Health care practitioners' perceptions of public mental health care in the Eastern Cape,South Africa

This qualitative study explored the perceptions of health care practitioners (HCPs) concerning public mental health care in the Eastern Cape Province of South Africa. Data were collected from thirteen purposively selected HCPs using in-depth unstructured interviews (males?=?6, females?=?7). Data were transcribed verbatim and later thematically analysed. The findings suggest that mental health professionals perceive mental health services to be both inadequate and of suboptimal quality. Specifically, they perceived public mental health care to have lower priority, to be poorly resourced and lacking in patient-oriented care qualities.     

Two-year outcome of internet-based relapse prevention for partially remitted depression

The objective of the study was to investigate the long-term effects of internet-based relapse prevention for sufferers of partially remitted depression. Eighty-four individuals with partially remitted unipolar depression were randomized to either internet-based CBT (iCBT) or to a control group. After the ten week intervention period the participants were followed for 24 months and diagnostic interviews conducted to detect relapse. The intervention and monthly self-ratings of depressive symptoms were administered via an internet-based platform that ensured secure communication with all participants. Significantly fewer participants in the iCBT group had experienced a relapse compared with those in the control group two years after the internet-based intervention. The relapse rate in the iCBT group was 13.7% (CI 95% = 2.5–24.9) and in the control group it was 60.9% (CI 95% = 44.8–77). Furthermore, a significantly larger proportion of the iCBT group experienced remission two years after the intervention compared with the control group. Internet-based CBT seems promising for preventing relapse in sufferers of partially remitted depression.     

Predictors of outcome in Internet-based cognitive behavior therapy for severe health anxiety

Internet-based cognitive behavior therapy (CBT) for severe health anxiety can be effective, but not all patients achieve full remission. Under these circumstances, knowledge about predictors is essential for the clinician in order to make reliable treatment recommendations. The primary aim of this study was to investigate clinical, demographic, and therapy process-related predictors of Internet-based CBT for severe health anxiety. We performed three types of analyses on data from a sample comprising participants (N = 81) who had received Internet-based CBT in a randomized controlled trial. Outcomes were a) end state health anxiety, b) improvement in health anxiety (continuous change scores), and c) clinically significant improvement. Outcomes were assessed at six-month follow-up. The results showed that the most stable predictors of both end state health anxiety and improvement were baseline health anxiety and depressive symptoms. Treatment adherence, i.e. the number of completed treatment modules, also significantly predicted outcome. Notably, health anxiety at baseline was positively associated with symptom improvement while depressive symptoms was negatively related to improvement. Demographic factors were largely without significant impact on end state symptoms or improvement. We conclude that baseline symptom burden and adherence to treatment have strong predictive effects in Internet-based CBT for severe health anxiety.     

Realism of Confidence,Modes of Apprehension,and Variable-Use in Visual Discrimination of Relative Mass

We investigated the role of movement in the perception of a novel affordance for wheelchair locomotion. Healthy adults without prior wheelchair experience judged the lowest lintel under which they could roll in the wheelchair. Prior to judgments, some participants were given brief (~2 min) practice at self-controlled wheelchair locomotion. There were 2 main results. First, participants who had this brief practice accurately judged their own minimum passage height (even when practice did not include passage under low lintels), whereas participants who had no practice gave inaccurate judgments. Second, prejudgment practice strongly influenced movement of the head and torso during judgment sessions. The results demonstrate that affordance perception can be learned through brief, indirect practice and suggest that such practice can inform exploratory movement.     

The Moment of a Star: The Ethics of Narration

The main theme of the following presentation of Ric?ur's philosophical preoccupations with religion is the interrelationship between reflection and revelation. In a first section, Ric?ur's philosophical profile is outlined in order to indicate the tone between sadness and joy, negativity and affirmation, in which religion has its existential and philosophical ambience. The following part discusses the pertinence of Ric?ur's position in light of contemporary debates about divine otherness and kenosis. Finally, a third section examines the antagonism between philosophy of reflection and biblical revelation, which marks the range and limits of Ric?ur's hermeneutic philosophy. The kind of dependency or heteronomy implied in religion, especially in the biblical idea of the absolute as an external truth-event, presents a genuine challenge to both phenomenology and hermeneutics. This problem is addressed in Ric?ur's theories of revelation and testimony.     

Couples' Experience of Enactments and Softening in Marital Therapy 1

Abstract

Beginning therapists are not prepared to deal with the complexity that families bring to the therapeutic setting and have a reductionistic approach to understanding what is occurring in a family. In order to move beyond a simplified approach, therapists with the assistance of a supervisor have the power to leave the security of their own being and can learn to take risks. This paper explores the development of a “therapeutic story” with the goal of assisting the beginning therapist in approaches that can be utilized to incorporate all available resources that will help to empower a family to change.     

Emotional Stroop via Internet among individuals with eating disorders

The present study investigated whether Stroop interference in eating disordered individuals for food - and body-related words, as repeatedly found previously using standard emotional Stroop tasks, would also be demonstrated when using an Internet based emotional Stroop task. Participants were anorexic women (n= 13), bulimic women (n= 20), non-clinically eating disordered women nevertheless over-concerned about eating and body appearance (n= 27) and normal control women (n= 31). Bulimic individuals showed Stroop interference for body-related words whereas anorexic individuals showed Stroop interference for food-related words. The present results thus suggest that administration of the emotional Stroop task is possible via the Internet. Furthermore, it is possible that the time consuming response delivery, relative to previous studies, could lead to Stroop interference only for the most emotionally significant information, in turn, differentiating between the core concerns of anorexic and bulimic individuals.     

A dichotic listening study of attention control in older adults

The influence of age on attentional control of bottom-up processing was investigated with a dichotic-listening paradigm. The typical right-ear-advantage (REA) without specific attentional instructions was used as a measure of bottom-up processing (non-forced condition). Top-down attentional control was evaluated by instructing subjects to report only the right or left ear stimulus of the dichotic pair (forced-right, forced-left conditions). Both young and old participants showed a REA in the non-forced condition and an increased REA in the forced-right condition. The old group failed, however, to use attention to modulate the REA to the same degree as the younger participants in the forced-left condition. Only the young group showed a significant left ear advantage (LEA). The results are discussed in relation to cognitive decline in normal aging and in early stages of dementia.     

Political Liberalism and the Interests of Children: A Reply to Timothy Michael Fowler

Timothy Michael Fowler has argued that, as a consequence of their commitment to neutrality in regard to comprehensive doctrines, political liberals face a dilemma. In essence, the dilemma for political liberals is that either they have to give up their commitment to neutrality (which is an indispensible part of their view), or they have to allow harm to children. Fowler??s case for this dilemma depends on ascribing to political liberals a view which grants parents a great degree of freedom in deciding on the education of their children. I show that ascribing this view to political liberals rests upon a misinterpretation of political liberalism. Since political liberals have access to reasons based upon the interests of children, they need not yield to parent??s wishes about the education of their children. A correct understanding of political liberalism thus shows that political liberals do not face the dilemma envisaged by Fowler.