Personality disorders: an overview for the physician.

Personality disorders are common clinical syndromes that often go unrecognized in medical practice. Because patients with personality disorders receive care in all clinical settings, physicians could profit from a heightened awareness of the personality psychopathology of their patients and its impact on medical practice. Personality traits are universal and describe the "normal" range of behavior, while personality disorders are characterized by enduring maladaptive patterns. The etiology of personality disorders is multifactorial. Physician awareness of the multiple manifestations of specific personality disorders is helpful in matching the proper interventions to appropriate patients. Although management is symptomatically palliative rather than curative, physicians and patients alike can benefit from appropriate recognition and treatment of personality disorders.

Evaluating the mediating effects of social support upon life events and depressive symptoms.

Previous research has yielded inconsistent results regarding the mediating effects of social support upon psychiatric illness. Using data (N = 2029) gathered as part of a major epidemiologic study in the southeastern United States, the authors examine the relationships among depressive symptoms, social support, stressful life events, and socioeconomic status. As anticipated, direct effects were found for social support, stressful life events, and socioeconomic status upon depressive symptoms. However, when the data were analyzed via three-way analysis of variance and multiple regression (including all possible interaction terms) analysis, no statistically significant interactive effects were found. The authors conclude that these findings clearly demonstrate direct effects of social support and stressful life events upon depressive symptoms. Respondents in the lower social support groups experience the greatest impact of stressful life events; in contrast, persons in high social support groups, although evidencing increased symptom scores with increasing numbers of life events, experience the buffering effect of social support by showing less severe distress.

Change and psychopathology: epidemiologic considerations.

The authors report data collected on 3674 subjects between 1970 and 1974 as part of an epidemiologic field survey of mental disorder in the southeastern United States, an area which was undergoing rapid sociocultural change. Rates of mental disorder, as measured by the Global Psychopathology Scale, are presented for various sociodemographic groups and are consistent with trends found in previous studies. Analysis of variance and multiple regression techniques are used to explore the relationships among awareness of social change, sociodemographic variables, and psychopathology. Low awareness of change is found to be consistently associated with low psychopathology scores across all socioeconomic groups. The authors postulate a "denial" or "filter" mechanism which may protect particularly vulnerable individuals from the psychic distress accompanying social change.

Drawings as a therapeutic medium. The treatment of separation anxiety in a 4-year-old boy.

This paper describes a 4-year-old boy whose presenting problem was anxiety. The treatment used is of particular interest because of the graphic exposition of the development of the therapeutic alliance, the immediacy of the Oedipal issues, and the usefulness of child's drawings as a therapeutic medium. The phases of therapy are reflected in the drawings, as is identification with the therapist and the integration of loss when patient and therapist terminate.