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PubMed1993

Reality monitoring in obsessive-compulsive disorder.

Individuals with obsessive-compulsive disorder (OCD) often doubt whether they have performed an action or merely imagined having performed it. Such doubts suggest that OCD patients may have deficits in reality monitoring--the ability to distinguish memories of doing from memories of imagined doing. We compared the reality monitoring abilities of OCD checkers, OCD noncheckers and normal control Ss. Although we found no evidence of reality monitoring deficits in OCD patients, they tended to express less confidence in their memories relative to control Ss. These findings suggest that obsessional doubt may reflect deficits in memory confidence rather than deficits in memory per se.

Adult↗
PubMed1994

The experimental induction of depersonalization and derealization in panic disorder and nonanxious subjects.

The present study evaluated the efficacy of three tasks in inducing depersonalization (DP) and derealization (DR) in three different groups: (a) panic disorder patients who report these symptoms while panicking (PD + DD; n = 10); (b) panic disorder patients never experiencing these symptoms during panic attacks (PD; n = 10); and (c) nonanxious controls (NC; n = 10). Clinical features of the PD+DD and PD Ss were compared as well. Relative to PD Ss, PD + DD Ss evidenced higher levels of depression, trait anxiety, more fear of panic, and had a briefer duration of their disorder. A substantial proportion of NC Ss reported past DP and DR experiences. DP and DR induction procedures were the following: staring at a dot on the wall, staring in a mirror, and silent repetition of one's name. Results indicated two tasks (mirror and dot) successfully elicited these sensations above baseline levels with DP reported more frequently and intensely than DR for all Ss. The PD + DD Ss evidenced greater baseline-to-task increases in DP and DR relative to the other two groups and exhibited a differential fear response, particularly on the dot task, with 30% of these Ss intentionally distracting themselves or terminating the induction.

Adult↗
PubMed1995

Perspectives on depressive realism: implications for cognitive theory of depression.

Beck's cognitive theory of depression has provided a successful description of depressive thinking, with one major exception. The hypothesis that depressed people show biased negative thinking seems contradicted by research indicating that Ss scoring 9 or above on the Beck Depression Inventory were more accurate than their nondepressed counterparts in judging contingencies between their responses and outcomes, seemingly showing "depressive realism". Depressive realism research has attracted attention in numerous areas of psychology, along with critical commentary focused on such issues as whether realism is limited to mild depressive states, whether laboratory tasks are sufficient to document realism, and whether realism is a general characteristic of either depressed or nondepressed people. We analyze the main critiques and show how debates about depressive realism can be heuristic for refinement of cognitive theory of depression.

Attention↗
PubMed1995

Inference processes in obsessive-compulsive disorder: some clinical observations.

In this paper we outline a cognitive model of Obsessive-Compulsive Disorder (OCD) which proposes that the core belief of OCD evolves through a series of illogical inferences. These faulty inference processes involve inferring the plausibility of events on the basis of irrelevant associations, dismissing actual evidence on the grounds of going beyond surface reality to a deeper reality, and finally inferring that a completely fictional narrative is a remote probability. A therapy aimed specifically at changing these inference processes is illustrated with case examples of OCD clients who had not benefited from conventional behavior therapy. The inference based approach (IBA) complements existing cognitive-behavioral therapy but suggests that in certain cases, the conventional cognitive therapy view of OCD beliefs as exaggerated fears of remote possibilities may actually reinforce the obsessional belief since even remote events are real. The IBA on the contrary suggests that an important goal in therapy is to highlight this confusion found in OCD between imagination and reality and illuminate for the OCD client how their compulsions, far from reassuring them about a remote possibility, actually take them further away from reality and reinforce their imaginary doubt.

Adult↗
PubMed1990

Melting chocolate and melting snowmen: analogical reasoning and causal relations.

Children's performance in the classical a:b::c:d analogy task is traditionally very poor prior to the Piagetian stage of formal operations. The interpretation has been that the ability to reason about higher-order relations (the relations between the a:b and c:d parts of the analogy) is late-developing. However, an alternative possibility is that the relations used to date in the analogies are too difficult for younger children. Two experiments presented children aged 3, 4 and 6 years with a:b::c:d analogies which were based on relations of physical causality such as melting and cutting, for example chocolate bar:melted chocolate::snowman:melted snowman. Understanding of these particular causal relations is known to develop between the ages of 3 and 4 years. It was found that even 3-year-olds could solve the classical analogies if they understood the causal relations on which they were based.

Cacao↗
PubMedDate not supplied

On defining delusions.

The DSM-III-R definition of delusions bears inconsistencies and does not account for the way delusions are detected clinically. It can be traced back to Karl Jaspers who was the first to mention the three criteria of delusions, which are to be found in the textbooks ever since: (1) certainty, (2) incorrigibility, and (3) impossibility or falsity of content. Psychiatrists always felt uncomfortable with the third criterion, and Kurt Schneider pursued the most thorough attempt to dispose of this criterion by his definition of delusional perception. It can be shown that while his definition is wrong, the phenomena he had in mind do, in fact, have some distinctive features. Proceeding from the first two criteria of Jaspers, a new definition is proposed that emphasizes the way certain contents are stated and disregards the issue of right or wrong. Advantages of this definition are discussed and a distinction between delusions (about external reality) and certain actual experiences (happening in the patient's mind) is proposed.

Delusions↗
PubMedDate not supplied

Autism in schizophrenia revisited.

The concept of autism is reviewed in its historical evolution. It is suggested that the Bleulerian insistence on the withdrawal component in autism contributed to the decline of its use in adult psychiatry. Phenomenology offers another approach to grasping the nature of autism as a relational (subject-outer world) phenomenon. European phenomenological psychiatry in the field of schizophrenia is introduced and its attempts to reveal the essence of autism are presented. Autism is here considered as a "loss of vital contact with reality" (Minkowski), "inconsistency of natural experience" (Binswanger), or "the global crisis of common sense" (Blankenburg). It is proposed that autism represents dysfunctional perceptual/expressive attunement to the outer world. The usefulness of this concept is briefly examined in relation to the diagnosis and etiopathogenesis of schizophrenia.

Autistic Disorder↗
PubMed1986

Self-recognition: a study of a population without mirrors.

The study of the influence of familiarity with mirrors on children's capacity to identify their reflected images permitted differentiation between two problems that confront the child in the mirror situation: (a) the identity of the image and (b) the capacity to relate mirror space to real space. Sixty children, 6 to 26 months old, without previous experience with mirrors, were observed systematically while discovering their mirror image and a reflected object. Their behavior was compared to a control group with habitual mirror familiarity. The results suggest that (a) self-recognition in the mirror is independent of the child's familiarity with reflecting surfaces and (b) the capacity to relate mirror to real space seems to be strongly influenced by previous experience with mirrors.

Affect↗
PubMed1995

Evidence for a global scanpath strategy in viewing abstract compared with realistic images.

Scanpaths, the repetitive sequences of saccadic eye movements, occurred when subjects viewed slide projections of both realistic and abstract art. Variance analysis demonstrated that global/local eye movement indices were lower for local scanning by professional art viewers who relied on more global viewing, particularly in abstract images. Non-professional, unsophisticated subjects carried their local scanpath patterns from realistic images on to abstract images. The blink rate of professional subjects viewing abstract images was also significantly lower, indicating increased visual effort. Non-professional viewers showed no difference in blink rates.

Adult↗
PubMed1991

Adaptive regression and ego identity.

An inventory of adaptively regressive experiences (Taft Ego Permissiveness Inventory) and the Identity Status Interview were administered to 71 college students (35 female, 36 male). As hypothesized, Moratorium status individuals (actively engaged in identity formation) showed a greater disposition to adaptive regression than did individuals in other statuses. This supports the view that adaptive regression may serve an important function in the identity formation process. Contrary to hypothesis, Achievement status individuals did not show greater disposition to adaptive regression than those in Foresclosure status. Females showed substantially greater disposition to adaptive regression than did males.

Adolescent↗
PubMed1993

Psychotic symptoms in depression and borderline personality disorder.

The authors investigated the prevalence of psychotic symptoms in depression and borderline personality disorder employing the Diagnostic Interview for Borderlines. Clear-cut delusions and hallucinations were rare among the borderlines. However, derealization and depersonalization symptoms were common and were found to be prevalent as among depressives. The prevalence of these symptoms among patients with both borderline personality disorder and depression was similar to that among patients with only borderline personality disorder or depression. The relationship between depression and borderline personality disorder and the significance of psychotic symptoms in these disorders is discussed.

Adolescent↗
PubMed1995

Induction of depersonalization by the serotonin agonist meta-chlorophenylpiperazine.

Sixty-seven subjects, including normal volunteers and patients with obsessive-compulsive disorder, social phobia, and borderline personality disorder, received ratings of depersonalization after double-blind, placebo-controlled challenges with the partial serotonin agonist meta-chlorophenylpiperazine (m-CPP). Challenge with m-CPP induced depersonalization significantly more than did placebo. Subjects who became depersonalized did not differ in age, sex, or diagnosis from those who did not experience depersonalization. There was a significant correlation between the induction of depersonalization and increase in panic, but not nervousness, anxiety, sadness, depression, or drowsiness. This report suggests that serotonergic dysregulation may in part underlie depersonalization.

Adult↗
PubMed1996

The creation of protection and hope in patients with malignant brain tumours.

The malignant brain tumour disease condenses much of the anguish of cancer diseases. The brain is a vital and delicate organ, and the prognosis is generally unfavourable. The patient is exposed and has to rely on cognitive manoeuvres to manage the mental stress. The purpose of this study was to generate new insights into how the patient constructs a new sense of reality when confronted with the malignant brain tumour diagnosis. Within grounded theory methodology, 30 patients with malignant gliomas were interviewed twice, in direct connection with diagnosis, surgery and radiotherapy. In addition, their partners were interviewed, and quantitative instruments (SMMSE, RDCQ) were used as additional references for assessing the patients cognitively and emotionally. Eleven patients were excluded from the final analysis because of cognitive impairment of personality change. Most of the patients were aware of the fact that the brain tumour exposed them to grave danger, but they were also able to use various cognitive manoeuvres to create protection and hope. This process originated from different sources: the body; helpful relations; cognitive schemata; and the handling of information. The importance of the body to raise hope is emphasized. In the discussion we consider this process as an expression of how the patient brings together reality and hope, thus creating her/his own illusion. These findings are also related to adjacent psychoanalytic theory, proposing a theoretical reference with clinical implications when discussing "What to tell cancer patients."

Adaptation, Psychological↗
PubMed1992

The Iowa therapeutic community model of chemical dependency treatment.

A model of inpatient chemical dependency treatment used in several facilities in Iowa is described. Through combining 12 Step, Therapeutic Community and Reality Therapy concepts, the issues of denial, control, and self centeredness are addressed in developmental phases. Individualizing the program through multidisciplinary input is explained in terms of identifying hindrances in perceiving reality and assisting the patients reduce resistance in a downhill process of increasing wholeness and growth.

Adult↗
PubMed1993

Three syndrome concept of schizophrenia. A factor analytic study.

One hundred and fifty-five DSM-IIIR schizophrenic patients were assessed for positive and negative symptoms using Andreasen's Scale for Assessment of Positive Symptoms (SAPS) and the Scale for Assessment of Negative Symptoms (SANS). Interrelationships of individual positive and negative symptoms were examined using a factor analysis. Results of the factor analysis are consistent with Liddle's proposition that there are three syndromes underlying symptomatology in schizophrenia: disorganization; psychomotor poverty and reality distortion.

Adolescent↗
PubMed1995

The development and reliability of the Mental Health Research Institute Unusual Perceptions Schedule (MUPS): an instrument to record auditory hallucinatory experience.

The Mental Health Research Institute Unusual Perceptions Schedule (MUPS) is a comprehensive instrument developed to record subjects' experiences of auditory hallucinations as completely as possible. The Schedule comprises a semi-structured interview and documents the physical characteristics of auditory hallucinations such as their onset and course, number, volume, tone, location, as well as other phenomena associated with them such as delusions. In addition, other aspects of hallucinations, such as coping strategies, contributing factors and subjects' personal views and reactions are also explored. In a sample of 100 subjects drawn primarily from the in-patient wards at Royal Park Hospital the MUPS was found to be an acceptable instrument to subjects in the field. Interrater reliability assessed in a subsample of 30 subjects was found to be high at the level of the individual items. Whether used in whole or part, the MUPS provides a reliable and acceptable method of assessing patients' experience of auditory hallucinations.

Adaptation, Psychological↗