bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological adjustment and the facilitative nature of close personal relationships
Authors: Cramer Duncan
Published: July 2011

The Rogerian hypothesis that psychological adjustment is positively related to having a relationship which is perceived as being characterized by understanding, congruence and unconditional acceptance was tested in the context of a current, close relationship, using the original Relationship Inventory in two studies which used different measures of assessing psychological adjustment. In the first study 26 females and 19 males completed Phillips’ questionnaire which assesses acceptance of self and of others, while in the second study, 98 females and 23 males completed Rosenberg's Self‐Esteem Scale and a 30‐item symptom checklist. The hypothesis was strongly confirmed for the females but not for the males in both studies.
Younger man/older woman: A cautionary tale
Authors: Seeman Mary V.
Published: July 2011

This is a single case study of a parallel relationship between (a) the patient and his romantic partner and (b) the patient and his therapist. While parallels such as these are not unusual in therapy and may, in fact, be universal, coincidences of age and duration facilitate the understanding of some of the competitive aspects of the patient‐therapist‐significant other triangle.
The psychosocial impact of a progressive physical handicap and terminal illness (Duchenne muscular dystrophy) on adolescents and their families
Authors: Witte Richard A.
Published: July 2011

This paper reports in narrative style on a sample of 13–16‐year‐old Duchenne muscular dystrophy adolescents in a residential setting in the UK. The terminally ill dystrophic boys’ physical handicaps were noticed at about five years of age. In‐depth interviews were conducted with parents, while projective assessment and psychodrama were used with the boys. Findings for this paper draw heavily on family interviews. Not surprisingly, the Duchenne boys evinced significant isolation from the mainstream of normal culture. The parents of the terminal group showed marked preoccupation with their sons, great stress and diminished expression of enjoyment. The Duchenne adolescents raised the issue of handicap surprisingly often with their parents, suggesting their great need to acknowledge their disease with parents. Their parents, however, evinced marked difficulty in responding to death issues with the boys – a reaction which leaves the boys alone and the parents guilty. These observations on the family are discussed in the context of a family identification process.
Left and right cerebral hemisphere differences in the occurrence of epilepsy
Authors: Scott D. F.
Published: July 2011

Differences in function between the cerebral hemispheres are well documented for normal subjects and, in diseased states, these are used to lateralize and localize a dysfunction. However, the difference in frequency of occurrence of left vs. right hemisphere lesions and the greater likelihood of epilepsy occurring on the left have received scant attention. In the present study patients with a diagnosis of meningioma or cerebral abscess were identified from the EEG computer file. After operation the meningioma patients with predominantly left‐sided tumours showed a statistically significant greater chance of developing seizures, similarly those with left‐sided cerebral abscess. Considering a larger group of patients with temporal lobe epilepsy from a variety of causes, a left‐sided EEG focus occurred more frequently – and was statistically significant – than a right‐sided or bilateral disturbance. The full explanation of these results is not clear but they suggest that the hemispheres function differently in patients with a cerebral disorder like epilepsy, as is known to be the case in normal subjects.
Anorexia nervosa in adolescents
Authors: Margo J. L.
Published: July 2011

This paper is a retrospective study of 40 carefully defined cases of anorexia nervosa in adolescents. The illness in adolescence appears similar to that in older patients with regard to most clinical features, an increased referral rate since the 1960s, an upper social class predominance, and the importance of antecedent events. Bingeing and vomiting appear to be relatively rare features of anorexia nervosa in adolescents.
Teaching counselling skills to non‐psychologists
Authors: Dryden W.
Published: July 2011

This paper is concerned with the training of medical and paramedical personnel in the use of counselling skills. It begins by considering the definition of counselling both in terms of the skills involved and the process. Particular attention is given to the framework elaborated by Gerard Egan. A number of questions are then examined which include the selection of trainees, the methods of teaching to be used, the timing and venue of courses and their effectiveness. It is concluded that in Britain this is a very new area, in which there remain many more questions than answers, but that the prospects for exciting research are good.
Sharing psychological skills in the general practice setting
Authors: Weinman John , Medlik Lenka
Published: July 2011

Three broad areas of work are described in this paper. The first is concerned with the nature of psychological processes within the general practice consultation and the indications these provide for skill sharing. In the second section there is an account of courses designed to develop skills in the recognition of psychological aspects of illness and in the detection of psychological problems. The third section outlines various courses for developing and improving the consulting and counselling skills of general practitioners.

In addition to describing a range of skills developed by ourselves and others, two general themes emerge from this paper. The first concerns the appropriateness of the general practice setting for the sharing of psychological skills and the extent to which the psychologist may be able to complement the skills of the general practitioner. The second theme concerns the importance of helping general practitioners to identify their own learning needs as an essential first step in deciding how to structure courses to meet these needs.
Psychological care by nurses, paramedical and medical staff: Essential developments for the general hospitals
Authors: Nichols Keith A.
Published: July 2011

To date clinical psychologists and psychiatrists have given sparse attention to the development of clinical services within general hospitals, despite a literature demonstrating high levels of need. It is argued that attempts to reverse this situation must resolve long‐standing obstacles in attitude and practice within the medical and nursing professions as well as the apparent ambivalence of psychologists and psychiatrists towards the endeavour. If projected developments are to hold credence, planned changes in practice must emphasize a preventive approach towards psychological care and must do this primarily through existing resources; that is, the nursing and paramedical professions. A scheme of psychological care designed to be operated by nurses and other professions is outlined. It depends on teaching and supervision by psychologists and psychiatrists, and it emphasizes the basic skills of monitoring psychological state, caring by informing, emotional care and basic counselling. The absorption of these practices into the daily routine is essential in order that psychological care becomes a standard provision for all seriously ill and injured people. Approaches to training are reviewed and an overview is given of the author's experiences in promoting such a scheme within a renal unit.
Training professionals in behaviour modification
Authors: Davis Hilton
Published: July 2011

This paper examines the general issues to be considered in training non‐psychologists in the social, health and education services to use a behaviour modification approach in their work. The work in this area is considered in relation to the justification of such training, the personnel involved, the length and content of courses and the methods of teaching. Attention is also given to the evaluation of the effectiveness of the teaching methods including the problems of subsequent maintenance of the knowledge and skills taught. Though behavioural techniques have attracted enormous research efforts, relatively little has been directed at the problems of training personnel in their use.
Training nurses in behavioural psychotherapy
Authors: Reavley William , Herdman Linda F.
Published: July 2011

Psychiatric nurses are showing increasing interest in acquiring clinical psychology skills. Reasons for meeting this demand and methods of so doing are presented with particular reference to the 18‐month English Nursing Board Course No. 650 in behavioural psychotherapy. The implications of training nurses in psychological skills are discussed. Since resources are generally not available for lengthy training, suggestions are made for increasing the effectiveness of brief courses.
Training non‐psychologists in the treatment of sexual dysfunction with special reference to the training of marriage guidance counsellors
Authors: Brown P. T. , Bollinger Charmian
Published: July 2011

This paper describes a study in which marriage guidance counsellors were trained in the treatment of sexual difficulties. This study is discussed in the wider context of the literature concerned with training issues in the treatment of sexual function problems. The results of the training programme give clear evidence that non‐professionals can be trained to produce results similar to those of a professional and it is argued that issues discussed in the literature concerning the training of professionals in the treatment of sexual difficulties are also applicable to non‐professionals.
Strategies for living: Teaching psychological self‐help as adult education
Authors: Butcher Peter , de Clive‐Lowe Sarah
Published: July 2011

This paper briefly describes some of the traditional approaches to teaching psychological skills and self‐help techniques to non‐psychologists. It is stressed that there have been few attempts to teach individuals a broad range of self‐help strategies for dealing with psychological problems. The paper goes on to give a detailed description of a 12‐week course of adult education evening classes designed for this purpose. During the course participants were taught strategies to improve self‐awareness and relationships, to control anxiety, confront fears, reduce worrying thoughts, fight depression and cope with major life changes. In the main it appeared that students were able to assimilate and benefit from the techniques offered. It was concluded that adult education classes are an appropriate way of teaching psychological self‐help, and provide a relevant alternative to more traditional treatment approaches.
Training and education approaches for parents of children with special needs
Authors: Cunningham Cliff
Published: July 2011

This is a review of attempts made to involve and to train parents in the endeavour of helping their children with special needs. The reasons for parent involvement are discussed, before describing and contrasting the variety of theoretical orientations and parenting skills that have been considered in this work, and the influences of parent and child characteristics. Detailed consideration is given to the methods used in training and their effectiveness. Although parent involvement can be said to be of value, more effort is required in terms of careful conceptualization and more elaborate multivariate research before definite answers may be provided for many of the issues raised.
An evaluation of the effectiveness of a class teaching breast self‐examination
Authors: Calnan Michael
Published: July 2011

Interviews were carried out with a sample of women before they were invited to attend a class teaching breast self‐examination (BSE), and then again a year later. Two‐stage interviews were also carried out with a sample of women in a control district. This enabled an evaluation of the effectiveness of the class by comparing the changes in BSE practice over the year amongst those who attended the class, those who declined to attend the class and those in the control district. Those who attended the class showed a more marked improvement in BSE practice, particularly in the technique used, compared with the non‐attenders and those in the control district. This finding was still evident even after a range of possible confounding factors was taken into account. Further analyses showed that beliefs about the value of BSE were the strongest predictors of changes in BSE practice.
Staff counter‐transference in the therapeutic milieu: Creating an average expectable environment
Authors: Szajnberg Nathan
Published: July 2011

Counter‐transference, investigated and described as a powerful technique in individual psychoanalytic psychotherapy, has been less extensively studied in the psychodynamically oriented milieu therapy of more regressed patients. Features of the setting of the psychodynamic milieu are suggested which foster the use of the staff's counter‐transference (evoked feelings) as a therapeutic tool. Several clinical examples are given which highlight the features necessary (1) to create a moment of illusion for the patient; (2) to create an observational frame of reference for the staff; (3) to clarify when certain intra‐staff differences about the patient's therapy reflect the patient's re‐creation of intrapsychic lacunae or conflicts among the staff.

The importance of action is discussed as a means of communication for regressed patients. This concept is reconciled with Loewald's stance that feelings and actions should be represented in words. A developmental hierarchy of interpretation is suggested which involves several levels of action, through levels of symbol. A review of the literature supports this hierarchy.

Both in the consulting room and in the psychodynamic milieu, the phenomenon of evoked feelings (counter‐transference) offers an interface between two sets of internal laws: the therapist's and the patient's. The therapist's task is to treat these two sets of laws with mutual respect, offering the patient an opportunity to experience a successful autonomous act, that is, affecting his or her therapist. This concept, when extended to the psychodynamic milieu, treats the milieu as a social organism that requires ongoing observation and revision by all its participants.
Is there a substitute for Structured Interview assessments of Type A behaviour?
Authors: O'Looney Barbara A. , Harding Christina M. , Eiser J. Richard
Published: July 2011

Discriminant analyses, attempting to predict the Type A behaviour categorization achieved by means of the Structured Interview (SI), were carried out on the responses of 93 British males to the Jenkins Activity Survey and the Framingham Scale, together with information regarding their smoking habits, alcohol consumption, tea and coffee drinking and obesity levels, all of which have been suggested as risk factors for coronary heart disease. Where classification agreements with the SI were found to be above 50 per cent, classification functions based on the discriminant analyses were calculated from the responses of 36 additional male subjects. The actual SI categories were compared with the predicted categories for this second subject group. The results indicated that no reliable and robust alternative was available to predict the SI categorization. The implications of these results for the substitution of the SI by self‐report questionnaires are discussed.
Dangers of the vagina
Authors: Beit‐Hallahmi Benjamin
Published: July 2011

Beliefs, myths, and literary expressions of men's fear of female genitals are reviewed. Both clinical evidence and folklore provide evidence that men imagine female genitals not only as a source of pleasure and attraction, but also as a source of danger in a very physical sense. The vagina dentata myth has many versions, including some modern ones, and its message is always the same: an awesome danger emanating from a woman's body. The prevalence of such feelings in folklore and in literature is noted.
A repertory grid study of restrained eaters
Authors: Neimeyer Greg J. , Khouzam Nermine
Published: July 2011

This study addressed the cognitive processes associated with eating restraint, a subclinical form of disordered eating marked by chronic dietary consciousness, food deprivation and binging‐purging. Results of a repertory grid testing of 68 college women indicated that higher levels of restraint were related to more negative and simplistic self‐schema. Findings are interpreted as suggesting the importance of considering possible cognitive – as well as behavioural and affective – components in the treatment of disordered eating. This interpretation is discussed in relation to an account of disordered eating based on Kelly's (1955) personal construct theory and treatment implications are noted.
The management of a sexually charged clinical problem: Social structural and psychoanalytic functionalist approaches in a therapeutic community
Authors: James O. W.
Published: July 2011

An event in a therapeutic community is examined from the perspectives of the structuralism of Durkheim and the functionalism of psychoanalysis. Although these two approaches might appear theoretically contradictory, analysis of the evidence shows them to be clinically complementary. The role of social structure in therapeutic communities requires deliberate conceptualization if such communities are to be demonstrably therapeutic.
Stress and arousal during pregnancy and childbirth
Authors: Wilson‐Evered Elisabeth , Stanley Gordon
Published: July 2011

Sixty primigravidae were assessed on the short form of the Stress‐Arousal Adjective Check List (SACL) at the commencement of the third trimester of pregnancy. Fifty‐four of these were also administered the SACL in the labour ward and at three days after birth. On the first assessment the mean levels for the group of mothers were above normative levels of stress but not normative levels of arousal. In labour there was a significant increase in stress accompanied by a significant decrease in arousal. On the third day stress and arousal means were at approximately normative levels. Of those women stressed antenatally, four‐fifths were also stressed in labour and half were stressed postnatally. Correlates of stress and arousal are examined and the utility of the measures discussed.
Type As who think they are Type Bs: Discrepancies between self‐ratings and interview ratings of the Type A (coronary‐prone) behaviour pattern
Authors: Herman Steve , Blumenthal James A. , Haney Thomas , Williams Redford B. , Barefoot John
Published: July 2011

The study described here explored discrepancies between self‐ratings and interview ratings of Type A behaviour. A total of 281 patients referred for diagnostic coronary angiography underwent a comprehensive psychological assessment including the Type A structured interview (SI), the Minnesota Multiphasic Personality Inventory (MMPI) and two self‐report measures of Type A behaviour, the Jenkins Activity Survey (JAS) and the Type A Self‐Rating Inventory (TASRI). Two subgroups of patients were identified—Type A subjects whose Type A self‐ratings were consistent with the SI classification, and subjects who obtained low self‐rating scores and yet were classified as Type A by the SI. A comparison of the MMPI profiles showed that the discordant Type As scored lower on MMPI scales 9 (Ma) and 4 (Pd), and higher on scales 0 (Si), 2 (D) and F. The personality attributes associated with this MMPI pattern are more consistent with individual self‐reports of Type A behaviour than observer ratings during the SI.
Personality and control of diabetes mellitus
Authors: Ohwovoriole A. E. , Omololu C. B.
Published: July 2011

The importance of psychological factors in the management of diabetes mellitus (DM) is increasingly recognized. One factor is the personality of the individual diabetic. The present study compared the personality structure of diabetics in good and those in poor control. The Arrow–Dot Test (ADT) was employed in 45 diabetic subjects. Subjects in poor diabetic control had significantly higher id scores than well‐contolled subjects. Subjects that were well controlled had significantly higher ego strength scores than those in poor control. Thus the ADT appears to have a potential use in the stricter control of DM; this is generally accepted to be desirable to reduce or slow down complications of the disease.
Teaching the psychotherapeutic method: Some literary parallels
Authors: Holmes Jeremy
Published: July 2011

There is a need for a theoretical account of the psychotherapeutic process or method, as distinct from psychotherapeutic or psychoanalytic theory itself. A four‐stage model is presented which attempts to delineate the elements of the psychotherapeutic method: structure, space, discovery and description. This account puts discovery as the central theme in psychotherapy. The psychotherapeutic method as described is compared first with Medawar' account of the scientific method, and then with two literary versions of creativity. The conditions under which psychotherapeutic discovery occurs, scientific hypotheses arise and artistic activity takes place are structurally similar. The implications of this for teaching psychotherapy are discussed, especially in relation to the establishment and recognition of transferential experience.
A fresh look at genealogical bewilderment
Authors: Humphrey Michael , Humphrey Heather
Published: July 2011

The concept of genealogical bewilderment is re‐examined in the light of empirical evidence gathered over the past 20 years. It is concluded that, where the quality of surrogate family relationships is sufficient to meet the child' emotional needs, then there is no reason why ancestral knowledge should be a prerequisite of mental health. It would appear that individuals with a spontaneous urge or sometimes even a compulsion to search for their biological relatives are not uncommonly suffering from emotional deprivation. However, this is not to deny the reality of healthy genetic curiosity in children cut off from their roots.
‘To Be or Not To Be’— anxiety following bereavement
Authors: Towse Margaret Susan
Published: July 2011

This paper is concerned with existential anxiety, as elaborated by Paul Tillich. It is related to and distinguished from neurotic anxiety. The paper is in four sections: (1) a brief historical background of the development of existentialism with particular reference to Heidegger; (2) a discussion of Tillich' thought regarding three basic forms of anxiety associated with death, meaninglessness and condemnation; (3) a description and discussion of the experiences of a young woman with extreme anxiety; (4) a consideration of the case in the light of Tillich' propositions suggests that, although more familiar psychodynamic theories go some way towards understanding her symptoms, fundamental to her distress and important in therapy were basic, existential anxieties.
Attrition from an out‐patient psychology clinic
Authors: Trepka Chris
Published: July 2011

Patient attrition is a considerable problem in many health care settings. This study examined attrition among out‐patients referred to a clinical psychologist. Forty per cent of all referrals dropped out and different factors were associated with dropping out at different times. Patients who engaged into treatment before dropping out had less initial pathology and made some improvement. Early drop‐outs were characterized by lower social class and unemployment. These non‐engagers were more likely to have been sent by referring agents who had relatively poorer contact with the psychologist. Further investigation of factors involved in the referral process might lead to practical ways of reducing the large amount of clinical time which is lost because of attrition.
Psychological vulnerability to alcoholism: Studies in internal scanning deficit
Authors: Heilbrun Alfred B. , Cassidy Joselyn C. , Diehl Michael , Haas Marilyn , Heilbrun Mark R.
Published: July 2011

Three studies considered the predispositional role of impaired internal scanning in alcoholism. Scanning represents the person's sensitivity to internal stimulation and the extent to which the person utilizes internally generated information. The first study found that more acute alcoholic patients displayed poorer scanning than more chronic alcoholics. This finding contra‐indicates deficit scanning as an effect of alcoholism and suggests that this impairment antecedes the alcoholic disorder. Two further studies tested the possible antecedent status of deficit scanning. Adolescent wards of the juvenile court, judged to be more at risk for alcoholism, were poorer scanners than their counterparts with fewer drinking‐related problems. Male college students with a greater number of alcohol‐related problems also proved to be poorer scanners. It is proposed that limited scanning contributes to alcoholic vulnerability by depriving the person of information vital to the control of drinking behaviour.
The prevalence and perceived aetiology of male sexual problems in a non‐clinical sample
Authors: Spector Karen R. , Boyle Mary
Published: July 2011

One hundred and nine men (38 per cent single, 48 per cent married) participated in a survey of the prevalence of erectile and ejaculatory difficulty in a non‐clinical sample. Perceived aetiology of erectile difficulty was also investigated. Twenty‐three per cent of the sample were currently experiencing sexual problems, with ejaculatory difficulty approximately three times as prevalent as erectile difficulty. Nearly one‐quarter had experienced erection difficulties at some time and, of these, 68 per cent had remitted without formal treatment. Most frequently cited ‘causes’ of erectile difficulty were ‘psychological’ rather than ‘physical’, ‘practical’ or specifically ‘sexual’, with relationship factors including communication between partners being perceived as particularly important. The presence of erectile and/or ejaculatory difficulty was related to sexual dissatisfaction but not to ratings of relationship happiness. Men having sexual relationships outside their permanent relationship found their partner less sexually attractive and rated themselves as less happy than those men not having affairs but the two groups did not differ in terms of presence of sexual difficulty or sexual dissatisfaction. The limitations of a sample biased towards younger, more educated men, are discussed.
The Framingham Type A Scale and severity of coronary artery disease*
Authors: Smith Timothy W. , Korr Kenneth S. , Follick Michael J. , McCartney James R.
Published: July 2011

The relationship between scores on the Framingham Type A Scale (FTAS) and angiographic severity of coronary artery disease (CAD) was examined in a sample of 50 patients undergoing diagnostic cardiac catheterization. Age and family history of coronary heart disease (CHD) were positively related to CAD severity. Contrary to prediction, the FTAS demonstrated a non‐significant, inverse relationship with CAD. However, FTAS‐defined Type As with at least some CAD were younger than Type Bs with CAD. This inverse relationship between FTAS scores and age was not found in patients without CAD. Thus, though the FTAS was related to a younger clinical presentation requiring catheterization, it was not associated with the severity of CAD.
Anxiety reaction of hospitalized children
Authors: Teichman Yona , Rafael Miriam Ben , Lerman Maya
Published: July 2011

This study suggests that the child's emotional reaction to hospitalization is determined by personal, interpersonal and environmental factors. The personal attribute investigated was the child's predisposition to experience anxiety, namely, trait anxiety. The interpersonal influence was the perceived level of maternal anxiety, and the environmental influence was type of hospitalization ‐ traditional hospital or day clinic.

We hypothesized that (1) hospitalized children with high trait anxiety would experience higher anxiety state than children with low trait anxiety; (2) hospitalized children who perceive anxious rather than calm mothers would experience more anxiety; (3) children in a traditional hospital would experience higher anxiety state than children in a day clinic; and (4) the most anxious children would be those who have high trait anxiety, are exposed to anxious mothers and are hospitalized in a traditional hospital.

Results indicate that the child's level of trait anxiety predicted the level of experienced anxiety and so did perceived maternal anxiety. Type of hospitalization did not influence the level of anxiety, but children with high trait anxiety who attributed to their mothers a high level of anxiety reported more anxiety in the day clinic rather than in the hospital. The findings imply that, when helping children and families deal with hospitalization, personal, interpersonal and environmental factors have to be considered.
The role of cognition in child development and disorder
Authors: Rutter Michael
Published: July 2011

The role of cognition in child development is reviewed with respect to the role of cognitive processing and cognitive deficits. Cognitive processing is discussed with respect to the self‐system; the effects of psychosocial experiences; risk, vulnerability and protective mechanisms; vulnerability to depression; aetiology and treatment of depression. Cognitive deficits are discussed with respect to the socio‐emotional consequences of language delay and reading difficulties; hyperkinetic/attentional deficit syndromes; schizophrenia; and autism. It is concluded that the ways in which we appraise our life circumstances and the ways in which we react to experiences of all kinds are greatly influenced by how we think about ourselves and our environment. Biases and distortions in such cognitive processing may be associated with social and emotional malfunction. These biases may derive from earlier experiences, from intensive temperamental styles, or from deficits in the ability to process incoming information. The further study of cognitive processing and cognitive deficits is likely to be rewarding and helpful for clinical practice.
Scrupulosity: Religious attitudes and clinical presentations
Authors: Greenberg David , Witztum Eliezer , Pisante Jean
Published: July 2011

The attitudes of Catholicism and Judaism to scrupulosity are presented and the similarity between their management programmes and present‐day behavioural psychotherapy is noted. Two famous cases are presented from 16th‐century Europe and a further four cases from our 20th‐century clinic in Jerusalem. Certain common features are noted, typical of obsessive‐compulsive disorders, while some features, typical of scrupulosity, are best understood by considering both their religious and psychological importance.
Psychological disturbance and illness behaviour in a clinic for sexually transmitted diseases
Authors: Ikkos G. , Fitzpatrick R. , Frost D. , Nazeer S.
Published: July 2011

Patients attending a sexually transmitted diseases (STD) clinic were asked to complete the General Health Questionnaire and the Illness Behaviour Questionnaire. Data were collected from 852 patients. One‐third of the sample were found to score positively on the GHQ, indicating possible psychological disturbance. Women were more likely than men to score positively on the GHQ. On the General Hypochondriasis scale of the IBQ the sample's scores were higher than any other normative data except those obtained from psychiatric in‐patients. On this scale homosexual and bisexual males scored significantly higher than heterosexual males. It is argued that the IBQ draws attention to important dimensions of psychological distress in STD clinics.
A follow‐up study of patients treated for benzodiazepine dependence
Authors: Golombok Susan , Higgitt Anna , Fonagy Peter , Dodds Susan , Saper Joanna , Lader Malcolm
Published: July 2011

By interviewing and administering questionnaires to 63 patients one to five years after treatment for benzodiazepine dependence the long‐term success rate was examined together with factors associated with outcome. Fifty‐four per cent of patients had permanently withdrawn from medication at follow‐up. Most of those who were successful continued to experience psychiatric symptoms after discharge. Significantly more women than men managed to withdraw from medication. Outcome was not related to previous benzodiazepine regimen, psychiatric history or experiences of withdrawal. It is argued that psychological adjuncts should be included in the treatment of benzodiazepine dependence in order to prevent relapse.
The effects of nurses changing from uniforms to everyday clothes on a psychiatric rehabilitation ward
Authors: Lavender A.
Published: July 2011

There are few controlled studies investigating the effects of nurses changing from uniforms to everyday clothes. A quasi‐experimental design was used where patient behaviour was measured before and after such a change and in which some degree of control was achieved by assessing the major sources of bias (i.e. medication, ward practices, etc.). The results suggest that the change in dress led to a decrease in deviant behaviour (particularly violent incidents) and patient estrangement and an increase in the number of nurses in whom patients could confide. These changes in behaviour appeared to be the result of changes in the nature of the relationships/interactions between patients and staff brought about by the change in nurse dress.
King Lear and some anxieties of old age
Authors: Hess Noel
Published: July 2011

The experience of ageing and the resulting emotional difficulties of elderly patients have only recently begun to be understood from a psychodynamic perspective. This paper draws on two sources, literary (Shakespeare's King Lear) and clinical (consultations with elderly patients in primary care) to highlight a fundamental anxiety of old age: the dread of being abandoned to a state of utter helplessness. This state is felt to be caused by the catastrophes of old age, such as stroke and dementia. The defence against this anxiety is often a narcissistic tyranny.
Expectant fathers: Emotional reactions, physical symptoms and coping styles
Authors: Teichman Yona , Lahav Yoram
Published: July 2011

This study investigated emotional and physical reactions in two groups of expectant fathers: expecting a first child, expecting a second or subsequent child. These were compared with each other and with a control group of fathers whose wives were not pregnant.

The hypotheses predicted that expectant fathers in general, and expectant fathers expecting their first child in particular, would report higher situational anxiety and would experience physical symptoms more frequently than the control group. It was also predicted that expectant fathers who reported high levels of emotional involvement with their wives' pregnancy would report high levels of anxiety and high frequency of physical symptoms while expectant fathers who reported active involvement would report a lower level of anxiety and lower frequency of symptoms.

Contrary to prediction, expectant fathers, particularly those who were expecting their first child, reported lower levels of anxiety. The hypothesis about physical symptoms was confirmed. Expectant fathers reported experiencing physical symptoms more frequently than controls, and the highest frequency was reported by those expecting their first child. The correlations between types of involvement and anxiety or physical symptoms indicate that all types of involvement are negatively correlated with anxiety. Emotional involvement correlates with frequency of experiencing physical symptoms, and active involvement does not correlate with frequency of experiencing physical symptoms.
Extraversion, neuroticism, obsessionality and the Type A behaviour pattern
Authors: May Jon , Kline Paul
Published: July 2011

A questionnaire consisting of a subset of questions from the Jenkins Activity Survey was given to 135 male military personnel aged between 18 and 25, together with the EPQ and the AI3, an obsessionality scale. A factor analysis of the answers revealed a four‐factor structure – impatience, hard‐driving competitiveness, speed and emotional unrepression. Neuroticism was found to correlate positively with impatience and speed, but negatively with hard‐driving competitiveness, which together with emotional unrepression correlated positively with extraversion. Impatience, speed and emotional unrepression also correlated positively with obsessionality. Obsessionality was the only personality measure to correlate significantly with the total Type A score. The nature of the relationships between the Type A behaviour pattern and the Eysenckian personality measures are discussed.
Reactive‐narcissistic character, obsessional personality and obsessive–compulsive behaviour: A study of the validity of Sandler and Hazari's typology
Authors: Trijsburg Rutger W. , Duivenvoorden Hugo J.
Published: July 2011

Sandler & Hazari's (1960) questionnaire measuring reactive‐narcissistic character and obsessional personality was filled in by 120 medical students. Principal components analysis was applied to their scores. The resulting factor structure is highly similar to Sandler & Hazari's. Both reactive‐narcissistic character and obsessional personality can be measured in a reliable way. In support of the hypotheses, reactive‐narcissism is correlated positively with achievement motivation, but shows no correlation with traits reflecting lack of self‐confidence (external locus of control and negative fear of failure), nor with aggression. Contrary to expectation, a positive correlation was found with control uncertainty. According to expectation obsessionality is correlated negatively with achievement motivation and positively with traits reflecting lack of self‐confidence and with aggression. The hypothesis that obsessional subjects exhibit more obsessive‐compulsiveness in a decision‐making task than reactive‐narcissistic subjects could not be confirmed. Results are discussed in the light of previous findings.

The conclusion is that the typology as measured by Sandler & Hazari's (1960) questionnaire has high construct validity. The question whether the typology is predictive of future obsessive–compulsive behaviour remains unanswered.
Paradoxical psychotherapy in a case of transvestism
Authors: Cliffe Michael J.
Published: July 2011

Paradoxical psychotherapy succeeded in removing the compulsive element and reducing the guilt attached to transvestism in a male transvestite patient. Cross‐dressing at home became acceptable to him and the temptation to cross‐dress in public ended. Data suggested three independent motivational systems in this patient.
Formulating and evaluating hypotheses in psychoanalytic psychotherapy
Authors: Smith David L.
Published: July 2011

Little psychoanalytic literature exists dealing with the formulation and evaluation of hypotheses in the therapeutic situation. This paper is an initial exploration and systematization of criteria presently in use. Hypothesis formation is discussed in terms of the accumulation of data and its recontextualization. Then follows an account of prevalidation, the silent evaluation of an hypothesis. Before an hypothesis can be turned into an intervention considerations of spoken form, order and timing must be taken into account. Finally, after intervening, post‐validation can occur: the evaluation of the hypothesis on the basis of the patient's responses.
Altered cognitive functioning in pregnant women: A shift towards primary process thinking
Authors: Condon J. T.
Published: July 2011

Psychoanalytically orientated writers have independently described an alteration in psychological functioning, which occurs in many pregnant women, and is probably best described as a shift towards a primary process mode of thinking. This literature is reviewed and an illustrative case history provided. Unlike affective changes during pregnancy, alterations in cognitive style have received little attention despite their significant diagnostic and psychotherapeutic implications. The phenomenon invites collaboration between the biological and psychoanalytic orientations within psychiatry further to investigate it.
Specific sources and patterns of anxiety in male patients with first myocardial infarction
Authors: Thompson David R. , Webster Rosemary A. , Cordle Christine J. , Sutton Terence W.
Published: July 2011

Anxiety was studied on four occasions over one year in 76 men under 66 years of age, who were admitted to hospital with a first acute myocardial infarction. Anxiety was measured by the Spielberger State‐Trait Anxiety Inventory, and by a self‐rating questionnaire. Average levels of State and self‐rated anxiety fluctuated over the study period with levels peaking after admission, falling at the fifth day, rising at six weeks, and falling to their lowest level at one year. Reported specific sources of anxiety, including the myocardial infarction, return to work, the future and possible complications, ranked highest in hospital and at six weeks post‐discharge.
Psychological correlates of hostility among patients undergoing coronary angiography
Authors: Blumenthal James A. , Barefoot John , Burg Matthew M. , Williams Redford B.
Published: July 2011

The Cook‐Medley Hostility (Ho) scale (Cook & Medley, 1954) has been associated with increased risk for coronary heart disease (CHD). There is relatively little information about the psychosocial correlates of the Ho scale in clinical or adult populations, however. In this study, 132 patients (mean age = 53 years) referred for diagnostic coronary angiography completed a battery of self‐report questionnaires including the Minnesota Multiphasic Personality Inventory (MMPI), Hopkins Symptom Check List (SCL‐90), State‐Trait Personality Inventory (STPI), Type A Self‐Rating Inventory (TASRI), and Perceived Social Support Scale (PSSS). Examination of the pattern of correlations among the Ho scale and the psychometric instruments revealed that the Ho scale may be viewed as tapping four general behavioural dimensions including anger and hostility, neuroticism, social maladjustment and ineffective coping style. These findings serve to further understanding about the psychological dimensions of hostility as measured by the Cook‐Medley Ho scale.
Responding to in‐patient suicide
Authors: Hodgkinson Peter E.
Published: July 2011

A personal experience of in‐patient suicide is detailed, and the process of and problems encountered by the staff in working through the tragedy are described. The responses are examined from the standpoint of bereavement theory and bereaved family systems. Many similarities are noted to exist, particularly with the documented responses of spouse survivors of suicide. Staff reactions are considered in terms of their emotional content and the support provided by organizational structure. The support required by the client group is also considered.
Environmental stress, reactivity and ischaemic heart disease
Authors: Krantz David S. , Raisen Shera E.
Published: July 2011

This article provides an overview of work in two areas of biobehavioural research: the effects of environmental stress and the role of psychophysiologic reactivity in the development of ischaemic heart disease. Attention is given first to evidence that low socio‐economic status, low social support, and occupational settings characterized by high demands and low levels of control over the job are associated with increased coronary risk. Also discussed is a promising animal primate model of social stress and its role in development of coronary atherosclerosis. Next, we discuss physiological responsiveness (reactivity) to emotional stress, which is being studied as a marker of processes involved in the development of cardiovascular disease. Stress and psychophysiological reactivity constitute promising targets for research on biobehavioural antecedents of coronary disease and for clinical intervention studies. However, further evidence is needed before these variables can be regarded as proven coronary risk factors.
Defining dependence
Authors: Birtchnell John
Published: July 2011

The need to define dependence arises out of accumulating evidence that it contributes to depression‐proneness. Its accurate definition is therefore a prerequisite for the development of valid methods of measuring it.

Because dependence is more a feature of childhood than of adulthood, a dependent person may usefully be viewed as an adult behaving as though he were a child. Dependence is best understood therefore in terms of those developmental deficiencies from which it results. These are failure to separate successfully from the principal parent figure and from the family as a whole, failure to establish a secure personal identity, failure to acquire a general feeling of competence and a realistic assessment of self‐worth and failure to feel deserving of the status of adult and to feel on equal terms with other adults.

Consequently, adult dependence is characterized by the need to stay close to others, the inclination to be primarily the recipient in interpersonal transactions and the tendency to relate to others from a position of inferiority and humility. The dependent person receives from others a borrowed identity, guidance and direction, compensation for those areas in which he is incompetent and, most important of all, acceptance, approval and affirmation of worth.
Empathy in psychiatric patients
Authors: Ladisich W. , Feil W. B.
Published: July 2011

The definition of empathy is controversial. Here one aspect of it, namely perception of others' feelings and personality, was investigated. Empathy was assessed by comparing self‐rating with rating by other persons. Group psychotherapy patients were used. Nineteen patients with a history of schizophrenic psychosis and 20 neurotics were found to have lower empathy than 20 patients with borderline personality disorders whose empathy was as high as the descriptively used scores of four psychotherapists. Empathy was not found to be dependent on similarity of personalities. It correlated negatively with obsessional features, such as emotional constriction or rigidity. The borderline patients' high empathy appeared of particular interest in view of clinical observations that psychotics had high empathy before the development of psychosis. The possible relevance of empathy in the development of psychosis is discussed.
The relationship between marital intimacy, perceived strain and depression in spouse caregivers of dementia sufferers
Authors: Morris Lorna W. , Morris Robin G. , Britton Peter G.
Published: July 2011

This study explored the quality of marital relationship between dementia sufferers and their spouse caregivers. It assessed the quality of the relationship (level of intimacy) prior to the onset of dementia and also at the time of the study. Caregivers who experienced lower levels of marital intimacy, both currently and before the onset of dementia, were found to have higher levels of perceived strain and depression. The decline in intimacy following the onset of dementia was estimated from the difference between the levels of past and present intimacy. Caregivers who experienced a greater loss of intimacy had a higher level of depression, but did not show evidence of increased perceived strain. It is speculated that a poor premorbid relationship makes caregiving more stressful because of a greater difficulty in performing the caregiving role. In addition, it is suggested that a poor premorbid relationship or high loss of intimacy acts as a vulnerability factor, predisposing the caregiver to depression.