Do Patients With Psychosis Experience Loss and Grief As a Result of Their Illness?

BACKGROUND: Depression and suicidality are frequently reported in patients with psychosis and schizophrenia, but the grief process that may be associated with this illness has not been systematically studied. In this study, we examined whether patients diagnosed with psychosis identify, grieve, and mourn losses engendered by the illness. METHOD: 24 patients diagnosed with psychosis in the past five years were surveyed to indicate whether their illness led to losses, and to describe their responses to the losses. Psychosis-related perceived losses were surveyed using three subscales of a loss and grief questionnaire (loss of self, self-care, and roles). Their relationship with beliefs about the illness, symptomatology, coping style, and self-efficacy and insight was studied. RESULTS: 23 (96%) patients named specific losses, and 16 patients (67%) reported feelings associated with grief and mourning. More than half reported loss of self-esteem at the onset of illness and only half saw themselves as having improved in the past month. Patients reported more loss within the past month than at the onset of illness. In the past month, patients with an intact sense of self experienced greater self-efficacy (r = .568, p < .004) while those with loss of self reported feelings of shame (r = ?.582, p < .003). Only patients with insight associated the onset of illness with loss. In the past month, most patients saw themselves as experiencing loss. DISCUSSION: The study results suggest that at some distance from diagnosis, patients still experience themselves as having much loss due to their illness. These unresolved feelings may indicate complicated mourning. Insight appears to be associated with the ability to look back at the onset of the illness and recognize that it engendered losses. Further study of the process of and barriers to grief and mourning is recommended. In clinical practice, the assessment of grief as a part of post-psychotic recovery could lead to providing more appropriate treatment and lead to a positive outcome.     

Gaze and informativeness during category learning: Evidence for an inverse relation

In what follows, we explore the general relationship between eye gaze during a category learning task and the information conveyed by each member of the learned category. To understand the nature of this relationship empirically, we used eye tracking during a novel object classification paradigm. Results suggest that the average fixation time per object during learning is inversely proportional to the amount of information that object conveys about its category. This inverse relationship may seem counterintuitive; however, objects that have a high-information value are inherently more representative of their category. Therefore, their generality captures the essence of the category structure relative to less representative objects. As such, it takes relatively less time to process these objects than their less informative companions. We use a general information measure referred to as representational information theory (Vigo, 2011a, 2013a) to articulate and interpret the results from our experiment and compare its predictions to those of three models of prototypicality.     

Configural Frequency Analysis in Applied Psychological Research

L'Analyse de Fréquence des Configurations (AFC) est une méthode de recherche des classes et anticlasses dans les classifications croisées de catégories de variables. Les classes sont des modèles de catégories de variables qui apparaissent plus souvent que le hasard ne le laisse supposes. Les anticlasses sont des modèles de catégorie de variables qui apparaissent moins souvent que le hasard ne le laisse supposes. On présente quatre applications d'AFC: l'AFC de premier ordre, l'AFC prédictive, l'AFC de symétrie axiale, et un modèle d'AFC longitudinale. On examine les caractéristiques de l'AFC en insistant sur les contraintes et l'applicabilité. On compare aussi l'AFC avec d'autres méthodes permettant l'analyse multivariée de catégories de données, en particulier la modèlisation log-linéaire. Des sorties informatiques sont traitées.
Configural Frequency Analysis (CFA) is a method for the search for types and antitypes in cross-classifications of categorical variables. Types are patterns of variable categories that occur more often than expected from chance. Antitypes are patterns of variable categories that occur less often than expected from chance. Four applications of CFA are reviewed: the First Order CFA, the Prediction CFA, Axial Symmetry CFA, and one model of Longitudinal CFA. Characteristics of CFA are discussed, focusing on constraints posed and applicability. Comparisons are made of CFA with other methods for multivariate analysis of categorical data, in particular, log-linear modelling. Computational issues are discussed.     

Anger management style and emotional reactivity to noxious stimuli among chronic pain patients and healthy controls: the role of endogenous opioids.

OBJECTIVE: Previous work suggests that elevated trait anger-out exacerbates pain responses in part through endogenous opioid dysfunction. The authors examined whether this opioid dysfunction affects not only perceived pain intensity, but also emotional responses to being hurt. DESIGN: 79 chronic low back pain (LBP) patients and 46 healthy controls received opioid blockade (8 mg naloxone i.v.) and placebo in randomized, counterbalanced order in separate sessions. During each session, participants sequentially experienced finger pressure pain and ischemic forearm pain tasks, with emotional state assessed at baseline and postpain. MAIN OUTCOME MEASURES: Blockade effects indexing opioid modulation of emotional reactivity were derived by subtracting placebo from blockade condition emotional reactivity. RESULTS: Significant Participant Type x Anger-Out interactions on blockade effects indicated that in LBP participants but not in controls, greater anger-out was associated with deficient opioid modulation of anxiety, anger, and fear reactivity to noxious stimulation. Across participant types, greater anger-in was associated with impaired opioid modulation of anxiety and fear reactivity. Anger-in opioid effects were partially due to overlap with general negative affect. CONCLUSIONS: Opioid dysfunction associated with trait anger-out may affect not only perceived pain intensity, but also pain-related suffering in individuals with chronic pain conditions. Implications for understanding the health effects of anger management styles are discussed.     

Training Mental Health Professionals to Assess and Manage Suicidal Behavior: Can Provider Confidence and Practice Behaviors be Altered?

Remarkably little systematic research has studied the effects of clinical suicidology training on changing practitioner attitudes and behaviors. In the current study we investigated whether training in an empirically‐based assessment and treatment approach to suicidal patients administered through a continuing education workshop could meaningfully impact professional practices, clinic policy, clinician confidence, and beliefs posttraining and 6 months later. At the 6 month follow‐up we found that 44% of practitioners reported increased confidence in assessing suicide risk, 54% reported increased confidence in managing suicidal patients, 83% reported changing suicide care practices, and 66% reported changing clinic policy. These results suggest that a brief and carefully developed workshop training experience can potentially change provider perceptions and behaviors with a possible impact on clinical care therein.     

The Distillation of “VISCI”: Towards a Better Identification of Suicidal Inmates

The “Viennese Instrument for Suicidality in Correctional Institutions” (VISCI) presented here is based on the results of a large case‐control study and on research on literature examining suicide prevention in general and in the prison population in particular. The aim of this study was to validate the properties of the VISCI to differentiate between suicides and nonsuicides. The sensitivity and specificity of the VISCI was tested in the files of 55 correctional suicides, and 110 controls. VISCI differentiated well between suicides and nonsuicides. The routine administration of the VISCI may help to direct the existing professional attention to inmates with the highest need.