Home About us Contact
|
Home About us Contact | ||
|
|
||
Other Person (other + person)
Selected AbstractsFamilial aggregation of amyotrophic lateral sclerosis,ANNALS OF NEUROLOGY, Issue 1 2009Fang Fang MD Objective To assess the relative risk for amyotrophic lateral sclerosis (ALS) in families of ALS patients. Methods We conducted a cohort study based on the Swedish Multi-Generation Register in 1961 to 2005. Among 6,671 probands (first ALS case in the family), 1,909 full siblings, 13,947 children, and 5,405 spouses were identified (exposed group). Other persons in the Multi-Generation Register, who were siblings, children, or spouses to persons without ALS, served as the reference group. Relative risks for ALS among the exposed group, compared with the reference group, were calculated from Poisson regression models. Concurrence of ALS within twins was assessed in 86,441 twin pairs registered in the Swedish Twin Register. Results Nine cases of ALS were noted among the siblings and 37 cases among the children of the probands, giving a 17-fold risk among the siblings (95% confidence interval, 8.1,30.4) and a 9-fold risk among the children (95% confidence interval, 6.2,12.0), compared with the reference group. Siblings and children had a greater excess risk if the proband was diagnosed at a younger age, and the excess risks decreased with increasing age at diagnosis of the proband (p < 0.001). Spouses had no significantly increased risk (p = 0.27). Two cases were identified among the cotwins of ALS probands, giving a relative risk of 32 (95% confidence interval, 5.2,102.6). Interpretation The siblings and children of ALS patients have an about 10-fold risk for ALS compared with the reference group. The excess risks vary with both age and kinship, indicating a major genetic role in familial ALS. Ann Neurol 2009;66:94,99 [source] JOHN DEWEY'S CONTRIBUTIONS TO AN EDUCATIONAL PHILOSOPHY OF INTELLECTUAL DISABILITYEDUCATIONAL THEORY, Issue 1 2008Scot Danforth In this article Scot Danforth takes as his project addressing that division from the perspective of a Deweyan philosophy of the education of students with intellectual disabilities. In 1922, John Dewey authored two articles in New Republic that criticized the use of intelligence tests as both undemocratic and impractical in meeting the needs of teachers. Drawing from these two articles and a variety of Dewey's other works, Danforth puts forward a Deweyan educational theory of intellectual disability. This theory is perhaps encapsulated in Dewey's observation that "The democratic faith in human equality is belief that every human being, independent of the quantity or range of his personal endowment, has the right to equal opportunity with every other person for development of whatever gifts he has."1 [source] Empathy-induced altruism in a prisoner's dilemma II: what if the target of empathy has defected?EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY, Issue 1 2001C. Daniel Batson What if participants in a one-trial prisoner's dilemma know before making their decision that the other person has already defected? From the perspective of classic game theory, a dilemma no longer exists. It is clearly in their best interest to defect too. The empathy-altruism hypothesis predicts, however, that if they feel empathy for the other, then a dilemma remains: self-interest counsels defection; empathy-induced altruism counsels not. This motivational conflict should lead at least some empathically aroused individuals not to defect. To test this prediction, we placed 60 undergraduate women in a one-trial prisoner's dilemma in which they knew the other had already defected. Among those not induced to feel empathy, very few (0.05) did not defect in return. Among those induced to feel empathy for the other, almost half (0.45) did not defect. These results underscore the power of empathy-induced altruism to affect responses in a prisoner's dilemma. Copyright © 2001 John Wiley & Sons, Ltd. [source] The flexibility of the master negotiatorGLOBAL BUSINESS AND ORGANIZATIONAL EXCELLENCE, Issue 2 2007Roy J. Lewicki Negotiating to resolve conflicting objectives requires flexibility,the willingness and skill to change your approach to suit the situation at hand. The authors discuss five negotiating strategies and which to select based on the importance of the outcome and the relationship with the other person to you and your company. Adopting the best style, avoiding, accommodating, competing, collaborating, or compromising,for the situation may require overcoming your natural preference for one style as well as matching or mismatching the other person's preferred style. This article is reprinted from the authors' book, Mastering Business Negotiation: A Working Guide to Making Deals and Resolving Conflict (New York: Jossey-Bass, 2006). Copyright © 2006 Roy J. Lewicki and Alexander Hiam. [source] Duly Authorized Officers' practices under mental health law in New Zealand: Are nurses meeting the requirements of the law?INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 4 2009Brian McKenna ABSTRACT The Mental Health (Compulsory Assessment and Treatment) Act (1992) introduced a number of statutory roles that are undertaken by mental health nurses. One of these roles is that of Duly Authorized Officer (DAO). The DAO is responsible for the procedural requirements necessary to facilitate compulsory assessment. Under Section 9(2)(d), the DAO is required to ensure that the purpose of the assessment and the requirements of the notice of assessment are explained to the person in the presence of a member of their family, a caregiver, or other person concerned with the welfare of the person. Three recent High Court decisions under the Habeas Corpus Act 2001 have challenged existing DAO practices in arranging the presence of a third party. This paper presents research, which focuses on unravelling some of the complexities associated with meeting this procedural requirement. It illustrates these complexities through a discussion of the results of an audit of files and three focus groups with mental health nurses who practise as DAO. The paper concludes that national guidelines for practice need to be developed for DAO to assist mental health nurses in meeting this statutory requirement. [source] "Seeing is believing": The effects of facial expressions of emotion and verbal communication in social dilemmasJOURNAL OF BEHAVIORAL DECISION MAKING, Issue 3 2010Jeroen Stouten Abstract In social dilemmas, verbal communication of one's intentions is an important factor in increasing cooperation. In addition to verbal communication of one's intentions, also the communication of emotions of anger and happiness can influence cooperative behavior. In the present paper, we argue that facial expressions of emotion moderate verbal communication in social dilemmas. More specifically, three experiments showed that if the other person displayed happiness he or she was perceived as honest, trustworthy, and reliable, and cooperation was increased when verbal communication was cooperative rather than self-interested. However, if the other person displayed anger, verbal communication did not influence people's decision behavior. Results also showed interactive effects on people's perceptions of trustworthiness, which partially mediated decision behavior. These findings suggest that emotion displays have an important function in organizational settings because they are able to influence social interactions and cooperative behavior. Copyright © 2009 John Wiley & Sons, Ltd. [source] An exploration of mothers' and fathers' views of their identities in chronic-kidney-disease management: parents as students?JOURNAL OF CLINICAL NURSING, Issue 23 2008Veronica Swallow Aim., To explore parents' views of their identities as they learn to manage their child's chronic kidney disease. Background., Parents are expected to participate in management and usually learn necessary skills from the multidisciplinary team. Research highlights the importance of professionals defining parents' management roles in chronic disease; but little is known about parents' views on their own identities as the complex and dynamic process of teaching and learning unfolds around their child's condition. According to positioning theory, identity development is a dynamic and fluid process that occurs during interaction, with each person positioning themselves while simultaneously positioning the other person, yet this concept has not been considered in relation to parents' contributions to disease management. Design., A longitudinal, grounded theory study conducted in a UK Children's Kidney Unit. Method., This paper focuses on one aspect of a larger study exploring family learning in disease management. Six mothers and two fathers of six children with a recently diagnosed chronic kidney disease participated in a total of 21 semi-structured interviews during the 18 months after referral to the unit. Interviews included discussion about the parts they played in relation to professionals during the management process. Findings were interpreted within a framework of positioning theory. Results., Parents participated in teaching/learning/assessment that was both planned (involving allocated clinical lessons and tasks) and spontaneous (in response to current situations), to facilitate their participation. They positioned multidisciplinary team members as teachers as well as professionals, simultaneously positioning themselves as students as well as parents. Conclusion., Parents' clinical duties and obligations are not an automatic part of parenting but become part of the broader process of sharing disease management, this can lead to them assuming the additional identity of a ,student'. Relevance to clinical practice., Involving parents in ongoing discussions about their positions in management may help promote their active and informed participation. [source] When similars do not attract: Tests of a prediction from the self-expansion modelPERSONAL RELATIONSHIPS, Issue 4 2006ARTHUR ARON This study tested the hypothesis from the self-expansion model that the usual effect of greater attraction to a similar (vs. dissimilar) stranger will be reduced or reversed when a person is given information that a relationship would be likely to develop (i.e., that they would be very likely to get along) with the other person. The study employed the "bogus stranger" paradigm and focused on similarity/dissimilarity of interests in the context of attraction to a same-gender other. The effect for similarity under conditions in which no information is given about relationship likelihood replicated the usual pattern of greater attraction to similars. However, as predicted, a significant similarity by information interaction demonstrated that this effect was significantly reduced (and slightly reversed) when participants had been given information that the partner will like self. In analyses for each gender separately, both of these effects were significant only for men, suggesting that the focus on interest similarity may have been less relevant for women. [source] Religious Belief and the Epistemology of DisagreementPHILOSOPHY COMPASS (ELECTRONIC), Issue 8 2010Michael Thune Consider two people who disagree about some important claim (e.g. the future moral and political consequences of current U.S. economic policy are X). They each believe the other person is in possession of relevant evidence, is roughly equally competent to evaluate that evidence, etc. From the epistemic point of view, how should such recognized disagreement affect their doxastic attitude toward the original claim? Recent research on the epistemology of disagreement has converged upon three general ways of answering this question. The focus of this article is twofold: first, we summarize and give a brief evaluation of the main accounts of the epistemic significance of disagreement; then, we look at what these accounts suggest about how to epistemically assess both inter-religious and intra-religious disagreements. A final section offers recommendations for further research. [source] The effects of the spontaneous presence of a spouse/partner and others on cardiovascular reactions to an acute psychological challengePSYCHOPHYSIOLOGY, Issue 6 2006Anna C. Phillips Abstract The presence of supportive others has been associated with attenuated cardiovascular reactivity in the laboratory. The effects of the presence of a spouse and others in a more naturalistic setting have received little attention. Blood pressure and heart rate reactions to mental stress were recorded at home in 1028 married/partnered individuals. For 112 participants, their spouse/partner was present; for 78, at least one other person was present. Women tested with a spouse/partner present showed lower magnitude systolic blood pressure and heart rate reactivity than those tested without. Individuals tested with at least one nonspousal other present also displayed attenuated reactivity. This extends the results of laboratory studies and indicates that the spontaneous presence of others is associated with a reduction in cardiovascular reactivity in an everyday environment; spouse/partner presence would appear to be especially effective for women. [source] Interaction Appearance Theory: Changing Perceptions of Physical Attractiveness Through Social InteractionCOMMUNICATION THEORY, Issue 1 2002Kelly Fudge Albada Can the effectiveness of your social interaction with a prospective romantic partner make him or her see you as more physically attractive? If so, under what conditions does this process occur? These questions prompted the development of a theoretical perspective to explain this process. Interaction appearance theory (IAT) requires (a) a set of beliefs about the importance and interdependence of physical attractiveness and social interaction in a satisfactory romantic relationship; (b) an initial perception of the other's physical attractiveness that is not high enough to trigger the pursuit of a romantic relationship but is not low enough to preclude it; (c) social interaction that is eventually perceived as more desirable than the perception of the other's physical attractiveness; and (d) bringing the discrepant perceptions into alignment by actually seeing the other person as more physically attractive. While providing support for the theory, the interviews in Study 1 also provided insights into how the process can vary. Study 2, using a sample of new daters, provided quantitative support for the belief structure. Study 3, using diaries, found changes in perceptions of a partner's physical attractiveness to be a function of positive and negative interactions. These studies provided support for IAT and the idea that perceptions of physical attractiveness can be changed by social interaction. [source] Dealing with Timing and Synchronization in Opportunities for Joint Activity ParticipationGEOGRAPHICAL ANALYSIS, Issue 3 2010Tijs Neutens The ability of people to access opportunities offered by the built environment is circumscribed by various sets of space,time constraints, including the requirements to meet other persons at particular times and places to undertake activities together. While models of space,time accessibility recognize that joint activities may constrain the performance of activities in space and time, their specifications do not explicitly acknowledge the opportunities that individuals of a group have for joint activity participation. Therefore, this article focuses on joint activity participation and argues that collective activity decisions are the outcome of a complex process involving various aspects of timing, synchronization, and social hierarchy. The utility-theoretic model proposed here quantifies the extent to which opportunities can be jointly accessed by a particular group of people within a specific time period. Central to the approach are three key variables: the attractiveness of an opportunity, the time available for activity participation, and the travel time to an activity location. Because of the multiperson character of joint activities, the determination of these variables is subject to individual preferences, privileges, and power differentials within a group. Specific attention is given to how time-of-day and synchronization effects influence the opportunities accessible to a group of individuals. The impact of these factors on joint accessibility is illustrated by a real-world example of an everyday rendezvous scenario. The outcomes of a simulation exercise suggest that time-of-day and synchronization effects significantly affect the benefits that can be gained from opportunities for joint activities. La capacidad de acceso a las oportunidades que los entornos construidos (como las ciudades) ofrecen a las personas, está limitada por un conjunto diverso de restricciones espacio-temporales. Entre ellas se incluyen los requisitos para coincidir y encontrarse con otras personas en determinados momentos y lugares con el fin de realizar actividades conjuntas. Los modelos de accesibilidad comunes reconocen que las actividades conjuntas pueden limitar el ejercicio de actividades en el espacio y el tiempo. Sin embargo, sus especificaciones no reconocen explícitamente las oportunidades disponibles a todos los individuos de un grupo para participar de una actividad conjunta. Es en este contexto y dadas las limitaciones descritas que este artículo se centra en la participación de individuos en actividades conjuntas y propone el argumento que la toma de decisiones relacionadas con dichas actividades son el resultado de un proceso complejo que involucra varios aspectos de temporización (programación temporal), sincronización, y jerarquía social. El modelo teórico de utilidad que se propone aquí cuantifica el grado en que las oportunidades pueden ser evaluadas en forma conjunta por un grupo de personas particular dentro de un período de tiempo específico. El marco general propuesto por los autores se basa en tres variables fundamentales: el atractivo de una oportunidad, el tiempo disponible para la participación de la actividad, y el tiempo de desplazamiento al lugar donde se lleva a cabo actividad. Debido al carácter particular de estas actividades (que involucran múltiples participantes), la determinación de estas variables está sujeta a preferencias individuales, a privilegios y a diferencias de poder dentro de un grupo. El presente estudio además presta atención especial a la forma en la que la hora del día y los efectos de sincronización pueden influenciar la disponibilidad de oportunidades para un grupo determinado de individuos. El impacto de estos factores sobre la accesibilidad agregada de actividades conjuntas es ejemplificado por los autores mediante un caso del mundo real que utiliza escenarios de encuentros diarios entre personas. Los resultados de este ejercicio de simulación sugieren que los efectos de la hora del día y la sincronización afectan significativamente los beneficios que se pueden obtener a partir las oportunidades disponibles para acceder a y realizar actividades conjuntas. [source] The practice of early recognition and early intervention to prevent psychotic relapse in patients with schizophrenia: an exploratory study.JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2002Part In this article we describe the findings of an exploratory study into the application of early recognition and early intervention methods aimed at prevention of psychotic relapses in patients with schizophrenia. We addressed several models of symptom recognition plans and indicated how patients, healthcare professionals and other persons involved may be able to list and evaluate early warning signs systematically. We also paid attention to the role of the patient's family and to the potential effects of using early recognition and early intervention methods. In a follow-up article (part 2), we will focus more specifically on factors which favourably or adversely affect the use of early recognition and early intervention methods. The results of this exploratory study will be used to design an intervention protocol for nursing staff to serve as a tool for preparing symptoms recognition plans with the individual patient and his/her social network. [source] Act and Event in Rahner and von Balthasar: A Case Study in Catholic Systematics,NEW BLACKFRIARS, Issue 1019 2008Cyrus P. Olsen Abstract In Benedict XVI's God is Love§1 humanity's relationship with God is described as an encounter with an ,event', the Christ-event. I argue that this shift in Catholic theology towards language of act and event signalled a relationship to existentialism, which, taken broadly, entailed an emphasis upon subjectivity and freedom uncharacteristic of the focus upon objectivity common to neo-Scholastic thought. As we shall see with Karl Rahner and Hans Urs von Balthasar, however, this newfound emphasis on subjectivity and freedom did not necessitate an abandonment of all the elements of the more ,objective' perspective. Rather, the task during the ascendancy of existentialist thought became the integration of human subjectivity with the objective and independent reality of the world and God. I suggest that Rahner and von Balthasar use notions such as act and event as a way of being mindful of the role of the subject's creativity and freedom in its encounter with the world, God, and other persons, without thereby undermining the freedom and creativity of that which is other than the subject. [source] Violent crimes and their relationship to personality disorders,PERSONALITY AND MENTAL HEALTH, Issue 2 2007Michael H. Stone Persons committing murder and other forms of violent crime are likely to exhibit a personality disorder (PD) of one type or another. Essentially any personality disorder can be associated with violent crime, with the possible exception of avoidant PD. This includes those described in DSM as well as other disorders such as sadistic PD and psychopathy. The latter two, along with antisocial and paranoid PDs, are the most common personality accompaniments of violent crime. Narcissistic traits (if not narcissistic PD (NPD) itself) are almost universal in this domain, since violent offenders usually place their own desires and urges far above those of other persons. While admixtures of traits from several disorders are common among violent offenders, certain ones are likely to be the main disorder: antisocial PD, Psychopathy, Sadistic PD, Paranoid PD and NPD. Instrumental (as opposed to impulsive) spousal murders are strongly associated with NPD. Men committing serial sexual homicide usually show psychopathy and sadistic PD; half these men also show schizoid PD. Mass murderers usually show strong paranoid traits. With a focus on murder, clinical examples drawn from the crime literature and from the author's personal interviews reflect 14 varieties of personality disorder. Animal torture before adulthood is an important predictor of future violent (including sadistic) crime. Whereas many antisocial persons are eventually capable of rehabilitation, this is rarely the case with psychopathic or sadistic persons. Suggestions for future research are offered. Copyright © 2007 John Wiley & Sons, Ltd. [source] Beryllium sensitivity among workers at a Norwegian aluminum smelter,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 7 2010A.M. Nilsen PhD Abstract Background Sensitivity to beryllium was investigated among workers at an aluminum smelter in Norway as a consequence of the findings in an occupational exposure survey. Methods Three hundred and sixty-two employees and 31 reference persons were tested for sensitization to beryllium with the beryllium lymphocyte proliferation test (BeLPT) based on specifications by the US Department of Energy in 2001. The results are reported as abnormal, borderline, or normal. Results One person (0.28%) from the aluminum smelter was found to have abnormal results in two separate blood samples and is sensitized to beryllium. Three other persons had one abnormal test that was not confirmed by a second test. One person in the reference group had one abnormal and one normal test result. No borderline samples were detected. None of the employees with one or more abnormal sample results had pot room asthma. The sensitized individual worked in a Soederberg line in 1972,1974. The beryllium concentration in the work atmosphere is estimated to have been similar as today (0.1,0.3,µg/m3), but work routines, etc. would cause higher total exposures. Conclusions Only one sensitized person of 362 is in line with what is found in other studies in the aluminum industry. The low number, compared with the beryllium handling industry, may be attributable to lower work atmosphere concentrations, beryllium speciation effects, or use of respiratory protection equipment. Pot room asthma does not appear to be associated with beryllium sensitization. Am. J. Ind. Med. 53:724,732, 2010. © 2010 Wiley-Liss, Inc. [source] Proceedings of the 20th Annual Conference of the Japanese Association for Adolescent Psychotherapy, 16 November 2002, Tokyo, JapanPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2003Article first published online: 28 AUG 200 Inpatient treatment of obsessive,compulsive disorder in a child and adolescent psychiatry ward M. USAMI National Center of Neurology and Psychiatry, Kohnodai Hospital, Chiba, Japan This is a case report of a 13-year-old-boy (2nd grade in junior high school). His father had poor communication; his mother was a very fragile woman. The boy had been overprotected by his parents, as long as he responded to their expectations. He did not have any other siblings. He played well with his friends since he was young, and did not have problems until the 1st term (from April to July) of 1st grade in junior high school. However, in September he started to have difficulties going well with his friends, and going to school. He spent most of his time in his room, and began to repeat checking and hand-washing frequently. Even at midnight, he forced his mother to touch the shutter from outside of the house for many times. He also ritually repeated to touch his mother's body, after he licked his hands, for over an hour. He became violent, when his parents tried to stop him. In April, year X, his parents visited our hospital for the first time. From then, his mother could not tolerate her son's coerciveness any longer. His father explained to the boy that ,your mother has been hospitalized', and she started to live in the next room to the boy's without making any noise. After 3 months he noticed that his mother was not hospitalized, and he got very excited. He was admitted to our hospital with his family and relatives, in October, year X. At the initial stage of hospitalization he showed distrust and doubt towards the therapist and hospital. He had little communication with other boys and did not express his feelings. Therefore, there was a period of time where he seemed to wonder whether he could trust the treatment staff or not. During his interviews with his therapist he repeated only ,I'm okay' and did not show much emotional communication. For the boy, exposing himself was equivalent to showing his vulnerability and incompleteness. Therefore, the therapist considered that he was trying to denying his feelings to avoid this. The therapist set goals for considering his own feelings positively and expressing them appropriately. Also, the therapist carried out behavioral restrictions towards him. He hardly had any emotional communication with the staff, and his peer relationship in the ward was superficial. Therefore, he gradually had difficulty spending his time at the end of December On the following day in which he and the therapist decided to return to his house for the first time, he went out of the ward a few days before without permission. From thereon it was possible for him to share feelings such as hostility and aggression, dependence and kindness with the therapist. The therapist changed his role from an invasive one to a more protective one. Then, his unsociability gradually faded. He also developed good peer relationships with other boys in the ward and began to express himself feeling appropriately. He was also able to establish appropriate relations with his parents at home, and friends of his neighborhood began to have normal peer relationships again. During childhood and adolescence, boys with obsessive,compulsive disorder are known to have features such as poor insight and often involving their mothers. We would like to present this case, through our understanding of dynamic psychiatry throughout his hospitalization, and also on the other therapies that were performed. Psychotherapy with a graduate student that discontinued after only three sessions: Was it enough for this client? N. KATSUKI Sophia University, Tokyo, Japan Introduction: Before and after the psychotherapy, SWT was administrated in this case. Comparing these two drawings, the therapist was provided with some ideas of what kind of internal change had taken place inside this client. Referring to the changes observed, we would like to review the purposes and the ways of the psychotherapy, as well as the adequacy of the limited number of the sessions (vis-a-vis result attained.) Also we will discuss later if any other effective ways could be available within the capacities of the consulting system/the clinic in the university. Case: Ms. S Age 24 years. Problems/appeal: (i) awkwardness in the relationship with the laboratory colleagues; (ii) symptoms of sweating, vomiting and quivering; and (iii) anxiety regarding continuing study and job hunting. Diagnosis: > c/o PTSD. Psychotherapeutic setting: At the therapy room in the clinic, placed at the university, 50 min-session; once a week; paralleled with the medical treatment. Process: (1) Since she was expelled from the study team in the previous year, it has become extremely difficult for her to attend the laboratory (lab) due to the aforementioned symptoms. She had a feeling of being neglected by the others. When the therapist suggested that she compose her mental confusions in the past by attending the therapy room, she seemed to be looking forward to it, although she said that she could remember only a few. (2) She reported that she overdosed on sedatives, as she could not stop irritating. She was getting tough with her family, also she slashed the mattress of her bed with a knife for many times. She complained that people neither understood nor appreciated her properly. and she said that she wanted revenge on the leader of the lab by punishing him one way or other. (3) Looking back the previous session, she said ,I had been mentally mixed up at that time, but I feel that now I can handle myself, as I stopped the medication after consulting the psychiatrist. According to what she said, when she disclosed the occurrences in the lab to her mother, she felt to be understood properly by her mother and felt so relieved. and she also reported that she had been sewing up the mattress which she slashed before, without any reason. She added, " although I don't even know what it means, I feel that this work is so meaningful to me, somehow". Finally, she told that she had already made her mind to cope with the situation by herself from now on, although it might result in a flinch from the real solution. Situations being the above, the session was closed. Swt: By the remarkable changes observed between the two drawings, the meanings of this psychotherapy and its closure to the client would be contemplated. Question of how school counselors should deal with separation attendant on students' graduation: On a case in which the separation was not worked through C. ASAHARA Sophia University, Tokyo, Japan Although time limited relationship is one of the important characteristics in school counseling, the question of separation attendant on it has not been much discussed based on specific cases. This study focuses on the question of separation through looking at a particular case, in which the separation was not worked through, and halfway relationship continued even after the student's graduation and the counselor's resignation. I was a part time school counselor at a junior high school in Tokyo. The client was a 14-year-old female student, who could not go to her classroom, and spent a few hours in a sick bay when she came to school. She was in the final grade and there was only half a year left before graduation when we first met, and we started to see each other within a very loose structure. As her personality was hyper-vigilant and defensive, it took almost 2 months before I could feel that she was nearer. Her graduation was the first occasion of separation. On that occasion, I found that there had been a discrepancy between our expectations; while I took it for granted that our relationship would end with the graduation, she expected to see me even after she graduated, and she actually came up to see me once in a while during the next year. A year later, we faced another occasion of separation, that was my resignation. Although I worried about her, all I have done for her was to hand a leaflet of a counseling office, where I work as a part time counselor. Again I could not refer to her feelings or show any concrete directions such as making a fixed arrangement. After an occasional correspondence for the next 10 months (about 2 years after her graduation), she contacted me at the counseling office asking for a constant counseling. Why could I not deal with both occasions? and how did that affect the client thereafter? There were two occasions of separation. At the time of the client's graduation, I seemed to be enmeshed in the way of separation that is peculiar to the school setting. In general in therapeutic relationship, mourning work between counselor and client is regarded as being quite important. At school, however, separation attendant on graduation is usually taken for granted and mourning work for any personal relationship tends to be neglected. Graduation ceremony is a big event but it is not about mourning over one's personal relationships but separation from school. That may be why I did not appreciate how the client counted on our relationship. At the time of my resignation I was too worried about working through a change from very loose structure which is peculiar to the school setting to a usual therapeutic structure (fees are charged, and time, place are fixed). That is why I did nothing but give her a leaflet. In this way, we never talked about her complex feelings such as sadness or loneliness, which she was supposed to experience on separation. Looking at the aforementioned process from the client's viewpoint, it can be easily imagined that she could not accept the fact of separation just because she graduated. and later, she was forced to be in double-bind situation, in which she was accepted superficially (handed a leaflet), while no concrete possibility was proposed concerning our relationship (she could never see me unless she tries to contact me.) As a result, she was left alone and at a loss whether she could count on me or not. The halfway situation or her suspense was reflected in her letter, in which she appeared to be just chatting at first sight, but between the lines there was something more implying her sufferings. Above discussion suggests that in some case, we should not neglect the mourning work even in a school setting. To whom or how it is done is the next theme we should explore and discuss in the future. For now, we should at least be conscious about the question of separation in school setting. Study of the process of psychotherapy with intervals for months M. TERASHIMA Bunkyo Gakuin University, Tokyo, Japan This is a report on the process of psychotherapy of an adolescent girl who showed manic and depressive state. At the time of a depressed state, she could not go to a college and withdrew into home, and the severe regressive situation was shown. Her therapy began at the age of 20 and she wanted to know what her problem was. The process of treatment went on for 4 years but she stopped coming to sessions for several months because of failure of the therapist. She repeated the same thing twice. After going through these intervals the client began to remember and started to talk about her childhood , suffering abusive force from her father, with vivid impressions. They once were hard for her to accept, but she began to establish the consistent figure of herself from past to present. In this case, it could be thought that the intervals of the sessions had a certain role, with which the client controlled the structure of treatment, instead of an attack against the therapist. Her object relation, which is going to control an object offensively, was reflected in these phenomena. That is, it can be said that the ambivalence about dependency , difficult to depend but desirous of the object , was expressed. Discontinuation of the sessions was the product of the compromise formation brought about the ambivalence of the client, and while continuing to receive this ambivalence in the treatment, the client started to realize discontinuance of her memories and then advanced integration of her self-image. For the young client with conflict to dependence such as her, an interval does not destroy the process of treatment but in some cases it could be considered as a therapeutic element. In the intervals the client could assimilate the matter by herself, that acquired by the sessions. Psychotherapy for a schizoid woman who presented eccentric speech and behaviour M. OGASAWARA Osaka University Graduate School of Medicine, Osaka, Japan Case presentation: A case of a 27-year-old woman at the beginning of therapy. Life history: She had been having a wish for death since she was in kindergarten and she had been feeling strong resistance to do the same as others after school attendance. She had a history of ablutomania from the age of 10,15, but the symptom disappeared naturally. and she said that she had been eliminated from groups that she tried to enter. After graduating a junior college, she changed jobs several times without getting a full-time position. Present history: Scolded by her boy friend for her coming home too late one day, she showed confusion such as excitement, self-injury or terror. She consulted a psychiatrist in a certain general hospital, but she presented there eccentric behaviours such as tense facial expression, stiffness of her whole body, or involuntary movement of limbs. and because she felt on bad terms with the psychiatrist and she had come to cause convulsion attacks in the examination room, she was introduced to our hospital. Every session of this psychotherapy was held once a week and for approximately 60 min at a time. Treatment process: She sometimes presented various eccentric attitudes, for example overturning to the floor with screaming (1), going down on her knees when entrance at the door (5), entering with a knife in her mouth and hitting the wall suddenly (7), stiffening herself just outside the door without entering the examination room (9), taking out a knife abruptly and putting it on her neck (40), exclaiming with convulsion responding to every talk from the therapist (41), or stiffening her face and biting herself in the right forearm suddenly (52). She also repeated self-injuries or convulsion attacks outside of the examination room in the early period of the therapy. Throughout the therapy she showed hypersensitivity for interpersonal relations, anxiety about dependence, terror for self-assertion, and avoidance for confrontation to her emotional problems. Two years and 6 months have passed since the beginning of this therapy. She ceased self-injury approximately 1 year and 6 months before and her sense of obscure terror has been gradually reduced to some extent. Discussion: Her non-verbal wariness and aggression to the therapist made the sessions full of tension and the therapist felt a sense of heaviness every time. In contrast, she could not express aggression verbally to the therapist, and when the therapist tried to identify her aggression she denied it. Her anxiety, that she will be thoroughly counterattacked to self-disintegration if she shows aggression to other persons, seems to be so immeasurably strong that she is compelled to deny her own aggression. Interpretations and confrontations by the therapist make her protective, and occasionally she shows stronger resistance in the shape of denial of her problems or conversion symptoms (astasia, aphonia, or involuntary movements) but she never expresses verbal aggression to the therapist. and the therapist feels much difficulty to share sympathy with her, and she expresses distrust against sympathetic approach of the therapist. However, her obvious disturbance that she expresses when she feels the therapist is not sympathetic shows her desire for sympathy. Thus, because she has both strong distrust and desire for sympathy, she is in a porcupine dilemma, which is characteristic of schizoid patients as to whether to lengthen or to shorten the distance between herself and the therapist. This attitude seems to have been derived from experience she might have had during her babyhood and childhood that she felt terror to be counterattacked and deserted when she showed irritation to her mother. In fact, existence of severe problems of the relationship between herself and her mother in her babyhood and childhood can be guessed from her statement. Although she has been repeating experiences to be excluded from other people, she shows no attitude to construct interpersonal relationship actively. On the contrary, by regarding herself to be a victim or devaluating other persons she externalizes responsibility that she herself should assume essentially. The reason must be that her disintegration anxiety is evoked if she recognizes that she herself has problems; that is, that negative things exist inside of her. Therefore, she seems to be inhibited to get depressive position and obliged to remain mainly in a paranoid,schizoid position. As for the pathological level, she seems to have borderline personality organization because of frequent use of mechanisms to externalize fantastically her inner responsibility. For her high ability to avoid confronting her emotional problems making the most of her verbal ability, every intervention of the therapist is invalidated. So, it seems very difficult for her to recognize her own problems through verbal interpretations or confrontation by the therapist, for the present. In general, it is impossible to confront self problems without containing negative emotions inside of the self, but her ability seemed to be insufficient. So, to point out her problems is considered to be very likely to result in her confusion caused by persecution anxiety. Although the therapy may attain the stage on which verbal interpretation and confrontation work better some day, the therapist is compelled to aim at promoting her ability to hold negative emotion inside of herself for the time being. For the purpose, the therapist is required to endure the situation in which she brings emotion that makes the therapist feel negative counter-transference and her process to experience that the therapeutic relation itself would not collapse by holding negative emotion. On supportive psychotherapy with a male adolescent Y. TERASHIMA Kitasato University Health Care Center, Kanagawa, Japan Adolescent cases sometimes show dramatic improvements as a consequence of psychotherapy. The author describes how psychotherapy can support an adolescent and how theraputic achievements can be made. Two and a half years of treatment sessions with a male adolescent patient are presented. The patient was a 19-year-old man, living with his family. He had 5 years of experience living abroad with his family and he was a preparatory school student when he came to a mental clinic for help. He was suffering from not being able to sleep well, from difficulties concerning keeping his attention on one thing, and from fear of going to distant places. He could barely leave his room, and imagined the consequence of overdosing or jumping out of a window. He claimed that his life was doomed because his family moved from a town that was familiar to him. At the first phase of psychotherapy that lasted for approximately 1 year, the patient seldom responded to the therapist. The patient was basically silent. He told the therapist that the town he lives in now feels cold or that he wants to become a writer. However, these comments were made without any kind of explanation and the therapist felt it very difficult to understand what the patient was trying to say. The sessions continued on a regular basis. However, the therapist felt very useless and fatigued. Problems with the patient and his family were also present at this phase of psychotherapy. He felt unpleasant at home and felt it was useless to expect anything from his parents. These feelings were naturally transferred to the therapist and were interpreted. However, interpretation seemed to make no changes in the forms of the patient's transference. The second phase of psychotherapy began suddenly. The patient kept saying that he did not know what to talk about. However, after a brief comment made by the therapist on the author of the book he was reading, the patient told the therapist that it was unexpected that the therapist knew anything of his favorite writer. After this almost first interaction between the patient and the therapist, the patient started to show dramatic changes. The patient started to bring his favorite rock CDs to sessions where they were played and the patient and the therapist both made comments on how they felt about the music. He also started asking questions concerning the therapist. It seemed that the patient finally started to want to know the therapist. He started communicating. The patient was sometimes silent but that did not last long. The therapist no longer felt so useless and emotional interaction, which never took place in the first phase, now became dominant. The third phase happened rapidly and lasted for approximately 10 months. Conversations on music, art, literature and movies were made possible and the therapist seldom felt difficulties on following the patient's line of thought. He started to go to schools and it was difficult at first but he started adjusting to the environment of his new part-time jobs. By the end of the school year, he was qualified for the entrance to a prestigious university. The patient's problems had vanished except for some sleeping difficulties, and he did not wish to continue the psychotherapy sessions. The therapist's departure from the clinic added to this and the therapy was terminated. The patient at first reminded the therapist of severe psychological disturbances but the patient showed remarkable progress. Three points can be considered to have played important roles in the therapy presented. The first and the most important is the interpretation by behavior. The patient showed strong parental transference to the therapist and this led the therapist to feel useless and to feel fatigue. Content analysis and here-and-now analysis seemed to have played only a small part in the therapy. However, the therapist tried to keep in contact with the patient, although not so elegant, but tried to show that the therapist may not be useless. This was done by maintaining the framework of the therapy and by consulting the parents when it was considered necessary. Second point is the role that the therapist intentionally took as a model or target of introjection. With the help of behavioral interpretation that showed the therapist and others that it may not be useless, the patient started to introject what seemed to be useful to his well being. It can be considered that this role took some part in the patient going out and to adjust to the new environment. Last, fortune of mach must be considered. The patient and the therapist had much in common. It was very fortunate that the therapist knew anything about the patient's favorite writer. The therapist had some experience abroad when he was young. Although it is a matter of luck that the two had things in common, it can be said that the congeniality between the patient and the therapist played an important role in the successful termination of the therapy. From the physical complaint to the verbal appeal of A's recovery process to regain her self-confidence C. ITOKAWA and S. KAZUKAWA Toyama Mental Health Center, Toyama, Japan This is one of the cases at Toyama Mental Health Center about a client here, we will henceforth refer to her simply as ,A'. A was a second grade high school student. We worked with her until her high school graduation using our center's full functions; counseling, medical examination and the course for autogenic training (AT). She started her counseling by telling us that the reason for her frequent absences from school began because of stomach pains when she was under a lot of stress for 2 years of junior high school, from 2nd grade to 3rd grade. Due to a lack of self confidence and a constant fear of the people around her, she was unable to use the transportation. She would spend a large amount of time at the school infirmary because she suffered from self-diagnosed hypochondriac symptoms such as nausea, diarrhea and a palpitation. She continued that she might not be able to have the self-confidence to sit still to consult me on her feelings in one of our sessions. A therapist advised her to take the psychiatric examination and the use of AT and she actually saw the medical doctor. In counseling (sessions), she eventually started to talk about the abuse that started just after her entering of junior high school; she approached the school nurse but was unable to tell her own parents because she did not trust them. In doing so, she lost the rest of her confidence, affecting the way she looked at herself and thought of how others did. At school she behaved cheerfully and teachers often accused her of idleness as they regarded this girl's absences along with her brightly dyed hair and heavy make-up as her negligent laziness. I, as her therapist, contacted some of the school's staff and let them know of her situation in detail. As the scolding from the teachers decreased, we recognized the improvement of her situation. In order to recover from the missed academic exposure due to her long absence, she started to study by herself. In a couple of months her physical condition improved gradually, saying ,These days I have been doing well by myself, haven't I?' and one year later, her improved mental condition enabled her to go up to Tokyo for a concert and furthermore even to enjoy a short part-time job. She continued the session and the medical examination dually (in tangent) including the consultation about disbelief to the teachers, grade promotion, relationships between friends and physical conditions. Her story concentrated on the fact that she had not grown up with sufficiently warm and compassionate treatment and she could not gain any mental refuge in neither her family nor her school, or even her friends. Her prospects for the future had changed from the short-ranged one with no difficulty to the ambitious challenge: she aimed to try for her favorite major and hoped to go out of her prefecture. But she almost had to give up her own plan because the school forced her to change her course as they recommended. (because of the school's opposition with her own choice). So without the trust of the teachers combined with her low self-esteem she almost gave up her hopes and with them her forward momentum. In this situation as the therapist, I showed her great compassion and discussed the anger towards the school authorities, while encouraging this girl by persuading her that she should have enough self-confidence by herself. Through such sessions, she was sure that if she continued studying to improve her own academic ability by herself she could recognize the true meaning of striving forward. and eventually, she received her parents' support who had seemed to be indifferent to her. At last she could pass the university's entrance exams for the school that she had yearned to attend. That girl ,A' visited our center 1 month later to show us her vivid face. I saw a bright smile on her face. It was shining so brightly. [source] Reducing aberrant verbal behavior by building a repertoire of rational verbal behavior,BEHAVIORAL INTERVENTIONS, Issue 3 2006Erik Arntzen The purpose of the present study was to train different verbal classes in a 44-year-old woman to reduce aberrant verbal behavior. She had been hospitalized for 22 years in different psychiatric institutions, and has been diagnosed with schizophrenia, developmental disabilities, non-organic psychosis, and autism. Assessment of her verbal behavior showed that a small amount was adequate verbal behavior, whereas almost the entire repertoire of verbal behavior could be characterized as aberrant verbal behavior (,psychotic' and repetitive verbal behavior), and this behavior was maintained by social reinforcement such as smiles, various comments from other persons. The treatment program was based on results from the assessment results and was focused on establishing relationships between a variety of verbal response responses and proper controlling variables. She was trained to produce different verbal classes, mainly mand, tact, intraverbal, textual, transcription, and dictation responses. The duration of aberrant verbal behavior and the rate of ,psychotic' verbal behavior were gradually reduced as a function of an increasing number of adequate verbal responses. In the study, we present data covering a very long period; the last data point was acquired 25 months after the start of the program. Copyright © 2006 John Wiley & Sons, Ltd. [source] Prevalence of HSV-1 LAT in Human Trigeminal, Geniculate, and Vestibular Ganglia and Its Implication for Cranial Nerve SyndromesBRAIN PATHOLOGY, Issue 4 2001Diethilde Theil Herpes simplex virus type 1 (HSV-1) enters sensory neurons and can remain latent there until reactivation. During latency restricted HSV-1 gene expression takes place in the form of latency-associated transcripts (LAT). LAT has been demonstrated to be important not only for latency but also for reactivation, which may cause cranial nerve disorders. Tissue sections of the trigeminal ganglia (TG), geniculate ganglia (GG), and the vestibular ganglia (VG) from seven subjects were examined for the presence of LAT using the in situ hybridization technique. LAT was found on both sides in all TG (100%), on both sides of five subjects (70%) in the GG, and in none of the VG. Using a second more sensitive detection method (RT-PCR), we found LAT in the VG of seven of ten other persons (70%). This is the first study to demonstrate viral latency in the VG, a finding that supports the hypothesis that vestibular neuritis is caused by HSV-1 reactivation. The distribution of LAT in the cranial nerve ganglia indicates that primary infection occurs in the TG and GG and subsequently spreads along the faciovestibular anastomosis to the VG. [source] | |||||||||||||||||||