Self-defining memories in complicated grief

There is increasing attention to the mechanisms underpinning maladaptive responses to bereavement. This study indexed self-defining memories in bereaved individuals with and without complicated grief (CG). Participants with and without complicated grief (N = 40) were asked to describe three self-defining memories. Results showed that CG participants provided more self-defining memories involving the deceased. Both groups were equally likely to report their loved one's death as a self-defining moment, however, the no-CG group showed more evidence of benefit finding in their memory narratives and experienced less negative emotion on recall. The findings suggest that CG is associated with distinctive patterns of autobiographical memory that are linked to self-identity. The pattern is consistent with self-memory system models of autobiographical remembering, and suggests that grieving individuals who experience ongoing yearning for their loved one view their self-identity as more closely linked to the deceased are more distressed by memories involving the loss.     

The Couple's Grid: A Tool for Assessing Interpersonal Construction in Couples

In the study of human relationships, interest in interpersonal construction is increasing because of its implications for the quality of the couple's relationship. The processes involved in construing self and others may play a key role. However, a precise methodology to study those processes has not yet been developed. The aim of this article is to present a dyadic assessment tool, the couple's grid (CG), which is inspired from constructivist and systemic perspectives. Derived from Procter's (1985) family grid, the CG is similarly based on the repertory grid technique. The CG assesses perception of self and partner, and their ideals, and also the metaperception of the partner's view (e.g., “What does your partner think about you?”). These two levels of analysis provide measures of perceived similarity, commonality, and sociality. This article describes the development of CG as an assessment tool with a case illustration.     

Suicidality and bereavement: complicated grief as psychiatric disorder presenting greatest risk for suicidality

The influence of complicated grief (CG) on suicidality among bereaved adults was examined. The Yale Evaluation of Suicidality scale and the Inventory of Complicated Grief-Revised were administered to 309 bereaved adults in face-to-face interviews conducted at baseline (6.2 months post-loss) and at follow-up (10.8 months post-loss). Cross-sectionally, CG was associated with a 6.58 (95% CI: 1.74-18.0) times greater likelihood of "high suicidality" at baseline, and an 11.30 (95% CI: 3.33-38.10) times greater risk of high suicidality at follow-up, after controlling for gender, race, major depressive disorder (MDD), posttraumatic stress disorder (PTSD), and social support. Longitudinally, CG at baseline was associated with an 8.21 (95% CI: 2.49-27.0) times greater likelihood of high suicidality at follow-up, controlling for the above confounders. The study results indicate that CG substantially heightened the risk of suicidality after controlling for important confounders such as MDD and PTSD, suggesting that CG poses an independent psychiatric risk for suicidal thoughts and actions.     

Passionate Yearning Theory as a Theory of Meaning in Life

In this paper, I offer an original account of meaning in life, which I call the passionate yearning theory. Within the framework of the passionate yearning theory, meaning is understood as the intrinsically derived yearning, and passionate striving, for something (an ideal, or a state of affairs) that possesses some plausible objective claim to truth or facticity, which makes it worth pursuing for its own sake. To properly delineate the view, I present the various criteria that serve as the foundation for the passionate yearning view. These include the truth/facticity criterion, the lack of immorality, intrinsic subjectivity, passion, yearning and striving. I then show how these criteria coalesce into the passionate yearning theory and how exactly the theory works. Finally, I motivate the passionate yearning theory by addressing some possible criticisms and objections that can be raised against the view and also differentiate it from similar competing views.

     

The role of social support in women’s health and recovery processes

The aim of this study was to assess the psychological state of women who have undergone surgery for breast cancer or cardiac surgery, including examination of the role of social support in both groups. The study included 48 women (mean age: 66.04?±?8.3 years). They were divided into two groups according to diagnosis: 23 women (mean age: 69.2?±?8.6 years) who underwent heart surgery (cardiac group, CG) and 25 women (mean age: 63.2?±?7.0 years) treated for breast cancer and associated with the Women After Mastectomy Club (oncology group, OG). In addition to the assessment of socio-demographic variables, the following self-report questionnaires were administered: Satisfaction with Life Scale, Acceptance of Illness Scale, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory as well as Berlin Social Support Scale. In the CG, the severity of depressive symptoms was two times higher than in OG (p?=?.003). In both groups, there was a high percentage (80%) of women with severe symptoms of anxiety (p?=?.37). In both groups, the level of life satisfaction was similar (p?=?.58), but OG was characterized by a higher level of acceptance of the disease (p?=?.003). The correlation analysis showed that in both groups, social support was related differently to the parameters of emotional state. Women treated for breast cancer were in a better mental condition than women treated for heart disease. The support coming from other women in similar circumstances (Women After Mastectomy Club) seems to be more effective than the support coming from the patient’s immediate environment. The results for social support ought to be interpreted not only through the prism of mean values of received support, but also with regard to the information on the sources of support.     

EFFECTS OF MULTIPLE ADMINISTRATIONS OF THE MMPI FOR EMPLOYEE SCREENING

Psychological screening has become commonplace in a number of occupational groups. With the growing popularity of screening and the relative scarcity of appropriate personality measures, re-screening individuals with the same inventory is frequent. This paper examines the effect of re-screening with the Minnesota Multiphasic Personality Inventory (MMPI) on contract workers (n = 1,997) from the nuclear power industry. Participants completed the Inventory as a part of a routine screening procedure. Each participant provided several profiles as a result of regular employment cycles. Although the differences are generally small, some scales show large enough mean changes to warrant concern when interpreting the profiles of those who have taken the profile multiple times. Although scale reliabilities tend to increase, the usefulness of the Inventory appears to decrease with an increasing number of administrations. The effect is one of increasing normality of test profiles. One interpretation of the results is that candidates for jobs become "test-wise," and the scores are the result of a combination of responses to the repeated assessment. It becomes increasingly difficult to identify unfit employees with the Inventory. Given these results, further research on retesting effects of the Inventov, as well as other personality measures, is indicated.     

Sexuality,Intimacy, and Recovery

Human sexuality is an inseparable part of the yearning for intimacy, merging, and touch, both for people in general and for those with severe mental disorders. The exploration and acceptance of sexuality and the yearning for intimacy are vital to the recovery process of people with severe mental disorders. Despite this importance, therapists appear to disregard sexual issues in therapy with people with severe mental disorders. This article discusses the sexuality difficulties of these patients resulting from their personal history and examines the difficulties of therapists and therapeutic institutions in dealing with these patients’ sexuality-related issues.     

General or specific? The memory–experience gap for individuals diagnosed with a major depressive disorder or a social phobia diagnosis,and individuals without such diagnoses

ABSTRACT

Psychological treatment and assessment necessarily rely on patients’ recall. Yet several empirical studies have documented a gap between memory and real-life experience (i.e., memory–experience gap; MeG). We investigated and compared the MeG of sadness, social anxiety, happiness, and physical activity for participants diagnosed with a major depressive disorder (MDD), a social phobia (SP), and participants without such diagnoses (CG). The study included 118 participants diagnosed with a MDD, 47 with a SP, and 119 CG. Using event-sampling methods (ESM), participants were asked via smartphone to report their experiences throughout a week and then to recall those again retrospectively at the end of the study week. Results indicate significant differences in the MeG with respect to the experience that was salient to them (e.g., MDD group – sadness; SP group – social anxiety; CG group – happiness). Furthermore, all groups showed a MeG for physical activity and, the results indicate significant group differences in the magnitude of the MeGs.

This study demonstrated the presence of a MeG in individuals in a MDD, SP, and CG group and in positive and negative affective experiences. Differential patterns across the samples contribute to a better understanding of this gap and its implications.     

Social-cognitive processes as moderators of a couple-focused group intervention for women with early stage breast cancer.

OBJECTIVE: The purpose was to examine whether social-cognitive variables would moderate the efficacy of a couple-focused group intervention (CG) for women diagnosed with early stage breast cancer. DESIGN: Participants (N = 238) were randomly assigned to 6 sessions of a couple-focused group versus usual care. Intent to treat growth curve modeling analyses indicated that emotional expression and emotional processing moderated CG effects on depression. MAIN OUTCOME MEASURES: The primary outcome measures for this study were psychological distress and psychological well-being. RESULTS: Treatment attrition analyses separating out participants assigned to but not attending CG indicated that emotional expression, emotional processing, and protective buffering moderated the effects of CG among those who attended CG with the most consistent effects noted for emotional processing on indicators of distress and well-being. CONCLUSION: The CG intervention may be more effective for patients who begin the group experience using emotional approach coping strategies to deal with cancer.     

Situational effects in trait assessment: The FPI,NEOFFI, and EPI questionnaires

While most researchers do agree now that situations may have an effect in the assessment of traits, the consequences have been neglected, so far: if situations affect the assessment of traits we have to take this fact into account in studies on reliability and validity of measurement instruments and their application. In the theoretical part of this article we provide a more formal exposition of this point, introducing the basic concepts of latent state–trait (LST) theory. LST theory and the associated models allow for the estimation of the situational impact on trait measures in non-experimental, correlational studies. In the empirical part, LST theory is applied to three well known trait questionnaires: the Freiburg Personality Inventory, the NEO Five-Factor Inventory and the Eysenck Personality Inventory. It is shown that significant proportions of the variances of the scales of these questionnaires are due to situational effects. The following consequences of this finding are discussed, (i) Instead of the reliability coefficient, the proportion of variance due to the latent trait, the consistency coefficient, should be used for the estimation of confidence intervals for trait scores, (ii) To reduce the situational effects on trait estimates it may be useful to base such an estimate on several occasions, i.e., to aggregate data across occasions. (iii) Reliability and validity studies should not only be based on a sample of persons representative of those to whom the test will be applied; they should also be conducted in situational contexts representative of the intended applications.     

延长哀伤障碍的概念、流行病学和病理机制

延长哀伤障碍是一种由亲近的人去世引发的病理性哀伤反应, 即死亡发生6个月后, 个体对死者的想念影响到了生活各方面, 且社会功能受损, 其最近20年才开始受到临床心理学研究者关注和探讨。本文首先回顾了概念提出及后续发展, 并讨论了其与持续性复杂哀伤相关障碍的区别与联系。随后, 本文综述了其独立的诊断标准、评估工具和流行病学调查、以及与正常哀伤、抑郁症和创伤后应激障碍的区别。接下来, 本文对其病理机制的理论思考和实证研究进行了讨论。最后, 本文指出未来可考察诊断标准的跨文化适用性、丰富病理机制的理论与研究。     

Concurrent validity of the Millon Adolescent Clinical Inventory as a measure of depression in hospitalized adolescents.

This study examined the concurrent validity of the Millon Adolescent Clinical Inventory (MACI; Millon 1993) in the assessment of depression among 88 adolescent inpatients. Doleful Personality and Depressive Affect scales were moderately predictive of a clinical diagnosis of depression, but both scales were strongly associated with scores on the Children's Depression Inventory (Kovacs, 1992). The Suicidal Tendencies scale was weakly associated with placement on suicide precautions. Overall, these results provide moderate support for the use of the MACI in the assessment of hospitalized adolescents.     

Web-based CBT for the prevention of anxiety symptoms among medical and health science graduate students

ABSTRACT

Medical and health science graduate students report greater anxiety problems than the general population, but they are less likely to seek treatment due to cultural and logistical barriers. One preventative approach that overcomes these barriers is web-based cognitive behavioral therapy (webCBT). It is unknown whether webCBT is effective for preventing anxiety escalation within this population. A randomized controlled trial was conducted, comparing the effects of webCBT versus a control group (CG). Medical university students (n=594; Mage=27; 67% female; 80% Caucasian) completed online baseline measures and four assigned online activities. Measures were re-administered after approximately three months. There was a small interaction effect between time of assessment and treatment condition. Anxiety severity was lower in the webCBT (M[SD]=2.88[3.36]) versus CG condition (M[SD]=3.69 [3.35]) at follow-up. This effect was moderate for students with mild, versus minimal, anxiety at baseline. The proportion of students with possible anxiety disorder was lower in the webCBT (4.5%) versus CG (8.5%) condition, and the proportion of mildly anxious students with a clinically significant increase in symptoms was lower in the webCBT (10%) versus CG (20%) condition. WebCBT may aid in preventing anxiety escalation in this population, particularly for at-risk students who report mild anxiety symptoms.     

Separation and Traumatic Distress in Prolonged Grief: The Role of Cause of Death and Relationship to the Deceased

A distinction has been drawn between symptoms of separation distress (e.g., yearning/longing for the lost relationship) and traumatic distress (e.g., numbness, anger/bitterness) in prolonged grief disorder (PGD), a chronic and severe form of grieving that has been shown to predict a range of negative mental and physical health outcomes. The present study relied upon information from 947 recently bereaved young adults and tested the hypothesis that levels of separation distress primarily would be influenced by aspects of the relationship with the deceased (i.e., primary attachment figures vs. more distant relationships), whereas levels of traumatic distress would be influenced more by situational factors surrounding the death itself (i.e., cause of death). Results generally supported this hypothesis with a few important qualifications. Implications for the assessment and treatment of bereaved individuals are discussed.     

孝的多维心理结构：取向之异与古今之变

孝的内在结构具有多面性, 但以往孝的量表存在信效度不高、掺入研究者主观意图、遗漏重要因素等弊端。研究通过经典文本改编和被试自由生成而编制条目, 通过因素分析与效标分析等方法考察孝的结构( 总样本量 = 1725), 发现孝包含尊敬安乐父母、服从父母、和颜对待父母、守身不辱父母、陪伴父母、扬名以显父母、思慕父母、不干涉父母、劝谏父母, 九因素结构具有良好的信效度。不同因素与效标变量(家庭自我概念、家庭弹性、父母教养方式、亲子边界不当、自立人格、服从倾向)具有不同的关联模式。这些发现反映出儒学论孝的敬慕之别、敬顺之变。此外讨论了不同因素的古今变迁。     

A Sense of ‘unrealness’ about the death of a loved‐one: An exploratory study of its role in emotional complications among bereaved individuals

After a loss, some people develop complicated grief (CG) and depression. A recent cognitive‐behavioural model postulates that three processes account for such problems: (a) lack of integration of the loss with implicit autobiographical knowledge about the relationship with the lost person, (b) negative cognitions and (c) avoidance behaviours. In the current study, it was proposed that the ‘lack of integration of the loss’ is mainly an implicit process, but has an explicit, introspectively accessible counterpart in the form of ‘a sense of unrealness’ that can be defined as a subjective sense of uncertainty or ambivalence about the irreversibility of the separation. The role of this ‘sense of unrealness’ was studied using self‐reported data from 397 mourners. Among other things, findings showed that items constituting unrealness were distinct from those of CG and depression. In addition, unrealness was significantly associated with CG, when controlling for negative cognitions, avoidance and concomitant depression. Copyright © 2009 John Wiley & Sons, Ltd.     

Concurrent Validity of the Multidimensional Health Profile—Health Functioning Scales (MHP-H) in the Pre-operative Assessment of Applicants for Gastric Bypass Surgery

The concurrent validity of a brief screening test, the Multidimensional Health Profile-Health Functioning (MHP-H) was examined in conjunction with a much more lengthy pre-operative assessment procedure in 449 applicants for gastric bypass surgery (GBS). The MHP-H is a 69-item screening inventory that assesses five areas of health functioning: Adult Health History, Health Habits, Health Care Utilization, Health Beliefs and Attitudes, and Response to Illness. The more lengthy procedure included a comprehensive 273-item structured interview plus the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Basic Personality Inventory (BPI), and Beck Depression Inventory (BDI). The MHP-H showed significant correspondence with the more comprehensive assessment on measures of potential relevance to outcome in GBS, supporting the use of the MHP-H as a low-cost alternative to the more extensive procedure. The utility of the MHP-Psychosocial Functioning (MHP-P), a companion instrument to the MHP-H, was demonstrated in an earlier study.     

Utility of the Multidimensional Health Profile—Psychosocial Functioning Scales (MHP-P) for Assessing Psychosocial Adjustment in Gastric Bypass Surgery Patients

This study examined the utility of the Multidimensional Health Profile—Psychosocial Functioning (MHP-P) for the preoperative assessment of gastric bypass surgery (GBS) applicants. The MHP-P, a 58-item screening inventory that assesses 4 psychosocial areas relevant to health (mental health, life stress, social resources, and coping skills), was administered to 449 morbidly obese patients who were being considered for GBS. Data were compared with the results of a much more lengthy assessment procedure involving a 273-item comprehensive biographical and medical history interview, the MMPI-2, the Basic Personality Inventory, and the Beck Depression Inventory. The 17 measures of the MHP-P showed highly significant correlations with other measures considered to be of relevance in GBS outcome, confirming the utility of the MHP-P as a cost-effective procedure for use in this clinical medical setting.     

Personality assessment across selection and development contexts: insights into response distortion

Insight into applicant intentional distortion on personality measures was obtained by comparing individual responses provided in an organizational context with high motivation to distort (selection) and those provided in an organizational context with low motivation to distort (development). An assessment firm database containing responses to the California Psychological Inventory (CPI) was searched for within-subject data. Seven hundred and thirteen individuals were identified as having completed the CPI twice: once for selection purposes and once for development purposes or twice for the same purpose. Scale-score analyses both within and across contexts revealed a limited degree of response distortion.     

The eternal yearning

Parker Palmer defines spirituality as ‘the eternal yearning to be connected with something larger than our own egos’ (2003, 121). This yearning is an innate human need that transcends age, culture, ethnicity and belief. Despite deficit assumptions about young people, they are drawn to this need to surmount the ego and contribute to something larger than their own wants and needs. Two counter stories of young people involved in social activism outline how this is achieved. These are stories of contribution, compassion, empathy and understanding. Implications for schools are outlined including the range of learning that social activism inspires.