Deconstructing the construct: A network perspective on psychological phenomena

In psychological measurement, two interpretations of measurement systems have been developed: the reflective interpretation, in which the measured attribute is conceptualized as the common cause of the observables, and the formative interpretation, in which the measured attribute is seen as the common effect of the observables. We advocate a third interpretation, in which attributes are conceptualized as systems of causally coupled (observable) variables. In such a view, a construct like ’depression’ is not seen as a latent variable that underlies symptoms like ’lack of sleep’ or ’fatigue’, and neither as a composite constructed out of these symptoms, but as a system of causal relations between the symptoms themselves (e.g., lack of sleep → fatigue, etc.). We discuss methodological strategies to investigate such systems as well as theoretical consequences that bear on the question in which sense such a construct could be interpreted as real.     

Creating a ‘psychological nest’ for vulnerable infants and children: an interview with Annette Mendelsohn

This is an edited version of a recent interview with Annette Mendelsohn, Child and Adolescent Psychotherapist at the Royal Free Hospital, London, UK. It aims to make available in published form Mendelsohn's thinking and approach in relation to her work with traumatised children in a hospital setting. Mendelsohn also discusses her work in a neonatal intensive care setting and the way in which approaches to psychosocial care in the hospital setting have changed over the course of her professional life.     

On the Importance of the Setting in the Psychoanalytic Situation

In this article, we explore the process of psychoanalytical listening in the context of language. We demonstrate through a clinical example how listening may act as a facilitator of a person's linguistic style, but also how the defence of negation blocks the same process. Guided by the modern speculations on the function of metaphor, we show how listening has been expressed in various metaphors and other “tropes” of language by psychoanalysts, and also how useful metaphors can be in our listening to patients.     

Illness perceptions and distress in women at increased risk of breast cancer

Variation in the levels of distress in women at increased risk of breast cancer has been reported, yet there is limited understanding of the factors that are associated with heightened distress in this population. This study took a theoretical approach using Leventhal's Self Regulatory Model (SRM) to understand variation in distress levels. The study examined the associations between perceptions of breast cancer and distress in women at increased risk of breast cancer, and a comparison sample with no experience of the disease in their social environment. Questionnaire data from 117 women at increased risk of breast cancer and 100 comparison women were analysed. Women at increased risk of breast cancer showed comparable levels of general distress but significantly higher levels of cancer specific distress than the comparison group. There were few differences in illness perceptions between the samples, although a number of cognitive perceptions of breast cancer were related to both general and cancer specific distress in the increased risk sample, but not in the comparison sample. The results suggest that the SRM provides a useful framework to explore the psychological response to genetic risk. Further research is required in this population to examine illness perceptions in more detail, validate quantitative measures of illness perceptions, and examine interactions between risk perception and the SRM constructs.     

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.     

Development and Initial Validation of a General Psychological Well-being Scale (GPWS) in an African Context

This study aimed to develop and validate the General Psychological Well-being Scale (GPWS) in an African sample, based on the empirical overlap between hedonic and eudaimonic facets of well-being as found in previous research. The quantitative cross-sectional study was conducted in three phases: secondary data analysis (n = 2005), pilot study (n = 296) and main study (n = 459). The pilot and main study included the GPWS as well as other psychological well-being measures for criterion-related validity. The pilot study yielded satisfactory psychometric properties. The main study yielded a high, reliable Cronbach alpha of.89 and evidence of construct validity. The GPWS appears to be a unidimensional scale suitable for research use with Setswana-speaking people.     

Well Children Living with Diabetic Siblings

Abstract

This article examines the psychological adjustment of well children who live with diabetic siblings. A sample of 28 well siblings between the ages of 8 and 12 were studied, utilizing standard tests and a semi-structured interview. Standard tests demonstrated that well siblings had adjustment difficulties manifested by internal stressors that originated from anxiety and low self-concept. This report emphasized the qualitative results of well siblings living with diabetic siblings. The findings conclude that well siblings have difficulties negotiating emotions, communications, and activities with their diabetic siblings. The report interprets sibling issues from a psychodynamic orientation, suggesting that many of the healthy psychological functions performed by the sibling relationship are interrupted by the introduction of a chronic illness. Recommendations based on the findings are offered to professionals who work with diabetic children and their families.     

Roles of Leisure in Coping with Stress Among University Students: A Repeated-Assessment Field Study

This article reports findings of a study to examine the effects of leisure coping on various stress coping outcomes including: immediate outcomes (perceived coping effectiveness, perceived satisfaction with coping outcomes, and perceived stress reduction) and distal or long-term outcomes (physical and mental ill-health and psychological well-being), above and beyond the contributions of general coping - coping not directly associated with leisure. A repeated-assessment field design was used to examine ways in which university students cope with stressors in their daily lives. The study found that leisure coping beliefs (leisure-generated dispositional coping resources) significantly predicted lower levels of mental and physical ill-health and greater levels of psychological well-being above and beyond the effects of general coping. Also, the use of leisure coping strategies (situation-specific stress coping strategies through leisure) was significantly associated with higher levels of perceived coping effectiveness and stress reduction when the effects of general coping were taken into account. Significant contributions of specific leisure coping dimensions were found as well.     

Goal disturbance,coping, and psychological distress in partners of myocardial infarction patients: Taking account of the dyad

Abstract

This study aims to explore the relationship between goal disturbance and levels of psychological distress in partners of myocardial infarction (MI) patients. Furthermore, the role of partner and patient coping behaviour in the context of goal disturbance is explored. Forty dyads were interviewed and completed questionnaires 1 month (T1) and 4 months (T2) post MI. All patients were men. Patients and partners do not differ on anxiety or depression scores, however, patients experience significantly more higher order goal disturbance at T1. Partners reporting more goal disturbance also show increased distress at T1. More use of approach coping by partners contributes to explained variance in their goal disturbance. Partner avoidant coping is moderated by patient avoidant coping. Approaches to reduce distress in partners should thus take account of goal disturbance and coping behaviours within the dyad.     

Speaking up in ad hoc multiteam systems: Individual-level effects of psychological safety,status, and leadership within and across teams

Speaking up in high-risk organizations plays a pivotal role in the mitigation of errors and can make the difference between life and death. To date, speaking up has been studied mostly within teams. However, many high-risk organizations rely on the effective collaboration across teams in ad hoc multiteam systems (MTS). This study widens the scope of research from teams to MTS and empirically compares the mechanisms involved in speaking up within versus across teams in ad hoc MTS-aircrews. In a sample of 1490 aircrew members of a European airline, we found that crewmembers’ individual level perceptions of psychological safety mediated both the relationship between status and speaking up and between perceived leader inclusiveness and speaking up within teams. Across teams, however, psychological safety and leader inclusiveness—as perceived by pursers in their role as boundary spanners—showed no effect. Instead, it was pursers’ within-team perceptions of psychological safety that mediated between status and speaking up across teams. Teams in ad hoc MTS may thus serve as safe harbours supporting their members also in interactions across team boundaries. Implications of findings for research on MTS and practical recommendations to improve speaking up within and across teams in ad hoc MTS are discussed.