A case of persistent neurogenic stuttering following a missile wound

Observational criteria that have been proposed to distinguish developmental from neurogenic stuttering are critically reviewed. It is concluded that both conditions may closely resemble each other. As an example, a case of neurogenic stuttering following a missile would is reported.     

Resistance and outcome expectations in cognitive‐behavioural therapy for generalised anxiety disorder

Greater client resistance has been consistently found to be negatively associated with outcome in psychotherapy. However, the pathways through which resistance impacts such outcomes are underexplored. Given that client outcome expectation (OE) has been identified as an important common factor in psychotherapy, the goals of the present study were to examine: (a) the impact of resistance on subsequent client and therapist OE (COE & TOE, respectively); and (b) whether COE and/or TOE mediate the relationship between resistance and outcome. These relationships were tested among 44 clients with severe generalised anxiety disorder treated with cognitive‐behavioural therapy in the context of a randomised controlled trial (Westra, Constantino, & Antony, 2016). Resistance was measured at a mid‐treatment session, and COE and TOE were assessed at baseline and immediately after the resistance session. Treatment outcome was measured via client‐rated worry severity at post‐treatment. As predicted, higher resistance was associated with lower subsequent COE and TOE; B = ?.73, p < .001 and B = ?.46, p < .001, respectively. In turn, lower post‐resistance COE predicted higher post‐treatment worry (B = ?.5, p < .001), indicating mediation. In contrast, TOE did not mediate the relationship between resistance and outcome (B = ?.02, p = .876). These results suggest that resistance can be demoralising to both clients and therapists. However, only lower client morale may be detrimental to therapy outcome. This study contributes to understanding outcome pathways through two common therapy processes.     

Sense of body and sense of action both contribute to self-recognition

Recognizing oneself, easy as it appears to be, seems at least to require awareness of one's body and one's actions. To investigate the contribution of these factors to self-recognition, we presented normal subjects with an image of both their own and the experimenter's hand. The hands could make the same, a different or no movement and could be displayed in various orientations. Subjects had to tell whether the indicated hand was theirs or not. The results showed that a congruence between visual signals and signals indicating the position of the body is one component on which self-recognition is based. Recognition of one's actions is another component. Subjects had most difficulty in recognizing their hand when movements were absent. When the two hands made different movements, subjects relied exclusively on the movement cue and recognition was almost perfect. Our findings are in line with pathological alterations in the sense of body and the sense of action.     

Managing resistance in cognitive behavioural therapy: the application of motivational interviewing in mixed anxiety and depression

While cognitive behavioural therapy is highly effective in the treatment of anxiety and depression, a substantive number of individuals either refuse treatment, fail to respond to treatment or respond only partially. Arguably, ambivalence about change or about engaging in treatment tasks may in part be related to incomplete recovery rates in cognitive behavioural therapy. Motivational interviewing is a client-centred, directive treatment originally developed in the addictions domain whose goal is to enhance motivation for change by understanding and resolving ambivalence. This method has consistently received support for enhancing outcomes in the addictions domain, particularly when used as an adjunct to further treatment. As yet, motivational methods have not been generalized to the treatment of prevalent mental health problems, such as anxiety and depression. The present paper presents the application of a treatment targeting motivation (motivational interviewing adapted for anxiety and depression) to the management of resistance in cognitive behavioural therapy for 3 clients with mixed anxiety and depression. Motivational interviewing is conceived as an adjunct to highly effective traditional cognitive behavioural therapy methods, which is indicated for use with clients resistant to and significantly ambivalent about change-based techniques for managing anxiety or alleviating depression.     

Referent cognitions theory: the role of closeness of reference points in the psychology of voice

The most generally accepted and best documented manipulation in procedural justice experiments is varying whether or not participants are allowed an opportunity to voice their opinion about a decision. To better understand the psychology of voice, the authors focus on Referent Cognitions Theory (RCT). It is argued that thus far RCT has not been used to explain the psychology of voice and that previous RCT research suffers from methodological problems and has been more outcome oriented than necessary. Two experiments resolve these problems and show that people react more strongly to procedures (especially no-voice procedures) when reference points are close as opposed to distant. These findings suggest that closeness of reference points plays an important role in the psychology of voice. The findings expand RCT in significant ways and indicate that insight into the role of reference points is essential for understanding the psychology of justice.     

HIV-related stigma in African and Afro-Caribbean communities in the Netherlands: manifestations, consequences and coping

HIV-related stigma in African and Afro-Caribbean diaspora communities in the Netherlands was investigated. Interviews with HIV-positive and HIV-negative community members demonstrated that HIV-related stigma manifests as social distance, physical distance, words and silence. The psychological consequences of HIV-related stigma among those diagnosed with HIV reported were emotional pain, sadness, loneliness, anger, frustration and internalised stigma. The social consequences included decreased social network size, limited social support and social isolation, and resulted from not only enacted stigma but also self-imposed social withdrawal. Also, poor treatment adherence was a health-related consequence. People living with HIV employed both problem-focused and emotion-focused coping strategies to mitigate the negative consequences of stigma. Problem-focused coping strategies included selective disclosure, disengagement, affiliating with similar others, seeking social support and, to a lesser extent, activism. Emotion-focused strategies included distraction, positive reappraisal, religious coping, external attributions, disidentification and acceptance. HIV-related stigma clearly permeates African and Afro-Caribbean communities in the Netherlands, and should be targeted for intervention.     

Blaming for a better future: future orientation and associated intolerance of personal uncertainty lead to harsher reactions toward innocent victims

People are often encouraged to focus on the future and strive for long-term goals. This noted, the authors argue that this future orientation is associated with intolerance of personal uncertainty, as people usually cannot be certain that their efforts will pay off. To be able to tolerate personal uncertainty, people adhere strongly to the belief in a just world, paradoxically resulting in harsher reactions toward innocent victims. In three experiments, the authors show that a future orientation indeed leads to more negative evaluations of an innocent victim (Study 1), enhances intolerance of personal uncertainty (Study 2), and that experiencing personal uncertainty leads to more negative evaluations of a victim (Study 3). So, while a future orientation enables people to strive for long-term goals, it also leads them to be harsher toward innocent victims. One underlying mechanism causing these reactions is intolerance of personal uncertainty, associated with a future orientation.