The listening heart and the chi square: clinical and empirical perceptions in the family therapy of anorexia nervosa

Clinical and empirical methods are commonly considered to be complementary activities. However, many people in the fields of mental health and social welfare espouse a strong adherence to experimental, scientific methods for the evolution of theory and practice and consider only that which has been experimentally tested as‘really true”. Others would propose the clinical method as the main source of useful knowledge and are suspicious of enumeration and quantification as sources of useful information. Formal, empirical methodology is well and extensively described whilst there is less systematic exposition of the clinical method. Family therapy evolved in a context in which activity was visible and the emerging discipline was propelled by a theoretical framework with strongly scientific origins that was critical of the exclusive clinical method of pre-existing psychotherapies. This paper describes some of the clinically based contributions to the family therapy of anorexia nervosa and compares this information with that which comes out of the Maudsley trials of psychotherapies in anorexia nervosa.     

Measuring intrinsic and extrinsic orientation toward religion: Amendments for its use among religious and non-religious samples

Amendments to the Age-Universal I-E scale, used to measure intrinsic and extrinsic orientations toward religion, are proposed to facilitate the scales' use among both religious and non-religious samples. The original and revised versions of the intrinsic and extrinsic scales were administered to six adult samples from the U.S.A. (N = 156; N = 144), England (N = 135; N = 149) and Norhern Ireland and Republic of Ireland (N = 189; N = 167). Data show in all six samples the percentage of I-E scales completed was greater for the revised version than the original version. In addition, the revised version of the scales demonstrates more satisfactory reliability estimates than the original version. It is suggested that researchers examining intrinsic and extrinsic orientation towards religion may benefit from using the revised version.     

Work plan availability and performance: An assessment of task strategy priming on subsequent task completion

The relation of task strategy planning to task performance was explored using a series of laboratory investigations. The first study examined the influence of providing a subject a work strategy and a specific work goal on his or her subsequent performance. A total of 72 subjects participated in a 2 (goal) × 2 (task strategy priming) × 3 (performance period) × 3 (task type) repeated measures, factorial design study. The results demonstrate that task strategy priming and goal setting increase the amount of an individual's planning and directs the type of plan developed. A second study was conducted (n = 90) to further explore the effect of task strategy priming on planning and performance. Taken together, the results of the studies demonstrate that (a) goal setting increases strategic planning, (b) priming influences the amount and type of planning engaged in by an individual, and (c) task performance varies as the result of the type of plan an individual develops. The results are discussed as a means of expanding the use of cognitive constructs in theories of work motivation.     

Affective States and Epistemic Immediacy

This article defends the view that an adequate response to some central epistemological problems requires us to find a role for emotions and other affective states in epistemic evaluation and also to invoke virtuous traits of character in order to explain how these affective evaluations are regulated. The argument is based on the need for some epistemic evaluations to possess a kind of immediacy, if we are not to face a worrying regress. The closing sections support the claim that epistemic evaluation depends upon appropriate character traits though a discussion of what is involved in being observant .     

Cognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment

This paper is concerned with the psychopathological processes that account for the persistence of severe eating disorders. Two separate but interrelated lines of argument are developed. One is that the leading evidence-based theory of the maintenance of eating disorders, the cognitive behavioural theory of bulimia nervosa, should be extended in its focus to embrace four additional maintaining mechanisms. Specifically, we propose that in certain patients one or more of four additional maintaining processes interact with the core eating disorder maintaining mechanisms and that when this occurs it is an obstacle to change. The additional maintaining processes concern the influence of clinical perfectionism, core low self-esteem, mood intolerance and interpersonal difficulties. The second line of argument is that in the case of eating disorders shared, but distinctive, clinical features tend to be maintained by similar psychopathological processes. Accordingly, we suggest that common mechanisms are involved in the persistence of bulimia nervosa, anorexia nervosa and the atypical eating disorders. Together, these two lines of argument lead us to propose a new transdiagnostic theory of the maintenance of the full range of eating disorders, a theory which embraces a broader range of maintaining mechanisms than the current theory concerning bulimia nervosa. In the final sections of the paper we describe a transdiagnostic treatment derived from the new theory, and we consider in principle the broader relevance of transdiagnostic theories of maintenance.