Personality Dysfunction and the Management of Chronic Medical Illness: A Community Health Sample

The purpose of this study was to determine the influence of personality disorders on perceived health status, self-efficacy for management of the chronic illness, and physician perception of patient health. A total of 607 patients with self-identified chronicillness(es) volunteered to participate in the study. Out of this sample, 147 had collaborative physician data indicating a chronic illness. The final sample was 143 due to incomplete data. Results suggested that maladaptive personality characteristics, as measured by the Short-Form of the Coolidge Axis II Inventory (SCATI), were related to a number of important factors that influence self-management of chronic illnesses. When the personality constellations were broken into 3 groups (normal, subclinical, and clinical) significant differences were found on the 3 groups of dependent variables (Subjective Health, Self-Efficacy, Physician Appraisal) for the different personality disorders. These data provide useful information on several factors that influence effective disease management. Clinical implications and directions for future research are provided.     

Spontaneous and learned turning behaviour in food- or water-restricted hooded rats

Some laboratory studies have suggested that whereas food restriction in animals leads to response alternation (behavioural flexibility), water restriction induces perseverative, stereotyped responding. Hooded rats, restricted to 1 hour per day access to either food or water, were tested on a radial-arm maze (using a procedure that eliminates algorithmic response strategies), for alternation in a 3-arm maze (both when the maze was familar and unfamilar, and with or without differential reward) and a 2-choice maze in which some animals were taught to alternate direction of turn, and others to perseverate. Both groups performed the radial-arm maze task competently and spontaneously alternated at a high rate. In the learned task, food-restricted rats were slower than water-restricted to reverse a consistent direction of turn; in the alternation condition, water-restricted rats developed a temporary, but strong, directional bias when making their first choice each day. Water-restricted subjects took water more readily than food-restricted took food when initially introduced to the apparatuses, but there was no consistent difference in motivation in the two conditions. The results provide little support for the notion that distinct cognitive-motivational states or behavioural strategies are induced by food- and water-restriction.     

Suicide in the Subway: Psychodynamic Aspects*

ABSTRACT: Fifty-one cases of suicide attempts in the subway have been investigated to examine the question of whether the method used has psychodynamic significance or is merely adventitious. We found that no single characteristic distinguished subway suicide from all other suicide modalities, although as a group the subway cases had a higher proportion of psychotic and previously suicidal patients than other series quoted in the literature. However, there were important differences between subway suicide cases seeking a “traumatic” death (jumping in front of a train; lying across the track awaiting destruction) and those seeking a “nontraumatic” death (electrocution on the live “third rail”). The traumatic group had histories of exposure to violence, other traumatic suicide attempts, hostile or destructive delusions, and many “destroy” words on psychological test protocols. The smaller nontraumatic group had no such history of exposure to violence; their previous suicide attempts were nontraumatic; delusions, when present, were not menacing; and the psychological tests showed more “escape” words than “destroy” words.