International Journal of Social Psychiatry

In a study of 500 formerly hospitalized mentally ill residents of comunity-based sheltered- care facilities in California, results indicate that rehospitalization services as a means of 'updating' the chronic patient's treatment. By returning to the hospital the patient is linked to the service system and its newest benefits accrue to him. In the absence of a care system which can more effectively link chronic patients to available services, rehospitalization may serve an unforseen positive function.

An examination is made of various hypotheses which have been developed to account for the frequently observed inverse relationship between social class and psychological disturbance. Two of these explanations — the social selection and social causation hypotheses — are tested in a study designed to enable an assessment of their relative power to be made. Quasi-random samples of 200 Indian-born, 200 Pakistani-born and 240 native-born residents of England were interviewed and measures of social class, psychological symptoms and other relevant variables made. The results failed to support either of the two hypotheses as the expected social class gradient in psychological disorder only emerged in the native group. Indian immigrants in fact showed a reversal with higher status individuals, especially women, having higher symptom levels. Overall Indian immigrants had significantly fewer symptoms than either of the other groups. The findings are discussed in terms of differential selection for migration and the varying experiences of immigrants after arrival in Britain.

The system desensitization procedure was modified in a manner that more closely approximates learning principles. Selected muscle groups were tensed, then relaxed contiguous with hiearchy item exposure. Subjects treated with traditional SD and subjects treated with the modified desensitization approach (MD) showed significant improvement in approach behaviour and subjective fear rating of the phobic stimulus. Placebo and no- treatment control group demonstrated no improvement.

The experiences of a community-based American methadone clinic and a Dutch residential Therapeutic Community are described. Both programs, which provided comprehensive psychotherapeutic services for a diverse subpopulation of heroin addicts who lived in different cultures independently, discovered that character disordered individuals respond positively to the structured environment and confrontation group psychotherapy orientation which are characteristic of the Therapeutic Community. Both programs modified the initial non-directive model into a structured one adopting the treatment technology of the American Self-Help Therapeutic Communities.

Analysis of recent data collected in a 1977 U.S. national epidemiologic study of substance abuse revealed that Vietnam veterans (N = 87) had substantially higher levels of alcohol con sumption and binge drinking, than comparable groups of Vietnam "era" veterans with no Vietnam service (N = 107), other veterans (N = 483), and nonveterans (N = 2,600). Vietnam veterans and Vietnam era veterans also had a somewhat higher level of drug abuse than expected for individuals from similar social backgrounds. Multiple Classification Analysis (MCA) was the technique used to adjust for demographic differences between these four groups. The results of these analyses reinforced previous research findings and substantiated the President's Commission on Mental Health, which speculated that alcohol abuse may become a special health problem among this population. Since evidence for "post-traumatic" or delayed stress among Vietnam veterans has been culminating, and some research has indicated a link between stress and increased alcohol consumption, it was suggested that the drinking pattern found among this Vietnam veteran sample may be a symptom of post traumatic stress.

Marshall's responsibility-reinforcement therapy with sensation awareness training was used in the treatment of primary nocturnal enuresis in 27 school-age Brazilian children. Significant improvement occurred in 22 children. The most improvement was shown by older children and children in whom a specific developmental delay was suspected as the cause of the enuresis.

Despite some resistances from the nursing personnel, the patients and their relatives, we have realized in the period from 1968 to 1977 the transferral of 78 patients into the family care at Geel. A brief survey of the selection criteria and the composition of this group is presented.

The outcome is analysed with regard to a number of parameters: stability of the family placing, symptoms or behaviour abnormalities, subjective attitude of the patient, interactions with foster family and other persons, occupational activities, distraction, contacts with the own family.

Of the total group, 56 patients are considered as relatively well integrated in the foster family setting. For a large majority of those patients, their social functioning seems enriched and more differentiated.

Parent-child relationship of schizophrenia has been studied and now the family with schizophrenic patient are main focus of the study.