bluuebunny/crossref_metadata_2025 huggingface dataset:
Autobiographical memory and parasuicide in borderline personality disorder
Authors: Startup Mike , Heard Heidi , Swales Michaela , Jones Bethan , Williams J. Mark G. , Jones Robert S. P.
Published: February 2003

Background. Several studies have found that parasuicidal patients are poor at recalling specific autobiographical memories when tested with the word‐cueing paradigm and two studies have reported some evidence that over‐general recall is a risk factor for repetition of parasuicide. The aim of the present study was to test whether this association could be replicated with a sample of patients suffering from borderline personality disorder (BPD).

Method. Twenty‐three patients with BPD completed a version of the Autobiographical Memory Test (AMT) and self‐report measures of depression, anxiety and trait anger. In a structured interview, they also reported the number of times they had engaged in parasuicidal acts during the previous 4 months.

Results. The number of general memories produced on the AMT made a significant contribution to the prediction of the frequency of parasuicidal acts in a multiple regression analysis but the partial correlation in the final equation was negative. That is, those who showed greatest over‐general recall reported fewest parasuicidal acts. Anxiety and depression, but not trait anger, also made significant independent contributions to the prediction of parasuicide.

Conclusion. Over‐general autobiographical recall may help to protect borderline individuals from parasuicidal acts by helping them to avoid distressing memories.
The ability of naive participants to report symptoms of post‐traumatic stress disorder
Authors: Burges C. , McMillan T. M.
Published: February 2003

Objective. Research suggests that naive participants can simulate PTSD (post‐traumatic stress disorder) using a symptom checklist. Is successful faking of DSM‐IV criteria B‐D on PTSD checklists due to prior knowledge of PTSD, the leading nature of symptom checklists, or a combination?

Design: Between‐groups design.

Method: Naïve participants self‐generated PTSD symptoms from a vignette. They were then randomly assigned to groups given a standard symptom checklist or a checklist containing bogus items not normally associated with PTSD.

Results: Less than 1% self‐generated symptoms that met DSM‐IV criteria B‐D for PTSD. It was found that 94% of participants satisfied these criteria using the standard checklist and 90% on the modified checklist. Participants incorrectly identified 38% of bogus symptoms as symptoms of PTSD.

Conclusions: Despite poor prior knowledge of PTSD, 94% of participants fulfilled diagnostic criteria using a standard checklist. This is probably due to symptom ‘guessing’.
Effects of retrieving childhood events on metamemory judgments depend on the questions you ask
Authors: Merckelbach Harald , Wiers Reinout , Horselenberg Robert , Wessel Ineke
Published: February 2003

Objective. The more people retrieve childhood memories, the less favourably they evaluate their own memory. It has been argued that this might play a role in self‐reports of amnesia. However, a limitation of previous studies addressing this phenomenon is that participants' judgments about their memory were based on a single item.

Design. Students were randomly assigned to either of two conditions. In one condition, they were asked to retrieve nine negative childhood events, whereas in the other condition, participants were required to recall three events.

Method. After recall, students completed measures on memory accessibility and ‘repression’.

Results. Students who retrieved nine events rated their memories as less accessible, but also reported less repression than did students who retrieved three events.

Conclusion. The direction of retrieval effects on metamemory judgments depends on the way in which questions are framed.
Utility of a demographic equation in detecting impaired NART performance after TBI
Authors: Freeman Jane , Godfrey Hamish P. D. , Harris Jacqueline K. J. , Partridge Fiona M.
Published: February 2003

Objective. This study applies a demographic regression equation devised by Crawford, Allan, Cochrane, and Parker (1990) to determine its utility in New Zealand, and to determine the proportion of persons with traumatic brain injury (TBI) with impaired performance on the National Adult Reading Test (NART).

Method. The NART was administered to 80 community participants, 65 people with traumatic brain injury (TBI), and 27 orthopaedic controls. The Crawford et al. (1990) equation was applied to all three samples.

Results. The Crawford et al. (1990) equation was applicable in the New Zealand community sample. It was found that 30% of the TBI sample had impaired performance on the NART. Using corrected NART scores, a significantly larger proportion of the TBI sample was detected as intellectually impaired than in the control sample.

Conclusion. Nearly one‐third of the TBI sample evidenced impaired performance on the NART. Consequently, clinicians that use the NART in assessing people with TBI should use the demographic equation to check the accuracy of NART performances, and correct the NART scores if this is indicated.
Autobiographical memories become less vivid and emotional after eye movements
Authors: van den Hout Marcel , Muris Peter , Salemink Elske , Kindt Merel
Published: February 2003

Objectives. To test (1) whether eye movements during retrieval of emotional memories are followed by less vividness and less emotionality of future recollections, (2) whether this effect, if present, is stronger than the effects of a control activity (finger tapping), (3) whether the alleged effects of tapping and eye movements are stronger than a no‐movement, control condition (mere imagery), (4) whether reductions in vividness and emotionality after eye movements (and finger tapping) are specific to negative memories or also occur in the case of positive memories.

Method. Sixty healthy volunteers recalled either positive or negative memories and scored the vividness and emotionality of the recollections. Next, memories were recalled whilst the participant was performing rapid eye movements, finger tapping, or not performing a dual task. Then participants were asked to recall the event again and to rate its vividness and emotionality.

Results. Compared to finger tapping and the no‐dual‐task condition, recollections after eye movements made future recollections less vivid. After eye movements, but not after the other interventions, negative memories became less negative, and positive memories became less positive.

Conclusion. The findings show that eye movements not only reduce vividness and emotionality of memories during the eye moving, but also affect future recollections, during which no eye movements are made. Some theoretical explanations are discussed. As to clinical implications, it is suggested that if there is a role for eye‐movement‐based treatments, it is very limited.
Moderators of trainee therapists' competence in cognitive therapy
Authors: James I. A. , Blackburn I.‐M. , Milne D. L. , Reichfelt F. K.
Published: February 2003

Objectives. A revised version of the Cognitive Therapy Scale (CTS‐R) was developed and used in an ecologically valid study designed to examine the acquisition of competence in cognitive therapy (CT). The relationship of therapist and patient variables to changes in competence was examined. Unlike most previous research, this study defines effectiveness of training in terms of therapist competence rather than patient outcome.

Design. A longitudinal design was employed within a naturalistic setting. Trainees' competence (the dependent variable) was sampled on three occasions during a training course.

Methods. Twenty screened out‐patients, who had been routinely referred to the Newcastle Cognitive Therapy Centre, were assigned to 20 postgraduate trainees receiving training in CT. Expert raters assessed trainees' competence at three points over the first 12 sessions of treatment using the CTS‐R. The relationship of therapist and patient variables to changes in competence was examined. The patient measures used were the Beck Depression Inventory (BDI) and the Suitability for Short‐Term Cognitive Therapy (SSCT).

Results. Three therapist factors were found to be related to competence: time (trainee therapists improving over the training period), previous experience with CT (those with most experience were most competent), and gender of the therapist (males improving at a greater rate than females). Therapist competence was also related to patients' suitability.

Conclusions. These findings suggest that previous CT experience is an advantage prior to attending an advanced training course, and also that careful patient selection helps trainees to demonstrate therapeutic competence.
Recall bias, pain, depression and cost in back pain patients
Authors: Pincus Tamar , Newman Stanton
Published: February 2003

Objectives. To investigate the relationship between recall bias for pain stimuli in chronic low back pain patients and the cost of managing their back pain in primary care.

Design. A retrospective cross‐sectional investigation.

Method. A sample of 63 low back pain patients were interviewed in a primary care setting. Information was gathered on their pain intensity, disability ratings, depression, anxiety, and duration of pain. They were also presented with a surprise recall test for pain descriptors. The cost of each patient's treatment specifically for back pain in the previous 12 months was calculated. The relationship between the cost of back pain treatment and the scores from the interview were calculated first for total cost, and then for the breakdown of individual cost items.

Results. Results indicated that recall bias for pain stimuli were significantly related to total cost (R2 = 8%). A detailed analysis revealed that pain intensity was related to the number of appointments with the general practitioners; depression scores related to the number of appointments with the in‐house osteopaths; and recall bias for pain stimuli related to referrals to external experts (out‐patients). A minority of patients high on recall bias was found to account for a disproportionate amount of the cost.

Conclusion. Although no causal path can be deduced from the findings, the study provides a novel approach to measuring psychological factors in back pain in reference to health care utilization. It is limited by its retrospective design, and should be followed by prospective studies to understand fully the relationship between cognitive bias and utilization of health services.
Processing of threat‐related affect is delayed in delusion‐prone individuals
Authors: Green M. J. , Williams L. M. , Davidson D. J.
Published: February 2003

Objectives. On the basis of previous reports of an attentional bias for threat‐related emotional material in deluded schizophrenics (e.g. Bentall & Kaney, 1989), the present study examined the proposal that a similar bias would be demonstrated by delusion‐prone individuals, reflected by longer response latencies for the task of processing threat‐related facially displayed affects (e.g. anger, fear).

Design. A non‐randomized matched group design was employed to examine the performance of delusion‐prone individuals in comparison with a control group.

Methods. 50 psychiatrically healthy participants completed the Peters et al. Delusions Inventory (PDI) as an index of delusional ideation (Peters, Day, & Garety, 1996; Peters, Joseph, & Garety, 1999). Subjects were presented with a standard set of facial stimuli depicting happy, sad, neutral, fearful and angry emotion expressions (Mazurski & Bond, 1993). Reaction times for the task of identifying each type of affect were compared between groups of high and low scorers on the PDI.

Results. Highly delusion‐prone individuals displayed a significant delay in processing angry facial expressions in comparison with low scorers on the PDI.

Conclusions. The increased response latency for processing angry expressions was interpreted as evidence of attentional bias for material posing a threat to the self, supporting previous cognitive data in relation to deluded patients. Threatening facial expressions may be regarded with increased significance by delusion‐prone individuals, and it is possible that this bias is involved in the formation of delusional beliefs.
Perception of negative emotions in close relatives by patients with schizophrenia
Authors: Scazufca Marcia , Kuipers Elisabeth , Menezes Paulo Rossi
Published: February 2003

Objectives. The perception of negative emotions in close relatives may play an important role in explaining how external stressors can affect vulnerable individuals with schizophrenia. However, there is considerable debate about the ability of people with schizophrenia to perceive emotions in others. The present study aimed to examine the reliability of patients' perception of relatives' criticism. Secondly, it aimed to investigate whether patients' judgement about relatives' criticism agreed with an independent assessment of relatives' criticism towards patients.

Method. Forty‐three patients with a DSM‐III‐R diagnosis of schizophrenia and their relatives were assessed soon after patients' admission to a psychiatric hospital and again 9 months after their discharge from hospital. Test‐retest reliability of patients' answers to a question about patients' perception of relatives' criticism towards them was carried out. The association between patients' perception of relatives' criticism and the expressed emotion (EE) measure of relatives' criticism was examined at inclusion and follow‐up. Patients' symptomatology was examined at both assessments.

Results. Reliability of the measurement of patients' perception of relatives' criticism was moderate to good. Patients' judgement of relatives' criticism towards them was associated with the number of critical comments and presence of hostility at inclusion. At follow‐up, this association became weaker.

Conclusion. The ability to judge and describe reliably negative emotions in close relationships may help to explain how perception of the external environment may act as a stressor in people who are vulnerable to schizophrenia.
Obesity‐related coping and distress and relationship to treatment preference
Authors: Rydén Anna , Karlsson Jan , Persson Lars‐Olof , Sjöström Lars , Taft Charles , Sullivan Marianne
Published: February 2003

Objectives. The primary purpose was to define obesity‐related strategies for coping with psychological problems connected with obesity. We also wanted to identify obesity‐related distress and explore the effect of coping on distress. Thirdly, we wanted to investigate differences in coping and distress related to choice of surgery or conventional treatment.

Design. Cross‐sectional data from patients in the Swedish Obese Subjects (SOS) intervention study.

Methods. An obesity‐related questionnaire concerning coping and distress was created and evaluated in 2510 patients from the SOS study, using multitrait, exploratory and confirmatory factor analysis procedures.

Results. Three coping factors were defined. Social Trust and Fighting Spirit were problem‐focused, whereas Wishful Thinking was emotion‐focused. Surgical candidates displayed lower levels of problem‐focused and higher levels of emotion‐focused coping. We also identified two distress factors: Intrusion and Helplessness. Wishful Thinking was positively related to distress, and Social Trust and Fighting Spirit were inversely related, thus explaining the higher levels of distress reported by the surgical candidates.

Conclusions. In our sample, emotion‐focused coping proved maladaptive and was associated with increased distress. Problem‐focused coping, however, was adaptive and associated with reduced distress. These findings partly explain psychological morbidity and should be taken into consideration in the treatment of obese people.
Compliance and outcome in treatment‐resistant anorexia and bulimia: A retrospective study
Authors: Towell Dawn Baker , Woodford Sally , Reid Steven , Rooney Barbara , Towell Anthony
Published: February 2003

Objectives. To investigate the extent to which compliance with treatment is related to outcome, and factors associated with compliance in a group of treatment‐resistant eating‐disordered in‐patients.

Design. A retrospective case study design was employed where clinic staff made expert ratings of eating behaviours, attitudes and outcome of former in‐patients.

Method. Ten health‐care staff at a specialist eating disorders clinic rated overall success of treatment outcome at discharge, as well as compliance, severity of disordered eating behaviours and body‐image disturbance at both admission and discharge for 46 anorexic and 14 bulimic patients.

Results. For all participants, high compliance at admission was associated with lower levels of body image disturbance, less disordered eating behaviours and higher ratings of overall treatment success at discharge. Compliance at admission predicted the body mass index (BMI) at discharge for anorexic participants and predicted higher ratings of overall treatment success at discharge for all participants. In all participants, compliance at admission was related to the extent of eating‐disordered behaviours at admission.

Conclusions. Results suggest the importance of compliance in facilitating recovery and treatment success among treatment‐resistant eating‐disordered in‐patients. The promotion of strategies to improve compliance in this population should be considered. A role for motivational interviewing is discussed.
Coping and psychological distress in children involved in road traffic accidents
Authors: Stallard P. , Velleman R. , Langsford J. , Baldwin S.
Published: February 2003

Objectives. The purpose of this study is to detail the natural coping strategies used by children involved in everyday road traffic accidents (RTAs). The relationship between coping strategies, post‐traumatic stress disorder (PTSD), gender and age was investigated.

Design. Children aged 7‐18 who attended an accident and emergency department following involvement in a RTA were assessed, 6 weeks after their accident (N = 97). A subgroup of 36 children were re‐assessed approximately 8 months after the trauma.

Methods. The presence of PTSD was determined via a semi‐structured interview incorporating the Clinician Administered Post‐traumatic Scale for Children (CAPS‐C). Self‐completed psychometric assessments were undertaken to assess the presence of clinically significant levels of depression (Birleson Depression Inventory), anxiety (Revised Manifest Anxiety Scale) and coping style (Kidcope).

Results. Children involved in RTAs used between 5 and 7 different coping strategies. Younger children and those with PTSD used more strategies than older children and those not suffering from PTSD. Children with PTSD were more likely to use the strategies of distraction, social withdrawal, emotional regulation and blaming others.

Conclusion. The limitations of Kidcope are discussed and the need to develop more complex ways of assessing childhood coping within a developmental framework highlighted.
Analysis of repertory grids in clinical practice
Authors: Leach Chris , Freshwater Kate , Aldridge Jan , Sunderland Joanne
Published: February 2003

Objective. This paper illustrates the use of several different forms of analysis of repertory grid data, using a case study of a client who completed repertory grids at various stages of therapy.

Method. Participants in a survivors' group completed grids before and after therapy and at 3‐ and 6‐month follow‐up. Grids from one of the participants, who had been sexually abused as a child, are presented using different levels of analysis: visual inspection of the raw grid; analysis of dissimilarities between pairs of elements or constructs; hierarchical cluster analysis of elements and constructs both separately and combined; principal components analysis; biplot representation of elements and constructs combined; multidimensional scaling analysis and unfolding analysis. The latter two methods also provide ways of presenting a combined analysis of a number of grids. Computer packages are reviewed, and SYSTAT commands are presented to perform the analyses.

Results. The review of methods illustrates how different levels of analysis can usefully back up clients' own accounts of progress through therapy, from detailed analysis of individual ratings in the raw grid, through analyses that pull out structural patterns at the expense of detail, to the broad sweep provided by methods that combine data from a number of grids.

Conclusions. Analysis of repertory grids completed at various stages of therapy can provide useful qualitative information on progress, but can also provide some simple quantitative measures (such as Self‐Ideal Self discrepancy as a measure of self esteem) to track progress. Different forms of analysis can be informative, highlighting different aspects of progress, but also allowing checks on adequacy and goodness‐of‐fit of particular analyses.
Interpretation of congruent and incongruent affective communications in paranoid schizophrenia
Authors: Davis Penelope J. , Stewart Katherine D.
Published: February 2003

Objective. It was hypothesized that people with paranoid schizophrenia would differ from depressed and normal participants in their interpretation of complex communications in which the affect conveyed verbally was either congruent or incongruent with the affect conveyed non‐verbally.

Design. A 3 (group) × 3 (positive, negative, neutral facial expression) × 3 (positive, negative, neutral verbal content) experimental design was used. There were eight participants per group, and the paranoid and depressed groups comprised inpatients in an acute psychiatric facility for either their first or second psychiatric episode.

Methods. Participants, tested individually, were asked to interpret the affect conveyed by the various communications presented.

Results. All participants interpreted most of the communications in a similar way. Paranoid schizophrenia patients, however, differed in their interpretation of communications in which negative feelings were expressed verbally. In contrast to both the normal and depressed groups, the paranoid schizophrenia group interpreted these communications as virtually devoid of any affect whatsoever.

Conclusions. Paranoid schizophrenia patients show an information‐processing bias in response to communications involving both congruent and incongruent negative verbal content. It is not obvious why the bias observed would be specific to negative verbal messages and not extend to negative non‐verbal messages. Replication and further study are required.
Social cognition and subclinical paranoid ideation
Authors: Martin James A. , Penn David L.
Published: February 2003

Objective. A number of cognitive biases have been identified relevant to persecutory thought (e.g. exaggerated self‐serving bias). Moreover, findings of increased depressed mood in conjunction with high levels of self‐esteem have contributed to theories of persecutory ideation (e.g. Bentall, Kinderman, Kaney, 1994). Using a nonclinical sample, the present study sought to expand upon previous research by examining the linear relationship between persecutory ideation and multiple clinical and social cognitive variables.

Design. A cross‐sectional design was used. Correlational and multiple regression analyses were conducted.

Method. One hundred and ninety‐three undergraduate students were administered a battery of questionnaires which assessed the following domains: Paranoid ideation, depression, social anxiety, self‐monitoring, attributional style and self‐esteem.

Results. Higher levels of paranoid ideation were significantly associated with greater depressed mood, social anxiety and avoidance, evaluation apprehension, self‐monitoring and lower self‐esteem. There were no significant associations between paranoid ideation and attributional biases.

Conclusions. These findings suggest that mood, anxiety and perceptions of the self are related to paranoid ideation in a nonclinical sample. These findings are tempered, however, by studying a nonclinical sample and the self‐report measures of paranoid ideation that might be assessing multiple aspects of paranoid thought (e.g. ideas of reference).
Effects of visuospatial tasks on desensitization to emotive memories
Authors: Kavanagh David J. , Freese Stefanie , Andrade Jackie , May Jon
Published: February 2003

Objective. Intrusive memories of extreme trauma can disrupt a stepwise approach to imaginal exposure. Concurrent tasks that load the visuospatial sketchpad (VSSP) of working memory reduce the vividness of recalled images. This study tested whether relief of distress from competing VSSP tasks during imaginal exposure is at the cost of impaired desensitization.

Design. This study examined repeated exposure to emotive memories using 18 unselected undergraduates and a within‐subjects design with three exposure conditions (Eye Movement, Visual Noise, Exposure Alone) in random, counterbalanced order.

Method. At baseline, participants recalled positive and negative experiences, and rated the vividness and emotiveness of each image. A different positive and negative recollection was then used for each condition. Vividness and emotiveness were rated after each of eight exposure trials. At a post‐exposure session 1 week later, participants rated each image without any concurrent task.

Results. Consistent with previous research, vividness and distress during imaging were lower during Eye Movements than in Exposure Alone, with passive visual interference giving intermediate results. A reduction in emotional responses from Baseline to Post was of similar size for the three conditions.

Conclusion. Visuospatial tasks may offer a temporary response aid for imaginal exposure without affecting desensitization.
Future‐directed thinking in eating disorders
Authors: Godley Joanne , Tchanturia Ketevan , MacLeod Andrew , Schmidt Uirike
Published: February 2003

Objective. The aim of the study was to examine future‐directed thinking in individuals with eating disorders, given the possible role of such cognitions in the maintenance of anorexia nervosa and bulimia nervosa.

Method. Twenty‐six anorexics, 18 bulimics and 34 female controls were interviewed using the “Future Thinking Task”, assessing quantitative and qualitative aspects of positive and negative anticipated events.

Results. Patients with anorexia nervosa had similar levels of positive future‐oriented cognitions and significantly more negative future‐oriented cognitions than controls. The most common positive themes in this group concerned the social/interpersonal and leisure/pleasure domains. The negative theme most commonly mentioned by anorexics was that of their own health, followed by the social/interpersonal domain, whereas controls were most preoccupied with achievement/failure and a broad range of other issues. Bulimics had significantly fewer positive future‐oriented cognitions and significantly more negative future‐oriented cognitions than controls, most commonly concerning the patient's own health.

Conclusion. In anorexia nervosa, anticipated positive future outcomes may to some extent help to maintain the disorder; however, these patients are also highly preoccupied with the possibility of negative future outcomes, i.e. a failure of recovery. Bulimia nervosa sufferers are relatively hopeless about their future. The clinical implications of these findings are discussed.
The effects of specific retrieval instruction on social problem‐solving in depression
Authors: Goddard Lorna , Dritschel Barbara , Burton Andrew
Published: February 2003

Objective. We examine the proposal that social problem‐solving in depression may be improved with the retrieval of specific autobiographical memories.

Design and methods. Social problem‐solving was assessed with the Means‐End Problem‐Solving task (MEPS; Platt & Spivack, 1975a). Depressed and non‐depressed participants were required either to retrieve a specific memory prior to generating a MEPS solution (primed condition) or to report on the memories retrieved during MEPS performance after giving their MEPS solution (non‐primed condition). Participants also judged whether the memories retrieved had been helpful or unhelpful for the process of solution generation.

Results. In both depressed and non‐depressed individuals, priming increased specific memory retrieval but did not improve MEPS performance. An interaction between depression and priming revealed that priming increased the retrieval of helpful memories in the depressed sample.

Conclusions. Specificity is not, in itself, a sufficient retrieval aim for successful social problem‐solving. However specific memory priming may be beneficial in depression because it facilitates the recognition of memories which are helpful for problem‐solving.
The Challenging Behaviour Scale (CBS): Development of a scale for staff caring for older people in residential and nursing homes
Authors: Moniz‐Cook Esme , Woods Robert , Gardiner Eric , Silver Miriam , Agar Sharon
Published: February 2003

Objective. A review of behavioural rating scales identified the need for a measure of resident behaviours that staff in care homes for older people find difficult to manage. A 25‐item, broad‐based rating scale, the Challenging Behaviour Scale (CBS), was developed to meet this need and its psychometric properties were examined.

Design. Cross‐sectional surveys.

Methods. Ratings of 484 residents, living in 16 homes across England, were used to examine four methods of collecting inter‐rater reliability data. Ratings of 382 residents living in 13 homes were used to evaluate criterion validity and to establish norms. Six further homes were used to explore qualitatively the validity of the suggested norms. Ratings of 98 residents living in four further homes were used to examine concurrent validity. The predictive validity of the CBS ‘challenge’ score was evaluated, using time‐sampled direct observation of challenging behaviour in 237 residents, living in 11 homes.

Results. The scale records staff reports of the incidence, frequency and ‘management difficulty’ of resident behaviour and it can also identify ‘challenging residents’ through a computed score. It has good internal consistency, good test‐retest reliability and adequate validity. Inter‐rater reliability is good when staff receive training or when staff groups of at least three, of mixed qualifications, complete the scale. Norms are suggested for prospective studies of the prevalence of challenging behaviour.

Conclusions. The CBS is quick to complete and may have potential for the evaluation of psychosocial interventions in care settings. It is, as far as we know, the first staff observational rating scale that is based on the reports of care staff, who constitute the backbone of residential care provision. Suggestions for improvements in criterion and content validity are outlined.
The revised version of the Screen for Child Anxiety Related Emotional Disorders (SCARED‐R): Treatment sensitivity in an early intervention trial for childhood anxiety disorders
Authors: Muris Peter , Mayer Birgit , Bartelds Emilie , Tierney Sandy , Bogie Nicole
Published: February 2003

Objective. The revised version of the Screen for Childhood Anxiety Related Emotional Disorders (SCARED‐R) is a recently developed self‐report questionnaire for measuring DSM‐IV defined anxiety disorder symptoms in children. The current study examined the treatment sensitivity of the SCARED‐R.

Methods. Thirty‐six children (aged 8‐13 years) who fulfilled the criteria for generalized anxiety disorder, separation anxiety disorder, and/or social phobia received either group or individual cognitive‐behavioural treatment. Children completed the SCARED‐R and a traditional measure of childhood anxiety, the State‐Trait Anxiety Inventory for Children (STAIC), at three points in time: (1) 6 months before treatment (i.e. baseline), (2) pre‐treatment, and (3) post‐treatment.

Results. Results showed that children's SCARED‐R and STAIC scores did not change from baseline to pre‐treatment, but significantly declined from pre‐treatment to post‐treatment. An additional finding of the present study was that group and individual CBT were equally effective in reducing children's anxiety symptoms.

Conclusions. It can be concluded that the SCARED‐R reliably taps treatment effects and thus should be regarded as a useful self‐report index of childhood anxiety in clinical and research settings. Furthermore, the data support the notion that CBT should be generally regarded as an efficacious intervention for anxiety disordered children.
The relevance of lowered personal control for patients who have stoma surgery to treat cancer
Authors: McVey Joanne , Madill Anna , Fielding Dorothy
Published: February 2003

Objective. The objective of this study was to explore the experience of patients who had stoma surgery to treat cancer in order to explicate why problems associated with stoma surgery are not decreasing despite technical improvements in stoma care.

Design. A longitudinal design was used in order to capture the process of preparing for surgery and dealing with its aftermath. Participants were interviewed using a semi‐structured protocol on three occasions; 1‐2 weeks before surgery (eight participants), 1‐2 weeks after surgery (seven participants), and 3 months after surgery (four participants).

Method. Transcripts were analysed guided by the procedures of grounded theory. This involved developing categories from the data and linking them together to form a conceptual understanding of our participants' experience.

Results. Lowered personal control was the most important concept to emerge from the analysis. We identified perceived causes of lowered control, its mitigating factors, the strategies used to manage this experience and the consequences of these processes.

Conclusions. We make three recommendations based on the conclusion that improvements could be implemented in the psychological aspects of stoma care and, in particular, the enabling of patient perceived self‐efficacy. First, improvements could be made in doctor‐patient communication with doctors becoming more aware of their psychological impact on patients. Second, specialist stoma care nurses could be trained to recognize patients with dysfunctional self‐efficacy beliefs and/or delayed adaptation. Finally, we identify a need for more prolonged practical emotional support for at least some stoma out‐patients.
Affective reactions to auditory hallucinations in psychotic, evangelical and control groups
Authors: Davies Martin F. , Griffin Murray , Vice Sue
Published: February 2003

Objective. Building on recent work on the similarities and differences in delusional ideation between psychotic and religious populations (Peters, Day, McKenna, & Orbach, 1999), the experiences of auditory hallucinations in psychotic, evangelical and control groups were examined in this study.

Method. The incidence and subjective experiences of hearing voices were assessed using questionnaire methods in psychotic out‐patients, evangelical Christians and controls (non‐psychotic, non‐evangelical).

Results. Incidence of auditory hallucinations differed significantly across the three groups with psychotics showing the highest levels and controls the lowest levels. The experiences of the evangelical group were significantly more positive than those of the control group, which in turn were significantly more positive than those of the psychotic group. The most recent experience of hearing voices was rated more positively than the first experience by the psychotic and religious groups but not by the control group. These findings were much stronger for affective reactions to the experiences than for perceptions of the voices.

Conclusion. These results provide only partial support for the findings of Peters et al. (1999) on differences in delusional ideation and possible reasons for this are discussed. The findings for religious and psychotic individuals are discussed further in terms of interpretational and coping mechanisms.
An investigation of models of illness in carers of schizophrenia patients using the Illness Perception Questionnaire
Authors: Barrowclough Christine , Lobban Fiona , Hatton Chris , Quinn Joanne
Published: February 2003

Objective. Although carers' reactions to schizophrenic illness in a close family member may have important implications for the patient and for themselves, little is known of factors that influence the way carers respond. In the area of physical health problems, people's models of their illness or illness representations have been found to be related to the ways they react and cope with their illness. This study examines the use of a modified form of the Illness Perception Questionnaire (IPQ) to investigate illness models in a sample of carers of schizophrenia patients.

Methods. Forty‐seven carers participated. The psychometric properties of the modified IPQ were examined, and a number of carer and patient outcomes were investigated in relation to carer scores on the illness identity, consequences, control‐cure and timeline subscales of the modified IPQ. These outcomes included measures of carer distress and burden, expressed emotion dimensions, and patient functioning.

Results. The modified IPQ was found to be a reliable measure of carers' perceptions of schizophrenia. Carer functioning, the patient‐carer relationship and patient illness characteristics were associated with different dimensions of illness perceptions.

Conclusions. The findings support the proposal that carer cognitive representations of the illness may have important implications for both carer and patient outcomes in schizophrenia.
The utility of dimensional and categorical approaches to understanding dissociation in the eating disorders
Authors: Waller Glenn , Ohanian Vartouhi , Meyer Caroline , Everill Joanne , Rouse Helen
Published: February 2003

Objective. The present study compared levels of dissociation across groups of eating‐disordered women, investigating the utility of dimensional and categorical measures of dissociation in understanding diagnoses and behaviours in the eating disorders.

Methods. The Dissociative Experiences Scale (DES‐II) was completed by 170 eating‐disordered women (drawn from out‐patient assessment clinics) and 203 nonclinical women. The clinical group also supplied information regarding eating behaviours and related features (alcohol abuse, reported history of sexual abuse). The DES‐II and a subset of its items (DES‐Taxon) were used as dimensional and categorical discriminators of the groups and of the presence/absence of specific features and symptoms.

Results. When treated as dimensional measures, the DES‐II and DES‐Taxon had similar levels of clinical utility (particularly discriminating the binge‐purge anorexics from the other clinical groups). However, the DES‐Taxon was a superior categorical measure, discriminating groups more clearly and predicting the presence of many symptoms and features much more powerfully.

Conclusion. The DES‐Taxon is a potentially valuable self‐report measure for indicating the level and presence of dissociative psychopathology in the eating disorders. As well as being convenient to administer and score, it has the clinical and research value of indicating those patients in whom treatment might need to include addressing pathological dissociation.
Prevention of anxiety symptoms in primary school children: Preliminary results from a universal school‐based trial
Authors: Barrett Paula , Turner Cynthia
Published: February 2003

Preliminary data are presented on the effectiveness of a universal school‐based intervention for the prevention of anxiety symptoms in primary school children. A sample of 489 children (aged 10‐12 years) were assigned to one of three intervention conditions: a psychologist‐led preventive intervention, a teacher‐led preventive intervention, or a usual care (standard curriculum) with monitoring condition. The intervention offered was the Friends for Children programme, a 12‐session cognitive‐behavioural intervention, originally based upon Kendall's (1994) Coping Cat programme. Participants in both intervention conditions reported fewer symptoms of anxiety at post‐intervention than participants in the usual care condition. These preliminary results suggest that universal programmes for childhood anxiety are promising intervention strategies that can be successfully delivered to a school‐based population and integrated into the classroom curriculum.
Predicting onset of depression: The Vulnerability to Depression Questionnaire
Authors: Moran Patricia M. , Bifulco Antonia , Ball Caroline , Campbell Caroline
Published: February 2003

Objective. The development of a self‐report questionnaire capable of assessing cognitive and interpersonal vulnerability factors for clinical depression is described. The Vulnerability to Depression Questionnaire (VDQ) was developed to provide a brief, economical alternative to the Self‐Evaluation and Social Support interview (SESS; O'Connor & Brown, 1984), assessing negative evaluation of self, negative interaction with partner or child and lack of a support figure.

Design. The VDQ was tested in a prospective study of community‐based women who were contacted on three occasions over the course of approximately 1 year, to: (i) compare the VDQ's capacity to categorize vulnerability compared with the SESS interview, and (ii) to test the VDQ's prediction of onset of clinical depression during the follow‐up.

Method. Selected nondepressed respondents completed the VDQ and were interviewed to determine their vulnerability using the SESS. They were reinterviewed on two further occasions during the follow‐up period, and the VDQ was also re‐administered at the time of first follow‐up. Onset of clinical depression during the follow‐up was assessed by interview at each contact.

Results. Comparison of VDQ and SESS interview classification of participants' vulnerability at first contact indicated that the questionnaire had good sensitivity and specificity. Test‐retest scores for the VDQ indicated satisfactory levels of reliability. VDQ scores also predicted onset of clinical depression in the follow‐up period.

Conclusions. Results suggest that the VDQ is an economical and effective means of screening large populations for the purposes of risk assessment, to aid future research into clinical depression and to facilitate the implementation of intervention strategies.
Normative data for the HADS from a large non‐clinical sample
Authors: Crawford J. R. , Henry J. D. , Crombie C. , Taylor E. P.
Published: February 2003

Objective. To provide normative data for the Hospital Anxiety Depression Scale (HADS).

Design. Repeated measures and correlational.

Methods. The HADS was administered to a non‐clinical sample, broadly representative of the general adult UK population (N = 1792) in terms of the distributions of age, gender and occupational status. Correlational analysis was used to determine the influence of demographic variables on HADS scores.

Results. Demographic variables had only very modest influences on HADS scores. The reliability of the HADS is acceptable; the Anxiety and Depression scales are moderately correlated (.53). Tables to convert raw scores to percentiles are presented for females and males.

Conclusions. The present normative data allow clinicians to assess the rarity of a given HADS score, and thus provide a useful supplement to existing cut‐off scores.
Self‐reported and actual physiological responses in social phobia
Authors: Edelmann Robert J. , Baker Sarah R.
Published: February 2003

Objectives. The aim of the current study was to compare physiological reactions and self‐reports of bodily sensations for social phobics, clinically anxious and non‐anxious controls across four tasks.

Design. A within‐group design was used in which each participant took part in four tasks. Two were designed to be demanding, either physically (riding an exercise bicycle) or mentally (mental arithmetic task), while two, a mental imagery task (personally relevant situation) and a social conversation, were designed specifically to be anxiety provoking.

Methods. Of the 54 participants, 18 were generalized social phobics, 18 were clinically anxious but not socially phobic (8 with panic disorder, 6 with generalized anxiety disorder and 4 simple phobics), and 18 were non‐anxious. Heart rate, skin conductance, and facial and neck temperatures were recorded continuously during four different tasks and rest periods with corresponding self‐report ratings of bodily sensations taken to reflect 13 sampling points.

Results. There were no group differences on any of the physiological measures during any of the four tasks. However, there were a number of between‐group differences with regard to ratings of bodily sensations. Both clinical groups had higher ratings of racing heart than the non‐anxious control group during the imagery task. In addition, social phobics had significantly higher ratings of racing heart during the social conversation in relation to both comparison groups. With regard to ratings of body heat, the anxious group had greater ratings than the non‐anxious controls during the imagery task. Finally with regard to ratings of sweaty hands, both clinical groups had higher ratings than the non‐anxious controls during the social conversation. All three groups were generally inaccurate in their ratings of bodily sensations.
Deductive and inductive reasoning in obsessive‐compulsive disorder
Authors: Pélissier Marie‐Claude , O'Connor Kieron P.
Published: February 2003

Objectives. This study tested the hypothesis that people with obsessive‐compulsive disorder (OCD) show an inductive reasoning style distinct from people with generalized anxiety disorder (GAD) and from participants in a non‐anxious (NA) control group.

Design. The experimental procedure consisted of administering a range of six deductive and inductive tasks and a probabilistic task in order to compare reasoning processes between groups.

Methods. Recruitment was in the Montreal area within a French‐speaking population. The participants were 12 people with OCD, 12 NA controls and 10 people with GAD. Participants completed a series of written and oral reasoning tasks including the Wason Selection Task, a Bayesian probability task and other inductive tasks, designed by the authors.

Results. There were no differences between groups in deductive reasoning. On an inductive ‘bridging task’, the participants with OCD always took longer than the NA control and GAD groups to infer a link between two statements and to elaborate on this possible link. The OCD group alone showed a significant decrease in their degree of conviction about an arbitrary statement after inductively generating reasons to support this statement. Differences in probabilistic reasoning replicated those of previous authors.

Conclusions. The results pinpoint the importance of examining inference processes in people with OCD in order to further refine the clinical applications of behavioural‐cognitive therapy for this disorder.
Predicting depressive symptoms with a new measure of shame: The Experience of Shame Scale
Authors: Andrews Bernice , Qian Mingyi , Valentine John D.
Published: February 2003

Objective. To investigate whether previous findings from interview studies of a prospective relationship between shame and psychopathology (e.g. Andrews, 1995) could be replicated using questionnaires.

Design. A total of 163 university students participated in a longitudinal questionnaire study.

Method. The Experience of Shame Scale (ESS), a questionnaire based on a previous interview measure, and an established shame scale (TOSCA), were considered in their relation to depressive symptoms assessed at two time points 11 weeks apart.

Results. Both scales made significant independent contributions to depressive symptoms at time 1. However, only the ESS predicted additional significant variance in time 2 symptoms when time 1 symptoms were controlled.

Conclusions. It was concluded that the reason for the differential performance of the two scales was that the ESS, like the shame interview, assesses specific areas of shame related to self and performance, whereas the TOSCA assesses general shame and may therefore be more prone to mood‐state effects.