Staff-patient relationships and outcomes in schizophrenia: the role of staff attributions

We investigated associations between staff-patient relationships and outcomes in a randomised controlled trial of motivational interventions for drug and alcohol misuse in schizophrenia. Participants were 204 patients and their care co-ordinators. We assessed relationship status (positive versus neutral) and staff attributions of control using Five Minute Speech Samples collected at baseline. We examined associations between this baseline data and symptoms at 12-months follow-up. We found that dyads with positive relationships at baseline had significantly less symptoms at 12-months compared to those dyads with neutral relationships. As predicted, care co-ordinators with positive relationships were less likely to attribute patients' problems as being within their control. The findings highlight the potentially important role of positive staff-patient relationships in outcomes. Our findings are also in line with the hypothesis that staff attributions may contribute to the development of more positive relationships.     

Expressed emotion and causal attributions in relatives of post-traumatic stress disorder patients

This study investigates the relationship between expressed emotion (EE) and causal attributions in relatives of post-traumatic stress disorder (PTSD) patients, and examines the contributions of EE and attributions to patient outcomes. Thirty-eight relatives of patients with PTSD participating in a treatment trial were assessed on EE, causal attributions for patient problems and nature of attributions. Patients' PTSD symptoms at 6 and 12 months were assessed. Criticism and hostility in relatives were associated with attributing problems to factors controllable by patients. Relatives with marked emotional over-involvement (EOI) had an attributional profile similar to low EE relatives. Deficits in normal behaviour ("negative symptoms") were perceived as more controllable, internal and stable than were more obvious signs of an illness or mental health problem such as hypervigilance and intrusive thoughts and nightmares ("positive symptoms"). Irritability or anger was perceived as more controllable and personal than any other problem. Hostility was associated with less psychological understanding. EE (hostility) but not attributions was found to predict clinical outcome. The results are consistent with previous studies of relatives of schizophrenia patients. The study suggests a need for interventions, which focus on helping relatives to reappraise the impact of PTSD.     

Mindfulness reduces the correspondence bias

The correspondence bias (CB) refers to the idea that people sometimes give undue weight to dispositional rather than situational factors when explaining behaviours and attitudes. Three experiments examined whether mindfulness, a non-judgmental focus on the present moment, could reduce the CB. Participants engaged in a brief mindfulness exercise (the raisin task), a control task, or an attention to detail task before completing a typical CB measure involving an attitude-attribution paradigm. The results indicated that participants in the mindfulness condition experienced a significant reduction in the CB compared to participants in the control or attention to detail conditions. These results suggest that mindfulness training can play a unique role in reducing social biases related to person perception.     

Self-esteem in schizophrenia: relationships between self-evaluation,family attitudes,and symptomatology

Participants with schizophrenia (N = 59) were assessed on self-evaluation, symptomatology, and positive and negative affect (expressed emotion) from significant others. An interview-based measure of self-evaluation was used and two independent dimensions of self-esteem were derived: negative and positive evaluation of self. As predicted, negative self-evaluation was strongly associated with positive symptoms, a more critical attitude from family members was associated with greater negative self-evaluation, and analyses supported a model whereby the impact of criticism on patients' positive symptoms was mediated by its association with negative self-evaluation. The interview-based method of self-esteem assessment was found to be superior to the questionnaire because its predictive effects remained after depressed mood was accounted for.     

Memory for how one learned of multiple deaths from AIDS: Repeated exposure and distinctiveness

Studies of memories for the circumstances in which an emotional event was learned of have generally explored isolated, single-occurrence events--for example, the Kennedy assassination. Such factors as the event's distinctiveness, its personal importance, its surprise, the elicited emotional change, and overt rehearsal have been posited as predictors of the memory's vividness and elaborateness. We examined whether these predictor variables would apply to a repeated trauma, using the repeated nature of the trauma to test, in particular, the contribution of distinctiveness. Focusing on the multiple deaths of loved ones from AIDS that many gay men have experienced, we contrasted the vividness and elaborateness of the circumstantial memory of the first death encountered with that of the most recent death, treating distinctiveness as the number of intervening deaths. In an analysis of responses by 80 gay men to a survey, no support was found for the claim that distinctiveness predicts a circumstantial memory's vividness or elaborateness. Only emotional change predicted these characteristics of the memories.     

Suicide schema in schizophrenia: the effect of emotional reactivity, negative symptoms and schema elaboration

Suicide risk is thought to increase with a greater potential for activation of suicide-related schemas. Suicide schemas are less likely to be activated with reductions of emotional range associated with certain negative symptoms of schizophrenia. The study tested whether suicide risk would increase in patients with recent onset schizophrenia with increased potential for suicide schema activation as indicated by lower levels of specific negative symptoms that reflected emotional reactivity, namely emotional withdrawal and blunted affect. A logistic regression analysis of baseline data of 278 recent onset schizophrenic patients with a measure of suicide behaviour as the dependent variable and negative symptoms, delusions, hallucinations, depression, gender, episode, ethnicity, education, age, duration of untreated psychosis and substance use as independent variables was carried out. Emotional withdrawal, but not blunted affect was significant and negatively associated, and depression positively associated with suicide behaviour. There was evidence to indicate that restricted emotions are associated with reduced suicide risk as predicted.     

A Cross-Sectional Survey of Pakistani Muslims Coping with Health Anxiety through Religiosity during the COVID-19 Pandemic

Journal of Religion and Health - Investigating the role of religiosity in coping with health anxiety during the outbreak of COVID-19 assumes significance given the continued onslaught of the...     

MEDICAL MANAGEMENT OF INFANT INTERSEX: THE JURIDICO‐ETHICAL DILEMMA OF CONTEMPORARY ISLAMIC LEGAL RESPONSE

Technological advances in the field of medicine and health sciences not only manipulate the normal human body and sex but also provide for surgical and hormonal management of hermaphroditism (intersexuality). Consequently, sex assignment surgery has not only become a standard care for babies born with genital abnormalities in the West but even in some Muslim states. On the positive side, it goes a long way in saving children born with abnormal genitalia from numerous legal interdictions of the pre‐sex corrective surgery. Nevertheless, the larger ethical and legal questions that medical management of genital abnormality raises to some extent have not been adequately appreciated by contemporary Muslim responses. This article, therefore, in principle argues against surgical management of intersexuality during early infancy from the Islamic legal perspective.