A Comparison of Enrollees Versus Non-enrollees in a Patient/Family HCV Psychoeducation Study

Despite the seriousness of Hepatitis C (HCV), many patients do not receive treatment. One promising means of addressing these issues for medically ill patients is through participation in support group services. This study examined individual-, treatment- and system-level factors associated with enrolling in a support group intervention (psychoeducation) for persons with HCV. A total of 235 research participants were recruited as part of a NIAAA-funded randomized clinical trial for patients with HCV and their family members, with 172 (73.2 %) agreeing to enroll in the psychoeducation trial and 63 (26.8 %) declining. Factors leading to enrollment indicated that individuals without employment, with certain personality structures (low cooperativeness and self-directedness), and traveling greater distance to their group were more likely to agree to participate. Populations being seen in public settings demonstrate a desire for additional support and education, but at the same time these potential participants are faced with challenges to following through and enrolling in the desired services.     

The Danger of Unrealistic Optimism: Linking Caregivers' Perceived Ability to Help Victims of Terror With Their Own Secondary Traumatic Stress

This study examined how caregivers' biased perceptions of ability to help traumatized patients relates to the caregivers' secondary traumatic stress (STS). There is reason to believe that caregivers overestimate their ability to help and underestimate their vulnerability to develop STS, but it is unclear how such unrealistic optimism relates to STS. The results show that Israeli caregivers working with terror victims believed that their ability to help traumatic patients is superior to their peers' while their likelihood to be negatively affected by such treatment is lower. Beyond the impact of the number of patients treated and caregivers' experience, unrealistic optimism was positively correlated to caregivers' STS. Theoretical and practical implications for those working with traumatized patients are discussed.     

Sensory empathy and enactment1

The authors propose the concept of sensory empathy which emerges through contact between analyst and patient as they get in touch with an area concerning the primary bond. This area is not so much based on thoughts and fantasies as it is on physical sensations. Sensory empathy has to do with that instrument described by Freud as pertaining to the unconscious of any human, which enables one person to interpret unconscious communications of another person. The authors link this concept to that of enactment precisely because the latter concerns unconscious, early elements that fi nd in the act a fi rst meaningful expression. It involves both analyst and patient. In other words, the authors wish to emphasize the importance of the analytical process maintaining contact with that immense fi eld of human interaction that can be defi ned as primary sensory area and which becomes intertwined with the evolution of affects. Clinical examples are provided to clarify these hypotheses.     

The paedophile and his inner world: Theoretical and clinical considerations on the analysis of a patient1

The main feature of the treatment of the paedophile is the distance that separates the analyst from the patient. However hard the analyst tries to understand his patient, the paedophile's world appears to him, especially at the beginning of the treatment, incomprehensible, disheartening and distant. This paper describes the analytic therapy of a paedophile patient. The psychopathological organization that dominates his inner world originates from a delusional nucleus in which an object (a child or an adolescent) is idealized and worshipped in place of the parents. This object promises all manner of pleasure and happiness. The positive outcome of this patient leads one to believe that, if analytically treated, some paedophile patients are open to therapeutic transformation.     

Successful Transitions of Runaway/Homeless Youth from Shelter Care

Previous research indicates that runaway and homeless youth often achieve positive outcomes after shelter stays however few studies have examined how these outcomes are achieved. This study employs qualitative methods to explicate this phenomenon. Twenty-five providers and 21 youth from four shelters participated in this study. Youth were recruited who had completed shelter care and returned home for minimally six months. Multiple raters identified themes and created a conceptual model. While in shelter, youths experienced structure and freedom, and the family experienced respite. Once youth became involved in treatment, the family re-connected and the youth returned home. After returning home, youth and family become involved in follow-up services. Results from our study provide insight into the process through which runaway/homeless youth return home after a shelter stay. Our findings emphasize the need for continued change by all members of the family system, highlighting the need for continued intervention to maintain positive changes.     

The impact of psychiatric diagnosis and family system relationship on problems identified by families coping with a mentally ill member.

The purpose of this study was to explore how psychiatric diagnosis and family relationships relate to problems identified by participants in three one-day public family psychoeducation workshops for families with a member with a serious mental illness. Workshop participants generated lists of problems they had faced, which were coded into eleven categories. Logistic regression models predicting listing of categories were developed based on ill member (diagnosis, sex, treatment compliance) and family member (sex, age, relationship to the ill member) characteristics. For models predicting content category from ill member characteristics, only denial/noncompliance and interpersonal/social categories were significantly predictive as dependent variables. For models predicting content categories from family member characteristics, only the resources/benefits model was predictive. The significant findings, in conjunction with the important negative results, suggest implications for further development of family intervention models. Building on previous research, groups composed of families coping with more than a single diagnosis and including a variety of family member relationships have the potential to reach consensus on curriculum topics.     

Anticipated Regret and Time Perspective: Changing Sexual Risk-taking Behavior

In two studies we test the effects of anticipated affective reactions such as regret on behavioral expectations and behavior. These effects were examined in the context of sexual risk-taking behavior. More specifically, we tested the impact of the anticipated feelings associated with unsafe sex on sexual risk-taking behavior. We assumed a difference between the feelingsabout unsafe sex and the feelings people anticipate to haveafter this behavior. Two studies tested the hypothesis that respondents who are induced to focus on their anticipated, post-behavioral feelings are more likely to report negative feelings such as regret and to adopt safer sexual practices than respondents who are asked to focus on their feelings about the behavior itself. Study 1 shows that anticipated feelings after unsafe sex were more negative than feelings about the behavioral act itself, and that respondents who were asked to consider these anticipated feelings expressed stronger expectations to reduce their risk in future interactions. Thus, asking respondents to take a wider time perspective, and to consider the feelings they would haveafter having had unsafe sex, resulted in ‘safer’ behavioral expectations. Study 2 replicates the findings of Study 1, and also yielded a reliable effect of the time perspective manipulation on actual, self-reported behavior. Respondents who were asked to report on their anticipated feelings after unsafe sex showed less risky behavior in the five months following the experiment than the remaining respondents. Thus, the induced focus on post-behavioral emotions increased the likelihood of preventive behavior. Implications of these findings for behavioral intervention programs are discussed.