The detection of malingered posttraumatic stress disorder with MMPI-2 fake bad indices.

This investigation explored the effect of posttraumatic stress disorder (PTSD) simulation on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) responses, to detect malingered from genuine PTSD. Sixty-four adult PTSD outpatients at a child sexual abuse (CSA) survivor treatment program were compared with 85 adult college students instructed and trained to malinger PTSD. MMPI-2 overreporting indices examined were F, F-Fb, F-K, F(p), Ds2, O-S, OT, and FBS. A stepwise discriminant analysis identified F(p), F-K, and O-S as the best malingering predictors. A predictive discriminant analysis yielded good hit rates for the model, with impressive cross-validation results. Cutoff scores were assessed for the model's predictors. Clinical implications for detecting malingered PTSD using the MMPI-2 are discussed.

How to design smile styles for cosmetic dentistry.

Even though many patients may simply let you choose a smile style for them, once you select it, show it to them for their approval. As Jennifer de St. Georges says, "Inform before you perform. No surprises!" On the other hand, when patients offer verbal descriptions of how they want their smiles to look, there is a lot of room for subjective interpretation. By using photographs and models, much of the confusion can be eliminated. After all, our goal is to make the patient smile.

Inexpensive high-quality full-face patient photographs.

Although even the simplest arrangement for taking extraoral patient photographs is better than no procedure at all, the most practical and efficient solution is to invest in a setup that includes an extraoral camera with electronic dual flash and backdrop screen. Once the components have been set up, and the optimal parameters established, the system is always ready, and taking the pictures is just a snap away. The studio quality of the photographs from this arrangement will provide invaluable contributions to the success of your cosmetic dental practice.

Treating dental disharmony with mixed media.

The art of designing a new smile often involves more than one cosmetic dental procedure. It is not uncommon to combine media such as tooth whitening with porcelain veneers and crowns to create an entirely new smile. To maintain dental harmony, it is paramount that media are indistinguishable from each other and are consistent with the existing dentition.

Achieving anterior aesthetics with an anti-rotational abutment.

Single-tooth implants of various minerals and metals have been used, with some success, since ancient times. However, single-tooth implant survival was unpredictable until Branemark and his co-workers developed the theory and technique for obtaining a predictable direct bone to implant interface, which has been termed "osseointegration." Retrospective studies suggest excellent survival of single-tooth implants that predictably achieve this direct bone to implant interface. Case reports of single-tooth implants in the anterior and posterior areas of the jaws suggest the efficacy of this treatment, although scientific prospective studies evaluating the safety and efficacy of this treatment have only recently begun.

Psychosomatic medicine: some past and current concepts.

Recognition of the body-mind dilemma goes back to antiquity. Growth in medical knowledge has produced an ever increasing emphasis on physiological deviations and somatic pathology--which too often is not accompanied by sufficient attention to the total patients. Psychosomatics is now the term often used by those who believe that illness in man is not usually caused by a single etiological agent. The American Psychosomatic Society succeeded in correlating biological processes with psychodynamics. The Academy of Psychosomatic Medicine had its roots in the belief that psychosomatic medicine belonged to all of medicine. Its goals were to close the gap between medicine and psychiatry. The Japanese Psychosomatic Society chose the best of both in setting its goals. Dunbar's personality profiles and Alexander's concept of specific conflicts are reviewed. Depression is seen to be a common core. Further correlations between depression and psychosomatic illness are evidenced by the work of Greene, Schmale and Engel. The contributions of Nemiah and Sifneos are reviewed. Many psychosomatic patients are noted to be incapable of expressing adequate feelings, which may account for the frequent failure of classical psychoanalytic techniques. The history of research is also reviewed. The role of biochemistry, neurophysiology and psychopharmacology in the understanding and management of psychosomatic problems is examined.