Psychiatry Commons^™

The Usefulness Of Neutrality, Julia Jones Zawatsky, Md

Jefferson Journal of Psychiatry

Recently, the idea of therapeutic neutrality has been attacked. Many observers have suggested that the neutral therapist is inhuman and unempathic. Actually, being a neutral therapist means being especially human and empathic. The neutral therapist's empathic contact with the patient is the most extensive in that it includes not only contact with feelings and thoughts of which the patient is aware, but also contact with all those intolerable thoughts and feelings of which the patient prefers to be unaware. Such awareness in the therapist is possible only when the therapist remains, as Anna Freud (I) recommends, equidistant from the patient's …

Trauma And Its Ramifications In Vietnamese Victims Of Piracy, Stuart Kleinman, Md

Jefferson Journal of Psychiatry

Approximately 400,000 Vietnamese fled by boat from their homeland to the United States during the years 1975 to 1985. Many of these people were brutally attacked by pirates during their sojourn. This paper is a preliminary investigation of various ramifications of this trauma in seven Vietnamese "boat people."

We found significant psychopathology which is temporally related to the pirate attacks in two of those interviewed and a prominent absence of survivor guilt in all of those interviewed. Factors such as mastery of previous trauma, advanced knowledge of potential traumata, empowerment fantasies, religious beliefs, and altruistic actions may have helped people …

Mead Johnson Award-1987

Jefferson Journal of Psychiatry

The editorial board of The Jefferson Journal of Psychiatry-A Resident Publication is pleased to announce the winner of the first annual Mead Johnson Award for excellence in writing as submitted to the Journal. Paul V. Trad, M.D. has received the one thousand dollar award for his work, "Infant Depression: Nature Seeking Nurture " (JP 5( 1) 15-33, 1987 ). His ambitious synthesis exemplifies the creative potential with in residency and fellowship programs. We hope that this further acknowledgement of Dr. Trad 's work will help to inspire other trainees to undertake such …

Editor's Column, Gregory B. Sullivan, Md

Jefferson Journal of Psychiatry

As the Jefferson Journal of Psychiatry continues in its early growth phase, having accomplished a successful synthesis to become a national publication, we note its own apparent power of accommodation equal to the strain of fusing and adjusting internal and external changes.

Psychiatric residency in itself demands such accommodation. A group of finishing second year residents were taking stock of the fir st half of this process: They noted the difficulty in reconciling their initial conceptions and intentions with the subsequent realization of the limits to knowledge or intervention; they called this disillusionment. Others spoke of a converse strengthening …

Resident Editorial Board

Jefferson Journal of Psychiatry

List of Resident Editorial Board for Volume 5, Issue 2, 1987.

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor.

In Response: New Controversial Diagnoses: Self-Defeating And Sadistic Personality Disorders, Frederic Kass, Md

Jefferson Journal of Psychiatry

Until several years ago the entire literature on Masochistic Personality was theoretical or anecdotal. Dr. Fuller's recent paper, "Masochistic Personality Disorder: A Diagnosis Under Consideration," is a timely contribution in that it is one of a growing number of empirical studies on this topic (1). His major finding, that Masochistic Personality describes a disorder which is not adequately described by the existing Axis II disorders, is consistent with data we recently reported (2). We have found, in addition, that the diagnosis is common, and that the criteria have good internal consistency, specificity, and sensitivity (3,4). At this point the data …

Commentary

Jefferson Journal of Psychiatry

DR. KRAMER COMMENTS ON PSYCHOACTIVITY OF CALCIUM CHANNEL BLOCKERS, CASE REPORTS, AND RESEARCH.

Worthwhile Supplemental Reading For Psychiatrists-In-Training, A. Kenneth Fuller, Md

Jefferson Journal of Psychiatry

Book Reviews of:

MODERN SYNOPSIS OF COMPREHENSIVE TEXTBOOK OF PSYCHIATRY/IV

Harold I. Kaplan and Benjamin J. Sadock,

4th ed.Baltimore, Williams & Wilkins, 1985, 937 pages, $38.50

STUDY GUIDE AND SELF-EXAMINATION REVIEW FOR MODERN SYNOPSIS OF COMPREHENSIVE TEXTBOOK OF PSYCHIATRY/IV

Harold I. Kaplan and Benjamin J. Sadock, 2nd ed.Baltimore, Williams & Wilkins,1985, 551 pages, $22.95

Book Review: The Feel Of The Road, Gregory B. Sullivan, Md

Jefferson Journal of Psychiatry

Book Review:

A PRIMER FOR PSYCHOTHERAPISTS

Kenneth Mark Colby, M.D.

New York, John Wiley and Sons, 195I, 167 pages,

$29 .95

Book Review: A Comprehensive Guide To Cognitive Therapy Techniques, Michael S. Greenberg, Phd

Jefferson Journal of Psychiatry

Book Review of:

HANDBOOK OF COGITIVE THERAPY TECHNIQUES

Rian E. McMullin, Ph .D.

New York, W.W. Norton, 1986, 356 pages, $34.95

Treatment Of The Negative Symptoms Of Schizophrenia With Verapamil, William A. Price, Md, Dawn Heil

Jefferson Journal of Psychiatry

The illness of schizophrenia, as it is understood today, appears to consist of a heterogeneous group of disorders which share several common features, such as partial response to medications, poor long-term prognosis, and the presence of psychotic symptoms. These psychotic symptoms have been arbitrarily divided into two subgroups, positive and negative, in an attempt to better understand this disease process (1,2). The positive symptoms, such as delusions and hallucinations, generally have an acute onset with frequent exacerbations and remissions and a favorable long-term prognosis and response to medications. The negative symptoms, which include affective blunting , social withdrawal, apathy, and …

Masson's Assault On Truth: A Critique, Emmanuel E. Garcia, Md

Jefferson Journal of Psychiatry

In his book, The Assault on Truth, j. M. Masson (I) proposes to challenge the very foundations of psychoanalysis by showing how Freud 's abandonment of the so-called seduction theory of the etiology of neurosis was erroneously predicated.

Masson's argument, in essence, may be summarized as follows. Freud, while studying with the eminent neurologist Charcot in Paris (from October 1885 to February 1886), found himself exposed to the prevalent horrors of ch ild abuse, which were copiously detailed in the French medical literature at the time, and which were very probably demonstrated to him at the …

Should Psychotherapy Be Taught To Psychiatric Residents? A Debate., Donald W. Black, Md, John Ascher, Md, Hal Cash, Md, John Markowitz, Md, Paul Hamburg, Md, Jeffrey Satinover, Md, Alan Mellow, Md

Jefferson Journal of Psychiatry

Much of this discussion was inspired by a debate held at the 1984 APA Annual Meeting, entitled " Does Psychodynamic Theory Have Little Relevance to Contemporary Psychiatric Care?" We saw the need for a debate, resident generated, that would address a corollary issue in residency training.

Our program will include an introduction, a debate involving statements for the affirmative, that is, that psychotherapy should be taught to psychiatric residents, and two statements for the negative, that psychotherapy should not be taught to psychiatric residents. Concluding remarks will follow.

If our title is provocative , if what we have to say …

A Review Of Ethnopsychiatric Studies Of Depression, Nancy E. Wilson, Ab, Daniel R. Wilson, Md

Jefferson Journal of Psychiatry

One of the common goals in medical anthropology is to elucidate the significance of culture in determining health and thus clarify the complex biopsychosocial model to provide better, more appropriate care (I). Prominent among environmental influences is the society in which a person develops: and it is his position in this constellation of people, with their shared ethos and world view, which molds experience, cognition, and affect (2). Cultural meanings, norms, and power arrangements shape illness to a great degree by defining the sick role and consequent illness behaviors. Medical anthropology, as a discipline, has among its concerns the cultural …

Reflections On The Psychotherapy Of A Patient With Multiple Personality Disorder, David Fink, Md

Jefferson Journal of Psychiatry

Historically, the diagnosis of Multiple Personality Disorder (MPD) has generated curiosity, fascination, skepticism, and disbelief. From the first reported cases in the early nineteenth century, controversy has abounded about the plausibility of the many dramatic manifestations of the illness, its pathogenesis, and appropriate approaches to its treatment (I). From the midst of scientific controversy and debate, a more refined conceptualization of the illness is being developed, particularly since the recent inclusion of the diagnosis in DSM-III (2). Noteworthy among these advances are the theories of pathogenesis described by Kluft (3), and Braun and Sachs (4) which …

Infant Depression: Nature Seeking Nurture, Paul V. Trad, Md

Jefferson Journal of Psychiatry

Of the numerous clinical and theoretical problems confronting medicine today, infant depression represents an increasingly compelling and misunderstood concern (1). Early studies notwithstanding, the concept of infant depression remains in the embryonic and evolving stages of clarification. In studying infant depression, the clinical investigator is initially faced with the difficulty of devising a specific operational definition. Several definitional schemes have been proposed. The first advocates that depression is a proliferative idea that retains a concrete, immutable definition; another scheme argues that depressive affect, a key index of the disorder, is merely an illusory signal that masks the underlying process; still …

Hypnosis In The Criminal Case: Facts And Fallacies, Phyllis E. Amabile, Jd, Md, Thomas H. Jobe, Md

Jefferson Journal of Psychiatry

Throughout the past century, criminal cases have been documented in which a party has sought to introduce into evidence information obtained through the process of hypnosis. The usefulness of the technique of hypnosis in various psychological the rapies has already been well established. The courts, however, have differed markedly in their decisions on the admissibility of hypnotic material into evidence. Consequently, no clear rationale or guidelines for admissibility have been established.

Editor's Column, Jeffrey R. Sarnoff, Md

Jefferson Journal of Psychiatry

As this issue of the Journal goes to press, it seems apt to reflect upon several years of editorship. An esteemed colleague, Gregory B. Sullivan , M.D .,is in the process of taking over the responsibilities of Chief Editor; the Journal is in able hands as I move on to other endeavors.

Since its inception nearly five years ago, th e Journal has flourished , riding out occasional rough weather in its course from a local to a national publication. Many residents and faculty members have worked with spirit and diligence to foster its growth ; I am thankful for …

Resident Editorial Board

Jefferson Journal of Psychiatry

Resident Editorial Board for Volume 5, Number 1, Winter 1987 for Jefferson Journal of Psychiatry.

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor.

In Response: The Biological Basis And Treatment Of Bulimia, Jeffrey M. Jonas, Md

Jefferson Journal of Psychiatry

The recent papers in the Jefferson J ournal of Psychiatry by Drs. Levin ("Bulimia as a Masturbatory Equivalent, " July, 1985) and Wilson ("A Discussion of 'Bulimia as a Masturbatory Equivalent'," Winter, 1986) contain a number of theories and recommendations about the etiology and treatment of bulimia which should be addressed. In large measure, both papers present a dynamic view of this disorder. However, psychodynamic formulations are but one of many theories put forward to explain this disorder. Other theories of etiology include notions that bulimia arises from cultural factors and an increased attention to body image, from disorders with …

Rome To Cologne, Jeffrey R. Sarnoff, Md

Jefferson Journal of Psychiatry

Book review: WHAT'S TO BECOME OF THE BOY? OR, SOMETHING TO DO WITH BOOKS

A memoir by Heinrich B611, translated by Leila Vennewitz New York, Penguin Books, 1985, 82 pp., $4 .95

Synthetic Heroin-Induced Parkinsonism, B.K. Gupta, Md

Jefferson Journal of Psychiatry

Parkinson's disease is a slowly progressive, neurodegenerative disorder affecting one in 1,000 of the general population; its incidence increases with age, but the cause remains unknown. The disease is characterized pathologically by a loss of neurons from the pigmented substantia nigra pars compacta, and a triad of physical symptoms of rigidity, tremor, and bradykinesia or akinesia . Thus the clinical condition of Parkinson's disease is a rather complex disorder with a variety of physical symptoms due to neuronal damage in a number of brain regions. Additional brain regions also affected in clinical Parkinson's disease include the ventral tegmental area, locus …

Psychosis In A Case Of Mycoplasma Pneumonia Encephalopathy, Alan Jay Cohen, Md

Jefferson Journal of Psychiatry

Mycoplasma pneumonia, a well known cause of acute respiratory infection in man, has been reported to frequently include central nervous system manifestations as part of its clinical course (1,2). The spectrum of neurologic syndromes associated with the disease is vast, ranging from direct invasion of brain and meninges by the organism to non-invasive parainfectious encephalopathy (3). This is a case report of an individual who presented to the emergency room in an acute psychotic state as the single manifestation of a parainfectious encephalopathy secondary to mycoplasma pneumonia infection of the lung.

Brief Reports: Depressive Phenomena In Infants, Vanshdeep Sharma, Md

Jefferson Journal of Psychiatry

Interest in childhood depression is demonstrated by an increasing amount of research in the area. A review of literature suggests that depression as a clinical entity is observable in children ( I ).

Body-Snatching: Medicine And The Cartesian Threat, Mark D. Sullivan, Md, Phd

Jefferson Journal of Psychiatry

Twentieth century physicians are proud to be biological scientists. It is this feature above all others that distinguishes us from our predecessors. Because it is the badge of our progress in medicine, biology is often considered the essential core of medical care. Indeed, we can become so focused upon the biology inmedicine that all other aspects of caring for patients fade into a murky background of ill-defined sentimentality.

Different Perspectives Of Psychiatry Within Two Neighboring Residency Training Programs, Bruce Rosenblum, Md

Jefferson Journal of Psychiatry

This paper arises out of my fortunate opportunity to observe two very different psychiatric residency training programs. While a fourth-year resident at a large, psycho dynamically-oriented private psychiatric hospital, I was able to do a consultation liaison rotation at a neighboring academic institution at the vanguard of biological psychiatry. I left the familiar, we ll-manicured suburban grounds for the inner city of Baltimore to be one of the first experiments in "cross-fertilization" between these residency training programs. Although the two institutions are located in the same city and stem from the early history of American psychiatry, they have been worlds …

Dynamic Considerations In Psychiatric Crisis Intervention, Keith Cheng, Md

Jefferson Journal of Psychiatry

One of the most challenging tasks for psychiatrists and psychiatric residents is emergency room triage. This task becomes more frequent as more patients depend on the emergency room for psychiatric treatment. Various social and economic pressures account for an increased utilization of psychiatric triage. The government funds that were to provide community care for the ex-patients of state hospitals have never materialized in adequate amounts (1). Many of these patients become dependent transients who in a crisis must use the emergency room as a psychiatric clinic. To keep premiums down, some insurance companies have eliminated their outpatient psychiatric coverage, often …

Treatment Of Mental Disorders In Pregnancy: A Review Of Neuroleptics, Antidepressants, And Lithium Carbonate, Lawrence L. Kerns, Md

Jefferson Journal of Psychiatry

Pregnancy is frequently complicated by the development or recurrence of a serious mental disorder; neurotic, major affective, and psychotic illnesses have all been observed (1-4). When a major mental disorder arises in a pregnant woman and threatens the health or life of the patient and/or fetus, it should be treated early and aggressively to minimize complications and forestall the advance of the disease. Nonbiologic methods like individual psychotherapy, couples or family therapy, social casework, and hospitalization in a supportive, structured milieu should form the first line of treatment. Electroconvulsive therapy (ECT) may be the treatment of choice for some patients, …