Abstracted from the Medical Press

AUDstracted froEQ the A PSYOHIATRIC STUDY OF PATIENTS WITH REGIONAL ENTERITIS. Oharles V. Ford, Gary A. Glober, and Pietro Oastel1luovo-Tedesco, JAMA, April 11" 1969. Vol. 208, No.2.

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before, and this terminates in a fainting episode like the one he had previously experienced. It is not known whether Jack London was familiar with hypnotic revivification. -AUTHOR'S ABSTRACT

Obsessive-compulsive traits and unresolved dependency conflicts were prominent in 17 patients with regional enteritis studied psychiatrically and medically. These characteristics often contributed to emotional stresses which precipitated attacks. Attacks of enteritis frequently led to changes in family equilibrium which in turn alleviated or removed the original stress. Patients with regional enteritis resembled psychologically descriptions in the literature of patients with ulcerative colitis. The mothers of these patients often were dominant, obsessive-compulsive, and hypochondriacal. Other similarities included low sexual interests, rigidity and inhibition in interpersonal relationships, and comparable Minnesota Multiphasic Personality Inventory test data. Noteworthy is the fact that in enteritis patients there was a high frequency of allergies. -AUTHOR'S ABSTRACT

HYPNOTIC AND NON-HYPNOTIC REVIVIFIOATION WITH SPEOIAL REFERENOE TO JAOK LONDON'S "MARTIN EDEN". Jerome M. Schneck. The Psychicttric Quarterly 42:503507, July 1968.

One of the problems in evaluating hypnotic behavior is the overlap in what is often regarded as hypnotic and what is generally regarded as waking activity. The greater the skepticism about hypnosis, the more the emphasis on similarities to it in the waking state. This emphasis is especially evident in the claims of a few experimental psychologists and is least apparent among experienced hypnotherapists with a dynamic orientation to psychopathology and normal personality functioning. But there is an overlap in hypnotic and non-hypnotic experience. Even revivification which is so closely identified with hypnosis, and often regard as one of its most dramatic attributes, has its ingredients in what is usually not classified as hypnotic behavior. A section in Jack London's novel, Martin Eden, describes an episode of dramatic revivification. It is so suggestive of hypnotic revivification that the present author offers it as an illustration of the overlap stressed here. It involves the intense recollection of a fight in which the hero had participated Ecveral years January-February 1970

THE EFFEOT ON ASTHMA IN OHILDREN OF EXPERIMENTAL SEPARATION FROM THE FAMILY. Kenneth Purcell, Kirk Brady, Hyman Chai, Joan Muser, Leiser Molk, Nathan Gordon, and John Means. PsyCh08om. Med. 31:144, 1969.

This experiment with outpatient children from the Denver community was designed to measure the effects on asthma of separating a child from his family with minimal change of the physical environment in which he lived. Asthmatic children were studied medically and psychologically on a daily basis during periods in which they live!! with their families and during an experimental period in which they had no contact with their families but were cared for in their own homes by a substitute parent. A total of 25 children were evaluated. On the basis of a detailed, structured interview for assessing parental perceptions of the precipitants of asthma attacks, it was predicted that 13 of these children would respond positively (show improvement in asthma) while 12 would respond negatively (show no improvement in asthma) to separation. For the 13 predicted positives, all measurements of asthma including expiratory peak flow rates, amount of medication required, daily history of asthma and daily clinical examination for sounds of wheezing _ indicated significant improvement during the period of family separation for the group as a whole followed by an increase in symptoms upon the family's return home. For the group of 12 predicted negatives, only the daily history suggested improvement during separation. None of the other measurements showed any differences between the separation and nonseparation periods. Statistics for the individual showed that 7 of the 13 predicted positives did indeed improve during separation while 3 of the 12 predicted negatives showed improvement. The degree of change evident in those 10 children who did improve ranged from a moderate reduction to virtually complete elimination of asthmatic symptoms. Clinical methods for assessing the relevance of psychological variables to asthma were briefly discussed as were possible mechanisms indicating the beneficial effects of separation on asthma. -AUTHOR'S ABSTRACT

63

PSYCHOSOMATICS PHYSIOLOGICAL EFFECTS OF RELAXATION TRAINING AND HYPNOTIC SUGGESTION. Gordon L. Paul. J. Abnorm. Psychol. Vol. 74: 425 (1969).

Hypnotherapists have made a point of attributing the success of systematic desensitization to "hypnosis". The abbreviated relaxation training used with desensitization does, indeed, share factors in common with hypnotic induction procedures, such as narrow stimulation, restricted attention, and limited bodily activity. The author has done extensive work in desensitization for reduction of anxiety. In this careful study comparative effects of hypnotic suggestion and brief relaxation training were evaluated with regard to lessening of subjective tension and physical arousal (heart and respiration rate, tonic muscle tension, skin conductance). Each sUbject ylas given two sessions of one or the other method. A third group, the control, was given the direction to sit quietly and relax for the same periods of time. Both the brief relaxation training and the hypnotic suggestion procedure were significantly effective in reducing sUbjective reports of tension and distress, even within a single session. However, the relaxation training produced significantly greater reductions than hypnosis in systems not under voluntary control (heart rate, muscle tension) in both sessions. Thus the author concludes relaxation training is relatively more effective in producing desired physiological changes as well as in reducing subjective symptoms. The findings for hypnotic suggestion support the growing body of evidence that hypnotic phenomena represent nothing discontinuous from other forms of behavior.-ELIZABETH THOMA, Ph.D.

FURTHER EVALUATION OF URINARY 17HYDROXYCORTICOSTEROIDS IN SUICIDAL PATIENTS. William E. Bunney, Jr., Jan A. Fawcett, John M. Davis and Sanford GifJord Arch. Gen. Psychiat. Vol. 21, Aug. 1969, pp. 138-150.

Longitudinal urinary 17-hydroxycorticosteroid (17-OHCS) data have been reported in detail on nine patients who subsequently committed suicide or made a serious suicide attempt. The mean urinary 17-OHCS levels, of both male and female suicidal patients, were significantly elevated when compared to the mean levels of 134 other individuals reported in the psychiatric literature, who had determinations run by the Glenn-Nelson method. 64

The long-term and short-term elevations of urinary 17-QHCS levels were evaluated for each patient. Six of the nine patients showed elevations for an extended period of time prior to the ten days before their suicidal behavior, while four of the six patients on whom data was available showed elevations during the ten days prior to the suicidal behavior. These findings continue to support the possible alerting value to physicians of analyzing urinary steroids in depressed patients. In such patients, repeated high urinary 17OHCS levels should raise the index of concern about suicide. Low urinary 17-QHCS levels may, however, accompany suicide and should not reassure one of the absence of suicidal potential. One of the nine patients reported ran only a few periodically high urinary 17-0HCS levels. The future clinical significance of these findings remains to be fully determined. Hopefully, in the future, sociological, biochemical, and interpersonal data may be combined to increase our abil-' ity to predict suicide potential. -AUTHOR'S ABSTRACT

BLOOD-PRESSURE AND CATECHOLAMINE EXCRETION AFTER MENTAL STRESS IN LABILE HYPERTENSION. P.J. Nestel. Lancet. 7597, Vol. I, 1969 p. 692.

The effect of mild mental stress on blood pressure and excretion of free adrenaline and noradrenaline in the urine was studied in seventeen controls and twenty patients wi':h r.::Id labile hypertension. The mean ages of the two groups were 31.4 and 35.2 years and mean pre-stress pressures were 17/75 and 147/95 mm. Hg, respectively. The mean basal excretion-rates of the catecholamines were not significantly different. The stress, which was of 40 minutes' duration and required the solution of visual puzzles, led to changes in systolic and diastolic pressures which were significantly greater in the hypertensive patients. The output of adrenaline rose in all subjects and was significantly greater among the hypertensives. The output of noradrenaline rose in seventeen hypertensives but in only nine controls, and the mean post-stress value and the mean change in excretion were significantly higher in the hypertensive patients. The changes in bloodpressure were significantly correlated with the changes in catecholamine output in the thirtyseven subjects studied. Labile hypertensive patients show on the average a heightened sympathetic response to mental stress. -AUTHOR'S ABSTRACT

Volume XI

ABSTRAcrS KIDNEY TRANSPLANT AND SHIFTS IN FAMILY DYNAMICS. John P. Kemph, Eric A. Bermana and Henry P. CoppoliUo. Am. J. 01 Psychiatry 125:1.1,85, 1969.

The authors studied the reactions of patients provided with renal homo transplantations and their families. Usually when the family learned of the imminent death of one of its members, one or more relatives offered to donate a kidney. The family then gave much support to the donor. However, shortly after the transplant the major investments of the family returned to the recipient. Some of the intrapsychic and interpersonal shifts - immediate fantasies and alterations in role structure. feelings and attitudes - within these famiHes· are discussed. In niany families the transplant is perceived as a rebirth for the patient, and it therefore serves, at least in fantasy, as an opportunity for vario~ family members, including donor and recipient!;.o redeem or considerably alter identities and roles that they had played within the family for years.-B. R. SHOCHET, M.D. THE WORLD THROUGH MYOPIC EYES. P. Trevor-Roper, Annals 01 Ophthal. Vol. 1, No.1, June-July, 1969, p. 15-20.

This delightful article treats in an historical vein the possible effect of myopia on personality. The poems of short-sighted Keats are compared to those of long-sighted Shelley. Keats images are usually auditory or fantasy, whereas Shelley is endlessly deploying his romantic imagery on prospects of the sky and mountains. The author points out that the myope not only sees reds better than blues but there is an actual color shift, greens being slightly redder to the myope and bluer to the hyperope. The range of natural projection of the myope is projected onto the canvas in such a way we can infer the degree of myopia of Venneer, Van Gogh, Van Dyck, etc.-T. F. SCHLAF.GEL, JR., M.D. CURRENT TRENDS IN GROUP THERAPY WITH CHILDREN. Margaret G. Frank and Joan Zilbach. Internat. J. Group Psychotherapy 18: J,47-~60 (Oct. (68).

The authors view the current scene of group treatment of the latency age child as chaotic and as constituting a crisis in the field. In many situations clinically trained personnel have yielded to the demands of an ever-increasing disturbed population by abandoning a careful diagnostic approach.

January-February 1970

One of the most striking characteristics of the latency age is that it forms a separate subculture, with traditions, games, loyalties, roles, and membership of its own. Child society is a proving ground where the child learns to live with people outside the family. The still-needed support and sense of belonging are now obtained from the peer group. The latency child's need to gauge the success of his developing skills finds expression as he competes with other group members. Based on this theoretical concept, activity group therapy was designed to respond to the needs of the latency child. It supplies therapist, materials, food, and activity, and members are carefully selected to include a range of ego strengths, coping capacities, and problem areas that will allow the children to activate and offset one another. In an atmosphere of acceptance and nonretaliation the therapist moves them to work on the conflicts exposed and helps them acquire new modes of coping. For example, in the face of one child's freely expressing anger, another is mobilized by the sight of it to curb his peer. The therapist responds and gives to both. His position of non-interference implies his trust in the egos of the children to solve and resolve on their own. In spite of the soundness of this method, there are fewer than ten clinical centers offering the traditional training and treatment developed by Slavson. Greater comfort with the talking therapies and the need to save time and money are apparently the obstacles to wider use of the activity concept. Meanwhile other group approaches are being used. In the schools these may be offered in the g-uise of "reading groups". Balance is possible only if the therapist understands not only the presenting symptoms but underlying dynamics of the class "trouble maker", who Is the usual sub.iect. Another modification of the traditional method is seen in hospital groups for discharged schizophrenic children. It has been found that the latency patient with sufficient ego development and social hunger can benefit, at least on the level of acquiring- more socially acceptable behavior. The therapist must be ready to protect the child's frail ego from emerg;ng material. He must respond in words and actions to their fear of destruction. In the residential treatment center the children have responded to deprivation and environmental disorder by lashing out uncontrollably. Here attempts to use the traditional method have resulted in bedlam. The therapists have lacked the training to realize that an entire group of impulse ridden children should not be Involved in treatment in which there are few controls: otherwise the therapist is forced into a prohibiting role.-EUZABETH THOMA