British Journal of Clinical Psychology

Dalgleish, Tim; Rosen, Kate; Marks, Melanie

doi: 10.1111/j.2044-8260.1996.tb01174.xpmid: 8773795

Seasonal affective disorder (SAD) is a depressive disorder which occurs during the winter and remits in the spring and summer. It differs from non‐seasonal depression in its seasonal variation and in the presence of neurovegetative symptoms such as increased appetite and hypersomnia. This review is aimed at clinical practitioners and presents a detailed description of the syndrome before discussing the assessment of SAD and the current treatment of choice of phototherapy. Particular attention is paid to the impotant issue of differential diagnosis during assessment and the practicalities involved in the administration of light therapy during treatment.

Dilks, Sarah L. E.; Shattock, Linda

doi: 10.1111/j.2044-8260.1996.tb01175.xpmid: 8773796

The focus of the debate over hospital versus community care for those with severe and enduring mental health problems has shifted somewhat towards ensuring the quality of care provided by services regardless of their location. One factor that is generally assumed to be an important indicator of quality of care is the opportunity for community contact that users of a residential service have. This is illustrated by its inclusion in most instruments designed to assess quality of care in psychiatric services. The present study set out to examine the amount of community contact made by residents of three units of a London psychiatric rehabilitation service. Level of community contact was indeed found to be unrelated to the location of these facilities on a hospital site or in the community. However, interesting differences did emerge across units in the type of community contact made by residents and in the identity of residents' companions on community trips.

Button, E. J.; Sonuga‐Barke, E. J. S.; Davies, J.; Thompson, M.

doi: 10.1111/j.2044-8260.1996.tb01176.xpmid: 8773797

A number of authors have emphasized the importance of self‐esteem in the aetiology of the eating disorders anorexia nervosa and bulimia nervosa. Evidence for such theorizing, however, mainly derives from clinical observations on people being treated for eating disorders. This study is the first prospective study to investigate the role of self‐esteem in aetiology prior to the onset of an eating disorder. Self‐esteem was measured in 594 schoolgirls aged 11–12 using the Rosenberg Self‐Esteem Scale (Rosenberg, 1965). Almost 400 of these girls were successfully followed up at age 15–16 and they completed a questionnaire examining eating and other psychological problems. Results showed that girls with low self‐esteem at age 11–12 were at significantly greater risk of developing the more severe signs of eating disorders, as well as other psychological problems, by the age of 15–16. It is argued that more research is needed to replicate and extend these findings. The results also give weight to the case for examining the potential role of self‐esteem enhancement in the prevention of eating disorders.

Richardson, John T. E.

doi: 10.1111/j.2044-8260.1996.tb01177.xpmid: 8773798

This paper reports the results of a questionnaire survey on problems in everyday memory that involved 115 community‐based patients with multiple sclerosis (MS) and their carers or close relatives. Cluster analyses of their responses enabled the patients to be classified as cither ‘impaired’ or ‘unimpaired’, though the salient items differed between the reports of the patients and the relatives. Both the self‐reports and the relatives' reports indicated that roughly 10 per cent of the patients were impaired, a much lower estimate than that which was previously suggested based upon psychometric testing. It is concluded that neuropsychological assessment may underestimate the capacity of MS patients in their daily activities.

Jones, Barry T.; McMahon, John

doi: 10.1111/j.2044-8260.1996.tb01178.xpmid: 8773799

When negative alcohol expectancies are measured appropriately they form at least as secure associations with measures of consumption as has been demonstrated by mainstream expectancy research for positive alcohol expectancies and they can be usefully used to represent a component of motivation to restrain consumption or recover in dependent drinkers. A study is reported in which (i) negative outcome expectancies assessed at admission to treatment reliably predicted number of days to first drink; (ii) the same relationship is discovered for discharge measures (iii) and, although the change in negative expectancies between admission and discharge does not, itself, predict the number of days to first drink, it does when the corresponding admission measure is also taken into account. The same predictive relationships were not found for positive expectancies. Implications for planning treatment are discussed in terms of treatment enhancement rather than treatment matching.

Crawford, J. R.; Allan, K. M.

doi: 10.1111/j.2044-8260.1996.tb01179.xpmid: 8773800

Base‐rate data on subtest scatter for the WAIS‐R was obtained from a sample of 200 healthy subjects recruited to match the adult UK population in terms of age, sex and social class distribution. Tables are presented which permit an assessment of the abnormality (i.e. rarity) of an individual's pattern of WAIS‐R performance in terms of subtest range and subtest deviations from an individual's subtest mean. Guidance on the appropriate use of the tables is offered and the data are compared with data from the US WAIS‐R standardization sample where appropriate. The distinction between reliable and abnormal differences is highlighted.

Clegg, J. A.; Standen, P. J.; Jones, G.

doi: 10.1111/j.2044-8260.1996.tb01180.xpmid: 8773801

Staff from four units for adults with profound learning disabilities described their relationship with a particular client during individual discussions. Issues arising from discussion were elaborated in subsequent individual and group meetings, evolving into an account of interactional aspects of professional care based on a core typology of relationships (Provider, Meaning‐maker, Mutual and Companion). The process of this grounded theory analysis is exemplified. The analysis concludes with four propositions about staff‐client relationships, and discussion of their implications for clinical services.

Cassidy, Tony; Long, Clive

doi: 10.1111/j.2044-8260.1996.tb01181.xpmid: 8773802

Problem‐solving style has emerged in the literature as an important variable in the development and maintenance of affective disorders. Furthermore, the literature would suggest that it is related to other variables such as attributional style, achievement motivation and control in the mediation of the stress process. Research has been hampered and somewhat clouded by lack of clarity regarding the nature of the construct. It would appear to be a multidimensional construct, yet a suitable multifactorial measure is not available. The current paper reports on two studies (N = 408 and N = 611 respectively) which produced a 24‐item six‐factor measure. The factors were labelled helplessness, problem‐solving control, creative problem‐solving style, problem‐solving confidence, avoidance style and approach style. The studies produced evidence that the utility of problem‐solving style as an explanatory variable is enhanced when it is treated as a multidimensional construct. The factors appear to be differentially predictive of different affective states and clinical disorders. The data also support the 24‐item measure as a useful, reliable and valid measure of problem‐solving style.

Cushway, Delia; Tyler, Patrick A.; Nolan, Peter

doi: 10.1111/j.2044-8260.1996.tb01182.xpmid: 8773803

This paper describes the development of the Mental Health Professionals Stress Scale (MHPSS): a self‐report method of identifying sources of stress for mental health professionals. The 42‐item scale, which includes seven subscales, was administered to 154 clinical psychologists and 111 mental health nurses. The MHPSS was found to have good internal consistency (alpha = .87 for clinical psychologists; alpha = .94 for mental health nurses). The preliminary evidence suggests that the concurrent validity of the MHPSS is good. The expected relationships between the scale and between the criterion measures— General Health Questionnaire, a symptom check list, job satisfaction, self‐reported stress level and quality of social support—were demonstrated. The results also provide evidence for the discriminant validity of the subscales to measure different aspects of the stress experience. The MHPSS was shown to discriminate between two groups of health professionals who might be expected to differ in their sources of stress. For clinical psychologists the most important source of stress was ‘professional self‐doubt’ whereas the major source of stress for mental health nurses was found to be the difficulty of handling potentially violent or difficult patients in the context of scarce staff resources. For both groups, however, ‘home‐work conflict’ was the subscalc most strongly and consistently associated with mental health outcome. It is concluded that the preliminary evidence regarding the utility of the MHPSS is encouraging, although further data are clearly needed.

Curle, C. E.; Williams, C.

doi: 10.1111/j.2044-8260.1996.tb01183.xpmid: 8773804

Although a number of studies have noted gender differences in post‐traumatic reactions, little has been written about the phenomena. This study examines the post‐traumatic reactions among 25 predominantly adolescent children, from a rural community college, two years after a non‐fatal school coach accident in the Austrian Alps. For the group as a whole psychological adjustment is good, but gender differences are noted with poorer adjustment for girls. Hospitalization was associated with worse outcome for both boys and girls. The gender differences noted are considered in the light of coping strategies chosen by the children.