Helpful processes in psychological therapy for patients with primary cancers: A qualitative interview study

Aims: The purpose of this study was to identify what patients with primary cancers found helpful in therapy. Method: In‐depth qualitative interviews were conducted with eight patients who had completed a course of psychological therapy within an NHS psychology service for cancer patients. Data were analysed using thematic analysis. Results: The participants identified a range of helpful processes in therapy: talking and expressing their feelings to someone outside of the family; forming a relationship with their therapist; normalisation through the therapists' expert knowledge; problem‐solving and CBT. Limitations: As with all qualitative studies, the small sample and size and dependence on participant recall limits generalisability of the findings. Implications: The findings of this study are consistent with a pluralistic perspective: that multiple therapeutic processes ‐ aligned to a range of different orientations ‐ can be of value to patients with primary cancers. This supports the provision of a range of therapeutic interventions and strategies for this patient group.     

Therapists' positive emotions in‐session: Why they happen and what they are good for

Aim: The therapist's feelings play a remarkable role in contemporary models of psychotherapy. However, these models are biased towards negative feelings. The present study explores therapists' personal experience with positive emotion in‐session. Method: A grounded theory analysis was conducted of interviews with 26 Brazilian psychotherapists. Results: Clinicians derive positive affect from the client's input in treatment, from their own input, and from the personal relationship with the client. Therapist positive emotion adds to the material that can be worked on in‐session by providing interpersonal events in the relationship with the client. It can improve therapist input in treatment by increasing in‐session awareness, resourcefulness and daring and by cuing efforts for professional development. It enhances involvement in the relationship with the client by prompting compassion and closeness in the dyad. Its effects may spill over and contribute to the therapist's personal thriving. Discussion: These results are discussed in light of what positive psychology can add to current work on therapist effects in the treatment process.     

A comparison of risk factors for women seeking labiaplasty compared to those not seeking labiaplasty

Little is known about the factors associated with the desire for labiaplasty. We compared 55 women seeking labiaplasty with 70 women in a comparison group who were not seeking labiaplasty. Measures administered included the Perception of Appearance and Competency Related Teasing Scale, Childhood Trauma Questionnaire, Disgust Scale Revised, and the Genital Appearance Satisfaction scale with open-ended questions about their genitalia. Approximately a third of the labiaplasty group recalled specific negative comments in the past towards their labia, a proportion significantly greater than the three per cent in the comparison group. Participants reporting genital teasing also showed higher Genital Appearance Satisfaction scores than those who were not teased. However, women seeking labiaplasty were, compared to the comparison group, no more likely to have a history of neglect or abuse during childhood. There was no difference between the groups on disgust sensitivity or the perception of being teased in the past about their competence or appearance in general.     

Childhood experiences of parental rearing patterns reported by Chinese patients with borderline personality disorder

The primary purposes of this study were to (1) compare the characteristics of childhood experiences of parental rearing patterns in China reported by patients with borderline personality disorder (BPD), patients with other personality disorders and patients without personality disorders; (2) identify the reported parental rearing patterns associated with BPD in China; and (3) determine whether these patterns differ for males and females. One hundred and fifty‐two patients with BPD, 79 patients with other personality disorders and 55 patients without Axis II diagnoses were administered the Chinese version of the McLean Screening Instrument for BPD and completed the Egna Minnen av Barndoms Uppfostran (EMBU), a self‐report measure of childhood parental rearing patterns. Parental rearing patterns reported by the BPD group were characterized by less emotional warmth, and greater punishment, rejection and control than patterns reported by the other two groups. Within the BPD group, males were more likely than females to report parental punishment, rejection and control. Paternal punishment, low maternal emotional warmth and female gender predicted BPD diagnosis. Negative parental rearing patterns appear to contribute to the development of BPD in China and vary with the gender of the child. Maternal emotional warmth may be a protective factor against BPD.     

A teacher‐centered exploration of the relevance of social factors to theory of mind development

Many accounts of children's Theory of Mind (ToM) development favor a cognitive explanation, for example, in terms of mental representational improvements at or before 4 years. Here, we investigated whether social factors as rated by a child's teacher, are related to ToM development. We tested 82 children of 3–6 years on each of four ToM tasks, and their class teacher completed a social questionnaire about each child's playing behavior, sharing, talkativeness, confidence, aggressiveness and outgoingness. A measure of task memory and the child's gender were also recorded. Here, children generally passed ToM tasks after 5 years‐old, but no one gender performed reliably better than the other. Teacher‐rated confidence and playing behavior were correlated to ToM. But in a regression analysis, these were replaced by teacher‐rated talkativeness; with age and memory given primacy in both sets of analyses. It is concluded that maturation and cognitive factors may well have primacy but social factors, facilitated during early primary education, must also be given a role in ToM development.     

Early drinking onset: A study of prevalence and determinants among 13‐year‐old adolescents in Norway

Early drinking onset is associated with different psychosocial adjustment problems among adolescents. The aim of this study was to assess determinants associated with early drinking and to identify factors predicting early drinking onset among adolescents. The study included 1,550 eighth‐graders with a mean age of 13.5 years from 41 schools. A total of 24% (boys 29%, girls 19%) had ever drunk alcohol, while 14% had drunk some alcohol in the last 30 days. Further, early drinking was associated with gender, religion, school performance, smoking and bullying in the bivariate tests. Predictors of early drinking onset were identified by generalized linear mixed models with two multivariable models created. The first model included social and environmental variables. Entering intentions, expectancies, attitudes and norms into the multivariable analysis resulted in a significant improvement of the model fit constituting 86% in the second model. The percentage correctly classified those (56%) who had been drinking in the second model which was two times higher compared to the first model. Gender, religion and smoking emerged as significant predictors of drinking in both models.     

Young clients' narratives of the purpose and outcome of counselling

This study explores how adolescent clients construct the purpose and outcome of counselling. A narrative analysis was performed on interviews with 22 clients (aged 16–18) who had used a school-based counselling service. The aim was to identify the purpose and outcomes that participants attributed to their counselling experience. The analysis identified four narrative forms that young clients used to describe counselling. These included ‘transformative’, ‘supportive’, ‘pragmatic’ and ‘disappointed’ narratives. Each narrative form constructed a different purpose and outcome for counselling. Engaging with clients' narratives about the purpose and intended outcome of counselling may allow counsellors to better match their expectations and approach to fit with their young client or to work with them to co-construct more flexible narratives that support helpful outcomes.     

Not starting psychotherapy is more often initiated by the therapist than the patient

The phenomenon of not starting psychotherapy is seldom investigated. The present study of psychotherapy in the Swedish mental health services differentiates between patients applying for and being offered psychotherapy but choosing not to start (n = 69), patients recommended to receive no treatment, another type of treatment or treatment at another clinic (n = 133), and therapy starters (n = 1294). After the initial assessment, nearly twice as many patients did not start based on the therapist’s decision than on the patient’s. Cases of not starting psychotherapy decided by the therapist were more frequent among patients whose occupational status was less stable, presented a danger to others, had lower levels of initial therapeutic alliance, and by therapists with lower levels of psychotherapy training and those at less structured and more unstable clinics. Patients choosing not to start therapy had lower levels of mental ill-health than both starters and therapist-initiated nonstarters. The most frequently presented reason for a patient-initiated decision to not start therapy was “patient wished another treatment or therapist,” whereas the most common therapist-initiated reason was “recommended or referred to another treatment or clinic”.     

尿微量白蛋白与急性缺血性脑卒中的关系研究

探讨尿微量白蛋白（MA）与急性缺血性脑卒中（AIS）的关系。选取2012年1月1日～2014年3月31日于大连大学附属新华医院神经内科住院的缺血性脑卒中患者175例为研究对象。分为试验组：A1S患者103例;对照组：非AIS患者72例。比较两组的一般资料和MA阳性率情况。结果试验组的MA阳性率为41．75％,显著高于对照组MA的阳性率20．83％（P〈0．05）。MA与AIS可能有相关性,MA可能是AIS的危险因素。     

Psychological distress in patients with chronic atrophic gastritis: the risk factors,protection factors,and cumulative effect

This study aimed to examine the psychological status among Chronic Atrophic Gastritis (CAG) patients and to find the cumulative effects of risk and protective factors. A sample of 101 CAG patients completed the investigation. Hierarchical linear regression was used to find risk and protective factors, and examine the cumulative effects in risk factor index (RFI) and protective factor index (PFI). Results showed that nine symptoms from SCL-90-R were severer among CAG patients than those in adult norm. Risk factors including positive family history of cancer and higher negative life events could predict higher GSI (β = 0.206, p = 0.023; β = 0.398, p < 0.001; R² = 0.203); more household resistant, positive coping and stronger resilience were protective factors and could predict GSI negatively (β = -0.188, p = 0.020; β = -0.350, p = 0.012; β = ?0.066, p = 0.621; R² = 0.190). The GSI was positively correlated with RFI (β = 0.338, p < 0.001; R² = 0.113) and negatively related to PFI (β = ?0.378, p < 0.001; R² = 0.133). In conclusion, CAG patients suffered from various psychological distress, and the protective factors should be enhanced cumulatively to protect against psychological distress.