bluuebunny/crossref_metadata_2025 huggingface dataset:
The mental health of Muslim mothers in extended families living in Britain: The impact of intergenerational disagreement on anxiety and depression
Authors: Sonuga‐Barke Edmund J. S. , Mistry Minal , Qureshi Shazia
Published: July 2011

Objectives. The study assessed the impact of intergenerational differences of opinion over child rearing on the mental health of Muslim mothers living in extended families.

Design. The study adopted a correlational design in an attempt to identify factors that accounted for mental health problems.

Methods. The child‐rearing attitudes of mothers and grandmothers, mothers' mental health, levels of family acculturation and a range of other background and demographic information was collected from 54 extended families living in two Muslim communities in London using Urdu versions of standard questionnaires.

Results. Rates of depression and anxiety among the mothers in the study were high. Grandmothers had more traditional attitudes to child rearing than did mothers. Intergenerational discrepancy over child rearing was more marked in more acculturated families. Discrepancy was associated with higher levels of mothers' anxiety and depression.

Conclusions. The unusually high levels of depression and anxiety displayed by Muslim mothers living in extended families can in part be accounted for by patterns of intergenerational discrepancy. These possibly reflect discordant world views within those families that have been assimilated into the dominant British culture.
The London‐East Anglia randomized controlled trial of cognitive‐behaviour therapy for psychosis IV: Self‐esteem and persecutory delusions
Authors: Freeman Daniel , Garety Philippa , Fowler David , Kuipers Elizabeth , Dunn Graham , Bebbington Paul , Hadley Clare
Published: July 2011

Objectives. There has been a resurgence of interest in the view that persecutory delusions serve a function of defending self‐esteem. An alternative account of levels of self‐esteem in individuals with persecutory delusions is that they result from processes similar to those studied in people with depression (i.e. from the occurrence of a range of life experiences and how the individual interprets and copes with them). This study aimed to examine both hypotheses together for the first time, and, as the literature indicates that delusions may not share a common cause, attention was given to the possibility of the presence of subgroups.

Design. Data were examined cross‐sectionally and longitudinally from a randomized controlled trial of cognitive behaviour therapy for 60 people with drug‐resistant psychosis.

Method. The study is based on the initial assessment of all participants on self‐esteem, delusional conviction and a large number of demographic, clinical and cognitive measures. Longitudinal analyses were also carried out, and are reported separately for those who received the therapy intervention and those in the control group.

Results. Almost three‐quarters of participants with persecutory delusions reported low self‐esteem. Changes over time in total self‐esteem correlated with changes in measures of mood and social functioning, but not conviction in persecutory delusions. The individuals who initially had normal levels of self‐esteem displayed a different pattern of results from the majority of participants.

Conclusion. Low self‐esteem in people with drug‐resistant persecutory delusions is common and, in most cases, can best be understood in terms of normal emotional processes. There was evidence that the majority of persecutory delusions do not fit either strong or weak formulations of the delusion‐as‐defence explanation and that there may be subgroups with differing aetiologies. These results need to be replicated, and extended to groups in which symptoms are not resistant to medication.
Neural correlates of adaptation to voice identity
Authors: Schweinberger Stefan R. , Walther Christian , Zäske Romi , Kovács Gyula
Published: July 2011

Apart from speech content, the human voice also carries paralinguistic information about speaker identity. Voice identification and its neural correlates have received little scientific attention up to now. Here we use event‐related potentials (ERPs) in an adaptation paradigm, in order to investigate the neural representation and the time course of vocal identity processing. Participants adapted to repeated utterances of vowel–consonant–vowel (VCV) of one personally familiar speaker (either A or B), before classifying a subsequent test voice varying on an identity continuum between these two speakers. Following adaptation to speaker A, test voices were more likely perceived as speaker B and vice versa, and these contrastive voice identity aftereffects (VIAEs) were much more pronounced when the same syllable, rather than a different syllable, was used as adaptor. Adaptation induced amplitude reductions of the frontocentral N1–P2 complex and a prominent reduction of the parietal P3 component, for test voices preceded by identity‐corresponding adaptors. Importantly, only the P3 modulation remained clear for across‐syllable combinations of adaptor and test stimuli. Our results suggest that voice identity is contrastively processed by specialized neurons in auditory cortex within ∼250 ms after stimulus onset, with identity processing becoming less dependent on speech content after ∼300 ms.
Clinical observations on the psychogenesis of impotence
Authors: NOY PINCHAS , WOLLSTEIN SHLOMOH , KAPLAN‐DE‐NOUR ATARA
Published: July 2011

In this paper we will try to summarize our impressions derived from the clinical study of twenty‐five patients suffering from impotence. The symptom of impotence may be found in different nosological entities; but our impression was that the men affected by this symptom show a number of similarities which unite them into a typical group with specified characteristics, and differentiate them from all other neurotic patients. Furthermore, we will try to relate the findings to the theoretical assumptions about this symptom, attempting to understand more about the dynamics and pathogenesis of impotence.
Book Review
Authors: TAYLOR DAVID C.
Published: July 2011

Put Away: A Sociological Study of Institutions for the Mentally Retarded. By Pauline Morris.
Attitudes of psychiatric patients to staff roles and treatment methods: A replication and extension
Authors: Trauer T.
Published: July 2011

A questionnaire dealing with attitudes toward staff roles and treatment methods was administered to a group of 191 psychiatric patients and their responses subjected to a rotated principal components analysis. The first three components accounted for the same proportion of the overall variance as did those obtained in an earlier study. The first components, emphasizing high regard for physical treatments and formal interpersonal relationships, were essentially the same in both studies. The second and third components, however, showed important differences; our second component dealt with the psychological and social aspects of patienthood, and our third reflected a critical attitude toward doctors.

Scores on the first component were significantly associated with age, score on the Hysteroid‐Obsessoid Questionnaire and social class. Women scored higher than men on the second component and scores on the third were related to total hostility scores on the Hostility and Direction of Hostility Questionnaire and to schizophrenia. Differences between diagnostic groups on the first component could be attributed almost entirely to the groups' mean ages.
Validation of the Delusions‐Symptoms‐States Inventory
Authors: Bedford A. , Foulds G. A.
Published: July 2011

Three studies are presented as supportive validatory evidence for the Delusions‐Symptoms‐States Inventory (DSSI). Firstly, senior psychologists and psychiatrists were asked to allocate the 84 DSSI items to clinical syndromes. For 17 items the assignment did not correspond to that of the authors, e.g. ‘neurotic depression’ items alloted to ‘psychotic depression’. Secondly, further referees had to put these 17 items into the DSSI sets, e.g. state of anxiety. This was done as predicted in all but two cases. The third study used clinicians of varied experience to rate their patients according to the presence of the syndromes. These ratings broadly agreed with the patients' scores on the DSSI sets, and for nine of the twelve the association was statistically significant.
The organization of judgements based on positive and negative adjectives in the Bannister‐Fransella Grid Test
Authors: Adams‐Webber J.
Published: July 2011

This study compared the level of organization of judgements involving evaluatively positive (E+) adjectives such as kind with that of judgements involving evaluatively negative (E‐) adjectives such as stupid in the Bannister‐Fransella Grid Test. The grids of 275 subjects, including 43 normals, 24 thought‐disordered schizophrenics, 30 non‐thought‐disordered schizophrenics, 50 ‘mixed’ schizophrenics, 18 depressives, 16 neurotics, and 94 undiagnosed new admissions were examined. The organization of judgements based on E‐ adjectives was significantly more random than that of judgements based on E+ ones across all ten groups. These results are inconsistent with the ‘null hypothesis’ that the grids of thought‐disordered schizophrenics contain only random ‘error variance’ since they reveal a source of systematic variation in the grids of thought‐disordered schizophrenics as well as those of other populations. These data were discussed also in relation to the hypothesis that comparative judgements involving E‐ adjectives are more difficult than those involving E+ ones.
Hostility, personality and depression
Authors: Fernando Suman J. M.
Published: July 2011

The study describes findings on two samples of depressives and normals matched for age, sex, social class and religious affiliation. The following observations on the psychopathology of depression were made by considering the relationships between personality, various aspects of hostility, and the degree of depression: (1) depression, guilt and anxiety are linked together; (2) the extent to which anxiety is somatized is not dependent on the way hostility is handled; also, somatic symptoms occur independently of hysterical symptoms in depressive illness; (3) obsessional symptoms are likely to occur together with hysterical symptoms and to be associated with hostility‐aggression during depressive illness; (4) hysterical tendencies may accentuate intropunitiveness.
Altruism and the practice of medicine
Authors: Pilowsky Issy
Published: July 2011

Biological and psychological research into the antecedents of altruism has considerable significance for those involved in the teaching or practice of medicine. The evidence available indicates that altruistic behaviour is a universal phenomenon influenced by intra‐individual, interpersonal, situational and sociocultural factors. A central theme which emerges is the strikingly ambivalent nature of the altruistic drive. The factors which may facilitate or inhibit altruism in medical students and doctors are discussed. Some ways of ensuring that medical training does not seriously distort altruism are suggested.
Psychotherapy: Theory, experience, and personalized actuarial tables
Authors: Leventhal Donald B. , Shemberg Kenneth M.
Published: July 2011

This paper addresses the issue of the role of theory in the actual application of psychotherapeutic operations. Within the present framework, psychotherapeutic effectiveness is seen as an empirical, actuarial process which occurs in an interpersonal setting separate from theoretical considerations. The role of theory is discussed and a rationale for the coexistence of equally ‘effective’ contradictory theories is presented. Suggestions for future research in the area of behaviour change are made and an argument for the eventual development of a ‘therapeutic cookbook’ is presented.
Voice analysis for the measurement of anxiety
Authors: Smith G. A.
Published: July 2011

A recently developed technique for the acoustical analysis of speech is described. Speech is analysed electronically for the presence or absence of a microtremor having a frequency of about 10 Hz. This tremor is said to be attenuated in states of psychological stress. The paper presents data supporting the validity of this as a measure of anxiety, using states of both normal and pathological anxiety. An objective scoring system is proposed to overcome some of the problems of unreliability. A number of practical advantages of the voice technique are described.
Person to person: The search for the human dimension in psychotherapy
Authors: Zinkin Louis
Published: July 2011

The Medical Section is a meeting place for those concerned with psychotherapy. We come from different schools, each of which has its own ways of thinking and its own ways of approaching patients, but over the years we have learnt to communicate extraordinarily well with each other, and looking back I can remember very few occasions when I have felt there to be a serious gulf between us. I do not mean there has been lack of disagreement, but there has been a growing understanding of each other's point of view. I am not sure that this is a reflexion of what is happening to psychology in general. Here I find that I am constantly going through a cyclical process, where I see rival schools coming together and I have rising hopes of unity, only to have these hopes dashed as new schools, new approaches, new conceptual models come into existence.
Internalization of the trainer's behaviour in professional training
Authors: Gosling R.
Published: July 2011

An important component of any course of professional training is the process by which a trainee comes to adopt a professional stance in relation to his patient, client or client system. This paper is concerned with the way a professional role model is adopted, maintained and developed, a process that should be clearly distinguished from the acquisition of specific skills appropriate to the profession, such as the use of conceptual schemata, selective attention, the ordering of data, manipulative skills, etc. The point at issue is: how does an amateur become imbued with a sense of identity, a set of values and an attitude to his client that marks him off from his fellows? In so far that in one segment of his social life he comes to have a special kind of relationship with those about him and to live life accordingly, he gives evidence of having been through a very particular socializing experience or conversion process: in one segment of his life at least he has come to look upon himself and those about him differently.
From object relations to attachment theory: A basis for family therapy
Authors: Heard D. H.
Published: July 2011

This paper describes the essence of object relations theory as developed by Winnicott through his concepts of the transitional object, the good enough mother holding a situation for her child and play both solitary and mutual. These concepts are compared and contrasted with the essential features of attachment theory as put forward by Bowlby.

It is suggested that Winnicott's object relations concepts and attachment theory each provide a framework to explain similar psychological and interpersonal phenomena. Reasons are put forward for the choice of attachment theory as a basis for family therapy and to suggest hypotheses to investigate the quality and quantity of intrafamilial social interaction and concomitant emotional states.

The family in family therapy is described in terms of the interpersonal dynamic suggested by attachment theory. The family is seen as a homoeostatic system of relationships between individuals at different stages of development who share set goals aimed at terminating a specific form of proximity‐seeking attachment behaviour and promoting exploratory behaviour.
The status of the anal character: A methodological and empirical reply to Hill
Authors: Kline Paul
Published: July 2011

Hill's (1966) critique of the experimental evidence for the anal character is subjected to a critical examination and some of the arguments are shown to be mistaken. In addition new evidence is presented which supports the previous interpretation. It is concluded that there is still factor analytic evidence for the anal character.
Body image, plastic surgery (prosthetic testes) and Kallmann's syndrome
Authors: Money John , Sollod Robert
Published: July 2011

A patient with Kallmann's syndrome received prosthetic testicular implants. In interviews and letters, he demonstrates that delay in electing surgery, and its eventual success, were both related to incorporation of the foreign bodies into the body image.
A multiple paradigm treatment programme for migraine headache
Authors: Lambley Peter
Published: July 2011

Despite the availability of a number of treatment methods for the alleviation of migraine headaches, many thousands of people continue to suffer from this disorder with little or no relief from symptoms, the main features of which are severe debilitating pain, nausea and visual disturbances. While the disorder has long been known to mankind it has only been in recent years that researchers have been able to advance treatment methods sufficiently to enable at least some relief to be given to patients. In this paper the status of treatment methods is reviewed and evaluated and a new integral approach suggested. Case material is provided to exemplify the method used.
A general classification of abnormal illness behaviours
Authors: Pilowsky I.
Published: July 2011

An awareness of one's own state of health cannot be avoided; neither can the impulse, in some form, to respond to this awareness. As is often the case, the delineation of this central, but poorly understood element of human experience and behaviour, may be more readily accomplished if approached through the study of individuals who manifest the more extreme deviations from the usual range of responses observed. As a step in that direction, this paper describes a framework within which such deviations may be ordered in the hope that responses to health status may thus be better conceptualized and managed, both in clinical and non‐clinical contexts.
Psychotherapy in the setting of general medical practice
Authors: Temperley Jane
Published: July 2011

This paper is designed to map some of the interventions with patients which psychotherapists working in the setting of general practice surgery are likely to find feasible and effective. For the past five years the Community Unit of the Adult Department of the Tavistock Clinic has been engaged in a project whereby trainees and staff on the four‐year adult psychotherapy course have been attached one morning per week to local group medical practices. The general pattern of this collaboration has been described elsewhere (Brook & Temperley, 1976). The consultative aspects of attachments to general practice are enormously important but I wish to concentrate in this paper on the help which psychotherapists in a surgery can offer direct to patients whose emotional problems are felt by the GP and the therapist to lie beyond the former's range or inclination.
Movement therapy with psychotic adolescents
Authors: Apter A. , Sharir I. , Tyano S. , Wijsenbeek H.
Published: July 2011

Non‐verbal behaviour has long been a focus of attention in the psychiatric literature. Furthermore, most psychiatric hospitals make use of non‐verbal therapies in their milieu programmes. These include art, music and dance therapy, and related to the latter, movement therapy. This paper represents the beginnings of an attempt to assess more scientifically the effectiveness of movement therapy. It describes the movement therapy programme on our adolescent unit, the evolution of a measuring scale and compares three groups of patients: (A) a group which had received individual therapy; (B) A group which had received group therapy; and (C) a control group. The results tend to confirm the effectiveness of movement therapy for psychotic adolescents.
Transference utilization in aim‐restricted psychotherapy
Authors: Gallwey P. L. G.
Published: July 2011

In this paper I am going to look rather generally at some of the problems facing psychotherapists who like to use the transference as a basis for their interpretive work, but are faced with the difficulties that exist within the National Health Service, where the number of hours that one can devote to a patient and the heavy loading of substantially disturbed cases inevitably limit what one can hope to achieve in the way of dynamic change or long‐term exploration of the patient's psychopathology.
Failure to mourn a stillbirth: An overlooked catastrophe
Authors: Lewis Emanuel , Page Anne
Published: July 2011

The reasons for the difficulty of mourning a stillbirth and the therapeutic management of this mourning process are outlined. A case is described of failed mourning of a stillbirth which gave rise to a profound disturbance in mothering of a subsequent live baby. A psychotherapeutic technique is discussed which facilitates the failed mourning of a stillbirth.
Arousal response predictions derived from ego psychology
Authors: Michael Judy L. , Hirt Michael
Published: July 2011

The purpose of this study was to examine the prediction from ego psychology that excessive stress leads to either a struggling or distancing response. Male subjects, preselected on the R‐S scale, were exposed to an explicit pornographic movie in the presence of a female confederate. Skin conductance levels, self‐report data, and a word association test with double entendre words were the dependent measures. The results indicated that subjects struggle rather than distance themselves when confronted with apparently stressful stimuli.
The Middlesex Hospital Questionnaire: A validity study
Authors: Crisp A. H. , Jones M. Gaynor , Slater P.
Published: July 2011

The MHQ is a brief self‐rating inventory purporting to measure aspects of six distinct categories of psychoneurosis and affective status. It has been found to be a reliable instrument and also valid as a profile measure. Two individual scales have also previously been explored in respect of validity. The present report describes a further attempt to examine the validity of individual scales in relation to pertinent single clinical diagnostic entities in a study involving 800 patients. The phobic and obsessional scales are found to be particularly accurate and differentiating in this respect. Patients variously diagnosed as suffering from anxiety states, depressive states and personality disorder tend to score very highly on several scales. The instrument serves overall to distinguish satisfactorily between such populations and others suffering from schizophrenia and anorexia nervosa. It also markedly differentiates them from ‘normal’ populations.
Contingency learning in chronic schizophrenia and its relevance to social motivation deficit
Authors: Mitchell William S.
Published: July 2011

The present study investigates the ability of chronic schizophrenic patients to learn to obtain social rewards when the incentive value of the contingent social event is known. From a group of 40 chronic patients tested for responsivity to social rewards, socially responsive and socially unresponsive patients were selected and compared on a learning task. Patients who were highly motivated to obtain social reinforcement did not emit the reinforced response during 300 learning trials any more frequently than did patients who were not motivated by social rewards. It was only when the experimental contingency was specified that responsive and unresponsive patients could be differentiated. The implications of these findings for social motivation theories of schizophrenia are discussed.
Reality orientation therapy — a controlled trial
Authors: Wallis G. G. , Baldwin M. , Higginbotham P.
Published: July 2011

Sixty long‐stay patients who were demented or withdrawn or both were randomly allocated to reality orientation or diversional occupational therapy and were assessed blind on two scales. Owing to a high drop‐out rate only 19 organic and 19 functional patients satisfied reasonable criteria for inclusion in the analyses. Those treated by reality orientation therapy fared better than the controls but not significantly so. Initial test scores were no guide to outcome. The results suggested that both organic and functional patients benefited cognitively, but hardly at all behaviourally, from both types of treatment.
Calenture — missing at sea?
Authors: Macleod A. D.
Published: July 2011

Calenture is a behavioural phenomenon, the predominant symptom being an irresistible impulse of sailors to jump into the sea from their vessels. The original description of this phenomenon was that of ancient Spanish sailors. Psychiatric descriptions of calenture appeared in the 18th and 19th centuries; subsequent psychiatric literature has, however, made no direct reference to calenture. This article describes calenture from a historical and clinical perspective, with discussion of the phenomenon in terms of modern psychological understanding. Some implications are considered, including the possible association with the nautical term ‘missing at sea’.
The value of written communications in dynamic psychotherapy
Authors: Ryle A.
Published: July 2011

The literature on the use of written communication in interpretive psychotherapy is reviewed, and a range of possible uses of writing by patients and therapists is described, with some illustration. It is suggested that greater use of writing at some stages of some psychotherapies could be valuable.
An investigation into variables affecting self‐change on personal constructs
Authors: Leitner L. M.
Published: July 2011

This study investigated the relationship between the anticipation of change, construct meaningfulness, construct differentiation, and the amount of change occurring on personal constructs over a six‐week period. The anticipation of change was defined as the degree of change the subject expected to occur over the six‐week time period. The anticipation of change was positively related to the amount of change that occurred in the construing of the self. Construct meaningfulness was defined as the importance of the construct for understanding the self. There was a negative relationship between construct meaningfulness and the amount of change that occurred over the six‐week interval. Construct differentiation was defined in terms of the relationship between constructs. A less differentiated construct has relationships with many other constructs; a more differentiated construct is more independent of other constructs. Although self‐change was more likely to occur on more differentiated constructs, this relationship decreased to near zero when the effects of anticipating change and construct meaningfulness were controlled. In summary, self‐change is most likely to occur on constructs on which the person sees change as likely, which are less important to the person, and are more independent of other constructs.
Type A behaviour and self‐reports of coping preferences
Authors: Vingerhoets A. J. J. M. , Flohr P. J. M.
Published: July 2011

Three hundred male subjects (age range 25–40) completed both the Dutch version of the Jenkins Activity Survey (JAS) and a revised version of the Ways of Coping Checklist (WCC). Principal component analysis on the WCC yielded six factors with eigenvalues above 2.0: 1 'wishful thinking/escape'; 2 'acceptance'; 3 'problem‐focused/help‐seeking'; 4 'withholding'; 5 'self‐blame'; and 6 'growth'. Factor scores for each factor were averaged and compared between Type As and Type Bs. Type A scores were lower on 'acceptance', but higher on 'problem‐focused/help‐seeking' and 'self‐blame'. These results favour the conclusion that Type As, when confronted with stressful situations, are more prone to active, problem‐focused behaviour, do not acquiesce in the problems, and see themselves, rather than the environment, as the cause of their problems.
The impact of care‐giving on care‐givers: Factors associated with the psychological well‐being of people supporting a dementing relative in the community
Authors: Gilhooly Mary L. M.
Published: July 2011

The aim of this paper is to present findings concerning a variety of factors expected to influence, either directly or indirectly as mediators, the psychological well‐being of persons caring for a dementing relative in the community. The sample included both co‐resident and non‐resident supporters and the data were collected via a semi‐structured interview. Only sex of dependant, sex of supporter, satisfaction with help from relatives, blood/role relationship, duration of care, frequency of visits from a home help and community nurse were significantly correlated with supporters' morale and mental health. The directions of these correlations were, however, not always as expected, e.g. the longer the duration of care‐giving the higher the supporters' morale and the better the supporters' mental health. It was interesting to find that level of impairment and help from family and friends were not significantly associated with morale and mental health of supporters.
Therapeutic function of diagnostic label ‘hysteria’
Authors: Nishiura Kenshi , Yamada Muneyoshi
Published: July 2011

Hysterics are not uncommonly believed by others to be deliberate malingerers; they may be accused of being sick for a purpose. Such an assumption has come to be considered as showing naivete on the part of the accusers from the formal psychiatric point of view.

The case histories of two hysterical in‐patients who conducted themselves 'hysterically' on the ward are cited. It is a noteworthy paradox that their hysterical symptoms faded away when they were able to assume the role of a 'hysteric'. The current report explores the meaning of the diagnostic label of 'hysteria' and the possibility of taking advantage of the very fact that a 'hysteric' can develop into a 'malingerer' through therapy.

The authors recommend that the diagnostic label of 'hysteria' be investigated not merely in terms of communication, but also in terms of its therapeutic function.
The fragile self: Narcissistic disturbance and the protective function of depression
Authors: Mollon Phil , Parry Glenys
Published: July 2011

The role of self‐esteem in the aetiology of depressive disorders is not limited to negative self‐evaluations. A broader concept, embracing the experience of the self, is necessary. A developmental model of self‐esteem regulation is proposed, derived in part from Mahler's work on separation‐individuation in infants and Kohut's work on narcissism. A concept of a ‘fragile self’ is formulated and developed; the depressive state is seen as protecting this fragile self. The model provides a coherent account of individual differences in proneness to depression (in interaction with environmental factors) which is useful to psychotherapists, yet open to empirical test and research use. The model is discussed in relation to psychological research on depression and implications for clinical practice are outlined.
Psychological aspects of patients having multiple operations for low back pain
Authors: Bouras N. , Bartlett J. R. , Neil‐Dwyer G. , Bridges P. K.
Published: July 2011

The aim of this study was to investigate whether psychological abnormalities were present in patients still complaining of low back pain after more than one operation. It was found that these patients were more psychiatrically disturbed and socially disabled than a matched control group whose back pain responded to one operation.

These results suggest that patients requiring assessment for a possible second laminectomy should also be psychiatrically examined.
A scale to measure locus of control of behaviour
Authors: Craig A. R. , Franklin J. A. , Andrews Gavin
Published: July 2011

Many behaviour, psychotherapy and healthy life‐style programmes require subjects to take responsibility for the control of the old unwanted behaviours or to be responsible for maintaining new desired behaviours after therapy has ended. A scale to measure the locus of control of behaviour would be valuable if it could predict persons likely to relapse following apparently successful therapy. A 17‐item Likert‐type scale to measure this construct was developed and shown to have satisfactory internal reliability, to be test‐retest reliable in the absence of treatment, to be independent of age, sex and social desirability, and to distinguish clinical disorder from normal non‐clinical subjects. Furthermore, change towards internality (a reduced LCB score) during therapy was shown to predict maintenance or, alternatively, change towards externality (an increase or no change in the LCB score) was shown to predict relapse 10 months later in treated stutterers. The scale was shown to be related to the personal control factor of the Rotter I–E scale but to be more powerful a predictor of relapse than this personal control subscale or the full Rotter scale.
Dependence and its relationship to depression
Authors: Birtchnell John
Published: July 2011

Evidence is provided that dependence, either as a trait or a state, is closely related to depression. Theories to explain this fall into two broad categories: that some individuals make excessive demands for affection and become depressed when these are not met; and that some have persistently negative attitudes to life and an inclination to self‐blame. These correspond with Blatt's (1974) two sources of depression, the ‘anaclitic’ and the ‘introjective’. Self‐esteem forms a link in both theoretical approaches.

It is proposed that there are three major components to dependence, which have been named affectional, ontological and deferential. The first corresponds with Bowlby's concept of anxious attachment and the psychoanalytic concept of the oral personality. The last is closely related to Beck's (1967) depression‐prone person. The second, originally described by Laing (1965), is concerned with a poorly established identity and causes the individual to relate to another by the imperfect process of fusion. Its part in predisposing the person to depression is less well recognized.

Excessive independence, or detachment, may be as maladaptive as dependence and the opposite of both dependence and independence is autonomy. The autonomous person is truly separate and yet able to form intimate relationships.
Anger, neuroticism, Type A behaviour and the experience of angina
Authors: Smith Timothy W. , Follick Michael J. , Korr Kenneth S.
Published: July 2011

The relationship of personality factors to self‐reported variations in symptoms of angina pectoris and their impact on functioning was examined in a sample of 50 cardiac patients. The frequency of anginal pains was significantly correlated with trait anger. The degree of perceived interference of angina with daily activities was related to Type A behaviour, anger and neuroticism. However, only neuroticism was related to the tendency to avoid activities because of the possibility of angina. Results are discussed in terms of the role of psychological factors in the manifestation and management of angina.
Thought organization and primary process in the parents of schizophrenics
Authors: Meloy J. Reid
Published: July 2011

The nature of the relationship between thought organization and primary process was explored by correlating clinical indicators of thought disorder on the Rorschach and formal primary process mechanisms in the dreams of 14 parents of schizophrenics recorded during a two‐week period. The relationship between variability of primary process intensity and the Thought Disorder Index produced a negative correlation at the 0.05 level of significance. Variability of primary process intensity was not found to be significantly related to the length or frequency of the dreams.

This inverse relationship between formal thought disorder and variability over time of primary process in the dreams of biological relatives of schizophrenics suggested that dream constriction could be a regressive marker in the heritability of schizophrenia.
Mourning distinct from melancholia: The resolution of bereavement
Authors: Rubin Simon Shimshon
Published: July 2011

The premise that mourning has been satisfactorily completed when symptoms associated with the response to loss subside is rejected. The emphasis on the bereaved's behavioural functioning in adjustment to loss has tended to overshadow the recollected relationship to the deceased as a major dimension in the resolution of loss. Elaborating the two‐track model of bereavement (Rubin, 1981), the author focuses upon the relationship to the representations of the deceased from the object relations point of view. The active relationship between representations of the deceased and the bereaved's self‐representations define resolution of loss. Two cases are presented to illustrate the thesis.
Environmental factors associated with continuers and terminators in adult out‐patient psychotherapy
Authors: Cross Darryl G. , Warren Christine E.
Published: July 2011

Two separate studies examined five areas in the patient's environment (e.g. life adjustment, external support, alternative counsel, intercurrent stress events, and other factors such as transport availability and difficulty obtaining time off work) which may influence continuation or premature termination from psychotherapy. In the first study, a mail questionnaire was completed by 69 adult clients (32 terminators and 37 continuers) who attended for therapy at a state‐controlled psychiatric out‐patient clinic. Multivariate analysis of variance on each set of environmental variables failed to achieve significance. Univariate analysis, however, showed the effect of alternative counsel in the community such as the number of people with whom clients could discuss their problems outside of the treatment setting. Continuers, for example, had access to more individuals in the community and actually received more help from specific individuals (e.g. spouses) than did terminators. A replication study was conducted on 45 clients (21 terminators and 24 continuers) who attended for treatment during a further period. Results from the second study showed similar patterning in the data as for Study 1. The role of informal support in conjunction with therapy cannot be overlooked as possibly assisting clients to continue towards their desired goals of treatment.
Cognitive theory, object relations and the self
Authors: Ryle Anthony
Published: July 2011

The main concepts of object relations theory are considered. While the clinical value of the theory is unquestionable, the persistant reification of intrapsychic processes is seen as a barrier to clear thinking and as a cause of the isolation of psychoanalytic thought from general psychology. An account is offered in cognitive terms of how a person's schemes or procedures for interpersonal relating and for structuring the self develop and are maintained. It is suggested that the insights of object relations theory can be restated in these terms.
Delusions: Problems in definition and measurement
Authors: Garety Philippa
Published: July 2011

A review is made of definitions of ‘delusion’. Problems with these are considered in terms of clarity and consistency with the evidence. Questions concerning the issues of fixity and intensity of delusions are raised and a proposal is made for attempting to operationalize these concepts using a ‘personal questionnaire’ method. The measurement in a pilot study of the fixity and intensity of the beliefs of two patients using this method is described and the results reported.
An evaluation of three crisis intervention programmes for general hospital patients
Authors: Viney Linda L. , Clarke A. M. , Bunn T. A. , Benjamin Yvonne N.
Published: July 2011

Three crisis intervention programmes were implemented on the basis of prior research and observation with patients in a general hospital. Programme 1 had been designed to decrease their anxiety and depression, programme 2 to decrease their indirectly expressed anger and increase anger which was directly expressed, and programme 3 to decrease the feelings of helplessness and increase their levels of competence. Examination of the psychological states of the sample of ill and injured patients on admission showed that those who were judged to have a poor counselling prognosis were found, as hypothesized, to be highly anxious, depressed and helpless, and to be expressing their anger only indirectly. The goals of the programmes therefore seem to have been appropriately selected to meet the psychological needs of the patients. After crisis intervention counselling, these differences on admission were no longer apparent on discharge or on follow‐up 12 months later. Programme 1 did not prove differentially effective on discharge or follow‐up. Programme 2 was not found to be more effective than the other programmes on discharge but, as hypothesized, was associated with direct expression of anger and decreased anxiety and depression more at follow‐up. Programme 3 increased patients' expressions of competence and decreased their anxiety more on discharge; but on follow‐up it proved more liable to maintain their depression than to have beneficial effects.
Narcissism and the narcissistic personality disorder: A comparison of the theories of Kernberg and Kohut
Authors: Russell Gillian A.
Published: July 2011

Narcissism has been a perennial topic for psychoanalytic papers since Freud's ‘On narcissism: An introduction’ (1914). The understanding of this field has recently been greatly furthered by the analytical writings of Kernberg and Kohut despite, or perhaps because of, their glaring disagreements. Despite such theoretical advances, clinical theory has far outpaced clinical practice. This paper provides a clarification of the characteristics, diagnosis and development of the narcissistic personality disorder and draws out the differing treatment implications, at various levels of psychological intensity, of the two theories discussed.
Relationships between spider constructs in phobics
Authors: Watts Fraser N. , Sharrock Robert
Published: July 2011

An index of tight construing was derived from a Kelly grid in which the elements were spiders. This index, the coefficient of concordance, corresponds to the average correlation between constructs. Concordance was significantly higher in spider phobics than controls, in line with the hypothesis that emotional disorders are associated with higher correlations between symptom‐related constructs (i.e. ‘tight’ construing). Desensitization, though it reduced phobic anxiety, had no effect on concordance.
Adaptation skills in the elderly, their supporters and carers
Authors: Garland Jeffrey
Published: July 2011

The elderly, their supporters and carers are a large group, relatively neglected by psychologists. They appear to have need of training in adaptation skills in areas which include: orientation; activities of daily living; coping with relocation; memory and reminiscence; problem solving; self‐care of health; coping with depression or anxiety; facing bereavement and other loss; and confronting dying. For care staff, promoting independent behaviour in elderly residents, maintaining positive attitudes and implementing organizational change are important, and for supporters effective use of resources and coping with caregiving strain. Reality orientation, behaviour modification, memory and reminiscence training, individual and group counselling, bibliotherapy and psychotherapy have been widely used but rarely evaluated thoroughly. Texts and training programmes for carers and supporters abound, but their effectiveness awaits detailed investigation.
The performance of depressed and manic patients on some repertory grid measures: A longitudinal study
Authors: Ashworth C. M. , Blackburn I. M. , McPherson F. M.
Published: July 2011

Sixteen of the depressed patients and nine of the manic patients, who were studied by Ashworth et al. (1982), were retested after clinical recovery. As on the previous occasion, each patient completed a repertory grid whose 10 elements were role titles and which employed 12 elicited constructs and one provided construct. After principal component analysis of each grid, various measures of cognitive structure and perception of self were derived. Whereas in the previous study the clinically depressed and manic patients had differed from one another, and usually also from normals, on ‘cognitive simplicity’, ‘integration of self and others’ and ‘self‐esteem’, after recovery these differences had disappeared although there was a tendency for the previously depressed patients to view themselves as different from other people, and for the previously manic patients to have abnormally high self‐esteem. However, for the most part, the cognitive abnormalities and features identified in the earlier study appear to have reflected the patients’ clinical status rather than more permanent aspects of their thinking.
Inversion of parent‐child relationships: A contribution to attachment theory
Authors: Bacciagaluppi Marco
Published: July 2011

Bowlby describes premature parental behaviour in children when discussing the inversion of parent‐child relationships. Normal parental behaviour in children is discussed. Pathological parental behaviour in children is viewed as basically elicited by the weak, infantile aspects of parents. A case history is presented. Premature parental behaviour is viewed as one of several binding mechanisms which may keep a child tied to his/her family of origin.
Relationships between the object focus of therapist interpretations and outcome in short‐term individual psychotherapy
Authors: Piper William E. , Debbane Elie G. , Bienvenu Jean‐Pierre , de Carufel François , Garant Jacques
Published: July 2011

The relationships between the object (person) focus of therapist interpretations and outcome were examined for 21 patients who received short‐term individual psychotherapy. Percentages of single objects and linked objects, e.g. therapist‐parent link, were derived from an analysis of the therapy sessions. Patients, therapists and an independent assessor provided pre‐therapy, post‐therapy and six‐month follow‐up outcome scores. Contrary to other reports in the literature little evidence was found to support the hypothesis of a direct linear relationship between object focus and favourable outcome. Several explanations for the findings are discussed.
The concept of character: Moral and therapeutic considerations
Authors: Dyer Allen R.
Published: July 2011

This paper discusses the relationship between the psychoanalytic concept of character and the moral considerations of ‘character’. Both psychoanalysis (and dynamic psychotherapy) as well as moral philosophy are concerned with judgements of right and wrong. Though psychotherapists take a non‐judgemental attitude toward those in treatment, there are implicit judgements based on the expectation of a developmental progression toward ‘maturity’ and the ability to value actions which go beyond the self. The history of the term character in the psychoanalytic literature is reviewed to show how character is dealt with in psychodynamic psychotherapy as well as the similarity of the concerns of the psychotherapist and the moral philosopher.