A Study of an Infant With a Gastric Fistula

Engel, George L.; Reichsman, Franz; Segal, Harry L.

doi:10.1097/00006842-195609000-00002

Cited by 115 publications

(14 citation statements)

References 3 publications

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“…It seems generally consistent with the findings from this research (Engel, Reichsman, & Segal, 1956;Kehoe & Ironside, 1964;Wolf & Wolff, 1943) to say that stomach activity and secretions tend to increase when the individual is interacting emotionally with his environment, whether in a positive or hostile way, and to decrease with reduced interaction, as in withdrawal and depression.…”

supporting

confidence: 89%

Responsivity/nonresponsivity in psychosomatic disorders

Greenwald¹

1984

J. Clin. Psychol.

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Tested the hypothesis that gastrointestinal and dermatological symptoms are associated with differing psychological styles. Specifically, it was predicted that tendencies toward heightened environmental responsiveness and heightened experiences of urges and affects would be associated with gastrointestinal diseases, whereas affectively reduced environmental responsiveness and muted experiences of urges and affects would be associated with dermatological diseases. Forty adult male Ss, 20 in each disease category, were given an open‐ended interview‐the basis for the main test of the hypothesis, the Mayman Early Memory Test, and the TAT. Based on the interview material, coders classified the Ss as predicted at levels well beyond chance. Though the data from the other tests did not provide clear‐cut evidence, they did offer tentative support for the hypothesis. S responses are presented that highlight the contrast between the two styles.

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supporting

confidence: 89%

Responsivity/nonresponsivity in psychosomatic disorders

Greenwald¹

1984

J. Clin. Psychol.

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“…However, it must be admitted that our findings are by no means as clear-cut as those of Engel and his co-workers. 17 The involved relationships and the many complicating factors did not permit us to establish categories as clearly defined and as accurately measurable (certainly as regards the time factor) as those described by Engel.…”

Section: Effect Of the Patient's Interpersonal Relationshipsmentioning

confidence: 94%

“…In a study of a 15-month old infant with a gastric fistula, Engel and his co-workers 17 were able clearly to demonstrate that the emotional and behavioral state of the infant at the time of the collection of the gastric secretions was directly related to changes in the hydrochloric acid secretion of the stomach. They stated: "Outgoing affective states, be they libidinal or aggressive, were associated with rising rates of hydrochloric acid secretion.... During the Depression-Withdrawal reaction .…”

Section: Vol XXIV No S 1962mentioning

confidence: 99%

Changes in Hydrochloric Acid Secretion in a Patient with a Gastric Fistula during Intensive Psychotherapy

Stein

et al. 1962

Psychosomatic Medicine

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After preliminary observation had shown the hydrochloric acid secretion of the stomach of a 60-year-old woman with a gastric fistula to be at persistently high normal levels, observations of the gastric secretions through the fistulous opening were made while the patient was leceiving, simultaneously, although separately, intensive psychotherapy. Eight months after the psychotherapy was begun, the high normal level of the gastric hydrochloric acid dropped abrupdy and remained at a low level for 12 months. A possible explanation is suggested, the methodology is described, and the effects of various parameters, especially the physiologic observations, upon the psychotherapy are noted. The difficulty in accurately correlating the physiological and the psychological data, especially with regard to the time factor, appears to indicate limitations in the method of making physiologic observations at the same time the patient is receiving psychotherapy.

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“…The interest of the investigator affects surgery in dogs (75), gastric acid secretion (160), metabolic changes (76), laboratory procedures (77), and the galvanic skin response (78). It has been described as a crucial variable for successful psychotherapy in sum maries reported at national research conferences on psychotherapy (79,80), the cornerstone of Rogerian non-directive therapy (81)(82)(83)(84), important in behavior therapy, psychotherapy and psychoanalysis (17, 31-33, 36, 39, 41, 48, 49, 50, 67, 85-110), psychochemo therapy (56, 111 -117), the placebo effect (56,75,104,105,(118)(119)(120)(121)(122)(123)(124)(125)(126)(127), hypnosis (128), the success of Shamans (48,129) and quacks (97), and the saving of derelicts by the Salvation Army (130).…”

mentioning

confidence: 99%

Iatroplacebogenics

Shapiro¹

1969

Int Pharmacopsychiatry

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This paper discussed how the psychosociology of the physician contributes to therapeutic and placebo effects. The mechanisms was referred to as iatroplacebogenics, a term describing the study of placebo effects produced by physicians. Iatroplacebogenesis can be direct or indirect. Direct iatroplacebogenesis includes: 1. Attitude to patients, which refers to the therapist’s interest, warmth, friendliness, liking, sympathy, empathy, neutrality, disinterest, hostility, and rejection. 2. Attitude to treatment, which refers to the therapist’s interest, faith, belief, enthusiasm, conviction, commitment, optimism, positive and negative expectations, skepticism, disbelief, and pessimism. 3. Attitude to results, which refers to data distortion caused by random observer effects and by intentional and unintentional nonrandom observer bias. An extensive review of the literature demonstrates that these attitudes of the physician are associated with therapeutic and placebo effects. The explanation of how these factors influence results is less clear, bift the following are suggested: The primary and direct effect of the healer’s interest in the patient is on reduction of guilt. It is also associated with increased potentials for learning, conditioning, suggestibility, catharsis, and it stimulates other factors which have been correlated with placebo effects. The primary and direct effect of the therapist’s interest in treatment is the mobilization of the patient’s hope and optimism. This factor also has a direct effect on reduction of guilt. The direct effect of interest in results is on nonrandom intentional or nonintentional observer bias. Data are influenced, communicated, distorted, and then used to confirm hypotheses. All of these factors may now interact with the potential specific effects of various therapies. Indirect iatroplacebogenesis is a subtle mechanism that has not been considered in the literature. The physician’s interest may be indirect, subtle, and paradoxical. An interest in a theory and method of treatment, despite disinterest in the patient, may produce placebo effects. This occurs when the patient displaces the interest from the therapy to himself and experiences the physician’s interest in his treatment as a personal one. Thus, placebo effects are produced or augmented when the physician is prestigious, dedicated to his theory and therapy, especially if it is of his own innovation, or if he is a recent convert, and when the therapies are elaborate, detailed, expensive, time-consuming, fashionable, esoteric, and dangerous. Data in support of the concept of direct and indirect iatroplacebogenesis were derived from the history of medicine, psychopharmacology, case histories of patients treated with psychochemotherapy and psychoanalysis, and many clinical and experimental studies and observations about placebo and therapeutic effects. The conclusion was reached that although the placebo effect is a multideterminedphenomenon,iatroplacebogenesismay parsimoniously help explain many observations about therapeut...

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A Study of an Infant With a Gastric Fistula

Cited by 115 publications

References 3 publications

Responsivity/nonresponsivity in psychosomatic disorders

Responsivity/nonresponsivity in psychosomatic disorders

Changes in Hydrochloric Acid Secretion in a Patient with a Gastric Fistula during Intensive Psychotherapy

Iatroplacebogenics

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