3 research outputs found
Persistent crying in infants and children as an adverse event following immunization: case definition and guidelines for data collection, analysis, and presentation
No full textJan Bonhoeffer, Patricia Vermeer, Scott Halperin, Anne Kempe, Stanley Music, Judy Shindman, Wikke Walop, The Brighton Collaboration Persistent Crying Working Grou
The post-viral fatigue syndrome
No full textPost-viral fatigue syndrome (myalgic encephalomyelitis) is a physically debilitating disorder associated with chronic disabling fatigue. This thesis presents two studies which look at the impact of illness from a personal-psychological and from a family perspective. The first investigates the psychological features of the syndrome. The prevalence of psychiatric disorder in 20 patients with the PVFS was determined. Sixty percent satisfied criteria for a current psychiatric disorder. Diagnoses were of neurotic depression and other neuroses. Only 25 % of a comparatively disabled group of 20 arthritis sufferers received similar diagnoses. Diagnoses did not substantially differ in type from a group of 20 subjects with major depressive disorders, although selected differences in symptom profile and the role of previous life-time psychiatric episodes, suggest that the PVFS cannot be regarded as a variant form of depressive disorder. A logistic regression analysis achieved a satisfactory separation of the two disorders on the basis of psychiatric symptoms. The second study investigates 9 school-aged children with mothers suffering from the syndrome, and 9 children with healthy parents. The children in the PVFS group had been exposed to their mother's illness from between 18 months and 14 years. They were found to have significantly more problems in the school environment in comparison to controls, rated as more shy and anxious, less assertive and with more relationship problems with peers. General family orientation was less active with fewer out-of-home family pursuits. Family interactions were somewhat more negative. Child adjustment is discussed in terms of the linkages between family, school and peer-group in the lives of these children. Investigations into the adaptive potential of such linkages and the permeability of the boundaries between the spheres raise important questions for ameliorative work in the counselling of PVFS sufferers and their families
Brief Psychotherapy for Management of Primary Headaches: a Clinical Grounded Approach
No full textThis research explores the potentialities of psychotherapy for the
management of chronic pain. The model used is brief therapy of systemic
orientation and the chronic pain managed is primary headaches (namely, migraines
and tension-type headaches). In order to produce clinically relevant material, this
research is carried out within an alternative research paradigm. The raw data are the
audio-recordings of two cases: one with a man suffering from migraines; the other
with a woman suffering from chronic tension-type headaches (aggravated by
migraine episodes). These were selected from a pool of cases because they illustrate
the phenomena under study and both completed a follow-up which confirmed an
acceptable headache management outcome. The recordings were transcribed in
order to be studied using discourse analysis of social constructionist orientation (DA
hereafter). The research questions explored are: How were the headache problems,
the therapeutic aims and the resources for managing them constructed during
therapy? What did the participants do with these constructions? How was this
particular type of talk interaction helpful in changing the way these two people
managed their primary headaches?
DA reveals that: (1) the headache problems are entangled in many vicious
cycles, Catch-22 situations and even double-binds, and that these patterns have the
tendency to perpetuate the problems; (2) the meaning of the headaches vary from
one patient to the other, being greatly influenced by their personal experiences,
family histories and interaction with health professionals; (3) these meanings
influence the co-construction of the therapeutic aims, with management (rather
than a cure) emerging as a more achievable goal, with additional auxiliary aims also
becoming very important; (4) specific interventions for managing the headaches and
for achieving the auxiliary aims lead to concrete changes; (5) these changes are
sometimes generalized for other situations, and therapy is seen as a useful resource.
Thus, this study shows some of the potentialities of brief therapy of systemic
orientation to manage primary headaches, producing concrete suggestions that can
be applied in clinical work
