Publications by authors named "Paul Steinberg"

Background: 'Chemsex' refers to the combining of sex and illicit drugs, typically mephedrone, GHB/GBL, and crystal methamphetamine. While numerous studies have examined the role of illicit drugs in sexual risk taking, less attention has been paid to the broader social context and structures of their use among gay men. Given their established role in influencing health related behaviour, this study sought to examine the nature and operation of social norms relating to chemsex among gay men residing in South London.

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Sleep disturbances are a common reaction to stress and are linked to a host of physical and mental health problems. Given the unprecedented demands placed on U.S.

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Background: Chemsex is a colloquial term used by gay men in some parts of the UK to describe the use of psychoactive substances (typically mephedrone, GHB/GBL or crystal methamphetamine) during sex. Use of these drugs by gay men in London appears to have risen sharply from relatively low levels and, as yet, there is little data to inform appropriate harm reduction services. This study sought to understand the personal and social context of chemsex and the nature of harm reduction need.

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Although psychoanalysis and psychodynamic psychotherapy have flourished theoretically and in practice for an increasingly widespread population of patients, the mental health professions have in recent decades experienced a hegemony of managed care, a preoccupation with pharmacological approaches at the expense of psychological approaches, and a predilection for brief symptom-focused, more easily researchable manualized psychotherapies, in spite of literature demonstrating the effective contribution of psychoanalysis and psychodynamic thought to the practice of the mental health professions. In this article a psychiatric inpatient is considered from the point of view of what psychodynamic theory can offer practically to understanding and managing her. It is not suggested that this patient might necessarily benefit from formal psychodynamic psychotherapy, but rather that incorporation of a psychodynamic understanding of her can lead to a more effective management approach, especially regarding dealing with staff reactions to disturbing patients.

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Pathological narcissism is associated with maladaptive interpersonal behavior, although less is known regarding the internal relational representations of narcissistic patients. The authors examined the relationship between pathological narcissism and two constructs that reflect internal representations of relational patterns: quality of object relations and attachment style. Patients attending a psychiatric day treatment program (N = 218) completed measures of narcissism, general psychiatric distress, and attachment style in terms of attachment avoidance and anxiety.

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Running the HIV risk.

Nurs Stand

November 2012

A report from the Health Protection Agency last month revealed that 3,010 men who have sex with men (MSM) were diagnosed with HIV in 2011 - the highest number in any year since the AIDS epidemic began in 1981.

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Objective: Efforts to improve the effectiveness of day treatment should attend to factors that influence treatment response. Our prospective study identified predictors of response to day treatment for personality disorder (PD).

Method: Patients with a PD, consecutively admitted to a day treatment program, were assessed with self-report and interview measures.

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Narcissistic personality disorder is the subject of extensive discussion in the literature. Yet, the validity of this diagnostic category remains questionable. This is owed, in large part, to the relative absence of empirical work that has examined narcissism in clinical samples.

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Background: Premature termination is a common problem in the treatment of personality disorder. Efforts to improve compliance should begin by recognising risk factors for premature termination. This prospective study identified predictors of premature termination from a day treatment program for personality disorder.

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This article considers threats of violence toward third parties during group therapy. An approach to preserve the group work, protect the threatened individuals, maintain the threatening patient's treatment, and protect the group leader medicolegally is described. Obtaining expert legal advice is very important.

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This paper describes the Psychodynamic Psychiatry Service (PPS) of the University of Alberta Hospital over its 30 years of development. This psychiatric organization consists of three clinical programs-an outpatient clinic and intensive day and evening programs-and an integral evaluation and research unit. The PPS is unique in its group therapy clinical orientation, its psychodynamic theoretical orientation, and its integration of an ongoing research program that establishes empirical validation of its clinical work.

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Threats of violence in a group-oriented day treatment program are examined regarding the patient's motivation to make threats, and what occurs among patients and staff that fosters threats. Effects of threats on other patients, the program, and therapists are considered. Management of the threatening patient, the group, and staff reactions are described.

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Background: The Arnold-Chiari malformation type I is characterized by the prolapse of the cerebellar tonsils below the foramen magnum. There is a lack of literature on the management of a pregnancy in a woman affected by an Arnold-Chiari malformation.

Case: A young primipara with severe headaches underwent an elective primary cesarean delivery under general anesthesia successfully.

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Objective: Many allergy patients complain of fatigue, moodiness, and dysphoria during their allergy seasons. This study evaluated the effect of symptomatic allergic rhinitis on both fatigue level and mood.

Method: Symptomatic ragweed allergic rhinitis patients on no medications and healthy control subjects completed the Multi-Dimensional Fatigue Inventory and the Positive Affect-Negative Affect mood rating scales in an in-out-in ragweed season research design.

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