Exposure with response prevention versus habit reversal in Tourettes's syndrome: a controlled study

The intentional nature of tics provides the opportunity to apply behavioural interventions aimed at tic reduction through interruption of stimulus-response sequences. The aim of this study has been to evaluate the effect of exposure and response prevention (ER) versus habit reversal (HR) in 43 Tourette's syndrome (TS) patients. The three outcome measures were: the Yale Global Tic Severity Scale (YGTSS), 15-min tic frequency registrations monitored at the institute and 15-min home tic frequency registrations. Both treatment conditions resulted in statistically significant improvements on all outcome measures (p < 0.001). No significant differences were found between the treatment conditions on any of the outcome measures, although there was a tendency in favour of ER on the YGTSS (p = 0.05). These results suggest that, at least in the short term, TS tic symptoms can be treated effectively with both types of treatment.     

Predictors of maternal reactions to excessive crying of newborns. Findings from a prospective study in a naturalistic situation

The prospective study examines which factors assessed in pregnancy predispose mothers to seeing their newborn crying more as a problem and to more mental health problems in response to excessive baby crying. A total of 2140 pregnant women participated in the study, of which 1798 delivered a living singleton. Data was collected by means of a series of written questionnaires. The duration of the baby crying as well as the maternal reactions to the crying were assessed at a mean time of 1–2 months following delivery. The maternal reactions were related to several variables assessed at the end of the first trimester of pregnancy. Data was analysed by means of the method of stepwise multiple regression. Four factors were found to be associated with the reactions of mothers to newborn crying. These are: the duration of the crying, a first-born baby, a relatively high maternal age, and a relatively high score on ‘neuroticism’ in mothers. It was concluded that it is possible to indicate to a certain degree which mothers of excessive crying babies are prone to report more impact of the crying or more mental health symptomatology. It might be worthwhile to offer those mothers some extra support in order to try to prevent the situation from becoming worse. © 1998 John Wiley & Sons, Ltd.     

成人日常问题解决的老化研究

日常问题解决能力是近十几年来老年心理学中研究比较活跃的一个领域。本文介绍了有关日常问题解决研究的四种理论,即心理测量的智力内隐理论、形式后思维的辨证思维理论、信息加工理论和社会认知与智慧理论,及其初步的研究成果,并进一步指出在理论上整合和在实践中开展干预的研究方向。     

The out-patient treatment of patients with an obsessional-compulsive disorder

The results in the treatment of patients with obsessional-compulsive disorders were poor, until Meyer, Rachman, Foa and Emmelkamp developed a strategy which combined exposure and response prevention. Their method is generally applied in a clinical setting, with considerable direct supervision of the patient. A programme that employs the same strategy, but which can be performed in the patient's natural environment, without the need of supervision, is described. A self-control procedure is utilized to assist the patient in carrying out the exposure and response-prevention regime. The results of this outpatient programme do not differ essentially from the results obtained by means of the clinical approach. Advantages of out-patient over clinical treatment are discussed.     

Hypnotic susceptibility in patients with conversion disorder

Conversion disorder has been associated with hypnotic susceptibility for over a century and is currently still believed to be a form of autohypnosis. There is, however, little empirical evidence for the relation between hypnotic susceptibility and conversion symptoms. The authors compared 50 patients with conversion disorder with 50 matched control patients with an affective disorder on measures of hypnotic susceptibility, cognitive dissociation, and somatoform dissociation. Conversion patients were significantly more responsive to hypnotic suggestions than control patients. In addition, conversion patients showed a significant correlation between hypnotic susceptibility and the number of conversion complaints. These results provide the first evidence of a relationship between hypnotic susceptibility and the presence and number of conversion symptoms.     

on the clinical validity of the maslach burnout inventory and the burnout measure

Abstract

Current knowledge about burnout suffers from a healthy worker bias since only working - and thus relatively healthy - employees have been investigated. The main objective of this study is to examine - for the first time among employees who sought psychological treatment - the validity of the two most widely used burnout instruments; the Maslach Burnout Inventory (MBI) and the Burnout Measure (BM). Two groups were distinguished: a “burned out” group (n = 71) that suffers from work-related neurasthenia (according to ICD-10 criteria), and a “non-burned out” group (n = 68). Results show that: (1) the validity of the three-factor structure of the MBI and the BM is confirmed; (2) burnout can partly be differentiated from other mental syndromes (e.g., anxiety and depression); and (3) two MBI-scales (Emotional Exhaustion and Depersonalization) and one BM-scale (Exhaustion) are able to discriminate between burned out and non-burned out employees. The practical implications of these results are discussed.     

Motor initiation and execution in patients with conversion paralysis

Motor initiation and motor execution in four patients with conversion paralysis were investigated in a non-affected motor modality (speech). In line with the hypothesis of dissociated control in conversion disorder [Cognit. Neuropsychiatry 8 (1) (2001) 21] motor initiation, but not response duration, was expected to be impaired. The motor initiation times (reaction time: RT) and motor execution times (response duration: RD) were compared on four RT-tasks that required the production of a verbal response: a simple choice RT-task, a mental letter rotation task, and an implicit and an explicit mental hand rotation task. Because conversion disorder is expected to primarily involve an impairment in the initiation of movement, we expected the following task characteristics to uniquely affect RT and not RD: type of instruction (implicit versus explicit instructed imagery), angle of rotation, and target arm (affected versus non-affected arm). The results indeed showed the task characteristics to significantly affect the participants' RT and not their RD. It was concluded that conversion paralysis is associated with a specific impairment in the explicit initiation of processes with a spatial and motor component.     

on the clinical validity of the maslach burnout inventory and the burnout measure

Abstract Current knowledge about burnout suffers from a healthy worker bias since only working - and thus relatively healthy - employees have been investigated. The main objective of this study is to examine - for the first time among employees who sought psychological treatment - the validity of the two most widely used burnout instruments; the Maslach Burnout Inventory (MBI) and the Burnout Measure (BM). Two groups were distinguished: a "burned out" group (n = 71) that suffers from work-related neurasthenia (according to ICD-10 criteria), and a "non-burned out" group (n = 68). Results show that: (1) the validity of the three-factor structure of the MBI and the BM is confirmed; (2) burnout can partly be differentiated from other mental syndromes (e.g., anxiety and depression); and (3) two MBI-scales (Emotional Exhaustion and Depersonalization) and one BM-scale (Exhaustion) are able to discriminate between burned out and non-burned out employees. The practical implications of these results are discussed.