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Biomedical subjects

C R Brewin

Publications and source records attributed to C R Brewin.

At least 37 records · Page 2Linked to original sources
PubMed1999

Characteristics, context and consequences of memory recovery among adults in therapy.

BACKGROUND: There are concerns that memories recovered during therapy are likely to be the result of inappropriate therapeutic techniques. AIMS: To investigate systematically these concerns. METHOD: One-hundred and eight therapists provided information on all clients with recovered memories seen in the past three years, and were interviewed in detail on up to three such clients. RESULTS: Of a total of 690 clients, therapists reported that 65% recalled child sexual abuse and 35% recalled other traumas, 32% started recovering memories before entering therapy. According to therapists' accounts, among the 236 detailed client cases very few appeared improbable and corroboration was reported in 41%. Techniques to aid recall were used in 42%, but only in 22% were they used before memory recovery started. CONCLUSIONS: Some of the data are consistent with memories being of iatrogenic origin, but other data clearly point to the need for additional explanations.

Age Distribution↗
PubMed1999

Integrating psychological therapies: processes of meaning transformation.

We review the role played by meaning in different schools of psychotherapy, and propose that the systematic study of meaning transformation has the potential to unify understanding of the scientific basis of psychotherapy. We describe some of the most important innate and social origins of meaning, and identify seven major themes that characterize the thinking of people with psychological disorders. We also describe how these themes are processed cognitively on multiple levels, and propose common change processes that are consistent with research in cognitive psychology. These core sets of themes and processes are offered as a first step toward a systematic study of meaning and psychotherapeutic change.

Attitude to Health↗
PubMed1999

An investigation of shame and guilt in a depressed sample.

A self-report measure of proneness to shame and guilt was administered to 86 patients with moderate to severe depression, with the prediction that there would be a positive correlation of shame with severity of depression. Contrary to other, non-clinical studies, we found that guilt but not shame was associated with levels of depression. Shame-proneness demonstrated a unique association with a stable attributional style for negative outcomes, global negative self-evaluation, submissive behaviour and internalized anger. Contrary to prediction, no relationship was found between shame- or guilt-proneness and a reported history of childhood sexual abuse.

Adult↗
PubMed1999

Repressive coping and self-reports of parenting.

OBJECTIVES: To investigate whether women who possess a repressive coping style (repressors) self-report more positive judgments of their childhood on questionnaire and repertory grid measures compared with non-repressors. DESIGN: Repressors (low anxiety-high defensiveness) were compared with a composite group of non-repressors, containing some low anxious (low anxiety-low defensiveness), some high anxious (high anxiety-low defensiveness), some defensive high anxious (high anxiety-high defensiveness) and some non-extreme scorers. METHODS: Participants completed the Parental Bonding Instrument (PBI; Parker, Tupling & Brown, 1979) and a 10 x 10 repertory grid, Self-Identification Form. RESULTS: On the PBI, repressors scored significantly higher than non-repressors on paternal care and significantly lower on paternal overprotection. There were no group differences for maternal measures. On the repertory grid, repressors compared with non-repressors perceived (a) themselves as significantly closer to their father, a woman they like, and their ideal partner, and significantly further from a woman they dislike, and a man they dislike; and (b) their father as significantly closer to a woman they like, a partner/person they admire, and an ideal partner. In addition, repressors were significantly tighter on construing than non-repressors. CONCLUSIONS: The results supported the hypothesis that repressors would rate their interactions with their fathers more positively than non-repressors when allowed to do so on self-report measures.

Adaptation, Psychological↗
PubMed1998

Intrusive cognitions, coping strategies and emotional responses in depression, post-traumatic stress disorder and a non-clinical population.

Patients with major depression but not PTSD, patients with PTSD with or without comorbid depression, and a sample of non-clinical controls, were interviewed about their most prominent intrusive cognition, coping strategies and emotional responses. Evaluative thoughts were more likely to be reported by the depressed sample and the control sample. They were also common in the PTSD group, but other types of intrusions were also common, particularly personal memory. All three groups reported a wide variety of different types of intrusive cognition, both singly and in combination. These included elaborative cognitions, future-oriented thoughts or images that represented an elaboration of a specific personal memory. Cognitions were more frequent, unacceptable, and intrusive in the PTSD group in the month preceding interview, but the two clinical groups did not differ in the use of or effectiveness of coping strategies, or in emotional responses.

Adaptation, Psychological↗
PubMed1998

Intrusive memories and depression in cancer patients.

Matched samples of depressed and nondepressed cancer patients were interviewed about past life events, particularly experiences of death and illness. They identified and described any spontaneous intrusive visual memories they had experienced in the past week corresponding to these events. About one quarter reported such memories and, as predicted, the majority of intrusive memories concerned illness, injury and death. The mean levels of intrusion and avoidance were equivalent to patients with post-traumatic stress disorder. Consistent with prediction, depressed patients reported significantly more intrusive memories than controls, and described the memories as typically beginning with or being exacerbated by the onset of depression. Greater numbers of intrusive memories were associated with more maladaptive coping, and greater avoidance with deficits in autobiographical memory functioning.

Adaptation, Psychological↗
PubMed1998

Recovered memories of trauma: phenomenology and cognitive mechanisms.

We outline four current explanations for the reported forgetting of traumatic events, namely repression, dissociation, ordinary forgetting, and false memory. We then review the clinical and survey evidence on recovered memories, and consider experimental evidence that a variety of inhibitory processes are involved in everyday cognitive activity including forgetting. The data currently available do not allow any of the four explanations to be rejected, and strongly support the likelihood that some recovered memories correspond to actual experiences. We propose replacing the terms repression and dissociation as explanations of forgetting with an account based on cognitive science.

Amnesia↗
PubMed1998

Memory processes and the course of anxiety and depression in cancer patients.

BACKGROUND: Intrusive memories of stressful events, many involving illness and death, are found in a minority of depressed cancer patients, and may predict the course of anxiety and depression. METHOD: Matched samples of mild to moderately depressed and non-depressed cancer patients were followed up after 6 months. Anxiety and depression at follow-up were related to measures of intrusive memories of stressful life events and autobiographical memory functioning that had been assessed at baseline. RESULTS: Levels of anxiety and depression remained fairly constant over time in the two groups, and the depressed group continued to experience high levels of intrusive memories. The presence of intrusive memories at baseline, and the extent to which these memories were consciously avoided, predicted greater anxiety at follow-up, even after controlling for initial severity of physical and psychiatric symptoms. None of the measures of memory functioning predicted levels of depression at follow-up. CONCLUSIONS: Intrusive memories appear to be a marker of more prolonged psychopathology in cancer patients and may respond to direct therapeutic intervention.

Adult↗
PubMed1998

Repressive coping and the directed forgetting of emotional material.

Using a directed forgetting task, the authors tested in 2 experiments the hypothesis that repressors would be superior to controls in forgetting negative experimental material. Consistent with previous studies, there was an overall directed forgetting effect, with significantly more to-be-remembered material recalled than to-be-forgotten (TBF) material. In both experiments, repressors forgot more negatively valenced words in the TBF set than did nonrepressors, suggesting that repressors have an enhanced capability for using retrieval inhibition. The data offer preliminary support for a cognitive account of repressors' deficits in recalling negative autobiographical memories.

Adolescent↗
PubMed1997

The assessment of parenting using the parental bonding instrument: two or three factors?

BACKGROUND: The Parental Bonding Instrument (PBI) is a widely used measure of parenting, and is usually used to measure two parenting dimensions, care and over-protection. However, there is disagreement in the research literature about whether the PBI is best used as a two-factor or a three-factor measure. METHOD: PBI scores from 583 US and 236 UK students were factor analysed to assess whether a three-factor solution was more satisfactory than a two-factor solution. RESULTS: A three-factor (care, denial of psychological autonomy and encouragement of behavioural freedom) solution was found to be more satisfactory than a two-factor solution. Using the three-factor solution, group differences that were not apparent with the two-factor solution were identified and it was found that the parenting behaviours associated with depression could be more accurately identified. CONCLUSION: The authors suggest that with modifications, the PBI could be used to measure three parenting variables (care, denial of psychological autonomy and encouragement of behavioural freedom), which would allow greater accuracy of prediction and a greater understanding of underlying processes.

Adolescent↗
PubMed1997

The need for psychiatric treatment in the general population: the Camberwell Needs for Care Survey.

BACKGROUND: This paper presents the first results of a two-stage psychiatric population survey, which uses a new method of directly evaluating needs for specific psychiatric treatment and the extent to which they have been met. METHOD: The sample was drawn at random from the population of an area of inner south London with high levels of deprivation. Seven hundred and sixty subjects aged 18-65 completed the GHQ-28. All those scoring > 5 and half of the rest were invited to take part in the second stage, comprising measures of mental state (SCAN), social role performance (SRPS), life events and difficulties (LEDS) and a Treatment Inventory. This information was used to rate the community version of the Needs for Care Assessment (NFCAS-C). RESULTS: In all, 408 subjects were interviewed in the second stage. The weighted 1 month prevalence of hierarchically ordered ICD-10 psychiatric disorders was 9.8%, the 1 year prevalence 12.3%. The equivalent prevalences for depressive episode were 3.1% and 5.3% respectively, while those for anxiety states were both 2.8%. At interview nearly 10% of the population were identified as having a need for the treatment of a psychiatric condition. This rose to 10.4% if the whole of the preceding year was assessed. Less than half of all potentially meetable needs were met. There was only partial overlap between diagnosis and an adjudged need for treatment. CONCLUSION: A majority of people with mental health problems do not have proper treatment; given more resources and greater public and medical awareness, most could be treated by family doctors.

Adolescent↗
PubMed1997

Dependency and self-criticism as predictors of depression in young doctors.

Brief measures of depression and of dependency and self-criticism, personality factors believed to convey vulnerability to depression, were administered to 318 medical students. Depression was subsequently measured 2 years later (in the highly stressful 1st postgraduate year) and 10 years later when careers were established. When initial symptom levels and concurrent workload were controlled, dependency and, more particularly, self-criticism were significant predictors of depression for male doctors in the 1st postgraduate year. For female doctors, self-criticism was the only significant predictor. Ten years later, the predictive effects for male doctors were similar, but rather weaker, whereas none of the variables predicted depression in female doctors. Implications for preventive interventions are discussed.

Adult↗
PubMed1996

Measuring the need for psychiatric treatment in the general population: the community version of the MRC Needs for Care Assessment.

The community version of the MRC Needs for Care Assessment Schedule (NFCAS-C) is a new instrument designed for the psychiatric conditions seen in general populations. Its principles are based on the original Needs for Care Assessment, although that was developed for the very different population of those with long-standing mental illness (Brewin et al. 1987). The NFCAS-C is designed to reproduce, in an itemized and systematic manner, the functioning of well-organized primary care and psychiatric services. It is primarily intended for research purposes, in particular, the comparison of treatment needs and services in different populations. In this paper we describe the problems of assessing the need for psychiatric care in general populations and the rationale and development of the instrument, while in its companion we present the results of a reliability study (Lesage et al. 1995).

Adult↗
PubMed1996

The reliability of the community version of the MRC Needs for Care Assessment.

One hundred and nine adults were screened in the community using the abridged version of the CIDI (CIDIS). The subjects comprised DSM-III-R current cases (N = 48), lifetime cases (N = 31) and non-cases (N = 30). The interviews with the 109 subjects were conducted by one of two pairs of clinicians and videotaped. Each interviewer-pair included a psychiatrist and a clinical psychologist. They rated the community version of the Needs for Care (NFCAS-C) by consensus. The other pair of judges then viewed the video and rated the NFCAS-C independently. The agreement on overall needs was excellent (kappa = 0.75), and very good for four of the seven specific sections (from kappa = 0.61 to 0.81). One section could not be rated because of low prevalence, and agreement was less good for the remaining two sections. Agreement was good on specific interventions (medication, kappa = 0.60; specific psychotherapy, kappa = 0.55), but poor on non-specific interventions. The majority of disagreements were due to differences in clinical judgement rather than to technical errors. A new instruction manual has been produced and should help training as well as stabilizing reliability. In devising reliable and valid instruments based on clinical judgement, a balance must be achieved between enhancing reliability with more precise rules and constraining clinical judgement so tightly that validity is lost.

Adult↗
PubMed1996

Intrusive memories in depression: an index of schema activation?

A sample of 31 male and female depressed patients was interviewed to investigate spontaneous, intrusive memories of immediate and past life events. Previous findings that depressed patients experience high frequency intrusive memories were confirmed, as was an association between intrusive memories of childhood abuse and severity of depression. Patients reported intrusive memories for a variety of other events, particularly involving illness and death. Limited support was obtained for the hypotheses that the course of depression would be related to the activation of negative memories, and that immediate life events would trigger the activation of memories of similar events from the past.

Adolescent↗
PubMed1996

A dual representation theory of posttraumatic stress disorder.

A cognitive theory of posttraumatic stress disorder (PTSD) is proposed that assumes traumas experienced after early childhood give rise to 2 sorts of memory, 1 verbally accessible and 1 automatically accessible through appropriate situational cues. These different types of memory are used to explain the complex phenomenology of PTSD, including the experiences of reliving the traumatic event and of emotionally processing the trauma. The theory considers 3 possible outcomes of the emotional processing of trauma, successful completion, chronic processing, and premature inhibition of processing We discuss the implications of the theory for research design, clinical practice, and resolving contradictions in the empirical data.

Adaptation, Psychological↗