Psychiatry Archives - searchfortruth.info

Shame and Humiliation: From Isolation to Relational Transformation

February 22, 2019December 28, 2017 by admin

Abstract

This paper is a discussion of shame and humiliation that goes beyond individualistic perspectives, offering a broader, relational analysis of these profound and complex experiences. In addition to defining and examining the harmful consequences of various forms of derision and degradation, the authors explore clinical encounters with shame and humiliation, present a case, and describe relational practices that can transform shame and humiliation into opportunities for growth and greater connection.

A Relational Conceptualization of Shame and Humiliation Linda Hartling, Ph.D.

While most of us can think of at least one occasion in which we felt shamed or humiliated, in many instances these types of experiences are difficult to identify, difficult to acknowledge, and difficult to express. To recount experiences of shame or humiliation, we risk revisiting painful images of being devalued, disempowered, or disgraced, perhaps triggering or reinforcing further feelings of shame. Yet, below...

Brief Screening for Family Psychiatric History The Family History Screen

February 21, 2019November 26, 2017 by admin

Abstract

BACKGROUND:

Brief screens to collect lifetime family psychiatric history are useful in clinical practice and for identifying potential families for genetic studies.

METHODS: The Family History Screen (FHS) collects information on 15 psychiatric disorders and suicidal behavior in informants and their first-degree relatives. Since each question is posed only once about all family members as a group, the administrative time is 5 to 20 minutes, depending on family size and illness. Data on the validity against best-estimate (BE) diagnosis based on independent and blind direct interviews on 289 probands and 305 relatives and test-retest reliability across 15 months in 417 subjects are presented.

RESULTS: Agreement between FHS and BE diagnosis for proband and relative self-report had median sensitivity (SEN) of 67.6 and 71.1 respectively; median specificity (SPC) was 87.6 and 89.4, respectively. Marked decrease in SEN occurred when a single informant....

When Munchausen Becomes Malingering: Factitious Disorders That Penetrate the Legal System

February 21, 2019November 26, 2017 by admin

Factitious disorders are those conditions in which individuals actively create signs or symptoms of physical or psychological disease states.' Although there are numerous reports of factitious psychological disorders, there is controversy about the legitimacy of the diagnosis This paper will limit its focus to factitious physical disorders and how they may enter the legal system in civil litigation. Although most psychiatrists are familiar with factitious disorders from their medical training, many attorneys and judges have had not any exposure to such cases. As these cases appear to be developing more frequently in legal and other non-medical settings,' it is important for these non-psychiatrists to become aware of the factitious disorders in order to deal with cases appropriately. Considerable education may be necessary to inform legal staff about factitious disorders because the entity is so counter intuitive-no one expects an apparently reasonable person to actively create a...

Therapeutic Communication

February 21, 2019November 26, 2017 by admin

Abstract

This article focuses on the concept of "Therapeutic communication". it also tries to highlight the importance of this concept, which through verbal or nonverbal communication makes the nurse consciously influence a client or help the client. it involves the use of specific strategies that encourage the patient to express feelings and ideas. There are different reactions to "therapeutic communication" as all patients differ in their characters, background, social status, culture, etc.

This article will also compare the role of the nurse as compared to that of the doctor. They must both master efficient therapeutic techniques of communication in order to establish empathy towards the experience that the patient reveals. it is of great importance for them to have communicative therapeutic skills in order to successfully apply the communicative process as well as to fulfill the standards of healthcare for the patients. Through therapeutic communication they should establish a relationship,...

The Case of the Confidential Confession: Psychiatry

February 21, 2019October 14, 2017 by admin

The law, medicine, and theology trilogy uniting these Essays, addressing the ethical response to information a professional gains in confidence about a wrongful conviction and an impending execution, raises an overarching question: How does the role of a professional affect our ethical duties as members of society? Likely, few would seriously argue that if the same disclosure about an impending wrongful execution were made to a friend wearing no professional garb that we would find an ethical duty to prevent the friend from disclosing a confidence, rather than an ethical duty compelling the friend to come forward to avoid the wrongful execution. Does the role of a professional displace personal moral standards? Implicit in the problem is the assumption that professionals should act differently. Attempts to articulate a profession's sense of its unique ethical responsibilities are contained, in part, in its ethical code. Psychiatric ethics draw from the field of medical ethics...

Psychosis (Schizophrenia And Bipolar Disorder) And Substance Use

February 21, 2019October 11, 2017 by admin

7 Psychosis (schizophrenia and bipolar disorder) and substance use

7.1 Psychosis

Psychosis is characterised by a loss of connectedness with reality. A person may develop false ideas or beliefs about reality (delusions) which in themselves may be based on false perceptions (hallucinations). People experiencing psychosis also have characteristic flaws in the ways they think. These are termed ‘thought disorders’. Examples are tangential thinking, loose associations between ideas, and incoherence. Psychosis significantly impairs work, family and social functioning. People with psychoses often experience poorer physical health. The worse the psychotic symptoms are, the higher the associated level nof impairment(251). Psychotic symptoms can occur in response to physical conditions, e.g. acute delirium with septicaemia. Alternatively, psychoses can be functional. There are two broad classes of functional psychotic disorders: schizophrenia and bipolar disorder. Generally, schizophrenia is a chronic condition with exacerbations, but always with some background symptoms. Bipolar disorder is ...

Lobotomy | Catholic Physicians’ Guild July 1948

February 21, 2019October 9, 2017 by admin

LOBOTOMY

Question: Is prefrontal lobotomy morally permissible in the treatment of mental disorders? Principle The principle to be applied in answering the question is this: Any procedure harmful to the patient is morally justifiable only in so far as it is designed to produce a proportionate good. As long as we remain in the sphere of theory this principle is easily explained and easily understood. It simply means that to pass judgment on the morality of any mutilation one must compare the harm that might be done with the benefit to be expected. If the hope of benefit is commensurate with the danger of harm, the procedure is morally justifiable; otherwise it is not. But when we pass from theory,to the judging of a particular procedure for a particular patient, we are often confronted with many difficulties. To make a fair comparison of harm...

Claims Of Crime-Related Amnesia In Forensic Patients

February 21, 2019October 8, 2017 by admin

Abstract

Many authors assume that crime-related amnesia arises from the stressful nature of crimes and/or drug intoxication at the time crimes are committed. The current study examined prevalence and correlates of crime-related amnesia in a German (n=180) and a Dutch (n=128) sample of forensic inmates. More specifically, patients claiming amnesia and control patients were compared with regard to their intelligence, criminal backgrounds, and psychiatric diagnoses. In contrast to the popular stress-dissociation interpretation, stressful features of the crime were not found to be related to claims of amnesia. Neither alcohol nor drug intoxication, nor psychotic episodes could fully account for claims of memory loss. Interestingly, amnesia claims were especially prevalent among recidivists. This suggests that such claims are the product of a learning process. Thus, it may well be that those who are familiar with the penal system may have experienced the advantages of claiming amnesia.

Therapeutic Forgetting: The Legal and Ethical Implications of Memory Dampening

February 20, 2019September 26, 2017 by admin

INTRODUCTION

Suppose we could erase memories we no longer wish to keep. In such a world, the victim of a terrifying assault could wipe away memories of the incident and be free of the nightmares that such memories often cause. Some memories, however, even quite unpleasant ones, are extremely valuable to society and ought not be eliminated without due consideration. An assault victim who hastily erases memory of a crime may thereby impede the investigation and prosecution of the perpetrator. In a world with memory erasure, our individual interest in controlling our memories may conflict with society’s interest in maintaining access to those memories.1 While true memory erasure is still the domain of science fiction,2 less dramatic means of dampening the strength of a memory may have already been developed. Some experiments suggest that propranolol, an FDA-approved drug, can dull the emotional...

False Memories, Psychology of

February 20, 2019September 27, 2017 by admin

A false memory is a mental experience that is mistakenly taken to be a veridical representation of an event from one’s personal past. Memories can be false in relatively minor ways (e.g., believing one last saw the keys in the kitchen when they were in the living room) and in major ways that have profound implications for oneself and others (e.g., mistakenly believing one is the originator of an idea or that one was sexually abused as a child). False memories arise from the same processes as do true memories and hence their study reveals basic mechanisms of memory.

This article describes empirical research investigating false memories and a theoretical approach—the source monitoring framework—for integrating the findings and guiding further investigation.

1. Selected Early Research Psychologists have long been interested in memory distortions. A classic example from the 1930s is Bartlett’s report of studies in which he told people a folk tale from an unfamiliar...

Concealment of Psychopathology in Forensic Evaluations: A Pilot Study of Intentional and Uninsightful Dissimulators

February 19, 2019September 9, 2017 by admin

Both clinical and forensic psychiatrists recognize that individuals whom they evaluate may be unreliable historians. Clinical psychiatrists are diligent in attending to the possibility that patients may not be forthcoming with all of their symptoms, beliefs, or personal history. For example, consider a clinician’s skepticism about the claims of a delusional paranoid schizophrenic brought to a clinic by his concerned family members or about the denials of suicidal intent of a depressed patient brought to the emergency room for a drug overdose. Clinicians approach cases such as these recognizing that patients may withhold critical information about their psychopathology, whether because of paranoid fears, in response to voices they hear, covert suicidal intent, desires to appear “normal,” or other motives. Forensic practitioners approach evaluations with a somewhat different focus, colored chiefly by inclusion of strategies to detect the possibility of malingering. It is certainly reasonable to be skeptical of a forensic evaluee’s...

Paranoid Personality Disorder

February 19, 2019September 22, 2017 by admin

Paranoid personality disorder (PPD) is characterized by a pervasive mistrust of other people (American Psychiatric Association [APA], 1994; Bernstein, Useda, & Siever, 1995; Miller, Useda, Trull, Burr, & Minks-Brown, 2001). Other common features of the disorder include quarrelsomeness, hostility, emotional coldness, hypersensitivity to slights or criticism, stubbornness, and rigidly held maladaptive beliefs of others’ intents (APA, 1994; Bernstein et al., 1995; Miller et al., 2001). The prototypical picture is of someone who is preoccupied with real or imagined slights or threats, mistrusts the intentions or motives of others, and rarely trusts the seemingly benign appearance of things. The guiding underlying assumption is that others are malevolent they can betray, hurt, take advantage, or humiliate. Thus, measures must be taken to protect oneself by keeping one’s distance from other people, not appearing weak or vulnerable, searching for signs of threat even in seemingly innocuous situations, preemptively attacking others who are viewed as threatening, and vigorously...

Pseudocyesis, Delusional Pregnancy, And Psychosis: The Birth Of A Delusion

February 19, 2019August 14, 2017 by admin

Abstract

Both pseudocyesis and delusional pregnancy are said to be rare syndromes, but are reported frequently in developing countries. A distinction has been made between the two syndromes, but the line of demarcation is blurred. The aim of this paper is to review recent cases of pseudocyesis/delusional pregnancy in order to learn more about biopsychosocial antecedents. The recent world literature (2000-2014) on this subject (women only) was reviewed, making no distinction between pseudocyesis and delusional pregnancy. Eighty case histories were found, most of them originating in developing countries. Fifty patients had been given a diagnosis of psychosis, although criteria for making the diagnosis were not always clear. The psychological antecedents included ambivalence about pregnancy, relationship issues, and loss. Very frequently, pseudocyesis/delusional pregnancy occurred when a married couple was infertile and living in a pronatalist society. The infertility was attributed to the woman, which resulted in her experiencing substantial distress and discrimination. When antipsychotic medication was used...

False Belief and Emotion Understanding in Post-Institutionalized Children

February 18, 2019August 14, 2017 by admin

Abstract

Deficits in social cognition may impair the ability to negotiate social transactions and relationships and contribute to socio emotional difficulties experienced by some postinstitutionalized children. We examined false belief and emotion understanding in 40 institutional care-adopted children, 40 foster care-adopted children and 40 birth children. Both groups of adopted children were adopted internationally. Controlling for verbal ability, post-institutionalized children scored lower than birth children on a false belief task. Almost half of the post-institutionalized children performed below chance levels. The foster care group did not differ from either group on false belief understanding. The groups did not differ on emotion understanding after controlling for verbal ability. The results suggest that some post-institutionalized children are delayed in false belief understanding.Since 1995, over 130,000 children have been adopted internationally into the USA. (US Department of State, 2004). Many of these children have been reared in institutions around the world prior to adoption, and they exhibit delays in physical and...

Interpretations Of Legal Criteria For Involuntary Psychiatric Admission: A Qualitative Analysis

February 18, 2019August 10, 2017 by admin

Abstract

Background: The use of involuntary admission in psychiatry may be necessary to enable treatment and prevent harm, yet remains controversial. Mental health laws in high-income countries typically permit coercive treatment of persons with mental disorders to restore health or prevent future harm. Criteria intended to regulate practice leave scope for discretion. The values and beliefs of staff may become a determinating factor for decisions. Previous research has only to a limited degree addressed how legal criteria for involuntary psychiatric admission are interpreted by clinical decision-makers. We examined clinicians’ interpretations of criteria for involuntary admission under the Norwegian Mental Health Care Act. This act applies a status approach, whereby involuntary admission can be used at the presence of mental disorder and need for treatment or perceived risk to the patient or others. Further, best interest assessments carry a large justificatory burden and open for a range of extra-legislative factors to be considered.

Methods: Deductive thematic analysis was used. Three ideal types of attitudes-to-coercion were developed,

When Did Prisons Become Acceptable Mental Healthcare Facilities?

February 17, 2019August 9, 2017 by admin

INTRODUCTION

We can no longer ignore the massive oppression we are inflicting upon the mentally ill throughout the United States. Over a century ago, Dorothea Dix began a movement to improve the deplorable conditions of mentally ill prisoners. Despite her success in changing the country’s perception and treatment of the mentally ill in prison, we are now right back where we started in the nineteenth century. Although deinstitutionalization was originally understood as a humane way to offer more suitable services to the mentally ill in community-based settings, some politicians seized upon it as a way to save money by shutting down institutions without providing any meaningful treatment alternatives. This callousness has created a one-way road to prison for massive numbers of impaired individuals and the inhumane warehousing of thousands of mentally ill people.We have created conditions that make criminal behavior all but inevitable for many of our brothers and sisters who are mentally ill. Instead of treating them, we are imprisoning them.