1/27. Psychogenic vomiting: report of two cases.Two patients were admitted to our hospital with the diagnosis of psychogenic vomiting of more than 9 months' duration. Both were treated with a combination of pharmacotherapy, relaxation training, cognitive therapy and supportive psychotherapy. Behavioral therapy and verbal catharsis were also used in one of the cases involving bereavement. The intervention was not directly aimed at the vomiting, but at the aspects of the patients' stress and emotional problems. Change in condition was assessed on basis of the frequency of vomiting and the severity of anxiety and depression. vomiting was found to be positively related to anxiety but not to depression. These 2 patients improved to the extent that the disturbance caused by vomiting was significantly reduced, and the reduction was closely related to the severity of anxiety. Both were also found to have similar personality traits and family types, which have been reported to be related to psychogenic vomiting. We review the characteristics of psychogenic vomiting and relate some important considerations for treating Chinese psychogenic vomiting cases.- - - - - - - - - - ranking = 1keywords = personality (Clic here for more details about this article) |
2/27. Possible sequelae of trauma and somatic disorder in early life.All children experience trauma. The age, state of development and constitutional factors will determine whether some children will have a traumatic effect. Trauma occurring before the age of three, at a time when the ego has not developed its synthetic and integrative functions, may be reproduced in later life as an isolated symptom, by selected sensations involved in a sensory imprint or screen sensation of the trauma as a simple recording. After the age of three, under the influence of a more mature ego, excessive traumatic stimuli will be integrated and elaborated in symptom formations as phobias or other conditions and extended as part of the total personality. recurrence in later life is triggered by events related not only to the original experience, but also to the content of its elaboration. The earlier in life the trauma occurs, the more likely that somatic imprints of primitive physiological symptoms would result as an archaic, biological defense or screen sensations. Recurrent sensory imprints or screens may appear as organic illness or functional somatic symptoms. Diagnostically, a detailed early life history is necessary to uncover the presence of a sensory screen memory of a trauma and so avoid diagnostic medical search for organic causation. Case material illustrating the two groups are presented. Indications for psychoanalysis and for supportive psychotherapy are discussed from our theoretical framework as well as from the literature.- - - - - - - - - - ranking = 1keywords = personality (Clic here for more details about this article) |
3/27. "Short and long-term therapies in psychosomatic disorders".Narcoanalysis (narcosynthesis) as well as psychoanalytically oriented psychotherapy (psychoanalytic psychotherapy) are both, in my opinion, practical and useful short-term methods of therapy in psychosomatic disorders. Psychoanalytic psychoterapy may also be used as an alternative to narcoanalysis when the latter method decisively fails the therapist. In selecting candidates for psychotherapy in psychosomatic practice, 3 essential factors should be taken into consideration, viz. the time of onset of the illness, the patient's personality structure and his intellectual capacities.- - - - - - - - - - ranking = 1keywords = personality (Clic here for more details about this article) |
4/27. dermatitis artefacta. case reports.patients who seek care for foot problems may present to the podiatrist with concurrent problems, such as anxiety, depression, phobias, personality disorders, and psychoses. These may or may not have any direct relationship to the pathogenesis of the foot problem. The podiatrist may learn of the presence of an emotional problem directly from the patient or from a family member. In many cases, the patient may be unaware or deny the presence of an emotional problem, leaving the podiatric physician in the dark about the patient's mental health state or its implications for the management of the skin problem. In a review of the psychosomatic aspects of dermatology, Koblenzer offered a working classification of the psychodermatoses. This is helpful to the podiatrist in recognizing those dermatologic disease states in which the various aspects of the individual participate in the disease, signs and symptoms of the disease, and the potential psychological value of the disease for the patient. It is also helpful to the podiatrist for recognizing those dermatoses in which psychiatric consultation may be useful so that recognition, treatment, improvement, and perhaps cure may be effected quickly.- - - - - - - - - - ranking = 1.6272329726337keywords = personality, personality disorder (Clic here for more details about this article) |
5/27. Psychogenic movement disorders.All varieties of movement disorders may be mimicked by a psychogenic disorder, most commonly tremor, dystonia, and myoclonus. Approximately 3% of patients seen in specialty clinics have a psychogenic movement disorder (PMD). The diagnosis of a PMD depends on not just ruling out an organic movement disorder, but moreover, recognizing features from the history and examination that are inconsistent or incongruous with an organic movement disorder. Most PMDs represent a conversion disorder, sometimes as part of a somatoform disorder; less common diagnoses include a factitious disorder or malingering. Co-morbid psychiatric illness is prevalent in patients with PMD including depression, anxiety, and personality disorders. Many PMDs remain chronic, but a multidisciplinary approach centering on psychiatric intervention can be successful. A shorter duration of symptoms and a co-existent treatable psychiatric disorder portend a better prognosis, whereas compensation and pending litigation are associated with a poorer prognosis.- - - - - - - - - - ranking = 1.6272329726337keywords = personality, personality disorder (Clic here for more details about this article) |
6/27. Self-reports, spouse ratings, and psychophysiological assessment in a behavioral medicine program: an application of the five-factor model.This article describes the integration of the five-factor model into assessment procedures used with 109 patients in an outpatient behavioral medicine program. The population, program, assessment techniques, and general findings are explored. A case history involving a psychophysiological disorder is utilized to demonstrate the utility of a taxonomy of personality traits. The NEO-PI, a five-factor instrument, is integrated with other assessment techniques to assist in diagnosis, rapport building with the patient, tailoring treatment techniques and goals to the individual's intrapersonal and interpersonal dynamics, and predicting relative success and compliance with noninvasive self-regulation procedures and psychotherapy.- - - - - - - - - - ranking = 1keywords = personality (Clic here for more details about this article) |
7/27. Psychosomatic subdecompensation.The ego of a psychosomatic patient enters the relations with the external world in a very archaic way. In new traumatic situations such a personality structure possesses a very poor repertoire of adaptation mechanisms. Owing to the lack of intrapsychic elaboration of the trauma, the conflict is solved in an "interpersonal" way. The authors emphasize the importance of interpersonal conflict as an actual necessity of maintaining the connection with reality. Such a response in the development corresponds to the fixation or regression to the conflict with the object from the subphase of practising. Unpleasure, because of the early forbidding of pleasurable activities by the object, is experienced as actual, thus the object becomes a hindrance in itself. The increased hostility is being discharged through the interpersonal conflict with the object. The quality of the actual object (the therapist) affects the development of the conflict, i.e. it either allows a more successful reparation of the patient's personality structure or brings about a deeper regression.- - - - - - - - - - ranking = 2keywords = personality (Clic here for more details about this article) |
8/27. Studies on psychosomatic implications of infertility--effects of emotional stress on fertilization and implantation in in-vitro fertilization.A case report shows the long and stony path of a couple who had to go through eight attempts at IVF in 4 years until the desired child was achieved. The psychosomatic implications of the various 'failures' of treatment become clearer when compared with the results of a psycho-endocrinological questionnaire completed by 551 patients and 115 controls since 1982. This questionnaire contains among others the Giessen personality test for the image of self, mother and father, a somatic complaints score to evaluate the severity of autonomic disorders, items for the presence and severity of possible gynaeco-endocrinological symptoms and items to evaluate the reference persons and their changes during childhood. The following results could be obtained. In a comparison of the means of 58 different somatic complaints, patients rated significantly higher than controls (P = 0.002). women with menstrual disturbances, menstrual pains, acne or unclear skin or dry skin also suffered more from other complaints. These symptoms were also correlated with a higher score for depressive mood. Those women who were not brought up by both parents during their childhood also scored significantly higher (P less than 0.0001) in the somatic complaints score. In the Giessen personality test patients appeared significantly more compulsive (P less than 0.002) and depressive (P = 0.003) than the controls and identified themselves more with their mothers. From 60 patients in our IVF programme, 19 had no fertilization of oocytes and scored significantly higher (P = 0.008) on the social potency scale than did the patients with fertilized oocytes. women with unsuccessful treatments in terms of pregnancy scored significantly higher in the social resonance and social potency tests. We interpret this exaggerated positive attitude as an attempt to overcome inner fears, doubts and ambivalences. These results support the importance of psychosomatic aspects in infertility and reassure us of the necessity of including counselling in any infertility treatment, including IVF.- - - - - - - - - - ranking = 2keywords = personality (Clic here for more details about this article) |
9/27. mmpi and headache: a special focus on differential diagnosis, prediction of treatment outcome, and patient-treatment matching.The relation between personality characteristics and the psychological functioning of headache patients has long been a topic of interest. Early investigations focused on clinical and anecdotal reports while recent research has moved toward a more objective evaluation of headache groups by using the mmpi. However, the findings from diverse studies have not been integrated, nor has a rationale for the use of these data in the clinical management of headache been formally presented. The focus of this review is to present a concise, integrated analysis of previous group mmpi headache studies and apply these findings to differential diagnosis, prediction of treatment outcome, and client-treatment matching. Five selected clinical case studies indicating various degrees of psychopathology in migraine headache patients are presented to highlight treatment issues in support of an idiographic utilization of the mmpi for the clinical treatment of headache patients.- - - - - - - - - - ranking = 1keywords = personality (Clic here for more details about this article) |
10/27. Evaluation of therapeutic outcome: some reflections on methodology.Problems connected with choice of outcome-criteria are discussed. Some results from an outcome study of student-conducted dynamic psychotherapies are presented. The discussion is focused on discrepancies between subjective data and more objective measures, as reflected in rorschach test results. It is claimed that in order to give a meaningful interpretation of these discrepancies, a conception of hierarchically ordered structures of personality is needed. Such a conception also seems to represent a necessary supplement both to Malan's psychodynamic hypothesis and to outcome-research applying multidimensional outcome measures.- - - - - - - - - - ranking = 1keywords = personality (Clic here for more details about this article) |
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