The transtheoretical model of change: Examples from stammering

Procaska and DiClemente's model of intentional change was initially associated with the field of addiction but has been more recently used in the treatment of a broad range of difficulties. Examples in this article come mainly from therapy with adults who stammer. The model explores how people initiate and maintain change and is based on empirical evidence. It comprises 3 dimensions. Ten processes describe the ‘how' of change. Five levels outline the ‘what' of change, arranged hierarchically from sympom/situational to intrapersonal conflicts level. The five stages of change, the ‘when' of change are described here in some detail, together with ideas for the most suitable therapeutic approaches to be used at each.     

Preserved re-experience of discrete emotions: Amnesia and executive function

Amnesic patients can re-experience emotions elicited by forgotten events, suggesting that brain systems for episodic and emotional memory are independent. However, the range of such emotional memories remains under-investigated (most studies employing just positive–negative emotion dyads), and executive function may also play a role in the re-experience of emotions. This is the first investigation of the intensity of the emotional re-experience of a range of discrete emotions (anger, fear, sadness, and happiness) for a group of amnesic patients. Twenty Korsakoff syndrome (KS) patients and 20 neurologically normal controls listened to four novel emotional vignettes selectively eliciting the four basic emotions. Emotional experience was measured using pen-and-paper Visual Analogue Mood Scales and episodic memory using verbal recollections. After 30 min, the recollection of stories was severely impaired for the patient group, but the emotional re-experience was no different from that of controls. Notably, there was no relationship between episodic recall and the intensity of the four emotions, such that even profoundly amnesic patients reported moderate levels of the target emotion. Exploratory analyses revealed negative correlations between the intensity of basic emotions and executive functions (e.g., cognitive flexibility and response inhibition) for controls but not patients. The results suggest that discrete emotions can be re-experienced independently of episodic memory, and that the re-experience of certain discrete emotions appears to be dampened by executive control. KS patients with absent or mild cognitive symptoms should benefit from emotion-regulation interventions aimed at reducing the recognized affective burden associated with their episodic memory deficit.     

Connecting to belonging: a cross-disciplinary inquiry into rural Australian Anglican Church engagements with people from culturally and linguistically diverse backgrounds

People from diverse backgrounds enrich the rural, regional, and remote communities where they relocate and settle. Research about rural diversity tends to focus on demographics (age, gender, country of origin) while ignoring personal narratives of integration, for example, engagements with religious institutions (such as the local Christian church). This article presents the research themes from an investigation using co-operative inquiry into rural diversity and the Anglican Church, with specific reference to the Australian experience. It is a cross-disciplinary dialogic exchange between social workers and theologians. Positive narratives about connection, welcome, participation, and belonging are shared.     

Value Priorities and Organ Donation in Young Adults

This research identifies major personal values among American university students that predict organ-donation registration with the Department of Motor Vehicles. Participants responded to a factual test of their knowledge about organ donation, indicated whether or not they had registered as posthumous donors, and filled out a personality inventory measuring their personal values (Schwartz, 1992, 1994). The data indicated a high level of factual knowledge about organ donation; and the greater the level of knowledge, the more likely participants were registered to donate their organs. Also, participants higher in benevolence, universalism, achievement, and stimulation were more likely to have registered to donate their organs. The results are discussed in terms of the need to develop more effective health-communication campaigns by using specific health-education messages tailored to students majoring in different disciplines or to people in various occupations as a means of increasing their willingness to donate.     

Cardiac morbidity risk and depression and anxiety: a disorder, symptom and trait analysis among cardiac surgery patients

The aim of this study was to examine depression and anxiety disorders and their characteristic symptoms (anhedonia/low positive affect and anxious arousal, respectively), along with measures of state negative affect (NA) and Type D personality, in relation to cardiac surgery related morbidity. Patients awaiting elective coronary artery bypass graft surgery (n=158; 20.9% female; 11.4% concomitant valve surgery; age M=64.7, SD=10.6) underwent the structured MINI International Neuropsychiatric Interview to determine current affective disorders. Patients also completed the Mood and Anxiety Symptom Questionnaire and a measure of Type D personality traits. Postoperative cardiac morbidity was confirmed after surgery during the index hospitalization and included stroke,renal failure, ventilation>24 h, deep sternal wound infection, reoperation, arrhythmia and 30-day mortality at any location (n=59, 37.3% of total). After adjustment for age, recent myocardial infarction, heart failure, hypertension, urgency of surgery and time spent on cardiopulmonary bypass generalized anxiety disorder was associated with cardiac morbidity (odds ratio [OR]=3.26, 95% confidence interval [CI] 1.10-9.67, p=0.03). Adjusted analysis of personality traits revealed the NA component of Type D personality was associated with cardiac morbidity (OR=1.07, 95% CI 1.01-1.14, p=0.03). The Mood and Anxiety Symptom Questionnaire subscales were not associated with increased morbidity risk. Affective disorders, affective phenotypes, and personality traits were differentially associated with post-cardiac surgery morbidity outcomes independent of cardiac surgery morbidity risk factors. Concurrent investigation of depression and anxiety with respect to cardiac outcomes warrants further research.     

Paranormal Encounters as Eyewitness Phenomena: Psychological Determinants of Atypical Perceptual Interpretations

Many people who report paranormal sightings (e.g., Bigfoot and UFO aliens) are apparently sincere. This places many such sightings in the category of eyewitness errors, rather than of deliberate deception. Recent research has supported this idea; in an earlier paper, we demonstrated that paranormal beliefs are facilitated by tendencies toward attention deficit hyperactive disorder, dissociation, and depression. These characteristics predicted specific patterns of beliefs in several paranormal phenomena. The present research addressed the question of whether such psychological tendencies would tend to create bias in perception and interpretation as well as in belief- in whether a person’s identification of a given stimulus as paranormal in nature would be influenced by the same factors previously demonstrated to influence paranormal beliefs. This hypothesis was supported. Specifically, those with dissociative tendencies were significantly more likely to identify given stimulus items as paranormal in nature than were those with lower dissociation scores. Dissociation was further shown to be related to paranormal beliefs, consistent with earlier findings. Results are discussed in terms of the reconfigurative dynamics known to operate in areas of human cognition such as eyewitness identification, and in terms of the generality of those effects to the realm of paranormal sightings.     

Threat in dreams: an adaptation?

Revonsuo's influential Threat Simulation Theory (TST) predicts that people exposed to survival threats will have more threat dreams, and evince enhanced responses to dream threats, compared to those living in relatively safe conditions. Participants in a high crime area (South Africa: n=208) differed significantly from participants in a low crime area (Wales, UK: n=116) in having greater recent exposure to a life-threatening event (chi([1,N=186])(2)=14.84, p<.00012). Contrary to TST's predictions, the SA participants reported significantly fewer threat dreams (chi([1,N=287])(2)=6.11, p<.0134), and did not differ from the Welsh participants in responses to dream threats (Fisher's Exact test, p=.2478). Overall, the incidence of threat in dreams was extremely low-less than 20% of dreams featured realistic survival threats. Escape from dream threats occurred in less than 2% of dreams. We conclude that this evidence contradicts key aspects of TST.