An exploratory study of psychodynamic therapists’ working with people with multiple sclerosis

There is little published on working psychodynamically with chronic illness and even less on the clinical insights of therapists working with people with multiple sclerosis. The objective of this study was to consider therapists’ reflections on the impact of multiple sclerosis on the internal worlds of clients with multiple sclerosis. I would also like to think about the challenges multiple sclerosis presents and how these challenges are worked with therapeutically. Finally, the impact of my multiple sclerosis diagnosis upon the research interviews was considered. Twelve counsellors / psychotherapists who had experience of working with clients with multiple sclerosis were interviewed. Data was analysed thematically and the findings revealed a number of significant themes. Denial appeared significant both for those with multiple sclerosis and those therapists working with them. Therapists also identified that people with multiple sclerosis hold a range of conscious and unconscious feelings in relation to their multiple sclerosis. Also, the meanings and impact of multiple sclerosis are broad and idiosyncratic. Therapists also faced a number of challenges in their work with people with multiple sclerosis: powerful countertransference feelings which could disable the therapy, embodied countertransference, the tendency to make generalisations, the physical reality of multiple sclerosis and its impact upon continuity, therapists’ unconscious phantasy and associations which if unaddressed could impact their ability to work with illness and the pressure multiple sclerosis placed on therapeutic boundaries. Therapists within the study recognised the need to work with both the physical reality of multiple sclerosis, as well as its psychological impact while at the same time keeping themselves open to powerful countertransference feelings and using them in the service of the therapy. The study has implications for theory, practice and future research.     

Caregivers’ perspective of the child support grant in South Africa: An exploratory study

This study explored caregivers’ perceptions of the South African Child Support Grant as a poverty alleviation instrument. Informants consisted of 72 caregivers who were purposively selected through the snowball method (female = 99%; single parent = 71%, blacks = 100%). They completed a survey based on their perceptions of the Child Support Grant. Thematic analysis applying the happiness or wellbeing approach to poverty revealed that caregivers find the Child Support Grant to be a family stress reliever by providing basic essentials for living. In addition, caregivers indicated the presence of inefficiencies in the administration of the grant. Findings suggest that the Child Support Grant has a buffering effect on poverty-stricken households in South Africa.     

An exploratory study of linguistic–colour associations across languages in multilingual synaesthetes

In one of the most common forms of synaesthesia, linguistic–colour synaesthesia, colour is induced by stimuli such as numbers, letters, days of the week, and months of the year. It is not clear, however, whether linguistic–colour synaesthesia is determined more by higher level semantic information—that is, word meaning—or by lower level grapheme or phoneme structure. To explore this issue, we tested whether colour is consistently induced by grapheme or phoneme form or word meaning in bilingual and trilingual linguistic–colour synaesthetes. We reasoned that if the induced colour was related to word meaning, rather than to the acoustic or visual properties of the words, then the induced colours would remain consistent across languages. We found that colours were not consistently related to word meaning across languages. Instead, induced colours were more related to form properties of the word across languages, particularly visual structure. However, the type of inducing stimulus influenced specific colour associations. For example, colours to months of the year were more consistent across languages than were colours to numbers or days of the week. Furthermore, the effect of inducing stimuli was also associated with the age of acquisition of additional languages. Our findings are discussed with reference to a critical period in language acquisition on synaesthesia.     

Psychological characteristics of women with eating disorders: Permanent or transient features?

The purpose of the study was to make a psychological profile of Danish women with Eating Disorders, who were not currently hospitalized. 75 women between the ages of 19 and 46 years participated. 22 participants suffered from a clinical eating disorder (ED). 20 women had previously suffered from a clinical ED, and 33 women had never suffered from ED. The study included sociodemographic data, problems in relation to eating and weight, exposure to stressful life events, and the following questionnaires: The Eating Disorder Inventory, the Rosenberg Self-Esteem Scale, the Coping Styles Questionnaire, the Perceived Stress Scale, the Defense Style Questionnaire, and the Trauma Symptom Checklist. Psychologically, women with ED differed significantly from women without ED by using a more primitive defense style, perceiving themselves as being more exposed to stress, using more inefficient methods of coping and having lower self-esteem. Unexpectedly, the study also showed that recovery from an ED was resulting in normalisation of both behavioral and psychological characteristics. The implications of these findings are discussed.     

Is there evidence for the use of art therapy in treatment of psychosomatic disorders,eating disorders and crisis? A comparative study of two different systems for evaluation

A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology 53, 47-53. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.     

Transgender women’s experiences and beliefs about hormone therapy through and beyond mid-age: An exploratory UK study

Background: Little is known about transgender women’s beliefs and experiences of hormone therapy (HT), as part of their transition process, and particularly as they grow older. Aims: This study aimed to investigate: (i) transgender women’s experiences and attitudes to HT, and (ii) expectations of what might occur and/or what occurred after they reached “menopausal age.” Methods: Participants were recruited through invitations to an online survey sent to 138 Lesbian, gay, bisexual, transgender plus (LGBT+) support groups across the UK. Sixty-seven transgender women consented and completed the questionnaire; responses were analyzed using a mixed-methods approach. The beliefs about medicines questionnaire (BMQ) was used to assess beliefs about HT, while an inductive thematic qualitative approach was used to explore participants’ personal expectations and experiences of HT and their views about the menopause. Results: Participants were aged on average 49 years ranging from 20 to 79 years old. Most (96%) were taking HT. BMQ scores revealed strong beliefs about the necessity of HT and some concerns. Positive views about HT were expressed, with themes including treatment importance, personal and mental health benefits, but concerns about long-term effects, side effects, and maintaining access to the treatment were also mentioned. Views about menopause included uncertainty and questioning of its relevance; some mentioned changes to HT dosage, but most expected to use HT indefinitely. Discussion: This study provides exploratory qualitative and quantitative information about transgender women’s views about HT and menopause. Practical implications include improving access to HT and provision of evidence-based information about long-term use.     

Do gender differences in academic attainment correspond with scholastic attitudes? An exploratory study in a UK secondary school

Research has examined how standardized tests give rise to gender differences in English and STEM attainment, but little research has explored gender differences in classroom-based attainment and the degree to which these correspond to differences in school-related attitudes. To explore the extent to which gender-achievement gaps in classroom-based performance parallel differences in self-perceptions and scholastic attitudes. An independent sample of first (n = 187, age 11–12, Study 1) and second-year students (n = 113, age 12–13, Study 2) from a UK comprehensive secondary school completed a questionnaire measuring academic mindset, self-efficacy, self-concept, competence beliefs, personal and social self-esteem, and endorsement of gender-subject and career stereotypes. Responses were then matched to their respective classroom grades in English, mathematics, science, and computing. Girls outperformed boys in English in their first year but reported lower global self-esteem and greater endorsement of science-career stereotypes. Conversely, girls outperformed boys in mathematics in their second year, but paradoxically reported lower self-concept and competence beliefs in mathematics and science, and higher competence beliefs in English. Across both studies, mindset, self-efficacy, competence beliefs, and social self-esteem were positively related to English attainment; academic self-efficacy was positively related to mathematics attainment; and mindset, self-efficacy, self-concept, and competence beliefs were positively related to science attainment. Gender-achievement gaps in classroom-based academic attainment are complex and highly nuanced; they appear to vary between school subjects across years and may not correspond with similar differences in self-perceptions and scholastic attitudes.     

Effect of parent responsiveness on young athletes’ self-perceptions and thriving: An exploratory study in a Belgian French-Community

ObjectiveThe purpose of this study was to examine the influence of parental responsive support (observed) and perceived parental responsive support on athletes’ self-perceptions and thriving.MethodsForty-one French-speaking Belgian individual sport athletes aged 12–15 years (M = 13.13, SD = 0.90) and one of their parent’s spent 10 min discussing three important athletes’ sport-related goals for the next season. The discussion was video-taped and coded to identify parents’ responsive support behaviors. After the discussion, athletes responded to a series of questionnaires measuring perceived parental responsiveness, self-efficacy, self-esteem, and thriving indicators (i.e., positive affect, vitality, life satisfaction, and health quality).ResultsThe results show that observed and perceived parental responsive support contributed to athletes’ proximal perceptions of self-efficacy. Both parental observed responsive support and athletes’ perceived parental responsiveness, mediated by athletes’ self-efficacy, were positively related to athlete’s self-esteem. Further, athletes’ perceived parental responsiveness was positively related with thriving while mediated in series by self-efficacy and self-esteem.ConclusionOverall, it appears that parents’ responsive support (observed) and athletes’ perception of responsive support are associated with positive self-perceptions and optimal wellbeing in young athletes. This study demonstrates that parents can provide responsive support to their children in the sport context. These results add further weight to suggestions that sport organizations should actively include, rather than exclude, parents in their processes.     

An exploratory study of early childhood teachers’ attitudes toward gender roles

This study explored the relationship between early childhood teachers’ adult gender role beliefs and their attitudes about children’s gender role behavior. The teachers, most of whom were women, expressed nontraditional beliefs regarding gender roles for adults. This feminist orientation appeared to be related to perceptions about child rearing in that teachers who espoused nontraditional gender role beliefs for adults also did for children. In addition, it was found that teachers were more accepting of cross-gender role behaviors and aspirations from girls than boys, and that this difference was related to homophobia. There were strong relationships found between child rearing gender role beliefs and attitudes toward gay men and lesbians. This study is based on a doctoral dissertation completed by the first author under the direction of Nancy Barbour and Beth Swadener. We wish to thank them for their support, comments, and suggestions.     

How honest do counsellors dare to be in the supervisory relationship?: An exploratory study

A study was conducted to investigate the extent to which psychodynamic counsellors feel able to disclose sensitive issues in supervision. Ninety-six counsellors in supervision responded to a questionnaire that asked about supervision arrangements, the supervisory working alliance, and the likelihood of disclosing issues such as erotic feelings towards clients and discomfort with the supervisor. Results showed that supervisees were likely to disclose more in individual rather than in collective supervision, when their supervisor was someone whom they themselves had chosen rather than had allocated to them, and when they were supervised independently of the setting in which they counselled rather than in-house. There was a positive correlation between the quality of the supervisory working alliance as experienced by the supervisee and the extent of his or her disclosure. Implications of counsellors feeling inhibited from disclosing particular issues in supervision, and the impact on the quality of their work with clients, are discussed.     

Can learning potential in schizophrenia be assessed with the standard CVLT‐II? An exploratory study

This study examined the potential of using the regular administration of a common neuropsychological test, the CVLT-II, to assess learning potential in schizophrenia. Based on List A trial 1 performance and the learning slope, a schizophrenia sample was divided into three learning potential groups (non-learners, learners and high-achievers) that differed in the use of learning strategies. High-achievers utilized more semantic clustering than learners and non-learners, and non-learners were less consistent in words recalled than the other two groups. This standard administration approach is a promising, time-saving alternative to the modified tests of learning potential used so far.     

Does academic dishonesty relate to unethical behavior in professional practice? An exploratory study

Previous research indicates that students in engineering self-report cheating in college at higher rates than those in most other disciplines. Prior work also suggests that participation in one deviant behavior is a reasonable predictor of future deviant behavior. This combination of factors leads to a situation where engineering students who frequently participate in academic dishonesty are more likely to make unethical decisions in professional practice. To investigate this scenario, we propose the hypotheses that (1) there are similarities in the decision-making processes used by engineering students when considering whether or not to participate in academic and professional dishonesty, and (2) prior academic dishonesty by engineering students is an indicator of future decisions to act dishonestly. Our sample consisted of undergraduate engineering students from two technically-oriented private universities. As a group, the sample reported working full-time an average of six months per year as professionals in addition to attending classes during the remaining six months. This combination of both academic and professional experience provides a sample of students who are experienced in both settings. Responses to open-ended questions on an exploratory survey indicate that students identify common themes in describing both temptations to cheat or to violate workplace policies and factors which caused them to hesitate in acting unethically, thus supporting our first hypothesis and laying the foundation for future surveys having forced-choice responses. As indicated by the responses to forced-choice questions for the engineering students surveyed, there is a relationship between self-reported rates of cheating in high school and decisions to cheat in college and to violate workplace policies; supporting our second hypothesis. Thus, this exploratory study demonstrates connections between decision-making about both academic and professional dishonesty. If better understood, these connections could lead to practical approaches for encouraging ethical behavior in the academic setting, which might then influence future ethical decision-making in workplace settings. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Too much – not enough. The representation of the body and the meaning of symptoms in patients with eating disorders

Eating disorders cover different clinical syndromes, all of which are characterized by an immense focus on food, body and weight, an endless attempt to combat the body and by a fluctuation between ‘too much and not enough’ on different levels (e.g., behaviourally, mentally, physically).

The aim of this article is to contribute to the psychoanalytic understanding of eating disorders, to highlight the vital importance of the symptoms as a psychological survival strategy and to illustrate similarities between eating disordered patients as well as the very different pathways that can lead to an eating disorder. Two clinical cases are presented, one very shortly and one in more detail.     

Associations of social relationships with consultation for symptoms of depression: a community study of depression in older men and women in Québec

To assess associations between social relationships and consultation for symptoms of depression, data from a representative sample of 2,811 French-speaking community-dwelling older adults in Québec were used. Less than half of the older adults meeting DSM criteria for depression (N = 379; 47.1%) had sought consultation about their depression-relevant symptoms in the preceding 12 months. Having a cohabitant partner or having children were not associated with frequency of consultation for women. Men without a partner tended to consult more frequently than men with a cohabiting partner (OR = 2.5; 95% CI = 0.81, 7.88). None of the men without a confidant had consulted. Among the 67 men with a confidant, consultation was more frequent among those not cohabiting with a partner (70%) than among those with a cohabiting partner (46%). The influence of social relationships on consultation for depression differed in men and women in this population of depressed elderly people in Québec.     

An interactional “live eye tracking” study in autism spectrum disorder: combining qualitative and quantitative approaches in the study of gaze

Recent studies on gaze behaviours in individuals with autism spectrum disorder (ASD) have utilised “live eye tracking.” Such research has focused on generating quantitative eye tracking measurements, which provide limited (if any) qualitative contextual details of the actual interactions in which gaze occurs. This article presents a novel methodological approach that combines live eye tracking with qualitative interaction analysis, multimodally informed conversation analysis. Drawing on eye tracking and wide-angle video recordings, this combination renders visible some of the functions, or what gaze “does,” in interactional situations. The participants include three children with ASD and their adult co-participants during body-movement gaming sessions. The article demonstrates how quantitative eye tracking research can be extended qualitatively using a microanalytic interaction analysis to recontextualise the gaze shifts identified. The findings in this article show that the co-participants treat a child’s gaze shifts differently depending on when these occur in a stream of other action. The study suggests that introducing this qualitative dimension to eye tracking research could increase its ecological validity and offer new insight into gaze behaviours in ASD.     

Do eating disorder voice characteristics predict treatment outcomes in anorexia nervosa? A pilot study

Individuals with anorexia nervosa often describe experiencing an internal “voice” of their disorder, which previous research has associated with multiple dimensions of eating pathology. This pilot study examined whether eating disorder measures use invoice characteristics at the outset of outpatient therapy predicted changes in disordered eating over the course of treatment. Participants were 14 individuals meeting ICD-10 criteria for anorexia nervosa. Participants completed measures relating to the severity of disordered eating and voice-related characteristics (perceived voice power and metacognitive appraisals about its nature) at the start and end of therapy. Results indicated that the perceived power of the eating disorder was reduced over the course of outpatient therapy, although its other characteristics remained stable. Greater levels of voice power, omnipotence and benevolence at the outset of therapy were related to greater improvements in eating attitudes. No voice-related characteristics were associated with changes in weight. These findings suggest that voice-related appraisals do not obstruct the effectiveness of outpatient therapies for anorexia nervosa. Further studies are needed to ratify these preliminary findings.     

Morally disengaged and unempathic: do cyberbullies fit these definitions? An exploratory study

In recent years, the phenomenon of cyberbullying has been gaining scholars' growing interest under various aspects, including its overlap with face-to-face bullying. Nevertheless, its relationships with cognitive and affective empathy, proactive and reactive aggression, and moral disengagement, constructs that proved to be crucial in distinguishing aggressive subjects from their targets and nonaggressive peers in traditional bullying, still represent, to some extent, an unexplored domain. The main purpose of the present exploratory study was to investigate the associations between cyberbullying and the mentioned constructs among Italian adolescents. 819 high-school students (mean age 16.08) were administered a battery of standardized tools, along with Cyberties, a new instrument created to assess the prevalence of (and the type of involvement in) different forms of electronic assaults. Analyses of variance were conducted to compare four roles ("pure" bullies, "pure" victims, bully victims, and noninvolved subjects). Participants who identified themselves as cyberbullies or cyberbully victims showed significantly higher levels of overall moral disengagement and of both types of aggression. Cyberbullies also displayed a lack of affective empathy. Our findings are in line with the ones in extant literature about correlates of traditional and electronic forms of bullying. Implications for prevention strategies are discussed.