‘Between the woods and frozen lake’: a child psychotherapist’s experiences of developing a grant application for an RCT feasibility study

Drawing on the six stages identified by Henton and Midgley (2012) in the narratives of five child psychotherapists involved in the IMPACT study on their evolving attitudes towards participation in outcome research, this paper explores another child psychotherapist’s internal and external world experiences of writing a National Institute of Health Research grant application for a randomised controlled trial feasibility study. It makes use of the key associations that came to mind on first reading Henton and Midgley’s article, outlines the practical and emotional stages of developing the grant proposal and briefly considers some of the wider implications of this kind of work on a personal, organisational and professional level.     

Do as you’re told! Facets of agreeableness and early adult outcomes for inner-city boys

With data from the middle cohort of the Pittsburgh Youth Study, a prospective longitudinal study of inner-city boys, we examined whether Big Five agreeableness facets could be reliably recovered in this sample, and whether facets predicted educational, occupational, social, and antisocial life outcomes assessed a decade later. Caregivers described their adolescent boys’ personalities using the Common California Q-Set; twelve years later, participants were interviewed and court records were obtained. Factor analyses recovered two facets: compliance and compassion. Compliance predicted more schooling and lower risk of unemployment, teenage fatherhood, and crime; compassion related to longer committed relationships. Findings highlight the value of studying personality at the facet level.     

Predictors of Smoking Status After Eight Years: The Interaction of Stages of Change and Addiction Variables

Abstract

With a smoking rate of 30% of the population Switzerland has one of the highest rates of all industrialised countries. Changes in smoking status over eight years are examined by analysing the course of non-smokers, former smokers and current smokers between 1987 and 1995. Stages of change and addiction variables, as well as their interaction, are analysed for 1987 as predictors of smoking status in 1995.A sample of 953 non-smokers and former and current smokers was interviewed in 1987 and followed up in 1995. Between 1987 and 1995 every fifth non-smoker (20.9%) began smoking. The higher one is in the stage hierarchy the higher the probability of forward than of backward movement. Within the stages of change the likelihood of cessation is moderated by addiction variables. Thus, in the case of contemplating smokers in 1987, the more cigarettes they smoked daily at that time the less likely they were to be former smokers by 1995, but for preparating smokers who had already made an attempt to quit the converse holds - the more they smoked in 1987, the more likely they were to be non-smokers eight years later. The same holds for former smokers in 1987: former moderate smokers then were more likely to relapse than former heavy smokers. The implications for prevention and intervention are discussed.     

Are fear-avoidance beliefs related to the inception of an episode of back pain? A prospective study

Abstract

Fear-avoidance beliefs and catastrophizing have been implicated in chronic pain and theoretical models have been developed that feature these factor in the transition from acute to chronic pain. However, little has been done to determine whether these factors occur in the general population or whether they arc associated with the inception of an episode of neck or back pain. The aim of this study was to evaluate prospectively the effects of fear-avoidance beliefs and catastrophizing on the development of an episode of self-reported pain and associated physical functioning. To achieve this, we selected a sample of 415 people from the general population who reported no spinal pain during the past year. At the pretest a battery of questionnaires was administered to assess beliefs about pain and activity and it featured the Pain Catastrophizing Scale and a modified version of the Fear-Avoidance Beliefs Questionnaire. One year later outcome was evaluated by self-reports of the occurrence of a pain episode as well as a self-administered physical function test. The results showed that scores on both fear-avoidme and cabstrophizing were quite low. During the one year follow-up, 19% of the sample suffered an episode of back pain. Those with scores above the median on fear-avoidance beliefs at the pretest had twice the risk of suffering an episode of back pain and a 1.7 times higher risk of lowered physical function at the follow-up. Catastrophizing was somewhat less salient, increasing the risk of pain or lowered function by 1.5. but with confidence intervals falling below unity. These data indicate that fear-avoidance beliefs may be involved at a very early pint in the development of pain and associated activity problems in people with back pain. Theoretically. our results support the idea that fear-avoidance beliefs may develop in an interaction with the experience of pain. Clinically, the results suggest that catastrophizing and particularly fear-avoidance beliefs are important in the development of a pain problem and might be of use in screening procedures.     

Temporal dimensions of the self-concept: Entrapped and possible selves in chronic pain

Abstract

The purpose of this qualitative study was to explore temporal aspects of chronic pain patients' conceptions of their selves; what they were in the past, how they were functioning at the present and what they thought about their potential and future. In-depth interviews with 21 chronic pain patients were performed and analysed. The main results of the analysis included four higher-order conceptual patterns: “the body and I”, “maintaining the consistency of past self”, the “entrapped self”, and “projected selves, defined by others”. These results are presented in a systems-oriented model illustrating the temporal dynamic between the perceived functioning self, the body and others, such as health care personnel and significant others. The mechanisms of the process of how selves are developing in the chronisation or healing process of pain are finally discussed. A clinical implication of these findings might be that with an enlarged insight of the temporal dynamic and the importance of interactive and social factors in shaping positive possible selves, health care personnel can contribute more effectively in stew-arding the chronic pain patient toward health-promotive ends and a concomitantly higher quality of life.     

A longitudinal study of psychosocial distress in breast cancer: Prevalence and risk factors

This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.     

The Impact of Rumination on State Paranoid Ideation in a Nonclinical Sample

Cognitive-behavioral models of paranoia have emphasized the potential role of perseverative thinking styles, such as rumination or worry, in the development, maintenance and exacerbation of paranoid beliefs. This study aimed to experimentally test the hypothesis that rumination may play a role in the maintenance or exacerbation of state paranoid ideation. Following a paranoia induction, 37 nonclinical participants were randomly assigned to either a rumination task or a distraction control condition. In accord with main hypothesis, rumination was associated with maintained levels of paranoia, whereas distraction was associated with a decrease in levels of paranoia. These findings suggest that perseverative thinking may play a role in the maintenance of paranoid ideas, which may have implications for our understanding of the maintenance of paranoia and persecutory delusions in the clinical population. Furthermore, the study used a novel experimental paradigm for inducing paranoia, which may prove valuable for future research aiming to elicit paranoid thoughts and feelings in vivo.     

The Assessment and Treatment of Post-Abortion Syndrome: A Systematic Case Study From Southern Africa

This article reports a clinical case study of “Grace”, a black Zimbabwean woman with post-abortion syndrome (PAS), a form of post-traumatic stress disorder precipitated by aborting an unwanted pregnancy. She was treated by a middle class white South African trainee Clinical Psychologist. The case narrative documents the assessment and the course of treatment which was guided by ongoing case formulation based on current evidence-based models. Factors that made her vulnerable to developing PTSD included active suppression of the memory of the event and lack of social support. An understanding of these factors was used to guide an effective intervention. In spite of the differences in culture and background between client and therapist, there was considerable commonality in their experience as young women and students who each had to balance personal and occupational priorities. The narrative also highlights the commonalities of Grace's experiences with those reported in the literature on post-abortion syndrome, which is mostly from the U. S. A. and Europe.     

Sense of meaning and study perseverance and completion: a brief report

The study examines sense of meaning influences on study perseverance and course completion among students within a faculty of management sciences at a South African university (n = 40). Participants were selected for high scores on the Purpose in life (PIL) scale (n = 20; 50%) and contrasting low scores on the same (n = 20; 50%) (age range = 27 to 30 years, females = 73%, majority ethnicity = 70% Sotho speaking). Data were analysed using independent-samples t-test group comparison procedure. The results suggest that a high sense of meaning can explain study perseverance and completion.     

“I control my own emotions for the sake of the team”: Emotional self-regulation and interpersonal emotion regulation among female high-performance curlers

ObjectivesThe purpose of this study was to examine emotional self-regulation and interpersonal emotion regulation within a team of competitive athletes.DesignInstrumental case study approach (Stake, 1995).MethodData collection involved multiple semi-structured interviews with all four members of a female high-performance curling team, as well as observation of team meetings, practices, and games over the entire season.ResultsAnalyses produced the main themes of emotional self regulation (body language and self-censorship) and interpersonal emotional regulation (providing positive and/or technical feedback, humour, cueing teammates about their emotions, prosocial actions and indirect actions). We also identified factors influencing emotional regulation (length of time together, team dynamics/cohesion, context, social norms and team roles, and seeking support outside the team).ConclusionsAthletes were aware of and took into account social and contextual factors (e.g., social norms and role on team) when regulating emotions in a team context, and they also identified challenges associated with emotional regulation within the team. Findings highlight the complex interplay between athletes' emotions, emotional expression, and self-regulation to achieve multiple goals (e.g., positive performances, positive social relationships), as well as the importance of examining interpersonal processes related to emotion and emotion regulation within team sports.