bluuebunny/crossref_metadata_2025 huggingface dataset:
Survivor guilt, submissive behaviour and evolutionary theory: The down‐side of winning in social comparison
Authors: O'Connor Lynn E. , Berry Jack W. , Weiss Joseph , Schweitzer Dina , Sevier Mia
Published: February 2003

In prior research submissive behaviour has been studied in relation to social comparison. Evolutionary theory conceptualized submissive behaviour as a fear‐based self‐protective strategy when in a subordinate position. In this study we hypothesized that survivor guilt, the type of guilt associated with feeling better off than others, is also linked to submissive behaviour. The Interpersonal Guilt Questionnaire, the Submissive Behaviour Inventory, the Eysenck Personality Questionnaire‐Revised and the Automatic Thoughts Questionnaire were administered to a sample of 199 college students. Submissive behaviour was found to be significantly correlated with survivor guilt. Introversion, used as an indirect measure of the fear of being put down, was also correlated with submissive behaviour. A principal components analysis found two components: the first was composed of high loadings of submissiveness, survivor guilt and omnipotent responsibility guilt; the second was composed of high loadings of submissiveness and introversion. This supports the hypothesis that there may be two motivational states related to submissive behaviour, the fear of harm to the self, as described in prior studies, and the fear of harm to another or guilt‐based submissive behaviour. We propose that survivor guilt has been selected by evolution as a psychological mechanism supporting group living, and that it may be considered from the perspective of inclusive fitness, reciprocal altruism, and multilevel selection theory.
Couples' grief and experience of support in the aftermath of miscarriage
Authors: Conway Kim , Russell Graeme
Published: February 2003

The aim of this prospective study involving 39 women and 32 partners was to investigate the grief response of both the woman and her partner to miscarriage and to ascertain if support received was adequate and appropriate to their needs. Previous research shows that partners' grief can often be delayed and chronic. Special emphasis is placed on this area in this study. The miscarriage was found to be a significant event and the majority of women and partners still experienced feelings of loss up to 4 months afterwards, describing their reactions as sad or very sad. Scores on the first administration of the Perinatal Grief Scale showed that, in contrast with previous findings, partners scored significantly higher than the women on the three subscales and overall. Partners' scores on the second administration were also higher than those for the women but the difference was not significant. The women tended to receive and welcome social support more than the partners. Support received from health professionals was not always optimal, particularly for partners. Pregnancy subsequent to miscarriage was often viewed with some anxiety. It is argued that the results of the study have important implications for health practice.
Self‐construal among psychiatric outpatients: A test of the golden section
Authors: Badesha Jaswinder , Horley James
Published: February 2003

Self‐construal among individuals diagnosed with a psychiatric disorder has been examined infrequently, and many variables (e.g. sex, patient status, type of problem) possibly related to self‐construal and psychological problems have yet to be examined in combination and in detail. This paper reports on research into a variety of factors that could influence self‐construing as predicted by the golden section hypothesis. A study was conducted to examine how psychiatric outpatients, both male and female with varying mental health diagnoses, view themselves and others in terms of positive and negative construct poles. A card‐sort repertory test was used to elicit personal constructs. Among 40 Canadian outpatient participants, the golden section could account for the overall results, with no significant statistical differences by sex or diagnosis. Some deviations from the golden section were found, however. Females with a diagnosis of schizophrenia, for example, applied more negative than positive constructs to themselves.
Shame and non‐disclosure: A study of the emotional isolation of people referred for psychotherapy
Authors: MacDonald James , Morley Ian
Published: February 2003

Thirty‐four people referred to an NHS psychotherapy department were given a modified form of Oatley and Duncan's (1992) emotion diary which included questions about whether each recorded emotion had been subsequently disclosed to anyone (for example a partner, friend or professional). One week later the diaries were collected and participants interviewed. Interviews focused, among other things, on reasons for non‐disclosure of recorded emotional experiences and the relationship between shame and non‐disclosure. The results indicated that a majority of the emotional incidents recorded in the diaries were not disclosed (68%). This result contrasts with studies on non‐clinical samples in which only approximately 10% of everyday emotions are kept secret. Qualitative analysis of the interview data revealed that participants appeared to be habitual non‐disclosers of emotional and personal experiences and that non‐disclosure was related to the anticipation of negative interpersonal responses to disclosure (in particular labelling and judging responses) in addition to more self‐critical factors including shame. It is suggested that these results add to the existing literature on shame by illustrating the interpersonal effects of shame in a clinical sample.
Cacosmia in healthy workers
Authors: Magnavita N.
Published: February 2003

Self‐reported cacosmia (i.e. feeling ill from the odour of xenobiotic substances) was studied in 151 young, healthy workers, unexposed to unpleasant odours and working in food stores without air‐conditioning. Almost half (46%) of the sample reported feeling ill from the smell of chemical materials. Chemical odour intolerance induced headache, itching eyes, irritated or congested nose, dry and/or sore throat, cough, dizziness, and itching or rash. Cacosmic subjects showed a slight prevalence of the female sex, and had significantly higher symptom scores, anxiety, and depression than non‐cacosmic subjects. Cacosmia may be related to multiple chemical sensitivity, sick‐building syndrome and psychopathology. Individual variability in odour tolerance may substantially bias epidemiological studies on indoor air quality and health.
Psychosis and the disintegration of dialogical self‐structure: Problems posed by schizophrenia for the maintenance of dialogue
Authors: Lysaker Paul H. , Lysaker John T.
Published: February 2003

Researchers and theoreticians across widely varying disciplines have increasingly stressed how sense of self is inherently ‘dialogical’, or the product of ongoing dialogue both within the individual and between the individual and others. This perspective emphasizes that self‐awareness is not an awareness of an isolated or seamless viewpoint, but a collective of numerous complementary, competing, and sometimes contradictory, voices. In this paper we suggest that changes in subjective sense of self in schizophrenia spectrum disorders may represent the collapse of this essential dialogue. We suggest that this collapse can have the end‐result of mentally ill persons either coming to embrace a singular, all‐incorporating self‐position or standing precariously on the brink of cacophony which is experienced as self‐dissolution. We point to two phenomena associated with schizophrenia that could contribute to the derailment of internal and external dialogue: impairments in associative processes and affect dysregulation. Illustrated with a case example, we finally suggest how psychotherapy has the potential to revive internal dialogue through its explicit use of external dialogue helping to restore previous levels of social function.
Psychopathology in paintings: A meta‐analysis of studies using paintings by psychiatric patients
Authors: Hacking Suzanne , Foreman David
Published: February 2003

We classified 242 reliable scales from 12 art‐based studies of psychiatric patients into 14 qualitative categories and also by three types of decision: form, objective or subjective content. We used meta‐analytic techniques to combine and compare different results from studies testing the asssociation of art characteristics with psychopathology. Distinctions between controls and patients were more apparent than those between diagnoses. The largest effects distinguished patients and controls on categories of content, body details, energy and media control. Diagnostic groups were differentiated on energy and complexity. There were other less distinct differences for both types of comparison. There were serious criticisms of the quality of the literature, and a lack of information on validity and reliability, but this study suggests that art characteristics do relate to psychopathology.
Treating personality fragmentation and dissociation in borderline personality disorder: A pilot study of the impact of cognitive analytic therapy
Authors: Wildgoose Amanda , Clarke Sue , Waller Glenn
Published: February 2003

Recent findings suggest that personality fragmentation may be a core component of borderline personality disorder (BPD) and that successful treatment of BPD may depend on the extent to which this is addressed. Cognitive analytic therapy (CAT) can increase integration by strengthening awareness, and hence control, of the dissociative processes maintaining fragmentation. This pilot study aimed to conduct a systematic evaluation of the impact of CAT on BPD severity and personality integration. A patient series within‐subject design was used. Five BPD participants completed a series of assessments to evaluate the impact of therapy on BPD severity, fragmentation, dissociation, symptomatology and interpersonal adjustment before, during and following 16‐session CAT. By follow‐up, CAT had produced reductions in the severity of BPD for all five participants, and three participants showed significant changes in their levels of personality fragmentation. Improvements in comorbid disturbance were less consistent, however. Although the small number of participants involved limits these findings, they have theoretical and clinical interest. They generally support the suggestion that integration should be enhanced with BPD patients, and suggest that CAT may be a useful method to achieve this goal.
Psychodynamic theory and narcissistically related personality problems: Support from case study research
Authors: Hingley Susan M.
Published: February 2003

An introductory overview of central psychodynamic theories relevant to narcissistically related personality problems and disorders of the self is provided, focusing on the central role of the child's relationship with primary care givers in the development of the self. A psychodynamic formulation is described for a 45‐year‐old woman experiencing depression, anxiety and despair following a severe rift in her previously enmeshed/merged relationship with her teenage daughter. The subsequent two and a half years of therapy were monitored using the Brief Symptom Inventory (BSI), the Dysfunctional Attitudes Scale (DAS) and the Object Relations Technique (ORT), producing data supportive of psychodynamic theory and therapy. A pattern of depression emerged during therapy which was in keeping with the concept of abandonment depression, as the client came to experience herself as more separate from her daughter and others. Changes in the functioning of primitive defences were also illustrated, plus the expression of previously denied anger, and increased abilities to be assertive, set limits and take care of herself.
Psychotherapists' approaches to gay and lesbian patients/clients: A qualitative study
Authors: Phillips Peter , Bartlett Annie , King Michael
Published: February 2003

We used qualitative research methods to examine the core issues relating to the approaches of psychodynamic and psychoanalytic psychotherapists to gay and lesbian patients and clients. The paper begins with a review of the psychoanalytic approaches to gay and lesbian sexuality and continues with material of a clinical nature, providing information about the experience of lesbians and gay men in psychotherapy. It also explores the attitudes of therapists towards gay and lesbian sexuality by discussing a range of psychoanalytic theories and their application to clinical work with patients and clients.
Bridging the gap between attachment and object relations theories: A study of the transition to motherhood
Authors: Priel Beatriz , Besser Avi
Published: February 2003

An empirical study of the relations between assessments of adult attachment styles and object representations was performed in the context of first‐time mothers' emotional ties to their unborn babies. We assumed that, while conceptualizations of attachment behaviour and internal working models grasp the early basic patterns of interpersonal relationships and affect regulation, object representations indicate current transformations of these patterns in an individual's internal world. Participants were a sample of 120 women in the third trimester of their first pregnancy. Participants' representations of their own mothers were found to fully mediate the association between internal working models and antenatal ties to their babies. Similarities and differences between theoretical conceptualizations and empirical operationalizations of attachment and object relations theories are discussed.
Characteristics of self‐regulation in adolescent patients with anorexia nervosa
Authors: Karwautz Andreas , Völkl‐Kernstock Sabine , Nobis Gerald , Kalchmayr Gudrun , Hafferl‐Gattermayer Andrea , Wöber‐Bingöl Çiçek , Friedrich Max H.
Published: February 2003

The purpose of the study was to investigate the different modes of self‐regulation in adolescent anorexia nervosa (AN). A self‐system questionnaire, the Narcissism Inventory, was given to 61 adolescent females with AN and 61 controls. Patients with AN reported higher overall disturbances in self‐regulation than controls. In particular, a highly unstable self‐system, a tendency to use idealization as modus of regulation, and high narcissistic gain from their illness was found in the patient group; however, the patients did not report a ‘classic narcissistic sellf’. Furthermore, we were able to differentiate between two clusters of patients, one with high (n = 34) and one with low (n = 27) disturbance in self‐regulation; the latter reported a shorter duration of illness and lower oral control but did not differ on any other clinical variables. Stronger relationships were found between the dimension ‘endangered self’ and the overall scores of the Eating Attitudes Test (EAT) and the Eating Disorder Inventory (EDI) as well as two subscales of the EAT and five of the EDI. Our study in anorexic adolescents demonstrated that the self‐system is experienced as highly unstable, that idealization is used as mode of regulation, and that the dimension of the ‘classic narcissistic self’ is less important in this patient group. It is important to evaluate the system of self‐regulation for planning treatment in the individual patient according to their needs.
The effects of solo singing, choral singing and swimming on mood and physiological indices
Authors: Valentine Elizabeth , Evans Claire
Published: February 2003

The effects of solo singing, choral singing and swimming on mood and physiological indices were compared. Engaging in these activities reduced tense arousal and increased energetic arousal, positive hedonic tone and heart rate. Effects were greater for swimming than for singing, with little difference between choral and solo singing. Possible mechanisms and the implications for mental well‐being are discussed.
Therapists' beliefs about research and the scientist‐practitioner model in an evidence‐based health care climate: A qualitative study
Authors: Corrie Sarah , Callanan Margie M.
Published: February 2003

The growing emphasis on achieving therapeutic practice that is informed by research evidence or ‘evidence‐based’ has been well documented. However, if therapists are to operate effectively within evidence‐based services, it is necessary to develop a better understanding of factors that influence their attitudes towards research in routine clinical work. Within this context, there is a need to re‐examine the scientist‐practitioner model as potentially complementing or competing with evidence‐based practice. This study explores the beliefs about research and the scientist‐practitioner model amongst a diverse group of therapists whose work is contextualized by evidence‐based practice. In‐depth, qualitative interviews were used to elicit significant themes that related to current practices, previous training and contact with other professionals. The findings suggest that the therapists' beliefs were shaped by different levels of influence that range from personal values to organizational and political issues. The results also highlighted how the therapists had constructed more idiosyncratic definitions of the scientist‐practitioner model that related to perceptions of its value. Implications for further research, training and practice are discussed.
‘I'm not picking up a heart‐beat’: Experiences of sonographers giving bad news to women during ultrasound scans
Authors: Simpson Rosie , Bor Robert
Published: February 2003

This study explores the experiences of obstetric sonographers imparting diagnostic information which may be considered ‘bad news’ to expectant mothers. Semi‐structured interviews were conducted with nine sonographers at two London Hospitals to elicit their experiences of giving bad news. Themes which emerged then formed the basis for a quantitative survey of 180 practising obstetric sonographers in England. Their perception of what constitutes ‘bad news’ was examined. It was found that sonographers were predominantly concerned with lack of time and the unpredictability of the patient's reaction when giving bad news. Staff working in settings where there was a clear protocol specifying how to proceed following disclosure of bad news experienced less stress than those working without such a protocol. These findings have implications for psychologists working with patients who suffer pregnancy loss who may consider provision of support and counselling skills training for sonographers.
Severe intellectual disability and transition to adulthood
Authors: Clegg Jennifer , Sheard Charlotte , Cahill Joe , Osbeck Lisa
Published: February 2003

Institutional and psychological aspects of transition were explored with parents and staff involved with five young adults with severe intellectual disability whose challenging behaviour diminished after they made the transition, and five whose challenging behaviour remained high. They were selected from a previously surveyed cohort. Grounded theory analysis of interviews suggested little connection between the perspectives of parents and staff. The impact these differences have on communication about challenging behaviour was explored, and recommendations for service changes are made.
Experimentally induced emotions, facial muscle activity, and respiratory resistance in asthmatic and non‐asthmatic individuals
Authors: Ritz Thomas , Claussen Christiane , Dahme Bernhard
Published: February 2003

We studied the effects of emotion induction on total respiratory resistance, and their relationship with cardiac vagal activity and facial muscle activity in asthma. Groups of 20 asthmatic and 20 non‐asthmatic participants were exposed to series of happy and depressing pictures or self‐referent Velten statements. Facial electromyographic activity over corrugator supercilii, orbicularis oculi, and zygomaticus major regions was recorded during periods of presentation and imagery of each stimulus. Following each stimulus series, mood, respiratory resistance, ventilation, and cardiac activity including respiratory sinus arrhythmia (RSA) were recorded. Significant increases of respiratory resistance were observed in asthmatic patients following depressing stimulation. Resistance increases were positively correlated with RSA and heart period. No substantial group differences were found in facial response to emotional stimuli. Changes in facial target muscle sites during positive stimulation were inversely correlated with RSA following stimulation. We conclude that respiratory resistance increases in asthmatics following depressing stimulation are dependent on vagal activity. Greater facial muscle activation during emotional stimulation can reduce vagal activation, which is consistent with claims in the clinical literature of the benefits of emotional expression in asthma.
Psychological functioning and bodily conditions in patients with pain disorder associated with psychological factors
Authors: Monsen Kirsti , Havik Odd E.
Published: February 2003

A sample of chronic pain patients (N = 40) was described with reference to defence mechanisms, interpersonal problems, psychological symptoms and bodily conditions. The relationships between pain intensity and different psychological and bodily indexes were examined. The defence mechanisms of somatization and denial measured by the Minnesota Multiphasic Personality Inventory (MMPI) characterized the sample. Interpersonal relations were typically overly nurturant, exploitable, non‐assertive and socially avoidant according to the circumplex version of Inventory of Interpersonal Problems (IIP‐C). Somatization, obsession, depression and anxiety were the highest symptom scales on the Symptom Check‐List 90, revised (SCL‐90‐R). The Comprehensive Body Examination (CBE) produced moderate findings mainly reflecting stiffness, and the intensity of pain was medium high. The MMPI psychosomatic pattern, the combined IIP‐C index consisting of the elevated subscales, and the elevated subscales on SCL‐90‐R were all moderately correlated with pain intensity. Contrary to our prediction, the global bodily stiffness score was unrelated to pain.
A qualitative study of mindfulness‐based cognitive therapy for depression
Authors: Mason Oliver , Hargreaves Isabel
Published: February 2003

Psychotherapeutic interventions containing training in mindfulness meditation have been shown to help participants with a variety of somatic and psychological conditions. Mindfulness‐based cognitive therapy (MBCT) is a meditation‐based psychotherapeutic intervention designed to help reduce the risk of relapse of recurrent depression. There is encouraging early evidence from multi‐centre randomized controlled trials. However, little is known of the process by which MBCT may bring therapeutic benefits. This study set out to explore participants' accounts of MBCT in the mental‐health context. Seven participants were interviewed in two phases. Interview data from four participants were obtained in the weeks following MBCT. Grounded theory techniques were used to identify several categories that combine to describe the ways in which mental‐health difficulties arose as well as their experiences of MBCT. Three further participants who have continued to practise MBCT were interviewed so as to further validate, elucidate and extend these categories. The theory suggested that the preconceptions and expectations of therapy are important influences on later experiences of MBCT. Important areas of therapeutic change (‘coming to terms’) were identified, including the development of mindfulness skills, an attitude of acceptance and ‘living in the moment’. The development of mindfulness skills was seen to hold a key role in the development of change. Generalization of these skills to everyday life was seen as important, and several ways in which this happened, including the use of breathing spaces, were discussed. The study emphasized the role of continued skills practice for participants' therapeutic gains. In addition, several of the concepts and categories offered support to cognitive accounts of mood disorder and the role of MBCT in reducing relapse.
Social institutions and psychological explanations: Druze reincarnation as a therapeutic resource
Authors: Littlewood Roland
Published: February 2003

For Emile Durkheim, to explain our social institutions through individual psychology was generally regarded as illegitimate. It has, however, often been assumed by psychologists and psychiatrists, particularly in the case of religious doctrine and institutions. However, the people actually concerned, our religious informants, might sometimes themselves volunteer interpretations which are psychologically functional for the origin and maintenance of certain cultural facts. This is particularly so when they are faced with a ‘modern’ worldview. The instance of the Druze belief in bodily reincarnation after death is considered in the context of the recent civil war in the Lebanon.
Voices of the self in psychotherapy: A qualitative analysis
Authors: Georgaca Eugenie
Published: February 2003

Approaches that view the self as constituted by socio‐cultural processes and as plural, consisting of a multiplicity of states, positions, functions, etc., have flourished in the last decades. This paper explores the multi‐voiced nature of the self, drawing upon Lacan's theory of subjectivity and Bakhtin's concept of dialogism. Subjectivity is seen as constituted through language as expressed in the speech of the subject's important early others. The psychoanalytic concept of transference, understood as a semiotic process of enacting early interpersonal patterns in the subject's present relations, provides a link between the unfolding of subjectivity in the present and its historical continuity. The articulation of subjectivity is discussed through a micro‐analysis of extracts from sessions of a long‐term psychoanalytic psychotherapy. The analysis demonstrates the enactment of transferential dialogical positions at the beginning of the therapy and traces their recognition by the client through the gradual development of increasingly reflexive subject positions towards the end of therapy. It is argued that the aim of therapy should be the facilitation of a complex subjectivity, whereby the different subject positions can be fluently articulated within an overall reflexive frame.
Rated casemix of general practitioner referrals to practice counsellors and clinical psychologists: A retrospective survey of a year's caseload
Authors: Cape John , Parham Alan
Published: February 2003

Although evidence‐based guidelines are beginning to be produced as to which psychological therapies might be appropriate for which patients, little is known about how general medical practitioners (GPs) in practice distribute referrals between different psychological therapy services. In a retrospective survey, 19 practice counsellors and 10 clinical psychologists from the same geographical area rated a year's caseload of GP referrals using identical data collection methods. Rated casemix was found to be broadly similar, although practice counsellors rated relationship and bereavement problems as more common in their caseloads (totalling 986 patients), and clinical psychologists rated panic disorder, phobias, and obsessive‐compulsive problems as more common in their caseloads (totalling 320 patients). Depression and anxiety reactions were the most common problems rated in both groups, but the clinical psychologist cases of depression were rated as more severe and complex. Where differences were found, they may have reflected the different ways that counsellors and clinical psychologists conceptualize cases rather than actual differences in casemix. The results are discussed in relation to evidence‐based guideline recommendations about cases appropriate to be seen by practice counsellors and by clinical psychologists in primary and secondary care, and the need to adapt such guidance to local services and skills of practitioners.
Translating the psychobiology of post‐traumatic stress disorder into clinically useful analogy
Authors: Scott Michael J. , Stradling Stephen G.
Published: February 2003

Psychological theorizing about post‐traumatic stress disorder (PTSD) has developed considerably since early behavioural formulations (Brewin, Dalgleish, & Joseph, 1996; Mowrer, 1960) and there have been parallel developments in biological understanding (Yehuda, 1998). However clinical practice has not been affected by the new psychobiology. It is suggested that it is possible to translate this new understanding into a clinically useful analogy that will help circumvent the difficulties of forming a therapeutic alliance with trauma victims which have been reported (Pitman et al., 1991; Scott & Stradling, 1997).
Differential psychotic symptomatology in polyglot patients: Case reports and their implications
Authors: de Zulueta F. I. S. , Gene‐Cos N. , Grachev S.
Published: February 2003

Polyglot psychotic patients can present with either different or less psychotic symptoms depending on the language they use. No known study has used a structured interview to assess such differences. A language history was taken on three patients who were then assessed using the Positive and Negative Syndrome Scale structured interview (SCI‐PANSS) for schizophrenia in their two languages. All three patients were found to have different positive symptoms depending on the language used in the interview procedure by the same bilingual researcher. These findings could have important implications in terms of our assessment and treatment of psychotic patients in the NHS. They demonstrate the need to carry out a large study in order to determine how common these findings are in multilingual patients.
Faith conquers all? Beliefs about the role of religious factors in coping with depression among different cultural‐religious groups in the UK
Authors: Loewenthal Kate Miriam , Cinnirella Marco , Evdoka Georgina , Murphy Paula
Published: February 2003

How effective is religious activity believed to be in coping with depression? This study assessed the perceived effectiveness of different religious activities — previously identified as important in coping — among 282 people in the UK. The mean age was 25 years, and participants were either Christian, Hindu, Jewish, Muslim, other religion, or no religion. Relative to other kinds of help for depression, religious activity was not seen as particularly helpful for depression. Religious activity was seen as less helpful by the ever‐depressed than by the never‐depressed and as less helpful by women than by men. Among religious activities, faith and prayer were seen as the most helpful. Muslims believed more strongly than other groups in the efficacy of religious coping methods for depression, were most likely to say they would use religious coping behaviour, and were least likely to say they would seek social support or professional help for depression. Other differences between groups were also observed, and comparisons with qualitative material obtained in an earlier study were made. The implications of these findings for help‐seeking are considered.
Contingent reinforcement or defending the self? A review of evolving models of aggression in people with mild learning disabilities
Authors: Jahoda Andrew , Trower Peter , Pert Carol , Finn Deborah
Published: February 2003

This paper examines the changing approaches to working with people with a moderate to mild learning disability, who are frequently aggressive. Long‐held assumptions about the lack of inter‐personal understanding and impulsiveness continue to play a central role in clinical assessment and intervention for this group. Yet, there is a lack of controlled studies indicating the influence of such factors in frequent aggression. The dominant behavioural tradition has long encouraged such assumptions, but has focused on people with more severe disabilities where such assumptions are arguably more appropriate. The current review of the literature shows a clear evolution away from a strict behavioural approach towards cognitive‐behavioural therapy (CBT) approaches that take account of the heterogeneous psychosocial causes of aggression. We find support for CBT in the child‐development literature, which examines inter‐personal difficulties from an information‐processing perspective. Finally, we argue that much of the literature implicitly utilizes the concept of self, and we suggest that this should be made explicit in a reformulated theory of the ‘person’, incorporating the self concept and embedding individual cognitive processes and behaviour in a social context.
The Bene‐Anthony Family Relations Test revisited: Directions in the assessment of children's perceptions of family relations
Authors: Parkin Andrew
Published: February 2003

The Bene‐Anthony Family Relations Test is designed to assess the child's perception of family relations using projective techniques. This article describes the test and background to its development. The validity of the test is limited by the content of some items and their categorization, though there is evidence that the test can distinguish between populations that differ on other related variables. A survey of professionals who use the test is described. Despite their enthusiasm for it, the majority of respondents had modified the test in some way, and 86% regularly rephrased at least one item from the test. There were several criticisms of the test, including the positive scoring of ‘sexualized items’. The respondents were also inconsistent in their administration and scoring of the test.

This test is used less frequently in research, possibly because it is not perceived as a sufficiently robust psychometric instrument. However, there is a danger of ‘throwing away the baby with the bath water’. Recommendations are made for the development of a test that reliably assesses the child's perception of the emotional content of relations.
Psychoeducation in the prevention of eating disorders: An experimental approach in adolescent schoolgirls
Authors: Rocco Pier Luigi , Ciano Rossana P. , Balestrieri Matteo
Published: February 2003

The aim of this report is to analyse the impact of a psychoeducational preventive programme on the eating habits of a sample of adolescent schoolgirls. Of the 112 schoolgirls attending five classes, about 86% agreed to participate in the program. Of these, 63 participants belonged to the experimental group and 33 agreed to the control group. The psychoeducational sessions were performed once a month for each of three experimental classes. The programme involved discussions on the nature of eating disorders, on epidemiological aspects and on the importance of early detection of risk factors. The tests used to evaluate the sample were the EDI‐2 and the PF‐16. The results showed a significant improvement in bulimic attitudes, asceticism, feelings of ineffectiveness, and maturity fears. Anxiety traits were also better managed in the experimental group. Our conclusions suggest that correct information about eating disorders can ameliorate unhealthy attitudes towards eating behaviour.
Cultural stereotype of the effects of religion on mental health
Authors: Lewis Christopher Alan
Published: February 2003

To examine if the religious are more likely to be rated as having a poorer mental health than the non‐religious, 48 Northern Irish undergraduate students completed self‐report measures of religious attitude and mental health under four counter‐balanced conditions: ‘control’ (present yourself ‘as you really are’) and as how ‘religious’, ‘non‐religious’, and ‘mentally ill’ respondents might be thought to answer. The ‘religious’ condition provided significantly higher scores for both the Obsessional Symptom Scale and the Obsessional Personality Trait Scale and significantly lower Psychoticism Scale scores than the ‘non‐religious’ condition. Moreover, significant associations were found between higher scores on the religiosity scale and higher scores on the Obsessional Personality Trait Scale in two of the four conditions (‘religious’ and ‘mentally ill’) and lower scores on the Psychoticism Scale in three of the four conditions (‘control’, ‘religious’, and ‘mentally ill’). These results suggest that the religious are viewed paradoxically as having both aspects of better (i.e. lower psychoticism scores) and poorer mental health (i.e. higher obsessional scores) than the non‐religious. As such, the present findings provide some support for the existence of a powerful cultural stereotype of the religious.
Intensive care unit syndrome: A consideration of psychological interventions
Authors: Bennun Ian
Published: February 2003

There is little in the psychological literature to guide clinicians treating ICU patients presenting with the ICU syndrome. Existing psychological models need to be developed and adapted in the management of these cases. This paper describes two clinical cases and offers psychological formulations and descriptions of treatment.
Personal constructs, childhood sexual abuse and revictimization
Authors: Freshwater Kate , Leach Chris , Aldridge Jan
Published: February 2003

Within the theoretical framework of Ryle's Procedural Sequence Object Relations Model and Kelly's Personal Construct Theory, this study investigates sex‐role polarization of incest survivors and the centrality of abuse within survivors' constructs of men that may contribute to revictimization. Repertory grid methodology was used with 40 female survivors of childhood sexual abuse and 28 non‐abused women. Grid measures and psychometric measures were compared between groups of women who had and had not experienced childhood sexual abuse, revictimized and non‐revictimized survivors, and survivors who had and had not experienced incestuous abuse. Results showed significant differences between survivors and non‐abused women, with survivors having higher levels of depression and perceived distress, lower self‐esteem and higher self/ideal self discrepancy. Hypothesized differences in sex‐role polarization were not found. There were few differences between revictimized and non‐revictimized survivors, although revictimized survivors rated ‘self now’ as more powerful than non‐revictimized survivors. No differences were found between survivors who had and had not experienced incestuous abuse. In addition to the value of exploring personal constructs, a range of models need to be considered in understanding revictimization and women's construal of men. The implications of using repertory grid methodology for research and clinical work are discussed.
Personal appraisal of the experience of a depressive disorder
Authors: Bookless Clara , McFarlane Alexander , Clayer John
Published: February 2003

In a prospective study, 61 patients receiving ongoing treatment for Major Depression rated the personal significance of the disorder by using the Personal Appraisal Inventory (PAI) (Bookless, Clayer & McFarlane, 2000) twice over a period of 7 months. The initial (Time 1) association between the individual items of the PAI and self‐reported levels of depression, anxiety, disability, self‐esteem and psychological distress was examined. It was found that these variables related to some items pertaining to appraisal of the harm and threat engendered by the disorder, but did not relate to appraisal of the positive and negative options for managing the disorder. Seven months later (Time 2) few significant changes were found in the way people appraised the impact of the disorder however, levels of depression, anxiety, disability and distress at Time 2 were predicted by several appraisal items. The clinical implications of these findings are discussed.
The CBT of delusional disorder: The relationship between schema vulnerability and psychotic content
Authors: Moorhead Steve , Turkington Doug
Published: February 2003

This paper reports the process, interventions, and outcome of the cognitive‐behavioural therapy of a patient who had a diagnosis of delusional disorder. The clinical features, process of therapy, and successful outcome are all discussed in relation to explanatory information processing models of delusion development and maintenance, and recent developments in formulation‐driven CBT of delusions. The implications for therapy, service development, and training are discussed. Beliefs that mediate the relationship between core schemas and delusions may form a helpful focus for early therapeutic endeavour in psychosis.
Existential loneliness: A review of the concept, its psychosocial precipitants and psychotherapeutic implications for HIV‐infected women
Authors: Mayers Aviva M. , Svartberg Martin
Published: February 2003

While many of the most urgent psychological issues that women with HIV infection are forced to deal with are existential in nature, and therefore shared by humankind, the assault on their physical and psychological being may trigger these issues in large amounts and may overwhelm their defensive structure. Existential loneliness may be an important existential issue that arises for these women and needs to be given equal consideration alongside other forms of loneliness. In this paper, we review the concept of existential loneliness, discuss methods to measure the concept, delineate some central psychosocial precipitants of existential loneliness among HIV‐infected women, and discuss psychotherapeutic implications. We conclude that incorporating an existential philosophical perspective into one's particular therapeutic stance may be especially appropriate with this population.
OCD patients and non‐patient groups reporting obsessions and compulsions: Phenomenology, help‐seeking, and access to treatment
Authors: Simonds Laura M. , Elliott Sandra A.
Published: February 2003

This article offers a preliminary examination of factors that may be important to seeking help and receiving treatment for obsessive‐compulsive symptoms. Community studies typically reveal individuals who display significant obsessive‐compulsive symptomatology. Such individuals are often used in analogue research that attempts to understand various symptom dimensions and associated characteristics relevant to clinical obsessional states. This article questions why, if these non‐patient groups are sufficiently similar to patients in terms of phenomenology, there should exist a disparity in treatment status. This question is addressed in the following way: first, obsessive‐compulsive symptoms and associated features that may be central to help‐seeking are considered in both patient and non‐patient groups. A central argument in this part of the article is that cross‐study phenomenological comparisons are hindered by diversity in research selection criteria. Secondly, general factors that may be considered important to help‐seeking for psychological distress are considered, as too are those factors that may be applied to the consideration of help‐seeking for obsessive‐compulsive problems specifically. Finally, the implications of these issues in the literature for research and clinical practice are considered.
The role of shame and guilt in traumatic events: A clinical model of shame‐based and guilt‐based PTSD
Authors: Lee Deborah A. , Scragg Peter , Turner Stuart
Published: February 2003

Post‐traumatic stress disorder is currently classified as an anxiety disorder with fear as the predominant emotion. This has led to the development of treatment techniques such as exposure aimed at alleviating fear. This article highlights the need to address other emotional responses, in particular shame and guilt, when assessing and treating PTSD. Hence, it presents two clinical models of shame‐based PTSD and guilt‐based PTSD. These models are offered as aids to clinicians in assessing and formulating cases of PTSD where shame and guilt are salient issues. The models highlight the importance of assessing meaning in the context of pre‐existing schemas and address two pathways to the development of shame and/or guilt: schema congruence and schema incongruence. Several treatment implications are drawn from the models.
The effect of dissociation at encoding on intrusive memories for a stressful film
Authors: Brewin Chris R. , Saunders Julie
Published: February 2003

The occurrence of memory intrusions after a trauma has been linked to peri‐traumatic dissociation. In this study, we attempted to induce dissociation experimentally and investigate the impact on intrusive memories. A total of 39 undergraduates were randomly assigned to watch a stressful film under standard conditions or under a dual‐task condition in which they simultaneously performed a tapping task. They rated their distress post‐film and again after 2 weeks, and kept a diary of intrusive memories. Contrary to prediction, there were no differences in levels of distress or explicit memory between the two conditions, and the dual‐task condition was followed by significantly fewer memory intrusions. Dual‐task conditions may not provide a good analogue to naturally occurring dissociation. The possible preventive effects of the tapping task are discussed in terms of the dual‐representation theory of post‐traumatic stress disorder.
Mediation of depression by perceptions of defeat and entrapment in high‐stress mothers
Authors: Willner Paul , Goldstein Richard C.
Published: February 2003

Previous studies have demonstrated a causal role of stress in depression, and an association between depression and perceptions of defeat and entrapment. The present study was conducted to determine whether perceptions of defeat/entrapment mediate the relationship between stress and depression. Seventy‐six mothers of children attending specialist educational provision for a range of special needs completed the Parenting Stress Index—Short Form (PSI‐SF), Defeat and Entrapment Scales, the Beck Depression Inventory (BDI), and the Fawcett‐Clark Pleasure Capacity Scale (FCPCS). Relative to population norms, respondents reported very high levels of stress, moderately high levels of defeat/entrapment, mild depression, and very low hedonic capacities. Most of these measures were more extreme in younger mothers and those with a prior history of depression. FCPCS scores were correlated negatively with stress, after controlling for levels of defeat/entrapment, but were not correlated with BDI scores, suggesting that the FCPCS may be an unsuitable instrument for use in the present participant population. Significant positive correlations were found between all measures of stress, defeat/entrapment and depression. After controlling for PSI‐SF scores, correlations between BDI and defeat/entrapment scores remained highly significant. However, after controlling for defeat/entrapment, correlations between BDI and PSI‐SF scores were non‐significant. Hence, perceptions of defeat/entrapment mediate the relationship between stress and depression. This relationship was confirmed formally using regression analysis. Because respondents reported high levels of stress in contrast to mild levels of depression, a causal link can be inferred, running from stress via defeat/entrapment to depression.
Affective states associated with bingeing and purging behaviours in Japanese patients with bulimia nervosa
Authors: Tachi Tetsuro , Murakami Ken , Murotsu Keizo , Washizuka Teruhisa
Published: February 2003

This study investigated the relationship between binge‐purge episodes and the affective state by analysing the changes in affective states during the binge‐purge cycle. Thirty‐seven Japanese patients with bulimia nervosa were surveyed for 22 types of affective states. Some negative affects were alleviated by bingeing or purging, while others were exacerbated by these behaviours. These findings suggest that one has to differentiate the temporal situations in the binge‐purge cycle in considering the relationship between the affective states and binge‐purge behaviours. The escape hypothesis and hopelessness hypothesis proposed by Beebe (1994) suggest some possible mechanisms. Binge and purge behaviours should be examined separately as defence functions to regulate negative moods and as acting out in response to intense negative affects.