International journal of psychosomatics : official publication of the International Psychosomatics Institute最新文献

The relationship between surface EMG recordings from paraspinalis recording sites and subjective pain ratings were examined in a group of pre-chronic back pain patients. thirty-eight back pain patients without major orthopedic diagnosis and a pain duration between 2 to 6 months participated in a three week long subjective pain rating. Following the completion of their pain diary, the paraspinal sites were assessed under the "static" postural conditions of sitting and standing using an EMG scanning procedure. Results of the correlational analysis revealed significant and positive relationships between pain and muscle activity in the upper back (Trapezius, T1 paraspinalis sites) and significant but negative relationships between erector spinae activity (L3 paraspinalis site) and pain. When considering etiological factors of pre-chronic back pain, the results support both the organicity model for upper back, as well as the biomechanical model for the lower back.

Major life events and daily hassles were examined in a sample of 102 university undergraduates. While the major clusters of events were related to personal loss, life-style changes, family conflict, and personal insecurity, those of hassles were related to drudgery and uncontrollable environmental irritants, personal concerns, time and work management, minor routine expenses, and the dilemma of emigration. Using life events and hassles, and hassle clusters added significantly to the sensitivity of the concurrent prediction of undifferentiated and differentiated physical and psychological symptom criteria, and consistently showed better performance as predictors. However, the independent contributions of events and event clusters could hardly be discounted. The combined effects of major discrete and minor chronic stress on health status and the limitations of the present retrospective study were discussed.

The following case studies provide insight into the effectiveness and methodology of the facilitation of insight technique in psychotherapy. This technique has been successful in reducing the incubation process, which is the second of four stages in Wallas's Stage Model of Creativity, i.e., Preparation, Incubation, Illumination and Verification. The application of this technique in other areas of human endeavor are discussed.

A general theory of relaxation is presented. It is based on an integrated model of the main states of consciousness, which enables one to differentiate "techniques for relaxing" leading to the "relaxing states" and "meditative techniques" leading to the differentiated waking states of consciousness. These latter include specific "only the relaxation response states" and the "ultraconsciousness states". Each state is described along the following dimensions: of biological rhythms, i.e., Sleep-Wakefulness and the Basic Rest-Activity Cycle; brain hemispheric activity; the threshold of the extero- and interoceptive stimuli reception; perceptual dominance of stimuli from external or internal sources; spontaneous versus goal-oriented imagination activity, i.e., passive or active state of mind; feed-back relation with the surroundings.

The concept of "stress" in the current academic literature is unstandardized, and therefore confusing. The theoretical approach of regarding stress as an intervening variable seems most generally agreed on by researchers; the unambiguous term "Psystress" proposal to denote the mental state involved. Aspects of vocabulary concerning psystress production and response are also discussed.

The interpersonal and psychodynamic aspects of the referral process, that is, the reciprocal relationship between the specialist and his referral source are investigated. A questionnaire designed by the author, with anonymity guaranteed, was given to the members of 2 dental societies. There were more similarities than differences in the answers of the respondents in both groups. Several conscious patterns of referral emerged or were evident. A number of unconscious, psychodynamic motivations were explored.

Fourteen women with functional hyperprolactinemia and an equal number of matched healthy controls completed a questionnaire on weeping behavior. Contrary to expectations the patient group were not more prone to weeping than the controls. In addition, their appraisal of weeping behavior (as a way to tension release and relief) did not differ from the controls. It is concluded that moderately elevated prolactin levels, although causing somatic disturbances such as amennorrhea and galactorrhea, do not affect the weeping threshold.

An interdisciplinary program with the goal of teaching self-regulation and minimizing excessive narcotic use in the management of vaso-occlusive pain (V-O) in pediatric sickle cell anemia patients is described. A small group of patients do not respond well to any of our outpatients or inpatients medical regimens, leading us to suspect that psychological factors are influencing pain reports. We outline our multi-faceted assessment approach to evaluating such psychological factors, which includes a pain flow sheet, symptom check list, and a psychophysiologic profile. Published reports of self-regulation training including biofeedback, relaxation/imagery, and hypnosis have been associated with decreased pain symptoms, reduced number of emergency room and hospital visits for pain, decreased narcotic use, and increased school attendance. A case study of a nine-year-old patient with sickle cell disease is described before and after self-regulation training. Finally, other alternative approaches that avoid excessive narcotic use are discussed with some case reports.

The authors describe current theoretical and clinical conceptualizations and treatment of anorexia nervosa in Russia, based on their experience in the follow-up of 800 patients. Three-quarters of the patients exhibited anorexia nervosa linked with a border-line state, and one-quarter associated with schizophrenia. Different relationships to dysmorphophobic fears were observed in the different anorexic groups. In the border-line group, follow-up study indicated that the clinical symptoms of anorexia nervosa were significantly reduced. However, the disorder preserved its connection with dysmorphophobic fears even in the remote stages of the disease, and in later stages there was an occurrence of pathological personality changes. In the second group, from the very beginning, anorexia nervosa in schizophrenia was closely connected with affective disorders, pathological body sensations, hypochondriacal complaints, and a gradual personality deterioration. As the schizophrenic defect increased, anorexia nervosa was reduced to an exhausted form of vomiting behaviour, and lost its connection with dysmorphophobic experiences.