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De Clérambault’s syndrome
Published in David Enoch, Basant K. Puri, Hadrian Ball, Uncommon Psychiatric Syndromes, 2020
David Enoch, Basant K. Puri, Hadrian Ball
It can be concluded, therefore, that the general therapeutic pessimism associated with the management of the erotomanic syndromes is misplaced. Unfortunately, in clinical practice, it becomes a self-fulfilling prophecy made prior to any substantial trials of treatment. However, a sea-change is occurring, and therapeutic pessimism is giving way to some therapeutic optimism in the light of recent research. We wish to endorse this positive shift in opinion while agreeing that there is a need for more long-term follow-up studies designed to establish more firmly the typology of erotomania, which should have clear therapeutic implications.
Diagnosis: an introduction
Published in Rolf Ahlzén, Martyn Evans, Pekka Louhiala, Raimo Puustinen, Medical Humanities Companion, 2018
Diagnosis sometimes cuts deeply into people’s lives. Like most labelling it has a strong effect on thoughts and feelings and hence also on the sequence of events that will result from it. Diagnosis may in this way play the role of a self-fulfilling prophecy. The way we look at ourselves (as a ‘diabetic’ or ‘psoriatic’ or an ‘epileptic’), and the way others look at us when we are given this label, will step by step transform us into something that we may not want to be. There are open or hidden expectations that strongly form those who carry such ‘sickness roles’, expectations that may be heavy to bear but not easily done away with. Hence, a diagnosis may strip a patient of his personality, of what is uniquely him, and replace it with stereotypical assumptions, hardly conscious for the one who holds them, of what it is to ‘be’ such a diagnosis. Yes, ‘be’ a diagnosis, because in this situation the diagnosis has taken on an existence of its own, has expanded far beyond the purposes for which it was constructed and become an obstacle to any attempt to restore the humanity of the ill. Thus, we still often talk of ‘the brain tumour in room 4’, or the ‘schizophrenic’ next door. Innocent as it may seem, it testifies to the inclination to reify individuals, to make them into their diagnoses.
Risk: What’s that all about then?
Published in Mohanna Kay, Ruth Chambers, Sir Kenneth Caiman, Risk Matters in Healthcare, 2018
Mohanna Kay, Ruth Chambers, Sir Kenneth Caiman
Availability bias leads us to overestimate the likelihood of future events happening if we have had similar events drawn to our attention, perhaps by the media. Confirmation bias results when new evidence is made to fit our understanding of how common an event is or our actions result in a self-fulfilling prophecy. Consider how often we have bought a new car only to suddenly notice them everywhere or how the experience of a miscarriage causes women to see pregnant women around every corner.
What are the demographic and clinical differences between those older adults with traumatic brain injury who receive a neurosurgical intervention to those that do not? A systematic literature review with narrative synthesis
Published in Brain Injury, 2022
Jack W. Barrett, Julia Williams, Joanna Griggs, Simon Skene, Richard Lyon
Discrepancies in the care of older adults suffering from a TBI were highlighted by Skaanser et al (52)., reporting that older adults who received less intensive treatment were likely to have an increased risk of mortality. They propose this has created a self-fulfilling prophecy in the care of this patient group. However, the authors acknowledge that it is unclear whether treatment decisions are due to patient wishes or the clinician’s biases. Kirkman et al (53). noted that older patients were more likely to be reviewed by junior doctors than by senior doctors, who were more likely to review young adults with TBI. The attitudes toward older adults have arguably contributed to a self-fulfilling prophecy where clinicians believe that due to a patient’s older age, their outcomes will be less favorable, choosing to manage their patient conservatively (52). In turn, this approach increases the likelihood of an unfavorable outcome (39,43,52,53), when these patients with TBI may benefit from intensive management (25,43).
A novel scoring system to predict the outcomes of adult patients with hypoxic-ischemic encephalopathy
Published in Expert Review of Neurotherapeutics, 2018
Feng Li, Guangwei Liu, Xin Tian, Fengying Quan, Bosong Li, Guibo Feng, Xuefeng Wang, Yida Hu
Some limitations of this study must be mentioned. First, several suggested variables such as NSE, serum astroglial S100 protein, and magnetic resonance spectroscopy were not investigated in our study, since only a part of the patient family could bear these expense tests. For the same reason, only less than half of the patients were tested for SEP (N20) (Table S3). Magnetic resonance imaging (MRI) is a sensitive tool in detecting brain injury after anoxia [50]. However, since most patients in this study had been receiving invasive ventilator-assisted breathing at the early stage of treatment (1–5 days), after evaluating the benefits and possible risks in the process of the examination, doctors did not perform MRI for these patients. Future studies need to consider the predictive role of these indicators in the scoring system. Second, the small cohort population and unblinded design are major confounders for this study. Self-fulfilling prophecy should be avoided in clinical practice. The accuracy of the CEGL may vary among centers, depending on the availability of EEG monitoring and the experience of the interpretation. Thus, clinicians and family members cannot make a decision to give up treatment only according to the CEGL score. Third, the follow-up period of our study was only six months. Thus, the long-term outcomes of patients could not be inferred based on the present results.
Ethnicity-related stereotypes and their impacts on medical students: A critical narrative review of health professions education literature
Published in Medical Teacher, 2022
Soham Bandyopadhyay, Conor T. Boylan, Yousif G. Baho, Anna Casey, Aqua Asif, Halimah Khalil, Nermin Badwi, Rakesh Patel
A self-fulfilling prophecy is described as a phenomenon where beliefs or expectations – whether correct or not – can become perceived to be true because of people’s behaviours aligning to fulfil a particular stereotype (Kaldis 2013). In this review, self-fulfilling prophecy was described in 6 articles. At an individual level, stereotypes that depicted minority ethnic students as less capable, less valuable, and less successful contributed to minority ethnic individuals changing the way they perceived themselves, acting in a stereotype-consistent way, and confirming to their own erroneous expectations (Kupiri Ackerman-Barger et al., 2015):