bluuebunny/crossref_metadata_2025 huggingface dataset:
Responses to activation and rest in patients with panic disorder and major depression
Authors: Rief Winfried , Hermanutz Max
Published: July 2011

Physical activity may be a trigger for panic attacks in patients with panic disorder, while exercise may have an antidepressant effect in patients with major depression. In order to examine reactions to rest as well as to exercise periods, we assessed physiological responses (heart rate, blood pressure), subjective responses on a visual analogue scale, and attentional responses with the span of apprehension test. Twenty participants met the diagnostic criteria for panic disorder, 20 patients had major depression, and 20 participants served as controls. Patients with major depression showed slower reaction times than participants in the other groups; this difference was more pronounced with increased task difficulty. Physical activation led to lower depression scores in all groups. Patients with panic disorder had elevated anxiety scores after physical activation, but also after rest. Heart rate as well as systolic blood pressure showed the expected acceleration after physical activation, but there were no differences between the groups. Activation did not seem to influence attentional performance as measured by the span of apprehension test. Results are consistent with a cognitive view of panic disorder. In contrast to patients with panic disorder, patients with major depression seem to have an attentional deficit which is more pronounced with more complex cognitive processing.
Hypomania, anxiety and the emotional Stroop
Authors: French Christopher C. , Richards Anne , Scholfield Emma J. C.
Published: July 2011

Bentall & Thompson (1990) selected participants on the basis of high, medium and low scores on the Hypomanic Personality Scale. In an emotional Stroop test, the high hypomanic participants showed interference of colour naming for depression‐related but not euphoria‐related words. The current study tests the hypothesis that the effects found were mediated by anxiety, and not hypomania as claimed. Bentall & Thompson's study was repeated but measures of state and trait anxiety were also taken. When analysis was restricted to three subgroups selected in the same manner as in Bentall & Thompson's (1990) study, the findings were very similar to those found in that study and the hypomania‐related interference effects were found to occur even when anxiety levels were taken into account. Further analyses of data from the full sample of participants supported the idea that hypomanic personality might reflect a partially successful means of coping with depressive tendencies.
The neuropsychology of obsessive—compulsive disorder: A review and consideration of clinical implications
Authors: Tallis Frank
Published: July 2011

Clinicians have suspected that obsessive compulsive disorder (OCD) is associated with fundamental information‐processing deficits beyond those attributable to mood disturbance alone. Neuropsychological investigations can be divided into four broad areas concerned with general intellectual functioning, an ‘under‐inclusive’ thinking style, performance on tests sensitive to frontal lobe impairment and performance on tests of memory. This body of research is critically reviewed. It is suggested that there is modest evidence for the presence of non‐verbal and praxic memory deficits in patients with OCD. These deficits are consistent with contemporary theories of fronto‐striatal functioning and may represent the cognitive substrate of doubt‐related phenomena such as checking. The demonstration of specific memory impairments in OCD may have significant implications for the revision of existing models of OCD and the development of novel treatment strategies that reduce doubt in compulsive checkers by increasing the distinctiveness of past actions.
Coping in family supporters of elderly people with dementia
Authors: McKee Kevin J. , Whittick Janice E. , Ballinger Brian B. , Gilhooly Mary M. L. , Gordon David S. , Mutch William J. , Philp Ian
Published: July 2011

Research into supporters of elderly people with dementia has a brief but significant history. Initially, research sought to establish the nature and extent of the distress that supporters endured in the fulfilment of their caring role. More recently, researchers have turned their attention towards the identification of coping techniques used by supporters in the community.

The Dundee Study of Supporters and Dementia is concerned with factors associated with the maintenance and care of the demented elderly in the community, and with the impact of dementia on family supporters. A total of 228 family supporters of community‐resident elderly (50 per cent of elders with dementia, 50 per cent without) were interviewed. Part of the interview focused on self‐reported coping, and identified coping strategies using open‐ended questions and a revised, 31‐item Ways of Coping checklist.

Findings indicated that the majority of supporters of community‐resident elderly relatives reported coping well. Supporters predominantly used emotion‐focused coping strategies as their main way of coping. However, those supporters who reported using a problem‐focused strategy were found to score better on measures of coping than those supporters using an emotion‐focused strategy. The supporters' main coping strategy was not associated with characteristics of the elder‐supporter dyad. Factors derived from the Ways of Coping checklist produced a pattern of associations with characteristics of the elder‐supporter dyad, but the same factors were largely not associated with other measures of coping.

The implications of the findings are discussed with regard to coping research, and for interventions to improve the well‐being of supporters of an elderly relative with dementia in the community.
An evaluation of the Cambridge Contextual Reading Test (CCRT) in Alzheimer's disease
Authors: Conway S. C. , O'Carroll R. E.
Published: July 2011

Thirty patients with a diagnosis of probable Alzheimer's disease were assessed using the traditional National Adult Reading Test (NART) and also by placing the NART stimulus words in context (meaningful sentences) ‐ the Cambridge Contextual Reading Test (CCRT) condition. Placing the stimulus words in sentences acted to significantly reduce overall pronunciation error rates. This beneficial effect was most marked for more severely cognitively impaired patients. NART performance was significantly correlated with Mini‐Mental State total score; however, CCRT performance was not. Placing the stimulus words in context acted to improve the performance of more cognitively impaired Alzheimer patients and thus provides a more valid estimate of premorbid ability compared with the standard presentation of NART stimulus words in isolation.
Schizotypal traits and dimensions of religiosity
Authors: Diduca Deborah , Joseph Stephen
Published: July 2011

In the present study the association between religiosity and schizotypal traits was investigated. Two hundred and one respondents completed self‐report measures of schizotypal traits as well as measures of religiosity developed, on the basis of theoretical work on the nature of delusional thinking, to tap the dimensions of preoccupation, guidance, conviction, and emotional involvement. For women, no associations were found between scores on the religiosity and schizotypy scales. For men, however, higher scores on religious preoccupation were associated with higher scores on magical ideation. It would seem that religiosity is not clearly associated with schizotypal traits.
The value of the Rivermead Behavioural Memory Test (Children's Version) in an epidemiological study of older adults with Down syndrome
Authors: Hon Johnny , Huppert Felicia A. , Holland Anthony J. , Watson Peter
Published: July 2011

The Rivermead Behavioural Memory Test for Children (RBMT‐C) was used to assess a population‐based sample of 74 people with Down syndrome (DS) aged 30 years and over (range 30–65 years) living in the Cambridge health district. Given the high age‐specific risk of Alzheimer‐like neuropathology in people with DS, the aim of this study was to determine whether this test provided a suitable measure of memory function in an older population of adults with DS who were at the age of risk for Alzheimer's disease. We also investigated whether there was a significant difference in everyday memory performance between different age, gender and day‐centre groups. The level of learning disability in our sample ranged from mild, through severe to profound. Individuals with severe or profound learning disability were virtually untestable on this and other cognitive tests, but for the remaining two‐thirds of the group, the RBMT‐C could be used to assess memory function. Significant differences in memory function were found between younger (30–44 years) and older (45 + years) participants. Performance also varied between groups (e.g. from different day centres), illustrating the importance of population‐based samples when determining the value of such tests. Ongoing longitudinal studies are required to establish the extent to which the RBMT‐C is useful in assessing change in retrospective and prospective memory.
Development of the Cambridge Contextual Reading Test for improving the estimation of premorbid verbal intelligence in older persons with dementia
Authors: Beardsall Lynn
Published: July 2011

Objectives. The Cambridge Contextual Reading Test (CCRT), which sets the NART words within semantic and syntactic context, has been shown to yield a higher prediction of premorbid intelligence than the National Adult Reading Test (NART) for patients with mild/moderate dementia (Beardsall & Huppert, 1994). This study validates and standardizes the CCRT in a sample of healthy older persons.

Design. The CCRT was validated against WAIS‐R verbal IQ (VIQ) and the Mill Hill Vocabulary Test (MHVT). Regression equations were used to compare predictions of WAIS‐R VIQ from CCRT and demographic variables. A conversion table was constructed for predicted VIQ from the equation derived from CCRT scores.

Methods. Seventy‐three healthy British older persons aged over 70 years completed the CCRT, NART, WAIS‐R verbal subtests and MHVT.

Results. The benefit of context was greatest for those with lowest word reading ability. The CCRT was satisfactorily correlated with VIQ and the MHVT. Whereas the regression equation predicting VIQ using CCRT alone accounted for 61 per cent of the variance, 68 per cent was accounted for when demographic variables were included.

Conclusions. The CCRT is a valid measure of verbal ability for older persons. When accurate information about years of full‐time education is available, prediction of verbal intelligence should be made combining CCRT with demographic variables. Otherwise, prediction should be made using CCRT alone. The CCRT may be used in preference to NART in neuropsychological batteries with older persons provided caution is exercised when language difficulties are indicated.
Depressed and non‐depressed mothers with problematic preschoolers: Attributions for child behaviours
Authors: White Caroline , Barrowclough Christine
Published: July 2011

Objectives. This study examines the spontaneous causal attributions made by mothers about their preschool children's problem behaviour and investigates the relationship between causal attributions and maternal depression.

Design. Two groups of mothers were compared, a depressed and a non‐depressed group, while all women included identified their preschool child as having some problem behaviours. There were 25 women in each group.

Methods. The spontaneous attributions of mothers were assessed from audiotaped interviews using an adaptation of the Leeds Attributional Coding System for the extraction and analysis of attributional statements.

Results. Depressed mothers made more spontaneous causal attributions about their children's problem behaviour than did the non‐depressed group; and the depressed group perceived these causes as being more stable, more controllable and more personal to the child than their non‐depressed counterparts. There was also evidence that depressed mothers made more internal attributions about themselves as the cause of their children's problem behaviour than non‐depressed mothers. The study indicates that the personal‐to‐child dimension is the attributional variable most strongly associated with depression.

Conclusions. This study provides evidence that depressed mothers have attributional biases when compared to non‐depressed mothers. The authors suggest that their attributions may mediate coping responses and hence may influence parenting behaviour. The clinical and research implications of the findings are discussed.
Loss: A central theme in psychotherapy
Authors: Wolff Heinz H.
Published: July 2011

As an essential aim of psychotherapy is to change in order to develop and grow the patient has to give up some mal‐adaptive patterns of behaviour and out‐of‐date values and belief systems. The inevitable losses involved in this process are discussed in detail. The losses the patient has to face when entering therapy are considered first, followed by consideration of the losses he encounters when during therapy he has to change his attitudes towards himself and others, including the giving up of infantile wishes and illusions and of value systems originally imposed upon him from outside sources. The losses and disappointments he experiences in the therapeutic relationship itself are discussed, and attention is focused on the way in which what is at first experienced as a loss can become the starting point of new developments and lead to a more positive acceptance of his psychic and physical functioning. To achieve these aims the therapist himself needs to learn to adopt a similar, positive attitude towards the losses and limitations involved in his own life experience and therapeutic work.
Homosexuality in adolescence
Authors: Glasser Mervin
Published: July 2011

This paper asserts that homosexuality in adolescence should not be regarded in the same way as it would be in adults. Different types of homosexuality emerge during adolescence according to the different psychodynamic conditions which occur at different stages of adolescence, particularly the changing relationship to the individual's parents, and these may subside or make an important contribution to the establishment and nature of an individual's homosexuality in adulthood.

The characteristic ‘identificatory facility’ of adolescence is discussed and it is suggested that this is retained in the make‐up of the adult homosexual. Some comments on the clinical assessment of homosexuality in adolescence are briefly made.
Communication behaviours of undergraduate medical students before and after training
Authors: Omololu C. B.
Published: July 2011

There is an increasing concern in developing methods to teach communication behaviours to undergraduate medical students. A literature review revealed that there is no research on specific programmes. We hypothesized that undergraduate medical students had poor communication behaviours and would improve with specific training. To test that hypothesis 23 medical students at the University of Lagos went through a training programme in communication behaviours. There was a significant improvement in communication behaviours after training.
How can we compare different psychotherapies? Why are they all effective?
Authors: Ryle Anthony
Published: July 2011

The relationship between different schools of psychotherapy can be defined by locating them in terms of a more general, cognitive, theory. They differ in respect (a) of the level in the patient's hierarchy of schemata that is considered and addressed, (b) of the stages in the procedural sequence organizing aim‐directed action at which treatment is aimed, (c) as to whether or not attention is paid to structural and defensive aspects of cognitive organization, and (d) according to where intervention is aimed in terms of the cycle of cognitive reorganization. The equivalent effectiveness of different methods is explained as being the result of the patient's capacity to integrate differently located treatment‐induced changes into similar revisions of his system. Some implications of this view are indicated.
Planned brief psychotherapy in clinical practice
Authors: Keller Anthea
Published: July 2011

A workshop was set up at the Tavistock Clinic to study the application in other clinical settings of techniques of brief psychotherapy developed there. Five people from mixed professional backgrounds met for three years and treated patients, unselected for brief therapy, utilizing these techniques. Of the 15 patients who embarked on treatment, 13 completed it, and 12 of these were followed up for periods ranging from three months to two and a half years. Forms were developed by the workshop to chart the clinical progress of therapy, and to evaluate data on the patient, the psychodynamic focus and treatment process. These data were compared with outcome, rated behaviourally and psychodynamically.

At non‐significant levels, results indicated that outcome was better for those patients who experienced high levels of distress subjectively but who functioned well externally, those who had a supportive relationship outside therapy and those for whom a psychodynamic focus could be formulated and worked with. Unrelated to outcome were: the extent of early deprivation, severity of damage to object‐relations capacities, time of onset and all of the practical aspects of therapy. Clinical illustrations are given and three exceptions to the trend of results are discussed. In general, the findings corroborate Malan's (1976) work. The claim is made that these results justify further exploration of the technique's applicability in NHS out‐patient psychotherapy clinics.
Genital herpes: The psychological consequences
Authors: Drob Sanford , Loemer Mathias , Lifshutz Harold
Published: July 2011

This study investigated the psychological consequences of genital herpes among 42 men and women. The impact of the disease was assessed relative to five life‐areas: sexual functioning, interpersonal relationships, emotional responses, self‐concept, and work or school performance. The impact of genital herpes can be best understood when placed in the context of (1) the ethical issues raised by the disease, (2) the individual sufferer's personal development, psychodynamics and self‐concept, and (3) the meaning which genital herpes has come to have in society. It was found that for some individuals this illness produces psychological reactions of sufficient severity to warrant psychotherapeutic intervention.
Lightning‐strike disaster among children
Authors: Dollinger Stephen J.
Published: July 2011

Thirty‐eight children playing or observing a soccer game were the victims of a lightning strike which killed one other child. Interviews with the children and their families documented a number of emotional effects of this disaster, chiefly situational adjustment reactions. The most common reactions involved anxiety, particularly at times of storms. However, the most severely upset children exhibited sleep disturbances, separation anxiety, and nocturnal enuresis. One of two side‐flash victims experienced depression for several months; the other experienced no significant emotional upset. Both suffered medical complications and had no memory for the incident. While all children reached at follow‐up were doing quite well, those who were most upset by the incident were more likely to refuse to play soccer during the follow‐up interval. Stories told to pictures of lightning revealed projections of the children's emotional upset, various defensive reactions to the incident and an increased sense of subjective probability for lightning injuries.
Childhood bereavement circumstances associated with adult depression
Authors: Parker Gordon , Manicavasagar Vijaya
Published: July 2011

Seventy‐nine women whose mothers had died during the subjects' childhood and whose fathers had remarried were studied to determine how bereavement might dispose to depression in adulthood. Lower social class appeared the most consistent predictor. The sudden death of the mother, the older age of the child, the perception of family support as being deficient in the immediate post‐bereavement phase, a longer delay between the mother's death and the stepmother's assuming a maternal role, and the judgement of any replacement mother‐figure as being inadequate were associated with adult depression. An important negative finding was that depression in the bereavement phase was neither predictive of a subsequent episode of depression nor of higher levels of state and trait depression in adulthood.
Arriving, Settling‐in, Settling‐down, Leaving and Following‐up: Stages of stay at the Arbours Centre*
Authors: Berke Joseph H.
Published: July 2011

The Arbours Centre is a small psychodynamically oriented therapeutic community which accommodates three live‐in psychotherapists and up to five ‘guests’ at any one time. This paper describes the ‘stages of stay’ which guests and therapists pass through during the course of an intervention at the Centre, and discusses their interactions during each of these periods.
Rhetoric as remedy: Some philosophical antecedents of psychotherapeutic ethics
Authors: Spillane Robert
Published: July 2011

Earliest forms of psychotherapy were based on noble rhetoric and a model of the human encounter regulated by values of virtue and courage (responsible autonomy). In this paper the relationship between noble and base rhetoric and values is considered and applied to the psychotherapeutic setting. Bühler's and Popper's hierarchy of language and values is extended so that the language of expression, communication, description, advice, argument, and promises may be related to noble and base values which, it is argued, therapists and clients invoke to define and condition the therapeutic relationship. An ethical hierarchy of language and values, based on the principle of responsible autonomy, is suggested for psychotherapeutic practice.
Construction and constriction in agoraphobia*
Authors: Winter David , Gournay Kevin
Published: July 2011

A formulation of agoraphobia is presented in personal construct theory terms. It is hypothesized that the construing of agoraphobics and their spouses is characterized by low cognitive awareness of constructs concerning interpersonal conflict and lack of tenderness; by dilemmas in which the ability to go out implies possible infidelity; and by low self‐esteem in the agoraphobic and high self‐esteem in their spouse. Evidence in support of these hypotheses is provided by a repertory grid study comparing agoraphobics, non‐agoraphobic neurotics, spouses of both client groups, and normal subjects. Features of construing of agoraphobic and spouse are shown to be predictive of the agoraphobic's response to behaviour therapy, and therapeutic improvement to be associated with some reconstruction in the above areas. The role of mutual validation of constructions between agoraphobic and spouse in the maintenance of agoraphobic behaviour is discussed, as are implications for the treatment of agoraphobia.
Physical and psychosocial functioning in multiple sclerosis: Descriptions, correlations, and a tentative typology
Authors: Zeldow Peter B. , Pavlou Marcia
Published: July 2011

Multiple sclerosis (MS) is a disease of great variety and ambiguity. Its outcome is both multidimensional and uncertain. As part of an ongoing effort to describe and differentiate the various courses that MS can follow, 81 out‐patients diagnosed with MS completed the California Psychological Inventory (CPI) and the Sickness Impact Profile (SIP) administered as a structured interview. Descriptive statistics for the SIP and the CPI are provided and examined as a function of age and sex. Correlations between health status and personality scales are reported. Increasing physical dysfunction is associated with lowered performance on a broad array of psychosocial dimensions but only among women. A cluster analysis of CPI factor scores is described and a very tentative typology of persons with MS is offered for further investigation.
Nailbiting and oral aggression in a Turkish student population
Authors: Gilleard Esen , Eskin Mehmet , Savaşir Buĝda
Published: July 2011

The study investigated the relationship between the occurrence and intensity of nailbiting in a Turkish student population and the association with questionnaire measures of oral aggression, trait anxiety and intropunitive and extrapunitive hostility. The results indicated that the most consistent trait associated with nailbiting was oral aggression. Taken together with other previous research these findings are thought to offer some support to the construct of oral personality.
Does contact with the mentally ill affect nurses; attitudes to mental illness?
Authors: Weller Leonard , Grunes Shoshana
Published: July 2011

This study examines the effects of contact on nurses' attitudes towards psychiatric patients. Three groups of nurses with differing degrees of contact answered the Attitude towards Mental Illness (AMI) questionnaire. No differences were found among the three groups. Practical nurses, nurses with less experience and religious nurses held more positive attitudes
Aspects of the relationship between cognitive theories and therapies of depression
Authors: Bradley Veronica A. , Power Roger
Published: July 2011

Cognitive theories of depression are examined with respect to the relationship between cognition and affect, the assumption that cognitions are accessible and open to modification, and the adequacy of cognitive accounts of the onset and maintenance of depression. The role of social and familial factors in maintaining depression and the extent to which negative cognitions may be based on accurate perceptions of the social milieu are considered. The relationship between cognitive therapy for depression and cognitive theories of depression is noted.
Type A behaviour pattern: Specific coronary risk factor or general disease‐prone condition?*
Authors: Rim Bernard , Ucros Claudia G. , Bestgen Yves , Jeanjean Michel
Published: July 2011

While the association between Type A behaviour pattern and coronary heart disease (CHD) has been abundantly investigated, the question of the specificity of this association remains virtually unexplored. The present study addressed this question by examining, in a sample of 1949 male and female adults, the relationship between JAS Type A measurement and self‐reported diseases (i.e. CHD, scarlatina, rheumatoid arthritis, asthma, diseases of the liver, diseases of the gall‐bladder, thyroid troubles, tuberculosis, peptic ulcer, renal disease, hypertension and diabetes). Type A subjects were found to report not only more CHD, but also more peptic ulcers, thyroid problems, asthma and rheumatoid arthritis. Globally, more Type A than Type B subjects reported having been ill, and the average number of reported diseases per person was higher among Type As than among Type Bs. These results were obtained in spite of the fact that Type A subjects in this study were markedly younger than Type Bs, and in spite of the empirically based reputation of the former to be symptom deniers rather than symptom reporters. Overall, the data supported the view that Type A behaviour pattern is a general disease‐prone condition rather than merely a specific coronary risk factor.
Body image in rheumatoid arthritis: The relevance of hand appearance to desire for surgery
Authors: Vamos Marina
Published: July 2011

To investigate the importance of body image concerns relating to hand appearance in rheumatoid arthritis, a questionnaire was devised and administered to 80 female out‐patients. Subjective judgements of hand attractiveness, feelings about hands, and behaviours relating to hand adornment and concealment were sought. Objective ratings of hand attractiveness were obtained from photographs taken at this time of the women's hands. Factor analysis indicated four principal orthogonal factors describe these body image items. Evaluative and affective elements were found to be independent of each other. The hypothesis that body image, thus rated, is relevant to desire for reparative hand surgery was tested using a two‐stage general linear modelling procedure. Body image concerns, particularly negative feelings about hands, emerged as significant predictors of desire for surgery, and remained significant after the removal of variance accounted for by duration of arthritis, age, grip strength and objectively rated hand attractiveness. It is suggested that in rheumatoid arthritis, self‐perception of hands and the associated emotional response, may be a covert agenda in women's decision to have surgery, and need specific clinical consideration.
Generality vs. specificity of attitudes towards people with disabilities
Authors: Gething Lindsay
Published: July 2011

This study explored the generality vs. specificity of attitudes as measured by the Interaction with Disabled Persons Scale. This scale is a new measure devised to measure discomfort in social interaction posited to be experienced by people with low levels of prior contact with people with disabilities. Twelve parallel versions of the IDP Scale were administered to a sample of 481 respondents. Eleven versions specified a different disabling condition in the preamble to the scale, whilst one version was based on the general concept of disability. Analyses of variance indicated that type of disability did not significantly influence responding, whereas a significant main effect emerged for level of prior contact. These findings are interpreted as providing support for the rationale of the IDP Scale and for the operation of generalized attitudes towards people with disabilities. Further analysis using t tests revealed six significant differences between parallel forms for diabetes, AIDS, drug dependence and other disabilities. These results were interpreted as reflecting high public awareness of these conditions and the likelihood that they fall outside the public definition of disability.
Fear of death and strategies for coping with patient death among medical trainees
Authors: Firth‐Cozens Jenny , Field David
Published: July 2011

This paper describes a longitudinal study of fear of death following up fourth‐year medical students in their junior house officer year. It confirms previous findings that the fear of death is and remains multidimensional, with fear of being dead having the lowest score on both occasions and fear of someone close dying being consistently the highest. Fear of death reduces on each dimension over time, though not significantly. An analysis of descriptions of strategies used by students to cope with patient death showed that passive acceptance through rationalizing was the most commonly used, especially by men, followed by supporting the patient emotionally or clinically, which was used especially by women. The highest fear and stress scores were associated with avoidance, dismissal and seeking advice, while the lowest were shown by those who rationalized the event. The paper goes on to describe the relationship of fear of death to various individual differences including empathy, gender, parental death, parental anxiety, and stress.
Increased substance use in survivors of the Herald of Free Enterprise disaster
Authors: Joseph Stephen , Yule William , Williams Ruth , Hodgkinson Peter
Published: July 2011

Cross‐sectional data are reported on 73 survivors of the Herald of Free Enterprise disaster. Many reported an increase in their consumption of alcohol, cigarettes, sleeping tablets, antidepressants and tranquillizers at six and 30 months. The level of increased use was, however, lower at 30 months than at six months, although this was less evident for alcohol and cigarettes than the other substances. In addition, self‐reports of increased substance use are associated with higher levels of psychological distress as measured by the General Health Questionnaire and the Impact of Events Scale. It is suggested that substance use might help to maintain subsequent psychological distress.
The integrative effect of reformulation: Cognitive analytic therapy with a patient with borderline personality disorder
Authors: Ryle Anthony , Beard Hilary
Published: July 2011

The impact of 26 sessions of Cognitive Analytic Therapy on a patient with a borderline personality disorder is presented, largely through the patient's account given at a follow‐up assessment interview. It is suggested that the account raises questions of practical and theoretical interest.
Post‐traumatic stress disorder ‘once removed’: A case report
Authors: Bledin Kenneth
Published: July 2011

This paper describes the successful treatment of an unusual case of post‐traumatic stress disorder (PTSD). The case was unusual in that the patient, a 38‐year‐old woman, had neither experienced nor witnessed the traumatic event, but seemed to have experienced PTSD ‘once removed’ from the incident (the murder of her colleague). The four treatment sessions focused on traumatic events in the patient's childhood which had produced no identified symptoms, but which had become intertwined with the adult trauma to provoke the PTSD syndrome.
On psychoanalysis and non‐linear dynamics: The paradigm of bifurcation
Authors: Priel Beatrice , Schreiber Gabriel
Published: July 2011

Some of Freud's main theoretical conceptualizations drew on metaphors from 19th century physics. However, though the physics of Freud's era was based on deterministic Newtonian mechanics and equilibrium thermodynamics, his descriptions of the dynamics of instincts, therapeutic change, and even transference, were far beyond this model. Freud's dynamic description of psychic development evokes contemporary theories of irreversible, far‐from‐equilibrium thermodynamics and non‐linear dynamics. The present paper focuses on bifurcation theory, which offers a paradigm for the investigation of unpredictable but deterministic phenomena; this paradigm sheds a retroactive light on the classical psychoanalytical conceptualizations of complemental series, repetition compulsion, transference and cure.
Therapist contributions to psychotherapeutic assimilation: An alternative to the drug metaphor
Authors: Stiles William B. , Shapiro David A. , Harper Heather , Morrison Leslie A.
Published: July 2011

A psychotherapist's verbal interventions may be understood as promoting a client's eventual improvement by facilitating developmental change processes within the client. This approach is an alternative to the traditional search for statistical links between aggregates of therapist interventions and global outcome measures. Our approach employs models of clients' assimilation of problematic experiences within problem domains and therapists' implementation of theoretically specified aims. In an empirical illustration, one client's change within a particular problem domain and its links with therapist interventions were assessed qualitatively across the course of brief psychodynamic‐interpersonal treatment.
Psychopathology and personal agency: Modernity, culture change and eating disorders in South Asian societies
Authors: Littlewood Roland
Published: July 2011

The cultural contribution to psychopathology may become more salient in situations of social change, but it remains difficult to distinguish individual agency among wider social and economic transitions, such as ‘modernization’ or simply ‘culture change’, which carry the potential for recourse to new patterns. Eating disorders, a biosocial pattern once identified exclusively with European societies, do occur among South Asian women including those living in the West. This seems not just a simple appropriation of contemporary Western ideals of female morphology — the ‘fear of fatness’ — but a reassertion of an instrumental strategy of self‐renunciation in situations of experienced constraint.
A case study of female genital self‐mutilation in schizophrenia
Authors: Krasucki Chris , Kemp Roisin , David Anthony
Published: July 2011

A case of deliberate genital self‐mutilation in a woman with familial schizophrenia is presented. Such behaviour, though well recognized in females with severe personality disorders, is extremely rare in female psychotics. The genital mutilation may be partially understood as a consequence of delusionally motivated action against a background of low self‐esteem, premorbid body‐image preoccupation, forced early sexual activity and hence profound ambivalence towards adult sexuality. Dealing with this constructively was hampered by a cognitive style characterized by impaired reasoning and reality testing. Tests of reasoning, judgement and reality testing showed deficits, and computed tomography revealed dilatation of the left frontal ventricular system. Both neuropsychological and psychodynamic factors appeared to be of relevance in this case.
Life‐events and psychiatric symptoms in a general psychiatry clinic: The role of intrusion and avoidance
Authors: Spurrell M. T. , McFarlane A. C.
Published: July 2011

Recent literature has been concerned with the relationship between life‐events and psychological symptoms, and more particularly studies of communities subsequent to disasters have suggested the presence of intrusive cognitions to be a mediating variable. In this investigation new patients presenting to a general community psychiatric clinic over a four‐month period completed a brief life‐event scale, the Impact of Event Scale (IES) and the 28‐item General Health Questionnaire (GHQ). Appropriate statistical methods were employed to model the intervening role of IES scores between numbers of life‐events and subsequent psychiatric symptomatology. Data was collected on 48 subjects, for whom it was shown that IES score accounted for the reporting of psychiatric symptoms following adversity. It appeared to be the dimension of cognitive intrusion that mediated this effect, with cognitive avoidance occupying a subsidiary, reactive role. There was also evidence of specific relationships between intrusion and anxiety and somatic subscales of the GHQ, and between avoidance and depression. Despite small numbers and simple measures, the findings supported the post‐disaster studies, and raises further questions about the emotional processing of adversity.
The role of coping strategies in protecting individuals against long‐term tranquillizer use
Authors: Bish Alison , Golombok Susan , Hallstrom Cosmo , Fawcett Sue
Published: July 2011

This research examined the influences of social circumstances, coping and level and length of drug intake on dependence and withdrawal from benzodiazepine use. A sample of long‐term benzodiazepine users were followed up over a period of six months. At first interview the participants' drug intake and anxiety and depression levels were established and the Life Events and Difficulties Schedule (LEDS) was administered. At follow up these measures were repeated and individuals' coping strategies for dealing with dependence were also assessed. By the time of the follow‐up interview slightly more than half of the participants (57 per cent) had either withdrawn completely from benzodiazepine medication or had reduced their daily dose. Analyses showed that reduction was unrelated to factors associated with the drugs themselves, to the severity of life‐events and difficulties, to lessening of difficulties or to the occurrence of positive life‐events. Significant associations, however, were found between participants' coping responses in relation to long‐term benzodiazepine use and the individuals' reduction or cessation of benzodiazepine use in the six month study period. The study showed that in the absence of positive life‐events and in spite of ongoing difficulties actively confronting the problems of benzodiazepine use can have a positive effect on outcome. The findings suggest that interventions which encourage cognitive, behavioural and affective aspects of coping are those which would appear to be most likely to succeed.
Dementia: An intimate death
Authors: Garner Jane
Published: July 2011

This paper focuses on the loss of intimacy and mutuality in the relationship when one partner has Alzheimer's disease and suggests that the paradigm of anticipatory grief described in terminal care work may need to be reconsidered in relation to organic brain disease. An attempt is made to link some of the psychoanalytic literature of grief and the experience of clinicians in old age psychiatry working with patients and their relatives. Mention is made of implications for management. The paper includes illustrative clinical material.
Imagery and concreteness in the reading of blind and sighted children
Authors: Pring Linda
Published: July 2011

Two experiments were carried out to investigate the role of auditory and visual imagery in word recognition processes of blind and sighted children. In Expt 1 children made lexical decisions to high auditory imagery and low auditory imagery words matched for concreteness. In contrast to results found by Paivio & Okovita (1971) in paired‐associate learning, neither the blind nor the sighted benefited from auditory imagery in word recognition. In a second experiment the blind children, who cannot use visual imagery, were significantly faster in recognizing concrete relative to abstract words matched for word frequency. This result was also found for the sighted children. It is argued that this may suggest that the lexicon is structured in terms of concreteness and that visual imagery need not play a necessary role in word recognition processes.
Preschool children's understanding of causal connections
Authors: Bullock Merry
Published: July 2011

Preschool‐aged children's understanding of causal mechanism was assessed by showing them a simple event sequence in which two objects moved in tandem. The central question was whether children would infer the presence of a mechanism linking the two objects whose movement covaried. This was tested by assessing five responses: actions when asked to move one object, explanations for how the object moved, predictions as to whether both objects would still move without a connection, inferences about the nature and location of the connection, and surprise when the objects moved without any apparent connection.

The results from 3‐, 4‐ and 5‐year‐olds indicated that an understanding of mechanism is firmly established by 5 years but fragile at 3 years and only revealed by some response modes. The implications of the results concerning how to characterize and test for early competence are discussed.
Ratings of temperament in families of young twins
Authors: Stevenson Jim , Fielding Jane
Published: July 2011

We studied a sample of 576 pairs of twins in three age groups (0–2, 2–5, 5+ years), and obtained for each family a set of temperament ratings which provided isomorphic dimensions for parents and children (EASI Temperament Survey). Both parents were asked to rate independently themselves, their spouse and each of the twin children. The results confirm the findings of Lyon & Plomin (1981) that parental projection does not take place in the rating of each other. Only the mothers' rating of Emotionality shows any indications of projection in the rating of children, and parental agreement on children's temperament shows modest levels of reliability (r = 0·53). There is no evidence of assortative mating for temperament characteristics. The intra‐class correlations for monozygotic and dizygotic twins are consistent with Emotionality and Sociability being under some genetic control only in girls, Activity shows increasing genetic influences with age in both boys and girls, and Impulsivity indicates a lower level of genetically determined variance at all ages in both sexes. We concluded that, in common with recent studies on environment associations with temperament, the origin of individual differences needs to be studied separately in boys and girls. A more general case is made for the utility of twin studies that include data on other family members.
Children's and adults' cognitive maps of very large unfamiliar environments
Authors: Herman James F. , Blomquist Susan L. , Klein Christine A.
Published: July 2011

Groups of 8‐, 11‐ and 19‐year‐olds were tested in two unfamiliar environments. The street system consisted of straight‐line routes that generally ran at right angles to one another in the ‘grid’ environment, but not in the ‘curved’ environment. In Expt 1, subjects rode in an automobile through the environments three times, and made bearing and distance estimates to target locations after each trip. The results showed that performance was equivalent across the types of environments (i.e. grid vs. curved), and that only 8‐year‐olds were unable to integrate target information. There was an increase in accuracy over successive trials at each age level on the bearing measure, and Expt 2 suggested that this increase was due to repeated environmental trips rather than to successive recall of target locations. These results indicate that young children cannot readily integrate spatial information in a very large, unfamiliar environment. However, their accuracy does improve as they become increasingly familiar with the environment.
Narrative story telling in autism and Down's syndrome
Authors: Loveland Katherine A. , McEvoy Robin E. , Tunali Belgin , Kelley Michelle L.
Published: July 2011

The present study investigated the ability of high functioning verbal children and adolescents with autism or Down's syndrome to tell a story to a listener. Sixteen subjects with autism and 16 with Down's syndrome (DS), matched on verbal mental age, watched a short puppet show or video sketch and were then asked to tell the story to a listener and answer follow‐up questions. The majority of both groups were able to produce recognizable, though primitive, narratives. The groups did not differ in general story characteristics and both groups exhibited errors in language use. Subjects with autism had a greater tendency to produce bizarre language and adopt an ‘externalized’ point of view in which the puppets/actors were seen as objects rather than characters. Also, DS subjects produced significantly more communicative gestures. Although the groups were about equally able to supply information for follow‐up questions, autistic subjects produced a higher proportion of bizarre responses. Results indicate that the story recall ability of autistic subjects resembles that of language‐matched, mentally retarded persons. However, some autistic subjects appeared to have difficulty grasping the story as a representation of meaningful events. Results are discussed in relation to the autistic person's awareness of listeners' needs and aspects of the social environment.
Tactile stimulation as a component of social interchange: New interpretations for the still‐face effect
Authors: Stack Dale M. , Muir Darwin W.
Published: July 2011

Three experiments were conducted to isolate the effect of touch as a component of mother‐infant interaction in the still‐face (SF) paradigm and to determine the impact of adult touch on infant affect and attention. In Expt 1 it was established that the amount of maternal touching which occurred during the normal periods of the SF procedure was greater than 65 per cent for 3‐, 6‐, and 9‐month‐olds. In Expts 2 (cross‐sectional) and 3 (longitudinal), the SF no‐touch period was compared with a SF period where mothers could touch their 3‐ to 9‐month‐olds. Infants who received touch while their mothers were still‐faced smiled more, grimaced less, and were more content relative to infants receiving the standard SF, no‐touch procedure. Adult touch proved to be an interactive component which, in isolation, reduced the SF effect by eliciting infants' positive affect and directing their attention toward the mothers' hands. The relevance of this work for better comprehension of early infant social interaction and new interpretations of the SF effect are discussed.