The effects of mortality reminders on posttraumatic growth and finding benefits among patients with life-threatening illness and their caregivers

Individuals confronted with a life-threatening illness often report posttraumatic growth (PTG) or finding benefits in disease. These positive evaluations of personal strength, perceptions of improved personal relations and new possibilities may represent a defensive response (cf Janus-face model). Three studies investigated the effects of mortality reminders on reports of PTG or benefit findings among people living with life-threatening illness or their caregivers. 80 people living with HIV (Study 1), 164 breast cancer survivors (Study 2) and 50 family caregivers for a patient with Huntington Disease (Study 3) were randomly assigned to the experimental (mortality reminders) or control conditions. Across three studies, those exposed to mortality reminders reported lower PTG or benefit finding, compared to the controls. These effects were moderated by time elapsed since diagnosis: mortality reminders led to lower PTG/benefit finding among those who received the diagnosis more recently. The results provide an insight into the defensive character of PTG/finding benefits in illness and changes in the function of these beliefs over time elapsing since diagnosis.     

The partnership between the Early Intervention Institute,St Petersburg,and the Anna Freud Centre,London

The authors describe study and teaching links between the Early Intervention Institute in St Petersburg and the Anna Freud Clinic in London. Some brief clinical examples from a variety of settings are given as well as a longer case presentation. The impact of widespread institutional care, alcoholism and terrible housing conditions on child mental health are illustrated. This raises questions about the role of child psychotherapy when social conditions are so harsh. The case material indicates that, despite this, children can be helped in some measure to feel more secure, by the therapist providing constancy and reliability within an often frightening and dangerous external world.     

Less may be more when choosing is difficult: Choice complexity and too much choice

Although consumers readily seek choice and abundance, the so-called too-much-choice effect suggests that having many alternatives to choose from eventually leads to negative consequences, such as decreased post-choice satisfaction. The present research extends this research by highlighting the role of choice complexity. It is argued that too-much-choice effects are associated with choice complexity, which is influenced not only by the number of alternatives, but also by other features of the choice set, such as the number of attributes that alternatives are differentiated upon. These other influences of choice complexity may propel or hinder the emergence of too-much-choice effects. Two experiments tested this hypothesis by orthogonally manipulating the number of alternatives and the number of attributes. Results revealed a too-much-choice effect when alternatives were differentiated on many attributes, but not when alternatives were differentiated on few attributes. Implications for theory and practice are discussed.     

Parental fear of negative child evaluation in child social anxiety

Parental anxiety has been linked to child anxiety in various studies. However, specific mechanisms responsible for this relationship in the context of child social anxiety are still largely unknown. A potential mediator between parental and child social anxiety may be parental fear of negative child evaluation (FNCE). To investigate this concept, we collected self-reported data from families with 9- to 16-year old children in a non-clinical sample (458 mother-child dyads and 336 father-child dyads). While both paternal and maternal FNCE predicted child social anxiety, only maternal FNCE mediated the association between maternal and child social anxiety. Maternal report of FNCE was also found to mediate the association between maternal social anxiety and general childhood emotional problems but not externalising problems. Overall, this study is the first to identify a mediator variable that may explain the association between mother and child social anxiety in school-age children. The results shed new light on the mechanisms by which fear and anxiety may be transmitted across generations.     

Social skills and social phobia: An investigation of DSM-IV subtypes

Social phobia is characterized as pervasive social timidity in social settings. Although much is known about this disorder, aspects of its clinical presentation remain unexplored, in particular characteristics that distinguish the generalized and non-generalized subtypes. For example, it remains unclear whether patients with the non-generalized subtype display social skills deficits in social interactions, and if so, are these deficits clinically, as well as statistically, significant? In this study, adults with either the non-generalized (NGSP; n = 60) or generalized (GSP; n = 119) subtype of social phobia and adults with no psychological disorder (n = 200) completed an extensive behavioral assessment of social skill and social anxiety. As expected, adults with NGSP and GSP reported equal distress and displayed similar rates of avoidance during an Impromptu Speech Task when compared to adults with no disorder. In contrast, the three groups were distinctly different when interacting with another person in various social situations. Adults with NGSP displayed social skill deficits when compared to individuals with no disorder, but they had fewer deficits than the GSP subtype. However, the identified skill deficits were clinically as well as statistically significant only for the GSP subtype. The results are discussed in terms of the contribution of skill deficits to the conceptualization and treatment of social phobia.     

Activity Level,Activity Enjoyment,and Weather as Mediators of Physical Health Risks in Seasonal and Nonseasonal Depression

Research suggests that depression has negative consequences on physical health. One of the mechanisms driving this link may be the decrease in physical activity characteristic of individuals before and during a depressive episode. However, the factors that influence changes in physical activity across the seasons remain unclear. For instance, weather has been proposed to play an important role in the frequency of activities and enjoyment derived from them. In addition, research has not investigated how weather variables influence activity levels across the seasons in individuals with seasonal versus nonseasonal depression. The present study compared patterns of activity level and enjoyment in samples of women with seasonal and nonseasonal depression and controls. Women with Major Depressive Disorder (MDD) and MDD with a seasonal pattern (Seasonal Affective Disorder, SAD) reported similar patterns of activity; engaging in less frequent activity and deriving less enjoyment from activities than controls across the entire year, most notably during the winter months. Women with SAD also reported being significantly impacted by the weather such that their mood and energy levels increased with warmer temperatures an increased sunshine. Results suggest that women with seasonal depression may be at similar health risks as women with nonseasonal depression and activity patterns may have implications for behavioral activation treatments for depression.     

The Hands of the Living God 1 : “Finding the Familiar in the Unfamiliar” 2

This paper represents the fruits of a long friendship and collaboration between Marion Milner and Nina Farhi. At the heart of the paper sits a famous treatment conducted by Milner over a 17-year period. The presentation of clinical material; many drawings, and the questions raised by Milner in one generation and Farhi in another gives shape to a unique and historically and theoretically meaningful document.

Farhi uses the work and her collaboration with Milner to push theory into new ground, to examine the complexity and intersubjectivity of regression and primitive states, to assess the long shadow of maternal destructiveness, and to propose her own ideas of the power of prenatal intersubjective process, the potential (ill or good) for communication before the child is born. Issues of intergenerational communication of trauma and prenatal sensitivity allow Farhi to bring a new dimension to this long-ago case.     

Childhood Abuse Types and Physical Health at the Age of 24: Testing Health Risk Behaviors and Psychological Distress as Mediators

This study examines whether adult psychological distress and health risk behaviors mediate the relationship between childhood abuse and physical health in adulthood. A randomly selected population-based sample, with oversampling to include a one-third subgroup of former child protection cases, completed a structured interview. Questions pertained to childhood exposure to abuse, adult psychological distress, physical health, and health risk behaviors. Previous research using this sample had identified three abuse typologies: emotional abuse, sexual abuse, and polyvictimization (physical abuse, emotional abuse, and neglect). All three typologies were significantly associated with poorer self-reported physical health. Psychological distress and health risk behaviors partially mediated the relationship between nonabuse, sexual abuse, polyvictimization, and physical health, and fully mediated the relationship between emotional abuse and physical health. The results of this study indicate that health risk behaviors and symptoms of psychological distress could contribute to some of the long-lasting consequences of childhood abuse on adult physical health.     

When is risk relevant? An assessment of the characteristics mountain climbers associate with eight types of climbing

Research concerned with the experiences and motivations of people who participate in mountain climbing tends to overlook the varied nature of this pursuit, with comparisons between different types of climbing only occasionally receiving attention. Accordingly, the present study (N = 207) sought to examine representations of a broad range of different types of climbing. Of particular interest was the notion of risk. Principal component analyses for each type of climbing revealed “challenge,” “risk,” “enjoyment,” and “perspective and self‐reflection” components. Attitudes toward participation were regressed on these components. Although the results revealed significant differences between the ratings of risk reported for the different types of climbing, risk had limited predictive impact on attitudes.     

On the peculiarity of simple reaction time

Two experiments are reported in which high-compatibility reaction time (RT) tasks were performed with, and without, a concurrent secondary task. In both experiments, the secondary task interfered to a greater extent with simple RT than with choice RT. In fact, the effect of adding a secondary task was to eliminate the advantage of simple RT over two-alternative-choice RT. Previous studies of this phenomenon employed a task in which subjects raised a finger when it received tactile stimulation, while engaging in continuous reading aloud. The present experiments show that the effect can be obtained using a different stimulus modality (vision) as well as other responses (vocal) and secondary tasks (shadowing, auditory step-tracking). The paradigm provides a means of isolating preparatory processes that are peculiar to the simple RT task.