency to extratraining settings. The delayed auditory feedback program required the least therapy hours, but it was difficult for the clinicians to operate correctly. The gradual increase in length and complexity of utterance programs produced the best overall results. The transfer and maintenance programs provided for additional generalization and permanency of fluency. Follow-up revealed that the children continued their increased level of fluency.     

Interpersonal Reactions to Depression and Physical Disablllty In Dyadic Interactions1

Examined the interpersonal responses of persons engaged in dyadic interactions with confederates who enacted either depressed or socially appropriate roles and appeared either with or without a physical disability. Subject negative evaluations of confederates were indirectly obtained from a thought-listing measure. The overt behaviors of subjects were surreptitiously recorded on videotape and measures of verbal and nonverbal behavior were acquired. Subjects spoke less to the depressed targets and had significantly higher rates of negative evaluations of these persons. In addition, subjects gazed less at the depressed confederates. These effects were not moderated by target physical appearance. Findings are discussed as they relate to social models of depression and the stigmatizing effects of disability.