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Biomedical subjects

M McCallum

Publications and source records attributed to M McCallum.

At least 37 records · Page 2Linked to original sources
PubMed1991

Transference interpretations, therapeutic alliance, and outcome in short-term individual psychotherapy.

Relationships between the proportion of transference interpretations provided by therapists and both therapeutic alliance and therapy outcome were investigated for a sample of 64 patients who had received approximately 20 sessions of short-term individual psychotherapy within a controlled, clinical trial investigation. Inverse relationships were found between the proportion of transference interpretations and both therapeutic alliance and favorable therapy outcome for patients with a history of high quality of object relations. An examination of individual sessions revealed evidence that was consistent with two different, but not mutually exclusive, causal explanations. The first concerned the negative effects of high proportions of transference interpretations; the second concerned the reaction of the therapist to the presence of a weak therapeutic alliance. While the evidence from our study was correlational, it was sufficiently strong to warrant alerting clinicians to the possibility of negative treatment effects when high levels of transference interpretations are used with certain types of patients receiving short-term individual psychotherapy.

Adult↗
PubMed1991

Emergent themes and roles in short-term loss groups.

Clinical observations regarding themes and roles that are characteristic of short-term, psychoanalytically oriented therapy groups for loss patients are presented. They reflect aspects of both the therapy and the patients. Themes refer to the content of a recurrent conflict in the group. They include trust, survivor guilt, mortality, and termination. Roles refer to a set of patient behaviors that represent a shared conflict. They include the apparition, monk, professor, professional nurturer, emotional conductor, and cruise director. Challenges that the themes and roles present to the therapist and clinical guidelines for addressing them are offered. Awareness of characteristic themes and roles and possible therapist responses are regarded as important parts of the preparation and training of therapists who plan to conduct short-term loss groups.

Ambulatory Care↗
PubMed1991

Quality of object relations versus interpersonal functioning as predictors of therapeutic alliance and psychotherapy outcome.

The purpose of the study was to compare an interview measure of quality of object relations to questionnaire and interview measures of recent interpersonal functioning with respect to the prediction of therapeutic alliance and psychotherapy outcome. The sample consisted of 64 patients who had received approximately 20 sessions of short-term individual psychotherapy within a controlled, clinical-trial investigation. Ratings of therapeutic alliance were provided independently by the patient and the therapist after each session. Outcome measures, which were provided by three sources (patient, therapist, and independent assessor), covered the areas of interpersonal functioning, psychiatric symptomatology, self-esteem, and life satisfaction. Quality of object relations, which characterizes the patient's lifelong pattern of relationships, was the best predictor. It was significantly related to patient-rated and therapist-rated therapeutic alliance and to patient improvement of both general symptomatology and specific target problems. The study also replicated previous studies that have reported significant relationships between therapeutic alliance and therapy outcome. The advantages of pretherapy predictors of therapy outcome, such as quality of object relations, are discussed.

Adjustment Disorders↗
PubMed1990

Patient suitability and outcome in short-term individual psychotherapy.

The effects of short-term (time-limited), dynamically oriented individual therapy and the patient characteristic quality of object relations (QOR) were studied in a controlled clinical trial involving 8 experienced therapists and 144 psychiatric outpatients. A comprehensive set of outcome scores was monitored at 5-month intervals including a follow-up assessment. A strong treatment effect that was maintained at follow-up was found. The effect was evident in terms of statistical significance, effect size, and clinical significance. Evidence for an additive effect of the combination of treatment and QOR was also found. The best results were attained by high QOR therapy patients, and the worst results were attained by low QOR control patients. The results were suggestive of an optimal match between type of patient and type of therapy.

Adolescent↗
PubMed1990

A controlled study of effectiveness and patient suitability for short-term group psychotherapy.

A controlled, clinical trial investigation of short-term psychoanalytically oriented group psychotherapy (STG) was conducted which included eight psychotherapy groups led by experienced therapists. Patient psychological mindedness (PM) was investigated as a selection criterion and prognostic variable. Seventy-nine psychiatric outpatients experiencing prolonged or delayed grief reactions were matched for level of PM and then randomly assigned to STG or a wait list. There was repeated measurement of several areas and sources of outcome. Results indicated a strong main effect for STG but not for PM on outcome, and minimal evidence for an interaction effect. Benefits were maintained at six-month follow-up. Psychological mindedness emerged as highly predictive of attrition. A clinical discussion is presented wherein the efficacy of STG is considered as reflecting a good patient-treatment match.

Adaptation, Psychological↗
PubMed1986

Non-colonic features of irritable bowel syndrome.

In 100 patients with irritable bowel syndrome a wide variety of non-gastrointestinal symptoms were significantly more common than in a group of 100 age, sex, and social class matched controls. Nocturia, frequency and urgency of micturition, incomplete bladder emptying, back pain, an unpleasant taste in the mouth, a constant feeling of tiredness and in women dyspareunia were particularly prominent (p less than 0.001). With reference to non-colonic gastrointestinal symptoms nausea, vomiting, dysphagia and early satiety were very common (p less than 0.0001). This symptom diversity was observed irrespective of whether the patient had a psychiatric disorder or not. Patients smoked more than controls (p = 0.02) drank more caffeine containing drinks (p = 0.03) and 26% had taken at least one week off work in the previous 12 months. Thirty three per cent of patients had a family history of irritable bowel syndrome. Cognisance of these diverse symptoms may prevent referral to the wrong medical specialty and inappropriate investigation. They may also be indicative of a much more diffuse disorder of smooth muscle than has previously been appreciated.

Adolescent↗
PubMed1982

Cognitive and behavioral knowledge about insulin-dependent diabetes among children and parents.

Youngster's knowledge about insulin-dependent diabetes was assessed across three domains: (1) general information; (2) problem solving and (3) skill at urine testing and self-injection. These youngster's parents completed the general information and problem-solving components of the assessment battery. All test instruments were showed good reliability. The test of problem solving was more difficult than the test of general information for both parents and patients. Mothers were more knowledgeable than fathers and children. Girls performed more accurately than boys, and older children obtained better scores than did younger children. Nevertheless, more than 80% of the youngsters made significant errors on urine testing and almost 40% made serious errors in self-injection. A number of other knowledge deficits were also noted. Duration of diabetes was not related to any of the knowledge measures. Intercorrelations between scores on the assessment instruments indicated that skill at urine testing or self-injection was not highly related to other types of knowledge about diabetes. Furthermore, knowledge in one content are was not usually predictive of knowledge in another content area. The results of this study emphasize the importance of measuring knowledge from several different domains. Patient variables such as sex and age need to be given further consideration in the development and use of patient educational programs. Regular assessment of patients' and parents' knowledge of all critical aspects of diabetes home management seems essential.

Adolescent↗
PubMed1981

Limited joint mobility in childhood diabetes mellitus indicates increased risk for microvascular disease.

We detected limited mobility of small and large joints in 92 (30 per cent) of 309 patients with diabetes who were one to 28 years old. Among patients who had had diabetes for more than 4.5 years (the shortest duration at which microvascular complications were noted), 82 of 169 had joint limitation. Forty-one of these 82 also had microvascular complications, but only 10 of the 87 patients without joint limitation had complications. Life-table analysis indicated an 83 per cent risk for microvascular complications after 16 years of diabetes if joint limitation was present, but only a 25 per cent risk if joint limitation was absent. Consequently, limited joint mobility identifies a population exceptionally at risk for the early development of microvascular complications, and intervention to forestall or prevent these complications can now be focused.

Adolescent↗
PubMed1978

Immunological studies in frozen shoulder.

Serum immunoglobulin levels were determined in 25 patients with frozen shoulder and in 25 age- and sex-matched controls. Serum IgA levels were significantly reduced (P less than 0.001) in the patients with frozen shoulder and remained so after clinical recovery. Lymphocyte transformation to phytohaemagglutinin in 21 patients also showed significant depression (P less than 0.01). These results support the suggested immunological pathogenesis of this condition.

Adult↗
PubMed1977

One year's experience with a regional hormone assay service.

To provide a service in England and Wales for specialised assays, clinical chemists envisaged a multi-tier system with area, regional, and supraregional laboratories. The Department of Clinical Biochemistry at Addenbrooke's Hospital was established as a regional centre for hormone assays and formal operation started in June 1975. The assays which seemed most suitable for regional development in East Anglia were those for investigating the pituitary-gonad and pituitary-thyroid axes. Most of these were introduced in the first year of operation. A specialised laboratory was not set up: instead, endocrine assays were integrated into a large service laboratory and little expenditure was needed for specialised facilities or staff. The work load of endocrine assays increased markedly during the first year of operation, but the main source of requests was local rather than regional. This lack of use by a region has implications for all three tiers of the specialised service. It suggests that effective centralisation of specialised assays is impracticable unless a dictatorial approach to the problem of rationalisation is made at regional and area level.

England↗