Outpatient treatment of primary anorexia nervosa in adult males.

The majority of studies of primary anorexia nervosa have focused on adolescent females. Relatively little has been written on anorectic males, and there has been scarcely any documentation of the occurrence of this disorder in adult males. The present paper describes three cases of adult-onset primary anorexia nervosa in males. For each case, the history and diagnostic patterns are considered, followed by a discussion of the course of outpatient treatment. The therapy was multimodal and included elements of behavioral contingency management, cognitive therapy, and dynamic psychotherapy. Suggestions are made for future research.

Psychological measurement of memory deficits in dialysis patients.

In light of recent research on "dialysis dementia," two questions were raised: (1) Is such dementia an all-or-none phenomenon or is it distributed in severity throughout the population of dialysis patients? (2) Is the dementia related to the uremia itself or to some aspect of dialysis? Memory decline was used as the operational definition of dementia. The Russell revision of the Wechsler Memory Scale was used to measure short- and long-term semantic and figural memory. Results suggested that both semantic and figural memory disturbances were distributed in varying degrees throughout the population of dialysis patients (n = 28). Further findings suggested that figural memory functioning was negatively correlated with the number of dialysis sessions and with the amount of time elapsed since the first dialysis session. Suggestions are made for further research and clinical considerations.

Correlates of the tourniquet ischemia pain ratio.

The Tourniquet Ischemia Pain Ratio was developed as a measure of pain. The present study examined the relationship between the ratio and other measures thought to be relevant to a patient's perception of, and reaction to, chronic pain. The ratio was correlated with the patient's estimate of the pain, the perceived impact of the pain on daily life, the degree of reactive depression, and a measure of hypochondriasis. The ratio relates to both pain and hypochondriacal tendencies.

The pain apperception test: an investigation of concurrent validity.

Gave 55 chronic pain patients the Pain Apperception Test (PAT), the MMPI, the Health Index Index, the Whitely Index, the Pain Estimate, and the Tourniquet Test in an investigation of the concurrent validity of the PAT. The results did not support strongly the concurrent validity of the PAT, given the small number of significant correlations obtained. However, several consistent patterns did emerge: The PAT appeared to be correlated positively with the Alcoholism and Social Introversion scales of the MMPI and with the Invalidism scale of the Health Index. The PAT appeared to be correlated negatively with the Psychopathic Deviate scale of the MMPI. The latter results are discussed with respect to the psychodynamics of chronic pain patients. Further research is suggested, especially with regard to direct pain measures and predictive validity.

Behavior modification in the treatment of hypertension.

This study examines the use of a behavior modification program as an adjunct to the medical treatment of essential hypertension. The subjects, outpatients with medically treated, but uncontrolled, essential hypertension, were exposed to group interaction (including such processes as peer reinforcement, peer competition, and cognitive dissonance), individual blood pressure monitoring, stimulus control, and direct social influence. The control subjects received only routine medical treatment for their hypertension. Results indicated that the experimental subjects significantly decreased their diastolic blood pressures between pre- and post-treatment measures (spanning a period of four weeks), whereas the control subjects showed no such change. Thus it appears possible to use behavior modification to help in the treatment of essential hypertension.

Clinical and psychological test findings in cerebral dyspraxia associated with hemodialysis.

Cerebral dyspraxia associated with hemodialysis is a progressive, fatal syndrome. Patients suffer from a combination of psychiatric and neurological signs and symptoms. Psychiatric manifestations include anxiety, depression, paranoid ideation, and a progressive dementia with impaired concentration, decreased memory, personality changes, and hallucinations. Neurological findings include deliberate speech, stuttering, dysarthria, dyspraxia of speech and movement, tremulousness, myoclonic activity, asterixis, and seizures. These symptoms are aggravated during and immediately following dialysis. Patients usually die within 6 months of its onset. The etiology is unknown. Treatment efforts have failed to reverse its course. Recognition of this syndrome is highlighted so that informed, critical decisions can be made as to whether to continue dialysis therapy.