bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive assessment of voices: Further developments in understanding the emotional impact of voices
Authors: Close Helen , Garety Philippa 
Published: July 2011

Objectives. This study examines cognitive behavioural assessments of auditory hallucinations (‘voices’) in people with psychoses. It aims to compare findings with previous work and validate the Assessment of Voices Schedule (Chadwick & Birchwood, 1994). Data were collected on appraisals of voices in relation to the self. It was hypothesized that self‐appraisals may be a further factor in understanding the emotional impact of voices.Design. A replication study where data were collected from a new sample of participants and compared with a previous independent sample.Method. Voices of 30 patients with a diagnosis of schizophrenia were assessed using a semi‐structured interview and questionnaires. Thought‐chaining was used to assess appraisals of the voice in relation to the self.Results. Compared to the previous study, current participants were significantly less likely to believe in the omnipotence of their voices, to view their voices as omniscient and to have a positive affective response to benevolent voices. Similar numbers in this study construed their voices as malevolent, but fewer participants in this sample had benevolent voices. There were no significant differences between samples in behavioural responses to voices or in the affective responses to malevolent voices. The Assessment of Voices Schedule was found to have generally good test—retest and inter‐rater reliability. Extremely negative self‐appraisals were common, as were negative affective responses to the voice experience and low selfesteem.Conclusion. The implications of these findings for both cognitive behavioural models and therapy are discussed.
An examination of the effects of gentle teaching on people with complex learning disabilities and challenging behaviour
Authors: Cullen Chris , Mappin Rachel 
Published: July 2011

Objectives. This study was conducted to investigate the efficacy of gentle teaching when compared with individual educational programming (IEP) for a group of people with complex learning disabilities and challenging behaviour.Design. An A—B design was used, in which gentle teaching was introduced as an addition to the IEP procedures already in place. Other designs, such as reversal, multiple baseline or group comparisons would have been impractical in this clinical setting.Methods. Thirteen students and seven staff were observed, using a hand‐held computer for direct observations, and video‐recordings for measures of interaction. Staff attitudes to gentle teaching and to the IEP system were also assessed. The intervention was systematic workshop‐based training in gentle teaching for all staff. Measures were taken pre‐intervention for 13 weeks and post‐intervention for 23 weeks. Approximately 45 hours of direct observational data and over 50 hours of video‐recording were analysed.Results. We found very few effects of gentle teaching. Wherever there were differences between gentle teaching and IEP these were in favour of gentle teaching, although they were generally relatively minor in terms of clinical (rather than statistical) significance. Inter‐rater reliabilities were generally poor, although the figures for those categories where there was a difference between gentle teaching and IEP were amongst the most respectable.Conclusions. Gentle teaching did not have a major impact on staff behaviour, and no discernible effect on student behaviour, but it did not lead to poorer interactions and may be a useful adjunct to more structured approaches such as individual educational programming.
Loss, humiliation and entrapment as appraisals of schizophrenic illness: A prospective study of depressed and non‐depressed patients
Authors: Rooke Oliver , Birchwood Max 
Published: July 2011

Objectives. Life‐events that precede the onset of unipolar depression usually involve an appraisal of loss; recent research has shown that where these events are also appraised as humiliating or involving entrapment and defeat (the absence of a way forward or failure to reaffirm an identity) they are especially potent in triggering depression. Depression in schizophrenia has not been studied from the cognitive or psychosocial perspectives, probably because of its confused nosological status. In a previous study we showed that patients' perceived loss of control and entrapment by psychotic illness (e.g. by recurring relapse) was strongly linked to depression.Design. In this study we follow up the original sample of 49 patients 2.5 years later to examine the hypotheses using more powerful prospective methodology. Two of the sample had died of natural causes and the remaining 47 agreed to be reinterviewed.Method. We used the same measures of patients' appraisal of their illness and symptoms in terms of the extent to which they perceive it as embodying loss, humiliation and entrapment.Results. It was found using multivariate analysis that perceived loss of autonomy and social role, particularly employment, were correlated with depression. The appraisal of entrapment in psychotic illness was found to have high cross‐sectional and prospective predictive value independent of illness, symptom and treatment variables and was shown to be influenced by certain aspects of psychiatric treatment, particularly compulsory detention.Conclusion. We propose that episodes of depression in schizophrenia are triggered by psychosis‐related events (relapse, compulsory admission, residual voices, loss of job, etc.) that signify the inability to overcome the loss of a cherished personal goal or social role and thereby to affirm an identity. Implications for psychological therapy are discussed.
Reasoning biases in delusion‐prone individuals
Authors: Linney Yvonne M. , Peters Emmanuelle R. , Ayton Peter 
Published: July 2011

Objectives. The objective was to test whether individuals high in delusional ideation exhibit a reasoning bias on tasks involving hypothesis testing and probability judgments. On the basis of previous findings (e.g. Garety, Hemsley & Wessely, 1991), it was predicted that individuals high in delusional ideation would exhibit a ‘jump‐to‐conclusions’ style of reasoning and would be less sensitive to the effects of random variation, in comparison to individuals low in delusional ideation.Design. A non‐randomized matched groups design was employed enabling the performance of the delusion prone individuals to be compared to that of a control group.Method. Forty individuals, selected from the normal population, were divided into groups high and low in delusional ideation, according to their scores on the Peters et al. Delusions Inventory (Peters, Day & Garety, 1996), and were compared on two tasks involving probability judgment and two tasks involving hypothesis testing.Results. Although no significant differences were found on tasks involving hypothesis testing and the aggregation of probabilistic information, it was found that individuals high in delusional ideation had a ‘jump‐to‐conclusions’ style of data gathering and were less sensitive to the effects of random variation, in comparison to individuals low in delusional ideation.Conclusions. In conclusion, although individuals high in delusional ideation were not found to have a general reasoning bias, some evidence of a more specific bias was found. It is thought that these aberrations may play some role in delusion formation in schizophrenia and paranoia.
A new performance‐curve method for the detection of simulated cognitive impairment
Authors: Wogar Mary A. , van den Broek M. D. , Bradshaw C. M. , Szabadi E. 
Published: July 2011

Objectives. To evaluate a new performance‐curve method for detecting simulated cognitive impairment.Design. The method was based on quantitative analysis of choice reaction times in a series of eight matching‐to‐sample tasks of graded complexity, in which participants were required to identify which of two comparison stimuli was identical to a simultaneously presented sample stimulus. The stimuli consisted of arrays of letters, the number of letters ranging from 1 to 10 in the eight tasks.Methods. Mean reaction times of a standardization group of 20 healthy young adults were used to construct regression equations to describe the behaviour of three test groups: 20 healthy individuals instructed to perform to the best of their ability (non‐simulators), 20 healthy individuals instructed to simulate cognitive impairment incurred as a result of a head injury (simulators), and 25 patients with a history of closed head injury (patients).Results. There was a linear relationship between individual participants' latencies and the mean latencies of the standardization sample; the patient group showed steeper slopes, and the simulators higher intercepts, than the non‐simulator group. A univariate measure of performance, based on the proportionate increase in latency corresponding to a standard increase in the standardization group's latency was able to identify 14/20 simulators while misclassifying 2/20 non‐simulators and 2/25 patients. Other measures, including the number of errors made in the choice reaction time task and in recognition memory tasks, and a performance‐curve measure based on Raven's Standard Progressive Matrices, were less successful in identifying simulators.Conclusions. This new performance‐curve method may prove to be a useful addition to tests currently used to diagnose simulated cognitive impairment in clinical and medicolegal settings.
Cognitive dissonance 2: A theoretical grounding of motivational interviewing
Authors: Draycott Simon , Dabbs Alan 
Published: July 2011

Purpose. The aim of this article is to demonstrate the utility of the concept of cognitive dissonance in clinical psychology by showing how it may underlie an existing intervention. The technique of motivational interviewing (MI) is taken as an example of an area where the literature on cognitive dissonance can find such an application. The further aim of this exercise is to utilize insights from cognitive dissonance to suggest possible modifications to the intervention as it currently stands.Method. A mapping is undertaken of principles of cognitive dissonance as found in Draycott & Dabbs (1998) onto the description of nature, principles and techniques of MI as set out by Miller & Rollnick (1991). Following this, areas where insights from cognitive dissonance are ignored or underutilized are drawn out and used to suggest modifications to MI.Results. The nature, principles and techniques of MI are, without exception, found to relate to one or more of the principles of cognitive dissonance. Criticisms and amendments to the technique of MI can be offered with the aim of making this mapping of cognitive dissonance more exact. Several practical suggestions can be made and a more structured approach offered.Conclusions. The concept of cognitive dissonance can clearly be seen to be of use in understanding the mechanism of action of MI. It can further be of use in guiding modifications to this existing intervention. This concept, and others available through the experimental psychological literature, can be of use in all branches of clinical psychology.
Learning disability care staffs emotional reactions to aggressive challenging behaviours: Development of a measurement tool
Authors: Mitchell Georgia , Hastings Richard P. 
Published: July 2011

Objectives. To describe the development of a rating scale measure of caregivers' emotional reactions to aggressive challenging behaviour, and to report preliminary psychometric data for the scale.Design. Using previous research on staff working with people with learning disabilities, a range of likely emotional reactions to challenging behaviours were selected for possible inclusion in a rating scale measure.Methods. A total of 83 care staff from 23 community residences for people with learning disabilities rated their recent emotional reactions to aggressive challenging behaviour using 18 emotion items. A further sample of 18 care staff participated in a test–retest study after the initial stages of scale development.Results. A rating scale was developed on the basis of a factor analysis and further item analysis. The measure has two subscales: feelings of depression/anger (10 items), and feelings of fear/anxiety (5 items). The subscales have a high internal consistency, good test–retest reliability and are relatively unaffected by social desirability biases.Conclusions. The emotional reactions to aggressive challenging behaviour scale has excellent face and construct validity, and other preliminary psychometric data are promising. The scale has a number of potential research and clinical applications.
Silence in psychiatric interviews
Authors: JARRETT F. J. 
Published: July 2011

The literature on silence in psychotherapy is somewhat diverse, and is confined almost entirely to its theoretical aspects. The following study presents a review of the subject, and considers some problems of management of silence in interview situations, with some suggestions for further investigations.For the purpose of this paper, silence has been defined in the following terms: ‘A period of time during a formal consultation between a therapist and a patient (or patients) when verbal communication ceases.’Implicit in this definition is the fact that both parties participate in the silence. It is convenient to consider their roles separately.
Adjustment and war bereavement–Some considerations
Authors: Purisman Ruth , Maoz Benjamin 
Published: July 2011

Forty‐seven parents from 25 families who had lost a son in the War of Attrition of 1969–1970 were interviewed in the course of this study. The interviews teok place 2–3 years after the bereavement.The purpose of the study was an assessment of personal adjustment of bereaved parents, and an examination of background and behavioural characteristics which might differentiate between parents making a better and less good adjustment to the loss of a son.To this end data were collected via semistructured interviews. Non‐objective variables: religiosity, social interpersonal relationships and adjustment were rated by independent judges. Reliability of interjudge agreement ranged from 0·67 to 1·00.Hypotheses were tested using correlation matrices. The hypothesis stating a positive relationship of high religiosity and good adjustment was not confirmed.The results suggest a very significant relationship between good adjustment and level of education (r = 0·668, α > 0·01). Level of education was responsible for most of the variance and thus made impossible an answer regarding the relationship between religiosity and recovery after bereavement.To elucidate religiosity's function in adjustment, control of education level would be necessary. While this was not done in the present study, a further research plan was suggested.The hypothesis stating a positive correlational relationship between adjustment and interpersonal skills as reflected in social contacts and marital relations was confirmed (r = 0·735, r = 0·573, α > 0·01).The findings of this study suggest that individuals who have suffered a severe stress, may gain strength, encouragement and compensation when their life style includes higher educational level and satisfying interactions with other people.
Self‐esteem and psychiatric syndromes
Authors: Foulds G. A. , Bedford A. 
Published: July 2011

The purposes of the study were (1) to dichotomize each of the personal illness classes into those expected and those not expected to retain a relatively high degree of anxiety‐depression; (2) to seek confirmation of this division by means of the combined DSSI sets of Anxiety and Depression; (3) to examine their respective scores on the Personality Deviance Scales; and (4) to examine the relationship between Anxiety‐Depression and intropunitiveness.It was found that within each of the four classes the predicted ‘affective’ group scored significantly higher on DSSI Anxiety‐Depression than did the ‘non‐affective’ group. On intropunitiveness, the ‘affective’ group scored significantly higher within three classes and almost so in the fourth.Although anxiety‐depression and intropunitiveness both discriminate between the ‘affective’ and ‘non‐affective’ groups their conceptual distinction is empirically based.
New developments in panic‐fear research in asthma: Validity and stability of the MMPI panic‐fear scale
Authors: Dirks Jerald F. , Kinsman Robert A. , Jones Nelson F. , Fross Kenneth H. 
Published: July 2011

An earlier study (Dirks et al. 1977) described the development of a 15‐item Minnesota Multiphasic Personality Inventory (MMPI) panic‐fear scale relating to the reported frequency of panic‐fear symptoms on the Asthma Symptom Checklist (ASC). High MMPI panic‐fear scale scores describe fearful, highly emotional individuals who profess to have their feelings hurt more easily than others, to feel helpless and to give up easily in the face of difficulty. High scoring asthmatic patients were prescribed more intensive steroid regimens at discharge from a residential treatment facility months after psychological testing (Dirks et al. 1977) and required longer periods of hospitalization while in residential treatment (Dirks et al. 1976). These relationships were not attributable to differences in longitudinal pulmonary function measures during hospitalization.Consistent with earlier findings, the MMPI panic‐fear scale was again shown to be significantly related to both ASC panic‐fear scores and to recommended discharge steroid regimens for an enlarged sample of patients. Additionally, MMPI panic‐fear scores were shown to be stable from admission to discharge despite two to four months of intervening medical treatment and to be independent both of age of asthma onset and longitudinal pulmonary function measures during treatment. These results suggest that the MMPI panic‐fear scale measures a personality dimension which should be regarded as a stable character trait, unaffected by severity or duration of asthma or by intervening medical treatment for asthma. As such, MMPI panic‐fear is not merely a product of the medical condition. Instead, it appears to be a consistent component of the patient's personality which influences medical intractability in asthma probably via associated behaviours, symptom reports, and attitudes during medical treatment. These considerations invite further inquiry.
Confrontation vs. belief modification in persistently deluded patients
Authors: Milton Frank , Patwa Vinod K. , Hafner R. Julian 
Published: July 2011

Psychiatric patients with persistent systematized delusions in the absence of major behavioural abnormalities have been traditionally regarded as largely inaccessible to verbal modes of treatment. This viewpoint is summarized in a standard textbook of psychiatry (Slater & Roth, 1969): ‘… it is a waste of time to argue with a paranoid patient about his delusions…’. Because of such views, and the related emphasis on a pharmacological approach, there is little to guide the clinician in his verbal dealings with patients in whom systematized delusions are the main feature.In contrast to the traditional view, Watts, Powell & Austin (1973) obtained significant changes in the delusional beliefs of three chronic paranoid schizophrenics after less than six hours of verbal intervention. Their procedure was designed to avoid direction confrontation, since they believed that this would induce ‘psychological reactance’ (Brehm, 1966) and might increase, rather than decrease, the strength of the delusions. They were unable to test this hypothesis.The present study aims to examine the effects of two contrasting types of verbal intervention in a larger sample of persistently deluded patients. It was predicted that (i) both interventions will reduce the strength of delusions and (ii) confrontation will produce less change in delusions and any associated behavioural abnormalities than belief modification.
On the validity of the Middlesex Hospital Questionnaire: A comparison of diagnostic self‐ratings in psychiatric out‐patients, general practice patients, and ‘normals’ based on the Hebrew version
Authors: Dasberg Haim , Shalif Ilan 
Published: July 2011

The short clinical diagnostic self‐rating scale for psycho‐neurotic patients (The Middlesex Hospital Questionnaire) was translated into everyday Hebrew and tested on 216 subjects for: (1) concurrent validity with clinical diagnoses; (2) discriminatory validity on a psychoneurotic gradient of psychiatric out‐patients, general practice patients, and normal controls; (3) validity of subscales and discrete items using matrices of Spearman rank correlation coefficients; (4) construct validity using Guttman's smallest space analysis based on coefficients of similarity.The Hebrew MHQ was found to retain its validity and to be easily applicable in waiting‐room situations. It is a useful method for generating and substantiating hypotheses on psychosomatic and psychosocial interrelationships. The MHQ seems to enable the expression of the ‘neurotic load’ of a general practice subpopulation as a centile on a scale, thereby corroborating previous epidemiological findings on the high prevalence of neurotic illness in general practice. There is reason to believe that the MHQ is a valid instrument for the analysis of symptom profiles of subjects involved in future drug trials.
On depersonalization in adolescence: A consideration from the viewpoints of habituation and ‘identity’
Authors: Meares Russell , Grose Dianne 
Published: July 2011

Depersonalization occurs in many psychiatric states but its origins are unknown. It is suggested that feelings of unreality may be unusually common in adolescents.Certain speculations are offered concerning the genesis of a sense of unreality. The neurophysiological mechanisms governing the perception of ‘familiar’ or ‘strange’ are seen to be the key to this experience. They involve the matching of events in the outer world against inner organizations of previous experience. These mechanisms are likely to be disturbed through epilepsy or other disorders of the temporal lobe, in which abnormal perceptions of strangeness and familiarity are frequently found. It is suggested that the matching process extends to include social situations, and that where an individual's identity is undeveloped or fragmented a sense of strangeness may result. The concept of identity is briefly discussed in order to distinguish it from ‘self’ and ‘ego’, and to intimate its possible fragmentation in adolescence. Finally, some reference is made to management and, in particular, to the use of the peer group.
The hysterical personality ‐ I. The healthy hysteric
Authors: Zisook S. , DeVaul R. A. 
Published: July 2011

This paper examines the meaning and validity of ‘hysterical personality disorders’. Theories and descriptions of hysterical personalities have been conflicting and often mutually incompatible, leading to a vague and imprecise nosology. No generally accepted specific inclusion criteria or follow‐up studies are available; consequently, the diagnosis of ‘hysterical personality disorder’ has reflected adaptive as well as maladaptive traits.This paper critically examines the healthy dimension of Lazare's continuum of personality pathologies exhibiting hysterical traits. The continuum, in an attempt to reconcile the inconsistencies of this diagnosis, ranges from the relatively healthy (good, genital, true) hysteric, to the sick (bad, oral, ‘so‐called good’) hysteric. But this paper concludes that here, too, evidence for diagnostic legitimacy is lacking. Women at the healthy end of the hysterical personality spectrum are best regarded as healthy and do not meet criteria for the diagnosis of a personality disorder.