Therapeutic factors in interactional inpatient groups: Results from a Turkish sample

Therapeutic factors in an inpatient group from Turkey are presented. A total of 40 patients were seen over a period of 2 years and each patient was given Yalom's (1983) 60-item therapeutic factor list on discharge. The first four most valued therapeutic factor groups were Catharsis, Existential Factors, Cohesiveness and Hope. There were significant differences in the highly valued factors in different diagnostic groups. Patients with diagnoses of anxiety/somatization and borderline/identity problem preferred factors resembling those in many out-patient studies. The results are discussed in the light of relevant literature.     

Characteristics of personally important episodic memories,counterfactual thoughts,and future projections across age and culture

We have limited knowledge as to whether the phenomenological differences between episodic memories, counterfactuals, and future projections show the same pattern across age groups and diverse samples. Here we compared the characteristics of these mental events, reported by younger and older participants in a Turkish (Study 1) and in an American sample (Study 2). In both studies, memories contained more sensory-perceptual-spatial details, were easier to bring to mind, and more specific. Future projections were the most positive, whereas counterfactuals were the least emotionally intense. In Study 1, older participants rated the events more positively and experienced them with more perceptual detail, whereas younger participants reported the future to be more voluntarily rehearsed, important, and central. These age differences did not replicate in Study 2. Overall, phenomenological differences between the events are robust and replicate across diverse samples. However, age differences are more sensitive to cultural or individual differences.     

Turning stressors into something productive: an empirical study revealing nonlinear influences of role stressors on self‐efficacy

This study suggests that stressors can be productive for self‐efficacy and that the influence of stressors on self‐efficacy is nonlinear. Analyses were conducted with ordinary least squares regression on a dataset covering responses from 311 deans in Swedish secondary schools. Results support the hypothesized U‐shape relationship between role conflict and self‐efficacy and the inverted U‐shape relationship between role ambiguity and self‐efficacy. Thus, findings offer evidence for nonlinear effects of stressors on the level of incumbents' self‐efficacy. This research has implications for further research focused on the association between role stressors and self‐efficacy.     

Narrative skill in children with early unilateral brain injury: a possible limit to functional plasticity

Children with pre‐ or perinatal brain injury (PL) exhibit marked plasticity for language learning. Previous work has focused mostly on the emergence of earlier‐developing skills, such as vocabulary and syntax. Here we ask whether this plasticity for earlier‐developing aspects of language extends to more complex, later‐developing language functions by examining the narrative production of children with PL. Using an elicitation technique that involves asking children to create stories de novo in response to a story stem, we collected narratives from 11 children with PL and 20 typically developing (TD) children. Narratives were analysed for length, diversity of the vocabulary used, use of complex syntax, complexity of the macro‐level narrative structure and use of narrative evaluation. Children’s language performance on vocabulary and syntax tasks outside the narrative context was also measured. Findings show that children with PL produced shorter stories, used less diverse vocabulary, produced structurally less complex stories at the macro‐level, and made fewer inferences regarding the cognitive states of the story characters. These differences in the narrative task emerged even though children with PL did not differ from TD children on vocabulary and syntax tasks outside the narrative context. Thus, findings suggest that there may be limitations to the plasticity for language functions displayed by children with PL, and that these limitations may be most apparent in complex, decontextualized language tasks such as narrative production.     

Mediators of Change in Cognitive Behavior Therapy for Clinical Burnout

Evidence supporting the effectiveness of cognitive behavior therapy (CBT) for stress-related illness is growing, but little is known about its mechanisms of change. The aim of this study was to investigate potential mediators of CBT for severe stress in form of clinical burnout, using an active psychological treatment as comparator. We used linear mixed models to analyze data from patients (N = 82) with clinical burnout who received either CBT or another psychological treatment in a randomized controlled trial. Potential mediators (i.e., sleep quality, behavioral activation, perceived competence, and therapeutic alliance) and outcome (i.e., symptoms of burnout) were assessed weekly during treatment. The results showed that the positive treatment effects on symptoms of burnout favoring CBT (estimated between-group d = 0.93) were mediated by improvements in sleep quality, ab = -0.017, 95% CI_asymmetric [-0.037, -0.002], and increase in perceived competence, ab = -0.037, 95% CI_asymmetric [-0.070, -0.010]. Behavioral activation, ab = -0.004 [-0.016, 0.007], and therapeutic alliance, ab = 0.002 [-0.006, 0.011], did not significantly mediate the difference in effects between the treatments. Improving sleep quality and increasing perceived competence may thus constitute important process goals in order to attain symptom reduction in CBT for clinical burnout.     

Documentary Bioethics: Visual Narratives for Generations X and Y

Narrative bioethics is primarily understood to involve storytelling through the use of literature. This article suggests that other forms of media are necessary to convey stories of an ethical nature to an audience broader than one being trained as medical professionals. "Documentary bioethics" is a manner to present and interpret stories of an ethical nature using forms of popular electronic media in a reality-based documentary style to society at large, specifically Generations X and Y.     

Midwives’ Approach to Genetic Diseases and Genetic Counseling in Denizli, Turkey

The purpose of this study was to evaluate Denizli midwives’ self-reported knowledge of genetic diseases and genetic counseling. Data was collected on forms that obtained information about midwives approaches to basic genetics, genetic disorders, and genetic counseling (response rate = 70.1%). The highest response rate of midwives describing themselves as “knowledgeable” about basic genetic information was for mitosis and meiosis with 4.8%, about genetic disorders was for phenylketonuria with 61.1%, and about genetic counseling was for recommending ultrasonography during pregnancy with 98.1%. The source for basic genetics information for 56.4% of participants was in their school level classes. None of the midwives felt that they had sufficient knowledge about genetic counseling or screening and 76.4% would like to attend an educational course. Even though the midwives have recognized their knowledge deficit they occasionally give genetic counseling. As a result of this study a genetics course is planned for midwives so they can actively participate in the prevention and early diagnosis of genetic diseases.     

Volitional problems in trying to quit smoking

A series of interviews was conducted with 10 patients in an anti smoking clinic. Earlier results implying that volitional breakdowns in trying to quit smoking occur under emotional stress and are preceded by distorted reasoning were replicated. The patients were also asked about techniques they used to resist temptations. These techniques involved (a) bringing to mind values and wishes incompatible with the wish to smoke, and (b) diverting attention to some other action. Such acts may be interpreted as processing mental energy rather than information, pointing to a need for a broader conception of the regulation of action than is available in contemporary work on decision making.     

Acquisition of phobias and anxiety response patterns in clinical patients

The ways in which phobic patients (N = 106; animal-, social- and claustrophobics) acquired their phobias were investigated in the present study. The results showed that a large majority (58%) of the patients attributed their phobias to conditioning experiences, while 17% recalled vicarious experiences, 10% instructions/information and 15% could not recall any specific onset circumstances. There was no clearcut relationship between the ways of acquisition and anxiety components (subjective, behavioral, physiological), nor did the conditioning and indirectly acquired phobias differ in severity. However, some interesting trends emerged in the data, showing that animal phobics who recalled conditioning experiences to a larger extent also responded physiologically. For patients with indirect onset experiences (for all three types of phobias) the reverse was true, i.e. they responded to a larger extent in a cognitive-subjective way, rather than with increased physiological arousal.     

Prediction of valency and productivity: An empirical study of longterm group psychotherapy

With reference to W. R. Bion's theory about individual's reactions to group stimuli the main hypothesis was formulated thus: individual's Valency (V) and Productivity (W) undergo changes in certain (definable) directions under the influence of longterm group psychotherapy. The main hypothesis was refined into seven sub-hypotheses. These were measured by four projective tests: Reaction Group Situation Test (RGST), Self Perceptual Q-sort (SPQ), Q-SORT(overt) and Q-SORT(covert). 48.0% of the total number of modalities, 120 out of 252, developed in a predicted and eligible direction. 29.0%, 74 modalities out of 252, remained unchanged whereas 23.0%, 58 modalities out of 252, developed in an opposite to predicted and non-eligible direction. Group members' Productivity (W) developed most of all the modalities in a predicted (eligible) direction. Group members' Valency and Productivity pattern (VP) changed least of all the modalities. The group members Valency (V) for the basic assumption Dependency (baD) developed most of all the modalities in an opposite to predicted, i.e. non-eligible direction.