Staging the psychoanalytic situation in supervision

Fantasies, parapraxes, and associations that figure significantly in the transference-countertransference process between patient and analytic candidate also work their way into the relationship between the candidate and the supervisor--sometimes in disguised fashion. The author illustrates this observation with vignettes and shows how, with the help of Lorenzer's concept of scenic understanding, the interaction pattern observable in the supervision can be utilized for the understanding of the material presented by the patient.     

Biotinidase deficiency--a progressive metabolic disease in children with seizures and ataxia

Biotinidase deficiency is the primary biochemical defect in late-onset multiple carboxylase deficiency and an autosomal recessive disorder and characterized by seizures, ataxia, alopecia and skin rash. We describe a colorimetric semiquantitative method for screening for biotinidase activity from dried samples of whole blood spotted on filter papers. The administration of biotin to affected children can be a lifesaving procedure and can prevent irreversible neurologic damage.     

Neuroleptic malignant syndrome--3 case reports

An account is given of three patients who exhibited a malignant neuroleptic syndrome after the administration of neuroplegics. Like other authors, we identified typical elicitation factors and clinical characteristics. In one case a catatonic dilemma with lethal issue was observed. In the final case dealt with in this paper, the renewed application of neuroplegics following the termination of the malignant neuroleptic syndrome was tolerated without complications, whereas in the case of an epileptic patient with damage to the brain, the malignant neuroleptic syndrome returned upon dosage increase.     

Height vertigo, fear of heights, acrophobia

Height vertigo (acrophobia) is a very frequent phenomenon being of interest for its physiological and psychological background, though usually only of limited significance in neuropsychiatry and otology. The different aspects as to its nature and origin are discussed. If acrophobia has developed into a conditioned reaction of avoidance with pressure of suffering, or acrophobia in persons, who have to work at heights, behavior therapeutic measures with systematic desensibilisation, starting from an imaginative training, are indicated.     

Pain and pain perception

Pain is both sensual perception and sense of touch, and it leads to emotional change of health, which has an effect back to a pain perception. Experience of pain is modified by intern and extern influences, and it can appear very multiformly in the chronicity. A part of these factors are described.     

Endogenous and symptomatic schizophrenia. Wherein lies the difference?

It is the opinion of the present writer that endogenous and symptomatic schizophrenia are two completely different matters. By classical symptomatology it is impossible to establish the distinction in every individual case. Nevertheless, in not one of the published cases known to us did Bonhoeffer err in his diagnosis of the one or the other. Evidently he made use of additional characteristica gathered in practice, about which he himself may not always have been quite clear.     

Marital conflict and children's adjustment: a cognitive-contextual framework

Marital problems have been related to numerous indexes of maladjustment in children. Although several parameters of this association have been identified, the process by which exposure to interparental conflict gives rise to adjustment problems in children is largely unexplored. Research on the link between marital conflict and child maladjustment therefore is critically evaluated, and a framework is presented that organizes existing studies and suggests directions for future research on processes that may account for the association. According to the framework, the impact of marital conflict is mediated by children's understanding of the conflict, which is shaped by contextual, cognitive, and developmental factors. The implications of the framework for children's adjustment are discussed.     

Punished and Nonpunished Responding in A Multiple Schedule in Humans: A Brief Report

Four male subjects responded on a multiple schedule in which responding was maintained by a random interval 20-sec (RI20) schedule of point presentation. Responding was suppressed in alternating components by an added variable ratio 30 (VR30) schedule of point subtractions. Each component was accompanied by distinctive stimulus lights. Subjects were exposed to the multiple schedule from the initial session. Two subjects experienced four 50-min sessions daily (Experiment 1) and the other two subjects participated in one 50-min session daily (Experiment 2). Once responding in the punished components had stabilized, responding in the nonpunished components continued to increase across sessions. Nonpunished responding did not stabilize even after as many as 36 sessions. These results are discussed in the context of previous studies using animals which employed multiple schedules with punished and nonpunished response contingencies.

     

Perceived parental inconsistency as a factor in the emotional development of behaviour-disordered children

55 English-speaking institutionalized adolescents (37 boys and 18 girls between ages of 14 and 19 yr.) were given questionnaires measuring perceived parental inconsistency and different components of emotional development. Canonical correlation analysis indicated that a significant proportion (51%) of the variation in emotional adjustment was accounted for by parental inconsistency. It is suggested that the efficiency of using parents as agents of change for their behaviour-disordered children can be enhanced by including theory on parenteral inconsistency in program content.     

Low self-esteem in eating disordered patients in the absence of depression

Both low self-esteem and depression are well recognised as occurring in patients with eating disorders. 43 patients with eating disorders were studied to assess whether this low self-esteem occurred as part of an affective disorder or was independent of this. The patients, 23 with anorexia nervosa and 20 with bulimia nervosa, were assessed for low self-esteem, using the Rosenberg Self-esteem Questionnaire, and for depression, using the Hospital Anxiety and Depression Scale. The patients had low self-esteem, despite only a minority (33%) being depressed. This study demonstrates that low self-esteem occurs in patients with eating disorders in the absence of depression.