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Showing papers in "British Journal of Clinical Psychology in 1999"


Journal ArticleDOI
TL;DR: A set of evolving guidelines for reviewing qualitative research to serve four functions: to contribute to the process of legitimizing qualitative research; to ensure more appropriate and valid scientific reviews of qualitative manuscripts, theses, and dissertations; to encourage better quality control in qualitative research through better self- and other-monitoring; and to encourage further developments in approach and method.
Abstract: We present a set of evolving guidelines for reviewing qualitative research, to serve four functions: to contribute to the process of legitimizing qualitative research; to ensure more appropriate and valid scientific reviews of qualitative manuscripts, theses, and dissertations; to encourage better quality control in qualitative research through better self- and other-monitoring; and to encourage further developments in approach and method. Building on a review of existing principles of good practice in qualitative research, we used an iterative process of revision and feedback from colleagues who engage in qualitative research, resulting in a set of seven guidelines common to both qualitative and quantitative research and seven guidelines especially pertinent to qualitative investigations in psychology and related social sciences. The Evolving Guidelines are subject to continuing revision and should not be used in a rigid manner, in order to avoid stifling creativity in this rapidly evolving, rich research tradition.

2,758 citations


Journal ArticleDOI
TL;DR: A multi-factorial model of delusion formation and maintenance incorporating a data-gathering bias and attributional style, together with other factors (e.g. perceptual processing, meta-representation) is consistent with the current evidence.
Abstract: Purpose. To review critically the evidence for three contemporary theories of delusions. Methods. The theoretical approaches to delusions proposed by Frith and colleagues (‘theory of mind’ deficits), Garety and colleagues (multi-factorial, but involving probabilistic reasoning biases) and Bentall and colleagues (attributional style and self-discrepancies) are summarised. The findings of empirical papers directly relevant to these proposals are critically reviewed. These papers were identified by computerised literature searches (for the years 1987-1997) and a hand search. Results. The evidence does not unequivocally support any of the approaches as proposed. However, strong evidence is found to support modifications of Garety and colleagues and Bentall and colleagues theories. Studies have replicated a ‘jumping to conclusions’ data-gathering bias and an externalising attributional bias in people with delusions. There is preliminary evidence for a ‘theory of mind’ deficit, as proposed by Frith, although possibly related to a more general reasoning bias. Evidence for an underlying discrepancy between ideal and actual self-representations is weaker. Conclusions. A multi-factorial model of delusion formation and maintenance incorporating a data-gathering bias and attributional style, together with other factors (e.g. perceptual processing, meta-representation) is consistent with the current evidence. It is recommended that these findings be incorporated into cognitive therapy approaches. However, there are limitations to existing research. Future studies should incorporate longitudinal designs and first episode studies, and should not neglect the co-morbidity of delusions, including affective processes, or the multi-dimensional nature of delusions.

793 citations


Journal ArticleDOI
TL;DR: The results are consistent with the hypothesis that coping strategies and responses to intrusive memories that prevent emotional processing of the distressing event maintain PTSD and support Ehlers & Steil's (1995) hypotheses about the role of negative interpretations of post-traumatic intrusions in PTSD.
Abstract: Objectives. To examine the relationship of coping strategies and responses to intrusive memories with post-traumatic stress disorder (PTSD) and other psychiatric symptoms in ambulance service workers. Method. Fifty-six ambulance service workers described the most distressing aspects of their work and completed questionnaires designed to measure their coping strategies in dealing with distressing incidents. They also described their intrusive memories of particularly distressing incidents and completed a questionnaire designed to measure their interpretation of these intrusions and their responses to them. In addition, they completed the Post-traumatic Stress Symptom Scale (PSS; Foa, Riggs, Dancu & Rothbaum, 1993) and the General Health Questionnaire (GHQ; Goldberg & Hiller, 1979). Results. Of the participants, 21 met DSM-III-R criteria for PTSD, and 22 met GHQ screening criteria for psychiatric symptoms. Wishful thinking and mental disengagement when confronted with critical incidents at work, negative interpretations of intrusive memories, and maladaptive responses to these memories (rumination, suppression and dissociation) correlated with PTSD severity. Conclusion. The results are consistent with the hypothesis that coping strategies and responses to intrusive memories that prevent emotional processing of the distressing event maintain PTSD. They also support Ehlers & Steil's (1995) hypotheses about the role of negative interpretations of post-traumatic intrusions in PTSD. A substantial subgroup of emergency service personnel may need support in processing distressing incidents at work and may benefit from information that normalizes post-traumatic symptoms such as intrusions.

585 citations


Journal ArticleDOI
TL;DR: The study confirmed not only that GAD patients show a bias in selective attention to threat, relative to controls, but also that this bias operates for naturalistic, non-verbal stimuli.
Abstract: Objectives. Recent cognitive theories propose that attentional biases cause or maintain anxiety disorders. This study had several aims: (i) to investigate such biases in generalized anxiety disorder (GAD) using naturalistic, ecologically valid stimuli, namely, emotional facial expressions; (ii) to test the emotionality hypothesis by examining biases for happy as well as threat faces; and (iii) to assess the time course of the attentional bias. Design. The dependent variable was an index of attentional bias derived from manual RTs to probe stimuli. There were four independent variables : one between subjects variable of group (2: GAD, control), and three within-subjects variables: Type of emotional face (2: threat, happy), Stimulus duration (2: 500 ms, 1250 ms) and Half of task (2: first, second). Method. Attentional bias was assessed with a dot probe task. The stimuli comprised photographs of threatening, happy and neutral faces, presented using two exposure durations: 500 ms and 1250 ms. Results. Anxious patients showed greater vigilance for threatening faces relative to neutral faces, compared with normal controls. This effect did not significantly vary as a function of stimulus duration. Anxious patients also showed enhanced vigilance for happy faces, but this was only significant in the second half of the task. Conclusions. The study confirmed not only that GAD patients show a bias in selective attention to threat, relative to controls, but also that this bias operates for naturalistic, non-verbal stimuli. As the attentional biases for threat and happy faces appeared to develop over a different time frame, different underlying mechanisms may be responsible.

439 citations


Journal ArticleDOI
TL;DR: These findings provide further support for the notion of a continuum between normality and psychosis and for the necessity to consider the multidimensionality of delusional beliefs.
Abstract: Objectives. Previous research into schizotypy has shown that certain groups of people have similar experiences to the positive symptoms of schizophrenia but remain functioning members of society, such as those with profound religious experiences (Jackson & Fulford, 1997). Method. The focus of the present study was to explore the incidence of delusional ideation in New Religious Movements (NRMs). Hare Krishnas and Druids were compared to two control groups (non-religious and Christian), and to deluded, psychotic in-patients on two delusions measures. Results. As predicted, individuals from the NRMs scored significantly higher than the control groups on all the delusional measures apart from levels of distress. They did not show as much florid symptomatology as the psychotic patients, but could not be differentiated from the deluded group on the number of delusional items endorsed on the Peters et al. Delusions Inventory (PDI; Peters, Day & Garety, 1996), or on levels of conviction. However, they were significantly less distressed and preoccupied by their experiences. No differences were found between the two control groups on any of the delusional measures, suggesting that religious beliefs per se do not account for the NRMs members scores. Discussion. These findings provide further support for, first, the notion of a continuum between normality and psychosis and, second, for the necessity to consider the multidimensionality of delusional beliefs.

245 citations


Journal ArticleDOI
TL;DR: The current findings suggest that disorganized memory structure may be one process that impedes access to, and modification of, trauma-related cognitive schema.
Abstract: Objective. Previous research has indicated that cohesive organization of traumatic memories may be necessary for the processing and resolution of post-trauma symptoms. The present study aimed to evaluate the qualitative features of memory organization, dissociation and perception of threat in traumatic memories recalled by individuals with and without acute stress disorder (ASD). Design. Survivors of motor vehicle accidents (MVA) with either ASD or no ASD participated in a study on traumatic memories within 12 twelve days of the MVA. Method. Participants audiotaped recollections of their memories of the MVA were coded in terms of disorganized structure, dissociative content and perception of threat. Result. The recollections of ASD participants were characterized by disorganization and dissociation more than those of non-ASD participants. Conclusion. The current findings suggest that disorganized memory structure may be one process that impedes access to, and modification of, trauma-related cognitive schema.

137 citations


Journal ArticleDOI
TL;DR: The illness representations paradigm has value in understanding psychosocial adjustment to epilepsy, and offers the potential to identify the critical factors in patients' adaptation to illness.
Abstract: Objectives. To determine the relative contributions of neuroepilepsy, coping and illness representation variables to psychological adjustment in epilepsy. Design. The study was a cross-sectional design, contrasting the adjustment of recently diagnosed and chronic patients. Neuroepilepsy, illness representation, coping and adjustment variables were all measured. Method. A total of 94 patients were studied comprising three groups: recently diagnosed patients, chronic patients cared for in hospital clinics, and chronic patients cared for by their GP. A measure was developed to assess each patient's illness representations of epilepsy. Results. Overall, the epilepsy patients showed significant adjustment problems relative to a normative group. There were, however, significant differences between epilepsy subgroups: recently diagnosed and chronic (clinic) patients exhibited problems, but chronic (GP) patients were relatively well adjusted. After controlling for the effects of group membership and neuroepilepsy variables, coping and illness representations, each explained significant additional variance on measures of psychological adjustment. Patients presenting with adjustment difficulties were characterized by high seizure frequency, avoidance rather than problem-focused coping, doubt about their diagnostic label and belief in poor containment. Conclusions. We conclude that the illness representations paradigm has value in understanding psychosocial adjustment to epilepsy. This approach offers the potential to identify the critical factors in patients adaptation to illness. Such insights into the coping process may contribute to the development of effective clinical interventions.

121 citations


Journal ArticleDOI
TL;DR: The results of the two studies indicate that the concept of thought-shape fusion is coherent, unifactorial and measurable and is associated with eating disturbance and elicits negative emotional and behavioural responses.
Abstract: Objectives. The primary objective of this study was to describe and investigate a cognitive distortion associated with eating psychopathology. This distortion, termed ‘thought-shape fusion’, is said to occur when merely thinking about eating a forbidden food increases the person's estimate of their shape or weight, elicits a perception of moral wrongdoing and makes the person feel fat. Design. Two studies were conducted. The first was a psychometric study and the second utilized a within-participants experimental design. Methods. In Study 1, thought-shape fusion was assessed in a sample of 119 undergraduate students using a questionnaire. In Study 2, 30 students with high thought-shape fusion scores participated in an experiment designed to elicit the distortion. Results. Thought-shape fusion was found to be significantly associated with measures of eating disorder psychopathology. The questionnaire used to measure thought-shape fusion had high internal consistency, a good factor structure accounting for 46.2% of the variance and predictive validity. The results from Study 2 indicated that the distortion can be elicited under experimental conditions, produces negative emotional reactions and prompts the urge to engage in corrective behaviour (e.g. neutralizing / checking). This corrective behaviour promptly reduces the negative reactions. Conclusion. The results of the two studies indicate that the concept of thought-shape fusion is coherent, unifactorial and measurable. It is associated with eating disturbance and elicits negative emotional and behavioural responses.

118 citations


Journal ArticleDOI
TL;DR: In the sample as a whole, agentic and communal behaviours were associated with pleasant affect, but highly self-critical participants experienced relatively less pleasant affect when they acted communally or agentically.
Abstract: Evolutionary accounts of vulnerability to depression have focussed either on the attachment system (Bowlby, 1980) or the social rank system (Gilbert, 1992; Price, 1972). According to a two-factor evolutionary model, depression-prone dependent and self-critical individuals suffer from insecurities regarding both attachment and social rank, but they differ in their strategies for dealing with those insecurities. Event-contingent recording was used to assess agentic (dominant-submissive) and communal (agreeable-quarrelsome) interpersonal behaviour as well as affect in 119 employed adults over 20 days. Participants also completed questionnaire measures of agency and communion. Self-criticism predicted low levels of agency and low levels of communion. In the sample as a whole, agentic and communal behaviours were associated with pleasant affect, but highly self-critical participants experienced relatively less pleasant affect when they acted communally or agentically. Individuals with high levels of immature dependency (neediness) were low in agency, whereas those with high levels of mature dependency (connectedness) were high in communion. Implications for evolutionary theories of vulnerability to depression were discussed, and interpersonal processes that may contribute to vulnerability were identified.

109 citations


Journal ArticleDOI
TL;DR: Evidence suggests that the CET intervention facilitated a significant improvement, in psychological adjustment to spinal cord injury, and may be understood in terms of changes in participants' appraisal of the implications of spinal Cord injury and of the coping skills needed to continue living meaningful and satisfying lives.
Abstract: Objectives. To develop and evaluate a brief group-based psychological intervention for improving psychological adjustment and enhancing adaptive coping following spinal cord injury. The Coping Effectiveness Training (CET) programme is grounded on the cognitive theory of stress and coping of Lazarus & Folkman (1984), and represents an original adaptation of the theory to the needs of this client group. Design. A controlled trial comparing patients receiving the CET intervention to matched controls in measures of psychological adjustment and coping was used. Methods. Nineteen intervention group participants and 19 matched controls were selected from in-patients at a hospital-based spinal injury rehabilitation centre. Outcome measures of depression, anxiety and coping were collected before, immediately after and six weeks after the intervention. Results. Intervention group participants showed significantly greater reductions in levels of depression (p<.01) and anxiety (p<.05) compared to matched controls immediately after the intervention and at six weeks follow-up. There was no evidence of a significantly greater change in the coping strategies used by the intervention group. Participants highlighted their interactions with other group members as the most helpful aspect of the intervention. Conclusions. This evidence suggests that the CET intervention facilitated a significant improvement in psychological adjustment to spinal cord injury. It is proposed this may be understood in terms of changes in participants appraisal of the implications of spinal cord injury and of the coping skills needed to continue living meaningful and satisfying lives.

104 citations


Journal ArticleDOI
Mike Startup1
TL;DR: In this article, the authors investigated the degree of correlation between measures and the extent to which the covariation can be explained by questionnaire items with similar content and experiences of childhood sexual and physical abuse.
Abstract: Objectives. The traits and experiences that are seen as de®ning the schizophrenic and the dissociative disorders have been found to be present in continuously variable, non-pathological formsin the general population.Althoughthe theoretical accounts that have been oaered for the two kinds of disorder diaer radically, there are reasons to expect that the measures that have been developed to assess schizotypal traits and dissociative experiences will be correlated. The aims of this study were to investigate the degree of correlation between measures and the extent to which the covariation can be explained by questionnaire items with similar content and experiences of childhood sexual and physical abuse. Design. Cross-sectional data from self-report measures completed by 224 participants were subjected to multivariate analyses. Method. The Dissociative Experiences Scale (DES), three subscales from the Oxford±Liverpool Inventory of Feelings and Experiences (O-LIFE) and two items assessing childhood abuse were mailed to all adult members of a volunteer participant panel. Results. Moderately large correlations were found between the DES and both the Cognitive Disorganization and the Unusual Experiences subscales of the O-LIFE. These correlations were hardly aaected when items with overlapping content were excluded. Hierarchical multiple regression analyses showed that the measures of abuse accounted for small but signi®cant proportions of the variance in both the DES and the Unusual Experiences subscale, but large proportions of the covariation between the measures of dissociative experiences and schizotypy remained unexplained. Conclusion. The substantial correlations between measures point to limitations in the discriminant validity of the DES and two of the O-LIFE subscales. Three possible explanations are oaered for the observed associations between dissociative experiences and schizotypal traits.

Journal ArticleDOI
TL;DR: Cross-validation data confirmed that a similar combination of measures to that found in the original study best predicted persisting PCS but that the strength of prediction diminished for the longer term prediction (i.e. 6 months post-injury).
Abstract: Objectives. King (1996) reported that a combination of emotional, organic and neuropsychological measures taken at 7-10 days following mild and moderate head injury may significantly help predict patients most likely to suffer persisting postconcussion symptoms (PCS) at three months post-injury. This study investigated a cross-validation sample (N= 57) to determine whether the results would be replicated for the early prediction of longer-term sufferers (i.e. those with persisting symptoms at 6 months post-injury). Design. Multiple regression analyses were used in which scores on the Hospital Anxiety and Depression Scale, Impact of Event Scale, Short Orientation Memory and Concentration Test, Rivermead Post-Concussion Symptoms Questionnaire and Post-Traumatic Amnesia taken at 7-10 days post-injury were the independent measures. Scoring on the Rivermead Post-Concussion Symptoms Questionnaire taken at 6 months post-injury was the dependent measure. Methods. Sixty-six consecutive patients admitted to any trauma ward in Oxfordshire with a mild or moderate head injury were recruited from a largescale randomized controlled sample. The assessment measures were administered at 7-10 days post-injury and the Rivermead Post-Concussion Symptoms Questionnaire at 6 months post-injury. Nine patients were unable to be followed up, leaving an active sample of 57. Results. The cross-validation data confirmed that a similar combination of measures to that found in the original study best predicted persisting PCS but that the strength of prediction diminished for the longer term prediction (i.e. 6 months post-injury). Conclusions. The Hospital Anxiety and Depression Scale, Impact of Event Scale and Post-Traumatic Amnesia in combination are recommended as useful prognostic screening instruments for predicting persisting PCS, but great caution is required if they are used to aid predictions beyond 3 months post-injury.

Journal ArticleDOI
TL;DR: Alexithymia, age, social support and awareness at the time of having a myocardial infarction, were each strongly predictive of one or all measures of symptoms.
Abstract: Objectives. To identify the associations between two personality variables (alexithymia, negative affect), social support, awareness of myocardial infarction, and the severity of post-traumatic stress symptoms. Design. A cross sectional design was adopted with simultaneous measures of both dependent and independent variables. Method. A random sample of 69 patients who had an MI between 6 and 12 months previously were sent postal questionnaires measuring alexithymia, negative affect, social support, awareness of myocardial infarction, the severity of post-traumatic stress symptoms and a number of demographic details. Results. Forty-four individuals completed and returned all the questionnaires. A 10 prevalence of post-traumatic stress symptoms was found. Regression analyses were conducted to identify independent associates of the dependent variables with and without the inclusion of the measure of negative affect. Alexithymia, age, social support and awareness at the time of having a myocardial infarction, were each strongly predictive of one or all measures of symptoms. Conclusions. Evidence supporting the impact of each of the variables on the course of post-traumatic stress disorder was supported in a population of myocardial infarction patients. If these variables were found predictive in a longitudinal study, they would indicate possible risk factors for post-traumatic stress disorder in this population.

Journal ArticleDOI
TL;DR: The VASES is a short and easy to administer measure of self-esteem that possesses good psychometric properties and is demonstrated to have good internal reliability among aphasic speakers.
Abstract: Objectives. To develop a visual analogue measure of self-esteem and test its psychometric properties. Design. Two correlational studies involving samples of university students and aphasic speakers. Method. Two hundred and forty-three university students completed multiple measures of self-esteem, depression and anxiety as well as measures of transitory mood and social desirability (Study 1). Two samples of aphasic speakers (N = 14 and N = 20) completed the Visual Analogue Self-Esteem Scale (VASES), the Rosenberg (1965) self-esteem scale and measures of depression and anxiety. (Study 2). Results. Study 1 found evidence of good internal and test-retest reliability, construct validity and convergent and discriminant validity for a 10-item VASES. Study 2 demonstrated good internal reliability among aphasic speakers. Conclusion. The VASES is a short and easy to administer measure of self-esteem that possesses good psychometric properties.

Journal ArticleDOI
TL;DR: The findings suggest that increasing suspiciousness does predict attributional style in the early stages of psychosis, although the relationship appears weaker than in reports with more chronic psychotic patient samples.
Abstract: Objective. The present study investigated covert and overt attributional styles in individuals experiencing a first episode of psychosis. It was hypothesized that those individuals experiencing paranoia, as operationalized by higher scores on the suspiciousness item of the Brief Psychiatric Rating Scale (BPRS) would perform differently on both covert and overt measures of attributional style when compared to those individuals who scored lower on the BPRS suspiciousness item. Design and Methods. A cross-sectional design was used. The sample consisted of 62 participants (50 males and 12 females) from the Early Psychosis Prevention and Intervention Centre. The Pragmatic Inference Task (PIT) was used to measure covert attributional style, whereas the Attributional Style Questionnaire (parallel form; ASQpf) measured overt attributional style. The Rosenberg Self-Esteem Questionnaire measured global self-esteem. Participants positive, negative, and depressive symptoms were assessed by means of the BPRS, the Scale for the Assessment of Negative Symptoms, and the Beck Depression Inventory, respectively. Results. Regression analyses found that less suspiciousness (p=.02) and more depression (p=.02) predicted higher internal attributions for negative events scores on the ASQpf. There was a trend (p=.07) for more suspicious individuals to endorse the self-serving bias (SSB) on the PIT, even despite the SSB not being large enough to be considered defensive. Verbal IQ emerged as a significant predictor of covert attributional style (p=.04). Conclusions. The findings suggest that increasing suspiciousness does predict attributional style in the early stages of psychosis, although the relationship appears weaker than in reports with more chronic psychotic patient samples. Longitudinal research is needed to ascertain whether attributional style is a stable characteristic in psychosis, or whether it fluctuates between periods of remission and active psychosis.

Journal ArticleDOI
TL;DR: The CAMCOG, with minor modifications, is a useful test to assess those areas of cognitive function known to decline with dementia, and people with DS were able to score above the floor of the test.
Abstract: Objectives. The Cambridge Cognitive Examination (CAMCOG) was designed for the general elderly population to assess cognitive impairments characteristic of dementia. CAMCOG yields a total score as well as separate scores on seven subscales. In this study the suitability of the CAMCOG for older adults with Down s Syndrome (DS) at the age of risk for dementia was assessed. Design. A near total population sample of people with DS aged 30 years and over (range 30-65 years) living in a single Health Authority catchment area was identified and assessed using the CAMCOG. The use of an unselected sample ensured that the value of this assessment instrument could be established across all levels of disability in those with DS. A lower age limit of 30 years was used, as from this age significant Alzheimer-like neuropathology is present and prevalence rates of Alzheimer's disease begin to increase. Methods. The CAMCOG was administered in a familiar setting together with other neuropsychological tests. Gender and age differences and the characteristics of those at the floor of the test were investigated. Results. Of the 77 people with DS aged 30 years or older, 74 agreed to take part. Scores on the CAMCOG were well distributed, with only eight participants (11%) scoring 0 on the test. This contrasted favourably with performance on the MiniMental State Examination where there was a narrower range of scores and a higher percentage scoring 0. There was a significant difference in cognitive performance between younger (30-44 years) and older (45+ years) participants on the total CAMCOG score and on six out of the seven CAMCOG subscales. Conclusions. The CAMCOG, with minor modifications, is a useful test to assess those areas of cognitive function known to decline with dementia. Apart from those with pre-existing severe learning disability, severe sensory impairments and/or already advanced dementia, people with DS were able to score above the floor of the test.

Journal ArticleDOI
TL;DR: This study suggests that over and above issues of emotional warmth and control, recall of direct experiences of being shamed, feeling inferior and less favoured in a family, may be particularly pathogenic and may be especially important in proneness to hostile feelings.
Abstract: Objectives. There is good evidence that early rearing experiences affect vulnerability to subsequent psychopathology. Recent research on memories of rearing style have been influenced by attachment theory and have focused primarily on domains of emotional warmth and control. However, early experiences of being shamed, criticized and made to feel inferior, together with believing one's sibling is favoured over oneself, are also likely to play a role in vulnerability. This study therefore explored recall of being shamed and sibling favouritism. Method. A large community sample (N = 638) and a varied non-psychotic patient sample (N = 213) completed two recall of parent rearing scales (the PBI and EMBU). These gave measures of recall of emotional warmth, overprotection control, being shamed and shown up, and self or sibling favouring. Participants also completed the SCL-90-R scale. Results. Patients recalled less warmth, more control, more shame and more favouring of siblings than the community sample. The difference was greatest for shame, and following MANOVA analysis shame remained significantly different between the two groups even after controlling for emotional warmth and control. Similarly, recalling being less favoured than a sibling and shamed had robust associations with indicators of psychopathology and these were only marginally reduced when emotional warmth was controlled for. Moreover, hostility (as measured by the SCL-90-R) was specifically related to recall of being shamed but not emotional warmth. Conclusion. This study suggests that over and above issues of emotional warmth and control, recall of direct experiences of being shamed, feeling inferior and less favoured in a family, may be particularly pathogenic. They operate independently of warmth and may be especially important in proneness to hostile feelings. Given this, therapists may wish to specifically explore shame issues with patients.

Journal ArticleDOI
TL;DR: The most potent short-term predictor of parasuicide repetition was found to be scores on the Beck Hopelessness Scale, whereas in the longer term the number of previous para-suicides was the major predictor.
Abstract: Objectives. This study explores whether the specificity of risk assessment for parasuicide repetition can be improved by measurement of two psychological variables (overgenerality of autobiographical memory and future fluency for positive events) in the immediate aftermath of the index parasuicide. Design. In a longitudinal study, parasuicide patients deemed to be at high risk of repetition on the basis of sociodemographic factors (Kreitman & Foster, 1991) were followed-up over a 12-month period. Method. As soon as practicable after taking a deliberate drug overdose, patients completed the Autobiographical Memory Test, the Personal Future Test and the Beck Hopelessness Scale. The relative power of each of these measures, together with the number of sociodemographic risk factors, in predicting parasuicide repetition was investigated using a forward step-wise logistic regression analysis. Results. The most potent short-term predictor of parasuicide repetition was found to be scores on the Beck Hopelessness Scale, whereas in the longer term the number of previous parasuicides was the major predictor. Conclusion. For the heterogeneous parasuicide population as a whole, psychological variables are unlikely to improve upon the Beck Hopelessness Scale, sociodemographic risk factors and clinical interview in the prediction of parasuicide repetition.

Journal ArticleDOI
TL;DR: People with paranoid delusions show information processing features similar to those previously reported in people with depression, and remember significantly more general and fewer specific memories than normal control subjects.
Abstract: Objectives. It was hypothesized that people with persecutory delusions, such as depressed people, would experience difficulty when attempting to generate specific autobiographical memories. Design. 20 deluded participants, 20 depressed patients and 20 normal controls were compared on an autobiographical memory test. Methods. Participants attempted to recall memories to positive and negative cue words. Independent raters classified responses as specific, general, imaginary or unscorable. Over-general memories were further classified as extended or categorical. Results. Deluded participants recalled significantly more general (especially categorical) memories and fewer specific memories than the normal control subjects. Depressed participants showed little evidence of over-general memories, although they showed faster recall latencies to negative than to positive cues. Conclusions. People with paranoid delusions show information processing features similar to those previously reported in people with depression. The possible contribution of adverse experiences to over-general autobiographical recall is discussed.

Journal ArticleDOI
TL;DR: The FMSS technique can be used reliably to identify negative relationships even by raters given very limited training, and Correspondence between the two measures of EE was found to be good.
Abstract: Objectives. Research on expressed emotion (EE) has demonstrated a remarkable consistency across cultures and over time; the psychosocial climate in relationships is important in determining the course of problems in mental health. The rating of EE might be described as the least accessible aspect of this literature to those who have not undertaken a training course. The purpose of this study was twofold: first, to obtain EE ratings for staff-patient relationships via interview and speech sample methods, in order to estimate the validity of the shorter method (the Five-Minute-Speech-Sample, FMSS); second, to examine the generalizability of the FMSS rating method to raters who were not previously trained to rate EE. Design and Method. Staff (N = 15) working in a day hospital service for people with enduring mental health problems were interviewed about their work with at least one patient (N = 32), and also asked to provide an FMSS on each relationship. Ratings of FMSS-EE were subsequently compared with the Camberwell Family Interview-EE ratings. Following an hour-long training period, the FMSS-EE ratings of five postgraduate students were then compared with those of a criterion rater. Design and Method. Staff (N = 15) working in a day hospital service for people with enduring mental health problems were interviewed about their work with at least one patient (N = 32), and also asked to provide an FMSS on each relationship. Ratings of FMSS-EE were subsequently compared with the Camberwell Family Interview-EE ratings. Following an hour-long training period, the FMSS-EE ratings of five postgraduate students were then compared with those of a criterion rater. Results. Correspondence between the two measures of EE was found to be good, with overall agreement achieved in 89.7 of cases. Raters with very limited training in the concept and rating of EE were accurate in identifying the overall rating of the relationship in question, but less accurate in identifying specific critical comments. Conclusion. The FMSS technique can be used reliably to identify negative relationships even by raters given very limited training. Clinical and research applications are suggested.

Journal ArticleDOI
TL;DR: It appears that the Novaco Anger Scale is able to discriminate between clinical and non-clinical populations, and these data offer further support to the validity of the scale and its use in clinical assessment.
Abstract: Objectives. To provide non-clinical normative data for the Novaco Anger Scale. To identify the ability of the scale to discriminate between clinical and non-clinical populations. Design. Postal survey of individuals from a non-clinical sample. Method. A non-clinical sample of 212 NHS employees was sent a questionnaire pack, including the Novaco Anger Scale. A clinical sample of 58 outpatient angermanagement referrals was identified from a retrospective case-note analysis. Results. Descriptive data are presented for both samples. t-score conversions are provided, based on the non-clinical data. Results from a discriminant function analysis demonstrated that the Novaco Anger Scale classified participants as clinical or non-clinical with 94 accuracy. Conclusion. From this study it appears that the Novaco Anger Scale is able to discriminate between clinical and non-clinical populations. These data offer further support to the validity of the Novaco Anger Scale and its use in clinical assessment.

Journal ArticleDOI
TL;DR: Semantic-based information processing paradigms may not be sufficiently potent to demonstrate biased performance towards threatening stimuli in individuals with mild specific phobias who are otherwise healthy.
Abstract: Objectives. The present study applied MacLeod, Mathews & Tata's (1986) dot probe attentional deployment methodology to individuals with specific phobias. Design. Attentional deployment towards spider-related, blood-related, positive, negative, and neutral words was examined. Method. Individuals with either spider phobia (N = 13) or blood/injury phobia (N = 14) and non-anxious controls (N = 14) completed the dot probe attentional deployment task. Results. Individuals with specific phobias did not demonstrate an attentional bias towards phobia-related stimuli relevant to their particular fears. Conclusion. Semantic-based information processing paradigms may not be sufficiently potent to demonstrate biased performance towards threatening stimuli in individuals with mild specific phobias who are otherwise healthy.

Journal ArticleDOI
TL;DR: It is suggested that a stable, well-consolidated negative self-concept is associated with prolonged depression and a poor response to psychosocial interventions.
Abstract: Objectives. To investigate the combined roles of level and perceived stability of self-esteem in prospectively predicting depression. Design. Symptoms of depression and anxiety were measured both before and after psychoeducational treatment for depression; level and perceived stability of selfesteem were measured before treatment. Method. Participants were 26 adults (16 female), age range 21-75 years. Results. More stable self-esteem was associated with greater depressive symptomatology at treatment completion, particularly among participants who began treatment with the lowest self-esteem. Effects were specific to symptoms of depression in contrast with anxiety. Conclusion. These results suggest that a stable, well-consolidated negative selfconcept is associated with prolonged depression and a poor response to psychosocial interventions.

Journal ArticleDOI
TL;DR: The findings suggest that change in mood state rather than the more habitual mood quality are relevant for bulimic women's body perception.
Abstract: Objectives. This study was designed to investigate the impact of mood changes on body width estimation in women with bulimia nervosa. Design. A pre-post controlled experimental design was chosen. Method. Mood changes were induced in 40 women with bulimia nervosa, 20 women with panic disorder and 40 women with no diagnosis of a psychological disorder. A combination of autobiographical memory method and music induction method was used to induce positive and negative mood, respectively. Before and after mood induction a video distorting technique was used for body width estimation. Results. Induction of negative mood increased and induction of positive mood decreased the body width estimations of women with bulimia. Patients with panic disorder and ‘healthy’ controls did not show these changes after mood induction. Conclusion. The findings suggest that change in mood state rather than the more habitual mood quality are relevant for bulimic women's body perception.

Journal ArticleDOI
TL;DR: A factor analysis of the Matson Evaluation of Social Skills for Individuals with Severe Retardation was conducted to determine if there was an underlying factor structure which supported a distinction between positive and negative social skills.
Abstract: Objective. A factor analysis of the Matson Evaluation of Social Skills for Individuals with Severe Retardation (MESSIER) was conducted to determine if there was an underlying factor structure which supported a distinction between positive and negative social skills. Design. Principal Axis Factoring with oblimin rotation was used to determine if a two-factor solution was valid. This method was selected to account for shared variance between the items and for correlation between the factors. Method. The MESSIER was administered by trained staff to 805 individuals with severe and profound intellectual disability residing in a state residential facility. Results. Results of the factor analysis yielded two categories (positive and negative behaviours) that corresponded to the general division of the clinically derived subscales. Conclusions. The psychometric research on the MESSIER was extended with an examination of the factor structure. The results of the factor analysis, corresponding with the general division of the clinically derived subscales, are promising. Future research should be conducted to determine if factor scores can be used to determine norms.

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TL;DR: The current findings justify greater optimism regarding the test-retest reliability of the Wisconsin Card Sorting Test.
Abstract: This study evaluates the temporal stability of the Wisconsin Card Sorting Test (WCST). The only previous similar study found unacceptably low test-retest stability in a non-patient elderly sample. In contrast, the present study utilizes 29 untreated obstructive sleep apnea patients who are more typical of persons likely to receive the WCST clinically. The 11 WCST scores examined demonstrated test-retest correlations from .34 to .83 (mean = .64). Six of 11 correlations were within .10 of the .80 criterion for clinical utility and there was minimal change across sessions. The current findings justify greater optimism regarding the test-retest reliability of the WCST.

Journal ArticleDOI
TL;DR: The performance of individuals on the Modified Card Sorting Test is more closely associated with general intellectual ability than with demographic variables.
Abstract: Objectives. The aim of this study was to obtain normative data for the Modi®ed Card Sorting Test (MCST), and to examine the relationship between performance on this task, general intellectual ability and demographic variables. Design. A sample of 146 healthy individuals was tested with a demographic distribution (age, sex, socioeconomic class) similar to that of the British population. Methods. The MCST and the Wechsler Adult Intelligence Scales ± Revised were administered to 146 people aged between 16 and 75 years. Results. Most people (56.6%) completed six categories, and many people made perseverative errors. Approximately 8% of the participants made over 50% perseverative errors.Performance on the MCST varied with age, years of education and general intellectual ability. Individuals with a Full Scale Intelligence Quotient (FSIQ) below 100 showed much more variability in performance than individuals with an FSIQ over 100. Detailed percentile norms for the performance on diaerent indices of the test are presented. Conclusions. The performance of individuals on the MCST is more closely associated with general intellectual ability than with demographic variables.

Journal ArticleDOI
TL;DR: The results supported the hypothesis that repressors would rate their interactions with their fathers more positively than non-repressors when allowed to do so on self-report measures.
Abstract: Objectives. To investigate whether women who possess a repressive coping style (repressors) self-report more positive judgments of their childhood on questionnaire and repertory grid measures compared with non-repressors.Design. Repressors (low anxiety-high defensiveness) were compared with a composite group of non-repressors, containing some low anxious (low anxiety-low defensiveness), some high anxious (high anxiety-low defensiveness), some defensive high anxious (high anxiety-high defensiveness) and some non-extreme scorers.Methods. Participants completed the Parental Bonding Instrument (PBI; Parker, Tupling & Brown, 1979) and a 10 x 10 repertory grid, Self-Identification Form.Results. On the PBI, repressors scored significantly higher than non-repressors on paternal care and significantly lower on paternal overprotection. There were no group differences for maternal measures. On the repertory grid, repressors compared with non-repressors perceived (a) themselves as significantly closer to their father, a woman they like, and their ideal partner, and significantly further from a woman they dislike, and a man they dislike; and (b) their father as significantly closer to a woman they like, a partner/person they admire, and an ideal partner. In addition, repressors were significantly tighter on construing than non-repressors.Conclusions. The results supported the hypothesis that repressors would rate their interactions with their fathers more positively than non-repressors when allowed to do so on self-report measures.

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TL;DR: The present data constitute a cross-validation of the normative data presented in the D&P test manual, indicating that cutting scores derived for the Visual-Verbal and Recall-Recognition indices based on the test manual norms may be unduly conservative and may lead to systematic errors in interpreting the scaled scores derived from the manual.
Abstract: Objectives. To validate the normative data on the Doors and People Memory Test (D&P) using a new sample of normal participants, and to investigate the relationship between D&P performance and general intellectual level. Design. 281 normal participants (16-75 years), subdivided into 10-year age bands, were tested on the D&P and the National Adult Reading Test (NART). Method. Each participant's raw scores on the D&P were converted into scaled scores, and scaled memory ‘indices’ were derived using the test manual. Stepwise multi-linear regression was used to predict the indices using age and NART error score as predictor variables. For each participant the discrepancy between the predicted and obtained values of each index was converted into a z score using the SD of the discrepancies from the whole sample. Results. The distributions of raw and scaled scores on the D&P were similar to those of the original standardization sample. The Visual-Verbal and Recall-Recognition Discrepancy indices had smaller dispersions in the present sample than in the original sample. None of the indices was significantly related to age. The Total Memory, Combined Visual Memory, Combined Verbal Memory, and Overall Forgetting indices were significantly correlated with NART error score. Conclusions. The present data constitute a cross-validation of the normative data presented in the DP and (ii) the relationship between some of the D&P indices and NART error score may lead to systematic errors in interpreting the scaled scores derived from the manual. ‘Correction formulae’ based on the regression equations derived from the present sample are provided.

Journal ArticleDOI
TL;DR: A formula for detecting faked Raven's Standard Progressive Matrices profiles was cross-validated on 46 experimental malingerers and 381 people from the standardization sample and yielded a cross- validated 26% false-negative rate and a 5%false-positive rate.
Abstract: A formula for detecting faked Raven's Standard Progressive Matrices profiles was cross-validated on 46 experimental malingerers and 381 people from the standardization sample. The formula yielded a cross-validated 26 % false-negative rate and a 5 % false-positive rate.