“Here we're all in the same boat” – a qualitative study of group based rehabilitation for sick‐listed citizens with chronic pain

Musculoskeletal pain impacts upon everyday life. A degree of chronicity may pose an increased risk of sickness absence. One of two rehabilitative interventions, “Tailored Physical Activity” or “Chronic Pain Self‐Management Program”, was offered to sick‐listed citizens who experienced pain. The objectives of this paper were to: (1) Assess what factors are experienced as problematic for sick‐listed citizens in everyday life with chronic pain, and (2) Evaluate the significance of two distinct rehabilitative interventions on the future everyday lives of sick‐listed citizens. Seven semi‐structured interviews with sick‐listed citizens were analyzed using a phenomenological‐hermeneutical approach. Results were discussed by applying the theoretical framework of Antonovsky's salutogenetic model and Yaloms principles for group psychology. The potential for development of citizen's coping is evaluated based on Roessler's notion of progression. The analysis revealed four main themes: (1) Living with pain and unemployment; (2) “Putting my foot down” and “asking for help”; (3) Significance of the group, including instructors, and; (4) Aspects significant to progression. Unemployment is a major life event that promotes stress and can be accompanied by problems related to depressed mood, acceptance of the life situation, feelings of not being useful, feelings of losing control and identity conflicts. Group characteristics that gave a significant basis for progression in the self‐management program are both emotional and instrumental, while the physical training program offers a “here‐and‐now”‐experience and motivation to participate. This study indicates that the self‐management program could potentially improve coping while the physical activity program revealed one example of a means of progression.     

Discriminating direction of motion trajectories from angular speed and background information

The effects of a background scene on the perception of the trajectory of an approaching object and its relation to changes in angular speed and angular size were examined in five experiments. Observers judged the direction (upward or downward) of two sequentially presented motion trajectories simulating a sphere traveling toward the observer at a constant 3-D speed from a fixed distance. In Experiments 1–4, we examined the effects of changes in angular speed and the presence of a scene background, with changes in angular size based either on the trajectories being discriminated or on an intermediate trajectory. In Experiment 5, we examined the effects of changes in angular speed and scene background, with angular size either constant or consistent with an intermediate 3-D trajectory. Overall, we found that (1) observers were able to judge the direction of object motion trajectories from angular speed changes; (2) observers were more accurate with a 3-D scene background, as compared with a uniform background, suggesting that scene information is important for recovering object motion trajectories; and (3) observers were more accurate in judging motion trajectories based on angular speed when the angular size function was consistent with motion in depth than when the angular size was constant.     

Communication Between Spouses as a Resilience Factor in Families in Which a Parent Has Depression: A Condensed Report

This study focused on communication as a family resilience factor in families in which an adult suffers from a depressive disorder. Six partners of depressive adults were interviewed. Results revealed two groups of couples. The “talkative couples” have many conversations during the depression and a facilitating factor was having insight into the depression. The other group, the “taciturn couples,” indicated large difficulties in having conversations, resulting in silence being the dominant contact between the partners. The majority of the participants stated that the absence of conversation would have meant the end of their relationship.     

Image Induction and Social Influence: Explication and Initial Tests

Image induction posits that social influencers can manipulate a target's self-image to gain increased compliance. By preceding a request with a question that creates a salient self-image in a target, targets are more likely to behave consistently with that image by complying with the request. Three studies provide empirical tests of image induction. Results indicate that the addition of an image-inducing pretreatment question is associated with increased rates of compliance when compared to a control group. These findings held across two types of image induction manipulations (helpfulness, willingness to try new things), two types of behaviors (agreeing to complete a survey, agreeing to receive a free soft drink sample), and both face-to-face and written requests.     

Mechanisms of change in cognitive behaviour therapy for panic disorder: The role of panic self-efficacy and catastrophic misinterpretations

The efficacy of cognitive behavioural therapy (CBT) for panic disorder with or without agoraphobia (PD) is well-established; however, little is known about the underlying change processes of clinical improvement during therapy. According to cognitive theories, CBT for PD primarily works by changing catastrophic misinterpretations of bodily symptoms and panic attacks. However, panic self-efficacy, i.e. the perceived ability to cope with panic attacks, has also been suggested as an important change mechanism in CBT for PD. The aim of the study was to investigate if change in catastrophic misinterpretations and panic self-efficacy mediated change in the level of anxiety during the course of thirteen sessions of group CBT for PD. Forty-five participants completed weekly self-report measures of the possible cognitive mediators and the level of anxiety throughout therapy. The results indicated that within-person change in panic self-efficacy in one session, but not in catastrophic misinterpretations, predicted within-person level of anxiety symptoms the following week. However, in a reversed analysis, prior change in level of anxiety symptoms also predicted change in panic self-efficacy the following session. These results support panic self-efficacy as a mediator of change in CBT for PD, although a reciprocal causal relationship between panic self-efficacy and level of anxiety seems to be implied.     

POST-TRAUMATIC STRESS REACTIONS AMONGST RESCUE WORKERS AFTER A MAJOR RAIL ACCIDENT

Abstract

Rescue tasks under heavy strain may act as traumatic events creating stress reactions among the rescue workers. After a major rail accident the rescue workers were examined by questionnaire at 3 and 7 months postaccident using the General Health Questionnaire-28 (GHQ), Impact of Event Scale (IES) and a structured questionnaire made for the purpose. Eighteen percent of the 77 rescue workers who participated in the study had GHQ-case-score and 10% had IES-case-score at 7 months using the usual GHQ-cut-off (4/5) and a low IES-cut-off (19/20). For the case-scorers there was a tendency towards increased GHQ- and IES-scores from 3 to 7 months. Five (6%) had post-traumatic stress disorders (PTSD) of low to moderate severity at 7 months.     

Defense mechanisms: An approach from the perspective of personal construct psychology

The psychoanalytic concept of defense mechanisms was theoretically and empirically approached from the perspective of personal construct psychology, in an attempt to investigate its cognitive components. Thirty neurotic clients of the Psychotherapeutic Center in Stuttgart, Federal Republic of Germany, were investigated by means of the Questionnaire for Defense Categories (Ehlers & Peter, 1989) and the Repertory Grid Test (Kelly, 1955). Tight construing, extremity of emotional evaluation, construal of the symptom as having positive implications, and construed similarity between certain aspects of the self were observed in clients who frequently used the defense mechanisms denial, rationalization, and turning against the object.     

A Confirmatory Approach to Examining the Factor Structure of the Strengths and Difficulties Questionnaire (SDQ): A Large Scale Cohort Study

The aim of this study was to examine the factor structure of the Strengths and Difficulties Questionnaire (SDQ) using a Structural Confirmatory Factor Analytic approach. The Danish translation of the SDQ was distributed to 71,840 parents and teachers of 5–7 and 10–12-year-old boys and girls from four large scale cohorts. Three theoretical models were examined: 1. a model with five first order factors (i.e., hyperactivity/inattention, conduct, emotional, peer problems and prosocial), 2. a model adding two internalising and externalising second order factors to model 1, and 3. a model adding a total difficulties second order factor to model 1. Model fits were evaluated, multi-group analyses were carried out and average variance extracted (AVE) and composite reliability (CR) estimates were examined. In this general population sample, low risk sample models 1 and 2 showed similar good overall fits. Best model fits were found when two positively worded items were allowed to cross load with the prosocial scale, and cross loadings were allowed for among three sets of indicators. The analyses also revealed that model fits were slightly better for teachers than for parents and better for older children than for younger children. No convincing differences were found between boys and girls. Factor loadings were acceptable for all groups, especially for older children rated by teachers. Some emotional, peer, conduct and prosocial subscale problems were revealed for younger children rated by parents. The analyses revealed more internal consistency for older children rated by teachers than for younger children rated by parents. It is recommended that model 1 comprising five first order factors, or alternatively model 2 with additionally two internalising/externalising second order factors, should be used when employing the SDQ in low risk epidemiological samples.     

A content analysis of person‐centered expressive therapy outcomes

Abstract

This study is a content analysis and follow‐up of thirty‐two former participants in multi‐modal expressive therapy training workshops conducted by the Person‐Centered Expressive Therapy Institute. The theoretical foundation of the study is based on Carl Rogers’ concept of the “significant learning” and Natalie Rogers’ concept of the “creative connection.” The expressive therapy applies core conditions of acceptance, empathic understanding, and congruence in a learning setting that uses writing, visual arts, drama, music and dance. Narratives of significant incidents were analyzed phenomenologically. Results revealed important learnings and shifts of self‐perceptions towards greater self‐awareness, improved self‐confidence, risk‐taking, deeper self‐exploration and appreciation for the process involved in the creative act. This qualitative study shows expressive therapy as making an important contribution to person‐centered theory and practice.     

A Spiritual Revolution in Denmark?

ABSTRACT

Based on data from the Danish part of the European Values Study 1981–2008, this article explores the validity of the claim for a spiritual revolution as proposed by Paul Heelas and Linda Woodhead. The article suggests an operationalisation of spirituality. The results of the analyses are that religious values—Christian faith as well as spirituality—tend to be stable over an individual’s life course. This suggests that, if there is a spiritual revolution, it must be the product of cohort replacement. If a spiritual revolution is taking place, Christian faith would be expected to decline in younger cohorts while spirituality would increase, but an analysis of cohort support for Christian faith and spirituality from 1981 to 2008 shows that both were constant across cohorts. Thus Danish data contain no indication that a spiritual revolution is taking place or will take place. Finally, we show that, contrary to theoretical expectations, spirituality and Christian faith are strongly correlated. A closer analysis reveals an indirect and more complicated support for parts of the theory since the two variables are explained by different factors and it shows that Christian faith, but not spirituality, is correlated with morality.