bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological theories of delusional thinking: In search of integration
Authors: Hingley Susan M.
Published: July 2011

Psychological theories approach the problem of delusional thinking in psychosis from a range of perspectives. Recent attention has focused on the attributional style of sufferers; research points towards the relevance of cognitive deficits; the potential value of cognitive therapy in reducing delusional thinking is being explored; and psychodynamic theories argue for the role of defence mechanisms. Aspects of these approaches are reviewed and ideas for integration discussed within the vulnerability‐stress model of psychosis. Implications for therapy are noted.
Paranoia and the defensive attributional style: Deluded and depressed patients' attributions about their own attributions
Authors: Kinderman Peter , Kaney Sue , Morley Stephen , Bentall Richard P.
Published: July 2011

A data set of Attributional Style Questionnaire responses collected by Kaney & Bentall (1989) from persecutory deluded, normal and depressed subjects was added to a similar data set collected by the first author. The attributions made for hypothetical positive and negative events by the combined pool of subjects were then blind rated for internality by five independent judges. Whereas the internality ratings made by the subjects for their own attributions showed evidence of an exaggerated self‐serving bias in the case of the deluded subjects, and an absence of such a bias in the case of the depressed subjects, the independent ratings showed no such group differences. These findings suggest that the differences in internality for positive and negative events observed on the ASQ between deluded, normal and depressed subjects may not reflect differences in the types of causal statements made by these subjects but differences in their attributions about their attributions. The relevance of this observation for attribution theory in general and attributional accounts of psychopathology in particular are discussed.
Psychosis precipitated by marriage: A culture‐bound syndrome?
Authors: Fisch Robert Z.
Published: July 2011

A retrospective study of 258 psychiatric out‐patients in Jerusalem compared 122 patients from an ultra‐orthodox Jewish community with 136 other Jewish patients. It was found that six patients who had a psychosis within a month of marriage all belonged to the ultra‐orthodox community. The possible links between cultural and educational practice in the ultra‐orthodox community and the vulnerability to the stress of marriage are discussed. It seems feasible to regard the precipitation of major mental illness by marriage as a largely culture‐bound phenomenon.
The phases and focus of empathy
Authors: Barrett‐Lennard Godfrey T.
Published: July 2011

Interpersonal empathy is a subtle and multisided phenomenon which can, nevertheless, lend itself to systematic portrayal and investigation. This paper further refines the author's account of empathy as involving a sequence of distinct steps or phases. Freshly introduced here is the idea of empathic response not only to self‐experience but also towards relationships conceived as emergent living wholes with their own felt presence and individuality. Given described preconditions for empathy, three main phases in a complete empathic process are distinguished: reception and resonation by the listener; expressive communication of this responsive awareness by the empathizing person; and the phase of received empathy, or awareness of being understood. The phases are not a single closed system, thus do not occur in lock step and are semi‐autonomous in practice. Responding empathically to relationship systems (existing as ‘we’ or ‘us’ to the participants and as a joint ‘you’ to others) may be interwoven with empathic response to individual ‘I’ experience. Although differing in focus, the empathic process follows the same phasic course in both cases. An underlying view is that individual selves are only one of the forms human life takes; other forms include relationships, families and living communities.
Post‐traumatic anorexia nervosa—A case study
Authors: Davis Jane da Roza , Crisp A. H.
Published: July 2011

The nature of the relationship between accidental trauma and psychopathology may not always be clear. Cases of post‐traumatic anorexia nervosa have been described but without detailed attention to pre‐existing psychopathological processes. This may give rise to spurious conclusions about direction of causality. We describe a male patient who developed anorexia nervosa on two occasions, both episodes occurring during the convalescent period following traumatic accidents several years apart. The intervening period was characterized by strict self‐regulation and conflict avoidance, typical of anorexia nervosa but with the body maintained at only a moderately low weight. We suggest that accidents can arise at times of crisis in such ongoing attempts at intense self‐regulation. They may then reflect the escape from control of impulsivity and also provide an ultimate means of avoidance of further guilt‐laden behaviour. They can be understood in the light of pre‐existing psychopathology. The difficulties in early recognition and diagnosis of anorexia nervosa, especially in the male and in the absence of extreme weight loss are also discussed.
Perceived and desired facilitativeness of one's closest friend, need for approval and self‐esteem
Authors: Cramer Duncan
Published: July 2011

The hypothesis that the positive association between self‐esteem and the perceived facilitativeness of one's closest friend can be explained by the presumed greater desire of low self‐esteem individuals for a facilitative relationship was not confirmed in 262 16–17‐year‐old females, who completed the Rosenberg (1965) Self‐Esteem Scale and a shortened version of the Barrett‐Lennard (1964) Relationship Inventory. Although desired facilitativeness correlated significantly positively with self‐esteem, the correlation between perceived facilitativeness and self‐esteem remained significantly positive when desired facilitativeness was partialled out. The further prediction that the correlation between perceived facilitativeness and self‐esteem would be more positive for those scoring higher on the Jones' (1969) Need for Approval Scale was also not confirmed. The opposite result was obtained in that this correlation was significantly positive for those with low need for approval but not for those with a high need.
Models of health and disease
Authors: Tamm Maare E.
Published: July 2011

This paper describes and analyses six models of health and disease. These are: religious, biomedical, psychosomatic, humanistic, existential and transpersonal. Of these six models, only one was unequivocally reductionist: the biomedical. The others were all holistic. The religious, humanistic and transpersonal models could be considered as health models, the biomedical, psychosomatic and existential models as disease or illness models. The different models were assumed to depict different, but related, ways of representing health and disease. It is probable that different groups in society, including the different groups in the health service ‐ doctors, nurses and patients ‐ look at health and illness from partly different models. This is considered to have significant implications for the health service.
Is alexithymia a non‐neurotic personality dimension? A counter‐response to Taylor, Bagby & Parker
Authors: Rubino I. Alex
Published: July 2011

A previously published research report (Rubino, Grasso, Sonnino & Pezzarossa, 1991a) is criticized by Taylor, Bagby & Parker (1993) on several grounds, and further data are cited to contrast our negative conclusions on one of the basic postulates of alexithymia research, i.e. the opposition, or at least independence between alexithymia and neurotic functioning. The theoretical and empirical arguments of Taylor et al. are closely examined, and it is concluded that alexithymia seems positively correlated not only with neurotic and psychotic conditions, but also with neuroticism.
Childhood adversity and adult defence style in eating disorder patients—A controlled study
Authors: Schmidt Ulrike , Slone Gaynor , Tiller Jane , Treasure Janet
Published: July 2011

The aims of the study were (1) to compare the defence style of patients with anorexia nervosa with that of patients with bulimia nervosa and of female controls; (2) to establish whether a link exists between childhood adversity and adult defence style in eating disorder patients. Twenty‐six patients with restricting anorexia nervosa (RAN), 61 patients with bulimia nervosa (BN), 37 patients with bulimic anorexia nervosa or bulimia nervosa with a history of anorexia nervosa (BAN/BN‐HistAN) and 88 female controls were given the short Defense Style questionnaire (Andrews, Pollock & Stewart, 1989). Eating disorder patients were asked about their childhood care using a semi‐structured interview (Harris, Brown & Bifulco, 1986). Bulimia nervosa patients had a significantly less mature defence style than the other groups and like the BAN/BN‐HistAN group more immature defences than the control group. In the RAN group no childhood predictors of adult defence style were found, whereas in bulimia nervosa, excessive parental control during childhood was a negative predictor of mature defences and physical abuse a positive predictor of immature defence style. These results provide some evidence that childhood adversity may constitute a vulnerability factor for the later development of bulimia nervosa, mediated by personality development.
A three‐month follow‐up of psychological morbidity after early miscarriage
Authors: Ptettyman R. J. , Cordle C. J. , Cook G. D.
Published: July 2011

The loss of a pregnancy in the first trimester is a common event and recent research has identified high levels of psychological distress amongst women who have miscarried. We believe this study is the first to examine the phenomenon from a longitudinal perspective using standardized measures. A sample of 65 women was rated for anxiety and depression using the Hospital Anxiety and Depression Scale at intervals of one, six and 12 weeks following early miscarriage. The results indicate that a large proportion of the sample had clinically important levels of anxiety (41 per cent) and depression (22 per cent) in the first week following miscarriage, which declined to 32 per cent and 6 per cent respectively by the 12th week. No association was observed between levels of psychological morbidity and a number of social and obstetric variables, the only exception being whether or not the pregnancy had been planned. These results are discussed with reference to the relevant literature. The possible implications for further research and clinical practice are addressed.
The phenomenology of shame and guilt: An empirical investigation
Authors: Gilbert P. , Pehl J. , Allan S.
Published: July 2011

This paper explores the various literatures concerned with shame and guilt. Lewis' (1987) model of shame is outlined. The phenomena she suggested to be part of shame (feelings of helplessness, anger at others, anger at self, self‐consciousness and feelings of inferiority) were investigated as to their relationship with shame. Strong support for these phenomena being related to shame, but not guilt, was found. Although located in separate literatures, shame and fear of negative evaluation have considerable overlap and this study set out to explore this relationship. The study further considered the role of submissive behaviour in shame and depression. Evidence was found to support the view that submissive behaviour is involved in both shame and depression.
Projective identification as early joint action sequences: A Vygotskian addendum to the Procedural Sequence Object Relations Model
Authors: Leiman Mikael
Published: July 2011

Some phenomena of projective identification, as examined by Ryle on the basis of the Procedural Sequence Object Relations Model, are readdressed by using the Vygotskian notion of joint sign‐mediated activity as the earliest form of psychological process. This notion is elaborated by presenting Clark's empirical studies of the emergence of gestural communication.
Resolving a challenge to the therapeutic relationship: A single‐case study
Authors: Agnew Roxane M. , Harper Heather , Shapiro David A. , Barkham Michael
Published: July 2011

The selection of a case of demonstrated change using a quantitative criterion preceded an exploration of possible change mechanisms in therapy. Between‐session variations in the therapeutic relationship revealed by a quantitative measure prompted an intensive qualitative investigation of in‐session events. Within these events, the study focused on challenges to the therapeutic relationship and their subsequent resolution. Understanding the resolution of such challenges to the relationship was guided by a rational model derived from the treatment rationale. A tentative account of the process of change is offered, and case replications are required to confirm and extend the findings.
The structure, validity and clinical relevance of the Inventory of Interpersonal Problems
Authors: Barkham Michael , Hardy Gillian E. , Startup Mike
Published: July 2011

This paper presents preliminary data on the psychometric and clinical properties of the Inventory of Interpersonal Problems (IIP: Horowitz, Rosenberg, Baer, Ureno & Villasenor, 1988) obtained from a UK sample of clients presenting with depression/anxiety for individual psychotherapy as part of two concurrent outcome studies: the Second Sheffield Psychotherapy Project (SPP2) and the Medical Research Council/NHS Collaborative Psychotherapy Project (CPP). The factor structure of the IIP is reported on a sample of 250 clients and eight factor‐analytically derived scales are presented. Data on the reliability of the IIP together with its relationship to the Symptom Checklist‐90R (SCL‐90R: Derogatis, 1983) are investigated in a subsample of 143 clients. In addition, data are presented on the clinical relevance of the IIP using case material. The structure of the IIP was further analysed using ipsatized scores. Four bipolar factors were extracted and these findings are discussed with reference to four primary sets of social competencies.
Factors contributing to the development of burnout in oncology nursing
Authors: Papadatou Danai , Anagnostopoulos Fotios , Monos Dimitris
Published: July 2011

The purpose of this study was to determine whether oncology nurses experience higher levels of burnout compared to nurses working in general hospitals, and to further identify the personal and environmental factors that contribute to the development of emotional exhaustion, depersonalization and lack of personal accomplishment. Seven tools, measuring a selected set of demographic, psychological and occupational variables, were administered to 217 female nurses who worked in oncological hospitals and 226 nurses who worked in general hospitals in the area of Athens. Measures used in the study included the Maslach Burnout Inventory, the Hardiness Scale, the Ways of Coping Scale, the Life Style Scale, the Type A Behaviour Scale, a Job Stress Questionnaire and a General Information Questionnaire. No statistically significant difference was revealed in the degree of burnout experienced by nurses in oncology and those in general hospitals. Multiple linear regression analysis suggested that personality characteristics seem to predict a greater percentage of the variability of the burnout experienced than occupational and demographic variables. A sense of personal control over the things that happen in life and in the work environment was found to protect nurses from emotional exhaustion, depersonalization and lack of personal accomplishment.
Belief in demons and exorcism in psychiatric patients in Switzerland
Authors: Pfeifer Samuel
Published: July 2011

Belief in demons as the cause of mental health problems is a well‐known phenomenon in many cultures of the world. However, there is little literature on this phenomenon in Protestant subcultures of the West. The author conducted a systematic investigation of the prevalence of this attribution in 343 mainly Protestant out‐patients of a psychiatric clinic in Switzerland, who described themselves as religious. Of these, 129 (37.6 per cent) believed in the possible causation of their problems through the influence of evil spirits, labelling this as ‘occult bondage’ or ‘possession’. One hundred and four patients (30.3 per cent) sought help through ritual ‘prayers for deliverance’ and exorcism. Prevalence of such practices was significantly related to diagnosis (p < .01) and to church affiliation (p < .005). Patients in charismatic free churches suffering from anxiety disorders and schizophrenia reported the highest rate of exorcistic rituals (70 per cent), and patients with adjustment disorders from traditional state churches the lowest (14 per cent). The various forms and functions of these healing rituals are described. Although many patients subjectively experienced the rituals as positive, outcome in psychiatric symptomatology was not improved. Negative outcome, such as psychotic decompensation, is associated with the exclusion of medical treatment and coercive forms of exorcism.
Cognitive behavioural therapy for drug‐resistant psychosis
Authors: Garety P. A. , Kuipers L. , Fowler D. , Chamberlain F. , Dunn G.
Published: July 2011

A small controlled trial of cognitive behaviour therapy for drug‐resistant psychosis is reported. The study was designed as a pilot study for a future larger and longer randomized controlled trial. The therapy was offered to patients with a diagnosis of schizophrenia or schizo‐affective psychosis who presented unremitting positive symptoms. An average of 16 sessions were delivered over a six‐month period. The results of this pilot study are promising. Rates of engagement in therapy were high. The treatment group also improved significantly on a number of key symptom measures when compared with the controls. These were reductions in delusional conviction, general symptomatology and depression scores. Future studies should offer therapy over a longer period, targeting social as well as symptom change, and considering factors which will enhance maintenance of improvement.
Personal constructs of survivors of childhood sexual abuse receiving cognitive analytic therapy
Authors: Clarke Sue , Llewelyn Sue
Published: July 2011

Increasing numbers of survivors of childhood sexual abuse (CSA) are now seeking psychological therapy; yet little evidence currently exists concerning optimum treatment formats, especially when re‐victimization has occurred in adulthood. This study reports an exploratory investigation of re‐victimization, and of the use of cognitive analytic therapy (CAT) with seven CSA survivor women, six of whom had experienced re‐victimization and five of whom were self‐abusive. Results of single element and dyad grids administered before and after therapy were consistent with the exploratory hypothesis that abuse forms a central component of the women's relationships, hence making recurrence of abuse a real possibility. Outcome of therapy using CAT was positive, although the considerable and significant symptomatic changes observed were accompanied by significant change in only a relatively small number of the women's constructs, suggesting the persistence of the centrality of abuse despite therapy. For two women, levels of disturbance remained high after termination, and some evidence of relapse was also evident at three‐month follow‐up.
The role of insight in exploratory psychodynamic psychotherapy
Authors: Høglend Per , Engelstad Vibeke , Sørbye Øystein , Heyerdahl Oscar , Amlo Svein
Published: July 2011

Psychoanalytic theory holds that dynamic insight is used for self‐observation and self‐analysis during and after explorative therapy. Such self‐analysis is held to lead to stable dynamic change. Within a sample of 43 moderately disturbed out‐patients, pre‐treatment level of insight was associated with treatment length, with not being an early or late drop‐out, and with receiving additional psychotherapy during a four‐year follow‐up period. Pre‐treatment level of insight turned out to be not directly correlated with outcome two and four years after therapy. However, level of insight was significantly correlated with outcome in interaction with treatment length. Gain of insight measured at two‐year follow‐up was the strongest predictor of overall dynamic change four years after therapy, compared with all the other outcome assessments made at two‐year follow‐up.
Psychological distress and Neuroticism: A two‐wave panel study
Authors: Cramer Duncan
Published: July 2011

The temporal relationship between psychological distress and Neuroticism, both measured at two points eight months apart, was examined in a representative sample of 225 adult residents in Canberra, using cross‐lagged panel correlation and latent variable LISREL analysis. Psychological distress was assessed by the 30‐item General Health Questionnaire (GHQ‐30). Because the synchronous and autocorrelations differed significantly, the interpretation of the significant difference between the cross‐lagged correlations was problematic. The cross‐lagged path coefficients in the LISREL models were not significantly positive, suggesting that the temporal relationship between these two variables was spurious and due to error variance. The test‐retest correlation was significantly higher for Neuroticism than for the GHQ‐30, implying that Neuroticism is more a measure of a relatively stable personality characteristic and the GHQ‐30 more one of transient psychological distress.
Maternal dominance and the conception of sons
Authors: Grant Valerie J.
Published: July 2011

Previous research (Grant, 1990, 1992) suggests that the sex of the infant is linked to maternal dominance, although it is unclear from existing studies whether women have obtained higher dominance ratings merely as a consequence of already carrying a male foetus. In an effort to overcome this problem, self‐report personality measures of dominance were completed by mothers of one‐ and two‐year‐old infants before they became pregnant again. In two independent studies (during 1983–84 and 1990–91), women who later conceived male infants scored significantly higher on dominance than those who later conceived female infants. The results of an analysis of all studies (N = 6) done on this topic (1969–91), are also presented, as are the results of an analysis of the four studies in which subjects were either not pregnant or were eight weeks pregnant or less. In both the combined analyses, those women who later bore sons were significantly more likely to have scored higher on the tests of dominance than those who later bore daughters (χ2 p < .0001).
Children in war: A silent majority under stress
Authors: Kuterovac Gordana , Dyregrov Atle , Stuvland Rune
Published: July 2011

To assess the amount of stress exposure and reactions among children following a war situation, two comparative groups of non‐displaced (N = 64) and displaced children (N = 70) from Croatia were administered a modified version of the War Trauma Questionnaire as well as the Impact of Event Scale (IES). The results showed that a majority of the children had been exposed to armed combat, with displaced children significantly more exposed to destruction of home and school as well as to acts of violence, and loss of family members, than the non‐displaced children. Regarding the IES scores, displaced children had significantly higher scores for the total score and for the intrusion and avoidance subscales. For girls the total score and intrusion score were significantly higher than for boys. Different exposure factors were significantly related to the IES scores, especially for the intrusion subscale of the IES.
Post‐adoption incest and phenotypic matching: Experience, personal meanings and biosocial implications
Authors: Greenberg Maurice , Littlewood Roland
Published: July 2011

Recent changes in British law have enabled adults who were adopted when young to trace their biological relatives. The reported frequency of incestuous sentiments and relationships in these reunions, together with the individual experiences and the meanings which are attached to them, challenge fundamental assumptions of both Westermarck's and Freud's theories. Post‐adoption incest is characterized experientially by a romantic search for attachment followed by a recognition of oneself in the other. The question of incest has been fundamental to biosocial theories of individual and cultural development. Some revisions are proposed, principally that adult sexual interests remain constrained both by early attachments and later phenotypic matching, reinforced by personal contingencies and cultural rules.
The process of coping with a gross anatomy exam during the first year of medical school
Authors: Wolf Thomas M. , Heller Sherryl S. , Camp Cameron J. , Faucett John M.
Published: July 2011

A total of 42 freshman medical students were evaluated before a major exam, after the exam and before grades were announced and after grades were announced. They completed measures relating to mood, emotions, coping, social support and stakes. Significant time and academic performance differences were found in many domains.
Psychotherapy with difficult patients
Authors: WILLIAMS RUTH M.
Published: July 2011

Book reviewed in this article:

Cognitive‐Behavioural Treatment of Borderline Personality Disorder. By M. M. Linehan.

Skills Training Manual for Treating Borderline Personality Disorder. By M. M. Linehan.

Self‐Management Therapy for Borderline Personality Disorder: A Therapist‐Guided Approach. By M. H. Langley.
Transference and counter‐transference variations in the course of the cognitive‐analytic therapy of two borderline patients: The relation to the diagrammatic reformulation of self‐states
Authors: Ryle Anthony
Published: July 2011

The cognitive‐analytic therapy of two patients with borderline personality disorder is described. Patients and therapists completed post‐sessional questionnaires which yielded measures of transference and counter‐transference. The relation of changes in these to the sequential diagrammatic reformulation of the patients' self‐states is considered.
Why do psychiatrists neglect religion?
Authors: Neeleman J. , Persaud R.
Published: July 2011

This paper analyses a number of possible reasons why modern psychiatry has neglected the therapeutic effects of religious beliefs. The gap which exists between psychiatry and religion is a relatively recent phenomenon and is partly related to psychiatry's progress in elucidating the biological and psychological causes of mental illness, rendering religious explanations superfluous. In addition, it is often assumed that religious attitudes are inevitably linked with phenomena such as dependence and guilt which are frequently seen as undesirable. Psychiatrists and psychologists tend to be less religiously orientated than their patients, which may further increase the professional's idea that religious beliefs are associated with disturbance. However, it has long been suspected that a positive relation exists between religion and mental health, and recently, the psychology of religion has provided empirical support for this idea. Psychiatry faces the challenge to accommodate this evidence into theory and practice.
The paradoxical power of the depressed patient: A problem for the ranking theory of depression
Authors: Price John , Gardner Russell
Published: July 2011

The social ranking (or social competition) theory of depression suggests that the capacity for episodes of depressed mood evolved as a mechanism for inhibiting challenge. Depressed mood induces the sufferer to accommodate to low social rank, or to losing in social competition, or to adopting the one‐down position in a complementary relationship (Price, 1991; Price, Sloman, Gardner, Gilbert & Rohde, 1994; Sloman, Price, Gilbert & Gardner, 1994). Thus depressed patients should be observed to forego the privileges of high rank and of winning, such as exercising social power and getting their own way. However, several commentators have noted that depressed patients often seem to be very powerful, and even appear to use their depression to manipulate others. This paper attempts to reconcile the theory to such observations.
A clinical concept of the self: The experiential being
Authors: De Waele Martin
Published: July 2011

This paper proposes a clinical concept of the self as experiential being. Such a concept offers the triple advantage of being non‐reductive, introducing experience as a clinical unit of analysis and intervention, and viewing a representational capacity to experience as a crucial element towards the construction of ‘I’. The central importance of ‘experience’ in health and disorder is addressed, followed by a characterization of the processes of ‘going through’, the integration of ‘experience’ into T and the processes of defence, which are viewed from the perspective of the experiential being. Experience, or ‘going through’, has five defining characteristics: awareness, motivation, linking, learning and evolution. The processing of ‘experience’ on two levels, the representational level and the level of the experiential being, leads to the integration of experience into ‘I’. The owning of experience, and not defence, is seen as the key factor in health and disorder. As the capacity to own experience, which includes the owning of defence, is the key to the road to health, it is argued that clinical intervention must focus on the person's capacity to own all his or her experiences.
Differentiation between patients with schizophrenia and borderline disorders in the Percept‐genetic Object‐Relation Test, PORT
Authors: Nilsson Alf
Published: July 2011

Schizophrenics (12 males), borderline patients (12 males), and self‐selected normal controls (11 males, 17 females) were compared using PORT (Percept‐genetic Object‐Relation Test), a projective test, diagnosis being on the basis of DSM‐III and Kernberg's six descriptive borderline criteria. The aim of the study was to compare the three groups in order to distinguish the two clinical groups from the control group, but also to distinguish the borderlines from the schizophrenic patients with specified diagnosis. The two patient groups differed from the controls on 15 different PORT signs/patterns. In addition, the borderline patients and the three schizophrenics of unspecified diagnosis showed signs in PORT of dissolution anxiety, splitting, whole configuration (fusion) and sexualization as defence, which the schizophrenics with specified diagnosis did not, although catatonic/hebephrenic, simplex, and paranoid schizophrenics could be distinguished in the test. Characteristic of the schizophrenics was also diffusion of domains of object relationships. In a blind prediction study with PORT involving five male and five female patients with severe psychiatric disorders (diagnosed by DSM‐III‐R), borderline patients could also be distinguished satisfactorily from schizophrenics.
Subject matter and poetic devices in psychotics' poetry
Authors: Rhodes Nicholas , Dowker Ann , Claridge Gordon
Published: July 2011

It has long been supposed that there is a connection between the mental processes of psychosis and those of creativity. The present study aimed to investigate this idea by means of a comparison between the poetic output of psychotics and that of normals, taking as its starting‐point the notion that if there are observable differences between these two groups in terms of subject matter and linguistic features, this would suggest that creativity and psychosis are not to be identified with each other. Eighty poems by contemporary, non‐professional poets (40 by psychotics and 40 by normals) were analysed on 11 different dimensions. The two samples of poems were highly similar on most of the dimensions investigated. The main differences found were in the incidence of self‐analysis as a theme, reference to proper names and specific locations, and in the proportion of metaphors which fell into the category ‘psychological/physical’. The two latter differences appeared to be largely a product of the first. It was concluded that although ‘normal’ and ‘psychotic’ poetic activities are not identical, they are closely related. This may be either because general poetic creativity does have psychotic features, or because the poetic function of language was relatively spared in at least this sample of psychotics.
Life‐events and the course of chronic fatigue syndrome
Authors: Ray Colette , Jefferies Sally , Weir William R. C.
Published: July 2011

Life‐events have been implicated in the onset and course of various illnesses. The present study examined their role in chronic fatigue syndrome, in the context of the ongoing illness. Using the PERI list, events experienced during the past year were elicited in interviews with 130 patients. The analyses were restricted to those events implying moderate or major life change, and separate analyses were carried out for positive and negative events. Positive events were found to be associated with lower scores for fatigue, impairment, anxiety and depression, as assessed at the time of the life‐events interview, and these relationships were also significant when prior scores at the beginning of the year were statistically controlled. Negative life‐events were associated with higher anxiety, but were unrelated to the other measures. It was concluded that positive life‐events and experiences may contribute to the process of recovery in chronic fatigue syndrome, though their occurrence may also be facilitated by a preceding lifting of symptoms.
An outbreak of copycat fire raising
Authors: Morgan N. , Cook D. A. G. , Dorkins C. E. , Doyle M. E.
Published: July 2011

A dangerous outbreak of fire setting occurred on two wards of a Bristol Psychiatric Hospital, in which six patients set eight fires over a five‐week period. One was the Intensive Care Unit, the other an admission ward serving the inner city of Bristol. Five of the six patients had moved between the two wards. The sequence of fires is in part explained by ‘copycat’ behaviour. The fires were set at a time when the hospital was particularly vulnerable because of major service changes. We emphasize the institutional and situational variables that led to disturbed behaviour in a vulnerable group of individuals, with inadequate controls over tension and anxiety.
Case report: Psychological response of a woman with schizo‐affective disorder on discovering she had ovarian cancer
Authors: Morris Marcia R. , Sullivan Timothy B.
Published: July 2011

Studies have shown that medical illness in those with psychiatric illness often exacerbates symptoms (Hall et al., 1981). This paper reports the case of a 53‐year‐old Chinese American woman with schizo‐affective disorder who surprisingly had a remission in psychiatric symptoms on discovering she had ovarian cancer.
Adapting cognitive analytic therapy to make sense of psychologically harmful work environments
Authors: Walsh Sue
Published: July 2011

This paper presents an exploratory qualitative study which draws upon cognitive analytic therapy (CAT) as part of an organizational assessment of a dysfunctional and disharmonious staff group. The remit of the research was to explore why relationships between nursing staff and management employed in a surgical theatre unit in a District General Hospital had disintegrated. Using the information generated from semi‐structured interviews a sequential diagrammatic reformulation was created which identified the object relational core of the work group and the consequent sabotaging cognitions and behaviours that emerged. The strengths and limitations of the use of therapeutic approaches for the psychologist interested in working with organizational change processes is discussed.
Clinical issues in the cognitive analytic therapy of sexually abused women who commit violent offences against their partners
Authors: Pollock Philip H.
Published: July 2011

Clinical issues arising in the cognitive analytic therapy (CAT; Ryle, 1990) are described for seven sexually abused women who committed violent offences against their partners in intimate relationships. Two principal findings are reported; firstly, support is provided for the original hypothesis of Pollock & Kear‐Colwell (1994) in that, following the offence, the women perceived themselves as ‘guilty aggressors’ and disavowed the role of their own victimization in the commission of the offence; secondly, psychometric data suggested that dissociative states were reported as common experiences for the women before, during and after the offence. The relationship between the abusing‐victimized reciprocal role procedure, affective functioning, dissociative states and violent acts is discussed. Themes encountered in the application of CAT for these women are described and a case report is used to illustrate specific treatment issues.
To change or not to change—‘How’ is the question?
Authors: Ward Anne , Troop Nicholas , Todd Gill , Treasure Janet
Published: July 2011

The objective was to apply the ‘trans‐theoretical’ model of change to a group of patients with eating disorders. Patients were studied in an in‐patient setting. Two sets of questionnaires were used, one to assess ‘stage’ of change, the other to measure the ‘processes’ used to achieve change. Three stages and eight processes were examined. Thirty‐five patients completed the study. Highest scores were found in the contemplation, and lowest in the precontemplation stage, Tile most frequently used processes of change were self‐reevaluation, helping relationships and consciousness raising, with different processes predominating at different stages. Covariance analysis supported an association between two latent variables ‘stage’ and ‘process’. Despite the limitations of small numbers, our results are in broad agreement with others using the ‘trans‐theoretical’ model, supporting its use in eating disorders. Although further work is necessary, the model suggests a way of thinking about helping this very ambivalent group of patients to institute and sustain change.
AIDS research and prevention: A social representational approach
Authors: Joffe Hélène
Published: July 2011

The KABP paradigm (knowledge‐attitude‐belief‐practice) dominates social scientific AIDS research and prevention programmes. This paper questions a number of the assumptions of the paradigm both theoretically and empirically. Having discussed a number of the paradigm's shortcomings, an alternative, a social representational approach, is proposed. The choice of an alternative approach is guided by theoretical concerns but its efficacy is demonstrated by way of a cross‐cultural analysis of data. By way of contrast to the KABP paradigm, the methodology of the social representational approach calls for the sampling of the social representations held by individuals in parallel with those which circulate in their social environment. In addition, the alternative approach highlights the importance of identity and of emotional factors in AIDS‐related thought and action. The shift in theory and methodology which is proposed provides an altered focus for efforts to control the spread of HIV.
Causal beliefs and acute psychiatric hospital admission
Authors: Whittle Peter
Published: July 2011

Causal beliefs regarding the onset of psychiatric disorder and treatment expectations for clients admitted to a psychiatric unit were examined from the points of view of the clients themselves, their relatives and staff. Results suggested that these beliefs were influenced by the admission itself. Those clients who had been admitted previously held significantly higher biological causal beliefs than those who had been admitted for the first time; as compared to staff who did not distinguish between the two groups in this way. The mean psychosocial views of relatives decreased significantly over the two‐month period following an admission. Clients' and relatives' mean biological views were significantly greater than those of staff. Various correlations were found between causal beliefs and treatment expectations including one in the relatives' view between psychosocial causal beliefs and the importance assigned to family therapy. Indeed, there was a significant decrease in the family therapy rating over time given by relatives.
Monitoring of intrusions in post‐traumatic stress disorder: A report of single case studies
Authors: Reynolds Martina , Tarrier Nicholas
Published: July 2011

The effect of monitoring on frequency and duration of intrusions, and on reported symptomatology in patients with a diagnosis of post‐traumatic stress disorder (PTSD) was investigated. Six patients were asked to monitor their intrusions over a period of two months. The patients were reassessed after completing the monitoring and followed up after three months. Four patients recovered and no longer met criteria for PTSD, one patient was still experiencing some symptoms, and one still met criteria for a diagnosis of PTSD.
Reflective capacity and its significance to the attachment concept of the self
Authors: West Malcolm L.
Published: July 2011

Attachment writing about the self systematically regards the working model of the self as a social product. At the same time, reflective self‐capacity is regarded as a particularly salient aspect of the individual's current state of mind with respect to attachment. Additionally, evidence has accumulated that some individuals have been able to create a coherent working model of the self despite a history of negative attachment experiences. This paper proposes that in these circumstances it is necessary to conceive of a private self through which the history of attachment experiences may be creatively transformed.
The candidate and the patient: Some transferential and counter‐transferential aspects of the reality of apprenticeship
Authors: Granek Michel , Neilman Ilan
Published: July 2011

This paper examines the impact of apprenticeship on the analytic process. It describes how the reality of the apprenticeship appears in or even intrudes into the transference‐counter‐transference dialogue. The clinical examples illustrate the use of candidate‐analyst's reality as a defence. In the authors' opinion, the realistic aspects of the apprenticeship should be analysed as a part of the transference and counter‐transference. The candidate is in a narcissistically vulnerable position between the analysand and the institute, and therefore prone to a Talion‐like response and to displacement of aggression. An appropriate working through of apprenticeship difficulties should take place in a double dialectical process between candidate and analysand, and between candidate and institute representatives.
The treatment of chronic post‐traumatic nightmares using psychodynamic‐interpersonal psychotherapy: A single‐case study
Authors: Kellett Stephen , Beail Nigel
Published: July 2011

This article presents a single‐case experimental study of a woman suffering a traumatized reaction to a road traffic accident (RTA). In addition to meeting the DSM‐IV (APA, 1994) criteria for the diagnosis of PTSD, the client suffered recurrent bizarre nightmares. The client reported at assessment, that each night her dreams were dominated by a terrifying hooded cloaked faceless figure. The central aim of the study therefore was to assess the efficacy of a psychodynamic‐interpersonal (PI) style psychotherapy in the context of an unusual PTSD reaction. The methodology employed an A/B multiple baseline time series design, with six month follow‐up. A and B represent a series of dream diary observations under two conditions: assessment/baseline (A) and treatment/intervention (B). Treatment consisted of a manualized psychodynamic‐interpersonal (PI) psychotherapy to facilitate insight into the content and meaning of the nightmares. The intervention reduced the frequency and associated distress of the nightmares to zero. Follow‐up at six months noted the long‐term efficacy of the psychotherapy. The study is discussed with reference to the assimilation model of psychotherapeutic change.
Commentary on Joffe (1996) AIDS research and prevention: A social representation approach
Authors: Fife‐Schaw Chris
Published: July 2011

Hélène Joffe's (1996) article provides us with a well‐presented argument detailing the failings of Knowledge, Attitude, Belief and Practice (KABP) approaches in the domain of AIDS/HIV prevention behaviours and argues that the Theory of Social Representations (Moscovici, 1984) offers a useful alternative perspective. In this commentary I would like to expand on some of the issues she raises and to counter‐argue that the case for adopting social representations theory as an alternative to KABP approaches has yet to be made convincingly. To do this I will first consider the problems surrounding traditional KABP approaches, then discuss social representations theory as an alternative and consider alternatives on the way.
Juxtaposing positivist and non‐positivist approaches to social scientific AIDS research: Reply to Fife‐Schaw's commentary
Authors: Joffe Hélène
Published: July 2011

Many academics argue that the AIDS‐related debates are hackneyed, that the area has been oversubscribed and that most AIDS research merely reinvents the wheel. I disagree. The energy which continues to be dedicated to the area is invaluable not only in terms of the theoretical and preventive terrain which is still to be covered, but with regard to the future transfer of knowledge to other areas of health risk research. Fife‐Shaw's commentary contributes to the vitality of the debate.
Prediction and course of grief four years after perinatal loss due to congenital anomalies: A follow‐up study
Authors: Hunfeld J. A. M. , Wladimiroff J. W. , Passchier J.
Published: July 2011

The emotional reactions of women (N = 29) after perinatal loss were evaluated over a four‐year period by means of standardized questionnaires and a semi‐structured interview. Eleven women (38 per cent) displayed a level of general psychological distress which is clinically significant. Grief reactions declined significantly during this period, except for difficulties with coping and despair concerning the loss, and a quarter of the women still showed a clinically significant high level of distress for intrusive images.

The disposition for feelings of inadequacy (i.e. feeling anxious, insufficient, depressed and having low self‐esteem) was strongly and positively related to the intensity of stress, grief and general psychological distress after four years. Our findings emphasize the importance of psychosocial screening of those women identified as showing signs of inadequacy in the face of (threatened) pregnancy loss with the objective to offer them additional psychological support.
The evolution of social attractiveness and its role in shame, humiliation, guilt and therapy
Authors: Gilbert Paul
Published: July 2011

This paper suggests that humans have innate needs to be seen as attractive to others. These needs form the basis for shame and mediate evaluations of social standing (status), social acceptance and social bonds. Shame and humiliation are associated with attacks on, and losses of, social attractiveness. The internal experiences of shame are derived from submissive strategies where one seeks to signal to others awareness of loss of social standing and limit possible damage. However, it is suggested that shame and humiliation differ from each other in a number of ways. For example, in shame the focus is on the self, while in humiliation the focus is on the harm done by others. Variations in the defensive strategies of shame and humiliation (e.g. avoidance, escape versus aggression and revenge) can pose particularly difficult problems in therapy. A focus on the role of social attractiveness in shame also allows for important distinctions to be drawn between shame and guilt.