Demographic,health-related and psychosocial predictors of changes in depressive symptoms and anxiety in late middle-aged and older persons with fall-related injuries

Research on anxiety and depression after fall-related injuries to the extremities and its pre-fall determinants is scarce. The present study sought to examine change between pre-fall and post-fall anxiety and depression and its (pre-fall) predictors. Data were obtained from 181 Dutch persons, aged 57 and older, who sustained fall-related injuries between 1993 and 1997. Demographic (e.g. socio-economic status), health-related (e.g. number of chronic conditions), and psychosocial (e.g. social support, neuroticism) factors were determined in 1993 (prior to the fall). Depressive symptoms and anxiety were determined prior to the fall, and two, five and twelve months after the fall. Taking into account pre-fall anxiety and depression, pre-fall neuroticism was the most consistent, independent predictor of adverse changes in anxiety and depression. Other factors, including severity of the fall and age were not related to changes in anxiety and depression. Our prospective findings may be interpreted as support for the importance of personality for mental health outcomes in persons who have sustained fall-related injuries.     

Autism spectrum conditions among children and adolescents: A new profiling tool

There is considerable debate about the sociocognitive features of autism spectrum conditions (ASC), and a tool for profiling the sociocognitive profiles of children and adolescents with ASC is needed. The aim of this research was to evaluate the psychometric properties of a new questionnaire—The Australian Scale for Autism Spectrum Conditions (ASASC). Three hundred twenty‐two parents of children on the ASC spectrum, including autistic disorder (n = 76), Asperger's disorder (n = 188), and pervasive developmental disorder not otherwise specified (n = 21), and a clinical group of children with subclinical ASC features and no ASC diagnosis (n = 37). Measures include an initial scale measuring eight potential dimensions of ASC, a related screening tool for autism, and two previously validated social skills questionnaires. The questionnaires were administered online. The ASASC was factor‐analysed, internal and test–retest reliabilities (for a randomly selected 84 parents) were calculated, and preliminary tests of convergent and divergent validity were conducted. The resulting measure (44 items) contained five coherent and reliable dimensions: understand and express emotion, fact orientation, sensory sensitivity, social communication, and rigidity. The questionnaire had good test–retest reliability and convergent/divergent validity. The ASASC enables profiles of ASC symptomatology that should be useful in adjusting interventions to individual needs.     

Mental Imagery and Post-Event Processing in Anticipation of a Speech Performance Among Socially Anxious Individuals

The present study investigated whether post-event processing (PEP) involving mental imagery about a past speech is particularly detrimental for socially anxious individuals who are currently anticipating giving a speech. One hundred fourteen high and low socially anxious participants were told they would give a 5 min impromptu speech at the end of the experimental session. They were randomly assigned to one of three manipulation conditions: post-event processing about a past speech incorporating imagery (PEP-Imagery), semantic post-event processing about a past speech (PEP-Semantic), or a control condition, (n = 19 per experimental group, per condition [high vs low socially anxious]). After the condition inductions, individuals’ anxiety, their predictions of performance in the anticipated speech, and their interpretations of other ambiguous social events were measured. Consistent with predictions, high socially anxious individuals in the PEP-Imagery condition displayed greater anxiety than individuals in the other conditions immediately following the induction and before the anticipated speech task. They also interpreted ambiguous social scenarios in a more socially anxious manner than socially anxious individuals in the control condition. High socially anxious individuals made more negative predictions about their upcoming speech performance than low anxious participants in all conditions. The impact of imagery during post-event processing in social anxiety and its implications are discussed.     

The role of perfectionism in cognitive behaviour therapy outcomes for clinically anxious children

The main aim of this study was to determine whether pre-treatment levels of child perfectionism impacted on anxiety treatment outcomes for school-aged children. In addition, it was investigated whether child perfectionism decreased following treatment for anxiety. Participants were sixty-seven clinically anxious children aged 6–13 years (female = 34; majority Caucasian) who were enrolled in a group-based cognitive behaviour therapy program, and their parents. They completed self-report questionnaires on anxiety and depressive symptoms and were administered a diagnostic interview to determine the type and clinician rated severity of anxiety and related disorders pre- and post-treatment and at 6-month follow-up. Self- and parent-rated perfectionism were also measured pre-treatment, while a subset of children completed perfectionism measures post-treatment as well. Self-Oriented Perfectionism, but not Socially Prescribed Perfectionism, predicted poorer self-reported treatment outcome (higher levels of anxiety symptoms) immediately following treatment and at 6-month follow-up when using a multi-informant approach. Additionally, both Self-Oriented and Socially Prescribed child perfectionism significantly reduced immediately following treatment. Despite reductions in child perfectionism following anxiety treatment, higher Self-Oriented Perfectionism may impact negatively on child anxiety treatment outcome.     

Enhancing recovery rates: Lessons from year one of IAPT

BackgroundThe English Improving Access to Psychological Therapies (IAPT) initiative aims to make evidence-based psychological therapies for depression and anxiety disorder more widely available in the National Health Service (NHS). 32 IAPT services based on a stepped care model were established in the first year of the programme. We report on the reliable recovery rates achieved by patients treated in the services and identify predictors of recovery at patient level, service level, and as a function of compliance with National Institute of Health and Care Excellence (NICE) Treatment Guidelines.MethodData from 19,395 patients who were clinical cases at intake, attended at least two sessions, had at least two outcomes scores and had completed their treatment during the period were analysed. Outcome was assessed with the patient health questionnaire depression scale (PHQ-9) and the anxiety scale (GAD-7).ResultsData completeness was high for a routine cohort study. Over 91% of treated patients had paired (pre-post) outcome scores. Overall, 40.3% of patients were reliably recovered at post-treatment, 63.7% showed reliable improvement and 6.6% showed reliable deterioration. Most patients received treatments that were recommended by NICE. When a treatment not recommended by NICE was provided, recovery rates were reduced. Service characteristics that predicted higher reliable recovery rates were: high average number of therapy sessions; higher step-up rates among individuals who started with low intensity treatment; larger services; and a larger proportion of experienced staff.ConclusionsCompliance with the IAPT clinical model is associated with enhanced rates of reliable recovery.     

Generational forgiveness and historical injustices: perspectives of descendants of victims of Apartheid-era gross human rights violations in South Africa

This study explored the issue of generational forgiveness in the political sphere in contemporary South Africa. It is based on qualitative interviews conducted with 20 children and grandchildren (females?=?10, males?=?10) of victims of Apartheidera gross human rights violations. The interview data were interpretively analysed to uncover underlying meaning. The results yielded three main themes namely: the myth of forgiveness in politics; political forgiveness as an inherently difficult human enterprise; and the intrinsic value of political forgiveness. Findings suggest that political forgiveness is likely if solutions are found to persistent poverty and inequality, which are structural legacies of the past.     

Development and Validation of the Xhosa Translations of the Beck Inventories: 1. Challenges of the Translation Process

This article describes the translation of the Beck Depression Inventory-II, the Beck Hopeless Scale, and the Beck Anxiety Inventory, into Xhosa the language spoken in the Eastern Cape of South Africa. The processes of translation, back-translation and committee discussion failed to yield trustworthy translations because of practical difficulties in working with translators. Critical words and phrases were identified which gave rise to lack of agreement. For each, a range of options was generated and the advantages and disadvantages evaluated in terms of criteria such as conceptual and idiomatic equivalence, and extensiveness of usage. Examples are given of the problems encountered and the way in which final decisions were made. A pilot clinical trial demonstrated the acceptability of the translated instruments. Two further articles report the psychometric evaluation of the translated scales.     

Development and Validation of the Xhosa Translations of the Beck Inventories: 2. Item Analysis,Internal Consistency and Factor Analysis

The Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), and the Beck Hopelessness Scale (BHS) were translated into Xhosa, a language widely spoken in South Africa to yield translated scales referred to as the XBDI-I (Xhosa BDI-II), the XBAI (Xhosa BAI) and the XBHS (Xhosa BHS). These scales were administered to a sample of 122 Xhosa respondents which included students and patients. The psychometric properties of the translated scales were comparable to those of the original English versions. Measures of internal consistency were as high as those for the validation studies in the USA and good item-scale correlations were obtained. This suggests that the translation yielded clinically useful scales which tap symptoms that are largely culturally universal.     

Counselling in a culture of competence

In this article, a counsellor working in the public sectors of health and education considers her work in the light of the contemporary political context. Describing the trend towards what she is calling a ‘culture of competence’, she notes recent changes to the identity of the professional, whose authority, once taken for granted, is increasingly limited and subject to evaluation and proof of effectiveness. She then considers some ways in which counsellors working in the public sector are now experiencing such measures, noting both the benefits that can accrue from evaluating their work, but also the dangers when certain pressures and anxieties are not taken into account.     

Psychology of Dreams

Abstract

This article describes the essential aspects of a creative, experiential course in dream interpretation for psychology and counseling students. Such a course offers counselor educators an opportunity to develop basic interviewing and advanced processing techniques in their students while facilitating greater self-exploration and improved relational functioning. The authors measured students' self-reported change in their overall functioning and satisfaction with self, others, and their future. Finally, practicing counselors may find the techniques outlined in this article useful in their own work with clients.