Attention-Deficit Hyperactivity Disorder: The Medicalization of Misbehavior

During the past decade, there has been an increase in the diagnosis and treatment of Attention-Deficit Hyperactivity Disorder (ADHD). This syndrome, typically diagnosed in childhood, is characterized by inattention, hyperactive motor behavior, and distractibility. Current prevalence rates obtained in various countries generally exceed the 3–5% reported by DSM-IV. Reasons for increased ADHD prevalence include changes in diagnostic standards, overlap between ADHD and other externalizing disorders, nonspecific behavioral criteria, and the rapid effects of stimulant medication on cognitive functioning. However, social, cultural, and economic factors may also contribute to increased diagnosis. ADHD has become a common topic in the lay media. Popular discussions of ADHD may serve as a metaphoric expression of social anxieties, particularly with respect to children. At the same time, ADHD has rapidly become incorporated into a medical model, with emphasis on pharmacological treatment. Reductions in mental health and educational services, as well as economic pressures of managed care, may also contribute to medicalization of behavioral problems. Collaboration between psychologists and primary care physicians can lead to more accurate diagnosis and appropriate treatment of ADHD and related disorders.     

Medical semiotics in the 18th century: A theory of practice?

Medical semiotics in the 18th century was more than a premodern form of diagnosis. Its structure allowed for the combination of empirically proven rules of instruction with the theoretical knowledge of the new sciences, employing the relation between the sign and the signified.     

Prescriptions: Autonomy,Humanism and the Purpose of Health Technology

My purpose is to examine two of the foundations of medical ethics: the principle of autonomy and the concept of the human. I also investigate the extent to which health technology makes autonomy and humanness possible. I begin by underlining Illich's point that the same health technology designed to promote health and autonomy also is pathogenic. I proceed to analyse the Kantian concept of autonomy, a concept which is closely associated with health and which continues to determine current ethical thinking. In so doing, I uncover an unexpected ontological function of health technology, a function described in Heidegger's work on technology. Based on this discovery, I suggest that calls for Kantian autonomy may often be self-defeating or even sometimes harmful. I conclude by calling for continued ethical vigilance, but also for a questioning of the hitherto virtually unquestionable concepts of ethics and humanness which may themselves play a role in our era's greatest problems.     

Report of the Working Group on Research

Prepared by the Working Group on Research from the November 1995 Georgetown conference sponsored by the Association of Medical School Psychologists, this paper focuses upon the challenges for psychologists who wish to maintain active research programs in academic medical settings. Six specific strategies are offered that, if followed, would increase opportunities and visibility of psychological research programs both within academic medical settings and within society at large.     

Building therapeutic relationship in schizophrenic and alcohol-related disorder cases

Current literature on the dual diagnosis in cases of schizophrenia and alcohol dependence has reported how pharmacological treatment has positive effects on the reduction of both disorders. Nevertheless, patients have considerable difficulties in following the prescribed medication. This work aims to build an engagement stage and therapeutic relationship in seven patients with schizophrenic and alcohol-related disorder cases. This result was achieved through the use of the vignette technique and narrative psychodynamic approach during group counselling sessions. Positive and Negative Symptoms Scale (PANSS) and Munich Alcoholism Test (MALT) were applied before and after treatment. A follow-up session was organized. The PANSS and MALT scores indicated there was no reduction of the psychiatric symptoms after treatment. The follow-up session showed positive outcomes in terms of increasing the level of socialisation as well as awareness of their own condition; at the same, an adherence to pharmacological treatment and psychotherapy for all the subjects.     

A fertile matrix: the birth of the Forensic Psychotherapy Society

This paper traces some aspects of the fertile matrix within which, over many years, the application of a psychoanalytic perspective to clinical work with the most severely mentally ill, difficult and at times frightening patients in secure and community settings has evolved and now led to the recent inauguration of the Forensic Psychotherapy Society (FPS), a new Member Institution of the British Psychoanalytic Council. The Society provides both a framework for a national, multidisciplinary professional training in psychodynamic forensic psychotherapy and the potential launching pad for an active post-qualification organisation supporting CPD and all other forms of professional development. The particular contributions to the birth of the FPS of the Forensic Psychotherapy Department at West London Mental Health NHS Trust, partly because we know it best but also because it is part of the largest forensic psychiatric service in the United Kingdom, are described.     

Psychology Internships in the Treatment of Severe Mental Illness: Implications for Training in Academic Medical Centers

Despite an increasing focus over the past 2 decades by federal and state governments on the care of persons with severe mental illness, psychologists remain underrepresented among behavioral health professionals working with this population. Within the discipline there is growing concern about the need to adequately train, recruit, and retain psychologists in this specialty. This is a particular concern in academic medical settings where the overall severity of illness among those receiving psychiatric services continues to increase. The purpose of this qualitative research study was to intensively examine the experience of predoctoral interns engaged in treating individuals with severe mental illness in an academic medical center in order to identify the professional developmental experiences and training needs of those learning to care for this population. This analysis, conducted with semistructured interviews at four points during the internship year, yielded a series of recommendations for improving internship training and recruiting psychologists to this specialty.     

论医学哲学的特征

医学哲学也称为医学辩证法,是在总结医学科学成就的基础上,通过对医学理论和实践中一般、普遍、共性问题的研究,揭示医学认识主体思维活动普遍规律的科学：是人们认识和处理健康和疾病问题的一般方法论。无论是与医学还是与哲学相比。医学哲学都有着显著的区别,运用对比分析的方法。对医学哲学的研究对象、理论体系特别是思维方式等不同方面的特征,进行理论探讨。     

当代中国医德建设与相对主义医学伦理学

当代西方相对主义医学伦理学有许多建树,但也有其致命性的缺陷,这就是否定医学道德的客观绝对性和普遍性医学伦理准则。在引进、介绍了这种学说之后,需要下功夫同它进行对话,即以医德绝对性与相对性辩证统一的原理,对这种学说进行追问,从中借鉴有益的经验和教训,以顺利全面地推进我国当代的医学道德建设。