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

Clonazepam was added to the neuroleptic regimen of 3 treatment-resistant schizophrenic patients with schizoaffective features. Manic symptoms improved but returned following discontinuation of clonazepam. The drug appears to benefit positive psychotic symptoms but worsens negative symptoms.

A control model of psychological health was utilized to assess the effects of a cognitive/behavioral intervention and/or cardiac counseling with post myocardial infarction patients evidencing Type A behavior. A previously developed four quadrant control inventory measuring perceived mode of control and perceived self-control was given to groups in two sections of the Recurrent Coronary Prevention Project. The experimental group (coronary counseling plus cognitive/behavioral intervention) was tested after one year (E1) and two years (E2) of treatment. The cardiac counseling group was assessed only after two years (C2). As hypothesized, the cognitive/behavioral treatment section at E2 had a significantly higher overall satisfaction level and congruence between real and ideal self on each of the four quadrants than at E1, and than the cardiac counseling only (C2). Further, on each of the four quadrants, E2 had a psychologically healthier mode of control profile than the cardiac counseling only (C2); and a healthier profile on both the positive assertive and positive yielding mode of control than at E1. Finally, E2's self-control score was significantly higher than C2's. Comments on future directions in measuring perceived control, and on the relationship of control and Type A behavior are offered.

Previous research on the effects of life events on maladaptation suggest they should be related to disease impacts in rheumatoid arthritis (RA). From the concept of Rational-Emotive-Therapy the hypothesis was derived that irrational attitudes-in a similar way-are associated with disease related impairment. Subjects were 128 patients with definite RA from a specialized treatment center. When disease activity was controlled, positive change was associated with less disability, negative change was related to general symptoms. Relations between life events and three pain measures could not be established. Irrational attitudes shared significant common variance with three pain-measures (attributes, recent intensity, avoidance), with physical abilities, and with general health condition. The results were discussed with respect to literature and to clinical practice.

This article begins by looking at the way we try to construe or make sense of the world in which we live. How in the very nature of such sense-making there is the potential for sowing the seeds of self-deception by trying to fit our (relatively simplified) bipolar constructs to a complex unitary universe. Non-verbal and verbal construing are compared. Verbal construing enables us to reach an even more sophisticated level of self-deception, via myths created by limiting metaphors--such as "man-the-machine." The institutions which we create and the people who are invested in them tend to solidify in-group myths, often with the help of metaphor. It is argued that personal, constructivist, and eclectic approaches to psychotherapy can be envisaged as enterprises to begin the process of demythologising clients in the safety of the therapeutic setting. In therapy, clients can experiment with empowering themselves in reconstruing the problem areas of their lives and actively testing out these new constructions against personal experience. Clients can also learn to explore the meaning behind symptoms, i.e., to give cognitive form to feeling with the help of their intuitive sensitivity.

The use of yoga and yoga related techniques in pain management is reviewed and discussed. Self-awareness, relaxation, approaches which use respiration, increased self-understanding and self-acceptance, changed context of pain, increased control, life style improvements, group and social support proved beneficial. The use of yoga in pain management has its transpersonal and philosophical dimensions. Independence and self-confidence of suffering people may be protected in this way.

Thirty-one patients suffering from chronic tension headache participated in one of four procedures, each of which comprised two one-and-one-half hour sessions per week for 4 weeks. The conditions were: Chamber/Control (both weekly sessions lying on a bed in a dimly-lit room), and three active treatment procedures: Chamber/Tank, one session as above, the other floating in a dark, silent REST tank; Chamber/Relaxation, one as above, one doing progressive muscle relaxation exercises; and Tank/Relaxation, one session floating and one doing progressive muscle relaxation. By 6 months after the end of treatment, complete data had been obtained from 20 subjects. There was a significant overall decrease in headache reports; the active treatment groups collapsed improved significantly more than the control group. At the 6-month followup, the treatment groups showed continuing improvement (57% over end of treatment for the Tank-Relaxation group and a mean of 25% for the other two), whereas the control group had deteriorated by 34% since end of treatment. Clinical improvements were comparable to those of more time- and effort-consuming relaxation therapies, and confirm the usefulness of REST as a long-lasting and versatile treatment in behavioral health.

The psychological characteristics of 38 patients with extreme dental fear were compared with those of an age and sex matched control group chosen from the average population visiting the dental clinic. The results were assessed by means of the Kleinknecht Dental Anxiety test, the Brief Symptom Inventory and Spielberger Anxiety State questionnaires. The majority of the dental fear patients were women, the male/female ration being 0.29. In the sample group, the dental anxiety manifested as a state and not as a trait: the anxiety state mean score of the dental phobic group was significantly higher than that of the controls (p less than 0.05), while the mean score for anxiety trait did not differ. Profound psychopathological distress other than anxiety was present only among the phobic males.

An approach to helping people cease smoking in a single, 50-minute session is outlined. A number of elements including direct suggestions to satisfy patients' expectations, metaphors, indirect commands, and motivation-enhancing statements are used, these being combined and sequenced in a pattern considered to be appropriate to the patient. Within elements, possible alternatives are outlined.

Forty-four Chinese male long-distance runners were surveyed regarding their running history, running habits, and injuries, as well as their experience of the "runner's high" phenomenon. The typical runner could be described as single, in his late 20s, well-educated, and running 60 km a week. He was also likely to be controlled and disciplined, not risk-taking, and not oriented intellectually or esthetically. While he was motivated to run to improve his physical health, he derived benefits for his emotional well-being from his running. Implications for the use of running as a therapeutic adjunct are discussed.