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Kuim(1-3), in describing the efficacy of imipramine (Tofranil) in the treatment of depressed states, underscored the reduced effectiveness of the drug in the aged and in patients with organic 'brain disease. He reported that acute... more
Kuim(1-3), in describing the efficacy of imipramine (Tofranil) in the treatment of depressed states, underscored the reduced effectiveness of the drug in the aged and in patients with organic 'brain disease. He reported that acute toxic psychosis (delir-iuan) did occur as a ...
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This article describes several studies that examine the relationship between the manifest content of selected dreams reported by patients and their clinical progress during psychoanalytic and psychodynamically oriented treatment. There... more
This article describes several studies that examine the relationship between the manifest content of selected dreams reported by patients and their clinical progress during psychoanalytic and psychodynamically oriented treatment. There are a number of elements that dreaming and psychotherapy have in common: affect regulation; conflict resolution; problem-solving; self-awareness; mastery and adaptation. Four different studies examined the relationship between the manifest content of selected dreams and clinical progress during treatment. In each study, the ratings of manifest content and clinical progress by independent observers were rank-ordered and compared. In three of the four studies there was a significant correlation between the rankings of manifest content and the rankings of clinical progress. This finding suggests that the manifest content of dreams can be used as an independent variable to assess clinical progress during psychoanalytic and psychodynamically oriented treatment.
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Bibring's conceptualization of the depres-sive state(9) as relating to overpowering situations of narcissistic frustration has cast doubt on the universality of the classic psychodynamic formulations( 1, 18) of in-ternalized... more
Bibring's conceptualization of the depres-sive state(9) as relating to overpowering situations of narcissistic frustration has cast doubt on the universality of the classic psychodynamic formulations( 1, 18) of in-ternalized aggression in depressions. Engel (15, 16) and ...
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The authors collected the initial dreams of treatment from 63 patients and independently evaluated the manifest dream report (MDR). Variables included: Affect and Valence of Affect; Associations; Psychodynamic Theme; Psychodynamic Theme... more
The authors collected the initial dreams of treatment from 63 patients and independently evaluated the manifest dream report (MDR). Variables included: Affect and Valence of Affect; Associations; Psychodynamic Theme; Psychodynamic Theme as Predictor of Core Psychodynamic Issues; Transference; Gender; Psychodynamic Theme Categories; Clinical Progress in relation to Psychodynamic Theme Categories and Transference. The initial MDR invariably contains Affect that is frequently Negative. The Psychodynamic Themes of MDRs are dependable predictors of Core Psychodynamic Issues that emerge during treatment. Transference is evident in a significant number of MDRs and is often Negative. Gender of the majority of MDRs is predictable. The most frequent Psychodynamic Themes of initial MDRs fall into Relational and Injury Categories. Relational and Injury Themes, as well as Positive and Negative Transference, are associated with clinical progress. This study confirms that the initial MDR of treatment provides a significant amount of clinical and predictive information.
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APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
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A n examination of the dreams of depressed patients revealed that there are measurable changes in dream content which accompany imipramine treatment and clinical improve-nient. The findings are consistent with a view of the intrapsychic... more
A n examination of the dreams of depressed patients revealed that there are measurable changes in dream content which accompany imipramine treatment and clinical improve-nient. The findings are consistent with a view of the intrapsychic condition in de-pression as being high in ...
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... Am J Psychiatry 136:563-566, 1979 BY JAMES K. WALSH, PH.D., MILTON KRAMER, MD, AND JANE E. SKINNER Several hypotheses have been presented to explain rocking and/on head banging (jactatio capitis) before and during sleep. ...
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In the past 30 years, numerous studies have increased our knowledge of the physical process of sleep. One sleep disorder, sleep apnea, has been studied and found to be a serious and life-threatening condition. Diagnosis of sleep disorders... more
In the past 30 years, numerous studies have increased our knowledge of the physical process of sleep. One sleep disorder, sleep apnea, has been studied and found to be a serious and life-threatening condition. Diagnosis of sleep disorders is very difficult and requires the use of sophisticated equipment, highly trained personnel, and a unique environment. To confirm the most dangerous form of sleep apnea, obstructive sleep apnea, fluoroscopic evaluation of the upper airway during sleep was performed. This fluoroscopic evaluation of the upper airway during sleep has been termed "somnofluoroscopy."
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The present study evaluated the efficacy of 25 mg of quazepam, a new benzodiazepine hypnotic, in a population of chronic insomniacs. The results indicate that a single dose (25 mg) administered for one night was efficacious when measured... more
The present study evaluated the efficacy of 25 mg of quazepam, a new benzodiazepine hypnotic, in a population of chronic insomniacs. The results indicate that a single dose (25 mg) administered for one night was efficacious when measured both objectively by polysomnographic recording and subjectively by questionnaire with no reported side-effects. The change in the objective measures paralleled the direction of change in subjective measures. Sleep efficiency and sleep maintenance were improved without EEG changes in Stages 2, 3-4, and REM. Further study is needed to evaluate the effects of chronic administration of different doses of quazepam in chronic insomniacs.
Research Interests: Adolescent, Humans, Male, Sleep, Benzodiazepines, and 6 morePlacebos, Aged, Middle Aged, Adult, Sleep Stages, and Clinical Trials as Topic
The present study investigated the effects of the benzodiazepine, 7-chloro-5-(2-fluorophenyl)-1,3-dihydro-1-(2,2,2-trifluoroethyl)-2H-1,4-benzodiazeepine-2-thione (quazepam), on hypnotic efficacy and sleep staging in chronic insomniacs.... more
The present study investigated the effects of the benzodiazepine, 7-chloro-5-(2-fluorophenyl)-1,3-dihydro-1-(2,2,2-trifluoroethyl)-2H-1,4-benzodiazeepine-2-thione (quazepam), on hypnotic efficacy and sleep staging in chronic insomniacs. We evaluated the acute withdrawal effects of several doses (0, 7.5, 30 and 45 mg) of quazepam. The effects of the different doses were assessed using both objective (polysomnographic) and subjective sleep parameters in a double blind repeated measures design (n = 15). The results indicated that daily administration of quazepam over three nights produced increased effects on sleep which suggested drug accumulation. Lower doses (7.5 and 15 mg) only had significant effects on sleep (sleep induction and maintenance and sleep architecture) with three days of administration, while 45 mg of quazepam produced significant effects on the first night of drug administration. Contrary to previous research investigating longer periods of administration, acute administration of low doses of quazepam did not produce carryover effects on withdrawal, while higher doses did. The accumulation of the parent compound or its active metabolites thus seemed to mediate these effects on sleep in a dose related fashion.
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Insomnia and sleeping pills use have a high prevalence worldwide and epidemiological evidence suggests that they may be associated with a decreased longevity. From this theoretical study, a review of the literature to examine that... more
Insomnia and sleeping pills use have a high prevalence worldwide and epidemiological evidence suggests that they may be associated with a decreased longevity. From this theoretical study, a review of the literature to examine that relationship between insomnia, sleeping pills and decreased longevity was undertaken. Insomnia and sleeping pills use were not consistently associated with an increased mortality rate. The definition of insomnia was poor and inconsistent. In most of the studies it was not determined what ¿sleeping pills¿ participants were taking. The design of the studies, the sample sizes, the age of the subjects, and the follow up period were variable across the studies, which made comparisons difficult. Well designed, prospective double blind, randomized, long-term clinical trials with an adequate number of subjects, and the use of the DSM-IV-TR definition of insomnia are needed to improve our understanding of the relationship between insomnia, hypnotic use and decrease...
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There is great interest in brain function as a result of the new laboratory and imaging techniques in the neurosciences. Psychoanalysis has embraced these contributions without adequate assessment of whether they bridge the mind/brain... more
There is great interest in brain function as a result of the new laboratory and imaging techniques in the neurosciences. Psychoanalysis has embraced these contributions without adequate assessment of whether they bridge the mind/brain divide and provide answers to the questions psychoanalysts ask. A review and critique of the biological theories of dreaming highlights their limitations and points out they do not address the semantics, meaning, and content of dreaming nor the pragmatics of dreaming, its function. At best these theories attempt to provide the syntax of dreaming, the form dreaming takes. Brain biology cannot provide the transduction rules to go from neuronal firing to the psychological experience of dreaming or other mind states.
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ABSTRACT The dream exists as an experience extended in time which can be captured in the dream report as an excellent approximation of the experience. Dreams can be adequately collected and reliably measured. Dream reports are both stable... more
ABSTRACT The dream exists as an experience extended in time which can be captured in the dream report as an excellent approximation of the experience. Dreams can be adequately collected and reliably measured. Dream reports are both stable and variable across time. Dream reports show meaningful content differences in group and individual situations where psychological differences are known to exist. Dreams and waking life are linked and dreams are responsive to the immediate emotional concern of the dreamer. The dream is sufficiently orderly that the search for its meaning is justified. Methods exist to establish the meaning of the dream experience working with dreamer through associations or amplification. A method “Dream Translation” is described in which the meaning of the dream report is explored using the associations of the translator rather than of the dreamers. The translation approach could be used by the clinician to assess whether the patient has improved and to establish the immediate current emotional concern of the patient at initial contact or at points of block in the therapy. Although the dream report has the necessary characteristics to establish a meaning from it; this does not address the possible functional significance of dreaming. I describe here my selective, mood regulatory function of sleep and dreaming. We have explored this question more thoroughly in a monograph on dream function (Moffitt et al., The functions of dreaming, Albany, State University of New York Press, 1993)
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The initial and last manifest dream reports (MDRs) of 30 patients who had either successfully terminated, or continued to make satisfactory progress at an advanced stage of psychodynamic psychotherapy and combined... more
The initial and last manifest dream reports (MDRs) of 30 patients who had either successfully terminated, or continued to make satisfactory progress at an advanced stage of psychodynamic psychotherapy and combined psychotherapy/pharmacotherapy, were rated according to the following variables: Affect and Affect Valence; Affect Valence of Associations and Direction of Association Themes; Dream Narrative; Psychodynamic Formulation; Transference; and Dream Theme. Similar to previous studies, the initial MDRs contained more negative than positive affect. Conversely, the last MDRs contained more positive than negative affect. Associations to initial MDRs contained more negative affect; on the other hand, associations to last MDRs contained more positive affect. Direction of association themes were more negative in initial MDRs and more positive in last MDRs. Dream narratives were more negative in initial MDRs and more positive in last MDRs. Psychodynamic formulations were more negative in...
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These practice parameters are an update of the previously published recommendations regarding use of oral appliances in the treatment of snoring and Obstructive Sleep Apnea (OSA). Oral appliances (OAs) are indicated for use in patients... more
These practice parameters are an update of the previously published recommendations regarding use of oral appliances in the treatment of snoring and Obstructive Sleep Apnea (OSA). Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer them to continuous positive airway pressure (CPAP) therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP. Until there is higher quality evidence to suggest efficacy, CPAP is indicated whenever possible for patients with severe OSA before considering OAs. Oral appliances should be fitted by qualified dental personnel who are trained and experienced in the overall care of oral health, the temporomandibular joint, dental occlusion and associated oral structures. Follow-up polysomnography or an attended cardiorespiratory (Type 3) sleep study is needed to verify efficacy, and may be needed when symptoms of OSA worsen or recur. Patients with OSA who are treated wi...