Teaching medical staff psychological concepts via a hospital newsletter

Despite the increased recognition of the critical role of social and psychological factors in health and illness, the teaching of psychology is rarely integrated in medical education. Staff generally have minimal formal training in psychological concepts. Patients on the inpatient rehabilitation unit frequently present with unexpected reactions in response to acute trauma and resulting changes in identity and capabilities. Rehabilitation goals therefore, must be based on psychological, as well as physical, capacities. A one-page, user-friendly newsletter was designed to illustrate basic psychological principles via case vignettes. The topics of fear, countertransference, and resistance were selected as critical issues staff frequently encounter in their work with patients. The newsletters provided the staff with basic conceptual tools for effectively treating patients, and the work of psychologists was demystified. The newsletter format is proposed as a creative adjunct to didactic teaching.Copies of the newsletter Insight can be obtained by request from Dr. Gold.     

Changes in Cognitions, Emotions, and Behaviors in Depressed Patients and Their Spouses Following Marital Cognitive Therapy, Traditional Cognitive Therapy, Pharmacotherapy, and No Intervention

This study evaluated specific influences of a cognitive marital treatment (CMT) for depression based on an integration of cognitive theory of depression and systems theory. The effects of CMT on variables representing cognitions, emotions, and behaviors were compared with the effects of traditional cognitive therapy (CT), pharmacotherapy (PT), and no treatment (NT). Subjects were Major Depression Disorder and Dysthymic outpatients and their spouses. The changes considered were for pre–post treatment and pre-treatment–follow-up. CMT affected a wider range of variables than other treatments. In most instances it was also superior to the NT condition. Most of the gains were manifested at termination and lasted through follow-up. The variables affected by CMT were patients' and spouses' cognitions and emotions. PT had best effects on patients' emotions. CT affected patients' cognitions, but did not achieve superiority on any of the compared variables. None of the treatments produced significant changes in behaviors.     

The role of primary prevention in mental health services: A review and critique

Community psychology in the West has had a growing impact on mental health service provision. One facet of this development has been the advocacy of an increased focus on the primary prevention of mental illness. This paper reviews both theoretical and practical work in this area in order to assess the current role and relevance of primary preventive interventions. There is a discussion of primary prevention's historical and theoretical contexts, of its conceptualisations and definitions, of criticisms of its relevance and efficacy, and of examples of its practice. It is argued that primary prevention is inappropriately marginalised in current service provision and that there is a need to engage in the long-term planning and evaluation of primary preventive interventions in order to facilitate their fuller incorporation into national and local policies on mental health.     

Chronic pain,compensation and clinical knowledge

The nosological status of the putative clinical entity of compensation neurosis and the relationship of chronic pain complaints to compensation are explored. It is concluded that, using the traditional criteria of diagnostic validity, there is no support for the view that a specific type of psychiatric disorder related to compensation or litigation can be demonstrated. Although it has been generally considered that chronic pain complaints reflect an underlying disease state, recent evidence has shown that in the medico-legal setting the nature of the compensation system and the level of available benefits have a marked influence on both the rate of chronic pain complaints and the duration of pain related work incapacity.     

The temporality of illness: Four levels of experience

This essay argues that, while much has been gained by medicine's focus on the spatial aspects of disease in light of developments in modern pathology, too little attention has been given to the temporal experience of illness at the subjective level of the patient. In particular, it is noted that there is a radical distinction between subjective and objective time. Whereas the patient experiences his immediate illness in terms of the ongoing flux of subjective time, the physician conceptualizes the illness as a disease state according to the measurements of objective time. A greater understanding of this disparity in temporal experiencing provides insights into the lived experience of illness and can preclude difficulties in communication between physician and patient.     

Spirituality in Disability and Illness

Spirituality appears with increasing frequency in the research literature, and a paradigm involving mind-body-spirit interaction is emerging. The relationship of spirituality to disability and illness is at the center of a growing body of knowledge. A comprehensive literature review supported spirituality as coping method among individuals experiencing a variety of illnesses including hypertension, pulmonary disease, diabetes, chronic renal failure, surgery, rheumatoid arthritis, multiple sclerosis, HIV/AIDS, polio and addictive illnesses. Additionally, spirituality is a resource when dealing with critical illness as well as terminal illness and end of life issues, and it is utilized by both patients, and family members. Discussion of research findings, implications for health care practice and future research is also presented.     

The stigma of mental illness: Explanatory models and methods for change

For people with mental illness, diminished quality of life and loss of personal goals does not result solely from the symptoms, distress, and disabilities caused by their psychiatric disorder. Quality of life and personal goals are also hindered by people who embrace the stigma that accompanies mental illness and mental health care. This paper reviews evidence of the impact of mental illness stigma and strategies for seeking to ease its impact. To achieve these goals, we (a) describe the ways in which stigma harm people with mental illness, (b) summarize models that explain the development and maintenance of these stigmatizing effects, and (c) review strategies that have been shown to decrease the impact of stigma. Concerns about stigma are on the political agendas of many mental health advocacy groups. It has recently also become the focus of extensive research. Our goal in this paper is to balance the practical concerns raised by mental health advocates against data that support or contradicts specific assertions.     

疾病的附魅与祛魅--为纪念苏珊·桑塔格而作

用马克斯·韦伯的祛魅理论来读解苏珊·桑塔格在<疾病的隐喻>一书中表述的反对隐喻、回到疾病本身的观点,探讨积极意义与局限性所在,并以此作为对这位当代美国最著名的"公共知识分子"的纪念.     

Group Therapy with Individuals and Families Coping with Illness or Disability in Israel

This paper illustrates a group intervention with individuals and family caregivers coping with illness/disability, and focuses on the relationship between the process of group development and the process of coping with the illness/disability. People experiencing illness/disability cope with a great deal of pressure and stress that stem from the illness's biopsychosocial demands. A group can provide encouragement and support and reduce helplessness, isolation, and despair through cooperation and use of mutual resources. The design of the intervention was based on our clinical experience with numerous groups for ill/disabled individuals or their family. The process is described and analyzed using examples from three documented groups, and is presented in terms of four variables: group process, group atmosphere, group content, and group intervention.     

心理疾病内隐污名述评

心理疾病内隐污名是个体无法内省或精确识别的与心理疾病有关的痕迹, 它潜在地调节着个体对心理疾病患者的观念和行为。心理疾病内隐污名的主要测量方法包括内隐联想测验、简式内隐联想测验、启动任务和生理心理测量。当前该研究领域集中在内隐污名的成分、公众内隐污名、自我内隐污名、去污名化评估等方面。未来研究可从心理疾病内隐污名的构成与结构、认知神经基础、测量整合和本土化等角度做进一步探讨。