Differential diagnosis and different etiologies of monopolar and bipolar phasic psychoses

Monopolar and bipolar phasic psychoses can be differentiated not only on the course but also on the symptom pattern. This applies also to the euphoric forms which usually are still assigned to Manic-depressive illness. The differential diagnosis is presented. Aetiology is completely different in the monopolar and the bipolar phasic psychoses. Manic-depressive illness has a hereditary basic, whereas in the monopolar ("pure") forms loading is very low. Particularly few psychoses among the relatives have been found in the euphoric forms which demonstrates their independency for if they would belong to Manic-depressive illness they necessarily would show the heavy genetic loading of this bipolar illness. In the pure phasic psychoses external causes were detected when we focused on the sibships in which the probands had grown up. The euphoric patients had relatively many older siblings, the depressive ones relatively few older siblings. A similar difference was found in two cycloid psychoses. Transcultural observations as well as shifts in the incidence rate of the psychoses in our times confirmed our results. Prophylactic measures can be derived.     

Mental illness disclosure in organizations: defining and predicting (un)supportive responses

Employees with a mental illness regularly encounter situations where they must make decisions regarding the extent to which they discuss their stigma. Past research has found links between positive disclosure experiences and positive well-being and job-related outcomes for the individual disclosing. However, research on stigma disclosure has not yet defined what differentiates a supportive response from an unsupportive one, and there is evidence to suggest that people are unsure of how to best respond to a disclosure. In a series of three studies, we sought to develop a better understanding of mental illness disclosure at work. First, we created a typology of supportive and unsupportive responses to disclosure via critical incidents gathered from working adults with a mental illness. Second, we surveyed working adults with and without a mental illness to examine if they perceive the supportiveness of responses differently. Third, in an experimental study, we examined which methods of disclosure are most effective in eliciting a supportive response. This work identifies several types of supportive (e.g., providing emotional support) and unsupportive (e.g., denial of symptoms) responses to mental illness disclosure and finds that individuals without a mental illness have a reasonable understanding of what an individual with a mental illness would also identify as supportive/unsupportive responses. We also find that downplaying one’s mental illness will likely lead to a less supportive response.

     

I Recognise You but I Can't Place You: An Investigation of Familiar-only Experiences during Tests of Voice and Face Recognition

In this paper, we examine in detail the situation in which a subject finds that a face or voice is familiar but is unable to retrieve any biographical information about the person concerned. In two experiments, subjects were asked to identify a set of 40 celebrities either from hearing their voice or from seeing their face. Although many more celebrities were identified and named in response to their face than their voice, the results showed that there was a very large number of occasions when a celebrity's voice was felt to be familiar but the subject was unable to retrieve any biographical information about the person. This situation occurred less frequently in response to seeing a celebrity's face; when a face was found familiar, the subject was much more likely to be able to recall the celebrity's occupation. The possibility that these results might have come about because subjects were using different criteria to determine familiarity in the face and voice conditions was investigated and discounted. An additional finding was that when subjects found a face to be familiar-only, they were able to recall significantly more additional information about the person when they were cued by the person's voice than when they simply saw the face again. These results are discussed in relation to the models of person recognition put forward by Bruce and Y oung (1986) and Burton, Bruce, and Johnston (1990).     

Monitoring the future: object and source memory for real and imagined events

In these experiments a memory‐monitoring decision is made, whereby subjects must decide not only whether or not to‐be‐learned stimuli will be remembered—the focus of all of the past research into the Judgement of Learning (JOL)—but also whether they will be able to assess the source of those stimuli, as assessed by a new measure, Judgement of Source (JOS). In Experiment 1 subjects had to judge whether they would remember the occurrence and the source of items that were either seen or imagined. Although seen items were better remembered and sourced than imagined, subjects were unable to predict this outcome: they underestimated their ability to recall seen items and overestimated their ability to recall imagined items. In Experiment 2 subjects had to discriminate between self‐performed or other‐performed enacted or imagined events. We expected that the motor cues associated with overt performance should provide more sensory information than had the visual input in Experiment 1, and this should help subjects to discriminate between real and imagined items. As predicted, JOL magnitude showed that subjects were now able to predict accurately that they would recall more enacted events than imagined events. JOS magnitude showed that subjects incorrectly predicted that self‐enactment would assist source memory compared to imagination. However, it was the source of other‐focused events which was more accurately remembered. The results are discussed in terms of Koriat's (1997) view about cue utility in making JOLs. Copyright © 1999 John Wiley & Sons, Ltd.     

Considering adaptation in preference elicitations

OBJECTIVE: Patients with chronic health conditions usually place higher utility on their condition than the public does. One explanation for this discrepancy is that healthy people focus on the negative aspects of the condition without considering their own ability to emotionally adapt to the condition over time. The aim of this randomized experimental study was to test whether people would give higher utility ratings for chronic health conditions when they were encouraged to consider their own ability to adapt to difficult situations before giving their ratings. MAIN OUTCOME MEASURE: Utility ratings for four chronic health conditions. RESULTS: The authors presented scenarios describing 4 chronic health conditions to 1,117 respondents drawn from a demographically balanced U.S. Internet panel. The adaptation exercise did not influence respondents' valuations. However, utility values increasingly improved with decreasing ratings of how upsetting it would be to live with the condition over time. CONCLUSION: The authors speculate that asking people to think about adaptation changes their evaluations of what it would feel like to live with chronic illness, but doing so does not change how much they are willing to trade off to avoid that chronic illness.     

Appraisals of control and predictability in adapting to a chronic disease

In a sample of 92 patients with rheumatoid arthritis, we examined interrelations among various control appraisals, illness predictability, psychosocial adjustment, mood, and illness status. Perceiving greater personal control over the disease and symptoms and perceiving greater health-care-provider control over symptoms were associated with greater illness predictability. Patients reported more personal control over their symptoms than over the course of the disease and thought that their health care providers had more control over disease course than they did themselves. Multiple regression analyses showed that perceiving greater personal control over one's medical care and treatment was associated with positive mood and psychosocial adjustment. Negative mood was also associated with the belief that providers have greater control over the patient's daily symptoms. Patients who had a more severe disease and expressed greater personal control over its course reported greater mood disturbance and were rated as exhibiting less positive adjustment, but those who had more severe daily symptoms and expressed greater personal control over their symptoms reported less mood disturbance. These findings are discussed in terms of the possible benefits of patients' active participation in their care and the implications of perceiving personal and others' control over more or less controllable aspects of the illness, especially when the illness is more severe.     

Error monitoring dysfunction across the illness course of schizophrenia

Response monitoring abnormalities have been reported in chronic schizophrenia patients, but it is unknown whether they predate the onset of psychosis, are present in early stages of illness, or are late-developing abnormalities associated with illness progression. Response-synchronized event-related potentials (ERP) recorded during a picture-word matching task yielded error-related negativity (ERN), correct-response negativity (CRN), and error positivity (Pe) from 84 schizophrenia patients (SZ), 48 clinical high risk patients (CHR), and their age-matched healthy controls (HC; n = 110 and 88, respectively). A sub-sample of 35 early illness schizophrenia patients (ESZ) was compared to 93 age-matched HC and the CHR patients (after statistically removing the effects of normal aging). Relative to HC, 1) SZ, ESZ, and CHR had smaller ERNs, and 2) SZ and ESZ had larger CRNs and smaller Pes. Within the SZ, longer illness duration was associated with larger CRNs but was unrelated to ERN or Pe. CHR and ESZ did not differ on ERN or CRN, although Pe was smaller in ESZ than CHR. These results indicate that while ERN, CRN, and Pe abnormalities are present early in the illness, only the ERN abnormality is evident prior to psychosis onset, and only the CRN abnormality appears to worsen progressively over the illness course. Brain regions subserving response monitoring may be compromised early in the illness and possibly during its clinical prodrome.     

Impact of chronic illness: Differing perspectives of younger and older women

Abstract

The purpose of this study was to examine the life experiences of six women with chronic illness who represent three differing life stages. The participants included two women who were in young adulthood, two who were between the ages of 40 and 60, and two women in their late 70s. The women were all diagnosed with multiple sclerosis, systemic lupus erythematosus, rheumatoid arthritis, osteoporosis, or a combination of these disorders. They were interviewed concerning the impact illness has had on their lives, the manner in which chronic illness has altered their self-perceptions, and the ways in which they have come to make meaning from the event. While the women had achieved varying levels of acceptance of their illness, it appeared that the ability to cope was dependent on numerous factors across several life circumstances. Distinctions were made regarding ability to either adjust to the illness or use the experience as a catalyst for personal growth.     

"Thanks for sharing that": ruminators and their social support networks.

Receiving positive social support after a trauma generally is related to better adjustment to the trauma. The personality of trauma survivors may affect the extent to which they seek social support, their perceived receipt of social support, and the extent to which they benefit from social support. The authors hypothesized that people with a ruminative coping style, who tended to focus excessively on their own emotional reactions to a trauma, compared to those without a ruminative coping style, would seek more social support, and would benefit more from social support, but would report receiving less social support. These hypotheses were confirmed in a longitudinal study of people who lost a loved one to a terminal illness.     

The stigma of having a parent with mental illness: Genetic attributions and associative stigma

Children often report associative stigma because they are ‘contaminated’ by association with a parent who has a mental illness. An exploratory study was conducted to investigate the role of genetic attributions in the aetiology of associative stigma. The first hypothesis was that genetic attributions would predict associative stigma over and above the contribution of biochemical and stressful‐event attributions, while the second hypothesis was that the relationship between genetic attributions and associative stigma would be mediated by the perceived likelihood that children would develop the same disorder as their parents. Two‐hundred‐and‐two individuals were asked to read a hypothetical scenario describing a teenage girl whose mother had been diagnosed with either schizophrenia or depression. Both hypotheses were supported. The findings of the study have implications for a number of professions working in the community such as teachers and psychologists. Additional avenues for future research are also explored.     

Young Children Have Difficulty Predicting Future Preferences in the Presence of a Conflicting Physiological State

This study examined children's predictions about their future preferences when they were in two different physiological states (thirsty and not thirsty). Ninety 3‐ to 7‐year‐olds were asked to predict what they would prefer tomorrow: pretzels to eat or water to drink after having consumed pretzels, and again after having had the opportunity to quench their thirst with water. Results showed that although children initially preferred pretzels to water at baseline, they more often indicated that they would prefer water the next day after they had consumed pretzels. After consuming water, however, the same children indicated they would prefer pretzels the next day. Children's verbal justifications for their choices rarely made reference to their current or future states, but rather justifications were more likely to make reference to their general preferences when they were no longer thirsty compared to when they were thirsty. Results suggest that current physiological states have a powerful influence on future preferences. The findings are discussed in the context of the development of episodic foresight, the Bischof‐Kohler hypothesis, and the important and often overlooked role that children's current states play in future decision making. Copyright © 2015 John Wiley & Sons, Ltd.     

Diabetes Knowledge as a Moderator of Reactions to Illness by Patients With Insulin-Dependent Diabetes Mellitus1

We examined patient knowledge as a moderator of psychological reactions to illness among patients with insulin-dependent diabetes mellitus. We reasoned that knowledgeable patients would have the most severe reactions to their illness because the causal implications of good or poor metabolic control would be most apparent. Accordingly, we expected that more knowledgeable patients would react more negatively than less knowledgeable patients to poor metabolic control but would react more positively to good metabolic control. Results from a sample of 46 patients with insulin-dependent diabetes mellitus supported this hypothesis. These findings suggest that increased patient knowledge may not produce uniformly positive results. Patient education programs must consider the psychological implications of patient knowledge in addition to the physiological consequences.     

Behavior change and individual differences in self-control

The use of self-control has become a major emphasis in recent behavioral treatment approaches. This has been especially true for the modification of appetitive disorders: high frequency behavior with immediate positive and delayed negative consequences, such as smoking and overeating. While the results have. for the most part. been promising, they have been marked by a high degree of intersubject variability: even the most generally effective programs have had only selective success (Mahoney, 1972). This variability might well be a function of fundamental interindividual differences in the ability to implement various self-control procedures. Kanfer (1971) has conceptualized self-control as a three component, closed loop process: self-monitoring followed by self-evaluation followed by self-reinforcement. The utilization of each component, the nature of their interaction and their implementation are all learned. Given the complexity of the process and idiosyncratic learning histories, individual differences are to be expected in each component of the self-control sequence. The effectiveness of any therapeutic program emphasizing self-control should, therefore, be a function of the ability and disposition of the patients to implement the self-control sequence or the specifie component required by the procedure. An individual having low facility to administer effective self-reinforcement might, for example, do poorly in a program that required self-reinforcement by containing little or no external supports. Someone who has not learned to accurately selfevaluate might contravene a program by administering self-reinforcement inappropriately.One way to test this contention would be to administer a self-control based treatment to individuals identified as differing in self-control ability: high self-controllers would be expected to do better. That method of attack might, however, be deferred. Lichtcnstein (1971) has suggested that before conducting extensive, elegantly designed treatment research, clinical evidence supporting the efficacy of the procedures be gathered. That approbation can be applied to the evaluation of the general hypothesis presented above, which has not yet had direct empirical support. An alternative, more conservative research strategy would be to precede a treatment study with an examination of individuals who had already changed their own behavior: a process that by definition requires the effective use of self-control. Were the hypothesis valid, differences in the general predisposition (or ability) to emit self-control responses should be observed between individuals who have modified their own behavior (e.g., quit smoking, lost weight) and those unable to do so. The purpose of the present study was to offer some preliminary data on this issue by comparing a group of people who had lost weight or quit smoking with a group that had failed at either. The component of self-control selected for study was self-reinforcement. It was predicted that individuals able to modify their own behavior would have a greater predisposition to use positive self-reinforcement than those unable to do so.     

Do Written Reports of Suicide Induce High-School Students to Believe that Suicidal Contagion Will Occur?1

To see if high-school students who read that a distressed adolescent knew about suicide thought that suicidal contagion would occur, 66 consenting high-school students read a written account of John, a high-schooler with multiple problems including knowing someone who had died (either by suicide or viral illness). They then anonymously completed the UCLA Loneliness scale and a questionnaire about what John (or they in the same situation) might do. When John knew of a sympathetic response to a viral illness death, or an unsympathetic response to suicide, he was rated as relatively more likely to make new friends and less likely to want to die. These high school students saw themselves as immune to suicidal contagion from a written report, but thought that others might be vulnerable if people were sympathetic.     

Therapist Awareness of Appropriate Intervention in Treatment of Domestic Violence

SUMMARY

Given the widespread nature of relationship violence, psychotherapists must recognize the probability that at some point they will treat a violent couple or someone involved in a violent relationship, even if they do not specialize in the treatment of family violence. Two analogue studies reported in this chapter were designed to investigate how therapists conceptualize cases involving domestic violence families and the types of interventions they indicate they would make. The first study surveyed 362 members of the American Association for Marriage and Family Therapy (AAMFT). Respondents were asked to conceptualize and provide interventions for one of two actual cases that involved family violence. The second study surveyed 402 members of the American Psychological Association (APA). Respondents were asked to give a diagnosis based on a case presentation. After being informed the case resulted in a homicide, respondents were asked what interventions they would have made prior to the outcome, had they been given the opportunity to provide counseling. Results from both analogue studies indicate that a large number of respondents were unable to properly assess the danger inherent in cases of domestic violence, and many more would not have intervened in a timely and appropriate manner.     

Can we get sick if we want to? Children's and adults' recognition of intentionality in the origins of illness and injuries

The present set of studies examined the impact of intentionality (wanting/not wanting to get sick) on the transmission of contagious illness and injuries. Study 1 examined whether preschoolers and adults thought that a recipient of an illness is more likely to get sick if he/she wanted to. Studies 2, 2a, and 3 examined if the intentions of the transmitter would influence the transmission of illness to the recipient. Study 4 examined the influence of germs on intentionality. Both preschoolers and adults reasoned that the intentions of the recipient would play a significant role in the probability of contracting an illness but only adults reasoned that the recipient having knowledge of the transmitter's intentions would have an impact on illness. Moreover, preschoolers (but not adults) judged that biological contaminants such as germs would interact with the intentionality of the recipient to increase the chances of contracting an illness whereas adults reasoned that psychological states can have a direct influence on the manifestation of illness. These results suggest that preschoolers and adults entertain a highly sophisticated and selective process when assessing, the impact of psychological factors such as intentionality on biological processes such as the origins of illness.     

Effects of Illness Representation,Perceived Quality of Information Provided by the Health-Care Professional,and Perceived Social Support on Depressive Symptoms of the Caregivers of Children with Leukemia

The present study examined the effects of illness representation, perceived quality of information provided by the health-care professional, and perceived social support on the depressive symptoms of the caregivers of children with leukemia. The sample was composed of 71 caregivers of children with leukemia living in Turkey. The obtained data were analyzed by path analysis. The results show that caregivers of children with leukemia experience higher levels of depressive symptoms when they have negative illness representation and lower levels of depressive symptoms when they perceive higher levels of social support. Moreover, they perceive higher social support when they perceive high quality of information provided by health-care professionals. It can be suggested that intervention programs which aim to increase caregivers’ social support and change their illness representation in a positive way would be helpful for the caregivers showing depressive symptoms.     

The effect of normative beliefs on anticipated emotions.

In 3 experiments, Ss were asked how they would or should make hypothetical decisions and how they would react emotionally to the options or outcomes. The choices were those in which departures from proposed normative models had previously been found: omission bias, status quo bias, and the person-causation effect. These effects were found in all judgments, including judgments of anticipated emotion. Arguments against the departures affected judgments of anticipated emotion as well as decisions, even though the arguments were entirely directed at the question of what should be done. In all but one study, effects of these arguments on anticipated emotion were as strong as their effects on decisions or normative beliefs. Thus, in many situations, people think that their emotional reactions will fall into line with their normative beliefs. In other situations, some people think that their emotional reactions have a life of their own. It is suggested that both normative beliefs and anticipated emotions affect decisions.