bluuebunny/crossref_metadata_2025 huggingface dataset:
Elder Mistreatment
Authors: FULMER TERRY
Published: September 2018

Elder mistreatment (EM) is a serious and prevalent syndrome that is estimated to affect between 500,000 to 1.2 million older adults in the United States annually (Pillemer & Finkelhor, 1988). This chapter reviews both the state of the published science and limitations in the knowledge base on the topic. The literature for this review was obtained through computer-assisted searches of PubMed (878 citations), the Cumulative Index of Nursing Research (CINAHL) (593 citations) and Psych-Info databases (443 citations). The search terms used were elder mistreatment, elder neglect, elder abuse, or domestic abuse of the elderly. No limit was placed on the age of publications because of the relative scarcity of research on the subject. Nonnursing articles were included because there are so few nurse researchers addressing this topic. The age limit for subjects in these studies was 65 years and older. Studies were limited to those conducted in the United States, and descriptive studies were included as they form the majority of the research to date. Findings indicate that frail, very old (over 75 years), older adults who have a diagnosis of depression or dementia are more likely to be mistreated (Dyer, Pavlik, Murphy, & Hyman, 2000; Coyne, Reichman, & Berbig, 1993; Fulmer & Gurland, 1996; Lachs & Pillemer, 1995; Lachs et al., 1997; Lachs, Williams, O’Brien, Pillemer, & Charlson, 1998; Lachs & Fulmer, 1993; Lachs, Berkman, Fulmer, & Horwitz, 1994). Those older adults who required assistance with activities of daily living had poor social networks and were at higher risk for EM (Lachs & Pillemer, 1995; Lachs et al., 1997; Lachs et al., 1998; Lachs & Fulmer, 1993; Lachs et al., 1994). Neglect, as a subcategory of EM, accounts for the majority of cases (Fulmer, Paveza, Abraham, & Fairchild, 2000; Pavlik, Hyman, Festa, & Bitondo Dyer, 2001; Fulmer & Gurland, 1996). There is still debate regarding the role of minority status, abuse in childhood, and the persons most likely to mistreat older adults. There is a critical need for replication studies and new research on this important topic. Problems with measurement, funding challenges, and the paucity of investigators conducting research on EM have left the field with several unanswered questions and some conflicting findings. This chapter summarizes the interdisciplinary literature and makes recommendations for future nursing research programs.
Growing Up With Chronic Illness: Psychosocial Adjustment of Children and Adolescents With Cystic Fibrosis
Authors: CHRISTIAN BECKY
Published: September 2018

This chapter reviews the published research from 1980 through 2001 on the psychosocial adjustment of children and adolescents with cystic fibrosis. The inclusion criteria were that research was conducted by nurses and researchers from related disciplines that focused on the psychosocial adjustment of children (6 to 12 years) and/or adolescents (13 to 22 years) with cystic fibrosis (CF). Three computerized databases were used for retrieval: Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, and PsycINFO. Of the 74 citations published from 1980 through 2001, only 20 studies met the inclusion criteria, including 7 nursing research studies and 13 studies published by nonnurses in related disciplines. Key findings from this review were that the focus of nursing research was on the social consequences of chronic illness, while the non-nursing research focused on self-concept, self-worth, and psychiatric symptoms of anxiety, worry, and behavior problems. Only two programs of research were identified. Developmental science was used as a guiding framework for the critique of the research. Recommendations for future research include developmentally sensitive longitudinal studies to track developmental change and stability over time, as well as research that captures individual developmental differences.
Children’s Psychological Responses to Hospitalization
Authors: VESSEY JUDITH A.
Published: September 2018

The data-based literature addressing children’s psychological responses to hospitalization was reviewed using methods outlined by Cooper (1989). Using a developmental science perspective, early research was reviewed and a model of variables that contribute to children’s responses was constructed. This model consists of three major foci, including maturational and cognitive variables (developmental level, experience, coping style), ecological variables (family and hospital milieu), and biological variables (inborn factors and pathophysiology). Coping serves as the overarching framework for examining these variables and their contributions to children’s responses to hospitalization. A variety of theoretical perspectives from the social sciences have been used, with psychoanalytic and stress and adaptation theories predominating. The majority of the research used simple case study, descriptive, or pre- and post-test designs. Methodologic issues were common. Little qualitative work has been done. Future research directions call for studies to adopt new theoretical and empirical models that are methodologically rigorous and clinically relevant and that embrace the precepts of developmental science.
Developmental Transition From Gavage to Oral Feeding in the Preterm Infant
Authors: THOYRE SUZANNE M
Published: September 2018

The development of early oral feeding skills in the preterm infant is an active and complex area of nursing research. This integrative review summarizes the accumulated nursing research since 1990 that describes feeding the preterm infant during the transition from gavage to full oral feeding. Literature was identified through searches of databases covering the fields of nursing and medicine and of journals and nurse researchers who publish in this area of study. Four main areas of research were identified: development of infant feeding skills, descriptive studies on the transition period, studies that focus on identifying infant readiness to begin oral feeding, and studies that explore optimal ways to advance oral feeding as the infant moves toward full oral feeding. Research studies were critiqued from a developmental science perspective, which conceptualizes feeding skill as an emergent property of multiple systems, both within and outside the infant, that are interacting and working together to promote optimal functioning. Through this analysis, areas for future research are identified.
Physical Symptoms in Children and Adolescents
Authors: RHEE HYEKYUN
Published: September 2018

This chapter summarizes and critiques research on physical symptoms in children and adolescents from a developmental science perspective. Studies conducted by researchers from various disciplines, primarily after 1990, were identified through searches of MEDLINE, CINAHL, and Psyc INFO. This review focuses on two areas: the prevalence of common physical symptoms—headache, abdominal pain or discomfort, musculoskeletal pain and fatigue—in pediatric populations and the developmental issues associated with these symptom experiences. Developmental factors were organized into two overarching categories, individual and environmental factors. Findings indicate that demographic factors, including age, pubertal development, gender, and race or ethnicity; psychological factors, particularly self-esteem, depression, and anxiety; and behavioral factors have varying relationships to the report of physical symptoms in children and youth. In addition, family and parents, peers, and the broader school and community ecology of children have an influence on physical symptom complaints. There is a need for further studies that are strengthened by the use of developmentally sensitive theoretical frameworks and methodologies that address complicated developmental issues.
Alcohol Use and Alcoholrelated Problems Among Lesbians and Gay Men
Authors: Hughes Tonda L.
Published: September 2018

While a substantial amount is known about some of the risk factors for alcohol-related problems among lesbians and gay men, major gaps in knowledge exist. Epidemiological studies focusing on alcohol use rarely ask about sexual orientation, and broad-based studies of sexual minority population groups have only occasionally assessed alcohol use. Although the AIDS crisis has stimulated substantial research on alcohol and other substance use among gay men, only a handful of studies have systematically explored lesbians’ use of alcohol. Further, existing research on sexual orientation and alcohol use is characterized by a plethora of methodological problems. Nevertheless, when viewed as a whole, this research suggests that lesbians and gay men are more likely than their heterosexual counterparts to drink alcohol and to report alcohol-related problems; differences based on sexual orientation are more pronounced for women than for men. Risks related to alcohol use do not stem from sexual orientation per se, but are more likely a consequence of cultural and environmental factors associated with being part of a stigmatized and marginalized population. Much of the research on alcohol use among sexual minorities has focused on White, middle-class, and well-educated lesbians and gay men. There is a clear need for more research with bisexual women and men and with sexual minority members of color. Longitudinal studies, including those that focus on treatment effectiveness, are particularly lacking.
The Case for Alcohol Research as a Focus of Study by Nurse Researchers
Authors: Stevenson Joanne S. , Sommers Marilyn Sawyer
Published: September 2018

Sixty percent of the U.S. population drinks alcohol. Although numerous investigators have shown that low-volume alcohol intake has positive influences on cardiovascular health, bone density, and cognition, there is a fine line between positive, neutral, and negative ramifications of alcohol consumption on health. Alcohol accounts for 7% of the global burden of disease and injury from all causes and for 10% to 11% of all illnesses and death each year worldwide. So alcohol use is a two-edged sword.

Psychiatric nurses have a long history of involvement with alcoholic patients, and alcohol users, misusers, and abusers comprise a significant percentage of the patient load in every specialty and subspecialty of nursing. Yet nursing education has neglected this important area of content in general nursing curricula, staff development has not trained mainstream nurses to routinely assess for alcohol problems among hospital patients, and primary care providers have failed to do case finding.

During the past 25 years, the federal government has funded curricular and faculty development programs to bring alcohol information into the core of health provider training. The process has been halting and minimally successful at best. One ramification of the inattention to alcohol-related education is the dearth of nursescientists engaged in programs of research in the field of alcohol abuse. A federally funded faculty development program in the 1990s focused attention on this issue, and a small cadre of nurses were trained to do related research. Several of the authors in this volume are members of that group.

A brief overview of the focus of each of the remaining chapters in this volume is presented. A rationale is provided for the importance of this area of research for nursing knowledge and quality patient care in essentially all areas of nursing practice. Finally, several burning research questions are posed that would most appropriately be answered through nursing research.
Hospital-Acquired Infections as Patient Safety Indicators
Authors: Peterson Ann Marie B. , Walker Patricia H.
Published: September 2018

Transmission of infection in the hospital has been identified as a patient safety problem adversely affecting patients, visitors, and health care workers. Prevention of infection should not be limited to the hospital epidemiology staff but also must involve the entire multidisciplinary team, including nurses. This chapter reviews the literature related to patient safety of nursing-authored studies of infection control in the hospital. The review indicated that there were key areas of research interest including drug resistance; hand hygiene products, procedures, and surveillance; preoperative skin preparations; health care worker transmission of infection; common procedures associated with an increased risk of transmission; and organizational issues.
Genomics and Proteomics Methodologies for Vulnerable Populations Research
Authors: Kasper Christine E.
Published: September 2018

This chapter describes common genomic and proteomic methods and their application to the study of vulnerable population groups. The International HapMap project is discussed in relation to unique Haplotype single nucleotide polymorphisms (htSNPs) in population groups. In addition, studies, which have used these methods to investigate aging, ethnic, and racial specific conditions, as well as psychiatric diseases, are reviewed. Advantages and limitations of various genomic and proteomic approaches are discussed in relation to population admixture and sample selection.
Vulnerable Populations in Thailand: Giving Voice to Women Living With HIV/AIDS
Authors: Nyamathi Adeline , Covington Chandice , Mutere Malaika
Published: September 2018

Thailand was the first Asian country hit by the AIDS epidemic, and in the 1990s reported the fastest spread of HIV/AIDS in the world. According to Thailand’s Ministry of Public Health, women, primarily between the child-bearing ages of 15 and 49, are increasingly becoming infected with HIV. A number of factors contribute to the increasing AIDS epidemic, including the rise of the commercial sex industry in Thailand; social disparities that have existed between men and women throughout Thailand’s history; and the gender-expectations faced by Thai women toward family and society.

Thailand enjoys one of the oldest, reputedly successful primary health care delivery systems in the world; one that relies on community health workers to reach the most rural of populations. In the mid-1990s, day care centers were established at district hospitals by the Thai government to provide medical, psychological, and social care to people living with HIV/AIDS (PWA). Buddhist temples also provide a source of alternative care for PWAs. However, the AIDS policy of the Thai government relies on families to care for the country’s sick.

Although poor women are a vulnerable population in Thailand, they are changing the paradigm of AIDS stigma while providing a significant cost-savings to the Thai government in their caregiving activities. Based on existing nursing studies on Thailand, this chapter gives voice to poor Thai women living with HIV/AIDS, and examines how they make sense of their gendered contract with society and religion while being HIV/AIDS caregivers, patients, or both.
Nursing Research and the Prevention of Infectious Diseases Among Vulnerable Populations
Authors: Peragallo Nilda , Gonzalez Rosa M.
Published: September 2018

Racial and ethnic minorities, women and infants, youth, and other special needs populations have been found to be disproportionately affected by infectious disease morbidity and mortality, particularly Human Immunodeficiency Syndrome/Acquired Immunodeficiency Syndrome (HIV/AIDS) and other sexually transmitted diseases (STDs). Being a vital component of the health care delivery system, nurses play an important role in improving the health of these vulnerable populations. Twenty-six studies reporting results from evaluations of prevention strategies targeting HIV/AIDS and other STDs among vulnerable populations were reviewed. The more effective interventions appeared to be those that tailored their program content to the specific risk factors of their target population and included skills training in their curriculum. Although nurses have contributed significantly in understanding the risk factors of vulnerable groups in the United States through cross-sectional research studies, more research is needed in the evaluation of intervention programs that use this knowledge to develop and implement prevention programs, particularly at a population-based level.
Establishing the Public’s Trust Through Community-Based Participatory Research: A Case Example to Improve Health Care for a Rural Hispanic Community
Authors: Shelton Deborah
Published: September 2018

This chapter describes the contextual nature of contemporary rural America to provide the background for the case example of a 4-year community-based participatory research project to enhance community capacity building in a rural New England community with a large Latino/Hispanic population. The changing nature of rural populations and implications for rural health care and nursing research are discussed.
Intimate Partner Violence in Rural Environments
Authors: Annan Sandra L.
Published: September 2018

The purpose of this chapter is to review nursing and other research related to rural intimate partner violence. The author presents a review of research in the area of intimate partner violence in the rural setting. The findings indicate that there is limited nursing research related to intimate partner violence in rural communities. The review describes the prevalence and types of abuse, the rural service issues, and the consequences of battering. The chapter also discusses the health implications of violence in the rural setting. The author concludes with a presentation of a research agenda for nursing research in rural environments.
Cognitive-Behavioral Interventions With Chronic Fatigue Syndrome: A Single Case Study
Authors: Bertagnolli Andrew , Morris Susan
Published: September 2018

Chronic Fatigue Syndrome (CFS) is a disorder characterized by disabling fatigue often causing a reduction in daily activities and depressed mood. Individuals struggling with CFS have been noted to have maladaptive automatic thoughts that interfere with efforts to return to a satisfying lifestyle. Cognitive behavioral therapy (CBT) has been shown to be an effective treatment in changing maladaptive cognitions. A treatment package applying CBT techniques to the maladaptive thoughts associated with CFS was developed for these patients. This case-study examines the effectiveness of a CBT group intervention with a 39 year old Caucasian woman diagnosed with CFS for 3 years. Presented is a CBT conceptualization of CFS and a detailed case formulation delineating some disease specific cognitions. The patient discussed showed improvements in measures of psychological distress, perceived stress and depression. Although no change was noted in levels of reported fatigue, the patient reported fewer symptoms of depression, increased activity tolerance and improved quality of life after participation in group.
Pain Management Training: A Cognitive-Behavioral Approach to Treating HIV-related Peripheral Neuropathy
Authors: Evans Susan , Fishman Baruch
Published: September 2018

Approximately 1-2 million Americans are estimated to be infected with the human immunodeficiency virus (HIV). Peripheral neuropathic pain in ambulatory patients with HIV is prevalent and associated with significant psychological distress, social-vocational impairment and diminished quality of life. Alternatives to analgesics are needed for a variety of reasons including the fact that analgesics alone are not always successful in treating pain and many patients have fears regarding side effects, addiction, and tolerance. Pain Management Training (PMT), a manualized treatment developed by the authors, is designed to target HIV-related peripheral neuropathic pain and its related distressing symptoms. PMT employs a cognitive-behavioral approach to pain and suffering, with the primary goal of increasing the patient’s sense of control and self-efficacy over the pain experience. This purpose of this paper is to describe, in detail, the structure of PMT utilizing patient examples to illustrate the approach.
The Integration of Cognitive and Behavioral Interventions in Routine Behavior Therapy
Authors: Linden Michael , Pasatu Jaqueline
Published: September 2018

Some theoretical positions see cognitive therapy and behavior therapy as separate while others see the two as integrated forms of treatment. An open question is how these perspectives are reflected in therapeutic practice and whether in routine care one should speak from different modes and schools of treatment or rather an integrated form of cognitive-behavior therapy. Thirteen hundred and forty-four epidemiologically representative and extensive case reports, written for treatment application in routine outpatient care, were analyzed by content-analytic methods. The results indicated that cognitive and behavioral interventions were used at the same rate and in an integrated way under the heading of behavior therapy. Some differences in treatment modes were found between different mental disorders. In depressive disorders cognitive methods were slightly more prevalent (95%) than behavioral methods (86%) while in anxiety disorders behavioral techniques (95%) were used somewhat more frequently than cognitive methods (83%). It was concluded that under the perspective of epidemiology of care an integrated form of cognitive behavior therapy is what therapists actually provide.
Integration of Cognitive Psychotherapies: Vive La Différence!, Right Now
Authors: Caro Isabel
Published: September 2018

This paper comments on Ramsey’s paper, Postmodern cognitive therapy: Cognitions, narratives, and personal meaning-making, which discusses the possibility of an integration between narrative and more traditional cognitive models. Although an integration is possible, I consider it to be a difficult task given the large theoretical, epistemological and ontological differences between the two ways of understanding not only therapy, but human beings as meaning-making subjects. Therefore, in reviewing this paper I discuss this difficulty and what I consider to be a more useful path to follow.
Anger Control in Men: Barb Exposure With Rational, Irrational, and Irrelevant Self-Statements
Authors: Tafrate Raymond C. , Kassinove Howard
Published: September 2018

Anger can be frequent, intense and enduring, and is associated with intrapersonal and interpersonal distress as well as medical disorders. It is, therefore, important that effective treatments be developed. Based on the rational-emotive behavior therapy hypothesis that situational anger experiences are related to irrational thinking, we evaluated the therapeutic effects of practice with rational self-statements. Angry adult men (n = 45) from the community received 12 individual treatment sessions which consisted of repeated exposure to anger-provoking verbal barbs while they rehearsed rational, irrational or irrelevant self-statements. Results were generally supportive of the rational-emotive based intervention. In response to imaginal and face-to-face provocations, men who practiced rational self-statements were less angry on measures of state anger, anger-out, dynamometer intensity, and dynamometer frequency. Reactions to the barb technique were good, as indicated by a positive therapeutic alliance. Further exploration of this technique as part of a full spectrum treatment strategy for anger is recommended.
Combining Guided Dialog With Cognitive Therapy for Depressed Women: Six Single-Case Studies
Authors: Randall Elizabeth J. , Thyer Bruce A.
Published: September 2018

Cognitive therapy (CT) alone was compared to CT, plus a communication skills and relationship repair intervention called Guided Dialog (GD), in the treatment of six depressed women. Outcomes measures were the Beck Depression Inventory and the Miller Social Intimacy Scale, repeatedly administered over time in the context of single-subject research designs. Three women received CT alone, and three received CT followed by CT plus GD. Results indicated that all patients recovered from depression; however, patients who received the combined form of treatment registered greater improvements in intimacy than did clients who received cognitive therapy alone. While tentative, these results suggest that the combination of a relationally based form of treatment such as Guided Dialog, together with cognitive therapy, may warrant a more formal randomized trial.
Short-Term Therapy for Somatization Disorder: A Cognitive Behavioral Approach
Authors: Allen Lesley A.
Published: September 2018

Somatization disorder is a distressing, disabling, and costly disorder. A short-term treatment manual, applying cognitive behavioral techniques to the maladaptive behaviors and thoughts associated with somatization disorder, was developed. The present case report examines the effectiveness of this 10-session treatment with a 38-year-old woman diagnosed with somatization disorder. The results show an improvement in the patient’s physical and emotional distress at termination, 6-month follow-up, and 12-month follow-up assessments.
The Relationship Between Interpersonal Schemas and Personality Characteristics
Authors: Soygüt Gonca , Nelson Liane , Safran Jeremy D.
Published: September 2018

The present study was designed to examine the relationship between the interpersonal schemas (as measured by the Interpersonal Schema Questionnaire) and personality characteristics (as measured by the Millon Clinical Multiaxial Inventory) within the framework of Safran’s (1990) cognitive-interpersonal approach. Ninety-two patients (40 men, 52 women) participated in this study. Their mean age was 35.09 years. The results generally demonstrated that expected responses from significant others in submissive situations were negatively correlated with histrionic personality characteristics. Expected responses from significant others in friendly situations were negatively correlated with schizotypal personality characteristics. Expected responses from significant others in friendly situations were positively correlated with antisocial personality characteristics.
Comparison of Rationales in Symptom Prescription
Authors: Boettcher Laura L. , Dowd E. Thomas
Published: September 2018

The present study examines the effects of the overt presentation of a variety of rationales underlying symptom prescription directives in a brief therapy experiment with anxious college student undergraduates. Forty undergraduate volunteers received a directive to increase their anxiety under one of four rationale conditions: (a) no rationale, in which the directive was given without a rationale; (b) positive refraining, which stressed the positive characteristics of anxiety symptoms; (c) performance anxiety, which described the vicious cycle created by direct attempts to decrease anxiety; and (d) double-bind, in which students were told that the counselor expected them to change whether or not they followed the directive and why this was so. Results showed significant therapeutic gain across all four treatment conditions on outcome measures of anxiety, internal attributions for change and self-efficacy; however, there were no differential effects due to type of rationale on any measure.
Cognitive Therapy with Aged Persons: Implications of Research Design for Its Implementation and Evaluation
Authors: Hayslip Bert , Caraway Marsha L.
Published: September 2018

On the basis of intervention research with elderly persons, numerous research design issues are discussed that influence the implementation and evaluation of cognitive therapy with aged individuals. These issues reflect a concern for the impact of placebo effects, sampling, and attrition on treatment efficacy, as well as attention to the measurement of rational thinking in the aged. Moreover, environmental support for rational solutions to everyday problems among older persons may vary. It is argued that given the limited research to date, an awareness of such issues must temper conclusions about the effectiveness of cognitive interventions with older persons.
Cognitive-Behavioral and Existential-Phenomenological Approaches to Therapy: Complementary or Conflicting Paradigms?
Authors: Edwards David J. A.
Published: September 2018

The relationship between the cognitive-behavioral and existential-phenomenological traditions in therapy is examined. While Beck cites phenomenological writers such as Heidegger, Husserl, and Binswanger, he does not initiate any dialogue with this tradition in depth. Parallels are drawn between the goals of psychotherapy as outlined by Rogers and goals identified in the contemporary cognitive-behavioral literature, between cognitive therapy’s approach to clients’ underlying assumptions and the phenomenological reduction as described by Husserl, and between a shared acceptance of the therapeutic use of the client-therapist interaction. While, in both approaches, therapists take on an educative role, in each approach a different aspect of the learning process is focused on. Phenomenological therapy’s attitude to reality testing, the dangers of a directive stance by the therapist, the conflict between empathy and rational dialogue, and cognitive therapy’s view of emotion are also discussed. The complementarity between the two approaches is emphasized and a continuing dialogue recommended.
Social Anxiety and the Recall of Interpersonal Information
Authors: Hope Debra A. , Heimberg Richard G. , Klein John F.
Published: September 2018

Sixty subjects classified as high or low in social anxiety participated in a structured heterosocial interaction under conditions of either high or low social-evaluative threat. Following the interaction, subjects were asked to recall detailed information about the interaction partner’s appearance and the content of the conversation. Socially anxious subjects recalled less information and made more errors in recall than nonanxious subjects. Contrary to prediction, social-evaluative threat did not affect recall. Anxious subjects also reported greater self-focused attention during the interaction. High self-focused attention was associated with superior recall for nonanxious subjects but associated with more frequent omission errors for anxious subjects. Results support cognitive-behavioral formulations of social anxiety which propose that socially anxious individuals engage in self-focused thinking which may impair their ability to process social information.
Concepts of Causality Applied in the Clinic: Interactional Models and Attributional Style
Authors: Munton Anthony G. , Stratton Peter M.
Published: September 2018

The purpose of the investigation was to compare causal attributions made by families attending a therapy clinic with those made by control families in interview. Attributional statements were extracted from transcripts of ten therapy sessions and ten control interviews, and coded according to a system described in Stratton et al. (1986). In order to examine the issue of whether a family can be said to possess an attributional style, a multivariate analysis of the data was undertaken. Results indicated that while differences between the family groups did exist on some attributional dimensions, attributional style was less evident. The clinical significance of those differences that did emerge is discussed within an interactional framework.
Assessment of Self-Efficacy in Articulated Thoughts: “States of Mind” Analysis and Association with Speech-Anxious Behavior
Authors: Davison Gerald C. , Haaga David A. F. , Rosenbaum Joel , Dolezal Sharon L. , Weinstein Karen A.
Published: September 2018

This study related articulated thoughts during simulated situations (ATSS) to behavioral observations. Articulated thoughts of undergraduates in supportive and stressful simulated public speaking situations were coded for indices of positive and negative self-efficacy and outcome expectations. Cognitions varied as expected across situations. In the stressful, but not the supportive, situation, a “state of mind” ratio relating (positive) to (positive + negative) self-efficacy was inversely correlated with behaviorally rated speech anxiety and self-reported trait speech anxiety. The results suggest that (1) self-efficacy can be reliably and validly inferred from articulated thoughts; (2) these thoughts are meaningfully related to overt behavior; (3) social cognitive theory might fruitfully incorporate the states of mind model; and (4) “challenging” subjects or clients by such means as imagining stressful situations may be necessary to activate cognitions associated with negative emotions and dysfunctional behavior.
Psychoanalysis and the Cognitive Therapy of Personality Disorders
Authors: Lockwood George
Published: September 2018

Personality disorders, through a series of vicious cycles and self-fulfilling prophecies, usually skew interactions and events in a manner that confirms the preexisting cognitive distortions. As a result, therapy often becomes part of the problem rather than the problem part of the therapy. Cognitive therapists can benefit in dealing with this phenomenon by drawing on recent developments in psychoanalytic theory and technique. Object-relations theory views problems in the therapeutic relationship as a function of internalized representations of early child-parent interactions being projected onto the relationship (the cognitive equivalent of schemas being triggered within the therapeutic relationship.) Treatment can be enhanced by taking advantage of this process as the therapist acts as a participant-observer, helping the client clarify the projections (schemas) and then test and correct them, in part, through having a new kind of interpersonal experience with the therapist (encountering new evidence in the here-and-now), and then re-internalizing a new self-image and set of assumptions about others.
Working Together: Belief Systems of Individuals and Organizations
Authors: Richman Diana R.
Published: September 2018

Individuals and organizations establish and maintain relationships to fulfill their needs and goals. When their expectations are met, their relationship is mutually beneficial. However, throughout their dynamic career development cycle belief systems may diverge and result in workplace issues. This article emphasizes the need to recognize the cognitive component in developing programs to reduce individual/organizational problems. Conflicting and incompatible belief systems are described, and a rational-emotive approach is recommended for identifying and modifying the unrealistic, rigidly maintained beliefs in the individual/organizational relationship.
Problem Solving from Different Perspectives: An Investigation of Instructional Context on Social Problem-Solving Ability
Authors: Penn David L. , Spaulding Will , Hope Debra A.
Published: September 2018

The Means-Ends Problem Solving task (MEPS) was used to assess the effect of instructional set on means-ends thinking. Half of the vignettes were presented from the perspective of a hypothetical individual and half from the subjects’ own personal perspective. Results showed that subjects instructed to respond from the perspective of the hypothetical other produced less socially appropriate responses when their own perspective was presented first. When the order of instructed perspective was reversed (i.e., hypothetical other first), no differences in response quality or quantity were found. This finding supports the use of the MEPS in its traditional form. Results from a second task (alternative solution generation), designed to assess the effect of priming across different social problem solving-tasks, revealed a facilitative priming effect. Individuals generated more solutions to a problem situation when the previous MEPS vignettes had been in the instructed perspective order of Other-Self. Implications of the study’s findings for a two-stage model of problem solving and clinical assessment are discussed.
Examining Specific Cognitive Change in Cognitive Therapy for Depression: A Controlled Case Experiment
Authors: Chadwick Paul D. J.
Published: September 2018

Cognitive therapy (CT) is purported to ease depression primarily by weakening the influence of certain depressive beliefs. Customarily, this claim is supported by a reduced score on one or more of the standardized measures of dysfunctional thinking, and not by measuring beliefs specific to the individual; nor is it usual practice to monitor dysfunctional beliefs regularly before and throughout CT. The present single-case study describes a new approach for studying specific cognitive change by obtaining ongoing data on process and outcome. Multiple-baseline methodology was used to measure the impact of CT on four depressive beliefs identified during apre-baseline assessment stage. The patient, a man in his late 30s, was diagnosed according to Research Diagnostic Criteria (RDC: Spitzer, Endicott, & Robins, 1978) as having a primary depressive disorder which showed as moderate to severe on the Beck Depression Inventory (BDI: Beck & Steer, 1987). Anumberof measures of change were used, including weekly ratings of the degree of conviction with which the four beliefs were held, and the BDI was given at regular intervals. By the close of therapy, all beliefs were rejected and the BDI scores indicated that the client was asymptomatic. Validation of change was provided by an independent clinician who conducted pre- and post-assessment interviews, and via the Dysfunctional Attitudes Scale (DAS: Weissman & Beck, 1978); while this increased confidence that the reported changes were genuine, the limitations of the study are acknowledged. Maintenance over the six-month follow-up period was good. The study thus offers provisional evidence of specific cognitive change in CT, and describes a new methodology that could be used on a wider scale to reveal if cognitive change has primacy over symptom relief.
The First Seven Years: A Review
Authors: Buboltz Walter C.
Published: September 2018

A review of the Journal of Cognitive Psychotherapy: An International Quarterly was conducted for the first seven volumes. Articles were classified under 17 content categories which were devised by the writer and the editor of the Journal. Additionally, leading contributors, institutional affiliations, and geographic locations were computed. A total of 139 articles were examined, excluding editorials, book reviews, and abstracts. The data collected present a view of the field of Cognitive Psychotherapy and the Journal. Two principal areas of research activity and publication were evident: Cognitive Models/Science and Cognitive Therapy with Specific Disorders, which accounted for over 35% of the articles examined. No one author or institution was dominant during the period covered. Small percentages found suggested that a variety of authors and institutions are active in research in the area of Cognitive Psychotherapy. A large geographical representation was present, with a number of foreign countries included.
Dysfunctional Beliefs About Intimacy
Authors: Kayser Karen , Himle David P.
Published: September 2018

Although research has identified a number of behaviors that can foster or hinder the expression of intimacy in relationships, the specific identification of dysfunctional beliefs about the nature and development of intimacy has been neglected in the literature. Based on clinical observations, this article presents eight such beliefs that may hinder the development of intimacy and become the target of cognitive therapy intervention strategies for appropriate revision. An example of the process of assessing dysfunctional beliefs about intimacy in the marital context is presented.
From What Kind of Self-Control Can Children Benefit?
Authors: Ronen Tammie
Published: September 2018

Meta-analyses have raised doubts concerning the effectiveness of cognitive methods for treating children’s disorders. This article contends that these doubts stem predominantly from the lack of a basic theoretical model for treating children with cognitive therapy, in contrast with the paradigm existing for adults. In view of the variety of different cognitive techniques used to solve children’s problems, this article presents an adaptation to children of Rosenbaum’s (1993) three types of self-control as a model for reference and comparison: redressive, reformative, and experiential. It is suggested that most children can benefit from cognitive therapy in general and from self-control training in particular. This can occur if treatments are designed in terms of developmental stage, socioeconomic background, and the nature of children’s problems regarding etiology and overcontrolled versus undercontrolled disturbances. This report aims to facilitate the therapist in adapting the appropriate cognitive techniques to the child’s specific behavioral problem, needs, and cognitive style.
Resource Column: Web Sites that Address Postpartum Depression
Authors: Heringhausen Julie , Montgomery Kristen S.
Published: September 2018

This column reviews four Web sites that address postpartum depression.
Activist for Change: An Interview with Suzanne Arms
Authors: Zwelling Elaine
Published: September 2018

Suzanne Arms’s name is readily recognized by many in the field of perinatal education. For 30 years she has been a tireless advocate for childbearing women, a fighter for change in the traditional maternity care system, and a feminist with strong beliefs about the physical, emotional, and spiritual impact of birth. Arms’s well-known books and frequent speaking engagements have allowed her to spread her message and her plea to humanize the childbirth experience. Talking with Arms is an energizing encounter. Her life path is a powerful and compelling story that is an inspiration to all who continue to work to make birth a positive event in the lives of women and their families.
Questions from Our Readers: Home Birth—Safely Protecting and Supporting Normal Birth
Authors: Lothian Judith A.
Published: September 2018

In this column, the author examines the safety and advantages of home birth. She urges childbirth educators to promote normal birth by encouraging pregnant women to consider the option of home birth.
Web Sites that Address Gestational Diabetes and Perinatal Obesity
Authors: Montgomery Kristen S.
Published: September 2018

Obesity contributes to multiple health problems during pregnancy and predisposes a woman to develop gestational diabetes. This column reviews the currently best Web sites that address gestational diabetes and obesity during the perinatal period.
Aquatic-Aerobic Exercise as a Means of Stress Reduction during Pregnancy
Authors: Parker Kara Mallory , Smith Sheila A.
Published: September 2018

The goals of this research were to explore the current literature regarding associations between psychological stress and adverse fetal outcome, associations between aerobic exercise and psychological stress reduction, and associations between aerobic exercise and fetal outcome. The published studies that were located provide evidence of the following: 1) Stress reactivity increases physiologically during pregnancy, 2) pregnant women may experience additional stressors that are usually not experienced in a nonpregnant state, 3) psychological stress in pregnancy is associated with adverse fetal outcome, 4) exercise can be a method of stress reduction, 5) exercise in pregnancy is not associated with adverse fetal outcome, and 6) exercise in pregnancy may provide benefit to the fetus. Data were analyzed from an original study and associations were reported between psychological stress-management activities and participation in aquatic aerobic exercise classes. No reports were available investigating an exercise-induced reduction in psychological stress with fetal outcome.
Childbirth Education and Doula Care During Times of Stress, Trauma, and Grieving
Authors: Pascali-Bonaro Debra
Published: September 2018

A collaborative, interspecialty volunteer program extending for nine months after September 11, 2001, provided free support and service to pregnant women widowed by the attacks on the World Trade Center. Participating providers studied the physiological and psychological effects of stress. Group sharing, discussions about the effects of emotions on labor progress, and other techniques were incorporated into sessions. The program’s success suggests that childbirth educators should prepare all pregnant women to cope with stress. Subsequent national and international events have reinforced the importance of such training. The childbirth educator can also help by maintaining a referral list of local trauma counselors and other resources.
Web-Based Perinatal Education for the New Obstetrical Patient: A Quality Improvement Project
Authors: Ellington Kelly
Published: September 2018

Mixed-methods quality improvement project improved the new obstetrical perinatal education curriculum by cultivating reliable delivery of evidenced-based initiatives linked to successful pregnancy. The web-based format enhanced family-centered care in a teaching format in the comfort of the home. The identification of at-risk populations resulted in improved referral for cell-free fetal DNA screening. A qualitative approach assessed overall provider satisfaction with web-based teaching. The patient survey identified barriers for noncompletion of web-based content. Quantitative data identified completion rate, high-risk populations for referral for advanced screening, and provider satisfaction with web-based curriculum content in a teaching platform linked to the provider’s website.
Amazing Things Happen When Student Nurses Are Given Birth Doula Training
Authors: O’Brien Erin , Hotelling Barbara A.
Published: September 2018

At the Duke University School of Nursing, accelerated BSN students participate in a free Doulas of North America birth doula training to learn support of prenatal, intrapartum, and postpartum women and their families. They learn to participate as team members providing continuous physical and emotional support to women in the perinatal period and to appreciate how hormones support physiologic labor and birth. This training complements classroom information and clinical experiences.
Using Generalizability Theory for the Estimation of Reliability of a Patient Classification System
Authors: McDaniel Anna M.
Published: September 2018

This article discusses the measurement issues associated with estimating the reliability of patient classification systems (PCSs). Generalizability theory is proposed as an approach to overcome the limitations of traditional methods of estimating reliability of PCSs. The results of a demonstration study in which generalizability theory is used to support the reliability of a PCS are reported. A coefficient of generalizability, analogous to the reliability coefficient, was computed based on the variance components estimated. The generalizability coefficient for the total PCS score was .034, which increased to .650 when one item was deleted. The generalizability coefficient for individual items ranged from .053 to .961. Suggestions for further instrument development are offered.
Development of the Multidimensional Hope Scale
Authors: Raleigh Edith H. , Boehm Susan
Published: September 2018

In this psychometric study, a scale to measure hope in chronically ill patients was developed and evaluated. Four hundred fifty participants with a variety of chronic diagnoses completed two forms of the Multidimensional Hope Scale (MHS) (state and trait) and the Beck Hopelessness Scale (BHS). High levels of internal consistency (alpha = .95) and test-retest reliability (r = .82, p < .001) were estimated for the state form. Good concurrent validity was also indicated with a significant negative correlation between the MHS and the BHS (r = -.45, p < .001). Factor analysis using principal axis factoring and oblimin rotation identified six factors: Resource to Others, Civic Interest, Spirituality, Health, Social Support, and Self-Actualization. The psychometric data suggest a promising tool for measuring hopefulness in physically ill individuals.