The lived experience of psychotherapists working with older clients: an heuristic study

This paper presents the results of an heuristic study based on the research question: ‘How do psychotherapists experience working with older clients?’ The question came from the researchers’ experience and interest in working with older clients in general practice. It started from the researchers’ desire to examine more closely feelings and elements present in their own experience in dialogue with seven other practising therapists who had an interest and experience of working with this client group. Qualities and elements identified were: perceptions of old age and ageism; boundaries and settings; changes to practice; culture and experiences; awareness of time; loss; decline and mortality; and parents and children. These are illustrated by material from each of the participants, a composite depiction of the experience, a creative synthesis and examples from the researchers’ experiences.     

Sorority and Fraternity Membership and Religious Behaviors: Relation to Gender Attitudes

This study was designed to explore gender attitudes and religious behaviors among sorority/fraternity (S/F) and non-S/F undergraduates. Two hundred and seventy-nine participants completed the Gender Attitude Inventory (GAI, a multidimensional gender attitudes instrument), items that assessed religious behaviors (i.e., attendance in a place of worship and frequency of prayer), and a measure of social desirability. Overall, it was found that fraternity members, compared to sorority and non-S/F members, held more stereotypical gender attitudes. Specifically, the results suggest that fraternity members tend to accept stereotypical beliefs about women and male heterosexual violence toward women; endorse casual sex by women; reject women's political leadership; oppose women's rights; and believe in differential work roles. Attendance in a place of worship and prayer were related to greater disapproval of casual sex by women. Non-S/F members who prayed at least weekly reported slightly higher condemnation of homosexuality than S/F members did.     

The forgiveness process in primary and secondary victims of violent and sexual offences

It is possible that the physical and mental health of crime victims might be improved by forgiving those who have offended against them. To date, no research has been undertaken to examine the processes that influence victims' forgiveness. The goal of this project was to examine the forgiveness process in primary and secondary victims of violent and sexual crimes. In Study 1, qualitative data were collected by interviewing 21 people who had been affected by sexual or other violent crime. Data analysis identified five themes that were common to both primary and secondary victims, namely benefit of forgiveness, self‐forgiveness, perspective taking, offender behaviour, and time. An empowerment theme was unique to primary victims, and a principal victim theme was unique to secondary victims. To further explore these qualitative findings, a quantitative survey of 60 primary and secondary victims was conducted. Results confirmed that primary victims are pragmatic forgivers who are internally focused and forgive because that will benefit their healing. Conversely, secondary victims did not think forgiveness benefited, or would impact on, their own or the primary victim's recovery process. Neither group saw forgiveness as a moral issue, nor thought that forgiveness should influence whether an offender should face court.     

Psychometric properties of the mobility inventory for agoraphobia: convergent, discriminant, and criterion-related validity

Aims of this study were (a) to summarize the psychometric literature on the Mobility Inventory for Agoraphobia (MIA), (b) to examine the convergent and discriminant validity of the MIA's Avoidance Alone and Avoidance Accompanied rating scales relative to clinical severity ratings of anxiety disorders from the Anxiety Disorders Interview Schedule (ADIS), and (c) to establish a cutoff score indicative of interviewers’ diagnosis of agoraphobia for the Avoidance Alone scale. A meta-analytic synthesis of 10 published studies yielded positive evidence for internal consistency and convergent and discriminant validity of the scales. Participants in the present study were 129 people with a diagnosis of panic disorder. Internal consistency was excellent for this sample, α = .95 for AAC and .96 for AAL. When the MIA scales were correlated with interviewer ratings, evidence for convergent and discriminant validity for AAL was strong (convergent r with agoraphobia severity ratings = .63 vs. discriminant rs of .10–.29 for other anxiety disorders) and more modest but still positive for AAC (.54 vs. .01–.37). Receiver operating curve analysis indicated that the optimal operating point for AAL as an indicator of ADIS agoraphobia diagnosis was 1.61, which yielded sensitivity of .87 and specificity of .73.     

How do Hostile and Emotionally Overinvolved Relatives View Relationships?: What Relatives' Pronoun Use Tells Us

Expressed emotion (EE) has been linked to negative outcomes for a variety of psychiatric illnesses. Despite development of effective interventions to reduce EE, relatively little is known about EE's antecedents or maintaining factors. The present study uses a novel methodology (measurement of pronouns used by relatives during the Camberwell Family Interview [CFI] or a problem-solving interaction with the patient) to explore possible cognitive correlates of EE. Participants were 98 outpatients with obsessive-compulsive disorder or panic disorder with agoraphobia and their primary relative. Results showed that relatives' pronoun use was stable across situations. Relatives' hostility and criticism, as measured by objective coding of relatives' behavior during the CFI and interactions, respectively, were related to relatives' decreased we-focus and increased me-focus in the 2 situations. In contrast to expectations, relatives' emotional overinvolvement was related to their decreased we-focus during CFIs and interactions. Results support the value of using pronouns as a means to explore important aspects of relationship functioning.     

Expressed emotion and familial interaction: a study with agoraphobic and obsessive-compulsive patients and their relatives

Patients with panic disorder with agoraphobia (n = 40) or obsessive- compulsive disorder (n = 61) participated in a 10-min problem-solving interaction with their primary relative. Relatives were categorized as hostile or nonhostile toward the patient on the basis of a measure of expressed emotion (EE). Observed interactions between patients and their hostile relatives, relative to those of dyads with a nonhostile relative, were marked by higher rates of relatives' criticism and of patients' negativity but not by higher rates of negative reciprocity. Analyses of sequences indicated that the dyads with a hostile relative had a higher rate of sequences in which the relative was first critical and the patient then negative than was the case for dyads with nonhostile relatives. Moreover, hostile relatives were more frequently critical than nonhostile relatives whether patients' preceding behavior was positive, negative, or neutral. The findings are consistent with the stress-vulnerability model of the effect of EE on mental health, in that patients living with a high EE relative appear to be exposed to higher levels of interpersonal stress.     

Social isolation, psychological health, and protective factors in adolescence

This study investigates the relationships among social isolation, psychological health, and protective factors in adolescents. Feelings of social isolation may influence psychological health in adolescents, but protective factors such as family connectedness, school connectedness, and academic achievement may also play a key role. The sample included 4,746 adolescents from 31 middle and high schools. Participants responded to 221 survey questions regarding peer relationships, psychological health, school connectedness, family relationships, and academic achievement. The findings revealed that social isolation was associated with an increased risk for depressive symptoms, suicide attempts, and low self-esteem. Protective factors influenced associations between social isolation and psychological health. Implications for prevention such as building healthy peer relationships, promoting family connectedness, and developing school-based interventions are discussed.     

The role of emotional elaboration in the creation of false memories

Two experiments employed an eyewitness suggestibility paradigm to examine the effects of emotional elaboration on the creation of false memories for suggested events. The results of both experiments converge in showing that reflectively elaborating on the emotional consequences of suggested events increases both false belief and false memory in having witnessed the suggested events. Moreover, the results also showed that emotional elaboration leads to higher false memory than other types of meaningful elaboration, thus providing evidence that the emotional content of the elaboration plays a role in promoting false memory development. The results have several real‐world implications for forensic and therapeutic interviews. Copyright © 2008 John Wiley & Sons, Ltd.     

Construct Validity of the Perceived Criticism Measure

The construct validity of the Perceived Criticism Measure (PCM) was examined in 2 studies. In Study 1, 50 community couples participated in problem-solving interactions after which they rated interaction-specific perceived criticism and their criticism of their spouses. In addition, they provided ratings of perceived criticism for their relationship overall and completed measures of psychopathology and marital satisfaction. For both husbands and wives, convergent validity was demonstrated by moderate-to-large correlations between the PCM and spouses' own ratings of their criticism for both general and interaction-specific perceived criticism. In Study 2, 37 patients with obsessive-compulsive disorder and their spouses participated in problem-solving interactions and provided ratings of marital satisfaction and general perceived criticism. Five untrained coders rated the interactions according to their own definitions of the relatives' destructive criticism of the patient. Their aggregated ratings proved strongly related to patients' PCM scores. Higher PCM scores were related to lower marital satisfaction in both Studies 1 and 2. The results of these studies are supportive of the convergent validity of the Perceived Criticism Measure. Evidence of discriminant validity was mixed.