摘要:

The use of the term sufferer to replace patient has become increasingly common. This paper examines the varied meanings implicit in the word sufferer from the Judaeo‐Christian perspective. This includes the biblical themes of suffering as human nature, as punishment, as a test, as atonement and as liberation and deliverance. The consequences of these themes for the sufferer's role are examined, particularly the sufferer as accepting and the sufferer as victim. It is argued that replacing the medical model, implied by ‘patient’ with a theological model, implied by ‘sufferer’ does not free the person from the constraints of a damag

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1993.tb01734.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Empathy is an important skill for the medical practitioner or medical students to develop when interviewing patients. It helps the interviewer establish effective communication, which is important for accurate diagnosis and patient management. Two facets of medical education limit students' development of accurate empathy: the traditional format of interviewing training and the social ethos of medical training and medical practice, which stress clinical detachment. A number of researchers and educators have developed consulting skills training programmes, designed to enhance students' empathic skills and ability. One difficulty for researchers has been the conceptual complexity of the term ‘empathy’ and greater difficulty in measuring the dimension.This paper reviews the range of approaches to the measurement of empathy and reports on a research study designed to evaluate a two‐stage measurement technique, involving a pencil‐and‐paper test of empathy and independent observer ratings of medical students' actual interview behaviours. Results lead to the conclusion that pencil‐and‐paper tests of empathy cannot incorporate the range of complex cognitive, emotional and behavioural components of the empathy construct. On the other hand, trained observers have been able to use items on a specially developed History‐taking Rating Scale to discriminate between the empathic behaviours of a group of students trained in consulting skills with those of a group of control students who each carried out videotaped history‐taking interviews with hosp

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1993.tb01735.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The increase in research into psychopathology in people with intellectual disability has recently spread to include depression. Several reports have appeared on the assessment of depression in the client group and there is a pressing need for research into treatment of depression in people with intellectual disability. The present paper reviews cognitive behaviour therapy for depression and reports on its adaptation for people with intellectual disability. Two case studies of individuals with mild intellectual disability illustrate the clinical applications. All the elements of cognitive behaviour therapy for depression were maintained and simplified. Both subjects were able to monitor their feelings of depression and subject 2 monitored the frequency of suicidal thoughts. Improvements were seen in both cases on the Zung Depression Inventory and daily monitoring of depressive feelings.

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1993.tb01736.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The first aim of this study was to explore the diagnostic specificity of coping styles by comparing ways of coping in non‐anxious major depressed, non‐depressed agoraphobic, and both major depressed and agoraphobic (comorbid) in‐patients. The second aim was to investigate whether a vulnerability model, a state model, or a combined vulnerability‐state model of coping accounted best for the data. On admission and when discharged, 95 patients completed the Way of Coping Checklist and were evaluated on several symptom scales. Self‐report symptom scales were completed at one‐year follow‐up as well. The ‘purely’ agoraphobic and the comorbid patients showed less seeking of social support and more wishful thinking than the major depressed patients. For the wishful thinking scale, these differences were related to differences in level of global psychopathology. Overall, the results for the seeking social support scale were consistent with a combined vulnerability‐state model. The problem‐focused coping and wishful thinking scores behaved mostly as state phenomena. The avoidance scores provided ambiguous evidence. In a subsample of 30 agoraphobic patients who received a combination of exposure and psychodynamic treatment, higher pre‐treatment levels of seeking social support and lower pre‐treatment levels of avoidance as coping both predicted a more favourable course of symptoms pertaining to fear of fear in the

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1993.tb01737.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The reliability and clinical utility of the rater form of the California Psychotherapy Alliance Scales (CALPAS‐R) was investigated on a sample of 12 one‐hour audiotapes representing differing therapeutic dyads and sampled from sessions two to six of a relationship‐oriented (exploratory) therapy within pilot cases of a large outcome study. Both global dimensions and element‐based ratings were used to test the feasibility of employing the elements as a way of obtaining a finer‐grained analysis of the therapeutic alliance. Results are reported in terms of the inter‐rater reliability of the dimensions and elements, and show element ratings to yield dimensional measures similar or superior to global ratings in reliability. In addition, CALPAS‐R ratings were analysed in conjunction with client ratings of session depth and smoothness as well a

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1993.tb01738.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The nature of the relationship which female and male expectant parents develop during pregnancy with their unborn baby has both theoretical and clinical significance. It potentially provides a framework for improved understanding of many aspects of psychosomatic obstetrics, including reactions to foetal loss. Existing instruments designed to assess this relationship inadequately differentiate between attitude to the foetusper seversus attitude to the pregnancy state or motherhood role. The present paper presents a theoretical model of the subjective experiences of human attachment. This is utilized to develop a questionnaire to assess the antenatal attachment construct. Item analysis results in a 19‐item maternal and 16‐item paternal questionnaire with high levels of internal consistency. Each takes approximately five minutes to complete. Finally, the factor structures of the resultant questionnaires are explo

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1993.tb01739.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Cross‐sectional data are reported on 73 survivors of the Herald of Free Enterprise disaster. Many reported an increase in their consumption of alcohol, cigarettes, sleeping tablets, antidepressants and tranquillizers at six and 30 months. The level of increased use was, however, lower at 30 months than at six months, although this was less evident for alcohol and cigarettes than the other substances. In addition, self‐reports of increased substance use are associated with higher levels of psychological distress as measured by the General Health Questionnaire and the Impact of Events Scale. It is suggested that substance use might help to maintain subsequent psychological distr

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1993.tb01740.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

We report on an unexpected phenomenon following the Herald of Free Enterprise disaster. A series of cross‐channel ferry workers referred by their GPs to the Folkestone Mental Health Team, during the three years after the disaster, presented with post‐traumatic stress disorder, despite having no direct contact with the disaster as survivors, bereaved relatives or helpers. A retrospective case study is described of 14 ferry crew members presenting with PTSD. Thirteen completed the GHQ60. Evidence is presented of severe functional impairment in this group. It is argued that these subjects are indirect victims of the Herald of Free Enterprise disaster. Ways in which the ‘ripples outward’ of a major marine accident might extend to such peripheral victims are di

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1993.tb01741.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Book reviewed in this article:Darwin's Influence on Freud: A Tale of Two Sciences.ByL. Ritvo.The Adaptive Design of the Human Psyche: Psychoanalysis, Evolutionary Biology, and the Therapeutic Process.ByM. Slavin&D. Kriegman.The Adapted Mind: Evolutionary Psychology and the Generation of Culture.Edited byJ. Barkow, L. Cosmides&J. Tooby.

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1993.tb01742.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Book reviewed in this article:Handbook of Character Studies: Psychoanalytic Explorations.Edited byM. Kets de Vries&S. Perzow.Introduction to Psychotherapy, 2nd ed.ByD. Brown&J. Pedder.Personality and Psychotherapy.ByD. Cramer.Religion in Psychodynamic Perspective: The Contributions of Paul W. Pruyser.Edited byH. Newton Malony&B. Spilka.Religion and the Family: When God Helps.Edited byL. A. Burton.The Inner World Outside: Object Relations, Theory and Psychodrama.ByP. Holmes.

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1993.tb01743.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY