bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and predictors of post‐traumatic stress symptoms following childbirth
Authors: Czarnocka Jo , Slade Pauline
Published: February 2003

Objectives. To identify the prevalence and potential predictors of post‐traumatic stress type symptoms following labour.

Design. A large sample, within‐participants design with initial assessment and postal follow‐up was utilized.

Method. Two hundred and sixty‐four women who had ‘normal’ births were assessed within 72 hours on potential predictive measures and at 6 weeks post‐partum for levels of symptoms of intrusions, avoidance and hyperarousal on a questionnaire derived from DSM‐IV (American Psychiatric Association, 1994) criteria. Symptoms of depression and anxiety were also assessed.

Results. Three per cent showed questionnaire responses suggesting clinically significant levels on all three post‐traumatic stress dimensions and a further 24 on at least one of these dimensions. Forward stepwise regression analysis yielded models for predicting outcome variables. Perceptions of low levels of support from partner and staff, patterns of blame and low perceived control in labour were found to be particularly related to experience of post‐traumatic stress symptoms. Personal vulnerability factors such as previous mental health difficulties and trait anxiety were also related to such symptoms as well as being relevant predictors for anxiety and depression.

Conclusions. A proportion of women reports all three aspects of post‐traumatic stress type symptoms following childbirth with many more reporting some components. A broader conceptualization of post‐partum distress which takes account of the impact of labour is required. There may be opportunities for prevention through providing care in labour that enhances perceptions of control and support.
Psychological management of post‐stroke depression
Authors: Kneebone Ian I. , Dunmore Emma
Published: February 2003

Purpose. To evaluate existing research literature on psychological interventions to manage post‐stroke depression (PSD).

Method. First, the particular nature of post‐stroke depression (PSD) was established. Then, relevant published material was identified through computerized literature searches (to May 1999) and via the first author's clinical experience in the area. This material was critically reviewed against recommended standards for the empirical validation of treatment effectiveness.

Results. Methodological limitations in existing research prevent a conclusion as any one psychological intervention has empirical support for its effectiveness. However, cognitive behaviour therapy in particular was identified as worthy of further investigation.

Conclusions. It is recommended that future research investigates treatments for PSD appropriate for those with cognitive impairment and communication difficulties, younger versus older stroke victims and those in institutional settings. Studies should also consider the necessity of specialist assessment strategies and allow for possible subtypes of PSD for which psychological treatments might be differentially effective.
Cognitive factors in predisposition to auditory and visual hallucinations
Authors: Morrison Anthony P. , Wells Adrian , Nothard Sarah
Published: February 2003

Objectives. This study adapted the Launay Slade Hallucination Scale (LSHS) to measure predisposition to auditory and visual hallucinations and examine the relationship between meta‐cognition and predisposition in a non‐psychiatric population. It also tested the hypothesis that individuals highly predisposed to hallucination would show positive and negative meta‐cognitive beliefs and report the use of different thought control strategies.

Design. A within participants correlational design was employed.

Methods. A revised LSHS was administered to 105 normal participants who were also asked to complete questionnaires assessing paranoia, meta‐cognitive beliefs, thought control strategies, anxiety, depression and beliefs about unusual perceptual experiences.

Results. Two empirically distinct but correlated hallucinatory traits (auditory and visual) were measured by the modified LSHS. Consistent with predictions, it was found that positive beliefs about unusual perceptual experiences were the best predictor of predisposition to auditory and visual hallucinations and that those participants who scored higher on predisposition to hallucination used different thought control strategies and had different negative meta‐cognitive beliefs in comparison with participants of low predisposition.

Conclusions. Meta‐cognitive beliefs about thoughts and hallucinatory phenomena appear to be implicated in predisposition to hallucination. The theoretical and clinical implications of the findings are discussed.
A confirmatory factor analysis of the Hospital Anxiety and Depression scale: Comparing empirically and theoretically derived structures
Authors: Dunbar Martin , Ford Graeme , Hunt Kate , Der Geoff
Published: February 2003

Objectives. To compare the fit of various factor solutions for the Hospital Anxiety and Depression scale (HAD; Zigmond & Snaith, 1983).

Design. A cross‐sectional postal survey was used to collect the data from community‐based participants in the West of Scotland Twenty‐07 study.

Methods. The HAD scale, a 14‐item self‐administered measure of anxiety and depression, was completed by 2547 participants from three age cohorts (aged approximately 18, 39 and 58 years). Using confirmatory factor analyses four models suggested by prior exploratory factor analyses were compared to a model derived from Clark and Watson's (1991) tripartite theory of anxiety and depression.

Results. The model derived from the tripartite theory of anxiety and depression (with factors labelled negative affectivity, anhedonic depression and autonomic anxiety) produced the closest fit to the data. This model produced a good fit in all three cohorts although group comparisons suggested that there were variations in the strength of some factor loadings across the three age groups. A model that had a hierarchical arrangement of the three factors in the tripartite model was also produced. This model fit the data equally as well as did the ‘flat’ tripartite model.

Conclusions. Three factors appear to underlie the HAD scale. Research is needed that examines whether or not using sub‐scales based on these factors increases the ability of the HAD scale to detect cases of anxiety and depression.
The validity of the NART‐RSPM index in detecting intellectual decline following traumatic brain injury: A controlled study
Authors: Freeman Jane , Godfrey Hamish
Published: February 2003

The present study replicated Van den Broek and Bradshaw's (1994) study by developing a multiple regression equation to predict Ravens Standard Progressive Matrices (RSPM) scores from participants National Adult Reading Test (NART) scores and demographic variables. A test of the validity of this procedure was undertaken by applying both the Van den Broek and Bradshaw equation and the present study s equation to a mixed sample of orthopedic control (OC) and closed head injury (CHI) participants. Premorbid RSPM scores were estimated using both equations and then compared to obtained scores. Results indicated that both equations had good predictive accuracy in estimating RSPM scores and were able to detect significantly higher rates of impairment in general intelligence in the CHI participants (24%) compared to the OC sample (7%).
A systematic review of effective cognitive‐behavioural supervision
Authors: Milne Derek , James Ian
Published: February 2003

Objectives. A systematic review was undertaken of studies that have assessed objectively the impact of supervision and consultancy. As well as gauging effectiveness, we examined the methodological rigour of these studies.

Method. Twenty‐eight empirical studies of the change processes occurring between participants within the educational pyramid, ‘consultant → supervisor’, ‘supervisor → supervisee’ and ‘supervisee → patient’, were analysed. The inclusion criteria also required that supervision was analysed under field conditions and there were objective measures of learning outcomes. Each study was analysed by reference to an evaluation manual, with two independent raters obtaining satisfactory reliability.

Results. Studies meeting the above criteria came mainly from the intellectual disability specialty and included many studies using cognitive‐behavioural methodologies. The studies included in this sample had more rigorous methodologies than those reviewed by Ellis, Ladany, Krengel, and Schult (1996). The findings of the review suggested that the pyramid approach benefited patients. Closely monitoring the supervisee, modelling competence, providing specific instructions, goal setting and providing contingent feedback on performance were the dominant methods of supervision and were associated with benefits to supervisees.

Conclusion. Despite the large body of literature on supervision, there have been relatively few empirical investigations of the educational pyramid. This work identified a number of studies with good methodological rigour, although these too often failed to provide adequate background and assessment details regarding each of the members of the pyramid, particularly the consultant. The results of cognitivebehavioural supervision were found to be positive.
The effect of extended family living on the mental health of three generations within two Asian communities
Authors: Sonuga‐Barke Edmund J. S. , Mistry Minal
Published: February 2003

Background. A study by Shah & Sonuga‐Barke (1995) identified a relationship between family structure and the mental health of Pakistani Muslim mothers and their children. Children in extended families fared better, but their mothers fared worse than their nuclear family counterparts. The present study replicates and extends this study by exploring the impact of nuclear and extended family living on the mental health of three generations (children, mothers and grandmothers) in British Hindu as well as Muslim communities.

Method. 44 Muslim and 42 Hindu families participated in the study. The mental health of mothers and grandmothers and the behavioural problems of children (aged 5‐11) were examined. Both mothers and grandmothers completed the Hospital Anxiety and Depression Scale. The children s behavioural adjustment was rated by their teachers using the Rutter Scale. Other relevant variables such as acculturation levels were also measured.

Results. Children and grandmothers were better adjusted in extended families than nuclear families. In contrast, mothers were better adjusted in nuclear families. This interaction between family type and generation was evident in both Muslim and Hindu families and did not appear to be mediated by other variables such as acculturation. Furthermore, mothers and childrens adjustment was significantly correlated with grandmothers, but not mothers, mental health in extended families (although not in nuclear families).

Discussion. These results provide further evidence for the link between family structure and mental health in Asian communities. They also challenge some of the assumptions about maternal mental health, its effects on child adjustment and its links to systems of social support. In extended families where social support was likely to be most available mothers were at greatest risk, while their children profited and this advantage seemed to be linked to the grandmaternal presence.
Associations between primary appraisals and life‐events while controlling for depression
Authors: Ferguson Eamonn , Lawrence Claire , Matthews Gerald
Published: February 2003

Objectives. The main objective of this paper was to explore the associations between life‐events and primary appraisals (threat, challenge and loss) controlling for depression. It was predicted that specific associations between life‐events and primary appraisals would remain once depression had been partialled. A subgoal of this paper was to develop a content analytic coding frame for student life‐events.

Design. This study was a retrospective survey in which participants provided accounts of recent stressful encounters, and completed indices of primary appraisals and depression.

Method. The participants were 979 undergraduates who provided descriptions of life‐events. A subsample of 391 provided additional information on primary appraisals and depression. The primary outcomes were the partial correlations between life‐events and primary appraisals.

Results. There were significant associations between life‐events and primary appraisals above and beyond variance explained by depression. Results also indicated that the definition of loss appraisals could be extended to include events that were related to anticipated future loss, especially if the event was also perceived as threatening. Also certain self‐defined negative life‐events were appraised as positive. Life‐events were shown to vary systematically as a function of external constraints (e.g. stage of the academic year).

Conclusions. A variety of events were associated with loss appraisals and this may have implications for risk factors in depression.
Carers' attributions for challenging behaviour
Authors: Stanley Brian , Standen Penny J.
Published: February 2003

Objectives. The purpose of this study was to apply Weiner s (1986) attributional model of helping to the care of clients presenting with challenging behaviour. A number of predictions were tested: (a) that aggressive, destructive, and selfinjurious behaviours would differentially affect carers ratings of attributional dimensions; (b) that carers propensity to help would be mediated by positive affect rather than optimism; (c) that optimism would be reduced by a perceived stable cause, such as client s level of dependency.

Design and method. The participants were 50 care staff working in challenging behaviour day services, who were presented with six case studies to rate. A twofactor repeated measures design was employed to examine the effects of challenging behaviour and dependency on carers ratings of attributional dimensions, affects, optimism and helping. Correlational analysis was employed to examine the relative effects of positive affect, negative affect and optimism on carers propensity to help.

Results. All three predictions were confirmed. The more independent and outer directed the challenging behaviour, the greater the carers attributions of control and negative affect, and the less the propensity to help. The more self‐directed and dependent the client s challenging behaviour, the greater the carers attribution of stability, positive affect and propensity to help.

Conclusions. The results are discussed in relation to the concept of helping and the experience of carers coping with challenging behaviours.
Factor analysis of three standardized tests of memory in a clinical population
Authors: Hunkin N. M. , Stone J. V. , Isaac C. L. , Holdstock J. S. , Butterfield R. , Wallis L. I. , Mayes A. R.
Published: February 2003

Objectives. The aim of this study was to determine the factor structure of three standardized memory tests: Wechsler Memory Scale‐Revised (WMS‐R), Warrington Recognition Memory Test (WRMT), Doors and People Test (D&P). We investigated whether these different standardized tests of memory are consistent in their evaluation of memory function, and the extent to which these tests} discriminate between different memory functions (e.g. recall/recognition and verbal/non‐verbal memory).

Design. Fifty patients with selective memory impairment were tested on the WMS‐R, WRMT and D&P.

Methods. Age‐scaled scores from selective measures of these tests (WMS‐R‐verbal, WMS‐R‐visual, WMS‐R‐delay, WRMT‐words, WRMT‐faces, D&P‐people, D&P‐doors, D&P‐shapes, D&P‐names) were used as input to a factor analysis.

Results. Maximum likelihood factor analysis yielded a three‐factor solution consistent with a theoretically motivated fractionation of memory function into recall and recognition components. Recognition performance, but not recall performance, showed dissociation into visual and verbal components.

Conclusions. The WMS‐R, WRMT and D&P are highly consistent in their assessment of memory function. The results of the factor analysis are consistent with a theoretically motivated fractionation of recall and recognition memory. They are also partially consistent with a dissociation between visual and verbal memory function.
Short test of semantic and phonological fluency: Normal performance, validity and test‐retest reliability
Authors: Harrison John E. , Buxton Pauline , Husain Masud , Wise Richard
Published: February 2003

Tests of verbal fluency, whether of Semantic Fluency (SF) or Phonological Fluency (PF), are often used as a standard method of neuropsychological assessment. However, very little normative data, standardized on a UK sample, is available, and little is known about the utility of popularly used 'short‐forms of these tasks. Additionally, very little is known about verbal fluency test‐retest reliability.

In this report we describe the performance of N = 365 normal participants on a version of SF requiring the generation of exemplars of the category 'animals and a version of the PF task requiring participants to generate words beginning with the letter 'B. From this data we have derived a percentile distribution for both tasks.

We also addressed the impact of sex, age, years of education and IQ upon both SF and PF performance. No sex differences were found on either the PF or the SF tasks. A significant but small correlation between age and SF, but not PF, was observed. Modest correlations between both years of education and IQ and PF and SF performance were also seen. We also report test‐retest reliability scores for performance on both SF and PF tasks. Performance on the longer 'FAS version was found to correlate highly with scores obtained using just the letter 'B. This suggests that little additional advantage obtains from administering three‐letter versions of PF. An extremely high degree of correlation between SF tasks in which participants are given 1 minute and scores obtained when participants are given 1 minute 30 seconds was also observed.

Finally, in order to assist users in deciding whether a changed retest score is due to error measurement or a real effect, we calculated Standard Error of Prediction (SEP) scores.
Differential environmental factors in anorexia nervosa: A sibling pair study
Authors: Murphy Fay , Troop Nicholas A. , Treasure Janet L.
Published: February 2003

Objectives. Previous studies have explored differences in psychosocial and familial factors between women who develop anorexia nervosa and those who do not. However, these studies have generally used between‐group comparisons. This study looks at the environmental factors which may be antecedents of anorexia nervosa looking at sister pairs where one had anorexia nervosa and the other did not.

Design. A paired design was used to compare anorexic women with an unaffected sister on a number of background variables, including sibling interaction, parental care, peer group characteristics and other events unique to the individual.

Methods. The Sibling Inventory of Differential Experience (SIDE) was used to determine non‐shared environment. Out of an initial sample of 148 women with past or current anorexia nervosa, 28 were identified who had sisters with no reported history of eating disorders and who also consented to complete the questionnaire.

Results. Anorexic sisters perceived more maternal control and reported more antagonism towards and jealousy of their sisters than did unaffected sisters. In addition, anorexic women reported having had fewer friends and boyfriends than their sisters.

Conclusions. These results confirm the perceived differences in background environment between women with and women without anorexia nervosa. These issues are discussed in relation to behavioural genetics, family dynamics and psychosexual development.
The relationship between parental bonding and core beliefs in anorexic and bulimic women
Authors: Leung Newman , Thomas Glyn , Waller Glenn
Published: February 2003

Objective. The role of core beliefs in the psychopathology of eating disorders has been considered in recent years. Young (1994) hypothesized that unhealthy core beliefs originate from the experience from the first few years of life. The aim of the present study was to consider whether perceived parental bonding might explain the development of such beliefs in eating disordered women.

Method. The participants were 30 anorexics, 27 bulimics and 23 comparison women who completed measures of core beliefs and perceived parental bonding.

Results. There were significant differences in perceived parental bonding behaviours across groups. The association between parental bonding and core beliefs were much stronger in the anorexic group than that in either the bulimic or the control group. In particular, a perceived low level of parental care was predictive of the presence of some unhealthy core beliefs in anorexic women.

Conclusion. Longitudinal research is needed to confirm these findings among anorexic and bulimic women. Clinically, these findings provide insight into the possible origins or core beliefs, and hence might aid their challenge in schemafocused cognitive therapy.
Underlying assumptions and core beliefs in anorexia nervosa and dieting
Authors: Cooper Myra , Turner Hannah
Published: February 2003

Objective. To investigate assumptions and beliefs in anorexia nervosa and dieting.

Design and method. The Eating Disorder Belief Questionnaire (EDBQ), was administered to patients with anorexia nervosa, dieters and female controls.

Results. The patients scored more highly than the other two groups on assumptions about weight and shape, assumptions about eating and negative self‐beliefs. The dieters scored more highly than the female controls on assumptions about weight and shape.

Conclusions. The cognitive content of anorexia nervosa (both assumptions and negative self‐beliefs) differs from that found in dieting. Assumptions about weight and shape may also distinguish dieters from female controls.
The role of cognitive vulnerability and stress in the prediction of postpartum depressive symptomatology
Authors: Grazioli Rachel , Terry Deborah J.
Published: February 2003

Objectives. The present study was designed to test the diathesis‐stress components of Beck's cognitive theory of depression and the reformulated learned helplessness model of depression in the prediction of postpartum depressive symptomatology.

Design and methods. The research used a two‐wave longitudinal design ‐ data were collected from 65 primiparous women during their third trimester of pregnancy and then 6 weeks after the birth. Cognitive vulnerability and initial depressive symptomatology were assessed at Time 1, whereas stress and postpartum depressive symptomatology were assessed at Time 2.

Results. There was some support for the diathesis‐stress component of Beck's cognitive theory, to the extent that the negative relationship between both general and maternal‐specific dysfunctional attitudes associated with performance evaluation and Time 2 depressive symptomatology was strongest for women who reported high levels of parental stress. In a similar vein, the effects of dysfunctional attitudes (general and maternal‐specific) associated with performance evaluation and need for approval (general measure only) on partner ratings of emotional distress were evident only among those women whose infants were rated as being temperamentally difficult.

Conclusion. There was no support for the diathesis‐stress component of the reformulated learned helplessness model of depression; however, there was some support for the diathesis‐stress component of Beck's cognitive theory.
Diabetes mellitus and the rate of cognitive ageing
Authors: Bent Nuala , Rabbitt Patrick , Metcalfe David
Published: February 2003

Objectives. There is some evidence that besides affecting peripheral neural function diabetes may also cause more widespread changes in the central nervous system which reduce cognitive efficiency and so, also, independence and quality of life. The present study explores whether diabetes mellitus is a compounding factor in average declines in cognitive performance observed in old age.

Design. A sample of diabetics and controls were compared on a battery of cognitive tasks previously used in cognitive ageing research.

Methods. Thirty‐three insulin dependent (IDDM), 135 non‐insulin dependent (NIDDM) diabetics and 2191 non‐diabetics aged between 50 and 91 years were compared on two tests of general intellectual ability, and on three tests of verbal memory.

Results. Overall, the combined IDDM and NIDDM groups had significantly lower average scores than the controls group on all cognitive tasks. Detailed analyses revealed most cognitive impairment for the NIDDM sub‐group whose condition was managed by hypoglycaemic drugs, slightly less for those managed by diet, and no impairment for the IDDM group. These effects were independent of age, depression, socio‐economic status, and presence of other illnesses.

Conclusions. Together with other recent studies these data emphasize the need for early detection and effective management of diabetes in older patients.
Adapting the Rivermead Behavioural Memory Test Extended Version (RBMT‐E) for people with restricted mobility
Authors: Clare Linda , Wilson Barbara A. , Emslie Hazel , Tate Robyn , Watson Peter
Published: February 2003

Objectives. The study aimed to facilitate use of the RBMT‐E with people who have impaired mobility by devising substitute tasks for the route and message subtests that do not require the individual to move around, and by presenting normative data for these substitute tasks.

Design. A within‐subjects design was used to assess a standardization sample. Participants completed two parallel versions of the tasks in counter‐balanced order in two test sessions approximately 1 week apart.

Methods. Substitute versions of the route and message subtests not requiring the individual to move around the test room were devised using commercially available materials. These were administered to participants along with other RBMT‐E subtests. Scores for each version were compared for the group as a whole and for subgroups divided according to age, gender and IQ. Based on the results, profile scores were derived for each task using box plot analysis. The participants (N = 111) were part of the standardization sample for the RBMT‐E and comprised consecutive series of recruits in two centres, Cambridge (UK) and Sydney (Australia)

Results. Normative data are presented in the form of mean scores for the group as a whole, for men and women, for people aged under 30, 30 to 50 and over 50 years, and for people with an IQ of either 90‐110 or over 110. Profile score transformations for the011011substitute tasks are provided.

Conclusions. Where mobility preclude the use of the route and message subtests of the RBMT‐E, the ‘model’ tasks described here can be substituted and profile scores calculated. 011011This allows clinicians to obtain a full spectrum of subtest scores for the RBMT‐E with mobility‐impaired patients, thus allowing the calculation of a total profile score.
The transtheoretical stages of change as a predictor of premature termination, attendance and alliance in psychotherapy
Authors: Derisley Jo , Reynolds Shirley
Published: February 2003

Objective. The Transtheoretical Model proposes that clients' stage of change will predict their engagement in therapy. This study tested the hypotheses that clients with high Precontemplation scores would prematurely terminate from therapy and that clients with high Action scores would attend a greater number of sessions and establish a more positive therapeutic alliance.

Design. Using a within‐subjects design, baseline measures of stage of change were used to predict the number of sessions attended, premature drop‐out from therapy, and the therapeutic alliance after sessions one and three.

Methods. Sixty clients completed the Stages of Change Scales and the Brief Symptom Inventory prior to therapy. The therapeutic alliance was assessed after the first and third therapy session using the Agnew Relationship Measure.

Results. The specific hypotheses were not supported. Premature termination from therapy was predicted by high level of initial symptom severity and low Contemplation scores. Positive therapeutic alliance at session one and session three was predicted by high Contemplation at baseline.

Conclusions. These results suggest that the Transtheoretical Model, which was developed in the context of interventions for behavioural change, may not be directly generalizable to outpatient psychotherapy populations. However, Contemplation did predict premature termination and engagement. This implies that with adaptation the model may be a useful adjunct to psychotherapy assessment.
Patient‐rated therapeutic relationship and outcome in general practitioner treatment of psychological problems
Authors: Cape John
Published: February 2003

Objective. To explore the association between therapeutic relationship and clinical outcome in general medical practitioner (GP) treatment of emotional problems.

Design. Correlational analyses of patient and observer measures of GP consultations with 3‐month clinical outcomes.

Method. Patients of nine GPs, presenting with emotional problems as assessed by the 30‐item General Health Questionnaire (GHQ‐30), were interviewed and completed a questionnaire about their experience of their consultation with the GP. The audiotaped consultations were coded by external observers for patient involvement, doctor empathy and amount of the consultation that involved listening interactions (patient talking and doctor listening). After 3 months the patients completed a postal follow‐up questionnaire including the GHQ‐30 and a single item measure of patient perceived change.

Results. Fifty‐seven patients provided follow‐up data. Interview and questionnaire measures of patient perceptions of their relationship with the GP in the consultation predicted both GHQ‐30 outcome at 3 months (partial correlations controlling for initial GHQ‐30, r = .30 and r = .36) and patient perceived change on the single item measure. Observer ratings of patient involvement and doctor empathy predicted patient rated change on the single item measure, but not follow‐up GHQ‐30. Observer coded listening interactions were unrelated to both outcome measures.

Conclusion. The results indicate an association between patient perceptions of how GP and patient related in the consultation and reduction in symptom severity 3 months later.
Perception, mental imagery and reality discrimination in hallucinating and non‐hallucinating schizophrenic patients
Authors: Böker Koen B. E. , Hijman Ron , Kahn René S. , de Haan Edward H. F.
Published: February 2003

Objectives. In this study the hypothesis was tested that hallucinations result from confusing external and internal stimulus sources, i.e., perception and imagery, respectively.

Design and methods. Thirteen hallucinating and 19 non‐hallucinating schizophrenic patients, as well as 14 control participants performed multiple tests of perception, vividness of mental imagery and the ability to discriminate between them (reality discrimination). These functions were tested in both the auditory and the visual modalities.

Results. There were no group differences on perceptual acuity. The results on one imagery task indicated that for the hallucinating patients, the relative, but not the absolute, level of vividness of mental images might be higher in the auditory modality, which was the modality in which 12 of the patients also experienced hallucinations, than in the visual modality. Finally, there was a positive relationship between severity of (auditory) hallucinations and reality discrimination problems.

Conclusions. Hallucinations may result from increased vividness of mental imagery, and their severity increases with larger impairments in reality discrimination. It is recommended that research into, and cognitive behavioural therapy for, hallucinations should also focus on their sensory qualities.
Comments on the content of persecutory delusions: Does the definition need clarification?
Authors: Freeman Daniel , Garety Philippa A.
Published: February 2003

Diagnostic criteria for subtypes of delusional beliefs based upon content have rarely been the subject of comment. In this article, several influential accounts of persecutory delusions are reviewed; differences and difficulties are noted, and their potential effect on cognitive psychological investigations discussed. One method of ensuring that researchers study similar phenomena is to use a more detailed definition than currently available, and therefore a new set of criteria is offered. Finally, related methodological problems in this emerging research area are highlighted. The issues discussed may stimulate further research on the content of delusional beliefs.
Symptom severity, personal and social variables after armed robbery
Authors: Richards David
Published: February 2003

Objectives. To investigate the relative importance of personal and social variables on post‐trauma symptom recovery.

Design. Prospective survey of armed robbery victims.

Methods. Fifty‐one consecutive armed robbery victims were assessed immediately and at 1 month post‐raid for post‐traumatic stress. One month post‐raid, crisis support, causal attribution and coping were also measured. Thirty‐one of the sample were assessed for symptoms 6 months after the raid.

Results. Both the main and follow‐up samples had high levels of post‐traumatic stress symptoms immediately after the raid which reduced significantly 1 month later and, for the follow‐up subsample, further still 6 months later. Higher levels of symptoms at 1 month and poor crisis support were associated with higher levels of symptoms at follow‐up.

Conclusions. Purposeful coping, symptom severity and social support effect post‐trauma recovery.
Process research in understanding and applying psychological therapies
Authors: Llewelyn Susan , Hardy Gillian
Published: February 2003

Objectives. Research on the process of psychological therapy aims to demonstrate how therapy works, partly to increase understanding, but primarily to increase effectiveness by pointing to the crucial ingredients which effect change. This paper aims to demonstrate some of the reasons why process research should be undertaken in the attempt to increase therapeutic effectiveness.

Methods. A model of scientific inquiry suggests three broad types of process research: (1) studies which describe behaviours and processes occurring within therapy sessions (exploratory studies); (2) studies which investigate the links between specific psychotherapy processes and treatment outcome (hypothesis testing); (3) studies which examine the links between specific psychotherapy processes and theories of change (theory development). Using this typology, we describe key aspects of process research: what it is; what has been studied; the limitations of existing research.

Results. Descriptive studies have deepened understanding of the therapeutic process; however, a large number of reliable process‐outcome links have been hard to establish. Comparative studies have been rare. Studies which are linked to models of change and which attempt to track therapist responsiveness are more complex and have been more promising. Most studies are beset by methodological difficulties.

Conclusions. There are a number of promising future research possibilities and methods. Despite methodological challenges, the field is developing and research is encouraging. We argue that process research has a significant place in advancing our understanding of the complexity of therapeutic change, and hence in facilitating theory development and effective therapeutic interventions.
Social anxiety and disfigurement: The moderating effects of fear of negative evaluation and past experience
Authors: Kent Gerry , Keohane Steve
Published: February 2003

Objectives. To examine the relevance of social anxiety and past experience to the social and psychological consequences of disfigurement.

Method. One hundred and forty‐one patients on the psoriasis register at a dermatology clinic responded to a postal survey which was designed to examine the effects of psoriasis on quality of life as it was related to clinical severity, level of social anxiety and patients' previous experiences of acceptance or rejection.

Results. Psoriasis was most relevant for quality of life for those patients whose condition was visible on their face and hands and who reported a high fear of negative evaluation. Current quality of life, fear of negative evaluation and HAD anxiety scores were only tentatively related to the nature of previous experiences.

Conclusions. Although direction of causality cannot be ascertained from these results, they suggest that interventions designed to reduce social anxiety could be used to help people who are having difficulty in adjusting to disfiguring medical conditions.
The Revised version of the Screen for Child Anxiety Related Emotional Disorders (SCARED‐R): First evidence for its reliability and validity in a clinical sample
Authors: Muris Peter , Steerneman Pim
Published: February 2003

Objectives. The Revised version of the Screen for Child Anxiety Related Emotional Disorders (SCARED‐R) is a 66‐item self‐report questionnaire that intends to measure the entire spectrum of DSM‐defined anxiety disorder symptoms in children. The current study was a first attempt to examine the reliability and validity of the SCARED‐R in a clinical setting.

Methods. Forty‐eight children (25 children with anxiety disorders and 23 children with disruptive disorders) aged between 8 and 17 years completed the SCARED‐R and the Revised Fear Survey Schedule for Children at their first visit to an outpatient treatment centre.

Results. Results showed that in this sample of clinically referred children, the SCARED‐R was reliable in terms of internal consistency, correlated significantly with an alternative measure of childhood anxiety (the Fear Survey Schedule for Children‐Revised), and discriminated well between children with anxiety disorders and children with disruptive disorders.

Conclusions. It can be concluded that the SCARED‐R is a valuable addition to the arsenal of self‐report instruments that are used for the assessment of childhood anxiety.
An experimental investigation of thought suppression and anxiety in children
Authors: Gaskell Sarah L. , Wells Adrian , Calam Rachel
Published: February 2003

Objectives. This study aimed to explore the effects of thought suppression in children ‐ in particular, whether trying to suppress a thought leads to an immediate and/or delayed increase in its occurrence. The influence of anxiety on children's performance in the experimental paradigm was also examined.

Design. Participants were allocated to conditions in a between‐groups experimental design devised on the basis of thought suppression methodologies reported in the adult literature.

Methods. One‐hundred and twelve participants were recruited from local primary schools and randomly allocated to four experimental conditions. Children in all conditions monitored the occurrence of a target thought (either neutral or anxiety‐provoking) by tapping their hand on a table each time the thought came to mind during two consecutive experimental periods. During the first period, half the children were asked not to think about the target thought, while the remaining half were asked to think about anything. During the second period, all children were instructed to think about anything.

Results. No evidence was found for either an immediate or a delayed increase in frequency of target thoughts as a consequence of suppression attempts. State and trait anxiety were, however, found to influence children's performance during these experimental tasks and were associated with increased intrusions under certain conditions.

Conclusions. The results of this study suggest that the experimental thought suppression paradigm is workable with 7‐11‐year‐old children. The methodological, theoretical and clinical implications of these findings are discussed.
Cognitively oriented psychotherapy for early psychosis (COPE): A 1‐year follow‐up
Authors: Jackson Henry , McGorry Pat , Henry Lisa , Edwards Jane , Hulbert Carol , Harrigan Susy , Dudgeon Paul , Francey Shona , Maude Dana , Cocks John , Power Paddy
Published: February 2003

Objectives. Cognitively oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode.

Design. A total of 80 people participated in the initial trial and completed assessments on a range of outcome measures. Post‐treatment assessment results from a non‐randomized controlled trial of COPE have been previously reported. The present paper describes the results obtained from 51 patients who attended a follow‐up assessment 1 year subsequent to the end‐of‐treatment assessment.

Method. The 51 patients formed three groups: (1) those who were offered and accepted COPE; (2) those who were offered COPE but refused it, and continued to receive other services from the Early Psychosis Prevention and Intervention Centre (EPPIC) (refusal subjects); and (3) those who were offered neither COPE nor any other continuing treatment from EPPIC (control subjects).

Results. At 1‐year follow‐up, there was only one significant difference and this was between the COPE and refusal groups on the Integration/Sealing Over (I/SO) measure (p = .008). End‐of‐treatment differences were mostly sustained over the 1‐year follow‐up period. When the complete sample of 80 was considered, there were no differences between the three groups in terms of hospital admissions, community episodes, or time taken to first in‐patient re‐admission.

Conclusions. The study was weakened by the poor follow‐up rates in the two control groups. This reduced power to detect differences between groups on the seven major measures. However, the relapse data gathered on the complete set of 80 patients were discouraging and suggest that the present formulation of COPE does not confer any advantage to those patients receiving the therapy over those not receiving the therapy.
Simulated malingering in pain patients: A study with the Pain Patient Profile
Authors: McGuire Brian E. , Harvey Allison G. , Shores E. Arthur
Published: February 2003

Objective. To investigate the utility of the Pain Patient Profile (P3) in detecting those who are faking or exaggerating complaints of pain while attempting to avoid detection.

Method. A control group of pain patients (‘Pain Controls’; PC; N=62) was compared with a general clinical group who did not report pain but were instructed to simulate malingered pain (‘General Rehabilitation Simulators’, GR; N=34); and a group whose primary problem was chronic pain who were instructed to exaggerate the extent of their pain and related problems (‘Pain Simulators’ PS; N=26).

Results. Both groups of simulating participants reported significantly higher scores on all clinical scales (anxiety, depression, somatization) compared with nonsimulating control participants and were more likely to obtain an abnormal T‐score on the clinical scales. The validity scale was able to differentiate the PS group from the PC group, but the GR group was not differentiated from the PC group by the validity scale.

Conclusions. The results indicate that with further study, the P3 may be a useful adjunct to the clinical assessment of symptom magnification in pain claimants.
A randomized controlled trial of the effects of multi‐sensory stimulation (MSS) for people with dementia
Authors: Baker Roger , Bell Steven , Baker Emma , Holloway Jane , Pearce Rebecca , Dowling Zena , Thomas Peter , Assey Julian , Wareing Lesley‐Ann
Published: February 2003

Objectives. To investigate short‐term effects of Multi‐Sensory Stimulation (MSS) on behaviour, mood and cognition of older adults with dementia, the generalization of effects to day hospital and home environments and the endurance of any effects over time.

Design. A randomized controlled trial comparing MSS with a credible control of one‐to‐one activities.

Methods. Fifty patients with diagnoses of moderate to severe dementia were randomized to either MSS or Activity groups. Patients participated in eight 30‐minute sessions over a 4‐week period. Ratings of behaviour and mood were taken before, during and after sessions to investigate immediate effects. Pre, mid, post‐trial, and follow‐up assessments were taken to investigate any generalization of effects on cognition, behaviour at the day hospital and behaviour and mood at home and endurance of effects once sessions had ceased.

Results. Immediately after MSS and Activity sessions patients talked more spontaneously, related better to others, did more from their own initiative, were less bored/inactive, and were more happy, active or alert. Both groups were more attentive to their environment than before, with a significantly greater improvement from the MSS group. At the day hospital, patients in the Activity group improved on their ‘speech skills’ (amount of speech; initiation of speech), whereas the MSS group remained unchanged during the trial. The MSS group showed a significant improvement in mood and behaviour at home compared to the Activity group whose behaviour deteriorated. No longer‐term benefits were shown; indeed, behaviour declined sharply during the month follow‐up period.

Conclusions. Both MSS and Activity sessions appear to be effective and appropriate therapies for people with dementia.
Estimating premorbid IQ from demographic variables: A comparison of a regression equation vs. clinical judgement
Authors: Crawford John R. , Millar Jane , Milne Alan B.
Published: February 2003

Objectives. To assess the accuracy with which clinicians estimate premorbid IQ from demographic variables and compare it with a regression equation which uses the same information.

Design. Repeated measures and correlational.

Methods. Sixty participants were administered the WAIS‐R and had their demographic variables recorded (age, sex, years of education and occupation). Eight clinical psychologists estimated the participants' IQs from the demographic variables. Estimated IQs were also obtained using a regression equation developed by Crawford and Allan (1997).

Results. The correlation between obtained IQ and the equation‐based estimate was significantly higher than the correlation between obtained IQ and the clinicians' estimates. Further, mean estimated IQ from the regression equation did not differ significantly from obtained IQ whereas the means for four of the eight clinicians' estimates did differ significantly.

Conclusions. Demographic‐based regression equations can provide unbiased and useful estimates of premorbid IQ; these estimates can be modified in the light of the additional qualitative information available to the clinician.
Croatian children's experience of war is not reflected in the size and placement of emotive topics in their drawings
Authors: Jolley Richard P. , Vulic‐Prtoric Anita
Published: February 2003

Objectives. The claim that topics in children's drawings convey the children's emotional attitude towards those topics was investigated.

Design. The influence of an emotional topic (neutral man, friendly and enemy soldier) and trauma group (child with father or father killed in war) was examined on the size of the topics and their placement relative to a self‐portrait drawing.

Methods. Sixty Croatian children drew a man, followed on a separate page by either (a) a Croatian soldier, (b) an enemy soldier or (c) a second drawing of a man. The child's self‐portrait drawing was placed on each page.

Results. There were no significant main or interaction effects on size or placement of topic.

Conclusions. There are unlikely to be reliable features of drawings that portray the child's emotional attitude towards the topic drawn.