bluuebunny/crossref_metadata_2025 huggingface dataset:
Transactional escalation in rigidity and intensity of interpersonal behaviour under stress
Authors: Van Denburg Todd F. , Kiesler Donald J.
Published: July 2011

The present study provides empirical support for a new interpersonal concept of transactional escalation. This proposition hypothesizes that an individual's typical pattern of interpersonal behaviour will become more extreme and rigid under stressful interpersonal conditions. Thirty Caucasian females participated in brief interviews that had two stages: low‐stress and high‐stress conditions. The half of the subjects who were assigned to a high‐stress interview condition were predicted to show an escalation of their typical friendly‐submissive patterns during the second half of the interview. Findings revealed that escalation was evidenced by an increase in the extremeness and rigidity of their interpersonal behaviour. Implications for interpersonal theory, and for diagnostic and psychotherapy endeavours are discussed and directions for future research are provided.
Abnormal grief and eating disorders within a mother‐son dyad
Authors: Randall Lynda
Published: July 2011

A 50‐year‐old married woman with a history of recurrent depression developed a severe abnormal grief reaction following the death of her son (who had recovered from an eating disorder) in a car crash. The patient reported a number of bizarre rituals involving her son's ashes and personal effects obtained post mortem. She developed anorexia nervosa four months after his death.
The patient as sufferer
Authors: Atkinson Jacqueline M.
Published: July 2011

The use of the term sufferer to replace patient has become increasingly common. This paper examines the varied meanings implicit in the word sufferer from the Judaeo‐Christian perspective. This includes the biblical themes of suffering as human nature, as punishment, as a test, as atonement and as liberation and deliverance. The consequences of these themes for the sufferer's role are examined, particularly the sufferer as accepting and the sufferer as victim. It is argued that replacing the medical model, implied by ‘patient’ with a theological model, implied by ‘sufferer’ does not free the person from the constraints of a damaging label.
Measuring medical students' empathy skills
Authors: Evans B. J. , Stanley R. O. , Burrows G. D.
Published: July 2011

Empathy is an important skill for the medical practitioner or medical students to develop when interviewing patients. It helps the interviewer establish effective communication, which is important for accurate diagnosis and patient management. Two facets of medical education limit students' development of accurate empathy: the traditional format of interviewing training and the social ethos of medical training and medical practice, which stress clinical detachment. A number of researchers and educators have developed consulting skills training programmes, designed to enhance students' empathic skills and ability. One difficulty for researchers has been the conceptual complexity of the term ‘empathy’ and greater difficulty in measuring the dimension.

This paper reviews the range of approaches to the measurement of empathy and reports on a research study designed to evaluate a two‐stage measurement technique, involving a pencil‐and‐paper test of empathy and independent observer ratings of medical students' actual interview behaviours. Results lead to the conclusion that pencil‐and‐paper tests of empathy cannot incorporate the range of complex cognitive, emotional and behavioural components of the empathy construct. On the other hand, trained observers have been able to use items on a specially developed History‐taking Rating Scale to discriminate between the empathic behaviours of a group of students trained in consulting skills with those of a group of control students who each carried out videotaped history‐taking interviews with hospitalized patients.
The assessment of antenatal emotional attachment: Development of a questionnaire instrument
Authors: Condon John T.
Published: July 2011

The nature of the relationship which female and male expectant parents develop during pregnancy with their unborn baby has both theoretical and clinical significance. It potentially provides a framework for improved understanding of many aspects of psychosomatic obstetrics, including reactions to foetal loss. Existing instruments designed to assess this relationship inadequately differentiate between attitude to the foetus per se versus attitude to the pregnancy state or motherhood role. The present paper presents a theoretical model of the subjective experiences of human attachment. This is utilized to develop a questionnaire to assess the antenatal attachment construct. Item analysis results in a 19‐item maternal and 16‐item paternal questionnaire with high levels of internal consistency. Each takes approximately five minutes to complete. Finally, the factor structures of the resultant questionnaires are explored.
Special Review: Evolution, mind and culture
Authors: GILBERT PAUL
Published: July 2011

Book reviewed in this article:

Darwin's Influence on Freud: A Tale of Two Sciences. By L. Ritvo.

The Adaptive Design of the Human Psyche: Psychoanalysis, Evolutionary Biology, and the Therapeutic Process. By M. Slavin & D. Kriegman.

The Adapted Mind: Evolutionary Psychology and the Generation of Culture. Edited by J. Barkow, L. Cosmides & J. Tooby.
On desire: Its development and some clinical examples
Authors: Owen Ian R.
Published: July 2011

This paper defines a progression through five aspects of the concept of desire: (1) the Hegelian concept of desire given to Jacques Lacan by Alexandre Kojeve; (2) Lacan's subsequent addition of the Freudian concept; (3) Anthony Wilden's redefinition of the Lacanian rendition used to illustrate some aspects of clinical practice; (4) the Freudian theory of social behaviour recapped: a tension exists between what the mass of others expects us to do and what we want to do; and finally (5) the philosopher Stuart Hampshire's elucidation of how desire may be known. This paper combines these authors' expositions of desire and sketches out its meaning and relevance for practitioners.
Mother‐son incest as a defence against psychosis
Authors: Bachmann Kurt M. , Bossi Jeannette
Published: July 2011

In the following, a case of mother‐adult son incest is described and explained from a psychoanalytical viewpoint. Two theories are put forward: (a) Mother‐son incest may occur as a defence against psychosis, and (b) the incest represents an unconscious search for triangulation, a process in which external authorities (such as, for example, a court of law) may function as surrogates for persons who have been missed in the pre‐oedipal past. It is therefore possible to understand mother‐son incest symbolically as an indicator of pre‐oedipal needs of the son and of the mother's longing for the absent partner. The incest is, however, not only a cry for help; it is also to be regarded as an attempt to solve the problem for both people involved. Looked at in this way, new ways of understanding and new possibilities for therapy emerge.
Bereavement reactions of female Scots and Swazis: A preliminary comparison
Authors: Lovell Deborah M. , Hemmings Graham , Hill Andrew B.
Published: July 2011

Forty matched Scottish and Swazi girls and women reported the intensity of the bereavement reactions which they had experienced two weeks and one year after the death of a close relative. The Swazi respondents reported more intense grief reactions during the first two weeks of bereavement than the Scottish participants, but the only way in which the two nationalities differed one year after the death was that the Scottish participants had a greater tendency to report feelings of guilt than the Swazi respondents. It is suggested that ritualistic crying and saying farewell to a dying relative may intensify feelings of grief during the early days of bereavement but, in the context of a clearly defined period of mourning, may play a part in reducing later feelings of guilt. Nationality was not a good predictor of the overall bereavement reaction at either of the time periods. A better prediction was obtained from the number of exchanges with other people which were perceived as being unhelpful, and the number of interactions which were absent but longed for.
Type A personality and marital intimacy in amputees
Authors: Monforton Michelle , Helmes Edward , Deathe A. Barry
Published: July 2011

The specific characteristics of the Type A personality have generated a great deal of recent attention due to the prevalence of these characteristics in persons suffering from coronary heart disease. Type A individuals are more likely to be involved in serious accidents and experience more secondary complications when faced with serious illness. They are also less apt to incorporate appropriate coping strategies to help deal with pain and discomfort, or to enlist the help of others for such purposes. These studies are particularly interesting for those involved in health care, as such personality characteristics may influence health and healing. The present study examines the Type A personality construct and marital intimacy in a sample of 34 lower extremity amputees. The Survey of Work Styles (SWS) was used to measure Type A behaviour patterns, and the Waring Intimacy Questionnaire (WIQ) to assess the marital relationship. When compared to a group of age‐ and sex‐matched controls, lower extremity amputees showed higher prevalence of some Type A behaviour patterns, and, in males, lower levels of marital intimacy. The low return rate of questionnaires in this study limits its generalizability, but results remain consistent with predictions for Type A behaviour patterns.
Reliability and validity of the Perinatal Grief Scale for women who experienced late pregnancy loss
Authors: Hunfeld J. A. M. , Wladimiroff J. W. , Passchier J. , Uden M. Uniken Venema‐van , Frets P. G. , Verhagexy F.
Published: July 2011

The psychometric qualities of the Perinatal Grief Scale (PGS) were evaluated in a sample of 46 Dutch women in late pregnancy (≥24 weeks), who had been informed of the diagnosis ‘lethal or severe fetal malformation’. The validity was assessed by comparing it to the Impact of Event Scale and to a clinical diagnosis of psychological instability. The PGS appeared to be internally consistent and particularly strongly related to psychological instability. It can therefore be considered as a valid assessment instrument, also for women who experience late pregnancy loss.
Atlas personality
Authors: Vogel L. Z. , Savva Stavroula
Published: July 2011

The paper concerns individuals who, as children, were asked to provide comprehensive psychological support for their family of origin. They cared for others before being taken care of themselves. They took on adult responsibilities from a very young age with the result of missing important aspects of their childhood. They became very sensitive and responsive to the needs of their parents and tried desperately to protect and stabilize their chaotic, angry and erratic families. They were anxious, depressed and crushed by the assumption of a role that was clearly beyond their abilities. The Atlas personalities retained their excessive sensitivity and concern for the emotional well‐being of others into their adult life. As adults, they were persistently depressed and anxious and unaware of their own needs.
Moving places: A glance at the Gulf War from the sealed room
Authors: Müller Uri F. , Yahav Aviva L. , Katz Galia
Published: July 2011

During the recent Gulf War a mental health team was set up to deal with immediate stress reactions and to help prevent future difficulties in a group of a few hundred temporarily relocated evacuees from a working‐ and lower‐class suburb of Tel Aviv, Israel. The contextually specific acute stress reaction syndrome observed in the affected population is described. A conceptualization was formulated which served the staff to deal with the problems that arose during this period. Concepts such as potential space, stranger anxiety, environment mother, triangulation in families in conflict, disruption of continuity, and holding and containing were integrated in order to illuminate some aspects of the stressful situation and to deal with problems that arose. The reactions of the mental health professionals to the situation and the relationships of the team with the evacuees and with their colleagues are discussed.
The psychopathology of authority and its loss: The effect on a ward of losing a consultant psychiatrist
Authors: Persaud Rajendra D. , Meux Clive J.
Published: July 2011

A consultant psychiatrist on an in‐patient psychiatric unit left temporarily for a four‐week visit to Australia. Eight of 11 patients under his care developed disturbed behaviour, although all had been stable for many months before. Of the other 11 patients on the same ward, under the care of another consultant psychiatrist, only one developed similar problems over this time. It has already been well established in previous research that loss events, particularly of attachment figures, contribute to psychopathology. However, what loss events the psychiatric unit itself presents to patients, and furthermore how the loss of perhaps more distant but important figures, like consultants or senior psychiatrists, also affect patients has not been previously explored. The neglected issue of the role of authority in the therapeutic relationship as well as in psychiatric illness is discussed. It is suggested that this has important implications for psychiatric practice.
Grieving related to development: A preliminary comparison of three age cohorts of parents of children with intellectual disability
Authors: Bruce Elizabeth J. , Schultz Cynthia L. , Smyrnios Kosmas X. , Schultz Noel C.
Published: July 2011

It is argued that a child with intellectual disability represents an ongoing source of loss and grief for parents. A developmental framework was employed to compare three age cohorts of parents. Grief was operationalized within the affective, behavioural and cognitive domains. Measures of intrusive thoughts, avoidance behaviours, current emotional distress over reminders of time of diagnosis of disability, and intensity of wishing for what might have been were used, collectively, to reflect the parents' grief reactions. As hypothesized, the results indicate no significant age‐related differences in the responses of 58 parent dyads but significant gender‐relatd differences. Mothers scored higher than fathers on all measures. However, on the Wishing Scale, there were no significant differences between fathers and mothers. It is concluded that grieving, as defined, is an ongoing feature of rearing a child with intellectual disability and is more intense for mothers than fathers. Results are discussed within the implications for research and practice, with particular reference to the merit of programmes and services which empower parents and strengthen bonds of partnership between parents and professionals.
The effects of varying auditory input on schizophrenic hallucinations: A replication
Authors: Gallagher Anthony G. , Dinan Timothy G. , Baker L. J. V.
Published: July 2011

The aim of this study was to investigate the effects of different types of auditory stimulation on reports of auditory hallucinations at the time of the experiment. The results showed that self‐reports by seven schizophrenic patients of auditory hallucinations were reduced by different types of auditory stimulation, particularly by listening to pop music. Requiring the subject to read a passage aloud also reduced the levels reported. This study was a replication of one by Margo, Hemsley & Slade (1981) who reported similar findings.
Diabetes: Its differential impact on child and family
Authors: Chisholm V. , Bloomfield S. , Atkinson L.
Published: July 2011

We argue that there are two groups of diabetic children who cope differently with the treatment regimen, (a) those who maximize their metabolic control and whose difficulties are associated with better control, and (b) those who maintain control less tightly and whose difficulties are associated with poorer control. This hypothesis was investigated with a sample of 47 diabetic children and their mothers. Analyses confirmed the hypothesis, indicating two distinct groups based on the type of symptom (emotional versus conduct) the child exhibited. Symptom type was associated with mother's knowledge of diabetes, diabetic control, scores received on a standardized measure of psychological disturbance and diabetes‐specific concerns. The comparison of these two diabetic groups proved more sensitive to differences in diabetic adjustment than did comparisons made on the basis of psychiatric disturbance.
Projective identification: A particular form of reciprocal role procedure
Authors: Ryle Anthony
Published: July 2011

Certain aspects of the phenomena considered under the concept of projective identification, notably those concerned with the relationship between intrapsychic and interpersonal phenomena and with indirect forms of communication and influence, are discussed in relation to an alternative theoretical framework. It is argued that these clinically important phenomena are best understood as particular forms of the more general processes involved in interpersonal relating.
Psychotherapy—delayed
Authors: Whyte Robert
Published: July 2011

The problem of the patient who presents repeatedly in distress, wanting help, is addressed with reference to one such patient. Paradoxically, by an admission that the patient could not be treated, treatment eventually became possible.
The relationship between ward atmosphere and staff attitude to treatment in psychiatric in‐patient units
Authors: Squier Roger W.
Published: July 2011

The relationship between staff ratings of ward atmosphere, their attitude to treatment, and their direction of interest was investigated in four psychiatric in‐patient units. Two general admission units, one intensive care unit, and one regional secure unit were studied. Fifty‐eight psychiatric nurses rated their units using the Ward Atmosphere Scale‐Form R (WAS) and expressed their direction of interest and attitude to treatment on the Direction of Interest Questionnaire and the Attitude to Treatment Questionnaire from the Claybury Selection Battery. An equamax factor analysis of the WAS subscales produced three clear factors. These factors, together with the original WAS subscales, were used to compare staff ratings of their units and to correlate with their attitude to treatment and direction of interest. A multivariate analysis of variance showed that staff ratings of ward atmosphere varied according to their unit and their attitude to treatment, but not with their direction of interest. Significant relationships were also found between staff characteristics, such as age, qualifications and experience, and ratings of ward atmosphere.
Retraumatization of Holocaust survivors during the Gulf War and SCUD missile attacks on Israel
Authors: Robinson S. , Hemmendinger J. , Netanel R. , Rapaport M. , Zilberman L. , Gal A.
Published: July 2011

The purpose of this work was to study the reaction to a new threat and a new trauma of people severely traumatized in the past, when the new trauma had associations with the original one caused by the Holocaust. The situation created during the Gulf War gave a rare occasion to study it. We also wanted to check if the reaction of Holocaust survivors to the war differed from that of the general population. In addition we wanted to find out if there was a difference in reaction to the war between two clinical populations: Holocaust survivors and patients who are not Holocaust survivors.

Sixty‐six Holocaust survivors living in Israel, 31 of them undergoing psychiatric or psychological treatment either as in‐patients or as out‐patients, were interviewed during the Persian Gulf War. In addition to the clinical group, there was a non‐clinical group of 35 Holocaust survivors—21 whose homes were not damaged by SCUD missiles, and 14 whose homes were damaged by missiles.

Those whose homes were damaged by SCUD missiles were retraumatized, and showed reactivation or exacerbation of the survivor syndrome. Six of them displayed the full syndrome of PTSD.
Assessing the fears of children with disability using the Revised Fear Survey Schedule for Children: A comparative study
Authors: King Neville J. , Josephs Angela , Gullone Eleonora , Madden Chris , Ollendick Thomas H.
Published: July 2011

This study compared the self‐reported fears of children with disability using the Fear Survey Schedule for Children ‐ Revised (FSSC‐R). Children with intellectual disability reported a significantly greater number of fears than children with no disability, children with hearing impairment and children with visual impairment. Also the children with intellectual disability reported more idiosyncratic fears related to the unknown, injury and small animals. Consistent with normative findings (King et al., 1989b; Ollendick, King & Frary, 1989), girls reported significantly more fears than boys. Methodological issues are discussed including the reliability and validity of self‐reported fears for children with disability.
The ideas and experiences of pregnancy and childbirth of Asian and non‐Asian women in East London
Authors: Woollett Anne , Dosanjh Neelam , Nicolson Paula , Marshall Harriette , Djhanbakhch O. , Hadlow Jan
Published: July 2011

This study examined differences between the ideas and experiences of pregnancy and childbirth of Asian and non‐Asian women giving birth in East London, and sources of variability in Asian women's accounts. In line with the findings of previous research, Asian women's ideas about diet in pregnancy, the gender of their children and postnatal care (e.g. the need for rest and recovery, and restrictions on their activities) were influenced by cultural beliefs and practices. However, in other ways Asian women demonstrated a strong commitment to Western maternity care. In contrast to some other studies Asian women wanted their husbands or partners present at delivery, indicating the extent to which traditional ideas are being modified. Qualitative analysis of Asian women's fuller accounts indicated that women subscribed to traditional practice as well as Western maternity care.

Acculturation or familiarity with Western ideas about maternity care was associated with variability in Asian women's ideas and experiences, in line with previous research. However, in spite of frequent assumptions about its significance, religion was not associated with variability in Asian women's ideas and experiences. Parity, however, was a major variable, for Asian and for non‐Asian women, suggesting that the first birth has different significance for parents than subsequent births.

The implications for the provision of maternity care are discussed, especially the need to go beyond stereotypical views based on women's ethnicity or religion to consider the beliefs and preferences of women as individuals and their personal circumstances.
The effects of varying information content and speaking aloud on auditory hallucinations
Authors: Gallagher Anthony G. , Dinan Timothy G. , Baker L. V. J.
Published: July 2011

The aim of this study was to investigate why requiring hallucinating schizophrenic subjects to read aloud produces large reductions in reports of auditory hallucinations. In Expt 1 hallucinating subjects (N = 9) were required to sort cards quietly into one, two, four, 13 and 26 piles. It was shown that the large reductions in the reports of hallucinations produced by reading aloud could not be accounted for in terms of the information content of the task. In Expt 2 the subjects (N = 7) were required to place the cards into one or two piles quietly or whilst saying the colour of the card aloud. Sorting cards into two piles whilst saying the colour of the card produced the largest reductions in the reports of hallucinations. It was concluded that it was the requirement to make overt motor and verbal response that produced the large reductions in reports of auditory hallucinations in the reading‐aloud task.
The role of the father in parental postnatal mental health
Authors: Marks Maureen , Lovestone Simon
Published: July 2011

Contrary to idealized images of parenthood, the months immediately following childbirth are characterized by enhanced rates of parental mental illness and filicide. In this paper we consider fathers and their role in the postnatal well‐being of the parturient couple. The process of becoming a father is influenced by not only the man's internal and external experiences of ‘father’, but also the woman's, since the new infant's relationship with father is mediated by mother and her conjugal relationship with father. When a couple's prenatal relationship is based on a system of shared parental constructs involving a denigrated father and overvalued mother and a concomitant intolerance of the idea of a creative (Oedipal) couple, they will experience particular difficulties in adjusting to the new family configuration. In working with individuals or couples who have experienced post‐partum psychological difficulties it is important to remember that not only maternal imagos but also paternal and conjugal ones need to be addressed.
Transpersonal processes: A bridge between object relations and attachment theory in normal and psychopathological development
Authors: Muir Roy C.
Published: July 2011

This paper has three aims: (a) to present the further development of the concept of transpersonal processes and the bimodal theory of relational cognition; (b) to show how the bimodal concept illuminates developmental theory and facilitates the move from object relations theory toward a relational systems model; and (c) to show how the attachment paradigm and the notions of internal working models (Bowlby, 1973) and self‐reflective capacity (Fonagy, 1991) are both congruent and synergistic with the transpersonal and bimodal concepts.
Miscarriage experience and the role of support systems: A pilot study
Authors: Conway Kim
Published: July 2011

A pilot study was carried out with 24 women with the main aim of examining retrospectively the experience of miscarriage to indicate issues worthy of further investigation. It was found that the psychological sequelae following miscarriage appear to be similar to the bereavement process. Whilst social support from partners, relatives and friends was helpful, subjects did not perceive that support from professionals and the wider community was always adequate.
The elusive factor1 structure of the Inventory of Interpersonal Problems
Authors: Savournin Rosamond , Evans Chris , Hirst J. F. , Watson J. P.
Published: July 2011

This paper reports data on the psychometric properties of the Inventory of Interpersonal Problems (IIP; Horowitz, Rosenberg, Baer, Ureño & Villaseñor, 1988) obtained from a UK inner city sample of 286 out‐patient clients presenting for cognitive analytic therapy or treatment in a sexual dysfunction clinic. The results are compared with those of Barkham, Hardy & Startup (1994): only moderate replication of their eight components in the raw data, and four bipolar components from analysis of ipsatized data were found. Split halves of the data were analysed and compared in order to explore the possible influences of clinical and demographic variables on the component structure.
The influence of psychological debriefing on emotional adaptation in women following early miscarriage: A preliminary study
Authors: Lee C. , Slade P. , Lygo V.
Published: July 2011

About a fifth of pregnancies end in miscarriage, leading to emotional consequences, such as anxiety and depression, which may last for a number of months. Despite this, women are not routinely provided with follow‐up care. Anecdotal evidence suggests that follow‐up focusing on emotional experiences may have beneficial effects. This study tests the hypothesis that the psychological debriefing process has a positive influence on emotional adaptation. Women were assessed, using the Hospital Anxiety and Depression Scale and Impact of Events Scale, at one week and four months post‐miscarriage. Half the women also received psychological debriefing at two weeks. Intrusion and avoidance scores were initially as high as those of post‐trauma victims, but had significantly decreased by four months. Depression was not detected at any time point, but anxiety was significantly higher than community sample estimates at one week and four months. Psychological debriefing was perceived to be helpful, but did not influence emotional adaptation. A number of hypotheses are provided to explain these results. Outcome scores at one week significantly predicted outcome at four months, suggesting that early assessment would be important in determining which women should be offered intervention.
Overconfidence and personal evaluations of social rank
Authors: Gilbert P. , Allan S. , Ball L. , Bradshaw Z.
Published: July 2011

Research on confidence judgements suggests that people are often overconfident. However, some studies have found that depressed mood reduces this positive bias. To date this has been explained as a mood phenomenon. In this study we explore an alternative theory which suggests that confidence is related to internal judgements of social rank and status. This theory suggests that the lower one perceives oneself to be in status and rank the less one can afford to be overconfident. Data from a student population suggests that confidence judgements are associated with internal judgements of status.
Self‐critical attitudes and parental criticism in young women
Authors: Brewin Chris R. , Andrews Bernice , Furnham Adrian
Published: July 2011

It has been suggested that self‐criticism derived from the family environment is a major vulnerability factor for depression. We tested in a sample of young women the hypothesis that self‐criticism would be linked to parental reports of criticism, with perceived parental criticism playing a mediating role. Results indicated that self‐criticism over appearance was independent of the other types of self‐criticism measured. The data revealed additionally that self‐criticism was related, independently of depression, to perceived parental criticism, but not to parents' own reports of criticism. Self‐criticism over appearance was not related to parental variables.
Ogden's autistic‐contiguous position and the role of interpretation in psychoanalytic theory building
Authors: Ryle Anthony
Published: July 2011

Ogden's proposed addition of the ‘autistic‐contiguous’ position to the existing P–S and D positions is critically examined. It is concluded that it is not an equivalent concept to the existing positions. The case vignettes offered by Ogden as illustrations of his proposed position are analysed and doubt is thrown on the way in which interpretations may be used to elicit apparent confirmation of theoretical positions.
Clinical decision making in intake interviews for psychotherapy: A qualitative study
Authors: Helstone Frederick S. , van Zuuren Florence J.
Published: July 2011

The present paper is based on a study, carried out in an institute for psychotherapy, of intake workers' appraisals of encounters with their clients during intake interviews for psychotherapy. The main purpose of the study was to gain insight into the factors determining intake workers' perceptions of encounters with their clients. The presumed relationship between the perception of clients and the formulation of specific proposals for treatment by intake workers was an additional point of interest. Four intake workers were interviewed by the first author. Each intake worker described his or her encounter during the intake with two separate clients. A semi‐structured qualitative interview format and a qualitative method of response analysis were used. A consistent relationship was found between the client's mode of self‐presentation as perceived by the intake worker and the formulation of a specific proposal for treatment. The most conspicuous distinction found was that between the proposal of either deep insight‐oriented therapy or supportive therapy and the client's perceived ability or relative inability to be genuinely open emotionally, and get to the core of his or her problems as presented. Further research will be necessary to corroborate the findings described.
The ‘Zar’ possession syndrome among Ethiopian immigrants to Israel: Cultural and clinical aspects
Authors: Witztum Eliezer , Grisaru Nimrod , Budowski Danny
Published: July 2011

This article describes a cultural pattern related to altered states of consciousness, observed amongst new immigrants from Ethiopia in Israel. The belief in possession by Zar spirits is one of the most common possession phenomena in Africa and in other continents. Possession by Zar is expressed by a wide range of behaviours, such as involuntary movements (often resembling epileptiform convulsions), mutism and incomprehensible language. Such behaviour can be misinterpreted as representing symptoms of neurologic or psychiatric disorders. Such misinterpretation has led to inappropriate psychiatric admissions and to misdiagnosis of such cases as major psychiatric disorders. The article illustrates the Zar phenomenon by three clinical vignettes and discusses its cultural and anthropological aspects, as well as its clinical implications within a Western society.
Personal hopefulness: A conceptual review of the relevance of the perceived future to psychiatry
Authors: Nunn Kenneth P.
Published: July 2011

Personal hopefulness, along with the perceived future, has been overlooked by psychiatry until relatively recently. There are cogent reasons why psychiatry should not ignore developments in relation to hope. Concepts related to hope are examined to delineate the components of the perceived future. Hope is defined in terms of its elements, its objects, its subject, its phenomenology and its relationship to despair and reality. The contribution of hope to our understanding of psychiatric and medical disorder and recovery from mental illness are also considered, with special reference to existing notions of depression and anxiety. Institutionalization is characterized as a disorder of personal hopefulness. Implications for potential shifts in current theoretical formulation and practice are anticipated. In particular, a critique of the learned helplessness/optimism formulation is outlined.
An episode of syncope attacks in adolescent schoolgirls: Investigations, intervention and outcome
Authors: Lee Peter W. H. , Leung Patrick W. L. , Fung Amy S. M. , Low L. C. K. , Tsang M. C. , Leung W. C.
Published: July 2011

An increasing number of students in a secondary convent girls school developed syncope attacks over a time course of about two months. Fourteen students who suffered from syncope and 12 other students from the same class with no symptoms were assessed by a team of psychologists and paediatricians with the aim of identifying the cause of the problem and to formulate possible remedial action. Psychological assessments included a mental state examination, developmental, personal and psychological history, state‐trait anxiety, self‐esteem, hypnotic suggestibility, and students' beliefs about the cause and nature of the syncope attacks. Physical investigations included physical examination, blood pressure and electrocardiogram. The results indicated that most participants and controls had no physical or psychological pathologies. The two groups were not different on the physical and psychological measures. Analyses of the interview data, however, indicated that all the syncope sufferers belonged to a cohesive and exclusive social network. Social psychological circumstances rather than individual psychopathology were noted to be primarily responsible for the spread and maintenance of the mass hysterical influence. Intervention consisted of health education, authoritative reassurance and back‐up support. Follow‐up assessment after three and 12 months indicated no further syncope episodes.
The grief response in the partners of women who miscarry
Authors: Johnson Martin P. , Puddifoot John E.
Published: July 2011

Research over the last two decades has revealed that significant psychological effects may ensue for women who suffer spontaneous abortion. The psychological impact on their male partners has been largely overlooked. This paper examines the psychological impact on the male partners of 126 British women who suffered miscarriage. Higher than anticipated levels of grief and stress were found on the Perinatal Grief Scale and the Impact of Events Scale respectively, indicating that these men were strongly affected by the miscarriage. The duration of the pregnancy prior to miscarriage, and the experience of confirmatory imaging of the foetus via routine ultrasound scan, were factors related to raised levels of grief and stress. A small number of semi‐structured interviews appeared to confirm that some men displayed symptoms of Bowlby's (1961) first stage of bereavement. These were modified by differences in the expected role behaviour of men, but in other respects were comparable to the findings of a recent study of an Australian cohort of women who miscarried (Conway, 1995).
Eating attitudes in young females with diabetes: Insulin omission identifies a vulnerable subgroup
Authors: Khan Y. , Montgomery A. M. J.
Published: July 2011

Eating attitudes were investigated in young females with diabetes (YFDs) and healthy age‐matched female controls. Results from the Eating Disorder Inventory confirmed that YFDs had higher scores for drive for thinness, body dissatisfaction and bulimia. In addition, YFDs who omitted insulin injections had high scores for ineffectiveness and interoceptive awareness and had increased sensitivity to external eating cues (as measured by the Dutch Eating Behaviour Questionnaire). It is suggested that dieting and weight gain associated with diabetes treatment precipitate a deterioration in eating attitudes. Furthermore, omission of insulin and increased sensitivity to external eating cues serve as markers for a group of YFDs who are at increased risk of developing an eating disorder. The present results provide support for the spiral model of eating disorders (Heatherton & Polivy, 1992) and its emphasis on the importance of self‐esteem and self‐awareness.
Representing the assessment process for psychodynamic psychotherapy within a computerized model of human classification
Authors: Buckingham Christopher D. , Birtle Janice
Published: July 2011

This research describes a computerized model of human classification which has been constructed to represent the process by which assessments are made for psychodynamic psychotherapy. The model assigns membership grades (MGs) to clients so that the most suitable ones have high values in the therapy category. Categories consist of a hierarchy of components, one of which, ego strength, is analysed in detail to demonstrate the way it has captured the psychotherapist's knowledge. The bottom of the hierarchy represents the measurable factors being assessed during an interview. A questionnaire was created to gather the identified information and was completed by the psychotherapist after each assessment. The results were fed into the computerized model, demonstrating a high correlation between the model MGs and the suitability ratings of the psychotherapist (r = .825 for 24 clients). The model has successfully identified the relevant data involved in assessment and simulated the decision‐making process of the expert. Its cognitive validity enables decisions to be explained, which means that it has potential for therapist training and also for enhancing the referral process, with benefits in cost effectiveness as well as in the reduction of trauma to clients. An adapted version measuring client improvement would give quantitative evidence for the benefit of therapy, thereby supporting auditing and accountability.
Ethical ideology and the allocation of scarce medical resources
Authors: Furnham Adrian , Ofstein Abigail
Published: July 2011

This study was designed to determine the ethical beliefs upon which both medical and non‐medical participants base their decisions when asked to construct a ranked waiting‐list for treatment for patients suffering from kidney failure. Participants were given minimal demographic and medical data about hypothetical patients and were asked to rank them in order of priority for treatment. A participant's initial ethical position was determined by the Forsyth (1980) Ethical Ideology Questionnaire which provides a fourfold typology based on two factors (relativism and idealism). Each participant's personal demographic information was also obtained. The analysis yielded a main effect of the ‘number of dependents’ variable of the patient and its interaction with the ‘religiousness’ variable of the participants which reflected a utilitarian moral ideology working within an egalitarian framework. Implications of studies of this sort for sociomedical moral decision making and research on ethical and moral issues are discussed. The limitations of this sort of research are also considered.
Personality factors related to the prevalence of somatic symptoms and medical complaints in a healthy student population
Authors: Neitzert Christina S. , Davis Caroline , Kennedy Sidney H.
Published: July 2011

Previous research in somatization has identified strong positive relationships between this variable, and both neuroticism, and depression. Many studies, however, are limited by a cross‐sectional approach, correlational analyses, and/or the restriction to clinical (psychiatric or medical) populations. The present investigation prospectively compared the relationships between neuroticism, depression, and somatic symptoms in a healthy student sample. As predicted, neuroticism and depression were significantly and positively related to symptom reporting. The results of a multiple regression analysis indicated that depression contributed significantly to the variance in symptom‐reporting even after controlling for the effects of neuroticism. This finding suggests the importance of mood state in the experience of somatic symptoms. However, this influence is not independent of the trait neuroticism. The results of this study also indicated that females reported significantly more symptoms than males, and gender‐specific relationships are discussed.
Type A behaviour pattern and traffic accidents
Authors: Magnavita Nicola , Narda Roberto , Sani Lorenzo , Carbone Antonella , De Lorenzo Giuseppe , Sacco Angelo
Published: July 2011

This study examines the possible relationship between Type A behaviour pattern (TABP) and traffic accident risk in a cohort of traffic policemen. Data were gathered from 86 police drivers from a small Italian town, using the Bortner questionnaire. Results reveal that police drivers with Type A behaviour had higher traffic accident risk than those with lower scores at the Bortner scale. Adjusted odds ratio was 4.2 (95 per cent CI: 1.17–15.17) after correction for confounding variables in multiple logistic regression.
Procedures as dialogical sequences: A revised version of the fundamental concept in cognitive analytic therapy
Authors: Leiman Mikael
Published: July 2011

Problematic action patterns that patients are unable to abandon or modify are important treatment targets in cognitive analytic therapy. They are called procedural sequences in the conceptual model underlying the approach. Interpersonal events in the patients' lives, and in the consulting room as well, frequently display such patterns. They are called reciprocal role procedures. In the present paper the sequential description of problem procedures will be examined by using Bakhtin's dialogical understanding of mental phenomena. A restatement of the original concept will be presented with the aim of integrating the sequential and reciprocal aspects of problematic action patterns. The revised concept of dialogical sequences will be illustrated by a number of case vignettes. The analysis of dialogical sequences provides a clear conceptual basis for early description of problem procedures in therapy. It also provides an effective tool for a detailed supervision of therapy sessions. Finally, dialogical sequence analysis may be used as a psychotherapy process research method to examine the interpersonal patterns in patient narratives.
Personality disorders: Research and management
Authors: RENTOUL ROBERT
Published: July 2011

Book reviewed in this article:

Interpersonal Diagnosis and Treatment of Personality Disorders, 2nd ed. By Lorna Smith Benjamin.

Personality Disorders: Recognition and Clinical Management. By J. H. Dowson & A. T. Grounds.

Schizotypal Personality. Edited by A. Raine, T. Lencz & S. A. Mednick.

Personality Disorders: Clinical and Social Perspectives. By J. C. Derksen.

Disorders of the Self—New Therapeutic Horizons: The Masterson Approach. By J. F. Masterson & R. Klein.
Psychodynamic perspectives on psychosis and psychotherapy II: Practice
Authors: Hingley Susan M.
Published: July 2011

Psychodynamic theory has a contribution to make to the overall care and management of people suffering from psychosis. The research literature in support of these contributions is reviewed and key psychodynamic concepts of value in understanding psychosis are illustrated by the case example of a two‐year supportive psychodynamic psychotherapy with a man experiencing paranoid and grandiose delusions. The contribution psychodynamic approaches may make to currently evolving cognitive‐behavioural therapies, and to the overall provision of care are discussed.
The meaning of the symbolic function in psychoanalytic psychotherapy: Clinical theory and psychotherapeutic applications
Authors: Keinanen Matti
Published: July 2011

This study presents the clinical theory and psychotherapeutic applications of symbolic function in psychoanalytic psychotherapy. The three modes of symbolic function (indexical, iconic and conventional symbolic) form the representations of the self and the object and further the unconscious fantasy, which includes the affective bond between these representations. During his/her development the child absorbs from the mother a new ego capacity (by means of identification), which I call the reflective‐integration capacity. Then, the ego of the child has two crucial functions: the fantasy world adopted through the symbolic function and the reflective‐integrative capacity. In psychoanalytic psychotherapy our aim is to study the fantasy world of the patient by means of the reflective‐integrative capacity, or if this capacity is missing or weak, to promote its development. During psychoanalytic psychotherapy a shared area of reflection‐integration is formed, in which the healing changes occur. These healing changes include mainly the formation, consolidation and enrichment of the symbolic function of the patient. The consolidation of symbolic function and the capacity to move within the different modes of symbolic function occur in the area of psychology in which there are incapabilities and/or conflicts (e.g. separation anxiety) in the patient. Clinical case material is presented to illustrate these phenomena.
How young children cope with separation: Toward a new conceptualization
Authors: Barrett Helen
Published: July 2011

In this paper, it is argued that 'separation protest' and the protest‐despair‐detachment (PDD) pattern, having passed into folklore and become an almost undebated cornerstone in the literature on separation and attachment, continue to have a potent influence which needs to be reexamined, disputed and replaced. Three arguments are advanced: first, that the evidence for the PDD pattern was never substantial; second, that there is now and has for some time been ample evidence for alternative accounts of separation responses; third, that the PDD account, being premised on a model of the very young child as far less socially competent than recent research has indicated, stands in need of refinement.