Speech presentation cues moderate frontal EEG asymmetry in socially withdrawn young adults

Socially withdrawn individuals display solitary behavior across wide contexts with both unfamiliar and familiar peers. This tendency to withdraw may be driven by either past or anticipated negative social encounters. In addition, socially withdrawn individuals often exhibit right frontal electroencephalogram (EEG) asymmetry at baseline and when under stress. In the current study we examined shifts in frontal EEG activity in young adults (N=41) at baseline, as they viewed either an anxiety-provoking or a benign speech video, and as they subsequently prepared for their own speech. Results indicated that right frontal EEG activity increased, relative to the left, only for socially withdrawn participants exposed to the anxious video. These results suggest that contextual affective cues may prime an individual's response to stress, particularly if they illustrate or substantiate an anticipated negative event.     

Negative beliefs about breathlessness increases panic for patients with chronic respiratory disease

Breathlessness is a multidimensional symptom of respiratory disease and is associated with the experience of panic. Patients with panic disorder have increased mortality, morbidity and healthcare utilisation that is unrelated to their disease severity. Our qualitative study aimed to appraise respiratory patients' experiences of breathlessness and whether their cognitions were associated with panic aetiology. The self-regulatory theory was utilised to develop the framework for the semi-structured interview schedule. Twelve individuals with respiratory disease at a U.K. cardiothoracic centre participated and their data were analysed using interpretative phenomenological analysis. Perceived control over the disease, symptoms and panic emerged as the core theme with three related belief systems; (1) Perceived consequences of panic and disease; (2) Illness and symptom coherence; and (3) Emotional adaptation. Panic symptoms were most prevalent in participants with low perceived control over symptoms and the disease, negative beliefs about the life-limiting consequences of unpredictable breathless attacks and by those using emotional coping strategies such as denial and avoidance. The experience of panic for respiratory patients can be explained through the cognitive-behavioural model of anxiety, which highlights the contributory role of catastrophic beliefs about the control and consequences of symptoms and disease as a significant contributory factor for the prevalence and maintenance of panic. The mortality and morbidity of respiratory patients is significantly affected by a co-morbid diagnosis of panic disorder and so it is critical to patients' long-term healthcare that their psychological experiences are assessed. Healthcare services must enhance patients' understanding about their disease to improve their confidence to control symptoms. Recent evidence suggests that cognitive-behavioural interventions that increase problem-solving coping will reduce catastrophic misinterpretations about the perceived consequences of breathlessness and improve emotional adaption to respiratory disease.     

The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.     

A preliminary investigation of the effect of hypomanic personality on the specificity and speed of autobiographical memory recall

There is some evidence that patients with bipolar disorder recall more overgeneral than specific autobiographical memories, a pattern widely reported in depression. However, there are also theoretical arguments (Barnard, Watkins, & Ramponi, 2006) suggesting that experiential processing should predominate during mania/hypomania, with an associated prediction of an increase in specific rather than overgeneral memories. This hypothesis was explicitly tested using the Autobiographical Memory Test (AMT). The specificity and speed of autobiographical recollection was compared for those with high or low levels of hypomanic personality as indexed by the Hypomanic Personality Scale (HPS). High HPS scorers recalled specific autobiographical memories in response to unpleasant cues more frequently and faster than low scorers. These results provide partial support for the hypothesis, but only for unpleasant cues.     

Palliative-care professionals' experiences of unusual spiritual phenomena at the end of life

Research literature has highlighted unusual phenomena occurring at the end of life. Palliative-care professionals often feel ill-prepared in managing these and in talking to patients and family members about them. This study aimed to explore the meanings and interpretations ascribed to these phenomena by palliative-care professionals. Eight participants were interviewed, and interpretative phenomenological analysis used to identify themes within their accounts. Four themes emerged from the analysis: (1) Who are we to say what's out there?: a connection with something beyond what can be seen; (2) It opened up conversations: the experience of talking about unusual experiences; (3) It knocked me sideways: managing the emotional impact of these experiences; and (4) The fact that she was so accepting made it easier: the value of acceptance in relation to unusual experiences. These findings are discussed within the context of existing literature and implications for palliative-care professionals are discussed.     

Eytan: The early development of a gifted child artist

The early graphic development of a precociously gifted child artist, Eytan, for whom a continuous record of drawings exists, is examined in the light of a set of theoretically‐based questions. These concern the course of graphic development, the role of perspective drawings, and the extent to which a precocious achievement of perspective drawing in childhood is a mark of pathology. The issue of giftedness as precocious development or as the mark of unique qualities, and the relationship between art and cognition are also considered.     

A Note on the Natural Basis of Action Categories

What is the basis for the categorical distinctions evident in action? For some visually-guided activities it can be shown that categories of action are specified by criterial values of optical properties. In the more general case, the criterial optical properties should be scaled relative to dimensions of the acting animal. The analysis of the prey-catching behavior of praying mantids is used to exemplify the strategy for determining naturally defined boundaries on actions.     

Intensive Gestalt Group Therapy with Schizophrenics

Abstract

Teaching group therapy is an essential aspect of graduate studies within the helping professions. Existing models discuss four basic elements required for such training: experience, observation, supervised practice, and theory. The present paper offers a model for a group therapy seminar based on these four elements and organized along developmental concepts. Clinical observations of 120 psychology students who participated in the seminar were gathered over a five-year period. Teaching techniques included supervised observation, fish-bowl, one-way mirror, and a final paper integrating theory and practice. The seminar enabled students to practice and to theorize about group processes, both as participants and as co-leaders. Seminar outcomes and conclusions are discussed.     

Getting lost

This paper seeks to explore the process, challenges and journey of setting up counselling within a boys’ public school setting, as an independent practitioner. It looks at the structure and way in which the service was set up and what had to be changed and adapted as time went on. The school had a strong reputation for pastoral care but had come to recognise that there were some issues that it was neither possible nor appropriate for school staff to deal with. So, whilst the school could and did provide containment for many of its pupils, there were those who got lost or were outside of the culture. This seemed to get reflected in my own experience. Setting up counselling in a school is not straightforward, and like the process of therapy itself, it takes time and is not a linear process. Although the service grew steadily, there were factors that led to my finally resigning from the post – I also got lost in the system. There is also a comparison with setting up a service under the auspices of an organisation at the same time.