The Verbal Summator and a Method for the Study of Latent Speech

Three age groups of children (7-8-, 10-11-, and 13-14-years) were administered a questionnaire dealing with their smoking experiences and attitudes and beliefs about cigarette smoking. The results indicated that the vast majority of children recognized the harmfulness of smoking and most strongly disapproved of smoking. However, experimentation with smoking was found to increase with age, and older children expressed less negative attitudes about smoking. The effects of age were due largely to the differences between the preadolescent groups, on the one hand, and the adolescent group, on the other. In addition, a similar percentage of children in all three age groups perceived strong parental pressure against smoking; however, with increasing age, less opposition from their teachers and friends was perceived. Theories of social influence and moral development are considered in explaining the results.     

Hypochondriasis Among Patients with Multiple Somatoform Symptoms—Psychopathology and Outcome of a Cognitive-Behavioral Therapy

As hypochondriasis often occurs with somatization, patients with somatization disorder plus hypochondriasis were compared to patients with somatization syndrome alone regarding psychopathology, patterns of physical symptoms and outcome of a cognitive-behavioral inpatient treatment. A sample of patients with DSM-IV hypochondriasis and multiple somatoform symptoms(N = 27) and a matched sample of patients with multiple somatoform symptoms but without hypochondriasis (N = 27) were assessed. All subjects obtained a cognitive-behavioral treatment for somatization and hypochondriasis. Assessment took place at admission and at one-year follow-up. Only a few differences between the groups were found: Hypochondriacs suffered more often from abdominal pain, and they reported a higher intolerance of bodily complaints. At follow-up, all outcome variables improved significantly. High effect sizes were found for the reduction of symptoms and the mean number of visits to the doctor. The specific effect on health care use highlights the socioeconomic relevance of these results.     

Chronic fatigue syndrome/myalgicencephalomyelitis as a twentieth-century disease: analytic challenges

The challenges of chronic fatigue syndrome (often called myalgic encephalomyelitis, especially in the UK) (CFS/ME) to analytical and medical approaches are connected with our inability to understand its distressing somatic symptoms in terms of a single identifiable and understandable disease entity. The evidence for the roles of viral aetiologies remains inconclusive, as does our understanding of the involvement of the immune system. The history and social context of CFS/ME, and its relation to neurasthenia and psychasthenia are sketched. A symbolic attitude to the condition may need to be rooted in an awareness of psychoid levels of operation, and the expression and spread of CFS/ME may sometimes be aided by the ravages of projective identification. Psychic denial, sometimes violent, in sufferers (especially children and adolescents) and their families may be important in the aetiology of CFS/ME. We draw out common threads from psychodynamic work with five cases, four showing some symptomatic improvement, analytic discussions of three cases being presented elsewhere in this issue of JAP.     

意象思维与躯体化症状：疾病表达的文化心理学途径

意象思维是中国人的传统思维模式, 它通过观物取象和取象比类的方式认知世界、推演联系。这种思维模式塑造了中国人特有的身心不分而非两分的身体观、疾病观和治疗观。在中国人的观念中, 身体不仅仅是一具生理躯体, 还具有气、阴阳、五行等本土概念所体现的弥合物质与精神、联结生理与心理的模糊性与开放性。人们在表达疾病感觉时通常不分生理与心理, 任何一方面出现不适感觉即可认为自己生病, 在面对心理医生时也倾向于同时报告躯体状况与心理感觉, 从而使得临床报告出现较高的躯体化报告率。这正是文化心理影响疾病表达的体现。这也使得疾病不仅是一种医学现象, 也是一种文化现象; 医学不仅需要生理知识, 也需要人文知识。     

Psychological Disturbances in Patients With Sphincter of Oddi Dysfunction

Sphincter of Oddi dysfunction (SOD) is a functional gastrointestinal disorder (FGID), which causes pancreatobiliary-type pain, cholestasis, and/or pancreatitis. Only a few studies have assessed the level of psychological distress in this population compared to healthy subjects or patients with other gastrointestinal disorders. In this study, we examined the self-reported level of psychological distress and certain psychiatric symptoms of SOD patients, and we compared them to depressed patients as well as healthy subjects. The results indicate that SOD patients have significantly lower levels of global and specific symptoms compared to depressed patients. When compared to healthy subjects, SOD patients expressed significantly higher levels of irritability–oversensitivity, and there was a trend toward higher levels of somatization.