The Self-Medication Hypothesis of Substance Use Disorders: A Reconsideration and Recent Applications

References

• Khantzian E J. The self-medication hypothesis of addictive disorders. Am J Psychiatry 1985; 142: 1259–64
   PubMed Web of Science ®Google Scholar
• Glass R. Blue mood, blackened lungs: depression and smoking. JAMA 1990; 264: 1583–4
   PubMed Web of Science ®Google Scholar
• Miller N S. The interaction between co-existing disorders. Treating co-existing psychiatric and addictive disorders: a practical guide, N S Miller. Hazelden, Center City, Minnesota 1994; 7–21
   Google Scholar
• Gold M S, Miller N S. The biology of addictive and psychiatric disorders. Treating co-existing psychiatric and addictive disorders: a practical guide, N S Miller. Hazelden, Center City, Minnesota 1994; 35–49
   Google Scholar
• Dranov P. The harrowing mystery of addiction. Cosmopolitan 1988; 205(1)148–51
   Google Scholar
• Gelman D, Drew L, Hagler M, Miller M, Gonzalez D L, Gordon J. Newsweek Feb, 1989; 20: 52–7
   Google Scholar
• Goleman D. Scientists pinpoint brain irregularities in drug addicts. NY Times 1990; C1, C7, Jun 26
   Google Scholar
• Rounsaville B J, Weissman M M, Crits-Cristoph K, Wilber C, Kleber H. Diagnosis and symptoms of depression in opiate addicts: course and relationship to treatment outcome. Arch Gen Psychiatry 1982; 39: 151–6
   PubMed Web of Science ®Google Scholar
• Rounsaville B J, Weissman M M, Kleber H, Wilber C. Heterogeneity of psychiatric diagnosis in treated opiate addicts. Arch Gen Psychiatry 1982; 39: 161–6
   PubMed Web of Science ®Google Scholar
• Ross H E, Glaser F B, Germanson T. The prevalence of psychiatric disorders in patients with alcohol and other drug problems. Arch Gen Psychiatry 1988; 45: 1023–31
   PubMed Web of Science ®Google Scholar
• Group for the Advancement of Psychiatry, Committee on Alcoholism and the Addictions. Substance abuse disorders: a psychiatric priority. Am J Psychiatry 1991; 148: 1291–300
   PubMedGoogle Scholar
• Weider H, Kaplan E. Drug use in adolescents. Psychoanal Study Child 1969; 24: 399–431
   PubMedGoogle Scholar
• Krystal H, Raskin H A. Drug dependence: aspects of ego functions. Wayne State University Press, Detroit 1970
   Google Scholar
• Milkman H, Frosch W A. On the preferential abuse of heroin and amphetamine. J Nerv Ment Dis 1973; 156: 242–8
   PubMed Web of Science ®Google Scholar
• Wurmser L. Psychoanalytic considerations of the etiology of compulsive drug use. J Am Psychoanal Assoc 1974; 22: 820–43
   PubMed Web of Science ®Google Scholar
• Khantzian E J. The ego, the self and opiate addiction: theoretical and treatment considerations. Int Rev Psychoanal 1978; 5: 189–98
   Google Scholar
• Meissner W W. Psychotherapy and the paranoid process. Jason Aronson, New York 1986
   Google Scholar
• Khantzian E J. Self-regulation vulnerabilities in substance abusers: treatment implications. The psychology and treatment of addictive behavior, S Dowling. International Universities Press, Madison, Connecticut 1995; 17–41
   Google Scholar
• Khantzian E J. Self selection and progression in drug dependence. Psychiatry Digest 1975; 36: 19–22
   Google Scholar
• Spotts J V, Shontz F C. Drug induced ego states: a trajectory theory of drug experience. Soc Pharmacol 1987; 1: 19–51
   Google Scholar
• Fenichel O. The psychoanalytic theory of neurosis. Norton, New York 1945
   Google Scholar
• Krystal H. Self representation and the capacity for self care. Ann Psychoanal 1978; 6: 209–46
   Google Scholar
• Nunes E V, Rosecan J S. Human neurobiology of cocaine. Cocaine abuse: new directions in treatment and research, H I Spitz, J S Rosecan. Brunner/Mazel, New York 1987; 48–94
   Google Scholar
• Akiskal H. Validating affective personality types. The validity of psychiatric diagnosis, L N Robbins, J Barrett. Raven, New York 1989; 217–27
   Google Scholar
• Khantzian E J. An extreme case of cocaine dependence and marked improvement with methylphenidate treatment. Am J Psychiatry 1983; 140: 784–5
   PubMed Web of Science ®Google Scholar
• Krystal H. Alexithymia and the effectiveness of psychoanalytic treatment. Int J Psychoanal Psychother 1982; 9: 353–78
   PubMedGoogle Scholar
• Krystal H. Integration and self-healing: affect, trauma, alexithymia. Analytic Press, Hillsdale, New Jersey 1988
   Google Scholar
• Sifneos P E. Clinical observations on some patients suffering from a variety of psychosomatic diseases. Acta Med Psychosom Proc 1967
   Google Scholar
• Nemiah J C. The psychological management and treatment of patients with peptic ulcer. Adv Psychosom Med 1970; 6: 169–73
   Google Scholar
• McDougall J. The “dis-affected” patient: reflections on affect pathology. Psychoanal Q 1984; 53: 386–409
   PubMed Web of Science ®Google Scholar
• Khantzian E J, Wilson A. Substance dependence, repetition and the nature of addictive suffering. Hierarchical concepts in psychoanalysis: theory, research, and clinical practice, A Wilson, J E Gedo. Guilford, New York 1993; 263–83
   Google Scholar
• Khantzian E J. Affects and addictive suffering: a clinical perspective. Human feelings: explorations in affect development and meaning, S Ablon, D Brown, E J Khantzian, J E Mack. Analytic Press, Hillsdale, New Jersey 1993; 259–79
   Google Scholar
• Brehm M, Khantzian E J. The psychology of substance abuse: a psychodynamic perspective. Substance abuse: a comprehensive textbook, J H Lowinson, P Ruiz, R B Millman. Williams & Wilkins, Baltimore 1992; 106–17
   Google Scholar
• Blatt S J, Berman W, Bloom-Feshbach S, Sugarman A, Wilber C, Kleber H D. Psychological assessment of psychopathology in opiate addicts. J Nerv Ment Dis 1984; 172: 156–65
   PubMed Web of Science ®Google Scholar
• Wilson A, Passik S D, Faude J, Abrams J, Gordon E. A hierarchical model of opiate addiction: failures of self-regulation as a central aspect of substance abuse. J Nerv Ment Dis 1989; 177: 390–9
   PubMed Web of Science ®Google Scholar
• Shedler J, Block J. Adolescent drug use and psychological health. Am Psychol 1990; 45: 612–30
   PubMed Web of Science ®Google Scholar
• Khantzian E J. Some treatment implications of the ego and self disturbances in alcoholism. Dynamic approaches to the understanding and treatment of alcoholism, M H Bean, N E Zinberg. Free Press, New York 1981; 163–88
   Google Scholar
• Khantzian E J, Mack J E. Self-preservation and the care of the self: ego instincts reconsidered. Psychoanal Study Child 1983; 38: 209–32
   PubMed Web of Science ®Google Scholar
• Khantzian E J, Mack J E. Alcoholics and contemporary psychodynamic theory. Recent Dev Alcohol 1989; 7: 67–89
   Google Scholar
• Donovan J M. An etiologic model of alcoholism. Am J Psychiatry 1986; 143: 1–11
   PubMed Web of Science ®Google Scholar
• Kellam S G, Werthamer-Larsson L, Dolan L J, Brown C H, Mayer L S, Rebok G W, et al. Developmental epidemiologically based preventive trials: baseline modeling of early target behaviors and depressive symptoms. Am J Community Psychol 1991; 19: 563–84
   PubMed Web of Science ®Google Scholar
• Kellam S G, Brown C H, Fleming J P. Developmental epidemiological studies of substance use in Woodlawn: implications for prevention research strategy. NIDA Res Monogr 1982; 41: 21–33
   Google Scholar
• Brook J S, Whiteman M, Cohen P, Tanaka J S. Childhood precursors of adolescent drug use: a longitudinal analysis. Genet Soc Gen Psychol Monogr 1992; 118: 195–213
   PubMedGoogle Scholar
• Moss H B, Mezzich A, Yao J K, Gavaler J, Martin C S. Aggressivity among sons of substance-abusing fathers: association with psychiatric disorder in the father and son, paternal personality, pubertal development and socioeconomic status. Am J Drug Alcohol Abuse 1995; 21: 195–208
   PubMed Web of Science ®Google Scholar
• Cloninger C R. Neurogenetic adaptive mechanisms in alcoholism. Science 1987; 236: 410–6
   PubMed Web of Science ®Google Scholar
• Schiffer F. Psychotherapy of nine successfully treated cocaine abusers: techniques and dynamics. J Subst Abuse Treat 1988; 5: 133–7
   Google Scholar
• Lichtenberg J D. Psychoanalysis and infant research. Analytic Press, Hillsdale, New Jersey 1983
   Google Scholar
• Gedo J. Conceptual issues in psychoanalysis: essays in history and method. Analytic Press, Hillsdale, New Jersey 1986
   Google Scholar
• Weiss R D, Griffin K L, Mirin S M. Drug abuse as self medication for depression: an empirical study. Am J Drug Alcohol Abuse 1992; 18: 121–9
   PubMed Web of Science ®Google Scholar
• Weiss R D, Mirin S M, Griffin M L. Methodological considerations in the diagnosis of coexisting psychiatric disorders in substance abusers. Br J Addict 1992; 87: 179–87
   PubMedGoogle Scholar
• Woody G E, Luborsky L, McLellan A T, O'Brien C P, Beck A T, Blaine J, et al. Psychotherapy for opiate addicts: does it help?. Arch Gen Psychiatry 1983; 40: 639–45
   PubMed Web of Science ®Google Scholar
• Weissman M M, Slobetz F, Prusoff B, Mezritz M, Howard P. Clinical depression among narcotic addicts maintained on methadone in the community. Am J Psychiatry 1976; 133: 1434–8
   PubMed Web of Science ®Google Scholar
• Khantzian E J, Treece C. DSM-III psychiatric diagnosis of narcotic addicts: recent findings. Arch Gen Psychiatry 1985; 42: 1067–71
   PubMed Web of Science ®Google Scholar
• Weiss R D, Mirin S M. Drug, host, and environmental factors in the development of chronic cocaine abuse. Substance abuse and psychopathology, S M Mirin. American Psychiatric Press, Washington, DC 1984; 41–55
   Google Scholar
• Gawin F H, Kleber H D. Cocaine abuse treatment. Arch Gen Psychiatry 1984; 41: 903–8
   PubMed Web of Science ®Google Scholar
• Khantzian E J, Gawin F, Kleber H D, Riordan C E. Methylphenidate (Ritalin) treatment of cocaine dependence—a preliminary report. J Subst Abuse Treat 1984; 1: 107–12
   PubMedGoogle Scholar
• Weiss R D, Pope H G, Jr, Mirin S M. Treatment of chronic cocaine abuse and attention deficit disorder, residual type, with magnesium pemoline. Drug Alcohol Depend 1985; 15: 69–72
   PubMed Web of Science ®Google Scholar
• Weiss R D, Mirin S M, Griffin M L, Michaels J K. Psychopathology in cocaine abusers: changing trends. J Nerv Ment Dis 1988; 176: 719–25
   PubMed Web of Science ®Google Scholar
• Kleinman P H, Miller A B, Millman R B, Woody G E, Todd T, Kemp J, et al. Psychopathology among cocaine abusers entering treatment. J Nerv Ment Dis 1990; 178: 442–7
   PubMed Web of Science ®Google Scholar
• Rounsaville B J, Anton S F, Carroll K, Budde D, Prusoff B A, Gawin F. Psychiatric diagnoses of treatment-seeking cocaine abusers. Arch Gen Psychiatry 1991; 48: 43–51
   PubMed Web of Science ®Google Scholar
• Carroll K M, Rounsaville B J. Contrast of treatment seeking and untreated cocaine abusers. Arch Gen Psychiatry 1992; 49: 464–71
   PubMed Web of Science ®Google Scholar
• Halikas J A, Crosby R D, Pearson V L, Nugent S M, Carlson G A. Psychiatric comorbidity in treatment-seeking cocaine abusers. Am J Addict 1994; 3: 25–35
   Web of Science ®Google Scholar
• Wilens T E, Biederman J, Spencer T J, Frances R J. Comorbidity of attention deficit hyperactivity and psychoactive substance use disorders. Hosp Community Psychiatry 1994; 45: 421–35
   PubMedGoogle Scholar
• Keeler M H, Taylor C I, Miller W C. Are all recently detoxified alcoholics depressed?. Am J Psychiatry 1979; 136: 586–8
   PubMedGoogle Scholar
• Dorus W, Kennedy J, Gibbons R D, Ravi S D. Symptoms and diagnosis of depression in alcoholics. Alcoholism 1987; 11: 150–4
   Google Scholar
• Hesselbrock M N, Meyer R E, Keener J J. Psychopathology in hospitalized alcoholics. Arch Gen Psychiatry 1985; 42: 1050–5
   PubMed Web of Science ®Google Scholar
• Weiss K J, Rosenberg D J. Prevalence of anxiety disorder among alcoholics. J Clin Psychiatry 1985; 46: 3–5
   PubMed Web of Science ®Google Scholar
• Penick E C, Powell B J, Nickel E J, Bingham S F, Riesenmy K R, Read M R, et al. Co-morbidity of lifetime psychiatric disorder among male alcoholic patients. Alcohol Clin Exp Res 1994; 18: 1289–93
   PubMed Web of Science ®Google Scholar
• Christie K A, Burke J D, Jr, Regier D A, Rae D S, Boyd J H, Locke B Z. Epidemiologic evidence for early onset of mental disorders and higher risk of drug abuse in young adults. Am J Psychiatry 1988; 145: 971–5
   PubMed Web of Science ®Google Scholar
• Regier D A, Farmer M E, Rae D S, Locke B Z, Keith S J, Judd L L, et al. Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiologic Catchment Area (ECA) study. JAMA 1990; 264: 2511–8
   PubMed Web of Science ®Google Scholar
• Vaillant G E. The natural history of alcoholism. Harvard University Press, Cambridge 1983
   Google Scholar
• Dackis C, Gold M. More on self-medication and drug abuse. Am J Psychiatry 1986; 143: 1309–10
   Google Scholar
• Miller M, Gold M. Dependence syndrome: a critical analysis of essential features. Psychiatr Ann 1991; 121: 282–8
   Google Scholar
• Schuckit M A. Genetic and clinical implications of alcoholism and affective disorder. Am J Psychiatry 1986; 143: 140–7
   PubMed Web of Science ®Google Scholar
• Schuckit M A, Irwin M, Brown S A. The history of anxiety symptoms among 171 primary alcoholics. J Stud Alcohol 1990; 51: 34–41
   PubMed Web of Science ®Google Scholar
• Schuckit M A, Hesselbrock V. Alcohol dependence and anxiety disorders: what is the relationship?. Am J Psychiatry 1994; 151: 1723–34
   PubMed Web of Science ®Google Scholar
• Vaillant G E. A long-term follow-up of male alcohol abuse. Arch Gen Psychiatry 1996; 53: 243–9
   PubMed Web of Science ®Google Scholar
• Vaillant G E. Natural history of male psychological health, VIII: Antecedents of alcoholism and “orality.”. Am J Psychiatry 1980; 137: 181–6
   PubMed Web of Science ®Google Scholar
• Vaillant G E, Milofsky E S. The etiology of alcoholism: a prospective viewpoint. Am Psychol 1982; 37: 494–503
   PubMed Web of Science ®Google Scholar
• Vaillant G E. Sociopathy as a human process. Arch Gen Psychiatry 1975; 32: 178–83
   PubMed Web of Science ®Google Scholar
• Schuckit M A, Smith T L. An 8-year follow-up of 450 sons of alcoholic and control subjects. Arch Gen Psychiatry 1996; 53: 202–10
   PubMed Web of Science ®Google Scholar
• Brown S A, Schuckit M A. Changes in depression among abstinent alcoholics. J Stud Alcohol 1988; 49: 412–7
   PubMed Web of Science ®Google Scholar
• Wells K B, Stewart A L, Hays R D, Burnam M A, Rogers W, Daniels M, et al. The functioning and well-being of depressed patients: results from the Medical Outcomes Study. JAMA 1989; 262: 914–9
   PubMed Web of Science ®Google Scholar
• Zucker R A, Gomberg E SL. Etiology of alcoholism reconsidered: the case for a biopsychosocial process. Am Psychol 1986; 41: 783–93
   PubMed Web of Science ®Google Scholar
• Andersen B. Berkson's fallacy. Nord Med 1969; 81: 729–30
   PubMedGoogle Scholar
• McKenna C, Ross C. Diagnostic conundrums in substance abusers with psychiatric symptoms: variables suggestive of dual diagnosis. Am J Drug Alcohol Abuse 1994; 20: 397–412
   PubMed Web of Science ®Google Scholar
• Martin W R, Hewett B B, Baker A J, Haertzen C A. Aspects of the psychopathology and pathophysiology of addiction. Drug Alcohol Depend 1977; 2: 185–202
   PubMedGoogle Scholar
• Noordsy D L, Drake R E, Teague G B, Osher F C, Hurlbut S C, Beaudett M S, et al. Subjective experiences related to alcohol use among schizophrenics. J Nerv Ment Dis 1991; 179: 410–4
   PubMed Web of Science ®Google Scholar
• Ciraulo D A, Sarrid-Segal O, Barnhill J, Ciraulo A M, Knapp C M, Greenblatt D J. Effects of benzodiazepines, buspirone, and placebo on mood and EEG activity in alcoholics and normal subjects [Abstract]. Scientific abstracts of the annual meeting of the American Psychiatric Association, Philadelphia, May, 1994, 159
   Google Scholar
• Ciraulo D A, Barnhill J G, Ciraulo A M, Greenblatt D J, Shader R I. Parental alcoholism as a risk factor in benzodiazepine abuse: a pilot study. Am J Psychiatry 1989; 146: 1333–5
   PubMed Web of Science ®Google Scholar
• Milin R, Loh E A, Wilson A. Drug preference, reported drug experience, and stimulus sensitivity. Am J Addict 1992; 1: 248–56
   Google Scholar
• Anda R F, Williamson D F, Escobedo L G, Mast E E, Giovino G A, Remington P L. Depression and the dynamics of smoking: a national perspective. JAMA 1990; 264: 1541–5
   PubMed Web of Science ®Google Scholar
• Glassman A H, Helzer J E, Covey L S, Cottler L B, Steiner F, Tipp J S, et al. Smoking, smoking cessation, and major depression. JAMA 1990; 264: 1546–9
   PubMed Web of Science ®Google Scholar
• Breslau N, Kilbey M M, Andreski P. Vulnerability to psychopathology in nicotine dependent smokers: an epidemiologic study of young adults. Am J Psychiatry 1993; 150: 941–6
   PubMed Web of Science ®Google Scholar
• Breslau N, Kilbey M M, Andreski P. Nicotine dependence and major depression: new evidence from a prospective investigation. Arch Gen Psychiatry 1993; 50: 31–5
   PubMed Web of Science ®Google Scholar
• Kandel D B, Davies M. Adult sequelae of adolescent depressive symptoms. Arch Gen Psychiatry 1986; 43: 255–62
   PubMed Web of Science ®Google Scholar
• Schifano F, Forza G, Gallimberti L. Smoking habits and psychological distress in adolescent female students. Am J Addict 1994; 3: 100–5
   Google Scholar
• Khantzian E J, Dalsiner J S, Semrad E V. The use of interpretation in the psychotherapy of schizophrenia. Am J Psychother 1969; 23: 182–97
   Google Scholar
• Crow T J. Molecular pathology of schizophrenia: more than one disease process?. BMJ 1980; 280: 66–8
   PubMed Web of Science ®Google Scholar
• Andreasen N C. Negative symptoms in schizophrenia: definition and reliability. Arch Gen Psychiatry 1982; 39: 784–8
   PubMed Web of Science ®Google Scholar
• Andreasen N C, Olsen S. Negative v positive schizophrenia: definition and validation. Arch Gen Psychiatry 1982; 39: 789–94
   PubMed Web of Science ®Google Scholar
• Andreasen N C, Flaum M, Swayze V W, II, Tyrrell G, Arndt S. Positive and negative symptoms in schizophrenia: a critical reappraisal. Arch Gen Psychiatry 1990; 47: 615–21
   PubMed Web of Science ®Google Scholar
• Breakey W R, Goodell H, Lorenz P C, McHugh P R. Hallucinogens as precipitants of schizophrenia. Psychol Med 1974; 4: 255–61
   PubMed Web of Science ®Google Scholar
• Richard M L, Liskow B, Perry P J. Recent psychostimulant use in hospitalized schizophrenics. J Clin Psychiatry 1985; 46: 79–83
   PubMed Web of Science ®Google Scholar
• Janowsky D S, Davis J M. Methylphenidate, dextroamphetamine, and levamfetamine: effects on schizophrenic symptoms. Arch Gen Psychiatry 1976; 33: 304–8
   PubMed Web of Science ®Google Scholar
• Kleber H D, Gavin F H. Cocaine. Am Psychiatr Assoc Annu Rev 1985; 5: 160–85
   Google Scholar
• Kelly M E, Gilbertson M, Mouton A. Deterioration in premorbid functioning in schizophrenia: a developmental model of negative symptoms in drug-free patients. Am J Psychiatry 1992; 149: 1543–8
   Google Scholar
• Albanese M J, Khantzian E J, Murphy S L, Green A I. Decreased substance use in chronically psychotic patients treated with clozapine. Am J Psychiatry 1994; 151: 780–1
   PubMed Web of Science ®Google Scholar
• Schneier F R, Siris S G. A review of psychoactive substance use and abuse in schizophrenia: patterns of drug choice. J Nerv Ment Dis 1987; 175: 641–52
   PubMed Web of Science ®Google Scholar
• Brady K, Anton R, Ballenger J C, Lydiard R B, Adinoff B, Selander J. Cocaine abuse among schizophrenic patients. Am J Psychiatry 1990; 147: 1164–7
   PubMed Web of Science ®Google Scholar
• Serper M R, Albert M, Richardson N A, Dickson S, Allen M, Werner A. Clinical effects of recent cocaine use on patients with acute schizophrenia. Am J Psychiatry 1995; 152: 1464–9
   PubMed Web of Science ®Google Scholar
• Van der Kolk B A. Psychological trauma. American Psychiatric Press, Washington, DC 1987
   Google Scholar
• Herman J L. Trauma and recovery. Basic, New York 1992
   Google Scholar
• Nace E P. Post traumatic stress disorder and substance abuse: clinical issues. Recent Dev Alcohol 1988; 6: 9–26
   Google Scholar
• Keane T M, Gerardi R J, Lyons J A. The interrelationship of substance abuse and post traumatic stress disorder: epidemiological and clinical considerations. Recent Dev Alcohol 1988; 6: 27–48
   Google Scholar
• Kosten T R, Krystal J. Biological mechanisms in post traumatic stress disorder: relevance for substance abuse. Recent Dev Alcohol 1988; 6: 49–68
   PubMedGoogle Scholar
• Penk W E, Peck R F, Robinowitz R, Bell W, Little D. Coping and defending styles among Vietnam combat veterans seeking treatment for posttraumatic stress disorder and substance use disorder. Recent-Dev Alcohol 1988; 6: 69–88
   Google Scholar
• Brady K T, Killeen T, Saladin M E, Dansky B, Becker S. Comorbid substance abuse and post traumatic stress disorder: characteristics of women in treatment. Am J Addict 1994; 3: 160–4
   Web of Science ®Google Scholar
• McLellan A T, Parikh G, Bragg A. Addiction Severity Index manual. 5th ed. University of Pennsylvania Center for the Study of Addiction, Philadelphia 1990
   Google Scholar
• Grice D E, Brady K T, Dustan L R, Malcolm R, Kilpatrick D G. Sexual and physical assault history and post traumatic stress disorder in substance dependent individuals. Am J Addict 1995; 4: 297–305
   Web of Science ®Google Scholar
• Swett C, Halpert M. High rates of alcohol problems and history of physical and sexual abuse among women inpatients. Am J Drug Alcohol Abuse 1994; 20: 263–72
   PubMed Web of Science ®Google Scholar
• Windle M, Windle R C, Scheidt D M, Miller G B. Physical and sexual abuse and associated mental disorders among alcoholic inpatients. Am J Psychiatry 1995; 152: 1322–8
   PubMed Web of Science ®Google Scholar
• Cottler L B, Compton W M, 3rd, Mager D, Spitznagel E L, Janca A. Posttraumatic stress disorder among substance abusers from the general population. Am J Psychiatry 1992; 149: 664–70
   PubMed Web of Science ®Google Scholar
• American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. American Psychiatric Association, Washington, DC 1994
   Google Scholar
• Stampfer H G. Negative symptoms: a cumulative trauma stress disorder?. Aust N Z J Psychiatry 1990; 24: 516–28
   PubMed Web of Science ®Google Scholar