bluuebunny/crossref_metadata_2025 huggingface dataset:
Facilitators and Regulators: Conscious and unconscious processes in pregnancy and early motherhood
Authors: Raphael‐Leff Joan
Published: July 2011

A model is presented, based on clinical experience, mother‐child observations and survey data, delineating two different maternal orientations towards babies and motherhood. The essential difference in orientation is that the Facilitator mother adapts to her baby while the Regulator mother expects the baby to adapt. On a behavioural level these two orientations are manifest in differing maternal practices: the Facilitator mothers exclusively, responding spontaneously to her baby's needs as they arise, whereas the Regulator establishes a routine to foster predictability and shares mothering with her partner or other caretakers.

This paper explores three areas within the different maternal orientations of the Facilitator and Regulator:

(a) bconceptualization: conscious beliefs and expectations of motherhood and babies;

(b) bpractice: observable differences in adaptation to pregnancy, labour, birth and early weeks of motherhood, and differential postnatal vulnerability to psychosocial provoking factors;

(c) unconscious processes: identifications, phantasies and defences underlying these practices.

The psychogenesis of the two maternal orientations is explored. It is suggested that unconscious identifications between various aspects of the mother's internal world and the foetus determine the maternal orientations, with the Facilitator mother employing idealization and manic reparation to sustain her maternal beliefs while the Regulator engages in manic defence and dissociation. Conscious and unconscious processes operate in conjunction with current socio‐economic circumstances to determine maternal practice.
The Type A behaviour pattern as a precursor to stressful life‐events: A confluence of coronary risks
Authors: Byrne D. G. , Rosenman R. H.
Published: July 2011

Both the Type A Behaviour Pattern (TABP) and the presence of stressful life‐events have been independently established as precursors to the onset of coronary heart disease (CHD). The thematic character of the TABP suggests, however, that the two phenomena might be linked, to the extent that features of the TABP may place an individual in social, occupational and personal circumstances which enhance the probability of encountering stressful life‐events. Evidence from survivors of clinical CHD gives some support to this idea. The present study extends the hypothesis to a large sample of healthy males, screened for CHD risk factors. These results, too, support the idea that the TABP and encounters with stressful life‐events are not entirely independent phenomena. Associations between the TABP and a range of measures of life‐events were most evident in the occupational aspects of the latter, though not exclusively so. The data do point to the need, in future epidemiological studies of CHD risk, to treat the TABP and stressful life‐events as related measures of CHD risk.
Assessment of cancer pain by the McGill Pain Questionnaire: Results of two scoring methods in a sample of British patients and comparison with previous studies
Authors: Lahuerta Juan , Campbell Jackie
Published: July 2011

Pain experienced by 29 British cancer patients was evaluated by the McGill Pain Questionnaire. The questionnaires were analysed according to the traditional and a newly proposed scoring method. The results were compared with previously published studies. Scores relating to the sensory and affective components of pain were found to be similar for all groups of cancer pain patients. On the contrary, differences between groups were found for evaluative scores of the overall experience of pain. A previously observed pattern of pain intensity‐complexity correlation in cancer pain patients was reproduced. Interpretations of the similarities and discrepancies among groups of patients are discussed.
A new projective test: The Caine‐Marteau‐Dympna Test (CMD)
Authors: Caine T. M. , Henley S. , Moses P. , Shamni S. , Smith H. , Winter D. A.
Published: July 2011

The Caine‐Marteau‐Dympna (CMD) Test, a new thematic apperception projective test, has acceptable inter‐rater reliability. Validity was demonstrated by its ability to differentiate psychiatric in‐patients from out‐patients and non‐patients, and by the relationships found between ratings derived from the test protocols and various questionnaires. These latter provide measures associated with either an inner or outer orientation towards the world. This has implications for many different areas of life, including occupational preference and adjustment, psychiatric symptom formation, psychological treatment expectancies and therapeutic outcome. Thus, the inner orientated individual, who is likely to be responsive to interpretative psychotherapy, tends to produce CMD responses displaying individualistic, abstract themes; a concern with intrapsychic conflict, deficiencies in social interaction and lack of structure; and internal control.
Senile dementia: Factors associated with caregivers' preference for institutional care
Authors: Gilhooly Mary L. M.
Published: July 2011

This paper presents findings concerning variables expected to influence the motivation of persons caring for a dementing relative in the community to continue giving care and support. The variables examined in relation to ‘preference for institutional care’ were those previously examined in relation to supporters' psychological well‐being (Gilhooly, 1984). The results indicate that factors within the relationship between supporter and the dependent dementing relative are important determinants of motivation to continue giving support. Other variables significantly associated with advocacy of institutional care included the age of the supporter, supporter' contacts with friends, satisfaction with help from relatives, another dependent relative, and whether or not the supporter was employed. Help from the services and supporters' well‐being were not significantly correlated with ratings of preference for institutional care.
Depersonalization and agoraphobia associated with marijuana use
Authors: Moran Carmen
Published: July 2011

This paper examines the role of uncontrolled depersonalization associated with marijuana use in the development of agoraphobia. Cases of six people are described, all of whom reported first experiencing depersonalization while using marijuana, and subsequently experiencing depersonalization while not using the drug. A fear of this ‘uncontrolled’ depersonalization resulted in considerable anticipatory anxiety and panic attacks. Patients ultimately presented for treatment of agoraphobia. A temporal relationship between marijuana use, uncontrolled depersonalization, panic attacks and agoraphobia does not imply causality. Comparison of these cases with other agoraphobia clinic patients provides tentative evidence for a difference between the two types of patients. There were no systematic patterns of stressors in the cases prior to the onset of symptoms. Data obtained before and after treatment indicated the cases were slightly more severe than clinic patients. Males and females were represented equally in the cases, whereas there was a higher incidence of females in the clinic patients. The cases' age of onset was younger than that of the clinic patients. Our standard cognitive‐behavioural treatment programme required modification to account for the intensity of the fear of depersonalization in the cases.
Psychological aspects of infertility
Authors: Edelmann Robert J. , Connolly Kevin J.
Published: July 2011

It has often been claimed that psychological problems accompany infertility among some couples attending infertility clinics. Some authors have suggested that psychological factors may be a primary cause of infertility, others have suggested that the state of infertility itself can provoke psychological symptoms. The importance of psychological counselling for involuntarily childless couples has also been noted. This paper, which reviews studies that have attempted to investigate psychological aspects of infertility, is organized around three issues: psychological factors as a cause of infertility, the impact of infertility on psychological functioning, coping with infertility and the counselling needs of the infertile couple. While there seems little doubt that infertility has psychological consequences for some couples, many questions will remain unanswered unless carefully designed and conducted longitudinal studies are undertaken.
The case of the anxious executive: A study from the research clinic
Authors: Parry Glenys , Shapiro David A. , Firth Jenny
Published: July 2011

Most psychotherapists are neither active researchers nor consumers of research findings. Research approaches are needed which build a bridge between clinical realism and independent evidence, but which are applicable in National Health Service settings by clinicians lacking substantial research resources. A new method of clinical inquiry is described which combines measurement techniques developed in psychotherapy research with the therapist's session notes and client perceptions of helpful events in therapy. The method is illustrated by a case study which examines the content of helpful and unhelpful therapy sessions.
Sudden idiopathic hearing loss: Psychopathology and antecedent stressful life‐events
Authors: Neuser Jürgen , Knoop Thomas
Published: July 2011

Otologists repeatedly state that patients suffering from Sudden Idiopathic Hearing Loss (SIHL) often have significant emotional problems or stressful living conditions. The study described here compared males and females suffering from SIHL with controls without any impairment of the inner ear. Personality data were gathered by means of Faschingbauer's Abbreviated MMPI (FAM). Stress factors were assessed by an Inventory of Stressful Life‐Events (ILE). SIHL patients reported more stressful life‐events, whose distressing effects lasted until onset of symptoms, than controls. There was no significant influence of personality upon report of stress. Stress factors and inability to cope with these seem to be important psychological factors in SIHL patients, while psychopathological disturbances may be important for some but not for the majority of cases.
Pre‐operative state anxiety as a mediator of psychological adjustment to and recovery from surgery
Authors: Wallace Louise M.
Published: July 2011

Psychological theories of stress suggest competing hypotheses for the predictive relationship between pre‐operative anxiety and post‐operative adjustment and recovery. Evidence is presented to assess whether linear or curvilinear (quadratic) relationships account for the associations between pre‐operative anxiety and post‐operative variables. These two hypotheses are tested on two samples of patients undergoing elective minor gynaecological surgery. Multiple regression analyses provided weak support for a linear, but not a curvilinear, relationship between pre‐operative anxiety and post‐operative anxiety but not with post‐operative outcomes other than anxiety such as pain or speed of returning to normal activities. Qualitative data are also presented which examine whether patients who show either low or high levels of pre‐operative anxiety differ in the nature of their fears of surgery or their preferred methods of coping with fear and with post‐operative pain. No evidence was found to suggest that patients with either high or low levels of pre‐operative anxiety differed in appraisal or coping strategies. There was little evidence that the beneficial effects of a special preparatory booklet on post‐operative adjustment and recovery were mediated by its influence on state anxiety.
Differences in reasons for taking overdoses in high and low hopelessness groups
Authors: Williams J. Mark G.
Published: July 2011

Thirty‐five people admitted to hospital following deliberate self‐harm by overdose were interviewed. Patients rated several ‘reasons’ for making the attempt on 0–10‐point scales. The ‘reasons’ used were those derived by Bancroft and his associates (e.g. find out if someone loved me, make people understand how desperate I was feeling). The patients also completed Beck et al.'s Hopelessness Scale. High hopelessness was associated with an increased wish ‘to die’ and ‘to get relief from a terrible state of mind’ but high and low hopelessness did not differentiate between other reasons, even the traditionally ‘manipulative’ ones. The intercorrelations between reasons suggested that in low hopelessness interpersonal reasons were the most central constructs, whereas in the high hopelessness patients, the escape motive was the most central.
Body satisfaction in adolescent girls
Authors: Davies Elizabeth , Furnham Adrian
Published: July 2011

Body satisfaction was examined in four age groups of female British adolescents. Overall satisfaction with nine body features declined from age 12 to 18 years, particularly upper thigh, buttocks and stomach measurements. Although a shape ratio (weight divided by height) determined various aspects of body satisfaction in older girls, self‐perceived weight (underweight, OK, overweight) related more directly to body satisfaction. The results suggest that body satisfaction declines during adolescence and is linked to psychological self‐esteem and excessive dieting.
Common personality features in neurotic disorder
Authors: Tyrer P. , Casey P. R. , Seivewright N.
Published: July 2011

The personality characteristics of 77 patients seen in general practice with a Catego diagnosis of anxiety state (including phobic state) or depressive neurosis derived from the Present State Examination were compared with those in 77 normal subjects chosen at random from the list of the same general practitioner. Each patient was matched with a normal subject of the same age and sex. The personality characteristics were rated using the Personality Assessment Schedule, an interview schedule designed to elicit the premorbid personality of the subject. The neurotic patients had significantly higher scores for the personality characteristics of anxiousness, vulnerability, resourcelessness, hypochondriasis and other features commonly described as oral and hysterical. Schizoid features were absent in the neurotic group. The results suggest that there are common personality attributes in neurotic disorder and that these have clinical significance.
The measurement of grief: Age and sex variation
Authors: Jacobs Selby , Kasl Stanislav , Ostfeld Adrian , Berkman Lisa , Charpentier Peter
Published: July 2011

Age and sex variation in the expression of grief were examined using a structured assessment to test clinically based impressions that (1) widowers by comparison with widows and (2) older bereaved persons by comparison with middle‐aged counterparts would report distinctive aspects of grief and less intense distress. One hundred and fourteen acutely bereaved spouses were interviewed one month after a loss. The psychological assessment used was designed to measure several dimensions of grief including separation anxiety, numbness‐disbelief and depression. Widows reported significantly more numbness‐disbelief and depression than widowers but no difference in the intensity of separation anxiety. Contrary to our hypotheses, no attenuation in the intensity of grief was observed among older bereaved spouses, though they reacted to the loss with less emotional numbness and disbelief of the reality than the middle‐aged comparison group. Furthermore, they reported no more neurovegetative or illusory symptoms than middle‐aged, bereaved spouses. Older widowers experienced more separation anxiety than younger widowers. It seems possible that these differences account, in part, for age and sex variation in the morbidity and mortality of bereavement.
Hostility and deliberate self‐poisoning
Authors: Farmer Roger , Creed Francis
Published: July 2011

Patients admitted to hospital following deliberate self‐poisoning have been shown to have high levels of hostility, but the exact role of hostility in self‐poisoning is not clear. It was hypothesized that those subjects with marked depression would have high intro‐punitive scores whereas those deliberately poisoning themselves who did not have marked depression would have high extra‐punitive scores. Seventy young adults admitted to hospital following deliberate self‐poisoning completed the Hostility and Direction of Hostility Questionnaire and half of these subjects had an identifiable depressive syndrome. Very high intro‐punitive scores were found in the depressed subjects but high extra‐punitive scores were found in all deliberate self‐poisoning subjects irrespective of depression. This suggests that extra‐punitiveness might distinguish self‐poisoners from other psychiatric patients. Within the self‐poisoning group, high intro‐punitive scores were associated with greatest suicidal intent but further studies are needed to see if these are an aspect of the depression or part of the personality.
Personal themes from training groups for health care professionals
Authors: Aveline Mark
Published: July 2011

The personal themes presented by 210 health care professionals in the training group component of an annual group psychotherapy course are described. The course, begun in 1976, provides inexperienced group leaders with an introduction to theory and a personal group experience in 12 weekly sessions. Within this brief period, the development of a cohesive working group is possible. Members have revealed much personal tragedy which cannot be expressed at work for fear of being thought weak. At times in their clinical work members have felt helpless and hopeless. Giving care and not receiving it has been a burden. The group experience has allowed members to transcend professional rivalries and see each other as people and not in stereotype. Members have often feared damaging their careers by self‐disclosure and, for some, the group has provided the first opportunity for intimate dialogue with colleagues. The groups have supported members through personal crises and helped them make career decisions. The results highlight the value to staff of having a safe, non‐punitive group setting in which they may speak of personal issues that trouble them, begin to become aware of how their own personality and life experience may impair and enrich their ability as therapists, and surmount the obstacle of stereotyping to meet their colleagues in dialogue.
Social support and psychological distress of parents of children with acute lymphocytic leukaemia
Authors: Magni Guido , Silvestro Alessandra , Carli Modesto , De Leo Diego
Published: July 2011

The relationship between psychological distress and social support was evaluated in 26 parents of children with acute lymphocytic leukaemia during the diagnostic phase. The Symptom Distress Checklist and the Social Support Questionnaire were used. A high percentage of subjects reported a score of moderate psychological distress in four subscales of the Symptom Checklist: Obsessiveness‐Compulsiveness (46 per cent), Depression (61–5 per cent), Anxiety (65 per cent) and Sleep Disturbances (57.5 per cent). Social support for parents was found to have a ‘buffering’ effect on the impact of the stress occasioned by the diagnosis of acute lymphocytic leukaemia in a child.
Staff resistance to interpretive psychotherapy in the in‐patient community meeting
Authors: Winer Jerome A. , Channon Robert A.
Published: July 2011

The authors propose using the in‐patient psychiatry unit community meeting for large‐group interpretive psychotherapy, employing the model of Winer & Lewis (1984). This model rests heavily on interpretation of group transferences in the here and now. The staff has the task of discovering patients' veiled references to them and interpreting the patients' resistance to direct expression of their experience of the staff. The authors discuss the impact of introducing the technique upon staff members. Staff members resist this new model in order to defend against self‐esteem injury, loss and regression, staff‐staff conflict, and the recognition of their own disavowed internal motives. Staff self‐esteem can be endangered by any programme change, by the loss of accustomed roles, by the patients' hostility and direct criticism, and by the staff's own sense of failure to realize therapeutic ambitions. Some of the resistance specific to interpretive group psychotherapy arises from the threat of group silence or alienation. The group leader, in addition, faces the difficult task of understanding the dynamics of a large group with only minimal support.
Self‐esteem and perception of attractiveness: An investigation of early rheumatoid arthritis
Authors: Skevington Suzanne M. , Blackwell Frances , Britton N. F.
Published: July 2011

During an investigation into the self‐esteem of early rheumatoid patients and controls matched individually by age and sex, it was found that at their first visit to out‐patients, patients had lower self‐esteem. The items of low self‐esteem showed a similarity with features of the rheumatoid personality. An observation that the word attractive in the Carlson Adjective Checklist was rarely used by both groups, and that items at the beginning and end of the checklist were less often ticked, led to a second study of 67 undergraduates where the position of the word attractive was experimentally varied in three forms of the scale. The results show that position only marginally affects response to this item. Probability analyses confirm that the word attractive is used very rarely by patients, rarely by healthy adults and less often than expected by healthy students, possibly demonstrating the respective effects of pain and illness, and age. Attractive tends to be included in the self‐concept only after self‐esteem reaches a relatively high level.
Locus of control as a predictor of outcome of psychotherapy
Authors: Foon Anne E.
Published: July 2011

The last 10 years have shown a notable increase in the consideration of locus of control as a variable pertinent to the explanation of outcome in psychotherapy. In particular, a body of research has provided evidence that an internal locus of control orientation facilitates both positive assessments of therapy and favourable outcomes, and that successful outcomes for clients with particular control orientations are facilitated by the degree of structure and directiveness in therapy. There appear to be a number of difficulties with the methods of measurement employed in these studies; in particular, the selection of subject groups and indexes of outcome as well as manipulation of treatment structures may have limited the generalizability of research findings. The possible therapeutic and clinical applications of locus of control in psychotherapy are considered.
Presentation of information to cancer patients: A comparison of two centres in the UK and USA
Authors: Newall Deborah J. , Gadd Elaine M. , Priestman T. J.
Published: July 2011

A questionnaire survey was carried out to compare the views of cancer patients at a UK and USA hospital with respect to the nature and sources of the information they received about their condition. Although there were many similarities, differences did emerge in the way the diagnosis was confirmed to the patient, the desire for additional information and the sources of such information. Among the UK patients 20 per cent reported that confirmation of their diagnosis had been delegated to junior staff, 30 per cent felt that their doctors did not have sufficient time to talk to them and 70 per cent stated that they relied on non‐medical sources for information about cancer. These findings indicate that there is considerable scope for improvement in communicating with cancer patients in the UK.
Cognitive impairment, emotional disorder and length of stay of elderly patients in a district general hospital
Authors: Johnston Marie , Wakeling Anthony , Graham Nori , Stokes Faith
Published: July 2011

All patients over 65 in a district general teaching hospital (n = 204) were screened for cognitive impairment and emotional disorder using the Clifton Assessment Procedures for the Elderly, the Mini‐Mental State and the General Health Questionnaire. Patients scoring in the disordered range were psychiatrically assessed. These procedures gave an estimated prevalence of cognitive impairment of 22 per cent in the 164 patients satisfactorily assessed. Forty‐three per cent of patients scored beyond the GHQ cut‐off, but there was a high false positive rate.

Cognitively impaired patients had a significantly longer hospital stay than the unimpaired. The majority (60 per cent) of these patients could not be discharged because of lack of an appropriate place elsewhere. Amongst all elderly patients whose discharge was prevented in this way, the cognitively impaired were markedly over‐represented. The data have implications for the efficient use of hospital beds and for the welfare of elderly patients in acute hospitals.
Assessing the Type A behaviour pattern with the Jenkins Activity Survey
Authors: Boyd David P. , Begley Thomas M.
Published: July 2011

Controversy has arisen over the usefulness and reliability of the Jenkins Activity Survey (JAS) as a measure of Type A behaviour. Ray & Bozek (1980), Jenkins & Zyzanski (1982) and Ray (1984) have exchanged contrasting views. Our data show (1) low internal consistency scores for the four components of the JAS: i.e. the Type A scale itself and factors speed and impatience (S), job involvement (J), and hard‐driving competitiveness (H); and (2) a low test‐retest reliability result for the Type A scale. Further, the weighted scoring scheme of the JAS is questioned. Recommendations are made to eliminate the weighted scoring scheme, delete factors S, J, and H, and revise specific items in the JAS.
Type A behaviour and time urgency: Perception of time adjectives
Authors: Mueser Kim T. , Yarnold Paul R. , Bryant Fred B.
Published: July 2011

Relations between time perception and Type A behaviour were investigated. Extreme Type A (n = 26) and B (n = 28) male college undergraduates rated the appropriateness of 158 adjectives as descriptors of time. Adjectives were independently rated using seven‐point Likert ‘speed’ and ‘energy’ scales. Analyses showed that Type As rate adjectives low in speed and energy as less descriptive of time than Type Bs and vice versa.
The relationship between stereotyped and self‐injurious behaviour
Authors: Jones Robert S. P.
Published: July 2011

Despite the widespread nature of stereotyped and self‐injurious behaviours within many patient groups, the precise relationship between these two behaviours has never been clearly delineated. A classification based on the frequency of emission is proposed which suggests separate forms of treatment for each behaviour class.
On describing mental states
Authors: Grounds Adrian
Published: July 2011

The later work of Wittgenstein was a major contribution to the philosophy of mind. One theme in his writings was a critique of the assumption that reports of psychological experience in ordinary language can be regarded as descriptions of inner states and processes. Some implications of this critique for our understanding of descriptive psychopathology and the use of psychological models in psychiatry are examined.
Intrusive unwanted thoughts: A two‐stage model of control
Authors: Edwards Sally , Dickerson Mark
Published: July 2011

It was proposed that the greater time taken to dismiss intrusive compared with neutral thoughts is better explained in terms of a decreased ability to disattend to the intrusive thought than a decreased ability to access a more pleasant replacement thought. A study of 43 subjects with ‘normal obsessions’ using a methodology that controlled the valence and content of replacement thoughts provided support for this disattention hypothesis.
Imagery in schizophrenic patients compared with normal controls
Authors: Chandiramani Kishore , Varma Vijoy K.
Published: July 2011

Comparison of imagery was made between 20 hallucinating schizophrenics, 20 non‐hallucinating schizophrenics and 20 normal controls using Bett's questionnaire on the vividness of mental imagery and Gordon's test of the control of visual imagery. Hallucinating schizophrenic patients did not differ from non‐hallucinating schizophrenic or normal controls with regard to the vividness or control of imagery, indicating a lack of relationship between hallucinations and mental imagery. Although it indicates that there is no disturbance in the vividness of volitional mental imagery in schizophrenia, the presence of abnormal spontaneous imagery cannot be commented upon.
A communication skills programme for increasing patients' satisfaction with general practice consultations
Authors: Evans B. J. , Kiellerup F. D. , Stanley R. O. , Burrows G. D. , Sweet B.
Published: July 2011

The research literature on patient perceptions of general practice consultations shows that, while patients are generally satisfied with the treatment they receive from doctors, they report less satisfaction with the amount and clarity of information they receive and doctors' expression of caring and respect. In the surgery, inadequate information transmission during the interaction also has the effect of increasing the level of anxiety reported by patients after their consultations. A communication skills programme was developed, incorporating variables from both the emotional and cognitive domains of the consultation. A group of GPs undertook training in this programme.

It was hypothesized that patients of the trained doctors would report greater satisfaction and less anxiety, compared with patients of untrained general practitioners. Subsequent randomized interviews with patients of the trained doctors showed that these patients were significantly more satisfied with their consultations. Patients of the trained doctors also reported less state anxiety immediately following their consultations, as measured using the State‐Trait Anxiety Inventory.

Attempts by doctors to communicate more effectively in consultations therefore increased patients' positive feelings and reduced anxiety.
Counter‐transference reactions contributing to completed suicide
Authors: Modestin Jiří
Published: July 2011

Counter‐transference reactions are frequently elicited while treating suicidal patients and they may contribute to the patient's committing suicide. Therapeutic constellations including the failure of the therapist to (1) cope with the patient's aggressiveness, (2) tolerate the patient's dependency, (3) handle the erotic transference adequately and (4) preserve loyalty towards the patient; they have all been identified as being responsible for a therapeutic impasse with fatal consequences. Knowledge of the therapeutic constellations especially prone to facilitate negative counter‐transference reactions may help the therapist to master them effectively.
The psychological adjustment of women experiencing infertility
Authors: Callan Victor J. , Hennessey John F.
Published: July 2011

A comparison of 53 infertile women and 24 mothers who now experienced infertility revealed that infertile women reported less satisfaction with their lives as a whole. In contrast to mothers they rated life as less interesting, less rewarding, emptier, more lonely and they were less content.
Brief Structured Recall: A more efficient method for studying significant therapy events
Authors: Elliott Robert , Shapiro David A.
Published: July 2011

Previously, significant therapy events have been studied using a time‐consuming form of tape‐assisted recall. Brief Structured Recall (BSR) was developed to overcome difficulties with this earlier method. We carried out two case studies of time‐limited therapy following the protocol of the Sheffield Psychotherapy Project (eight sessions each of Prescriptive and Exploratory therapies). In the first case study, we developed a more efficient method of identifying significant therapy events. In the second case study we developed structured interview schedules for obtaining client and therapist ratings and descriptions of a broad range of factors involved in significant events. The events identified in the two cases were typically 5–10 min in length, occurred in the second halves of sessions, contained 2–4 ‘peak’ (most helpful) speaking turns, and were most often attributed to the therapist. The most common predominant impact of these events was Problem Clarification, followed by Personal Insight and Problem Solution. Treatment differences were more marked in the therapist's ratings of event impacts than in the clients' ratings.
Psychological defences and menstrual distress
Authors: Heilbrun Alfred B. , Renert Diane
Published: July 2011

Two studies considered the possible role of psychological defences and defensive awareness in the distress reported by women during the menstrual (flow) period and during the week before menstruation. Unconscious rationalization was associated with the least distress at both times among college women. The same defensive pattern also was found to be related to less menstrual and premenstrual distress among women reporting the symptoms of premenstrual syndrome. None of the other three defences studied (projection, repression, and denial) was associated with menstrual or premenstrual distress. The adaptive role of rationalization was explained in terms of coping by confrontation rather than evasion when the sources of stress tend to be inevitable.
Making sense of a delusion of smell: A psychotherapeutic approach
Authors: Nelki Julia
Published: July 2011

Drug treatment is now recommended as the treatment of choice in mono‐symptomatic delusional states and attempts are made to distinguish these from their ‘neurotic’ equivalents who may be given different treatments. Such psychotic/neurotic distinctions are not always possible and are sometimes unhelpful, if relevant dynamic issues are ignored. The most appropriate treatment may better be decided by an assessment of other factors such as personality, motivation and important details of a patient's childhood. A case report is presented of a young woman with a delusional belief that a foul smell emanated from her womb and who was treated successfully with weekly dynamic psychotherapy for 18 months. The process of therapy is outlined in the hope that psychotherapy may be offered more often to such patients.

Dragon, smoking nostrils, fire, blood,…burning, dead, dead snakes…smell of death…the dead snake in the road, smelt like bad fish, smell of death, bad…dead, a smell, something dead.

Marion Milner, A Life of One's Own
Martial arts and psychological health
Authors: Fuller Julian R.
Published: July 2011

The misleading public image of the martial arts masks a rich though esotetic psychological legacy containing informative parallels for contemporary psychotherapeutic concepts and practices. To date, empirical research on the martial arts has lacked sophistication in the questions it has posed and in the methodology adopted to answer them. Whilst not entirely consistent, findings from studies of martial artists' personalities, outlooks and behaviour have generally indicated positive psychological effects of training. Clinical and psychotherapeutic applications are at an exploratory stage but appear promising. As an exemplar the psychological facets of the art of Aikido are discussed, and prospective uses of martial arts principles as systemic or adjunctive therapies are considered.
Patients' techniques for coping with schizophrenia: An exploratory study
Authors: Carr Vaughan
Published: July 2011

Non‐hospitalized schizophrenic patients were administered a questionnaire designed to assess how they coped with various symptoms of their illness. Of the 200 subjects in the sample, 92 gave additional descriptions of coping techniques which they found useful in addition to those listed in the questionnaire. This report presents the latter findings and categorizes the range of coping techniques described. Patients used a variety of such techniques ranging across a spectrum of behaviour change, socialization, cognitive control and use of medical care as well as behaviours which were likely to have been identified by others as symptomatic of the illness.
A content analysis of thoughts and emotions elicited from depressed patients during cognitive therapy*
Authors: Blackburn Ivy M. , Eunson Kate M.
Published: July 2011

A sample of 200 thoughts obtained from 50 depressed patients at the beginning of a course of cognitive therapy were analysed within the context of Beck's cognitive theory of depression. The results indicated that, of the three elements of the negative cognitive triad, negative view of self and of the world occurred more frequently than negative view of the future. Correspondingly, the principal themes referred to self‐deprecation and a hostile world, with hopelessness occurring less frequently; inter‐ and intra‐personal situations were equally represented. Anxious mood was reported as often as depressed mood with anger, directed inwards or outwards, being less frequent. Two raters were able to label the five logical errors listed by Beck reliably, although there was a certain degree of overlap; arbitrary inferences were the most frequent and personalization the least frequent. Emotions, themes and errors were not indiscriminately related; anger was predominantly associated with themes of hostile world and ‘shoulds’; ‘selective abstraction’ was predominantly associated with depression and ‘arbitrary inference’ with anxiety; ‘selective abstraction’ was predominantly associated with ‘shoulds’ and ‘arbitrary inference’ with ‘illness’ themes. The conclusion was that Beck's early analysis of depressed thinking is valid cross‐culturally and across time.
Meta‐analyses of the reliability of Type A behaviour measures
Authors: Yarnold Paul R. , Mueser Kim T.
Published: July 2011

The accuracy of assessments of Type A behaviour made using different methods is the focus of active debate. Presented here are preliminary meta‐analyses regarding: (a) internal consistency, test—retest and parallel forms reliabilities of the most frequently used questionnaire (Jenkins Activity Survey); (b) inter‐rater and test—retest reliabilities of the most prospectively valid method (Friedman Structured Interview); and (c) correlations and percentage classification agreement between these measures. The findings generally suggest highly statistically significant yet moderate effect strengths for these various psychometric properties.
Sources of stress and dissatisfaction among nurses in four hospital environments
Authors: Hipwell Alison E. , Tyler Patrick A. , Wilson Christine M.
Published: July 2011

A study was designed to examine the hypothesis that occupational stress in nurses is a function of how they perceive their work environment. Sixty‐five nurses on four mixed‐sex wards were interviewed using a nursing stress and work environment scale. Demographic data including age, sex and nursing status were also collected. ‘Work overload’ and the ‘death and dying’ of patients were identified as the major sources of stress for all the nurses. In general, although there was little difference between the specialized and non‐specialized groups of nurses in the degree of stress experienced, the work environments were found to be dissimilar. The reported level of dissatisfaction with their work environment combined with certain demographic characteristics were found significantly to predict the degree of stress experienced. These findings have implications for the organization of the ward and for the skills taught to nurses by which stress may be managed or alleviated.
A note on early indicators of non‐adherence to a cardiac rehabilitation programme
Authors: Fielding Richard
Published: July 2011

Of 44 patients enrolled in a study to examine rehabilitation efficacy from myocardial infarction (Ml), seven experimental subjects did not adhere to the rehabilitation programme. Serendipitous differences in early Cortisol levels following admission for MI differentiated adherent from non‐adherent subjects at six to 12 weeks post‐MI.
In‐patients' views of the helpful aspects of group psychotherapy: Impact of therapeutic style and treatment setting
Authors: Mushet Greta L. , Whalan Graham S. , Power Roger
Published: July 2011

Selected in‐patients admitted to an acute psychiatric unit over a seven‐month period were offered group psychotherapy which incorporated an interactional focus. At discharge group members were offered out‐patient group therapy. Patients' perceptions of therapy were examined by means of a ‘helpful event’ questionnaire. The study supports previous findings but it is suggested that the interactional focus boosted the value ascribed by patients to vicarious learning. Psychological exploration became of more major importance in out‐patient therapy.
Adoption and identity: A case of anorexia nervosa
Authors: Fry Richard , Crisp A. H.
Published: July 2011

Anorexia nervosa, as a retreat from and subsequent avoidance of intolerable maturational turmoil, can provide a vivid insight, especially as body weight is restored to normal within treatment, into the sexual and identity conflicts that have previously characterized the adolescence of the individual. When the adolescent has been adopted into the family then the challenge of developing biological (genetic) identity is especially great to the individual and his adoptive parents. A rare case of anorexia nervosa in a male adoptee is presented against this background. Our patient's dependent and smothering bond with his adoptive mother, which was loving but highly conditional, left him with no room for negotiation when it was threatened by his emerging sexual and other impulsivity and new assertiveness. Understanding and treatment of such cases can also help to shed light on the particular challenges that face many adoptive parents when their adopted children experience the thrust of puberty and enter adolescence.
Type A behaviour and the authoritarian personality
Authors: Byrne D. G. , Reinhart M. I. , Heaven P. C. L.
Published: July 2011

The demonstration of modest statistical associations between measures of the Type A behaviour pattern (TABP) and some measures of authoritarianism has given rise to a view that the TABP represents little more than an attempt by some individuals to exercise the personality attribute of dominance. The present study examined this view with regard to a wide selection of measures of the authoritarian personality and found that measures of the TABP related only to measures of authoritarianism reflecting authoritarian behaviours. While such correlations indicate a facet of the TABP resembles the attribute of dominance, they do not amount to conceptual equivalence of the TABP and authoritarianism. The conceptual complexity of the TABP demands a more multidimensional view of this explanatory notion in medical psychology.
Dementia and mental handicap: Attitudes, emotional distress and caregiving
Authors: Whittick Janice E.
Published: July 2011

Against the current climate of hospital closure programmes and community care, attitudes to caregiving were examined in three groups of carers, namely mothers caring for a mentally handicapped child, mothers caring for a mentally handicapped adult and daughters caring for a parent with dementia.

An ‘attitude questionnaire’ was developed by the author and administered, postally, to the three groups. Daughters were found to be more likely than the mothers to see their caring role in a negative way and were more inclined to favour institutional care. Possible reasons for this are discussed.

The relationship between attitudes and emotional distress (as measured by the GHQ‐30) were also examined for the sample as a whole. Negative and pro‐institutional attitudes towards the caregiving situation were associated with elevated levels of emotional distress.

Implications at both a local and a national level for all those involved with carers are discussed in the light of these findings.
Persecutory delusions and attributional style
Authors: Kaney Sue , Bentall Richard P.
Published: July 2011

Seventeen psychotic patients with persecutory delusions were matched against depressed and normal controls and assessed for magical ideation, locus of control and attributional style. The deluded and depressed patients were found to make global and stable attributions when compared to the normal subjects. However, the deluded patients, in contrast with both control groups, made excessively external attributions for negative events and internal attributions for positive events. Highly significant differences were observed between the deluded group and the two control groups on magical ideation and on the ‘powerful others’ subscale of the locus of control questionnaire. Both psychiatric groups differed from the normal control group on ‘chance’ locus of control and a significant difference was observed between the persecuted and normal subjects on the ‘internality’ subscale of the questionnaire. The implications of these findings for the understanding and treatment of paranoid delusions are discussed.
Exercise and health psychology: Emerging relationships*
Authors: Biddle Stuart J. H. , Fox Kenneth R.
Published: July 2011

The increasing prominence of health psychology has been paralleled by developments in the study of the psychology of health‐related exercise. Evidence has been amassed which supports the efficacy of regular physical activity in reducing the risks of some debilitating health conditions such as coronary heart disease and obesity, as well as the promotion of physical function and mental well‐being. The significance of exercise as a health‐related behaviour has brought to the fore the need to address motivational problems associated with its adoption and maintenance. In this respect, exercise psychology research would appear to provide potential for guiding significant public health initiatives. This paper addresses the issues of exercise and mental health and exercise motivation with a view to highlighting key sections of the exercise psychology literature for health and medical psychologists.
Reflections on the role of the supervisor*
Authors: Springmann Rafael R.
Published: July 2011

Counter‐transference can be conceived of as being composed of two components: therapist‐induced counter‐transference (TIC), and client‐induced counter‐transference (CIC). These components are mostly intertwined into combined countertransference. One of the foremost tasks of the supervisor is to help the therapist to analyse counter‐transference, when encountered in the combined form, into its contributing components in order to apply each component in accordance with its defining origin.

Strong transferential forces, that are independent of the specific contents of the therapy, are generated inside the supervisory situation, manifesting themselves, sometimes destructively so, in the therapy (parallel process in reverse). In order to forestall this destructive effect, these forces ought to be interpreted by the supervisor to the supervisee inside the supervisory situation.

In order to gauge the extent of such interpretations as well as those of other dynamic manifestations in supervision, the supervisory situation is compared to therapy administered to the therapeutic couple ex parte.

The situation of the supervisor vis‐à‐vis the patient is briefly discussed.
In‐patient psychiatric care: The patient's view
Authors: McIntyre Keith , Farrell Michael , David Anthony
Published: July 2011

Little attention has been paid to psychiatric patients' views on their treatment in the medical literature. We carried out a consumer survey of 99 in‐patients at an inner London psychiatric hospital. Patients were asked to rate 10 non‐treatment and treatment items. Most highly regarded was being free to leave the ward. Of the treatment items, talking to a member of staff was found to be most helpful. The relationships between different items and patient variables such as voluntary versus involuntary status, age and diagnosis are discussed. Sex and number of previous admissions exerted only minor effects. The results are compared with other studies and more work in this area is recommended in order to improve hospital care.