Perceptions of Turkish psychiatric inpatients about therapeutic factors of group psychotherapy

Many studies on therapeutic factors in group psychotherapy were done during the 1970s and 1980s, primarily with Western samples, The present study was carried out in a psychiatric inpatient clinic in Turkey. Using Yalom's (1975) therapeutic factor questionnaire administered at discharge, patients rated existential factor, instillation of hope and self-understanding as the most helpful factors and identification as the least helpful. There were significant differences among patients with regard to gender, age, education, comorbid personality disorder, but not with Axis I diagnosis or number of attended sessions. Patients' and psychiatrist's rating showed significant differences. Differences between this Turkish sample and those reported in common Western literature are discussed under the light of relatedness psychology, which is an important concept of cross-cultural psychology.     

Effects of gender and sex role orientation on help-seeking attitudes

This study investigated the effects of gender and sex role orientation (masculinity and femininity) on attitudes toward seeking professional psychological help in a sample of 163 student trainee teachers (52 males and 111 females) in Singapore. The mean age of students was 25.39 years (SD = 3.80). ANOVAs revealed statistically significant main effects for gender and femininity on attitudes toward help-seeking. Specifically, females were reported to have more positive overall attitudes toward professional help-seeking and were more willing to recognize a personal need for professional help compared to males. Femininity significantly influenced students’ level of stigma tolerance. These findings suggest that both gender and sex role orientation play an independent role in influencing help-seeking attitudes. In addition, these variables appear to have a differential impact on different aspects of helpseeking.     

Depression in child psychiatric inpatients: Cognitive and attributional patterns

Cognitive and learned helplessness models of depression view maladaptive cognitive and attributional patterns as core features of depressive disorders. This study examined cognitive and attributional patterns in depressed children, nondepressed children, and a subgroup of remitting depressives who had histories of depression but were not reporting depressive symptoms when evaluated during the first 2 weeks of hospitalization. When compared with nondepressed controls, depressed children reported significantly more hopelessness, more negative self-perceptions, and negative self-perceptions across a wider variety of domains, and they displayed more dysfunctional attributional styles. While 55% of depressed children displayed pervasive maladaptive cognitive patterns, the other 45% of depressed children scored more similarly to nondepressed children, suggesting that childhood depressive disorders may be heterogeneous with respect to cognitive patterns. Contrary to the notion of traitlike depressive cognitive and attributional patterns that persist after the remission of depressive episodes, children with remitting depressions scored similarly to nondepressed children.Partial support for this project was provided by a grant from the John D. and Catherine T. MacArthur Foundation as part of their Network on Risk and Protective Factors in the Major Mental Disorders. I wish to thank Donald Guthrie for providing statistical consultation, Gwen Gordon for her computer assistance, and Niels Mueller and Jean Keller for their help with data collection.     

Effects of gender and sex role orientation on help-seeking attitudes

This study investigated the effects of gender and sex role orientation (masculinity and femininity) on attitudes toward seeking professional psychological help in a sample of 163 student trainee teachers (52 males and 111 females) in Singapore. The mean age of students was 25.39 years (SD = 3.80). ANOVAs revealed statistically significant main effects for gender and femininity on attitudes toward help-seeking. Specifically, females were reported to have more positive overall attitudes toward professional help-seeking and were more willing to recognize a personal need for professional help compared to males. Femininity significantly influenced students’ level of stigma tolerance. These findings suggest that both gender and sex role orientation play an independent role in influencing help-seeking attitudes. In addition, these variables appear to have a differential impact on different aspects of helpseeking.     

The role of psychopathology and gender in respiratory self-regulation

A group of 12 male and 12 female psychiatric patients were recruited among an anxiety-disordered population, and their performance on a respiratory modulation test was compared with that of a matched non-patient sample. Inferior performance was expected in the patient group, and males were expected to show better respiratory modulation than females. Results supported the conclusion that females were less able than males in modulating respiratory muscle behaviour according to requested patterns, and female psychiatric patients showed a relative lack of flexibility in the thorax or abdomen regions or in both trunk levels.     

Reliability of self-reported attachment style in patients with severe psychopathology

Little is known about whether severe psychopathology influences the assessment of self-reported attachment style. Fifty-eight randomly selected adult psychiatric inpatients completed the Experiences in Close Relationship questionnaire (ECR; Brennan, Clark, & Shaver, 1998) and were administered the 24-item Brief Psychiatric Rating Scale (BPRS; Ventura et al., 1993) and the Hamilton Depression Rating Scale (HDRS; Hamilton, 1960) at both admission and discharge. The Structured Clinical Interview for DSM-IV (SCID-I; First, Spitzer, Gibbon, & Williams, 1996) was used to establish Axis I diagnoses. The ECR scales showed good internal consistency and absolute stability both in patients with (n = 24) and without (n = 34) a psychotic disorder. Relative stability was only fair among patients with psychotic disorders but good among patients without psychotic disorders. Neither higher BPRS or HDRS scores, nor the presence of a psychotic disorder, significantly reduced the retest reliability of the ECR scales. These findings suggest that self-report measures might provide a reliable assessment of attachment style in patients with severe psychopathology, except for the most severely impaired patients.     

Clinical psychopathology, psychiatric diagnosis and therapy in psychiatry

Clinical psychopathology has a diagnostic and therapeutic purpose. On the level of phenomenology one has to deal with four paradoxes. 1. The paradox of gradual transition from normality towards pathology versus the occurrence of symptoms of a new quality, 2. the paradox of nosological nonspecificity of various symptoms versus typical constellations of special symptoms for certain diseases, 3. the paradox of pure and typical symptoms and diseases versus symptoms and diseases which are mixed and non typical. 4. The paradox of the prevalence of psychopathological phenomena versus prevalence of somatic phenomena in one and the same disease. On the level of etiology one must face the fact that there are not only typical endogenous, exogenous (organic) and psychogenic syndromes. Neurotic symptoms may have an endogenous cause. Therefore neuroses may be treated effectively with antidepressants.     

Psychological distress and help-seeking among Taiwanese college students: role of gender and student status

This study investigated the relationship between psychological distress and attitudes toward seeking professional help and whether the relationship was moderated by gender and student status (traditional vs. non-traditional) among Chinese college students in Taiwan. 961 first-year university students completed standardised measures of depression, anxiety, attitudes toward seeking professional psychological help, and a demographic questionnaire. Results from the multiple regression analysis found that while higher levels of depression were adversely correlated with help-seeking attitudes, gender was positively correlated with help-seeking attitudes. Chinese female students held more favourable attitudes toward seeking psychological help than their male counterparts. Additionally, gender interacted with depression and anxiety in affecting attitudes toward help-seeking. These results were discussed within the Chinese cultural context and recommendations were given for student outreach programme aimed at increasing utilisation of mental health services on campus.     

Subgrouping with psychiatric inpatients in group psychotherapy: linking dependency and counterdependency

Abstract A model of inpatient group psychotherapy that focuses on two frequently observed patient subgroups reflecting contrasting attitudes toward authority is presented. The counterdependent subgroup overly values autonomy, opposes unit restrictions, and rejects treatment. The dependent subgroup tends to accept the unit's treatment and structure but is overly passive. In this model these attitudes are addressed in order to help patients adapt to the unit and to facilitate discharge. The author describes a three-stage group designed to help patients achieve these goals.     

Locus of control and achievement in child psychiatric inpatients

The relationship between the Nowicki-Strickland Locus of Control Scale for Children (Nowicki & Strickland, 1973) and academic achievement was examined in a sample of 66 child psychiatric inpatients. Previous studies had suggested that this measure correlated with achievement in normal samples (Nowicki & Strickland, 1973) but not in populations of male juvenile offenders (Little & Kendall, 1978). The product-moment correlation between the Nowicki-Strickland Scale and the Peabody Individual Achievement Test was significant. However, when the effect of IQ was controlled for in a partial correlation, there was no significant correlation. Discussion focuses on the relationship between these results and other findings in the area of locus of control, intelligence, and achievement.     

Complementary and alternative medicine use by psychiatric inpatients

82 psychiatric inpatients hospitalized for acute care were interviewed about their use of complementary and alternative medicine (CAM) modalities. The clinical diagnoses of respondents included Depressive Disorder (61%), Substance Abuse (26%), Schizophrenia (9%), and Anxiety Disorders (5%). Analysis indicated that 63% used at least one CAM modality within the previous 12 mo. The most frequently used modality was herbal therapies (44%), followed by mind-body therapies such as relaxation or mental imagery, hypnosis, meditation, biofeedback (30%), and spiritual healing by another (30%). Physical modalities such as massage, chiropractic treatment, acupuncture, and yoga were used by 21% of respondents. CAM therapies were used for a variety of reasons ranging from treatment of anxiety and depression to weight loss. However, most respondents indicated they did not discuss such use with their psychiatrist or psychotherapist.     

Spiritual well-being and spiritual practices in elderly depressed psychiatric inpatients

This study's aims were to describe the spirituality of depressed elderly psychiatric inpatients and to examine associations among spirituality, depression, and quality of life (QOL). Forty-five persons participated. Most reported frequent, stable spiritual practices and experiencing spiritual comfort and guidance. Some reported spiritual distress and changes in spirituality. During hospitalization, participants demonstrated increased spiritual well-being (SWB) and peacefulness, and reduced hopelessness, worthlessness, and guilt. Positive associations were found between SWB and QOL and negative associations between SWB and depression.     

Neuropsychological performance and suicidal behavior in adult psychiatric inpatients.

Although various studies have shown that suicidal persons exhibit greater cognitive deficiencies than both normals and other psychiatric patients, researchers as yet have been unable to account for the source(s) of the differences. Some of these differences (e.g., cognitive rigidity and impaired problem solving) hint of possible organic involvement. This study explored the relationship of neuropsychological functioning to suicidal behavior by comparing 20 suicidal and 27 nonsuicidal psychiatric inpatients on several tests of neuropsychological functioning. Although results showed no significant differences between the two groups on most measures, both groups showed evidence of notably high levels of cortical dysfunction relative to test norms. Thirty-five percent of suicidal patients and 44% of nonsuicidal patients scored in the impaired range. Implications of this high frequency of impairment for the treatment of suicidal and nonsuicidal psychiatric patients are discussed.     

MMPI validity scales and behavioral disturbance in psychiatric inpatients.

Sixty psychiatric inpatients were assigned to one of three groups on the basis of F and K MMPI validity scales. Staff ratings of patient behavior and recorded incidents of "acting-out" behavior were obtained for patients with: (a) "plea for help" validity profiles, (b) hyper-defensive profiles, and (c) average profiles. Patients with "plea for help" profiles were perceived as "acting-out" more frequently and engendering more feelings of frustration than patients in the other groups. These patients account for 77% of the incidents of inappropriate, destructive behavior and 83% of the seclusions in the patients sampled. Although the "plea for help" profile is considered invalid in some scoring systems, results suggest that this validity profile may be useful in treatment planning.     

WAIS-R scatter with psychiatric inpatients: I Intrasubtest scatter.

Intrasubtest scatter values for eight WAIS-R subtests were estimated for a sample of 150 psychiatric inpatients and compared with those reported for a comparable portion of the WAIS-R standardization group by Kaplan, Fein, Morris, and Delis in 1991, using the normal deviate (z) test. The standardization group's intrasubtest scatter was significantly greater than those reported for the psychiatric inpatients on all subtests except Arithmetic and Information. These results suggested that, contrary to expectation, limited intrasubtest scatter may characterize WAIS-R protocols of psychiatric inpatients, while the presence of scatter may characterize normal WAIS-R performance.