James Boehnlein - Academia.edu (original) (raw)
Papers by James Boehnlein
Prospects, 1999
Scholarship about Depression-era proletarian literature has had to adapt itself to new political ... more Scholarship about Depression-era proletarian literature has had to adapt itself to new political and social realities since 1984. With the collapse of socialism in Eastern Europe and Soviet Russia, literary analyses of texts written in the atmosphere of the Communist-led cultural movement may seem to lose currency; to argue for the relevancy at the close of the 20th century may seem irrelevant to postmodern aesthetics. Likewise, as Barbara Foley suggests, reading proletarian texts with their self-conscious critiques of class struggle and their formulaic and didactic plots offers little to audiences who are used to postmodern experimentation and “confessional” poetics (viii).
The Journal of Nervous and Mental Disease, 1991
Journal of the American Academy of Psychiatry and the Law Online, 2010
The journal of the American Academy of Psychiatry and the Law, 2010
Individuals fleeing persecution have the right to asylum. This most fundamental right was guarant... more Individuals fleeing persecution have the right to asylum. This most fundamental right was guaranteed by the 1951 United Nations (UN) Convention Relating to the Status of Refugees and was implemented in the 1967 UN protocol regarding refugee status. The United States codified refugee protection and the procedures for asylum in the Refugee Act of 1980, which was made part of the Immigration and Nationality Act (INA). In claiming refugee status, the burden of proof rests with the asylum seeker and is often a daunting task, given language and cultural barriers, lack of knowledge about U.S. legal procedures, and the reality that oppressive states do not document their intentions to persecute dissidents. Forensic psychiatrists may be asked to provide mental health assessment in immigration cases. In this article, an example of a Central American man with a nontraditional but increasingly common request for asylum is presented, the asylum process is described, and the role of the forensic ...
Journal of psychiatric practice, 2007
This article reviews the neurobiologic rationale for and presents clinical guidance concerning th... more This article reviews the neurobiologic rationale for and presents clinical guidance concerning the use of medications that reduce central nervous system noradrenergic activity in the treatment of intrusive symptoms of posttraumatic stress disorder. The authors reviewed neurobiological studies, nonclinical studies using animal models, clinical case reports, open-label drug studies, and blinded, placebo-controlled drug studies. This review of the basic science and clinical literature, and the authors' clinical experience with culturally and demographically diverse populations, indicate that clonidine and prazosin can play a useful role in treating sleep disturbance and hyperarousal in posttraumatic stress disorder, with minimal adverse effects and low financial cost.
Culture, medicine and psychiatry
In this paper, we examine the performance of a pencil-and-paper screening questionnaire on depres... more In this paper, we examine the performance of a pencil-and-paper screening questionnaire on depressive symptoms (the Center for Epidemiologic Studies Depression Scale, or CES-D) in a sample of 120 adult American Indians belonging to a single Northwest Coast tribe. Results of factor analyses suggest that somatic complaints and emotional distress are not well differentiated from each other in this population. CES-D scores (which have shown good sensitivity and specificity for depressive disorders in this sample) also show weak and apparently nonsignificant trends to be elevated in the presence of other psychiatric diagnoses (including alcoholism) or general impairment. However, because of the use of a convenience sample (rather than a probability sample), analyses of associations between study factors--including comorbidity--are liable to produce spurious results due to selection bias (including Berkson bias). On this basis, we suggest that the use of probability samples should assume ...
Social Science & Medicine, 1991
The Mien, a Southeast Asian hill people, have immigrated to various countries throughout the worl... more The Mien, a Southeast Asian hill people, have immigrated to various countries throughout the world since the mid-1970s. They have brought their ancient culture with them, including beliefs and practices related to health, illness, and healing. During the last several decades they have suffered much war-related trauma, including extensive human, material and symbolic losses. This report describes our clinical experience with Mien refugees in the Indochinese Psychiatric Program of the Oregon Health Sciences University. We discuss symptom presentation among this group of patients, diagnostic and treatment issues, and the impact of cultural health beliefs upon illness and treatment. Major depression and post-traumatic stress disorder have been the most commonly encountered psychiatric diagnoses, usually revealed through somatic symptoms. Not only must clinicians take careful medical and psychiatric histories, but they must also be alert to the high probability of an extensive history of trauma. Clinical improvement in response to psychotropic medications has been limited. As a result, psychosocial and psychotherapeutic approaches to treatment have been developed and expanded and now are commonly employed, effectively combining support and education in the creation of a holding environment that includes both individual and group formats. Two case histories are presented which describe symptom presentation, health belief systems and therapeutic issues involved in treating Mien patients. They also illustrate that traditional and Western healing approaches can co-exist in the optimal care of these patients.
Psychiatry Research, 1993
The Center for Epidemiologic Studies Depression scale (CES-D) has been widely used in stu... more The Center for Epidemiologic Studies Depression scale (CES-D) has been widely used in studies of late-life depression. Psychometric properties are generally favourable, but data on the criterion validity of the CES-D in elderly community-based samples are lacking. In a sample of older (55-85 years) inhabitants of the Netherlands, 487 subjects were selected to study criterion validity of the CES-D. Using the 1-month prevalence of major depression derived from the Diagnostic Interview Schedule (DIS) as criterion, the weighted sensitivity of the CES-D was 100 % ; specificity 88 % ; and positive predictive value 13n2 %. False positives were not more likely among elderly with physical illness, cognitive decline or anxiety. We conclude that the criterion validity of the CES-D for major depression was very satisfactory in this sample of older adults.
Journal of Traumatic Stress, 1989
... Two patients threatened suicide with knives and one completed suicide. ... common in adult PT... more ... Two patients threatened suicide with knives and one completed suicide. ... common in adult PTSD patients and was found in an adoles-cent community sample (Kinzie et ... the psychotic symptoms we have reported are a particularly severe manifestation of intensive imagery in post ...
The Journal of Nervous and Mental Disease, 1992
The Journal of Nervous and Mental Disease, 1991
The Journal of Nervous and Mental Disease, 2002
... PhD, Psychology Department, Wellesley College, Wellesley, MA Everett L. Worthington, Jr., PhD... more ... PhD, Psychology Department, Wellesley College, Wellesley, MA Everett L. Worthington, Jr., PhD, Department of ... 75 Findings from a Longitudinal Study of Women and Men Paul Wink and ... Strategies as Predictors A. Sandra Willis, Kenneth A. Wallston, and Kamau RS Johnson 10 ...
General Hospital Psychiatry, 1986
Pafienfs who are medically ill and distrustful of their care-providers are unforfunafely a fact o... more Pafienfs who are medically ill and distrustful of their care-providers are unforfunafely a fact of life for most physicians. Medical management of such patients can bea frustrating experience because their suspiciousness is usually heightened by the stress of medical illness. Most often the patient's mistrust covers profound feelings of personal inadequacy and is a defense against feared passivity. Understanding of basic paranoid thought processes combined with knowledge of practical management techniques will lead to increased confidence and effectiveness when interacting with these difficult patients.
Academic Psychiatry, 2008
The purpose of this article is to describe the goals and structure of cross-cultural psychiatric ... more The purpose of this article is to describe the goals and structure of cross-cultural psychiatric training at Oregon Health and Science University (OHSU). This training in core knowledge, skills, and attitudes of cultural psychiatry over the past three decades has included medical students, residents, and fellows, along with allied mental health personnel. The curriculum includes both didactic sessions devoted to core topics in the field and varied clinical experiences in community settings and the Intercultural Psychiatric Program under the supervision of experienced academic faculty. The authors review the central elements of the training experiences and include a detailed description of the core clinical settings and experiences. At the conclusion of their clinical experiences, trainees have specialized cross-cultural psychiatric knowledge and skills, including treatment of refugees and immigrants, sociocultural variables that influence the assessment and treatment of a wide range of psychiatric conditions, and comfort with cultural dynamics that influence both the doctor/patient relationship and collaboration with a wide range of mental health professionals. Because of rapid demographic changes in the U.S. population, providing cross-cultural training for students, residents, and fellows is an essential foundation for the education of the next generation of clinicians and health care leaders. OHSU has provided a long-term model for this training in a busy clinical and academic setting that places an emphasis on multidisciplinary and multicultural collaboration.
Business and Information Systems Engineering, 2013
Journal of the American Academy of Psychiatry and the Law Online, Feb 1, 2005
In forensic psychiatry, there is increasing recognition of the importance of culture and ethnicit... more In forensic psychiatry, there is increasing recognition of the importance of culture and ethnicity in the criminal justice process as the population becomes more culturally diverse. However, there has been little consideration of the role of cultural factors in the trial process for criminal defendants, particularly in the sentencing phase of trial. Using a capital murder case study, this article explores the role of cultural forensic psychiatric consultation, focusing on the sentencing phase of trial as the place where the full scope and power of a cultural evaluation can be brought most effectively to the attention of the court. Cultural psychiatric perspectives can enrich a core forensic evaluation and be maximally helpful to the court, by exploring family dynamics and psychological health influenced by cultural history, immigrant and refugee experiences, and sociocultural environment. Specific recommendations and cautions for effective cultural consultation in forensic psychiatry are discussed.
Journal of the American Academy of Psychiatry and the Law Online, Feb 1, 1995
Partnerships for Mental Health, 2015
Prospects, 1999
Scholarship about Depression-era proletarian literature has had to adapt itself to new political ... more Scholarship about Depression-era proletarian literature has had to adapt itself to new political and social realities since 1984. With the collapse of socialism in Eastern Europe and Soviet Russia, literary analyses of texts written in the atmosphere of the Communist-led cultural movement may seem to lose currency; to argue for the relevancy at the close of the 20th century may seem irrelevant to postmodern aesthetics. Likewise, as Barbara Foley suggests, reading proletarian texts with their self-conscious critiques of class struggle and their formulaic and didactic plots offers little to audiences who are used to postmodern experimentation and “confessional” poetics (viii).
The Journal of Nervous and Mental Disease, 1991
Journal of the American Academy of Psychiatry and the Law Online, 2010
The journal of the American Academy of Psychiatry and the Law, 2010
Individuals fleeing persecution have the right to asylum. This most fundamental right was guarant... more Individuals fleeing persecution have the right to asylum. This most fundamental right was guaranteed by the 1951 United Nations (UN) Convention Relating to the Status of Refugees and was implemented in the 1967 UN protocol regarding refugee status. The United States codified refugee protection and the procedures for asylum in the Refugee Act of 1980, which was made part of the Immigration and Nationality Act (INA). In claiming refugee status, the burden of proof rests with the asylum seeker and is often a daunting task, given language and cultural barriers, lack of knowledge about U.S. legal procedures, and the reality that oppressive states do not document their intentions to persecute dissidents. Forensic psychiatrists may be asked to provide mental health assessment in immigration cases. In this article, an example of a Central American man with a nontraditional but increasingly common request for asylum is presented, the asylum process is described, and the role of the forensic ...
Journal of psychiatric practice, 2007
This article reviews the neurobiologic rationale for and presents clinical guidance concerning th... more This article reviews the neurobiologic rationale for and presents clinical guidance concerning the use of medications that reduce central nervous system noradrenergic activity in the treatment of intrusive symptoms of posttraumatic stress disorder. The authors reviewed neurobiological studies, nonclinical studies using animal models, clinical case reports, open-label drug studies, and blinded, placebo-controlled drug studies. This review of the basic science and clinical literature, and the authors' clinical experience with culturally and demographically diverse populations, indicate that clonidine and prazosin can play a useful role in treating sleep disturbance and hyperarousal in posttraumatic stress disorder, with minimal adverse effects and low financial cost.
Culture, medicine and psychiatry
In this paper, we examine the performance of a pencil-and-paper screening questionnaire on depres... more In this paper, we examine the performance of a pencil-and-paper screening questionnaire on depressive symptoms (the Center for Epidemiologic Studies Depression Scale, or CES-D) in a sample of 120 adult American Indians belonging to a single Northwest Coast tribe. Results of factor analyses suggest that somatic complaints and emotional distress are not well differentiated from each other in this population. CES-D scores (which have shown good sensitivity and specificity for depressive disorders in this sample) also show weak and apparently nonsignificant trends to be elevated in the presence of other psychiatric diagnoses (including alcoholism) or general impairment. However, because of the use of a convenience sample (rather than a probability sample), analyses of associations between study factors--including comorbidity--are liable to produce spurious results due to selection bias (including Berkson bias). On this basis, we suggest that the use of probability samples should assume ...
Social Science & Medicine, 1991
The Mien, a Southeast Asian hill people, have immigrated to various countries throughout the worl... more The Mien, a Southeast Asian hill people, have immigrated to various countries throughout the world since the mid-1970s. They have brought their ancient culture with them, including beliefs and practices related to health, illness, and healing. During the last several decades they have suffered much war-related trauma, including extensive human, material and symbolic losses. This report describes our clinical experience with Mien refugees in the Indochinese Psychiatric Program of the Oregon Health Sciences University. We discuss symptom presentation among this group of patients, diagnostic and treatment issues, and the impact of cultural health beliefs upon illness and treatment. Major depression and post-traumatic stress disorder have been the most commonly encountered psychiatric diagnoses, usually revealed through somatic symptoms. Not only must clinicians take careful medical and psychiatric histories, but they must also be alert to the high probability of an extensive history of trauma. Clinical improvement in response to psychotropic medications has been limited. As a result, psychosocial and psychotherapeutic approaches to treatment have been developed and expanded and now are commonly employed, effectively combining support and education in the creation of a holding environment that includes both individual and group formats. Two case histories are presented which describe symptom presentation, health belief systems and therapeutic issues involved in treating Mien patients. They also illustrate that traditional and Western healing approaches can co-exist in the optimal care of these patients.
Psychiatry Research, 1993
The Center for Epidemiologic Studies Depression scale (CES-D) has been widely used in stu... more The Center for Epidemiologic Studies Depression scale (CES-D) has been widely used in studies of late-life depression. Psychometric properties are generally favourable, but data on the criterion validity of the CES-D in elderly community-based samples are lacking. In a sample of older (55-85 years) inhabitants of the Netherlands, 487 subjects were selected to study criterion validity of the CES-D. Using the 1-month prevalence of major depression derived from the Diagnostic Interview Schedule (DIS) as criterion, the weighted sensitivity of the CES-D was 100 % ; specificity 88 % ; and positive predictive value 13n2 %. False positives were not more likely among elderly with physical illness, cognitive decline or anxiety. We conclude that the criterion validity of the CES-D for major depression was very satisfactory in this sample of older adults.
Journal of Traumatic Stress, 1989
... Two patients threatened suicide with knives and one completed suicide. ... common in adult PT... more ... Two patients threatened suicide with knives and one completed suicide. ... common in adult PTSD patients and was found in an adoles-cent community sample (Kinzie et ... the psychotic symptoms we have reported are a particularly severe manifestation of intensive imagery in post ...
The Journal of Nervous and Mental Disease, 1992
The Journal of Nervous and Mental Disease, 1991
The Journal of Nervous and Mental Disease, 2002
... PhD, Psychology Department, Wellesley College, Wellesley, MA Everett L. Worthington, Jr., PhD... more ... PhD, Psychology Department, Wellesley College, Wellesley, MA Everett L. Worthington, Jr., PhD, Department of ... 75 Findings from a Longitudinal Study of Women and Men Paul Wink and ... Strategies as Predictors A. Sandra Willis, Kenneth A. Wallston, and Kamau RS Johnson 10 ...
General Hospital Psychiatry, 1986
Pafienfs who are medically ill and distrustful of their care-providers are unforfunafely a fact o... more Pafienfs who are medically ill and distrustful of their care-providers are unforfunafely a fact of life for most physicians. Medical management of such patients can bea frustrating experience because their suspiciousness is usually heightened by the stress of medical illness. Most often the patient's mistrust covers profound feelings of personal inadequacy and is a defense against feared passivity. Understanding of basic paranoid thought processes combined with knowledge of practical management techniques will lead to increased confidence and effectiveness when interacting with these difficult patients.
Academic Psychiatry, 2008
The purpose of this article is to describe the goals and structure of cross-cultural psychiatric ... more The purpose of this article is to describe the goals and structure of cross-cultural psychiatric training at Oregon Health and Science University (OHSU). This training in core knowledge, skills, and attitudes of cultural psychiatry over the past three decades has included medical students, residents, and fellows, along with allied mental health personnel. The curriculum includes both didactic sessions devoted to core topics in the field and varied clinical experiences in community settings and the Intercultural Psychiatric Program under the supervision of experienced academic faculty. The authors review the central elements of the training experiences and include a detailed description of the core clinical settings and experiences. At the conclusion of their clinical experiences, trainees have specialized cross-cultural psychiatric knowledge and skills, including treatment of refugees and immigrants, sociocultural variables that influence the assessment and treatment of a wide range of psychiatric conditions, and comfort with cultural dynamics that influence both the doctor/patient relationship and collaboration with a wide range of mental health professionals. Because of rapid demographic changes in the U.S. population, providing cross-cultural training for students, residents, and fellows is an essential foundation for the education of the next generation of clinicians and health care leaders. OHSU has provided a long-term model for this training in a busy clinical and academic setting that places an emphasis on multidisciplinary and multicultural collaboration.
Business and Information Systems Engineering, 2013
Journal of the American Academy of Psychiatry and the Law Online, Feb 1, 2005
In forensic psychiatry, there is increasing recognition of the importance of culture and ethnicit... more In forensic psychiatry, there is increasing recognition of the importance of culture and ethnicity in the criminal justice process as the population becomes more culturally diverse. However, there has been little consideration of the role of cultural factors in the trial process for criminal defendants, particularly in the sentencing phase of trial. Using a capital murder case study, this article explores the role of cultural forensic psychiatric consultation, focusing on the sentencing phase of trial as the place where the full scope and power of a cultural evaluation can be brought most effectively to the attention of the court. Cultural psychiatric perspectives can enrich a core forensic evaluation and be maximally helpful to the court, by exploring family dynamics and psychological health influenced by cultural history, immigrant and refugee experiences, and sociocultural environment. Specific recommendations and cautions for effective cultural consultation in forensic psychiatry are discussed.
Journal of the American Academy of Psychiatry and the Law Online, Feb 1, 1995
Partnerships for Mental Health, 2015