framing of prenatal screening test results and women's health-illness orientations as determinants of perceptions of fetal health and approval of amniocentesis

Abstract

Framing effects of medical test results and interactions of these effects with personal perspectives were investigated in the context of prenatal screening. Hundred and Thirty-three pregnant women undergoing the ‘triple-test’ were assessed as having health or illness orientations, and were randomly presented with reassuring/moderate/severe diagnoses framed in normal/abnormal terms, forming a 2 × 3 × 2 between subjects design. Evaluations of fetus' health and recommendations to perform amniocentesis were assessed. Findings showed healthier evaluations of the fetus and weaker recommendations to perform amniocentesis in normal versus abnormal framings. An interaction was found between framing, diagnosis, and personal orientations: women with health orientations receiving a moderate diagnosis framed in abnormal terms were significantly more inclined to recommend amniocentesis than illness-oriented women given the same diagnosis; the normal/abnormal framing of severe diagnoses yielded opposite effects on health-oriented versus illness-oriented women. The influences of framing effects and health/ illness orientations on health perceptions and behavioral intentions were discussed.     

Interventions for Family Members and Carers of Patients with Borderline Personality Disorder: A Systematic Review

Carers of patients with borderline personality disorder (BPD) experience high levels of distress. Several studies have been carried out on interventions designed to decrease their burden. However, the evidence from these studies has not been summarized. The objective of this work is to explore the clinical utility of interventions developed for family members of patients with BPD. A systematic review was conducted following the PRISMA guidelines (registration number CRD42018107318), including psychological interventions focused on relatives of patients with BPD. The following databases were used: PsycINFO, PubMed, EBSCOhost, and Web of Science. Two independent researchers reviewed the studies to determine whether the eligibility criteria were met. A total of 2,303 abstracts were identified. After duplicates had been removed, 1,746 studies were screened. Finally, 433 full‐text articles were reviewed, yielding 11 studies that satisfied the inclusion criteria. Results show that these interventions with different clinical formats and settings are effective. The quality of the included studies varies, and the empirical support for these programs is still preliminary. The results help to establish a general framework for interventions specifically developed for family members of patients with BPD, but additional efforts should be made to improve the methodological quality of this field of research and more solidly determine the utility of these interventions. Given the paucity of data so far, this information may open up new lines of research to improve the effectiveness of future programs for carers of patients with BPD and help to reduce their burden.     

Countertransference,enactment and sexual abuse

This paper examines the development of a therapeutic relationship with a sexually abused latency girl who, in the course of her two years of four times weekly psychotherapy, was placed in two different foster-homes. It is argued that the child's re-enactment of the abuse in the consulting room allowed her to move from a seductive relationship with the therapist to one characterized by basic trust. This was paralleled by her development of a capacity to think and to tolerate affect states. The use of an imaginary twin by the child and the use of powerful countertransference feelings in the therapist are seen as the main therapeutic tools in the treatment. The premature termination of the treatment – due to the therapist's departure – enabled the child to articulate for the first time her feelings, in the transference, about the trauma and the traumatizing agent. The child's progressing moves in the therapy are also presented.     

Perceived Stress in Young Carers: Development of a Measure

We report the development of a 5-factor, 31-item, Young Carers Perceived Stress Scale (YCPSS) from an initial 50-item pool. The scale was developed and tested on 108 young carers aged between 12–18 years, and acceptable Cronbach Alpha values were obtained for the individual factors and the overall scale. In addition, both the overall scale and individual factors produced a pattern of correlations with social support, burden of care, psychological distress, and coping, supporting the initial validity and utility of the scale.     

Carers' attributions about positive events in psychosis relate to expressed emotion

Background

Relapse is increased in people with psychosis who live with carers with high expressed emotion (EE). Attributional style has been used to understand EE at a psychological level. Previous studies have investigated carer appraisals for negative events in the patient's life. We therefore aimed to examine spontaneous carer attributions for both negative and positive events. Further, we distinguished between high EE based on critical comments, and that based on emotional-overinvolvement.

Method

Audiotapes of the Camberwell Family Interview (CFI) (N = 70) were rated using the Leeds Attributional Coding System (LACS). Raters were blind to previous ratings of EE.

Results

In our sample, low EE carers made significantly more attributions about positive events, and less about negative events than high EE carers. This is because criticism, but not overinvolvement, was strongly associated with responsibility attributions for negative events, while overinvolvement, but not criticism, was inversely associated with responsibility attributions for positive events.

Conclusion

Carers' attributions for both positive and negative events may be a useful target for improving family interventions in psychosis.