Neurotic Reactions Research Articles

Cognitive deficits in patients after soft tissue injury of the cervical spine.

Fifty-one patients suffering from soft tissue injury of the cervical spine underwent clinical and psychometric examination. Clinical interview evaluated subjective complaints and formal testing of self-estimated cognitive impairment, divided attention, and speed of information processing. Results indicated at least two different syndromes: 1) the "cervicoencephalic syndrome," characterized by headache, fatigue, dizziness, poor concentration, disturbed accommodation, and impaired adaptation to light intensity; and 2) the "lower cervical spine syndrome," which is accompanied by cervical and cervicobrachial pain. When comparing patients with either of these two syndromes, those suffering from cervicoencephalic syndrome had significantly poorer results when tested for divided attention. Speed of information processing was reduced to a comparable extent in both syndromes. These findings were not related to the length of the post-traumatic interval. Reduced processing of working memory is assumed, which may account for more global cognitive problems as well as secondary neurotic reaction.

Aspekte psychischer Störungen bei japanischen Studenten

The present study discusses the reasons which moved 88 students during one year from April 1987 till March 1988 to make their first spontaneous visit to the Department of Psychiatry in the Health Service Center of Tokyo University. The number of patients amounted to 0.60% of the total student enrollment during the period mentioned. The sufferings which motivated their visits could be phenomenally divided into two sectors. The first sector was related to the individual problems of the students and could be sub-divided into somatic and psychic spheres. To the other sector belonged the social or intersubjective relationships with either a general or a special point of reference. The majority of cases (ca. 70% of all patients) fell into the individual sector. Some reasons for this distribution are discussed. Among the patients there was a large percentage of freshmen. This seems to be due to the internal and external milieu changes caused by entering the university life. The ICD-9 diagnosis showed that ca. 80% of the patients exhibited Neurotic disorder and Adjustment reactions. This raises the question of applicability of ICD-9 to minor ailments, frequent among the clients of a Student Health Center. The dominant source of troubles motivating students to seek psychiatric help appeared to be problems connected with the academic life, like entrance into the university, examinations, choice of field of study, and graduation.

Pavlov, psychoanalysis, and neuroses

Pavlov's discovery of experiment neurosis was serendipitous, yet it was made under the influence of Breuer and Freud's case of Anna O. In 1914, Pavlov's disciple N. R. Shenger-Krestovnikova, exploring the limits of visual discrimination in dogs, noticed that when the discrimination was difficult, the dogs' behavior became disorganized. Pavlov drew an analogy between the condition of Shenger-Krestovnikova's dogs and their disorganized behavior with Anna O.'s situation and her neurotic reaction. Pavlov concluded that he had demonstrated in the laboratory the elements of neurosis in animals and human alike. Schilder's criticism of his position, his later study of human neuroses in clinical settings, and the views of Janet may have induced Pavlov to differentiate between animal and human neuroses.

A review of the Rett syndrome with a theory of autism

In a review of results of clinical observations, girls from 2:03 (yrs:mos) at stages III and IV of the Rett syndrome (RS) and autistic children from 4:01 with or without severe mental retardation were compared as to their behavioral traits. Signs of concordance between the extremely low mental, affective and motor developmental levels, such as in the expression of the eyes, are a prominent feature of RS, whereas signs of higher cortical functions that are in contrast with insufficient relations to objects, people and space are a prominent characteristic in autism. It is argued that insistence on sameness, avoidance of social stimuli and self-injurious stereotypies of autistic children are neurotic reactions based on their insufficient object relations. On the basis of the clinical findings a theory is proposed, according to which there exists a system for involuntary contributions to the affective engagement in perception, which is insufficiently developed in autism and in earlier stages of RS. Regarding its structure and function, it is analogous to the phylogenetically old extrapyramidal system and its necessary involuntary emotional contributions to all voluntary movements and postures.

Pathopsychological assessment of the nosological independence of neuroses

In clinical neurology today, there is a revision of the principal positions, which casts doubt on the nosological essence of neuroses. The issues of differential diagnostic criteria of neuroses, boundaries of neuroses and neurotic personality development, accentuation of character traits and decompensation of psychopathies remain rather debatable in psychiatry up to now. Questions of clinical differentiation of psychologically adequate, preclinical, neurotic and psychopathic reactions to frustration are poorly studied. As a consequence, the importance of pathopsychological studies of borderline neuropsychiatric disorders, the study of patients' self-esteem and self-awareness, and the analysis of compensation mechanisms and protective measures that contribute to the prevention of neurosis is growing.

Experience of psychotherapy in the provision of emergency and t emergency medical care

Recently, in the work of doctors at the ambulance and emergency medical care station, a tendency towards an increase in the number of calls for various psychosomatic diseases, situational neurotic reactions, that is, precisely those cases where one of the main methods of treatment is psychotherapy, has been clearly revealed.

Psychodynamic and Family Issues in Post-Divorce Child Custody Litigation

Court requests for evaluation of children and families involved in post-divorce litigation are increasing. The range of situations which may confront the professional, including access problems and requests for change of custody, are described. Eight distinct psycho-dynamic patterns which have been observed in such cases are discussed. These include: 1) normal developmental crises, 2) unresolved grief regarding the divorce, 3) current life crises, 4) recapitulation of familial patterns, 5) projected recapitulation of familial patterns, 6) neurotic reactions, 7) pyschotic reactions, and 8) characterlogical manipulations.

A brief review of organic diseases masquerading as functional illness.

A wide variety of physical diseases masquerade as psychiatric disorders. Clinicians may be distracted by a patient's chief complaint of anxiety, depression, or personality change and fail to pursue the possibility of organic disease. The author provides a brief review of physical diseases that produce psychiatric symptoms. He stresses the danger of misdiagnosis and urges clinicians to remain alert to etiological clues during examination, especially when treating patients who have a history of depression, neurotic reactions, or psychosis.

Neuroses of the Aged

A treatment method which has been used quite successfully in the psychotherapy of the neurotic reactions of the aged is described. Its aim is to reactivate the patient both socially and occupationally. It uses a threefold approach-psychotherapeutic sessions whereby the problems of the patients are discussed and use is made of the tendency of the aged to reminisce. Concurrently the patient is offered the opportunity, and is encouraged, to communicate with others of his age group on everyday topics, and at the same time steps are taken to reactivate him within the limits of his capacities.

Psychiatric consultations in clinical haematology.

A psychiatrist's role in the management of patients with malignant blood disorders being treated by clinical haematologists is described. Twenty-seven patients were seen, the majority (21) for an initial assessment only, and many (21) within three months of diagnosis or their death. Seventeen were referred for assessment of abnormal mood or behaviour and the others for a variety of problems which affected their management. A small group (4) had organic psychosyndromes; the majority (15) were suffering from understandable adjustment reactions, with another 5 having morbid neurotic or depressive reactions. Family and hospital factors were important and a description of these is included in an account of the consultation process.

Precipitating factors of neurotic reactions in middle and upper-middle class Persian women (Iran).

In search of the socio-cultural factors contributing to the development of neurotic reactions in Persian women, the author has examined the records of two hundred and eighty five (285) patients from his private practice in Tehran. Factors to marital conflicts superceded the others by a wide margin. The content of marital conflicts seems to be related to the cultural confusion that has come out of the meeting of the cultural values of the West and the East. The author stresses the role of the communication media in the development of this confusion. In conclusion, implications and limitations of the paper were discussed.

Psychological aspects of chronic pelvic pain in women

Three psychometric tests: (1) A Dutch adjustment of the Minnesota Multiphasic Personality Inventory (MMPI), (2) The Amsterdam Biographical Questionnaire (ABV-V), and (3) The Interpersonal Relations Questionnaire (VIR) were administered to three groups of patients: (1) fifteen patients with chronic pelvic pain without clear organic cause; (2) twenty-two patients with chronic pelvic pain due to endometriosis; and (3) twenty-three pain-free patients. The analysis of the results showed that Groups 1 and 2 did not differ significantly on the MMPI and a global view of the two pain groups indicates a neurotic behavior, but both Groups 1 and 2 differed from Group 3 (the control group) and from Group 4 (the standardization group of the adapted MMPI). On the ABV-V the pain groups' answers were similar to those of neurotic patients, while the patient control group showed a certain neurotic tendency. The results on the VIR lead to the conclusion that Group 2 has the same profile as Group 1, although they did not deviate as strongly from the control group. As it is improbable that chronic pain for which an organic cause has been found occurs predominantly in patients with neurotic personality structure or neurotic reactions, we must admit that chronic pain with an organic origin can lead to neurotic reactions. These data confirm earlier studies on neurologic patients and on patients with chronic low back pain. Because even the patient control group showed a certain neurotic tendency, it follows that every contact with the medical world results in some degree of uncertainty and that the selection of control groups, when psychosomatic problems are being studied, is especially difficult.

Neurotic problems in middle age

Physical, social, and vocational changes characteristic of middle age often activate emotional distress in normal individuals and precipitate overt neurotic illness in predisposed individuals. Since the emotional distress tends to be focused on physical well being and since the neuroses tend to be expressed in somatic symptoms, knowledge of the interactions peculiar to this period can help the physician not only better understand and deal with emotional and neurotic reactions but also better distinguish between organic and psychogenic etiology, thus lessening the possibility of iatrogenic harm.

Extrapyramidal reactions in adolescents treated with high-potency antipsychotics.

Bandura (7) proposed that unless the external conditions controlling a set ofdeviant responses are altered, removal by behavior therapy of one type of maladaptive behavior merely results in the emergence of alternative deviant responses. Wolpe (8) seemed to argue for the presence of an internal ‘ ‘autonomic core of neurotic reactions’ ‘ in his report of the case of an obese woman who became depressed after aversion therapy helped to eliminate her overeating. Kanfer and Phillips (9) suggested that new problems could emerge when a patient encountered previously avoided situations for which he lacked well-learned coping skills. In the case I have described, treatment for needle phobia was successful but produced a marked cxacerbation of the patient’s social and travel phobias. One possible explanation is that his phobias played an essential part in his relationship with his girlfriend and that he was resorting to another set of maladaptive phobic behaviors to secure relative stability in the relationship. Hafner’s recent study (10) ofthe husbands of agoraphobic women seems to substantiate this cxplanation.

The trauma of being psychotic: a neglected element in the management of chronic schizophrenia?

A hypothesis is put forward in regards to what is called "chronic schizophrenia" that those observations which suggest a continuing disease process may turn out not to be intrinsic facets of schizophrenia as a neurochemical instability but rather neurotic reactions to the acute schizophrenic process. The hypothesis goes on to suggest that this reaction to the acute psychosis is such as to constitute a traumatic neurosis and that while controlling the psychosis with an "umbrella" of major tranquilizers, it is possible to resolve this neurosis. Resolution of the neurosis requires a particular approach to therapy. This is a hypothesis which is very much open to experimental examination and one which may, if proven, markedly affect the postpsychosis management of schizophrenia.

Intrapair difference in personality traits, and emotional and social adjustment in monozygotic twins.

During the last decade, there has been a growing interest in the advantages that MZ twin pairs offer for studying the effect of environmental factors on the development of emotional disturbances. Much of this research has been aimed at investigating the relationship between childhood differences and later discordance with regard to schizophrenia in MZ twin pairs. A few studies have used similar methodology to investigate the development of neurotic reactions. There has been very little work dealing with the causes of discordance in the normal personality development of MZ twin pairs. The paper presents some of the results from a larger twin project which show the relationship between childhood differences and differences in adulthood. The study examined differences in oral, obsessive, and hysterical personality traits, as well as differences in phobic fears, general neurotic symptomatology, occupational and marriage adjustment in 50 relatively unselected MZ twin pairs. The results show that many of the same childhood differences which have been reported to be associated with the discordance found in regard to schizophrenia and neuroses, are also related to differences in personality structure, emotional and social adjustment in less disturbed MZ twin pairs. Other childhood differences, however, seem to be more specifically related either to neurotic or to normal personality development, pointing to the importance of studying the relationship between specific intrapair differences in childhood and differences in various areas of later personality development.

Disaster at Buffalo Creek. Family and character change at Buffalo Creek.

Psychiatric evaluation teams used observations of family interaction and psychoanalytically oriented individual interviews to study the psychological aftereffects of the 1972 Buffalo Creek disaster, a tidal wave of sludge and black water released by the collapse of a slag waste dam. Traumatic neurotic reactions were found in 80% of the survivors. Underlying the clinical picture were unresolved grief, survivor shame, and feelings of impotent rage and hopelessness. These clinical findings had persisted for the two years since the flood, and a definite symptom complex labeled the "Buffalo Creek syndrome" was pervasive. The methods used by the survivors to cope with the overwhelming impact of the disaster--first-order defenses, undoing, psychological conservatism, and dehumanization--actually preserved their symptoms and caused disabling character changes.

Psychoneuroses and neurotic reactions in old age.

ABSTRACT: Chronic psychoneuroses that have developed in earlier life are mitigated in the senium. New psychogenic syndromes in old age are either acute reactions to life stress or character developments which accentuate former personality features. The acute psychogenic reactions are manifested as depressive or hypochondriac syndromes, clearly related regarding time and content to the situational burden. Psychiatrists seldom see new psychoneuroses and neurotic reactions in the elderly and such patients are seldom admitted to psychiatric institutions. It is noteworthy that few of these new psychoneuroses are linked to the nearness of death.

Obsessional Symptoms and their Relevance in Schizophrenia

The need to distinguish genuine obsessions from apparently similar states is discussed from a phenomenological and psychoanalytic point of view. Four case-histories are presented to illustrate obsessive-compulsive symptoms associated with different nosological entities; signs of hidden psychosis, particularly non-regressive schizophrenia, are discussed. Psychological tests are performed using techniques well adapted for the differentiation of neurotic and psychotic reactions.

Rejection of motherhood. A psychosomatic appraisal of habitual abortion.

9 HABITUAL ABORTERS (WOMEN WHO CONSISTENTLY MISCARRY WITHOUT SUFFICIENT ORGANIC REASON) were compared with normal subjects in a prolonged psychodynamic study at the Psychosomatic Gynecological Clinic of the Hadassah University Hospital in Jerusalem. The clinical investigation seemed to confirm that habitual aborters have a greater tendency toward phychophysiological reactions under stress than the controls. They seem to have a poorer emotional control as well as a relatively limited ability for planning and for positive anticipation. It seems that as the world did not want them on their terms they rejected the world -- including pregnancy. The investigator assumes that a specific psychodynamic situation (with emphasis on dependency needs) can trigger a chain of biological events leading finally to miscarriage. The author believes that intensive psychotherapy can efficiently counteract the increase of intrapsychic tension. The study also emphasizes the need for intervention after successful deliveries to prevent the development of neurotic reactions toward the newborn. Habitual aborters often become overprotective and develop an obsessive preoccupation with the physical health of their first child.(Authors modified)