Sociopsychological Characteristics of Resident Psychiatrists and Their Use of Drug Therapy

Klerman, Gerald L.; Sharaf, Myron R.; Holzman, Mathilda; Levinson, Daniel J.

doi:10.1176/ajp.117.2.111

Cited by 19 publications

(5 citation statements)

References 12 publications

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“…Later studies have shown that professional groups may also differ in 'authoritarianism' (13). Of interest here is an earlier study which by investigating the prescribing habits and attitudes of some American psychiatrists showed that those scoring high on 'authoritarianism' were making a greater use of drugs than their less authoritarian colleagues (14). In a recent study of British hospital psychiatrists, social attitudes and treatment orientation were also shown to correlate : psychiatrists who expressed a preference for physical treatments and considered that interpersonal relationships were relatively insignificant treatment tools, were more likely to have conservative social attitudes than psychiatrists who subscribed to the opposite view of treatment.…”

Section: Attitudes and Valuesmentioning

confidence: 86%

Psychiatric Treatment: the Question of Attitudes

Pallis

1978

Int J Soc Psychiatry

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DESPITE advances in treating mental illness, differences of opinion about the value of existing treatments are deep and continue to attract public attention.Given the unreliability of diagnosis and the lack of specificity of most psychiatric treatments, such differences may seem inevitable. Yet, in everyday practice, when confronted with a patient, his symptoms or his problems, the psychiatrist has to choose from several possible treatments the one he thinks will work. In the absence of adequate knowledge, how does he embark on a particular treatment which may have to be continued for a long period?Since the care of the behaviourally disturbed person and responsibility for mental health has for social and historical reasons been largely assigned to the medically qualified psychiatrist, the greater reliance on a medical 'illness model' seems inevitable. In psychiatric hospitals or in community services, however, non-medical personnel, such as nurses and social workers, are not only expected to provide support for medically prescribed therapeutic regimes but they may also actively participate in treatment decisions. Although it is a common experience that attitudes to psychiatric treatment affect the communication between professional workers and their contacts with patients, this subject has not attracted the research interest it deserves. The available evidence, however, does suggest the existence of broad therapeutic preferences which in practice may result in adoption of relatively ineffective methods of treatment. This paper aims to review some of these findings and discuss their implications. THE PSYCHIATRIST Treatment OrientationStudies of psychiatrists' attitudes to treatment both in Britain and the United States have provided broadly comparable results, despite the socio-cultural and training differences between the two countries. By investigating psychiatrists in a London teaching hospital, Kreitman (1) was able to describe, like earlier American investigators (2), two distinct orientations, an 'analytical' and an 'organic' one; the former deriving mainly from psycho-analytic theory, stresses the importance of interpersonal relations in treatment while the latter concentrates more on the 'mental illness' aspect of psychiatric disorders and the use of physical treatments. These findings were largely supported by a subsequent study which used an empirically derived scale to measure attitudes to treatment and to professional roles within a psychiatric hospital (3). Although the sample studied was not an entirely representative one, Caine and Smail (3) were able to identify three 'psychologically distinct' attitudes to treatment indicating preferences for physical treatments, group therapy and individual psychotherapy. Their first attitude component was the best discriminator between an 'organic' and a 'psychological' treatment orientation. A further testing of a new sample of British hospital psychiatrists (4) has shown that they differ primarily in their acceptance or rejection of the 'organic' attitude to ...

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Section: Attitudes and Valuesmentioning

confidence: 86%

Psychiatric Treatment: the Question of Attitudes

Pallis

1978

Int J Soc Psychiatry

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“…Data recently gathered on the occupational and educational characteristics of patients in psychoanalysis offer useful leads for research on the possibilities and limitations of psychoanalytic treatment. Equally interesting leads for studying the role of the therapist in various types of psychotherapy might be found in data on the personal and social characteristics of therapists having various professional backgrounds and theoretical persuasions (Sharaf & Levinson, 1957;Klerman et al, 1960).…”

Section: Some Research Problemsmentioning

confidence: 99%

The Psychotherapist's Contribution to the Patient's Treatment Career.

Levinson¹

Research in Psychotherapy.

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“…They also place relatively greater value upon manifest status differences, sense of duty, and self-control than the psychiatrists who are low drug users. (Klerman et al ., 1960: 114)In their assessment of the role of drugs in psychiatry, the researchers noted that the process of handing down a drug to a patient contained a risk of control over the patient, one that the psychiatry trainees should be educated to identify.…”

Section: Student and Resident Selection And Evaluationmentioning

confidence: 99%

“…They also place relatively greater value upon manifest status differences, sense of duty, and self-control than the psychiatrists who are low drug users. (Klerman et al ., 1960: 114)…”

Section: Student and Resident Selection And Evaluationmentioning

confidence: 99%

“…We observed that their aversion to acting in an assertive or directive manner was laden with emotion, indicating that this was an area of conflict for them. It may be that these concerns relate to their resistance to accepting the learning of techniques in drug therapy as part of their psychiatric skills.The team concluded that it was critical for residency programs to recognize the role of the personal characteristics of psychiatry residents to guard against potential misuses of power (Klerman et al ., 1960: 116). Further, the team encouraged educators to use their ability to judge and assess personalities to interpret the residents as part of the training program.…”

Section: Student and Resident Selection And Evaluationmentioning

confidence: 99%

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Managing power and psychiatric training in the United States, 1945–1990

Hirshbein

2023

History of the Human Sciences

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In the wake of their heightened role in addressing the emotional challenges of United States soldiers during World War II, American psychiatrists increasingly argued that their knowledge of human nature, based on interpretation of unconscious processes, was a powerful tool in effecting changes in society. As they turned to training an adequate supply of psychiatrists to meet expanding demand, educators in psychiatry residency programs faced questions about whom to entrust with the power of psychiatric interpretation, how educators’ knowledge about trainees’ own unconscious processes should be harnessed, and how much to adhere to strict psychoanalytic doctrine in training. During the 1970s, social and cultural upheavals outside and inside psychiatry began to dismantle the grand claims of the postwar generation of psychiatrists, while shifts in the 1980s led educators to focus more on seemingly objective educational measures. Trainees’ and critics’ serious questioning of authority and structures in American society, and within psychiatry training programs, was perhaps as much of a factor – if not more – in the shift away from an emphasis on the interpretive power of psychoanalysis in favor of more eclectic and ultimately biological approaches in academic psychiatry.

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Sociopsychological Characteristics of Resident Psychiatrists and Their Use of Drug Therapy

Cited by 19 publications

References 12 publications

Psychiatric Treatment: the Question of Attitudes

Psychiatric Treatment: the Question of Attitudes

The Psychotherapist's Contribution to the Patient's Treatment Career.

Managing power and psychiatric training in the United States, 1945–1990

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