Diaphragmatic spasm: A neglected cause of dyspnoea and chest pain

The study included 17 patients, 12 women and 5 men, with a recurrent symptom complex involving chest pain and dyspnoea characterized by inability to get a full breath. Some attacks had subsided spontaneously. Others had lasted hours or days. When examined by fluoroscopy during an attack, each subject was found to have a nearly maximally contracted (flat) diaphragm. In some of them the attack was promptly interrupted by a small intravenous injection of sodium amytal. In others it could be aborted by a conscious effort at full expiration. The syndrome associated with diaphragmatic spasm is discussed in comparison with other noncardiac sources of chest pain and dyspnoea.     

Adaptation effects and reversible figures: A comment on Horlitz and O’Leary

In a recent article, Horlitz and O’Leary (1993) offer a reinterpretation of the results of several studies over the past 40 years that have employed the prolonged-inspection technique in the investigation of reversible figures. Specifically, they contend that, contrary to the favored interpretation of neural adaptation effects, the results of these studies reveal the combined influence of such topdown processes as attention and perceptual learning as well as such methodological difficulties as unwanted demand characteristics. In this note, we examine their analysis of the literature, their alternative theoretical model, and the supporting conclusions they draw from their two experiments. We argue that there is considerable evidence from a variety of studies for the joint role of bottom-up and top-down processes in reversible figures. Moreover, we propose that Horlitz and O’Leary’s own research, rather than eliminating the possibility of neural-adaptation effects, is best conceptualized as providing additional evidence for the role of higher-order processes in these phenomena.     

The expanding role of the minister as community health services develop

Conclusion In summary, we have suggested in this brief discussion that (1) clinical pastoral training has established itself firmly in our culture and will be an important resource in the function of community mental health centers; (2) there will also be need for many clinically trained pastoral ministers who will serve importantly in the prevention of mental illness and promotion of mental health; (3) that standards of training in the clinical pastoral field are very much needed and should be nationally unified and coordinated; and (4) that the Association of Mental Hospital Chaplains might well exercise the leadership in developing a national resurgence of interest in a dynamic religion which will better meet the needs of our people as we move forward in this complex scientific age. For myself, I have no doubt that religion can provide many of the positive elements of good mental health, and I believe that this concept will grow to full maturity in the years ahead.Delivered at Annual Anton T. Boisen Banquet, Association of Mental Hospital Chaplains, Los Angeles, California May 6, 1964.