bluuebunny/crossref_metadata_2025 huggingface dataset:
Hysterical conversion and dissociation arising as a complication of behavioural psychotherapy treatment of obsessive‐compulsive neurosis
Authors: Bartlett Ann E. A. , Drummond Lynne M.
Published: July 2011

The case history of a patient with obsessive‐compulsive disorder who developed hysterical conversion and dissociative symptoms during exposure treatment is described. The theoretical implications of this finding are discussed.
Alexithymia and Type A behaviour compared in psychodynamic terms of personality
Authors: Keltikangas‐Järvinen Liisa
Published: July 2011

Similarities between alexithymia and Type A behaviour in terms of psychoanalytic personality theory were studied in 164 non‐acute surgical patients. The methods used were the Beth Israel Hospital Questionnaire, the Swedish version of the Jenkins Activity Survey and the Lazare‐Klerman‐Armor personality test. The results showed that alexithymia and Type A behaviour can be compared in terms of compulsive personality. The most evident difference was that certain hysterical features were related to Type A pattern but not to alexithymia.
Interpreting mood scores: Clinical implications of individual differences in mood variability
Authors: Cooper Colin , McConville Chris
Published: July 2011

Mood variability is shown to be a stable characteristic of individuals, such individual differences accounting for some 25 per cent of the total variability of mood scores over time. This large effect is shown to have three major consequences: it is impossible to use tables of norms to assess the severity of a given mood for an individual; the whole logic of using norms for the interpretation of moods is flawed; and correlations between moods and traits have been underestimated in the literature. Various techniques are discussed for minimizing the effects of bias caused by individual differences in mood variability.
Attributional style in paranoid vs. depressed patients
Authors: Candido Carmie L. , Romney David M.
Published: July 2011

The Attributional Style Questionnaire was given to three groups of 15 adult patients: a group of paranoid patients who were not depressed, a group of depressed patients who were not paranoid, and a group of patients who were both paranoid and depressed. As predicted, the paranoid patients manifested an attributional style opposite to that of the depressed patients: that is, they tended to attribute good events to themselves and bad events to others or to chance, whereas the depressed patients tended to attribute bad events to themselves and good events to others or to chance. These findings confirm those of Kaney & Bentall (1989). The patients who were both paranoid and depressed fell in between the two other groups with respect to their attributions of good events but did not differ from the paranoid group in their attributions of bad events. In addition, differences among groups were manifest with respect to self‐esteem, delusional content and suicidal ideation. The implications of these findings for therapy are discussed.
The mood‐peak flow relationship in adult asthmatics: A pilot study of individual differences and direction of causality
Authors: Hyland Michael E.
Published: July 2011

The relationship between mood and peak flow (PEF) was examined in 10 adult asthmatics by taking twice daily readings over 15 days. Three subjects showed a clear overall mood‐PEF relationship but this effect was attributable to recordings taken in the evening and not those taken in the morning. The size of the mood‐PEF relationship correlated significantly with the percentage difference between morning and evening PEF. The results are discussed in terms of the direction of causality between mood and PEF and the need to examine individual differences in the mood‐PEF relationship.
Maintaining a balanced treatment approach with the borderline patient
Authors: Schaffer Norman D.
Published: July 2011

There has been an ongoing controversy in the nature of the recommended treatment for the borderline personality disorder early in therapy. Kernberg emphasizes the negative features of the transference early in therapy and recommends dealing with it primarily by interpretation, confrontation, and limit setting. Adler views the transference early in therapy as primarily reflecting subjectively perceived breakdowns in needed self‐object merger, and recommends creating a symbolic holding environment through empathy and support. Gunderson devotes more equal emphasis to empathizing with and challenging the patient's point of view. The balance between empathy and confrontation is difficult to maintain because of the counter‐transference pull of the borderline. In order to avoid bias toward empathic or confrontive treatment strategies, it is argued that one must pay special attention to the extent to which the therapist understands the plausibility and adaptiveness of the borderline patient's experience and behaviour as readily as the implausibility and maladaptiveness.
Mental illness and rèligious change
Authors: Witztum Eliezer , Greenberg David , Dasberg Haim
Published: July 2011

Over the last 20 years there has been a revival of interest in orthodox Judaism in Israel. In an area of Jerusalem with a large concentration of academies of study for ‘baalei teshuva’ (those who have undergone change to orthodox Judaism), it was noted that 12.6 per cent of referrals to the community mental health centre were newly religious. These referrals tended to have schizophrenia or severe personality disorders and were less likely than other referrals to have anxiety, depressive or adjustment disorders. Most of the newly religious referrals had psychiatric problems prior to becoming religious. Subsequent to religious change, many married and started a family before their psychiatric referral. The link between religious change and mental illness is explored.
A comparison between women seeking self‐help and psychiatric treatment in anorexia nervosa and bulimia
Authors: Deeble Elizabeth A. , Crisp Arthur H. , Lacey J. Hubert , Bhat Ashok V.
Published: July 2011

Thirty new members of a branch of Anorexic Aid were interviewed to determine their characteristics and compared with women seeking psychiatric treatment for anorexia nervosa and normal‐weight bulimia. It was expected that the two samples would be similar and that the women in the self‐help group would have also had professional treatment. Over half (53 per cent, 16) of the Anorexic Aid sample were anorectic, 40 per cent (12) were normal‐weight bulimics and 7 per cent (2) could not be classified and were excluded. Demographic characteristics were similar, with both samples being mainly British, single and from social classes I‐III, but the Anorexic Aid sample was significantly older. Clinical features were also similar, although there was a trend towards the Anorexic Aid anorectics being less severely ill at presentation. Nearly 90 per cent (25) of the Anorexic Aid sample had had professional treatment. The hypotheses are partially confirmed. Reasons for the differences in age and severity are discussed.
Psychological aspects of male infertility
Authors: Kedem Peri , Mikulincer Mario , Nathanson Yvonne E. , Bartoov Benjamin
Published: July 2011

The aim of this research was to study the effect of suspected infertility on psychological functioning, comparing men who suspect that they are infertile (N = 107) with men who have no such suspicion (N = 30). Infertile men had lower self‐esteem, higher anxiety and showed more somatic symptoms than fertile men. The effects of moderating variables on the psychological functioning of the subfertile men were analysed. The findings were that causality of infertility, feelings of hopelessness and global attribution were related to sexual inadequacy. Depression was uniquely related to stress of infertility and global attribution. Global attribution, though predictive of psychological consequences, was not affected by the objective variables of infertility.
Psychiatric out‐patients' reactions to summary letters of their consultations
Authors: Asch Rachel , Price John , Hawks Gail
Published: July 2011

The research reported here was an initial attempt to assess the feasibility and utility of providing new referrals to a psychiatric out‐patient clinic with written summaries of their consultations. After routine consultations patients were randomly assigned to the experimental group (those sent a summary letter, N = 23) or control group (letter to GP only, N = 29). Subsequent assessment interviews revealed that the summary letters were very well received and patients in the experimental group were significantly more satisfied with their consultations than their control group counterparts. Study findings suggest that such letters offer a practicable option which may provide considerable benefits to patients, their families and referring GPs.
Coping, problem solving and stress: A framework for intervention strategies
Authors: Ostell Alistair
Published: July 2011

This article outlines a problem‐solving approach to stress and coping. Beginning with a discussion of these concepts a model is then proposed to describe some of the key psychological processes involved when a person appraises and reacts to a potentially stressful situation. These concepts and the model are then used to provide a framework which illustrates the different ways in which interventions might be made by a psychotherapist to help people improve their coping behaviour when confronted with such situations.
Mental well‐being of good sleepers in a random population sample
Authors: Hyyppä Markku T. , Kronholm Erkki , Mattlar Carl‐Erik
Published: July 2011

It is generally assumed that a good night's sleep has a beneficial effect on mood. The present survey aimed to evaluate what a good night's sleep means for mental well‐being and psychic functional capacity. A random community sample of 670 adult subjects was divided into three groups: good, intermediate and poor sleepers according to a sleep habit questionnaire based on self‐reports. Their cognitive, emotional and personality features were assessed with various psychometric and personality tests, and differences between the groups were evaluated statistically. In the age‐ and gender‐adjusted population the average good sleeper turned out to be a person who falls asleep in 10 minutes, after which his/her 7.5 hours' sleep is serene and without parasomnias. Immediately on awakening in the morning and later during the day he/she is mentally alert without distress or emotional problems.

Definite mood and personality differences between good and other sleepers in the adult population surveyed revealed that good sleepers are psychologically capable of maintaining a self‐esteem which is in functional balance with their life‐goals and mental well‐being.
A semiotic perspective on chronic pain: Implications for the interaction between patient and physician
Authors: Priel Beatrice , Rabinowitz Betty , Pels Richard J.
Published: July 2011

A semiotic conceptualization of pain in the chronic pain syndrome is proposed. It is suggested that among chronic pain patients pain ceases to be an icon or an index and acquires a symbolic structure: this transformation interferes with the usual patient‐physician relationship. The semiotic perspective on the structure of meaning in the chronic pain syndrome underlines the need to include a psychotherapeutic approach in the patient‐physician relationship; specific aspects of the approach to chronic pain as a symbolic communication are discussed.
Fear of dependence in therapeutic relationships
Authors: Pedder Jonathan
Published: July 2011

The fear of dependence is considered as it is experienced by therapists and patients in therapeutic relationships. The concept of dependence is briefly reviewed in the psychoanalytic literature of both East and West. A clinical illustration is given of the fear of dependence in a male patient. It is suggested that the Western ideal of independence is a myth which especially ignores the reliance on internal others.
Psychological research on the martial arts: An addendum to Fuller's review
Authors: Columbus Peter J. , Rice Donadrian L.
Published: July 2011

Most psychological research on the martial arts has been conducted from a positivist stance, and Fuller's (1988) review of research reflected a positivist tone while suggesting that therapeutic influences may be achieved from martial arts training methods abstracted from their traditional setting. This addendum cites two important contextual problems influencing martial arts research. First, the martial arts are influenced by Oriental styles of thinking such as Taoism and Zen Buddhism that are difficult to grasp from a Western positivist point of view. We suggest that phenomenology seems to have some stylistic parallels with Oriental thinking and appears to offer the Westerner a point of entry toward understanding the martial arts as Oriental arts. Second, the cultural and psychological values and meanings of the Oriental martial arts may change when situated in a Western context, thus changing their method, content, and therapeutic influence. We suggest that a non‐positivist and context‐sensitive approach such as phenomenology might clarify the contextual intricacy of the martial arts and thereby facilitate improved theoretical foundations and empirical research of martial arts participation as a psychological phenomenon.
Treatment of a 15‐year‐old girl with chronic muscle‐contraction headache using implosive therapy
Authors: Payne Thomas J. , Colletti Gep
Published: July 2011

A 15‐year‐old girl with chronic muscle‐contraction headache was treated initially using a behaviourally based headache programme. Little change in headache activity resulted. Implosive therapy was incorporated into treatment after the girl revealed a past episode of sexual abuse. A substantial reduction in headache activity was noted at post‐treatment and follow‐up.
Ownership: A pathography of the self
Authors: Mann David W.
Published: July 2011

With this essay I intend to base a theory of psychodynamics on the concept of ownership. I begin with the crucial but negative notion, unconsciousness, exploring certain ways in which this notion is necessary to any psychodynamic theory. Following Havens (1986), I take the concept of self as supraordinate to the elements of psychoanalytic structural theory. Building upon a unique relationship between the self and the unconscious, I then show that variations in self‐ownership suffice to generate the gamut of psychopathological situations. I critique the economic aspect of Freudian psychodynamic theory, suggesting a way to improve upon it. In light of the theory thus elaborated, I examine the problem of deliberate suffering. Finally, I suggest a place of special importance for the present theory in psychoanalysis and psychiatry.
Psychotherapy of a fatherless young woman
Authors: Gill Harwant S.
Published: July 2011

Psychotherapy of some fatherless adult patients suggests that they may replace the shameful experience of their childhood by an illusory picture of their past, and that they may exalt their absent fathers to an ideal perfection in order not to face the possibility that their fathers might have been irresponsible deserters. The two conflicting versions of the absent father, one conscious and one unconscious, are reflected in their image of themselves. They do not talk of their shame, because they hide it from themselves and from others, but it emerges in their dreams. They are driven to enact shame repeatedly, not by experiencing it themselves, but by subjecting their partners and lovers to shame. Their anger against the deserting father remains unexpressed, and is revealed, instead, in relation to the therapist, and in other relationships, and should be interpreted as an unconscious device to conceal their shame at the hands of their fathers. Such interpretations take time to be effective, because knowing the true source of anger (the absent father) would bring the patients too close to the unbearable experience of shame.
Redefining dependence: A reply to Cadbury's critique*
Authors: Birtchnell John
Published: July 2011

What appears to concern Cadbury, as it concerned Kaplan some years earlier, is the suggestion that women may be considered dependent more often than men. My linking dependence with imperfect maturation carried the unfortunate implication that women may be less mature than men. My paper concerned predominantly pathological dependence, which may well be due to imperfect maturation. The distinction between normal and pathological dependence is crucial and has now been more clearly defined. Evidence from a number of sources is provided to confirm that dependence is a complex concept which incorporates the components I proposed. The closeness‐seeking component stands out more distinctly than the others. Dependence is not so much a precursor as a concomitant of depression. Depression is linked only with pathological dependence and this link is probably via a common factor of psychopathology. Pathological dependence is more common in women but only because of its link with depression. There are other pathological forms of relating which are more common in men and which may induce dependence in women. Though conventional femininity may be associated with dependence, dependence as a concept stands up without reference to femininity and applies equally to men and women.
Object relations theory and activity theory: A proposed link by way of the procedural sequence model
Authors: Ryle Anthony
Published: July 2011

An account of object relations theory (ORT), represented in terms of the procedural sequence model (PSM), is compared to the ideas of Vygotsky and activity theory (AT). The two models are seen to be compatible and complementary and their combination offers a satisfactory account of human psychology, appropriate for the understanding and integration of psychotherapy.
Change or homeostasis? A systems theory approach to depression
Authors: Price John S.
Published: July 2011

Looking at the onset of depressive states in linear terms, there is often a problem of distinguishing cause and effect: did the adverse life‐events cause the depression, or did the depression cause the adverse life‐events? If we abandon linear thinking and look at depression in systemic terms, the problem of cause and effect disappears, but it is replaced by another problem: is the patient/environment system characterized by homeostasis or change? Some depressed patients seem to be spiralling down towards disaster. Others seem to be stuck in a rut. In systems terms, can depression be at the same time an agent of change and an agent of stasis (or even homeostasis)? The paradox can be resolved if we postulate that the function of depression is to reconcile the individual to an involuntarily subordinate social role; depression which reconciles to a pre‐existing subordinate position has static properties; depression which mediates a switch to a subordinate position from a previously dominant position has properties of systemic change.
A questionnaire designed to assess roles and goals: A preliminary study
Authors: Lam Dominic H. , Power M. J.
Published: July 2011

Social‐cognitive theories of depression predict that an individual is at more risk of becoming depressed if the individual's only dominant role or goal is disrupted by a life‐event. This paper reports the development of an instrument which assesses the individual's important roles and goals; preliminary data are presented from two samples (sample 1 of elderly people, sample 2 of younger adults) taken from the age‐sex registers of GP practices. The overall reliability of the questionnaire is good, and evidence was obtained for the predicted pattern of an overvalued role or goal being more likely to be correlated with depressive symptomatology.
Is alexithymia a non‐neurotic personality dimension?
Authors: Rubino I. Alex , Grasso Silvia , Sonnino Alberto , Pezzarossa Bianca
Published: July 2011

The basic hypothesis of the literature on alexithymia, i.e. that alexithymia has a higher prevalence in psychosomatic than in neurotic (and delusional) patients, was empirically tested by means of the well‐validated Toronto Alexithymia Scale (TAS). Surprisingly, neurotic and delusional patients (N = 71) had significantly higher mean total scores on the TAS, compared with the psychosomatic group (N = 150); the normal control sample (N = 224) was, as predicted, the lowest scorer. This hierarchical distribution was confirmed for the first two factors of alexithymia: (1) difficulty in distinguishing between feelings and bodily sensations, and (2) difficulty in expressing feelings. The psychiatric group was, instead, the lowest scorer on the third factor (lack of fantasy life). A substantial cross‐validation of the above findings was achieved by comparing on the TAS three subgroups of the normal sample (symptom‐free, somatizing and ‘neurotic’ normal controls). The postulate of the non‐neurotic nature of alexithymia, along with its many psychopathological and technical corollaries, is completely contradicted by the present findings.
Maternal personality and sex of infant: A comment on Grant
Authors: James William H.
Published: July 2011

Grant (1990) reported significantly higher dominance scores during pregnancy of mothers who later bore sons than mothers who later bore daughters. Such findings have been reported in other species, and evidence is adduced here to suggest that this difference is not wholly a temporary effect of the pregnancy but probably pre‐ and post‐dates the pregnancy.
Beliefs and fears underlying the Type A behaviour pattern in adolescents
Authors: Shahidi Shahriar
Published: July 2011

The present study was designed to test Price's (1983) cognitive social learning model of Type A in an adolescent population. A questionnaire measuring beliefs and fears thought to underlie Type A together with two measures of Type A (the Bortner scale and the student version of the Jenkins Activity Survey, SJAS) were administered to over 300 adolescents. Results showed that subscales measuring Type A beliefs and fears had acceptable levels of internal reliability and formed two separate components (beliefs and fears). Measures of beliefs and fears correlated significantly but modestly with measures of Type A thus providing some support for Price's cognitive social learning model. Furthermore, some striking sex differences were found. Results are discussed in terms of the implications of these beliefs and fears in studying the Type A behaviour pattern in children and adolescents and the modification of the behaviour pattern in the younger population.
The effect of olfactory stimulation on fluency, vividness of imagery and associated mood: A preliminary study
Authors: Roberts Amelia , Williams J. Mark G.
Published: July 2011

Twenty‐two subjects were asked to visualize positive and negative phrases following exposure to either chamomile oil or placebo. Chamomile oil significantly increased the latency for all images, and shifted mood ratings and frequency judgements in a more positive direction, suggesting a possible mode of action for such oils.
Human motivation objectively, experimentally analysed
Authors: Cattell Raymond B.
Published: July 2011

The growth of validated objective devices, and of knowledge of ergic and sentiment structure has now, for 20 years, put new instruments (MAT and SMAT) in the hands of psychological practitioners. They have been slow to recognize, however, the theoretical powers in conflict measurement, decision theory, the general dynamic calculus, and structured learning theory which this has brought about. Illustration is given here of the experimental and clinical gains, with a view to the growth of several areas inaccessible to bivariate experiment.
Group therapy in the management of epilepsy
Authors: Mathers Carola B. B.
Published: July 2011

A pilot project using group therapy with patients from an epilepsy clinic is described. Observations of the group show that members were able to discuss their feelings about having epilepsy, and the difficulties the disorder caused in all areas of their lives, and to tolerate and learn from seizures which took place during group meetings. The greatest benefit was meeting others with epilepsy and sharing experiences in an environment that was not overprotective or overanxious, in contrast to their usual surroundings. The author suggests that groups of a similar nature could be a useful addition to the management of people with epilepsy.
If A–B does not predict heart disease, why bother with it? A clinician's view
Authors: Conduit E. H.
Published: July 2011

Ray asks the question: ‘If A–B does not predict heart disease, why bother with it?’ (British Journal of Medical Psychology, 64 (1) 1991). Having worked for several years in prevention of heart attack recurrence, I am inclined to agree with his conclusion that the construct is a trail which should now be abandoned. Grief, hostility and social isolation, fear and work demands have each been implicated in heart disease independently of Type A.
The psychodynamics of the STD clinic: Secrecy, splitting and isolation
Authors: Coleman R. , Etchegoyen A.
Published: July 2011

We introduce the idea of a professionally isolated and apparently disconnected agency. We describe how health professionals working in settings with good multi‐agency links may not recognize the effect of the isolated agency system on the presentation of problems.

In particular, we describe the setting of the Sexually Transmitted Diseases clinic (STD) in which confidentiality can be turned into secrecy by the patients at the service of their denial of the seriousness of their problems. The isolation of the STD clinic as an agency resonates with the patients' isolation from their own feelings and emotional contact with people. It also isolates the professional and the therapeutic network. By way of clinical examples, we describe how this may deskill the staff and lead to dangerous situations.
The music therapy of an anorectic mentally handicapped adult
Authors: Heal Margaret , O'Hara Jean
Published: July 2011

Where words fail, music may be a medium through which to explore one's inner world and experiences. Psychodynamic approaches have helped us to understand what it means to be handicapped (e.g. Sinason, 1992). The subtleties of diagnosing anorexia nervosa have recently been recognized in this group (e.g. Cottrell & Crisp, 1984). Music therapy has been used with clients of normal intelligence who have eating disorders (Nolan, 1989; Sloboda, 1993; Smeijsters & van den Hurk 1993). This article illustrates the music therapy of a woman with Down's syndrome (IQ = 50) and anorexia nervosa. It describes her management and progress in music therapy in relation to her external world and anorectic behaviours.

Music has charms to soothe a savage breast

The Mourning Bride, I.1 William Congreve (1670–1729)
The role of psychological processes in the aetiology and treatment of cervical cancer: A biopsychological perspective
Authors: Lambley Peter
Published: July 2011

Cervical cancer is one of the most serious illnesses affecting women today, particularly in developing societies. Despite medical advances in treatment and the success of cervical screening programmes in detection, the incidence of the disease is increasing. In this paper it is argued that one of the reasons for this is that the aetiological model employed for cervical cancer takes little account of psychological and psychophysiological factors. Both of these factors are now thought to play important roles in disease processes. Research in these areas is reviewed and a new aetiological model for cervical cancer described. This model incorporates existing epidemiological and medical formulations into a new multifactor framework. The implications of this model for treatment are explored and it is suggested that psychological interventions could play a much greater role than they have in the past.
Crazy talk: Thought disorder or psychiatric arrogance?
Authors: Szazz Thomas
Published: July 2011

The crazy talk exhibited by some mental patients is re‐examined. Our inability to understand the other is not a valid reason for concluding that he is insane, much less that he has a brain disease. The seemingly senseless speech of persons called ‘psychotic’ resembles glossolalia or the religious phenomenon of ‘gift of tongues’ rather than a speech disturbance, such as aphasia, indicative of brain disease.
Thomas Szasz, crazy talk and the myth of mental illness
Authors: Bentall Richard P. , Pilgrim David
Published: July 2011

In this article, Szasz's analysis of ‘crazy talk’ is considered in the context of his wider critique of psychiatric theory. We argue that Szasz has performed an important service by drawing attention to psychiatric prejudice regarding the causes of abnormal behaviour, and by pointing to the role of values in psychiatric decision making. However, Szasz may be criticized for his oversimple analysis of the concept of ‘illness’ and for his failure to recognize that values are central to all clinical decision making, including the diagnosis of physical illness. In the light of these criticisms we identify important weaknesses in his arguments about the incoherent speech of psychiatric patients.
Cognitive therapy for depression with individuals with intellectual disabilities
Authors: Lindsay William R. , Howells Lesley , Pitcaithly Deborah
Published: July 2011

The increase in research into psychopathology in people with intellectual disability has recently spread to include depression. Several reports have appeared on the assessment of depression in the client group and there is a pressing need for research into treatment of depression in people with intellectual disability. The present paper reviews cognitive behaviour therapy for depression and reports on its adaptation for people with intellectual disability. Two case studies of individuals with mild intellectual disability illustrate the clinical applications. All the elements of cognitive behaviour therapy for depression were maintained and simplified. Both subjects were able to monitor their feelings of depression and subject 2 monitored the frequency of suicidal thoughts. Improvements were seen in both cases on the Zung Depression Inventory and daily monitoring of depressive feelings.
Coping strategies in major depressed, agoraphobic and comorbid in‐patients: A longitudinal study
Authors: Hoffart Asle , Martinsen Egil W.
Published: July 2011

The first aim of this study was to explore the diagnostic specificity of coping styles by comparing ways of coping in non‐anxious major depressed, non‐depressed agoraphobic, and both major depressed and agoraphobic (comorbid) in‐patients. The second aim was to investigate whether a vulnerability model, a state model, or a combined vulnerability‐state model of coping accounted best for the data. On admission and when discharged, 95 patients completed the Way of Coping Checklist and were evaluated on several symptom scales. Self‐report symptom scales were completed at one‐year follow‐up as well. The ‘purely’ agoraphobic and the comorbid patients showed less seeking of social support and more wishful thinking than the major depressed patients. For the wishful thinking scale, these differences were related to differences in level of global psychopathology. Overall, the results for the seeking social support scale were consistent with a combined vulnerability‐state model. The problem‐focused coping and wishful thinking scores behaved mostly as state phenomena. The avoidance scores provided ambiguous evidence. In a subsample of 30 agoraphobic patients who received a combination of exposure and psychodynamic treatment, higher pre‐treatment levels of seeking social support and lower pre‐treatment levels of avoidance as coping both predicted a more favourable course of symptoms pertaining to fear of fear in the one‐year follow‐up period.
The California Psychotherapy Alliance Scales: A pilot study of dimensions and elements
Authors: Barkham Michael , Agnew Roxane M. , Culverwell Alison
Published: July 2011

The reliability and clinical utility of the rater form of the California Psychotherapy Alliance Scales (CALPAS‐R) was investigated on a sample of 12 one‐hour audiotapes representing differing therapeutic dyads and sampled from sessions two to six of a relationship‐oriented (exploratory) therapy within pilot cases of a large outcome study. Both global dimensions and element‐based ratings were used to test the feasibility of employing the elements as a way of obtaining a finer‐grained analysis of the therapeutic alliance. Results are reported in terms of the inter‐rater reliability of the dimensions and elements, and show element ratings to yield dimensional measures similar or superior to global ratings in reliability. In addition, CALPAS‐R ratings were analysed in conjunction with client ratings of session depth and smoothness as well as helpfulness.
Peripheral victims of the Herald of Free Enterprise disaster
Authors: Dixon Penny , Rehling Graham , Shiwach Raj
Published: July 2011

We report on an unexpected phenomenon following the Herald of Free Enterprise disaster. A series of cross‐channel ferry workers referred by their GPs to the Folkestone Mental Health Team, during the three years after the disaster, presented with post‐traumatic stress disorder, despite having no direct contact with the disaster as survivors, bereaved relatives or helpers. A retrospective case study is described of 14 ferry crew members presenting with PTSD. Thirteen completed the GHQ60. Evidence is presented of severe functional impairment in this group. It is argued that these subjects are indirect victims of the Herald of Free Enterprise disaster. Ways in which the ‘ripples outward’ of a major marine accident might extend to such peripheral victims are discussed.
Is alexithymia a non‐neurotic personality dimension? A response to Rubino, Grasso, Sonnino & Pezzarossa
Authors: Taylor Graeme J. , Bagby R. Michael , Parker James D. A.
Published: July 2011

Rubino, Grasso, Sonnino & Pezzarossa (1991) reported a significantly higher level of alexithymia in neurotic and delusional patients than in psychosomatic patients, and concluded that alexithymia is not a non‐neurotic personality dimension. Further empirical data are cited, however, that contradict this conclusion and support the view that alexithymia is a type of affect deficit.
Previewing and the therapeutic use of metaphor
Authors: Trad Paul V.
Published: July 2011

This paper proposes a new technique for diagnosing and treating conflict in adult patients. Referred to as previewing, the technique is grounded in the developmental progression from somatic modes of representation to symbolic modes of representation. During early life, infants experience the world primarily through sensory phenomena. Later in childhood, however, symbolic modes of representation become pre‐eminent. The manner in which an individual represents conflict reflects this developmental progression. For example, if the patient manifests a psychosomatic symptom, it is likely that the conflict has been represented on a physical level and thus emerges in somatic form; if the conflict is expressed as a metaphor, however, it has probably been represented on a cognitive level and thus emerges as a symbol. Previewing, a technique derived from early life interaction between mother and infant, incorporates both the somatic and symbolic components of psychological disorganization and may therefore be of benefit in psychotherapy.
Religiosity as a predictor of well‐being and moderator of the psychological impact of unemployment
Authors: Shams Manfusa
Published: July 2011

This paper examines the relationship between employment status and psychological well‐being for a sample of British Asians; and explores the role of religiosity both as a direct predictor of well‐being and as a moderator of the impact of unemployment. Two samples of male employed (N = 69) and unemployed (N = 71) British Asians were interviewed, selected to be equivalent in age and a number of demographic variables. Findings showed poorer psychological well‐being for the unemployed group, and especially for those of middle age; thus replicating findings for white groups. Furthermore, the hypothesis of religiosity as buffering the impact of unemployment was confirmed. Results are interpreted in terms of transactional models of stress, and the benefits of religious belief and practice for unemployed people of Asian background are discussed.
Phobics show poor recall of anxiety words
Authors: Watts Fraser N. , Coyle Kieran
Published: July 2011

An experiment was conducted on recall bias between words relating to stimulus and response aspects of spider phobia. In contrast to the experiment of Watts & Coyle (1992) mixed lists were used. Whereas Watts & Coyle had found no bias of phobics between stimulus and response words, the present experiment found that phobics were relatively impaired in the recall of words relating to the anxiety response, compared with words relating to the stimulus features of spiders. This suggests a cognitive mechanism, not unlike repression, in which diminished recall of anxiety‐related material helps to protect against the build‐up of anxiety. Also, over the three times the word list was presented, phobics showed a non‐significant trend to forget more stimulus words between lists. It is recommended that future studies on recall bias associated with anxiety should examine trial‐to‐trial changes as well as overall recall levels.
Daily events and mood prior to the onset of respiratory illness episodes: A non‐replication of the 3–5 day ‘desirability dip’
Authors: Stone Arthur A. , Porter Laura S. , Neale John M.
Published: July 2011

We attempted to replicate and extend the findings of three previous studies (Evans & Edgerton, 1991; Evans, Pitts & Smith, 1988; Stone, Reed & Neale, 1987) that found a lagged relationship between daily life events, mood and the onset of episodes of respiratory illness. The findings and methods of the three previous studies are reviewed, and similarities and differences in their analytic approaches are discussed. Seventy‐nine middle‐aged male subjects completed daily records of life events, mood and symptoms for an average of 83 days. Twenty‐three men suffered at least one illness episode that met our selection criteria. Using the methodology of Stone et al. (1987) and Evans et al. (1988), we were unable to detect a relationship between daily events or mood and the onset of illness episodes. The necessity of standardizing procedures of defining illness episodes and control days and the importance of including analyses of variables that may mediate the relationship between events and illness are discussed.
Women who stab: A personal construct analysis of sexual victimization and offending behaviour
Authors: Pollock Philip H. , Kear‐Colwell John J.
Published: July 2011

The personalities and perceptions of two women with a history of very significant sexual abuse who had committed serious violent offences against ‘boy friends’ are investigated using role construct repertory grid (Kelly) and hypotheses developed for treatment, in particular to prevent any reoffending. The most significant dimension that emerged was in general terms that of ‘abuser‐victim’. It was clear that there was significant confusion about their self‐perceptions with regard to these roles. They perceived themselves as abusers despite their histories of victimization. There was a high level of guilt associated with the victim role in each woman and in previous therapy simply dealing with their victim role gave rise to very disturbed self‐destructive behaviour and even more guilt.

The grid results enabled the abuser self‐perception to be identified and treatment programmes to be developed using Ryle's cognitive‐analytic therapy. Following treatment further grids and clinical evidence suggested that there were significant changes in self‐perception and in behaviour. The findings were discussed and the need for further investigations suggested.
Attentional bias, persecutory delusions and the self‐concept
Authors: Kinderman Peter
Published: July 2011

Recent studies of cognitive processes associated with persecutory delusions suggest that such delusions are associated with abnormalities in the processing of information relevant to the self. Attention to positive and negative trait words was studied in subjects suffering from persecutory delusions, matched subjects with depressed mood and normal controls using an emotional Stroop task. Subjects were required to name the ink colours of: (i) meaningless strings of Os, (ii) low self‐esteem personal adjectives, (iii) high self‐esteem adjectives and (iv) neutral adjectives. Subjects were also asked to rate the degree to which they endorsed as self‐descriptive these and other personally descriptive adjectives. The subjects with persecutory delusions demonstrated a significantly higher rate of endorsement for positive adjectives than negative adjectives, but showed a marked degree of interference when colour‐naming both positive and negative words. The relevance of these findings to a model of persecutory delusions involving the self‐concept is discussed.
Consciousness and psychotherapy
Authors: Ryle Anthony
Published: July 2011

The origins and resistance to change of neurotic procedures are considered with particular reference to the nature and role of consciousness. It is argued that the traditional opposition between conscious and unconscious systems provides an unsatisfactory model. The crucial role of language in the formation of human self‐consciousness is emphasized. The restricted procedural repertoire of neurotic subjects, and their deficient self‐consciousness, can be attributed to a number of factors. It is argued that the main use of consciousness in therapy should be to heighten the patient's awareness of his or her damaging or restricting procedural repertoire through the process of reformulation, which allows recognition, and in due course revision to be achieved.
The professional construction of ‘paranoia’ and the discursive use of diagnostic criteria
Authors: Harper David J.
Published: July 2011

This study examined the ways in which five mental health professionals talked about paranoia. A discourse analysis (Potter & Wetherell, 1987) suggested that interviewees positioned themselves, and were themselves positioned, by a number of discourses, or systematic ways of talking, in relation to this topic. These discourses appeared to serve a number of functions including the maintenance of professional legitimacy. Interviewees used a number of rhetorical strategies (including exploiting the range and ambiguity of diagnostic definitions, criteria and theories) in order to meet challenges, for example that paranoid beliefs might be true.
Self‐evaluation of psychotherapeutic competence
Authors: Elizur A. , Kretsch R. , Spaizer N. , Sorek Y.
Published: July 2011

The authors investigated the process of change of self‐evaluation of therapeutic competence in psychotherapists enrolled in a postgraduate training programme of psychotherapy. An analysis of the relationships between self‐evaluated therapeutic skills and level or stage of formal training was performed. The results of this study suggest that a higher level of self‐evaluated therapeutic skill among applicants was followed by a decline in self‐evaluation as the training progressed, and a gradual increase in self‐evaluation towards the end of formal training. The findings reveal a curvilinear pattern of change which suggests specific internal cognitive/emotional processes leading to the formation of a professional self‐image as a psychotherapist.
Avoidant attachment as a risk factor for health
Authors: Kotler Tamara , Buzwell Simone , Romeo Yolanda , Bowland Jocelyn
Published: July 2011

A style of coping with stress is described which has been observed in cancer patients and in highly dependent, insecurely attached individuals. This coping style includes the suppression of negative emotions and avoidance of support seeking. It is suggested that this pattern of responses is potentially dysfunctional insofar as it tends to perpetuate distress and may increase vulnerability to a broad range of illnesses. These considerations provide the basis for a provisional conceptual model, which links avoidant attachment style to the regulation of negative affect and to symptoms of psychological and physical ill‐health. This is tested on a sample of young adults under stress and predictions from the model are largely supported.
The meaning of parenthood and couples' reactions to male infertility
Authors: Edelmann Robert J. , Humphrey Michael , Owens David J.
Published: July 2011

This paper reports findings from a postal survey of 205 couples belonging to the National Association for the Childless who saw their infertility as due to the male partner. Two self‐report scales used in previous studies were administered to measure personal and social identity needs as a basis for parenthood (the Meaning of Parenthood scale), and emotional distress and marital problems. Endorsement of items on the Meaning of Parenthood (MOP) scale showed only small mean gender differences for each item and a consistent item rank order for men and women. Factor analysis confirmed that the scale tapped dimensions pertaining to social and personal identity needs. For women, distress was associated with ratings on the MOP scale which emphasized the link between femininity and motherhood, while for men distress was associated with ratings which emphasized masculinity and fatherhood. Implications of the results for further research and counselling in relation to male infertility are discussed.
Pornography and the paedophile: Is it criminogenic?
Authors: Howitt Dennis
Published: July 2011

There are few case‐study‐based reports of the role of pornography in the lives of sex offenders in contrast with numerous studies of a survey and statistical nature. Very little is known about the ways in which offenders process pornographic and other erotic materials as part of their offending patterns. The research reported in this study was based on case studies of fixated paedophiles in a private clinic for sex offenders. The men were interviewed about a range of matters including their offending, their psychosexual histories, pornography, fantasy, and sexual abuse in childhood. Commercial pornography was rarely a significant aspect of their use of erotica although some experience of such materials was typical of the men. Most common was ‘soft‐core’ heterosexually oriented pornography. Explicit child pornography was uncommon. However, offenders also generated their own ‘erotic’ materials from relatively innocuous sources such as television advertisements, clothing catalogues featuring children modelling underwear, and similar sources. In no case did exposure to pornography precede offending‐related behaviour in childhood. All of the offenders had experienced childhood sexual abuse by adults or older peers. The relationship of these findings to previous research and implications for legislation are noted.
Power, boundaries, intersubjectivity
Authors: Owen Ian R.
Published: July 2011

The first part of this paper is a brief overview of the keynote speech given by Jeffrey Masson at the Sixth Conference of the Society for Existential Analysis, London, entitled Issues of power in the psychotherapeutic relationship, in which Masson raised various questions about the assumptions of what constitutes the alleged inappropriate behaviour of therapists, and the boundaries of the professional role that must not be overstepped. These criticisms are begun to be addressed in this paper. The overall aim of this paper is to promote a sceptical and critical discussion of the psychotherapeutic relationship and a few of its founding assumptions.
Family therapy with ‘invisible families’
Authors: Hay Justin , Leheup Rachael , Almudevar Mariano
Published: July 2011

This paper describes a therapeutic model for working with children in the care system who have severe behavioural problems. The model is an extension of consultation work and was developed from clinical material. It links some of the theories about the internal conflicts of children to their family history and ways of consulting with the professional network, to give a coherent framework for action. The advantages and shortcomings of this model are discussed and some preliminary results are reported.