bluuebunny/crossref_metadata_2025 huggingface dataset:
Attachment in anorexia nervosa: A transgenerational perspective
Authors: Ward Anne , Ramsay Rosalind , Turnbull Susan , Steele Miriam , Steele Howard , Treasure Janet
Published: February 2003

Both clinical and empirical studies suggest that insecure attachment is common in eating disordered populations. Clinical studies have addressed mother‐daughter interactions, but there has been little empirical research into the mother's own attachment patterns and whether there might be intergenerational transmission of these patterns. We aimed to examine the attachment status of patients with severe anorexia nervosa and their mothers, using the ‘gold standard’ Adult Attachment Interview (AAI). We predicted: (1) a high level of insecurity among the patients (women with anorexia nervosa with or without bulimic behaviours); (2) that the mothers would show a higher rate of insecurity than predicted by population norms; and (3) that there might be attachment style associations within mother‐daughter pairs. Twenty consecutive in‐patients with a DSM‐IV diagnosis of anorexia nervosa were interviewed using the AAI, as were 12 of their mothers. The mental state of daughters was rated by experienced clinicians, and that of mothers by the Clinical Interview Schedule (Revised). AAIs were transcribed and rated by expert raters. Nineteen (95%) daughters and 10 (83%) mothers were rated insecure on the AAI. Of these, 15 (79%) daughters and seven (70%) mothers were dismissive in type. We did not find an association between mothers' and daughters' attachment style. The incidence of unresolved loss was high among the mothers (67%). Idealization scores were high and reflective functioning scores low in both mother and daughter groups. Women with anorexia nervosa and their mothers commonly have a dismissive attachment style. Low levels of reflective functioning and high idealization scores are found in both groups, and may be learned (or transmitted) from mother to daughter. A difficulty in emotional processing, exemplified by unresolved loss, may be transmitted to daughters, and act as a risk factor for the development of anorexia nervosa.
Body experience and mental representation of body image in patients with haematological malignancies and cancer as assessed with the Body Grid
Authors: Weber Cora , Bronner Ekkehard , Thier Pia , Schoeneich Frank , Walter Otto , Klapp Burghard F. , Kingreen Dorothea
Published: February 2003

The domain of body image plays a central role in the quality of life of patients with haematological malignancies and metastasized cancer, since the disease itself as well as the enrolled therapies interfere with psychological and bodily well‐being. We approached this highly subjective field by using the repertory grid technique and hypothesized that patients would display a restricted body image, focusing on functional aspects of the body. In all, 55 in‐patients (27 men, 28 women, M age = 45.7 yrs, N = 46 with haematological malignancies, N = 9 with metastasized cancer), at the time of initial diagnosis, were included in the study and assessed with the Body Grid, an instrument specifically designed by us for the exploration of body image. The data were analysed by principal component analysis (PCA) and construct categorization. Further, 42 chronic tinnitus sufferers (20 male, 22 female, M age = 46.5 yrs) served as a comparison group. Based on the constructs elicited, six construct categories were formulated in the sense of a first attempt of a hierarchical model (emotion, control, activity, strength, function, appearance). The central constructs (373 construct pairs) were assigned to these categories by three inter‐raters. The categories appeared in the following order of frequency: function (27.1%), emotion (20.4%), strength (20.1%), activity (15%), control (10.2%) and appearance (7.2%). PCA indicated that the patients mainly demonstrated a restricted view of their body. In the tinnitus group, the most frequent category proved to be activity (21.3%), closely followed by function (21.1%) and control (20.9%). The body image was also restricted (PCA). The restriction of body image, together with the specific construct choice, seen in the haematology and cancer patients reflects the existential threat of the disease and may serve as a coping strategy. The high percentage of emotional constructs may mirror the patients' need for further support. The distinct distribution of construct categories in the two different patient samples supports the applicability of the proposed preliminary model.
Fatigue and patterns of pain in fibromyalgia: Correlations with anxiety, depression and co‐morbidity in a female county sample
Authors: Kurtze Nanna , Svebak Sven
Published: February 2003

This study explored the prevalence of fibromyalgia, the relationship of anxiety and depression with two major symptoms (pain and fatigue), and the role of co‐morbidity. Participants were recruited from the Nord‐Trøndelag Health Study (The HUNT Study) in Norway (N = 92 936). They were females given the diagnosis of fibromyalgia by their doctor (N = 1 816), divided into one sample without (N = 977) and another with (N = 839) co‐morbidity. Owing to colinearity between anxiety and depression, extreme groups were defined according to high vs. low anxiety and depression scores. About four‐fifths of the initial sample were excluded by this approach, which permitted a two × two factorial split‐plot ANCOVA for the assessment of the relations of anxiety and depression with pain and fatigue. The overall prevalence was 3.2%, which obscured a highly biased sex difference with 5.2% for females and .9% for males. Results from the sample without co‐morbidity (N = 977) supported the idea of independent partial correlations of anxiety and depression with pain and fatigue. A different trend was indicated in the co‐morbidity sample (N = 839) where fatigue was only significantly associated with depression, whereas pain was associated with anxiety. The idea of widespread pain was supported consistently only in participants without co‐morbidity who scored low on anxiety. Age, incident pain and depression contributed to a discriminant function reflecting the status of co‐morbidity.
How do transitional objects work?: The therapist's view
Authors: Arthern Jenny , Madill Anna
Published: February 2003

Research into the use of transitional objects (Winnicott, 1971) by adult clients in psychotherapy has given little attention to the question of how a transitional object (TO) works. This question is addressed through the use of a semi‐structured interview. Data was collected on the clinical practice and theoretical understanding of TO emergence and use of three psychodynamic‐interpersonal (PI) and three Gestalt psychotherapists. A grounded theory analysis suggests that a TO works by a process of embodiment which can be structured with reference to a four‐level model consisting of physical, process, contextual and conceptual levels. Therapists of both orientations emphasized the TO as a focus of intersubjectivity within the therapeutic relationship. Differences between the PI and Gestalt therapists are also examined. The clinical implications of this four‐level model of embodiment for the use of TOs in psychotherapy are explored, together with suggestions for further research.
Detecting complex patterns in interpersonal profiles
Authors: Haslam Nick , Gurtman Michael B.
Published: February 2003

The assessment of interpersonal problems has advanced in recent years with the development of new methods for analysing individual profiles. These new methods assume that each profile can be modelled by a mathematical function that reflects the person's single prevailing interpersonal theme. However, some profiles may contain more complex patterns, with two or more distinct themes. Such complexities in a person's interpersonal profile might be clinically important, perhaps reflecting an interpersonal style that is conflictual. In an effort to detect complex patterns, Fourier analysis was applied to profiles of 200 psychotherapy out‐patients and 200 undergraduates, using the Inventory of Interpersonal Problems. Although many profiles did not clearly manifest a single prevailing interpersonal theme, having two distinct profile peaks, their apparent complexity generally resulted from measurement error. Systematically complex or conflictual patterns were rarely detectable. Profiles of interpersonal problems may contain complex patterns, but simple patterns reflecting the prevailing interpersonal theme are apt to be more clinically informative.
Multidimensional scaling analysis of paranoid symptoms in the context of depressive and psychotic disorders
Authors: Whaley Arthur L.
Published: February 2003

The present study examined a continuum of paranoid symptoms in the context of depressive and psychotic disorders from a multidimensional perspective on psychopathology. Based on the self‐ratings of 404 community residents, 96 depressed patients, and 65 psychotic patients, similarities or dissimilarities among multiple measures of paranoia (i.e. mild, moderate, and severe types), along with 16 other psychiatric symptom scales taken from the Psychiatric Epidemiology Research Interview (PERI; Dohrenwend, Shrout, Egri & Mendelsohn, 1980, Dohrenwend, Levav & Shrout, 1986 b, were analysed using multidimensional scaling supplemented by cluster analysis. Four hypotheses were tested. Only one hypothesis was fully supported and two were partially supported. No distinct dimension for the continuum of paranoia emerged, but a global dimension of severity of psychopathology was pervasive and stable across diagnostic subgroups. The latter finding replicated and extended previous multidimensional studies of psychopathology.
Designing response scales for cross‐cultural use in health care: Data from the development of the UK WHOQOL
Authors: Skevington Suzanne M. , Tucker Christine
Published: February 2003

Designing response scales for use in cross‐cultural situations presents several semantic and conceptual challenges. Here we report response scales designed in the UK, using a method developed collaboratively by the WHOQOL Group to tackle some of these issues. The response scales were generated for use with items established for a British version of a new cross‐cultural quality of life measure for health and health care‐the UK WHOQOL. A quota sample of 20 sick and well people assigned 60 descriptions to separate 100 mm lines (15 for each of 4 types of response scale) where the polar anchor points had been internationally agreed as meaningful in 10 countries. Means and standard deviations (SD) were calculated for each label appropriate to that response scale. The closest mean and smallest SD earmarked labels for each type of scale at the 25%, 50% and 75% interval. This research provides a set of contemporary, 5‐point interval response scales that have the potential to be used in any number of British health and health‐care questionnaires where subjective measures are needed.
Transference‐counter‐transference constellations and enactments in the psychotherapy of destructive narcissism
Authors: Ivey Gavin
Published: February 2003

Destructive narcissism, characterized by a perverse alliance between the self and an omnipotent bad internal object, constitutes a serious obstacle to psychoanalytic psychotherapy. This paper draws together various object relations theories of destructive narcissism, and presents a case study of a failed psychotherapy to illustrate the transference‐counter‐transference constellations and their associated enactments in treatment of this disturbance.
GP referrals to adult psychological services: A research agenda for promoting needs‐led practice through the involvement of mental health clinicians
Authors: Ross Helen , Hardy Gillian
Published: February 2003

General practitioners' responses to psychological problems presented in the surgery have a significant impact on the care that their patients will receive. Importantly, their referral behaviour has a knock‐on effect on the shaping of psychological treatment services. The present paper summarizes the types of influences that impact on GPs' referral decisions and investigates the possible role that mental health clinicians may play in facilitating these processes. GPs' referral decisions are shown to be affected by a large number of factors which fall within the following domains: patients' help‐seeking behaviour and their representations of mental ill‐health; the ability of GPs to detect psychological disorders; GPs' attitudes towards psychological problems and their management; service criteria for appropriate referral; and links with mental health services. For each of these domains, methods by which mental health clinicians can promote better referral practice are suggested. Recommendations are made for further research into the efficacy and clinical utility of these methods.
Representation of goodness or badness in contacts of 5‐year‐old children with mother and nursery school teacher
Authors: Ben‐Aaron Miriam , Eshel Yohanan
Published: February 2003

The present study assessed children' s evaluation of their own goodness' or badness' in interactions with a caregiver. These assessments were derived from 5‐year‐olds' responses to interviews where (a) the adult takes the role of a child and addresses the child as a knowledgeable fairy (with the help of two appropriate dolls), and (b) the adult addresses the child directly. These interviews referred to positive as well as negative contacts with two different adult figures, mother and nursery school teacher; and two different child‐rearing settings, town and kibbutz. The sample consisted of 72 5‐year‐olds drawn from both kibbutzim and towns in Israel. Results indicated that children' s representation of self‐goodness or self‐badness, in positive as well as negative contacts, was more positive in the role of self than in the role of a fairy. The difference between these representations was larger among kibbutz children than among town peers. Statistical interactions were obtained (three‐way child role by nature of contact by place of origin) for contacts with mother, and were not replicated in child contacts with the nursery school teacher. These findings suggest that the regulation of feelings of goodness or badness of 5‐year‐old children is facilitated and sustained by lived' experiences with significant other, as compared with as if' relations.
The plans in unplanned pregnancy: Secondary gain and the partnership
Authors: Harris Kate , Campbell Elizabeth
Published: February 2003

A total of 128 North London women were interviewed using a semi‐structured interview technique. Life‐events, difficulties, variables relating to the quality of their sexual partnerships, self‐esteem and the secondary gain inherent in becoming pregnant were examined. Results indicated that women with unplanned pregnancies were significantly more likely to have been in a situation of potential secondary gain from a pregnancy than were women with planned pregnancies and women who were not pregnant. Measurements of the women's partnerships were also linked to the intentionality of pregnancy. The implications of these results are discussed.
Doctors' narratives in Balint groups
Authors: Rabin Stanley , Maoz Benjamin , Elata‐Alster Gerda
Published: February 2003

There is a limited place today for narratives in traditional medicine. However, the Balint group is a legitimate forum providing doctors to unconditionally engage in discussing patients' stories within a secure and safe environment. This paper examines the importance of doctors' narratives in Balint groups and describes how insightful listening may help them move from a mainly biomedical mode to a narrative one, in order to change and repair their patients' and their own personal narratives.
Integrating psychological therapies: Processes of meaning transformation
Authors: Brewin Chris R. , Power Mick J.
Published: February 2003

We review the role played by meaning in different schools of psychotherapy, and propose that the systematic study of meaning transformation has the potential to unify understanding of the scientific basis of psychotherapy. We describe some of the most important innate and social origins of meaning, and identify seven major themes that characterize the thinking of people with psychological disorders. We also describe how these themes are processed cognitively on multiple levels, and propose common change processes that are consistent with research in cognitive psychology. These core sets of themes and processesare offered as a first step toward a systematic study of meaning and psychotherapeutic change.
Emotional and behavioural problems in adolescents/young adults receiving treatment at a community‐based psychotherapy centre for young people: A preliminary study of the correspondence among adolescent/young adult and significant other reports
Authors: Baruch Geoffrey , Fearon Pasco , Gerber Andrew
Published: February 2003

The present study examined the correspondence among adolescent/young adult and parental figure, professional, peer and partner reports, in their rating of emotional and behavioural problems of 195 young people aged between 12 and 25 years who attended a community‐based psychotherapy centre. Data from young people were obtained at intake by participants completing the Youth Self Report Form and from significant others by them completing the Significant Other version of the Teacher's Report Form. Professionals rated internalizing (emotional) problems lower than peers, partners or parental figures. Externalizing (disruptive) problems were rated lowest by professionals, highest by partners with parental figures and peers in between. Agreement for internalizing problems was highest between self and professionals and lowest for partners and peers; parental figures were in between these two extremes. For externalizing problems, agreement was highest between self and friends but very low for partners. Professionals' ratings of internalizing problems showed a strong association with clinicians' assessment of global functioning and there was a strong association between partner ratings of total problems and clinicians' ratings of global functioning. The study showed the value of using a wider range of informants for assessing emotional and behavioural problems presented by young people seeking treatment than used in the assessment of pre‐adolescents.
Does ‘denial’ really cover our everyday experiences in clinical oncology? A critical view from a psychoanalytic perspective on the use of ‘denial’
Authors: Salander Par , Windahl Gunnar
Published: February 2003

The concept of ‘denial’ emanates from psychoanalytic psychology. Within this framework it is regarded as a primitive defence mechanism related to personality disorder. The concept has been adopted by coping research but invested with quite other implications. Different researchers operationalize ‘ denial’ in different ways which contributes to this confusion. This paper views ‘denial’ from the different perspectives of psychoanalysis and coping research and, based on a previous qualitative study, it proposes a reconceptualization which distinguishes between three different processes: ‘avoidance’, ‘disavowal’ and ‘denial’. ‘Disavowal’, self‐deception in the face of accurate perception, is, more than ‘denial’, regarded as the appropriate concept covering everyday experiences of patients dealing mentally with their strain.
Stress and intervention strategies in mental health professionals
Authors: Rabin Stanley , Feldman Dina , Kaplan Ze' Ev
Published: February 2003

There is growing evidence to show that mental health professionals by the nature of their work are particularly vulnerable to stress with all its detrimental effects on service delivery and quality of care. This comes at a time when mental health services in many countries are under considerable strain. The present paper examines the multifaceted stressors encountered by the mental health team and recommends possible ways of reducing burnout through innovative intervention strategies. The detection of emotional distress and psychological dysfunctioning in mental health providers is outlined and their management carefully considered.
Some psychometric properties of the Texas Grief Inventory adjusted for miscarriage
Authors: Nikcevic A. V. , Snijders R. , Nicolaides K. H. , Kupek E.
Published: February 2003

The psychometric properties of an adjusted version of the Texas Grief Inventory (Zisook, Devaul & Click, 1982) were evaluated in a sample of 207 women following an early pregnancy loss. Factor structure of the Inventory was examined, and the validity was assessed by comparing the level of grief in women who became pregnant following a miscarriage and those who did not. Factor analysis resulted in a three‐factor solution that was theoretically interpretable. The identified subscales were: pure grief, griefrelated emotions and perceived adjustment and functioning since miscarriage. Significantly lower levels of grief‐related behaviours and feelings were reported in women who became pregnant, which was suggestive of the construct validity of the Inventory. The high reliability coefficient (Cronbach's alpha = .90) obtained with this 17‐item version of the Grief Inventory suggests it to be a reliable instrument for the assessment of grief after early miscarriage.
Dialogical engagement with voices: A single case study
Authors: Davies Peggy , Thomas Philip , Leudar Ivan
Published: February 2003

This paper raises the possibility that a dialogical, or discursive, model of human experience may be useful in helping someone who experiences verbal hallucinations. The model regards verbal hallucinations as a variety of inner speech with dialogical properties. The explication of these properties in the context of a personal narrative allowed the individual to engage in dialogue with the voices, through the medium of a new, supportive and positive voice. This process made it possible to introduce moral responses to distressing and potentially dangerous imperative verbal hallucinations, through the mediation of the new voice. Her dialogical engagement with this voice enabled her to deal effectively with troublesome voices, and was a powerful source of self‐esteem. We briefly present the theoretical perspective underlying this approach, and compare and contrast the approach with cognitive‐behavioural techniques.
Mother and caregiver representations of toddlers in a kibbutz setting
Authors: Ben‐Aaron M. , Eshel Y. , Yaari G.
Published: February 2003

Seventy‐seven mother‐caregiver pairs were interviewed by a 10‐item instrument in order to evaluate their perception of children which they cared for, and their dyadic relationships with him or her. Children' sages ranged between 16‐38 months. Results indicated that mothers presented more elaborated and more positive descriptions of their children, and perceived them as more developed as compared with caregivers. Mothers' emotional tone in describing the child was more ambivalent, namely more anxious and at the same time also more enthusiastic, as compared with the caregivers. Results are discussed in terms of the distinction between the meaning attributed by mothers and caregivers to their respective experiences of caregiving role‐relations with the same child, and their different representations of the same child.
Brains, minds and selves: Changing conceptions of the losses involved in dementia
Authors: Cheston Richard , Bender Mike
Published: February 2003

Until the last 10 years or so, dementia research had been dominated by the psychiatric or medical approach to dementia. However, increasing numbers of new psychological and social psychological approaches to dementia have begun to emerge. Consequently, there has been a significant change in the descriptions of the losses involved in the dementing process: from being represented in terms of brain functioning, they have become repositioned as occurring within both personal and social contexts. We elaborate these frameworks and apply them to three phenomena associated with dementia‐depressions, delusions and denial. While these conceptualizations are limited by a number of difficulties, they nevertheless represent a significant change in approaches to dementia care and allow the potential for positive change through psychological as well as chemical means. The emergence of these new accounts of the losses involved in dementia needs to be matched by the equivalent development of effective psychosocial interventions to maintain individuals within their own homes.
Phasic influences on psychometric measures during the menstrual cycle: Implications for the construct integrity of the locus of control dimension
Authors: Martin Colin R.
Published: February 2003

Thirty healthy female volunteers with normal menstrual cycles participated in a study to examine the influence of menstrual cycle phase on locus of control (LC) orientation. LC measures were taken on the follicular, luteal and premenstrual phase of the cycle. It was found that menstrual cycle phase had little effect on LC orientation suggesting that previously observed LC differences across the cycle in dysmenorrhea and premenstrual syndrome sufferers cannot be generalized to a normal non‐clinical population. Surprisingly, it was further found that no significant statistical relationship was found between the two LC measures used, in spite of the finding that, individually, each LC measure intercorrelated highly significantly across the menstrual cycle. Since one of the LC scales was derived theoretically, and the other LC scale used was derived from clinical practice, the findings are discussed in relation to the theory‐practice divide and the prima facie value of self‐report LC measures.
The helping process in couples during recovery from heart attack: A single case study
Authors: Pistrang Nancy , Clare Linda , Baker Chris
Published: February 2003

This single case study aimed to illustrate help‐intended communication in couples, in particular how a husband and wife attempted to help each other with adjusting to the husband' s recent myocardial infarction. The study employed a semi‐structured communication task to gather samples of the couple's helping interactions: the couple had two conversations in which they alternated helper and discloser roles. Quantitative and qualitative data were obtained from the couple and from expert raters (observers) about their perspectives of the conversations. The observers' ratings and verbal response mode patterns indicated that the conversations were characterized by low levels of empathy and exploration of feelings and relatively high levels of helper disclosure and advice; overall, the observers found the conversations to be somewhat unhelpful. In contrast, the couple rated the conversations more positively; the ' helpful events' they identified consisted of their partner disclosing a new piece of information and giving advice. The results were discussed in terms of the unique features of helping in close relationships.
Absolutist thinking and health
Authors: Ostell Alistair , Oakland Susan
Published: February 2003

Absolutist thinking has been identified in therapeutic studies as a style of thinking which is believed to promote emotional distress, particularly anger, when people are confronted by situations which do not conform to their demands concerning what ought to happen. It is not a discrete thought process, however, but a key aspect of a framework of beliefs and reactions which are thought to make people vulnerable to poor psychological and physical health when faced with personal, domestic or work problems. This thinking style was assessed in a study of the coping behaviour of headteachers to examine associationsbetween absolutist thinking, coping behaviour and health. The headteachers were classified as absolutist (N = 49) or non‐absolutist (N = 31) in the ways they handled two work problems, one with a ‘successful’ outcome, the other with an ‘unsuccessful’ outcome. In line with predictions, statistically significant differences were found between the two groups when using multivariate and univariate analyses. Absolutist headteachers experienced their job demands as less pleasant, and perceived themselves to be less effective at managing their emotions for both problems; they perceived themselves as producing less ‘successful’ outcomes for the successful problem, as handling this problem less effectively, and as having poorer psychological and physical health.
Developmental vs. social personality models of adult attachment and mental ill health
Authors: George Carol , West Malcolm
Published: February 2003

Both the developmental and social personality approaches to the study of adult attachment are concerned with understanding those factors that describe an individual's quality of relational adaptation and risk for mental ill health. This paper examines the theoretical and methodological assumptions of these alternative models and how these assumptions have markedly different implications for addressing clinical issues. It is suggested that recent evidence necessarily leads to the conclusion that mental and relational difficulties, such as partner violence and victimization, borderline personality, dissociation, suicidal behaviour and other clinical symptomology thought to be related to experiences of severe relationship distress, are best explained in terms of attachment disorganization rather than as normative forms of attachment insecurity or fearful avoidant adult romantic attachment.
Confirmatory factor analysis of the Level of Expressed Emotion (LEE) scale
Authors: Startup Mike
Published: February 2003

A confirmatory analysis of a previously reported structure for the Level of Expressed Emotion (LEE) scale was conducted with data from 75 volunteers. Three principal components were extracted and rotated to maximum congruence with a target based on previous research. The fit was found to be highly significant and retest correlations for the subscales of the LEE were good. However, the revised LEE scale could probably be improve, especially by the addition of a subscale designed to measure perceived criticism.
Attachment style and adult love relationships and friendships: A study of a group of women at risk of experiencing relationship difficulties
Authors: Mccarthy Gerard
Published: February 2003

This study examines the relationship between attachment style and love relationships and friendships in a group of women (N = 40) known to be at risk of experiencing relationship problems. The association between attachment style and measures of self‐esteem and depression were also investigated. Women with a secure attachment style had more positive ratings in the domain of adult love relationships than women with insecure attachment style (avoidant and ambivalent) and difficulties in adult love relationships werefound to be particularly related to an avoidant attachment style. Insecure attachment style was also related to having cohabited with a deviant partner. Adult attachment style was not found to be related to ratings of current mood but was significantly related to self‐esteem and to ratings of functioning in the domain of adult friendships. In particular, participants with an anxious‐ambivalent attachment style had more negative self‐esteem than secure participants. Secure participants had more positive ratings in the domain of adult friendships than insecure participants and a moderately significant association was also found between difficulties in the domain of adult friendships and an anxious‐ambivalent attachment style. In addition, 20% (N = 8) of the women also reported attachment styles characterized by high levels of avoidance and ambivalence: this group was found to have more pervasive difficulties in their close relationships than women who endorsed a single dominant attachment style.
An investigation of shame and guilt in a depressed sample
Authors: Alexander Barbara , Brewin Chris R. , Vearnals Simon , Wolff Geoffrey , Leff Julian
Published: February 2003

A self‐report measure of proneness to shame and guilt was administered to 86 patients with moderate to severe depression, with the prediction that there would be a positive correlation of shame with severity of depression. Contrary to other, non‐clinical studies, we found that guilt but not shame was associated with levels of depression. Shameproneness demonstrated a unique association with a stable attributional style for negative outcomes, global negative self‐evaluation, submissive behaviour and internalized anger. Contrary to prediction, no relationship was found between shame‐or guilt‐proneness and a reported history of childhood sexual abuse.
Linking verbal and non‐verbal representations: Computer analysis of referential activity
Authors: Mergenthaler Erhard , Bucci Wilma
Published: February 2003

The objective of this study was to develop a computer assisted procedure to model the Referential Activity scales as scored by raters. Referential Activity is defined as the function of connecting non‐verbal experience with language. Using a large text corpus that had been rated by experienced and reliable judges, extreme samples from both ends of the Referential Activity Scales were selected. The Characteristic Vocabularies for each of these corpora, words that were significantly more frequent in each corpus as compared to the other, were then identified. A small set of 181 frequent words was derived that accounted for half of all words in the text corpora. These words were used as dictionaries for a Computerized Referential Activity measure based on computer assisted content analysis techniques. The new measure showed a correlation with judge‐scored Referential Activity of around .50 across both the development and test corpora.
A cross‐case comparison of two independent analyses of intake workers' descriptions of the process of assessment for psychotherapy
Authors: Helstone Frederick S. , Van Zuuren Florence J. , Houtkooper Sonja
Published: February 2003

This study compares the analyses by two clinical psychologists of material gathered during research interviews held with 18 intake workers employed by four different institutes for psychotherapy. Each intake worker responded to questions regarding their experiences with two clients during intake interviews for psychotherapy. During the research interviews, the intake workers described their impressions regarding the clients as persons, the course of the encounter with these clients as well as motives for proposing a particular type of treatment. Comparison of the two psychologists' analyses of the original material revealed remarkably similar descriptions of the structure of the intake workers' experiences and of that of their motivation for proposing several types of treatment. In line with contemporary qualitative research practices, the current comparative study may be seen as a form of interpreter triangulation.
Therapeutic commitment and role security in work with men with violence‐related problems: An investigation and test of a model
Authors: Manley John , Leiper Rob
Published: February 2003

This study investigated whether therapists' therapeutic commitment and role security could be important therapist factors in therapy with those client groups that are perceived as being difficult to work with. Therapeutic commitment represents how committed therapists were to such work and role security measures to how secure they felt in their role. This study explored whether these factors could potentially explain some of the individual variation found between therapists in treatment outcomes. Following a pilot study, 209 therapists, consisting of 20 violence counsellors, 56 Relate counsellors, 58 forensic and prison psychologists and 75 clinical psychologists, completed self‐report questionnaires by post about their work with violent men. Therapists' therapeutic commitment and role security were found to correlate significantly with expectations of clinical outcome on a case vignette, and with the level of violence that was usually worked with. Role security and therapeutic commitment also correlated significantly with therapists' level of experience, education about violence, role support and self‐esteem. Differences existed between the professional groups on these latter factors and also intherapeutic commitment and role security. The results indicated the importance of role security in dealing with violence.
Coping with the disfiguring effects of vitiligo: A preliminary investigation into the effects of cognitive‐behavioural therapy
Authors: Papadopoulos Linda , Bor Robert , Legg Charles
Published: February 2003

Vitiligo is a progressive condition involving a loss of pigmentation in the skin; it can be disfiguring and no effective treatment or cure exists. Although vitiligo's medical effects have been studied extensively, little attention has been paid to its psychological impact or to the effects of psychological state on the illness itself. To address these issues, the present study examined the effect of cognitive behavioural therapy on coping with vitiligo and adaptation to the negative effects on body image, quality of life and self‐esteem in adult patients. The study also examined whether any psychological gains acquired from psychological therapy would influence the progression of the condition itself. Two matched groups of vitiligo patients were compared, one of which received cognitive‐behavioural therapy over a period of 8 weeks, while the other receivedno changes to their treatment status. All patients were assessed on self‐esteem, body image and quality of life, prior to, immediately following and 5 months following the end of therapy. The progression of the condition was assessed by photographing patients prior to the start of counselling and 5 months following counselling. Results suggest that patients can benefit from cognitive‐behavioural therapy in terms of coping and living with vitiligo. There is also preliminary evidence to suggest that psychological therapy may have a positive effect on the progression of the condition itself. Implications for incorporating psychological counselling into patient care and management are discussed.
The use of stop signals to reduce the pain and distress of patients undergoing a stressful medical procedure: An exploratory clinical study
Authors: Richardson P. H. , Black N. J. , Justins D. M. , Watson R. J. D.
Published: February 2003

The present study investigates stop signals and their effects on the pain and distress of patients undergoing a stressful medical procedure. Thirty‐six chronic pain patients (17 men, 19 women) attending an out‐patient operating theatre for diagnostic nerve blocks/ local anaesthetic injections were allocated to one of two conditions (experimental and control). All patients received a standard information leaflet concerning the forthcoming injections. Additional information was given to those in the experimental group on four occasions (three orally, one written) before the injections which stated that they could halt the procedure at any time by saying ‘stop’. Subjective measures of anxiety, pain, distress, sense of control over the procedure as well as observer ratings of patient distress and pain behaviour were obtained before, during and after the injections. After initial differences in pre‐injection pain were controlled for the experimental group, patients rated themselves as less distressed during the injections and recorded lower state anxiety following treatment. In view of various methodological limitations of the present study its findings may only be accorded ‘pilot study’ status. Theselimitations are explored in the discussion along with their implications for a more robust replication study. Nevertheless the present findings provide tentative support for the hypothesis that the use of stop signals can reduce the stressful nature of diagnostic nerve blocks.
Interpreting the Inventory of Interpersonal Problems: Subscales based on an interpersonal theory model
Authors: Riding Nick , Cartwright Alan
Published: February 2003

There remains considerable debate about a theoretically interpretable subscale structure for the Inventory of Interpersonal Problems (IIP). In this paper items are extracted from the IIP to form a 40‐item shortened version (the IIP‐40) comprising eight subscales, each of five items, which conform to the eight octant positions within Birtchnell's interpersonal octagon: a version of interpersonal theory. The inter‐item reliability of the subscale structure is found to be acceptable when tested against a sample of 150 preassessment for psychotherapy IIP completions within the Centre for the Study of Psychotherapy (CSP), University of Kent. The face validity is established through acceptable inter‐rater reliability scores in an experiment using blind raters. Subscale scoresare shown for patients within CSP and are found to be significantly different between genders in the octant positions of Upper Close and Neutral Distant. High scores in the octant position of Upper Distant is found to be a significant predictor of therapeutic drop‐out. The results for gender and therapeutic engagement are consistent with other published work in the interpersonal theory field.
The identification and characteristics of the partially dissociated states of patients with borderline personality disorder
Authors: Golynkina Katya , Ryle Anthony
Published: February 2003

A developmental and structural model of borderline personality disorder is described. Partial dissociation provoked by trauma and deprivation in childhood is seen to result in the persistence of separate self states. The characteristics of these and alternations between them are seen to account for the main features of the condition. The identification and characterization of states through clinical procedures and the use of the states grid are described and case illustrations are given. The states identified by the grid method in a series of 20 borderline patients are described and classified into six groups, named abuser rage, victim rage, passive victim, ideal, coping and zombie. The clinical value and nosological implications of the model and these findings are briefly discussed.
How counselling psychologists view their personal therapy
Authors: Williams Fridrun , Coyle Adrian , Lyons Evanthia
Published: February 2003

A survey of UK chartered counselling psychologists (N = 192) was carried out to investigate how they viewed their personal therapy. Eighty‐four respondents completed questionnaires about their reasons and motivations for therapy, as well as its outcome and process. The results indicated that the majority (88%) were in favour of personal therapy as a training requirement. Most respondents rated the outcome and process of their personal therapy as positive, however 27% also reported some negative effects. A factor analysis of various components of personal therapy indicated that counselling psychologists made a distinction between three factors, i.e. learning about therapy itself, issues arising out of training and dealing with personal issues. Analyses of the data suggested that aims and motivation for therapy were related to dealing with personal issues, whereas these were not important for the other factors. Learning about therapy itself was related to the number of sessions: more specifically, those who had more than the mandatory 40 sessions rated contributions of their personal therapy to understanding therapeutic relationships and processes more highly than those who had less. Initial sessions may be used by trainees to explore personal issues, leading to a preoccupation with the self, and learning about therapy per se may only occur once this has been dealt with.
Testing two mechanisms by which rational and irrational beliefs may affect the functionality of inferences
Authors: Bond Frank W. , Dryden Windy , Briscoe Rachel
Published: February 2003

This article describes a role playing experiment that examined the sufficiency hypothesis of Rational Emotive Behaviour Therapy (REBT). This proposition states that it is sufficient for rational and irrational beliefs to refer to preferences and musts, respectively, if those beliefs are to affect the functionality of inferences (FI). Consistent with the REBT literature (e.g. Dryden, 1994; Dryden & Ellis, 1988; Palmer, Dryden, Ellis & Yapp, 1995) results from this experiment showed that rational and irrational beliefs, as defined by REBT, do affect FI. Specifically, results showed that people who hold a rational belief form inferences that are significantly more functional than those that are formed by people who hold an irrational belief. Contrary to REBT theory, the sufficiency hypothesis was not supported. Thus, results indicated that it is not sufficient for rational and irrational beliefs to refer to preferences and musts, respectively, if those beliefs are to affect the FI. It appears, then, that preferences and musts are not sufficient mechanisms by which rational and irrational beliefs, respectively, affect the FI. Psychotherapeutic implications of these findings are considered.
Bridging the gap or damming the flow? Some observations on using interpreters/bicultural workers when working with refugee clients, many of whom have been tortured
Authors: Tribe Rachel
Published: February 2003

This paper will comment upon some of the dilemmas inherent in the task of using interpreters/bicultural workers when working with refugee clients who have fled to Europe, many who have been tortured. A high proportion of refugees may not speak European languages or share explanatory health beliefs. The author would argue that these differencesshould not act as barriers to obtaining health and counselling services and that employing interpreters/bicultural workers may help to bridge these gaps and improve service provision and delivery.
Tracing therapeutic discourse in material culture
Authors: Parker Ian
Published: February 2003

Approaches to language and subjectivity from post‐structuralist theory outside psychology and from deconstructive perspectives within counselling and psychotherapy have questioned the way therapeutic relationships are formed in Western culture. Discourse analysis has been developed as a methodological framework to take this questioning further, and to provide detailed readings of therapeutic patterns of meaning. Foucauldian discourse analytic approaches help us to address how we are made into selves that speak, how we experience the self therapeutically. I will elaborate this methodological framework through an analysis of a piece of text‐ an item of consumer packaging‐ tracing the contours of therapeutic discourse through a series of 20 methodological steps. Therapeuticdiscourse draws the reader in as the kind of subject who must feel a relationship at some depth with the (imagined) authors for the text to work. This paper thus illustrates the value of discourse analytic readings of texts, and helps us to reflect upon our commitment to discourses of counselling and psychotherapy as empowering stories and as culturally‐specific patterns of subjectivity.