Archives of General Psychiatry

Offer, Daniel;Offer, Judith Lynn

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110001001pmid: 5680964

Abstract FOR comparative studies of adolescence, the evaluations of normal populations can add much to data which are now derived mainly from patient populations. To know the deviant is to know something about the society that calls him deviant; studying the society directly tells us in what way the deviants' behaviors are unusual and in what way typical for the particular culture. Sociologists and psychologists frequently work with normal populations. Our purpose in this study is to utilize psychiatric interviews to further our understanding of a nonpatient adolescent population. Can the psychiatric interview, which is designed to help a patient, be useful for data collection? The interview is invaluable only if it is modified to fit the differing demands of research rather than therapy. In psychiatric interviews, we gain the patients' cooperation through the development of a therapeutic alliance. For interviews aimed primarily at understanding rather than References 1. Offer, D., and Sabshin, M.: Research Alliance vs Therapeutic Alliance: A Comparison , Amer J Psychiat 123:1519-1526 ( (June) ) 1967. 2. Offer, D.: Normal Adolescents: A Psychiatric Study of Teen-Age Boys , New York: Basic Book, Inc., Publishers, 1969. 3. Offer, D., and Sabshin, M.: Normality: Theoretical and Clinical Concepts of Mental Health , New York: Basic Books, Inc., Publishers, 1966. 4. Offer, D., and Sabshin, M.: The Psychiatrist and The Normal Adolescent , Arch Gen Psychiat 9:427-432 ( (Nov) ) 1963.Crossref 5. Deutsch, H.: The Psychology of Women: A Psychoanalytic Interpretation , New York: Grune & Stratton, Inc., Vol 1, 1944. 6. Nixon, R.E.: The Art of Growing: A Guide to Psychological Maturity , New York: Random House, Inc., 1962. 7. Rogers, C.: On Becoming a Person , New York: Houghton Mifflin Co., 1961. 8. Gesell, A.; Ilg, F., and Ames, L.: Youth: The Years From Ten to Sixteen , New York: Harper & Row, Publishers, Inc., 1956. 9. Blos, P.: On Adolescence , New York: The Free Press of Glencoe, Inc., 1962. 10. Erikson, E.H.: Identity and the Life Cycle , Psychol Issues 1:1-171, 1959. 11. Grinker, R.R., Sr.; Grinker, R.R., Jr.; and Timberlake, J.: Mentally Healthy Young Males (Homoclites): A Study , Arch Gen Psychiat 6:405-453 ( (June) ) 1962.Crossref 12. Peck, R.F., and Havinghurst, R.J.: The Psychology of Character Development , New York: John Wiley & Sons, Inc., 1960. 13. Silber, E., et al: Adaptive Behavior in Competent Adolescents: Coping With the Anticipation of College , Arch Gen Psychiat 5:354-365 ( (Oct) ) 1961.Crossref 14. Douvan, E., and Adelson, J.: The Adolescent Experience , New York: John Wiley & Sons, Inc., 1966. 15. Deutsch, H.: Selected Problems of Adolescence , New York: International Universities Press, Inc., 1967. 16. Baittle, B., and Offer, D.: On the Nature of Adolescent Rebellion, read before the Department of Psychiatry, Michael Reese Hospital, Chicago, Nov 7, 1967. 17. Freud, A.: Adolescence , Psychoanal Stud Child , 13:225-273, 1958. 18. Bettelheim, B.: The Problem of Generations , Daedalus , 91:64-92 ( (Winter) ) 1962. 19. Silber, E, et al: Competent Adolescents Coping with College Decisions ; Arch Gen Psych 5:517-527 ( (Dec) ) 1961.Crossref

Barter, James T.;Swaback, Dwight O.;Todd, Dorothy

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110011002pmid: 5680965

Abstract THIS PAPER, a follow-up study of adolescent patients hospitalized for suicidal attempts, compares those who made posthospitalization suicidal attempts with those who did not with regard to five variables: living situation, parental loss, social life, social agency contact, and school adjustment. It attempts to answer the following questions: (1) Did suicidal behavior continue after hospitalization? (2) What factors are associated with those who do continue to show suicidal behavior? Representative studies of adolescent suicidal behavior include: (a) general reviews, Balser and Masterson,1 Bakwin,2,3 Gould,4 Jacobziner5; (b) methods used, Jacobziner6; (c) etiological factors, such as school problems, Otto7; (d) or family disorganization, Tuckman and Connon,8 Teicher and Jacobs9,10; (e) psychodynamics, Schrut,11 Glaser12; and (f) presuicidal behavior, Schneer et al,13 and Otto.14 The research by Teicher and Jacobs represents one References 1. Balser, B., and Masterson, J.: Suicide and Adolescents , Amer J Psychiat 116:400-404 ( (Nov) ) 1959. 2. Bakwin, H.: Suicide in Children and Adolescents , J Amer Med Wom Assoc 19:489-491 ( (June) ) 1964. 3. Bakwin, H.: Teenage Suicide , Arch Environ Health 12:276-278 ( (March) ) 1966.Crossref 4. Gould, R.E.: Suicide Problems in Children and Adolescents , Amer J Psychother 19:228-246 ( (April) ) 1965. 5. Jacobziner, H.: Attempted Suicides in Adolescence , JAMA 191:7-11 ( (Jan) ) 1965.Crossref 6. Jacobziner, H.: Attempted Suicides in Adolescents by Poisoning: Statistical Report , Amer J Psychother 19:247-252 ( (April) ) 1965. 7. Otto, U.: Suicidal Attempts Made by Children and Adolescents Because of School Problems , Acta Paediat Scand 54:348-356 ( (July) ) 1965.Crossref 8. Tuckman, J., and Connon, H.E.: Attempted Suicide in Adolescents , Amer J Psychiat 119:228-232 ( (Sept) ) 1962. 9. Teicher, J.D., and Jacobs, J.: Adolescents Who Attempt Suicide: Preliminary Findings , Amer J Psychiat 122:1248-1257 ( (May) ) 1966. 10. Teicher, J.D., and Jacobs, J.: The Physician and the Adolescent Suicide Attempter , J Sch Health 36:406-415 ( (Nov) ) 1966.Crossref 11. Schrut, A.: Suicidal Adolescents and Children , JAMA 188:1103-1107 ( (June) ) 1964.Crossref 12. Glaser, K.: Attempted Suicide in Children and Adolescents: Psychodynamic Observations , Amer J Psychother 19:220-227 ( (April) ) 1965. 13. Schneer, H.; Kay, P.; and Brozovsky, M.: Events and Conscious Ideation Leading to Suicidal Behavior , Psychiat Quart 35:507-515 ( (July) ) 1961.Crossref 14. Otto, U.: Changes in the Behavior of Children and Adolescents Preceding Suicidal Attempts , Acta Psychiat Scand 40:386-400, 1964.Crossref 15. Greer, S.: The Relationship Between Parental Loss and Attempted Suicide: A Control Study , Brit J Psychiat 110:698-705 ( (Sept) ) 1964.Crossref 16. Greer, S.; Gunn, J.C.; and Koller, K.M.: Aetiological Factors in Attempted Suicide , Brit Med J 2:1352-1355 ( (Dec) ) 1966.Crossref 17. Dorpat, T.L.; Jackson, J.K.; and Ripley, H.S.: Broken Homes and Attempted and Completed Suicide , Arch Gen Psychiat 12:213-216 ( (Feb) ) 1965.Crossref 18. Levi, L.D., et al: Separation and Attempted Suicide , Arch Gen Psychiat 15:158-164 ( (Aug) ) 1966.Crossref 19. Motto, J.A.: Suicide Attempts: A Longitudinal View , Arch Gen Psychiat 13:516-520 ( (Dec) ) 1965.Crossref 20. Hamburg, D.A., and Adams, J.E.: A Perspective on Coping Behavior , Arch Gen Psychiat 17:277-284 ( (Sept) ) 1967.Crossref

Hertzig, Margaret E.;Birch, Herbert G.

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110016003pmid: 5680966

Abstract THIS IS the second report in an ongoing series of investigations concerned with examining the association between primary central nervous system abnormality and serious psychiatric disturbance in adolescents. In the first of these investigations we examined this association in psychiatrically disturbed adolescent girls1 who represented all patients sequentially admitted to the female adolescent service of a psychiatric receiving hospital over a six-month period. On each of the indicators of neurologic dysfunction used in that study it was found that psychiatrically abnormal adolescent girls exhibited a far higher prevalence of neurologic abnormality than would have been expected had they been drawn at random from their age group in the general population. Moreover, the proportion of individuals as well as the frequency with which CNS abnormalities were found varied systematically with the severity of psychiatric illness. The findings of this study encouraged us in our References 1. Hertzig, M.E., and Birch, H.G.: Neurologic Organization in Psychiatrically Disturbed Adolescent Girls , Arch Gen Psychiat 15:590-598 ( (Dec) ) 1966.Crossref 2. Bender, L.: Clinical Study of 100 Schizophrenic Children , Amer J Orthopsychiat 17:40-56 ( (Jan) ) 1947.Crossref 3. Bender, L.: " Twenty Years of Clinical Research on Schizophrenic Children With Special Reference to Those Under Six Years of Age ," in Caplan, G. (ed.): Emotional Problems of Early Childhood , New York: Basic Books, Inc., 1953, pp 503-515. 4. Creak, M.: Childhood Psychoses: A Review of 100 Cases , Brit J Psychiat 109:84-89 ( (Jan) ) 1963.Crossref 5. Fish, B.: The Study of Motor Development in Infancy and Its Relation to Psychological Functioning , Amer J Psychiat 1:1113-1118 ( (Jan) ) 1961. 6. Fish, B., et al: " The Prediction of Schizophrenia in Infancy: 11. A Ten-Year Follow-up Report of Predictions made at One Month of Age ," in Hoch, P., and Zubin, J. (eds.); Psychopathology of Schizophrenia , New York: Grune & Stratton, Inc., 1966. 7. Goldfarb, W.: Childhood Schizophrenia , Cambridge, Mass: Harvard University Press, 1961. 8. Goldfarb, W.: An Investigation of Childhood Schizophrenia: A Retrospective View , Arch Gen Psychiat 11:620-634 ( (Dec) ) 1964.Crossref 9. Kennard, M.A.: The Characteristics of Thought Disturbances as Related to Electroencephalographic Findings in Children and Adolescents , Amer J Psychiat 115:911-92 ( (April) ) 1959. 10. Pasamanick, B., and Knobloch, H.: " Epidemiologic Studies on the Complications of Pregnancy and the Birth Process ," in Caplan, G. (ed.): Prevention of Mental Disorders in Children , New York: Basic Books, Inc., 1961, pp 74-94. 11. Pollack, M., and Greenberg, I.M.: " Paranatal Complications in Hospitalized Schizophrenic and Non-Schizophrenic Patients ," in Wortis, J. (ed.): Recent Advances in Biological Psychiatry , New York: Plenum Press, 1966, pp 36-37, vol 8. 12. Birch, H.G., and Hertzig, M.E.: "Etiology of Schizophrenia: An Overview of the Relation of Development to Atypical Behavior," in Romano, J. (ed.): The Origins of Schizophrenia, Proceedings of the First Rochester International Conference, Excerpta Medica International Congress Series No. 151, 1967, pp 92-110. 13. Rutter, M.; Graham, P.; and Birch, H.G.: Inter-Relations Between the Choreiform Syndrome, Reading Disability, and Psychiatric Disorder in Eight to Eleven Year Old Children , Develop Med Child Neurol 8:149-159 ( (April) )1966.Crossref 14. Birch, H.G., and Belmont, L.: Auditory-Visual Integration, Intelligence and Reading Ability in School Children , Percept Motor Skills 20:295-305 ( (Feb) ) 1965.Crossref 15. Wechsler, D.: Wechsler Intelligence Scale for Children , New York: Psychological Corporation, 1949. 16. Bender, L.: The Concept of Pscudopsychopathic Schizophrenia in Adolescents , Amer J Orthopsychiat 29:491-509 ( (July) ) 1959.Crossref 17. Pollin, W., et al: Life History Differences in Identical Twins Discordant for Schizophrenia , Amer J Orthopsychiat 36:492-509 ( (April) ) 1966.Crossref 18. Rutter, M.: The Influence of Organic and Emotional Factors on the Origins, Nature, and Outcome of Childhood Psychosis , Develop Med Child Neurol 7:518-528 ( (Oct) ) 1965.Crossref 19. MacMahon, B., and Sowa, J.M.: " Physical Damage to the Fetus ," in Causes of Mental Disorders: A Review of Epidemiological Knowledge, 1959 , New York: Milbank Memorial Fund, 1961, pp 51-110. 20. Taft, L.T., and Goldfarb, W.: Prenatal and Perinatal Factors in Childhood Schizophrenia , Develop Med Child Neurol 6:32-43 ( (Feb) ) 1964. 21. Kennard, M.A.: The Electroencephalogram in Psychological Disorders: A Review , Psychosom Med 15:95-115 ( (March-April) ) 1953.Crossref 22. White, P.T.; Demyer, W.; and Demyer, M.: EEG Abnormalities in Early Childhood Schizophrenia: A Double Blind Study of Psychiatrically Disturbed and Normal Children During Promazine Sedation , Amer J Psychiat 120:950-958 ( (April) ) 1964. 23. Belmont, I., et al: Perceptual Evidence of Central Nervous System Dysfunction in Schizophrenia , Arch Gen Psychiat 10:395-408 ( (April) ) 1964.Crossref 24. Birch, H.G., and Walker, H.A.: Perceptual and Perceptual-Motor Dissociation: Studies in Schizophrenia and Brain-Damaged Psychotic Children , Arch Gen Psychiat 14:113-118 ( (Feb) ) 1966.Crossref 25. Gittleman, M., and Birch, H.G.: Childhood Schizophrenia: Intellect, Neurologic Status, Perinatal Risk, Prognosis, and Family Pathology , Arch Gen Psychiat 17:16-25 ( (July) ) 1967.Crossref 26. Pollack, M., and Woerner, M.G.: Pre and Perinatal Complications and "Childhood Schizcphrenia," J Child Psychiat Psychol 7:235-242 ( (July) ) 1966.Crossref 27. United States Department of Health, Education and Welfare: Outpatient Psychiatric Clinics , Adolescent Patients, 1962 , National Institutes of Health, Washington, DC, 1964. 28. Hollingshead, A.B., and Redlich, F.C.: Social Class and Mental Illness: A Community Study , New York: John Wiley & Sons, Inc., 1958. 29. Bahn, A.K.; Chandler, C.A.; and Eisenberg, L.: Diagnostic and Demographic Characteristics of Patients Seen in Outpatient Psychiatric Clinics for an Entire State (Maryland): Implications for the Psychiatrist and the Mental Health Program Planner , Amer J Psychiat 117:769-778 ( (March) ) 1961. 30. Miles, H.E., et al: A Cumulative Survey of all Psychiatric Experience in Monroe County, NY, Summary Data for the First Year (1960) , Psychiat Quart 38:458-487 ( (July) ) 1964.Crossref 31. Warren, W.: A Study of Adolescent Psychiatric In-Patients and the Outcomes Six or More Years Later: I. Clinical Histories and Hospital Findings , J Child Psychol Psychiat 6:1-17 ( (May) ) 1965.Crossref 32. Symonds, A., and Herman, M.: The Patterns of Schizophrenia in Adolescence: A Report on 50 Cases of Adolescent Girls , Psychiat Quart 31:521-530 ( (Jan) ) 1957.Crossref 33. Eisenberg, L.: The Autistic Child in Adolescence , Amer J Psychiat 112:607-612 ( (Feb) ) 1956. 34. United States Department of Health, Education and Welfare: Patients in Mental Institutions, 1965, Part II, State and County Mental Hospitals , National Institues of Health, Washington, DC, 1967.

Fox, Peter D.;Kuldau, John M.

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110026004pmid: 5693025

Abstract WHILE there is an extensive literature on the evaluation of mental health programs, the state of the art in mental health program evaluation is unsettled, given the various competing criteria and methodologies that have been proposed. In spite of the long history of psychiatry, psychiatric programs remain among the most difficult to evaluate in the field of medicine. A comprehensive view of a psychiatric program must encompass three related activities that are usually performed by groups of workers who are separated by training, tradition, and organizational barriers. These activities are (1) administrative and financial, involving the assignment of resources, eg, mental health workers, to a program; (2) clinical treatment; and (3) assessment of treatment outcome. In spite of the strong interrelationships, the three factors are usually treated as separate by the social system in which they are imbedded. This paper offers new References 1. Daniels, D., and Kuldau, J.: Marginal Man, the Tether of Tradition, and Intentional Social System Therapy , Community Ment Health J 3 ( (1) ):13-20 (spring) 1967.Crossref 2. US Public Health Service, Department of Health, Education, and Welfare: Veterans With Mental Disorders Resident in Veterans Administration Hospitals, October 31, 1962 , Washington, DC: Public Health Service Publication No.1223, 1966. 3. US Public Health Service, Department of Health, Education, and Welfare: Patients in Mental Institutions , Washington DC: Public Health Service Publication No.1452, 1966, parts II and III. 4. Kandel, D.B., and Williams, R.: Psychiatric Rehabilitation , New York: Atherton Press, 1964. 5. Conley, R.W.; Conwell, M.; and Arrill, M.B.: An Approach to Measuring the Cost of Mental Illness , Amer J Psychiat 124:755-762 ( (Dec) ) 1967. 6. Conley, R.W.; Conwell, M.; and Arrill, M.B.: Estimate of Amount and Distribution of Current Cost of Mental Illness , 1966, mimeographed. 7. Fox, P.: A Theory of Cost-Effectiveness for Military Systems Analysis , Operations Res 13 ( (2) ):191-201 (March-April) 1965.Crossref 8. Rosenthal, R.: Experimenter Effects in Behavioral Research , New York: Appleton-Century-Crofts, 1966. 9. Marshall, H.:" Politics and Efficiency in Water Development ," in Kneese, A., and Smith, S.(eds.): Water Research , Baltimore: Johns Hopkins Press, 1966, pp 291-310. 10. Freeman, H.E., and Simmons, O.: The Mental Health Patient Comes Home , New York: John Wiley & Sons, Inc., 1963. 11. Engelhardt, D.M., et al: Phenothiazines in Prevention of Psychiatric Hospitalization , Arch Gen Psychiat 16:98-101 ( (Jan) ) 1967.Crossref 12. Pasamanick, B.; Scarpitti, F.; and Dinitz, S.: Schizophrenics in the Community , New York: Appleton-Century-Crofts, 1967. 13. Polak, P.: Unclean Research and Clinical Change , Milbank Memorial Fund Quarterly XLIV (1) (pt 2) , pp 337-345 (Jan) 1966.Crossref 14. Binner, P.: Development of the Research Department , Milbank Memorial Fund Quarterly XLIV (1), (pt 2) , pp 313-319 (Jan) 1966.Crossref

Almond, Richard;Keniston, Kenneth;Boltax, Sandra

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110033005pmid: 5680967

Abstract THIS paper reports the first part of a study of therapeutic values in a milieu therapy unit. We deal here with the exploration and measurement of those shared beliefs and values which make up the "hospital culture." Later reports will deal with value change during patients' hospitalizations, and the relations of value change to variables such as outcome of treatment. The patient-in-the-psychiatric-hospital has been the focus of increasingly intense interest during the past two decades. Clinicians and administrators have explored a variety of approaches to the hospitalized patient beginning with "total-push," and going on to include milieu therapy, therapeutic community, patient government, and a variety of unnamed enrichments and innovations in hospital treatment. In the past ten years there has been widespread acceptance and utilization of such approaches in psychiatric inpatient facilities, especially in general hospital wards, university-affiliated services, References 1. Caudill, W., et al: Social Structure and Interaction Processes on a Psychiatric Ward , Amer J Orthopsychiat 22:314-334 ( (April) ) 1952.Crossref 2. Detre, T.; Kessler, D.; and Sayers, J.: " A Socioadaptive Approach to Treatment of Acutely Disturbed Inpatients ," in the Proceedings of the Third World Congress of Psychiatry , Toronto: University of Toronto Press. 3. Dunham, H.W., and Weinberg, S.K.: The Culture of the State Mental Hospital , Detroit: Wayne State University Press, 1960. 4. Durell, J.; Arnson, A.; and Kellam, S.G.: A Community-Oriented Therapeutic Milieu , Med Ann DC 34:468-474 ( (Oct) ) 1965. 5. Edelson, M.: Ego Psychology, Group Dynamics, and the Therapeutic Community , New York: Grune & Stratton Inc., 1964. 6. Glasser, W.: Reality Therapy , New York: Harper & Row Publishers, Inc., 1965. 7. Goffman, E.: Asylums , Garden City, NY: Doubleday and Co., 1961. 8. Saslow, G.: " The Use of a Psychiatric Unit in a General Hospital ," in The Psychiatric Hospital as a Social System , Albert F. Wessen (ed.), Springfield, Ill: Charles C Thomas, Publishers, 1965. 9. Strauss, A., et al: Psychiatric Ideologies and Institutions , New York: Free Press of Glencoe, 1964. 10. Lifton, R.: Thought Reform and the Psychology of Totalism , New York: W.W. Norton & Co., Inc., 1961. 11. Brady, J.P.; Zeller, W.W.; and Reznikoff, M.: Attitudinal Factors Influencing Outcome of Treatment of Hospitalized Psychiatric Patients , J Clin Exp Psychopath 20:326-334 ( (Aug) ) 1959. 12. Small, I.F.; Messina, J.A.; and Small, J.G.: The Meaning of Hospitalization: A Comparison of Attitudes of Medical and Psychiatric Patients , J Nerv Ment Dis 139:575-579 ( (Dec) ) 1964.Crossref 13. Small, J.G.; Small, I.F.; and Hayden, M.P.: Prognosis and Change in Attitudes , J Nerv Ment Dis 140:215-217 ( (Sept) ) 1965.Crossref 14. Levinson, D.J., and Gallagher, E.: Patienthood in the Mental Hospital , Boston: Houghton Mifflin Company, 1964. 15. Hollingshead, A.B., and Redlich, F.C.: Social Class and Mental Illness: A Community Study , New York: John Wiley & Sons, Inc., 1958. 16. Almond, R., and Esser, A.H.: Tablemate Choices of Psychiatric Patients: A Technique for Measuring Social Contact , J Nerv Ment Dis 140:68-82 ( (Jan) ) 1965.Crossref 17. Couch, A., and Keniston, K.: Yeasayers and Naysayers: Agreeing Response Set as a Personality Variable , J Abnorm Soc Psychol 60:151-174 ( (Feb) ) 1960.Crossref 18. Astrachan, B.; Harrow, M.; and Flynn, H.: The Influence of the Value System of a Psychiatric Setting on Behavior in Group Therapy Meetings, Soc Psychiat 1968, to be published. 19. Carstairs, G.M., and Heron, A.: " The Social Environment of the Mental Hospital Patient: A Measure of Staff Attitude ," in The Patient and the Mental Hospital , Greenblatt, M.; Levinson, D.J.; and Williams, R.H. (eds.), New York: Free Press, 1957. 20. Kahn, M.W., et al: A Factorial Study of Patient Attitudes Toward Mental Illness and Psychiatric Hospitalization , J Clin Psychol 19:235-241 ( (Feb) ) 1963.Crossref 21. Jones, M.: Social Psychiatry , Springfield Ill: Charles C Thomas, Publishers 1962. 22. Sharaf, M., and Levinson, D.J.: The " Quest for Omnipotence " in Professional Development: The Case of Resident Psychiatrists, Psychiatry 27:135-149 ( (Feb) ) 1964. 23. Yablonsky, L., and Dederich, C.E.: The Social Structure of an Anti-Addiction Society: Synanon, read before the American Sociological Association, 1965. 24. Silverman, J.; Berg, P.; and Kantor, R.: Some Perceptual Correlates of Institutionalization , J Nerv Ment Dis 141:651-657( (June) )1966.Crossref

Kysar, John E.

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110050006pmid: 5680968

Abstract THE ATTITUDES and reactions of any professional toward a given patient are a complex result of a number of factors. An important one among these factors is the orientation toward a particular type of behavior or problem which is largely derived from the training and theoretical persuasion of the professional. In a previous paper1 it was highlighted that there are two "camps" in child psychiatry with respect to the orientation toward seriously disturbed children (ie, childhood psychoses, autism, or childhood schizophrenia). The predominant camp holds to some variety of a functional-psychogenic etiology of these serious disturbances of early childhood. The second and smaller camp, which is more cognizant of the genetic-biologic-organic components as well as the functional, has seen some resurgence in its support in child psychiatry and related disciplines within the past five years. The present paper will examine the attitudes of References 1. Kysar, J.E.: The Two Camps in Child Psychiatry: Report from a Psychiatrist-Father of an Autistic and Retarded Child , Amer J Psychiat 125:1103-1109 ( (July) ) 1968. 2. Fenichel, C.: Psychoeducational Approaches for Seriously Disturbed Children in the Classroom , in Intervention Approaches in Educating Emotionally Disturbed Children , Division of Special Education and Rehabilitation Syracuse, NY: Syracuse University, 1966. 3. Eisenberg, L., and Kanner, L.: Early Infantile Autism, 1943-1955 , Amer J Orthopsychiat 26:556-566 ( (July) ) 1956.Crossref 4. Bettelheim, B.: The Empty Fortress , Free Press: New York, 1967. 5. Bettelheim, B.: Childhood Schizophrenia As A Reaction to Extreme Situations , Amer J Orthopsychiat 26:507-518 ( (July) ) 1956.Crossref 6. Wing, J.K. (ed.): Early Childhood Autism: Clinical , Educational, and Social Aspects, Pergamon Press: Toronto, 1966. 7. Rimland, B.: Infantile Autism , New York: Appleton-Century-Crofts, 1964. 8. Creak, M., and Ini, S.: Families of Psychotic Children , J Child Psychol Psychiat 1:156-175 ( (June) ) 1960.Crossref 9. Fenichel, C: The League School and Its Pioneering Role In Educating Seriously Disturbed Children , Congressional Record 112:100 ( (June) ) 1966. 10. Peck, H.B.; Rabinovitch, R.D.; and Cramer, J.B.: A Treatment Program for Parents of Schizophrenic Children , Amer J Orthopsychiat 19:592-598 ( (Oct) ) 1949.Crossref 11. Mahler, M.A.: On Child Psychosis and Schizophrenia , Psychoanalytic Study of the Child , 7:286-305, 1952. 12. Goldfarb, W.: An Investigation of Childhood Schizophrenia , Arch Gen Psychiat 11:620-634 ( (Dec) ) 1964.Crossref 13. Gittelman, M., and Birch, H.B.: Childhood Schizophrenia: Intellect, Neurologic Status, Perinatal Risk, Prognosis, and Family Pathology , Arch Gen Psychiat 17:16-25 ( (July) ) 1967.Crossref 14. Pitfield, M., and Oppenheim, A.N.: Child Rearing Attitudes of Mothers of Psychotic Children , J Child Psychol Psychiat 5:51-57 ( (June) ) 1964.Crossref 15. Menolascino, F.J.: Autistic Reactions in Early Childhood: Differential Diagnostic Consideration , J Child Psychol Psychiat 6:203-218 ( (Dec) ) 1965.Crossref 16. Ornitz, E.M., and Ritvo, E.R.: Perceptual Inconstancy in Early Infantile Autism , Arch Gen Psychiat 18:76-98 ( (Jan) ) 1968.Crossref 17. Lashley, K.S.: Structual Variation in the Nervous System in Relation to Behavior , Psychol Rev 54:325-334 ( (Nov) ) 1947.Crossref 18. Lewis, N.D.C.: in discussion, Proceedings of the Association for Research in Nervous and Mental Diseases , Baltimore: The Williams and Wilkins Co., 1954, p 364. 19. Fenichel, C.: Psychoeducation for Severely Disturbed Children , in Roche Report: Frontiers of Clinical Psychiatry 4:17 ( (Oct) ) 1967. 20. Goldfarb, W.: Corrective Socialization for Schizophrenic Children , in Roche Report: Frontiers of Hospital Psychiatry ( (Feb) ) 1967. 21. Donahue, G.T.: A School District Program for Schizophrenic, Organic, and Seriously Disturbed Children , in Emergent Approaches to Mental Health Problems : Cowen, E.L.; Gardner, E.A.; and Zax, M. (eds.): New York: Appleton-Century-Crofts, 1967. 22. Davis, D.R.: Family Processes in Mental Retardation , Amer J Psychiat 124:3, 340-350 ( (Sept) ) 1967.

Rowitz, Louis;Levy, Leo

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110059007pmid: 5680969

Abstract OVER the last 30 or more years, mental health researchers have been interested in the ecological study of mental disorders. It has been argued by these researchers that studies of the distribution of various mental disorders within the urban area would give some insight into the social factors associat ed with mental illness. Some of these researchers have promulgated a cause and effect relationship from their findings. Others have been more cautious and argued that strong ecological relationships do not necessarily show causality but rather help to identify social problem areas which aid the social planner in his endeavors. Much of the interest in the use of the ecology methodology for preliminary investigations into the incidence and prevalence of mental disorders in a specified geographic area stems from a study of mental disorders in Chicago in the 1920's and early 1930's.1 Faris and References 1. Faris, R.E.L., and Dunham, H.W.: Mental Disorders in Urban Areas , New York: Hafner Publishing Co., 1960. 2. Clausen, J.A., and Kohn, M.: " Relation of Schizophrenia to the Social Structure of a Small City ," in Pasamanick, B. (ed.): Epidemiology of Mental Disorder , Washington DC: American Association for the Advancement of Science, 1959, publication 60. 3. Stein, L.: Social Class Gradient in Schizophrenia , Brit J Prev Soc Med 11:181-195 ( (Oct) ) 1957. 4. Myerson A.: Review of Mental Disorders in Urban Areas , Amer J Psychiat 96:995-997 ( (Jan) ) 1940. 5. Gerard, D.L., and Houston, L.G.: Family Setting and the Social Ecology of Schizophrenia , Psychiat Quart 27:90-101 ( (Jan) ) 1953.Crossref 6. Lapouse, R., et al: The Drift Hypothesis and Socio-Economic Differentials in Schizophrenia , Amer J Public Health 46:978-986 ( (Aug) ) 1956.Crossref 7. Roman, P.M., and Trice, H.M.: Schizophrenia and the Poor , Ithaca, NY: School of Industrial and Labor Relations, 1967. 8. Dunham, H.W.: Community and Schizophrenia , Detroit: Wayne State University Press, 1965. 9. Dunham, H.W.: " Social Structures and Mental Disorders: Competing Hypotheses of Explanation ," in Causes of Mental Disorders: A Review of Epidemiological Knowledge , New York: Milbank Memorial Fund, 1961. 10. Robinson, W.S.: Ecological Correlation and the Behavior of Individuals , Amer Soc Rev 15:351-357 ( (June) ) 1950.Crossref 11. Menzel, H.: Comment on Robinson's Ecological Relations and the Behavior of Individuals , Amer Sociol Rev 15:674 ( (Oct) ) 1950. 12. Rowitz, L.: Mental Hospital Utilization by Chicago Residents , Statistical Bulletin, Division of Planning and Evaluation Services, Illinois Department of Mental Health, vol 2, No. 2, June 1967. 13. Park, R.E.: " The City ," in Human Communities , Glencoe: The Free Press, 1952. 14. Kitagawa, E.M., and Taeuber, K.E. (eds.): Local Community Fact Book: Chicago Metropolitan Area , Chicago: University of Chicago Press, Chicago Community Inventory, 1963. 15. Pugh, T.F., and MacMahon, B.: Epidemiologic Findings in U. S. Mental Hospital Data , Boston: Little Brown & Co., 1962. 16. US Bureau of the Census, U. S. Census of Population: 1960, Subject Reports, Inmates of Institutions, Final Report PC (2)-8A. 17. Maris, R.W.: Suicide in Chicago, University of Illinois, Urbana, Ill, unpublished dissertation, 1965.

Kollar, Edward J.;Edgerton, Robert B.;Beckwith, William C.

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110068008pmid: 5680970

Abstract THE purpose of this paper is to document the behavior of the ARL colony chimpanzees. (The ARL Colony is officially designated the Chimpanzee Colony of the 6571st Aeromedical Research Laboratory, Holloman Air Force Base, NM 88330.) Our study is a reflection of the increasing interest in the use of chimpanzees, as well as other Primates, in medical and behavioral research. Because of the development and refinement of electronic telemetering systems, as a "spin off" from space research, neurophysiologists are now in a position to begin studies of the telemetered electrophysiological correlates of the freely moving primate or to study the behavioral effects of telemetered impulses Delivered to specific neural centers and tracts through implanted electrodes. Because of its physiological similarity to man, the chimpanzee is envisioned as a primary animal in these telemetry studies. However, these studies must be done on animals with carefully References 1. Goodall, J.: " Chimpanzees of the Gombe Stream Reserve ," in de Vore, I. (ed.): Primate Behavior , New York: Holt, Rhinehart and Winston, 1965, pp 425-473. 2. Reynolds, V., and Reynolds, F.: " Chimpanzees of the Budongo Forest ," in de Vore, I. (ed.): Primate Behavior , New York: Holt, Rhinehart and Winston, 1965, pp 368-425. 3. Kortlandt, A.: Observing Chimpanzees in the Wild , Sci Amer 206:128-138 ( (May) ) 1962.Crossref 4. Spitz, R.: " Anaclitic Depression ," in Psychoanalytic Study of the Child , International Universities Press, 1946, vol 2. 5. Bowlby, J.: Maternal Care and Mental Health , Geneva: World Health Organization, 1951. 6. Harlow, H.F.: Love in Infant Monkeys , Sci Amer 200:68-74 ( (June) ) 1959.Crossref 7. Goodall, J.: My Life Among Wild Chimpanzees , National Geographic 124:472-308 ( (Dec) ) 1963. 8. van Lawick, J.G.: My Friends, The Wild Chimpanzees , Washington, DC: National Geographic Society, 1967. 9. Wilson, W.L.; Wilson, C.C.; and Beckwith, W.: Patterns of Aggressive Behavior of Captive Chimpanzees Living in a Semi-Free-Ranging Environment , J Ment Nerv Dis , to be published. 10. Morris, R., and Morris, D.: Men and Apes , New York: McGraw Hill, 1966, p 187. 11. Kollar, E.J.; Beckwith, W.; and Edgerton, R.: The Sexual Behavior of the Holloman Vivarium Chimpanzees, to be published. 12. van Zon, J.C.J., and van Orshover, J., as quoted by Kortlandt, A.: Chimpanzee Ecology and Laboratory Management: Reply to Comments by G. H. Bourne and by J. Moor-Jankowski , Laboratory Primate Newsletter 6:10, 1967. 13. Yerkes, R.M.: Chimpanzees: A Laboratory Colony , New Haven, Conn: Yale Univ Press, 1943. 14. van Hooff, J.A.R.A.M.: The Care and Management of Captive Chimpanzees With Special Emphasis on the Ecological Aspects , ARL-TR-67-15, 6571ST Aeromedical Research Laboratory, Holloman AFB, New Mexico, 1967. 15. Davenport, R.K., and Menzel, E.W.: Stereotyped Behavior of the Infant Chimpanzee , Arch Gen Psychiat 8:99-104 ( (Jan) ) 1963.Crossref 16. van Lawick-Goodall, J., and Harris, K.: Our Closest Relations , Observer Rev , (April 30) , 1967, p 10. 17. Mason, W.A.: " The Social Development of Monkeys and Apes ," in de Vore, I. (ed.): Primate Behavior , New York: Holt, Rhinehart and Winston, 1965, pp 514-543. 18. Harlow, H.F.: The Heterosexual Affectional System in Monkeys , Amer Psychol 17:1-9, 1962.Crossref 19. Winnicott, D.W.: Transitional Objects and Transitional Phenomena , Int J Psychoanal 34:89-95 ( (March) ) 1953. 20. Shiller, P.H.: " Innate Motor Action as a Basis of Learning ," in Shiller, C. (ed.): Instinctive Behavior ; New York: International Univ Press, 1957. 21. Kortlandt, A.: Chimpanzee Ecology and Laboratory Management , Laboratory Primate Newsletter 5:1-11, 1966.

Pitts, Ferris N.;Woodruff, Robert A.;Craig, Alan G.;Rich, Charles L.

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110083009pmid: 5680971

Abstract WE BEGAN the systematic evaluation of drug-modification in electroconvulsive treatment (ECT) with a study1 of the two rapid-acting barbiturates most commonly used for ECT induction, thiopental (Pentothal) sodium and sodium methohexital (Brevital Sodium). The electrocardiogram was used as the index of cardiovascular complication, and two series of patients receiving ECT were compared. ECT was induced with thiopental in one series, and with methohexital in the other series, of 500 consecutive treatments. Many more cardiac arrhythmias occurred with thiopental anesthetic induction, providing preliminary evidence that methohexital is safer, as well as more convenient, than thiopental for the induction of brief anesthesia in ECT. A second study of methohexital and pentothal anesthetic induction for ECT confirmed these differences.2 With each patient serving as his own control while atropinization, muscle relaxation, and resuscitation were held constant, four experimental variables were References 1. Pitts, F.N., Jr., et al: Induction of Anesthesia With Methohexital and Thiopental in Electroconvulsive Therapy , New Eng J Med 273:353-360 ( (Aug 12) ) 1965.Crossref 2. Woodruff, R.A., Jr.; Pitts, F.N., Jr.; and McClure, J.N., Jr.: Drug Modification of Electroconvulsive Therapy: I. Methohexital, Thiopental, and Preoxygenation , Arch Gen Psychiat 18:605-611 ( (May) ) 1968.Crossref 3. Steinitz, K.; Eichhorn, F.; and Zelmanowski, S.: Screening Tests for the "Atypical" and "Intermediate" Serum-Cholinesterase Types , Lancet 2:883-884 ( (Oct 26) ) 1963.Crossref 4. Swift, M.R., and LaDu, B.N.: A Rapid Screening Test for Atypical Serum-Cholinesterase , Lancet 1:513-514 ( (March 5) ) 1966.Crossref

Dlin, Barney M.;Fischer, H. Keith;Huddell, Benjamin

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110087010pmid: 5680972

Abstract OUR STUDY, based on experience with and knowledge of the psychiatric complications common before and after heart surgery, holds that each patient undergoing heart surgery should be seen by a psychiatrist for evaluation and treatment. Psychiatric consultation in conjunction with heart surgery is commonly observed now, and we predict that it will be increasingly, but such consultation should be routinely prescribed in each case. We are limited at present by the relatively few psychiatrists trained to work in this field although we have noted great steps forward both medically and surgically. It is estimated that in 1968 approximately 10,000 patients will require a temporary or permanent pacemaker, and that 30,000 to 50,000 patients will undergo open or closed heart surgery. Even in the face of these numbers, there has been little written on the detailed psychodynamics that the patient experiences and works through during this emotionally charged, life threatening References 1. Algazy, K.M., and Fischer, D.H.: Psychophysiologic Responses to Open Heart Surgery, unpublished, Temple University Health Sciences Center: Student Research Program, 1966. 2. Fischer, H.K., et al: Emotional Factors in Coronary Occlusion (Coronary Series No. 2) . Psychosomatics 5:280-291 ( (Sept-Oct) ) 1964.Crossref 3. Rosen, H., and Dascher, J.J.: A Primary Investigation Into the Testing of Memory Impairment Following Open Heart Surgery, unpublished, Temple University Health Sciences Center: Student Research Program, 1967. 4. Allen, J.: A Study of Patient Morale in a Cardiovascular Unit, unpublished, Temple University Health Sciences Center, 1966-1967. 5. Strick, P.: Sound and Motion Studies, unpublished, Temple University Health Sciences Center, 1966-1967. 6. Weiss, E., et al: Emotional Factors in Coronary Occlusion (Coronary Series No. 1) , Arch Intern Med 99:628-641 ( (April) ) 1957.Crossref 7. Dlin, B.M., et al: Psychological Adaptation to Pacemaker Following Cardiac Arrest , Psychosomatics 7:73-80 ( (March-April) ) 1966.Crossref 8. Druss, R.G., and Kornfeld, D.S.: The Survivors of Cardiac Arrest: A Psychiatric Study , JAMA 201:291-296 ( (July) ) 1967.Crossref 9. Abram, H.S.: Adaptation to Open Heart Surgery: A Psychiatric Study of Response to the Threat of Death . Amer J Psychol 122:659-667 ( (Dec) ) 1965. 10. Richter, K.: The Phenomenon of Unexplained Sudden Death in Animals and Man: The Meaning of Death , New York: McGraw-Hill Book Co., Inc., 1959. 11. Burgess, G.N.; Kirklin, J.W.; and Steinhilber, R.M.: Some Psychiatric Aspects of Intracardiac Surgery , Mayo Clin Proc 42:2-12 ( (Jan) ) 1967. 12. Hazan, S.J.: Psychiatric Complications Following Cardiac Surgery: Part 1. A Review Article , J Thorac Cardiov Surg 51:307-319 ( (March) ) 1966. 13. Ruff, G.F.: " Isolation and Sensory Deprivation ," Chapter 24 of the American Handbook of Psychiatry , Vol 3, New York: Basic Books, Inc., 1966. 14. Kornfeld, D.S.; Zimberg, S.; and Malm, J.R.: Psychiatric Complications of Open Heart Surgery , New Eng J Med 273:287-292 ( (Aug) ) 1965.Crossref 15. Hunter, R.C.A.: On the Experience of Nearly Dying , Amer J Psychiat 124:122-126 ( (July) ) 1967. 16. Hilgard, J.R., and Newman, M.F.: Anniversaries in Mental Illness , Psychiatry 27:113-120 ( (Dec) ) 1959. 17. Cannon, W.B.: Voodoo Death , Amer Anthropologist 44:169-181 ( (April-June) ) 1942.Crossref 18. Fox, H.M.; Rizzo, N.D.; and Clifford, S.: Psychological Observations of Patients Undergoing Mitral Surgery , Psychosom Med 16:186-208 ( (May-June) ) 1954.Crossref 19. Engel, G.L., and Schmale, A.H.: Psychoanalytic Theory of Somatic Disorder , J Amer Psychoanal Assoc 15:344-365 ( (April) ) 1967.Crossref

Gershon, Samuel;Shopsin, Baron;Bergen, John R.;Pinckney, Lorraine

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110099011pmid: 5680973

Abstract IN 1947, Sjovall1 reported occurrence of hemoglobin in the urine of mice following injection of serum of schizophrenics and loss of this activity of serum following heating at 56 C for one half hour. Turner and Chipps pursued this lead and in 1966 reported2 that there is an antirabbit heterophil hemolysin of widespread occurrence in human serum. Their study indicated that this hemolysin was present at higher levels in the serum of schizophrenics than those of other persons. The interest aroused by this notion of heterophil hemolysins as another3 potential "biochemical lesion" in schizophrenia prompted further investigation. Operating essentially within the same framework as Turner and Chipps, the data we collected fails to indicate a difference between schizophrenic and nonschizophrenic populations with respect to serum hemolysis of rabbit erythrocytes. Methods Blood was drawn in the morning from fasting subjects. One part of the References 1. Sjovall, T.: Preliminary Studies on a Possible Serum Toxicity in Schizophrenia , Acta Psychiat Neurol ( (suppl) ) 47:105-117, 1947.Crossref 2. Turner, W.J., and Chipps, H.I.: A Heterophil Hemolysin in Human Blood: I. Distribution in Schizophrenics and NonSchizophrenics , Arch Gen Psychiat 15:373-377 ( (Oct) ) 1966.Crossref 3. Friedhoff, A.J., and Van Winkle, E.: Isolation and Characterization of a Compound From the Urine of Schizophrenics , Nature 194:867-868 ( (June) ) 1962.Crossref 4. Kety, S.S.: Biochemical Theories of Schizo Phrenia: I and II , Science 129:1528-1532 ( (June) ) 1959Crossref 5. 1590-1596 (June) 1959. 6. Gershon, S., and Lonigro, A.: A Study of Lymphocytes Stained With Masson's Trichrome Stain in Masson's Trichrome Stain in Psychiatric Patients , J Nerv Ment Dis 138:569-573 ( (Dec) ) 1964.Crossref 7. Shopsin, B., and Gershon, S.: The Effects of Sera From Psychiatric Patients on Guinea-Pig Brain Tissue Respiration, to be published. 8. Kety, S.S.: Biochemical Theories of Schizophrenia , Int J Psychiat 1:409-446 ( (July) ) 1965. 9. Perry, T., et al: Urinary Amines of Intestinal Bacterial Origin , Clin chim Acta 14:116-123 ( (July) ) 1966.Crossref 10. Friedhoff, A.J.: Biochemical Effects of Experimental Diets , J Psychiat Res 5:265-271 ( (Sept) ) 1967.Crossref 11. Horwitt, M.K.: Fact and Artifact in the Biology of Schizophrenia , Science 124:429-430 ( (Sept) ) 1956.Crossref 12. Willoughby, W.F., and Mayer, M.M.: Antibody-Complement Complexes , Science 150:907-908 ( (Nov) ) 1965.Crossref 13. Race, R.R., and Sanger, R.: Blood Groups in Man , 4th ed, Oxford, England: Blackwell Scientific Publications, 1962, pp 49-50. 14. Irvine, D.G., and Miyashita, H.: Blood Types in Relation to Depressions and Schizophrenia: A Preliminary Report , Canad Med Assoc J 92:551-554 ( (March) ) 1965. 15. Cushing, J.E., and Campbell, D.H.: Principles of Immunology , New York: McGraw-Hill Book Co., Inc., 1958 pp 148-149. 16. Friedberger, quoted by Davidson, I.: Heterophilic Antibodies in Serum Disease , J Infect Dis 53:219-229 ( (Sept-Oct) ) 1933.Crossref

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110103012

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In the article "Age, Appearance, and Schizophrenia" by Gottheil and Joseph (Arch Gen Psychiat 19:232-238 [Aug] 1968), Table 5 (cited on page 236) was omitted from the final version of the article. It is printed in its entirety below.

Turner, William J.;Turano, Patricia A.

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110104013pmid: 5680974

Abstract IN AN EARLIER publication in the ARCHIVES OF GENERAL PSYCHIATRY1 we reported the occurrence in human serum of an antibody which hemolyses rabbit erythrocytes. We reported that when a large number of persons, including patients at this hospital, patients in general medical-surgical hospitals, and healthy controls, were studied, a bimodal distribution of hemolysin level was found. Over 70% of schizophrenics but less than 25% of controls gave sera with titres above the low point of the distribution. During two years of work on this system, these findings were extended, with a final N of 616 and a χ2 of 111 differentiating schizophrenics from all other groups. Two other laboratories were unable to confirm our observations. At a third laboratory, differences in hemolysin titre were found to be related to a difference in time of mixing serum and erythrocytes and in the subsequent References 1. Turner, W. J., and Chipps, H.I.: A Heterophil Hemolysin in Human Blood: I. Distribution in Schizophrenics and Nonschizophrenics , Arch Gen Psychiat 15:373-377 ( (Oct) ) 1966.Crossref

Uhlenhuth, E. H.;Lipman, R. S.;Chase, Chevy;Rickels, K.;Fisher, S.;Covi, L.;Park, L. C.

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110107014pmid: 5680975

Abstract AS THE minor tranquilizers gain increasing acceptance in the treatment of ambulatory psychiatric patients, a closer delineation of their clinical effects and the most favorable circumstances for their use become important considerations. This report is one of a series based on a multiclinic, placebocontrolled trial of meprobamate in anxious outpatients, directed toward these questions.1 Method The study was designed originally to determine whether the doctor's expressed attitude toward the prescribed medication influences the effect of the drug (defined as the difference in response to drug and placebo). Psychoneurotic outpatients, 138, manifesting anxiety were treated for six weeks with medication and brief, supportive interviews every two weeks with a psychiatric resident. The patients were divided among 12 (2 X 2 X 3) different treatment conditions composed of: (1) meprobamate 400 mg, q.i.d., vs an identical placebo in a double-blind arrangement; (2) a doctor expressing an enthusiastic attitude toward the medication References 1. Uhlenhuth, E.H., et al: Drug, Doctor's Verbal Attitude and Clinic Setting in the Symptomatic Response to Pharmacotherapy , Psychopharmacologia 9:392-418 ( (July) ) 1966.Crossref 2. Lipman, R.S., et al: Selected Measures of Change in Outpatient Drug Evaluation, read before the annual meeting of the American College of Neuropsychopharmacology, San Juan, PR, December, 1967. 3. Uhlenhuth, E.H.; Duncan, D.B.; and Park, L.C.: " Some Non-pharmacologic Modifiers of the Response to Imipramine in Depressed Psychoneurotic Outpatients: A Confirmatory Study ," in May, P.R.A., and Wittenborn, J.R. (eds.): Psychotropic Drug Response: Advances in Prediction , Springfield, Ill: Charles C Thomas, Publishers, to be published. 4. Mason, A.S., and Sacks, J.M.: Measurement of Attitudes Toward the Tranquilizing Drugs , Dis Nerv Syst 20:457-459 ( (Oct) ) 1959. 5. Fisher, S., et al: Drug Effects and Initial Severity of Symptomatology , Psychopharmacologia 7:57-60 ( (Jan) ) 1965.Crossref 6. Uhlenhuth, E.H., and Park, L.C.: The Influence of Medication (Imipramine) and Doctor in Relieving Depressed Psychoneurotic Outpatients , J Psychiat Res 2:101-122 ( (June) ) 1964.Crossref 7. Wilder, J.: Modern Psychophysiology and the Law of Initial Value , Amer J Psychother 12:199-221 ( (April) ) 1958. 8. Raab, E.; Rickels, K.; and Moore, E.: A Double-Blind Evaluation of Tybamate in Anxious Neurotic Medical Clinic Patients , Amer J Psychiat 120:1005-1007 ( (April) ) 1964. 9. McNair, D.M., et al: Patient Acquiescence and Drug Effects, read before the IV World Congress of Psychiatry, Madrid, September, 1966. 10. Hesbacher, P.T.; Rickels, K.; and Weise, C.: Target Symptoms: A Promising Improvement Criterion in Psychiatric Drug Research , Arch Gen Psychiat 18:595-600 ( (May) ) 1968.Crossref 11. Bahn, A.K.; Conwell, M.; and Hurley, P.: Survey of Private Psychiatric Practice: Report on a Field Test , Arch Gen Psychiat 12:295-30 ( (March) ) 1965.Crossref 12. Gardner, E.A., et al: All Psychiatric Experience in a Community: A Cumulative Survey: Report of the First Year's Experience , Arch Gen Psychiat 9:369-378 ( (Oct) ) 1963.Crossref 13. Uhlenhuth, E.H., and Duncan, D.B.: Subjective Change With Medical Student Therapists: II. Some Determinants of Change in Psychoneurotic Outpatients , Arch Gen Psychiat 18:532-540 ( (May) ) 1968.Crossref 14. Jenner, F.A.; Kerry, R.J.; and Parkin, D.: A Controlled Trial of Methaminodiazepoxide ("Librium," Roche) in the Treatment of Anxiety in Neurotic Patients , J Ment Sci 107:583-589 ( (May) ) 1961. 15. Rickels, K., et al: Humanism in Clinical Research , Psychosomatics 5:315-316 ( (Sept-Oct) ) 1964.Crossref 16. Truax, C.B., and Carkhuff, R.R.: Toward Effective Counseling and Psychotherapy: Training and Practice , Chicago: Aldine, 1967. 17. Uhlenhuth, E.H.; Covi, L.; and Lipman, R.S.: "Indications for Minor Tranquilizers in Anxious Outpatients," in Black, P. (ed.): Drugs and the Brain: Experimental and Clinical Considerations, Baltimore: Johns Hopkins, to be published. 18. Feldman, P.E.: The Personal Element in Psychiatric Research , Amer J Psychiat 113:52-54 ( (July) ) 1956. 19. Kast, E.C., and Loesch, J.: A Contribution to the Methodology of Clinical Appraisal of Drug Action , Psychosom Med 21:228-234 ( (May-June) ) 1959.Crossref 20. Uhlenhuth, E.H., et al: The Symptomatic Relief of Anxiety With Meprobamate, Phenobarbital and Placebo , Amer J Psychiat 115:905-910 ( (April) ) 1959. 21. Rickels, K.: Psychopharmacologic Agents: A Clinical Psychiatrist's Individualistic Point of View: Patient and Doctor Variables , J Nerv Ment Dis 136:540-549 ( (June) ) 1963.Crossref 22. Klett, C.J., and Moseley, E.C.: The Right Drug for the Right Patient , J Consult Psychol 29:546-551 ( (Dec) ) 1965.Crossref 23. Goldberg, S.C.: Prediction of Response to Anti-psychotic Drugs, read before the annual meeting of the American College of Neuropsychopharmacology, San Juan, PR, December, 1967.

Evans, J. I.;Lewis, S. A.

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110119015pmid: 4300660

Abstract IT HAS BEEN shown in many publications1,2 that there are two types of sleep: orthodox or nondreaming sleep and rapid eye movement (REM) or dreaming sleep. The description of these two separate physiological states and the finding that barbiturates have a profound and long-lasting effect on REM sleep3 gave impetus to many recent studies of the effects of drugs on sleep. It has been found that hypnotics,3-5 meprobamate,6 and alcohol7 cause an immediate decrease in REM sleep. With continued administration, tolerance develops so that REM sleep values return to normal. On withdrawal, there is an immediate overswing or "rebound" in REM sleep taking several weeks,3 even from small doses4 of the drug, to return to predrug levels. During some drug withdrawal syndromes, there is an excess of REM sleep. This is true of both alcohol withdrawal8,9 and barbiturate withdrawal.10 In the initial withdrawal period a frequent clinical complaint is what the alcoholic calls "night terrors" and the studies by Greenberg References 1. Jouvet, M.: Neurophysiological States of Sleep , Physiol Rev 47:117-177 ( (Jan) ) 1967. 2. Hartmann, E.: The Biology of Dreaming , Springfield, Ill: Charles C Thomas, Publishers, 1967. 3. Oswald, I., and Priest, R.G.: Five Weeks to Escape the Sleeping Pill Habit , Brit Med J 2:1093-1099 ( (Nov) ) 1965.Crossref 4. Evans, J.I., et al: Sleep and Barbiturates , Brit Med J , to be published. 5. Oswald, I.: " Some Psychophysiological Features of Human Sleep ," in Akert, K.; Bally, C.; and Schadé, J.P. (eds.): Sleep Mechanisms , Amsterdam: Elsevier Publishing Co., 1965, pp 160-169. 6. Oswald, I.; Evans, J.I.; and Lewis, S.A.: " Addictive Drugs Cause Suppression of Paradoxical Sleep With Withdrawal Rebound , in Steinberg, H. (ed.): The Scientific Basis of Drug Dependance , London: J.& A. Churchill (to be published). 7. Yules, R.B.; Freedman, D.X.; and Chandler, K.A.: The Effect of Ethyl Alcohol on Man's EEG Sleep Cycles , Electroenceph Clin Neurophysiol 20:109-111 ( (Feb) ) 1966.Crossref 8. Greenberg, R., and Pearlman, C.: Delirium Tremens and Dreaming , Amer J Psychiat 124:133-142 ( (Aug) ) 1967. 9. Gross, M.M., et al: Sleep Disturbances and Hallucinations in the Acute Alcoholic Psychosis , J Nerv Ment Dis 142:493-514 ( (June) ) 1966.Crossref 10. Evans, J.I., and Lewis, S.A.: A Study of Delirium Due to Drug Withdrawal and an Evaluation of Phenothiazines on Such a Drug Withdrawal State , Electroenceph Clin Neurophysiol (abstracted),to be published. 11. Lewis, S.A.,and Evans,J.I.: Dose Effects of Chlorpromazine on Human Sleep, to be published. 12. Gorden, M.:" Phenothiazines ," in Gordon, M. (ed.): Psychopharmacological Agents , vol 2, New York: Academic Press, Inc., 1967. 13. Agnew, H.W.; Webb, W.B.; and Williams, R.L.: The First-Night Effect: An EEG Study of Sleep , Psychophysiology 2:263-266 ( (March) ) 1966.Crossref 14. Kay, D.C.; Eisenstein, R.B.; and Jasanski, D.R.: Morphine Effect in Human REM Sleep, Waking State, and NREM Sleep , Psychophysiology , to be published. 15. Khazan, N.; Weeks, R., and Schroeder, L.A.: Electroencephalographic, Electromyographic, and Behavioural Correlates During a Cycle of Self-maintained Morphine Addiction in the Rat , J Phatmacol Exp Ther 155:521-531 ( (March) ) 1967. 16. Oswald, I.: Drugs and Sleep, Pharmacol Rev, to be published. 17. Rechtschaffen, A., et al: Nocturnal Sleep of Narcoleptics , Electroenceph Clin Neurophysiol 15:599-609 ( (Aug) ) 1963.Crossref 18. Evans, J.I., and Oswald, I.: Some Experiments in the Chemistry of Narcoleptic Sleep , Brit J Psychiat 112:401-404 ( (April) ) 1966.Crossref 19. Hishikawa, Y., et al: The Nature of Sleep Attack and Other Symptoms of Narcolepsy , Electroenceph Clin Neurophysiol 24:1-10 ( (Jan) ) 1968.Crossref 20. Feinberg, I.:" Sleep Electroencephalographic and Eye Movement Patterns in Patients With Schizoqhrenia and Chronic Brain Syndrome ," in Kety, S.S.; Evarts, E.V.; and Williams, H.L.(eds.): Sleep and Altered States of Consciousness , the Association of Nervous and Mental Diseases, 1967, pp 211-240.

Denney, Duane

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110123016

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Pain-Psychological and Psychiatric Aspects. By H. Mersky, MA, DM, DPM, and F. G. Spear, MD, DPM. Price, $8.50. Pp 223. Williams and Wilkins, 428 E Preston St, Baltimore 21202, 1967. Psychologist Richard Sternbach has written a short monograph with a threefold Purpose: (1) to review recent research literature on pain; (2) to introduce the reader to "linguistic parallelism," ie, an orientation which permits multiple different but parallel descriptions of a phenomenon to be considered of equal validity; and (3), to illustrate how certain concepts appear in different form in several of the languages we use in describing pain. In my opinion, he has achieved his goal. According to the author, pain is a single construct which refers to private experience ("a hurt that we feel"), a stimulus which causes tissue damage or carries the threat of doing so, and an observable series of responses

Sabelli, Hector C.

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110126018

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract As with other volumes of the series of Progress in Brain Research, this publication meets the increasing need for authoritative reviews in an everexpanding field. This volume contains the papers presented at a symposium of the same title (held in connection with the VIth International Congress Collegium Internationale Neuro-psychopharacologium, Washington, DC, 1966); such proceedings often fail to deal with the subject matter in a comprehensive way and the present volume is not an exception. The selection of the topics is much more restricted than the title of the book suggests. Modern electrophysiological techniques, particularly intracellular microelectrode studies, are relatively underemphasized, although the recent investigations of Krnjevic and Curtis have opened new views in the analysis of central depolarizing and hyperpolarizing muscarinic receptors and excitatory nicotinic sites. Differences between nicotinic and muscarinic actions are not analyzed intimately, thereby allowing one of the

Grinker, Roy R.

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110126017

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract This book compiled under the editorship of Marriane Simmel, a loving pupil of Goldstein honors a great investigator of the human mind who died in 1965 at the age of 87. The editor has written the story of his personal life, Walther Riese the eminent historian contributed a chapter concerning "The Man and His Work," and Joseph Meiers collected the extensive bibliography of Goldstein's writings. Within the book are essays by his pupils, colleagues and investigators who have been influenced by Goldstein on subjects related in varying degrees to his creative work. By far the most interesting chapter is Shakow's contributions from schizophrenia to normal psychological function. There is no question that Goldstein has contributed greatly to psychology and psychiatry but his own writings in journals and books give a better idea of his unique creativity. The current volume fails in

Masserman, Juses H.

1968 Archives of General Psychiatry

doi: 10.1001/archpsyc.1968.01740110127019

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract This is a compendium of reports on psychiatric theories and practices in the USSR, East Germany, Hungary, Yugoslavia, Czechoslovakia, Poland, Bulgaria, Rumania, and China, each written by an authority resident in the respective communist country. Ari Kiev's introduction, although occasionally overlaid with statistics, discerningly reviews the political, economic, and doctrinaire evolution of Soviet psychiatry, its rejection of strictly individualistic motivations, (Freud, consequently, is anathema) and its derivative emphasis on the sociocultural determinants of human behavior. Paradoxically, however, psychiatric disorders—which are rising as rapidly in the communist world as elsewhere—are not placed in this context, but are classified as separate no sologic entities somewhat obscurely explicable on Pavlovian principles. Therapy is generally eclectic: there is considerable reliance on ECT, insulin, ataractics and prolonged sleep, but with special emphasis on a warm, personalized, supportive doctor-patient relationship directed toward an early