M.A. (Clinical Psychology) / The increasing interest in cognitive factors both in the literature on pain and in developments in research on depression has led to the present study, where cognitive factors associated with depression were investigated in clinical groups of chroni c pa in patients. The cognitive factors studied were learned helplessness (Seligman, 1975), cognitive errors and distortions (Beck, 1976), perfectionism (Bums, 19800 1980b), as well as hopelessness (Beck, 1974). It was hypothesised that these factors would occur in definite patterns in relation to each other, in groups of pain patients categorised into four groups on the basis of raised or lowered levels of both depression and a subjective pain rating. It was hypothesised that learned helplessness would vary in direct relationship to depression but that simultaneously increased levels of pain would elevate helplessness further. It was also hypothesised that perfectionism and cognitive errors and distortions would vary inversely with helplessness and that amongst pain patients with high levels of pain and low levels of depression, raised scores on measures of perfectionism and cognitive errors may indicate the presence of a 'masked' depression. Some evidence was found to suggest that cognitive factors do play an important role in pain, although no significant results were found to support the specific hypotheses of this study. The need for finer discrimination in the type' of pain patient selected, particularly in regard to ·the diagnosis of the pain syndrome, as well as the inclusion of cognitive factors other than those presently considered, is indicated for future research.

In der Anästhesiologie ist die Nutzung sog. Full-Scale-Simulatoren in der Aus- und Weiterbildung inszwischen etabliert. Bisher weitgehend ungenutzt ist dieses Setting zur Untersuchung habitueller und situationaler Faktoren im Zusammenhang mit Stressreaktionen sowie der Leistungen, die Trainierende hier zeigen. Der Fokus der vorliegenden Arbeit liegt auf dem Konzept der Kontrolle. Dabei werden ausgewählte habituelle Persönlichkeitsmerkmale (Studie 1) untersucht. Zudem wird die situative Kontrollierbarkeit von Narkosekomplikationen experimentell variiert (Studie 2): Gemäß der Theorie der gelernten Hilflosigkeit führt Unkontrollierbarkeit (im Vergleich zu Kontrollierbarkeit) von Ereignissen erhöhter Stressbelastung (im Sinne eines emotionalen und somatischen Defizits) und zu Leistungsreduzierungen (im Sinne eines kognitiv-assoziativen Defizits). Teilnehmer der Studien waren Medizinstudierende im Praktischen Jahr mit Wahlfach Anästhesiologie, wobei das Geschlecht als quasiexperimenteller Faktor berücksichtigt wurde. In Studie 1 durchliefen 34 Probanden (16 Frauen und 18 Männer) in gegenbalancierter Reihenfolge eine Ruhe-, eine Standardlaborstress- und eine Simulationsbedingung. Die Simulationsbedingung umfasste ein Notfallszenario mit einer Phase des Kammerflimmerns. Während dieser Phase wurde die medizinische (Reanimations-)Leistung anhand der Richtlinien des Europäischen Fachrates für Wiederbelebung evaluiert (Nolan et al., 2005). Der Standardlaborstress bestand aus einer Rede vor einer Videokamera. Die psychische Stressreaktion (mittels visueller Analogskalen) und endokrine Stressreaktion (per Speichelcortisol) wurde in allen Bedingungen zu sieben Messzeitpunkten erfasst. In der vorliegenden Arbeit wurde bezüglich Studie 1 die Teilfragestellung untersucht, welche Zusammenhänge zwischen habituellen Persönlichkeitsmerkmalen und der medizinischen Leistung sowie der psychischen bzw. endokrinen Stressreaktion in der Simulationsbedingung auftreten. Als habituelle Variablen wurden allgemeine Kontrollüberzeugungen (mittels Fragebogen zu Kompetenz- und Kontrollüberzeugungen [FKK]; Krampen, 1991) und für die Anästhesie spezifische Kontrollüberzeugungen (mittels Anästhesie-spezifischer Kontroll-überzeugungen [SKÜ]; unveröffentlichter Fragebogen) erfasst: Diese generalisierten Erwartungen betreffen den Glauben einer Person, bedeutsame Ereignisse in ihrem Leben selbst beeinflussen zu können (Internalität), bzw. äußeren Kräften, wie anderen Personen (soziale Externalität) oder dem Schicksal (fatalistische Externalität), ausgeliefert zu sein. Außerdem wurden kontrollorientierte Copingstrategien, d. h. Stressbewältigungsversuche durch Veränderung der Situation, der eigenen Reaktion oder Selbstinstruktionen (mittels Stressverarbeitungsfragebogen [SVF]; Janke et al., 1985) erhoben. Die medizinische Leistung korrelierte wie folgt mit den habituellen Variablen: Allgemeine und spezifische fatalistische Externalität korrelierten in der Gesamtgruppe (Frauen und Männer) signifikant negativ mit der medizinischen Leistung (jeweils p < 0.05). Bei Frauen war die negative Korrelation zwischen allgemeiner fatalistischer Externalität und der Leistung ebenfalls signifikant (p < 0.01). Außerdem ergaben sich für die Copingstrategien durchweg negative Korrelationen mit der medizinischen Leistung: In Bezug auf die Copingstategien „Situationskontrolle – SVF“ und „Reaktionskontrolle – SVF“ waren diese Korrelationen für die Gesamtgruppe signifikant (jeweils p < 0.05). Bei Männern korrelierte die „Positive Selbstinstruktion – SVF“ signifikant negativ mit der medizinischen Leistung (p < 0.05). Die medizinische Leistung wurde dabei im Rahmen einer multiplen Regressionsanalyse durch die Kombination von anästhesie-spezifischer fatalistischer Externalität und der Copingstrategie „Situationskontrolle – SVF“ vorhergesagt (p < 0.01). Hinsichtlich der Korrelation zwischen der psychischen Stressreaktion und den habituellen Variablen zeigte sich eine Geschlechtsdifferenzierung: Bei Frauen war das „Selbstkonzept eigener Fähigkeiten – FKK“ negativ und die allgemeine „Fatalistische Externalität – FKK“ positiv mit dem Anstieg im psychischen Stressmaß korreliert (jeweils p < 0.05). Bei Männern hingegen trat zwischen der „Reaktionskontrolle – SVF“ und dem Anstieg im psychischen Stressmaß eine negative Korrelation auf (p < 0.01). Zwischen den habituellen Variablen und der endokrinen Stressreaktionen wurden keine signifikanten Assoziationen festgestellt. In Studie 1 konnten erstmals in einem anästhesiologischen Simulationssetting substantielle Zusammenhänge zwischen habituellen Variablen, die mit dem Konzept der Kontrolle assoziiert sind, und medizinischer Leistung sowie psychischer Stressreaktion festgestellt werden. Diese Zusammenhänge legen nahe, in Trainingsmaßnahmen in Full-Scale-Simulatoren zukünftig Module zur Modifikation von Kontrollüberzeugungen (insbesondere fatalistischer Externalität) – und damit zur Leistungsförderung – zu integrieren. Durch die Erhebung habitueller Variablen könnte das Training individuell an die jeweilige Persönlichkeit des Trainierenden angepasst werden. Angesichts der negativen Assoziationen zwischen den betrachteten Copingstrategien und der medizinischen Leistung sollten zukünftig solche negativ assoziierten Copingstrategien modifiziert und auch Strategien identifiziert werden, die in anästhesiologischen Notfallsituationen eher leistungsförderlich sind. In Studie 2 durchliefen 24 Medizinstudierende (12 Männer, 12 Frauen) jeweils eine von zwei Versuchsbedingungen. Erneut wurden zu sieben Messzeitpunkten die psychische und endokrine Stressreaktion erfasst. Die Probanden hatten an Tag 1 („Trainingsphase“) entweder durch ihre Interventionen Kontrolle über den medizinischen Zustand des simulierten Patienten bei der Behandlung auftretender Narkosekomplikationen (Kontrollierbar) oder aber die Ereignisse waren unkontrollierbar und durch das Verhalten des Joch-Kontrollpartners der Kontrollierbarkeitsgruppe determiniert (Unkontrollierbar). Tag 2 („Testphase“) beinhaltete ein weiteres simuliertes Notfallszenario mit Kontrollierbarkeit für beide Versuchsgruppen, wobei neben der psychischen und endokrinen Stressreaktion die medizinische Leistung in einem Reanimationsszenario (analog zum Vorgehen in Studie 1) erfasst wurde. Infolge der Vorerfahrung von unkontrollierbaren (verglichen mit kontrollierbaren) Narkosekomplikationen war die medizinische Leistung in der Testphase in der Gesamtgruppe entgegen der Erwartung höher (und nicht geringer). Eine große Effektstärke belegte, dass dieser Effekt insbesondere bei Männern auftrat. In der psychischen Stressreaktion trat für die Gesamtgruppe in der Testphase ein tendenziell höherer Ausgangswert nach Unkontrollierbarkeit (im Sinne eines emotionalen Defizits) auf (p < 0.10). Dies war primär auf die Frauen zurückzuführbar, bei denen ein signifikanter Effekt vorlag (p < 0.05). Auch im endokrinen Stressmaß war der Ausgangswert in der Testphase nach Unkontrollierbarkeitserfahrung (im Sinne eines somatischen Defizits) für die Gesamtgruppe tendenziell höher (p < 0.10). Der Anstieg im Cortisol fiel infolge der Vorerfahrung von Unkontrollierbarkeit nur bei Frauen tendenziell höher aus (p < 0.10). In Hinblick auf die Veränderungen im Cortisolanstieg von der Trainingsphase zur Testphase ergaben sich unterschiedliche Ergebnismuster für Frauen und Männer: Bei Frauen nahmen die Cortisolanstiege von Trainings- zu Testphase unter der Bedingung Kontrollierbar ab und unter der Bedingung Unkontrollierbar zu, bei Männern zeigte sich das umgekehrte Muster (jeweils p < 0.05). Diese Interaktion (Versuchsbedingung x Geschlecht) erwies sich als signifikant (p < 0.01). Es konnte erstmals für ein anästhesiologisches Setting gezeigt werden, dass die Vorerfahrung von Kontrollierbarkeit vs. Unkontrollierbarkeit signifikante Transfereffekte hervorruft. Der leistungsförderliche Effekt von Unkontrollierbarkeit könnte in Simulatortrainings genutzt werden, sofern er sich in weiteren Studien als stabil erweist. In Hinblick auf die Folgen von Erfahrungen im (simulierten) Operationssaal ist gleichzeitig zu berücksichtigen, dass erfahrene Unkontrollierbarkeit im Hinblick auf emotionale und somatische Hilflosigkeitsdefizite stresserhöhend wirkt. Die Daten liefern ferner erste Hinweise darauf, dass die Effekte von Unkontrollierbarkeit vs. Kontrollierbarkeit in einem Full-Scale-Simulator auf die Stressreaktionen in nachfolgenden kontrollierbaren Transfersituationen bei Männern und Frauen unterschiedlich ausfallen. Diese Ergebnisse sollten in Folgeuntersuchungen an größeren Stichproben repliziert und erweitert werden. Die vorliegende Arbeit erbrachte für den Simulationsbereich neue Erkenntnisse: Mit dem Konzept der Kontrolle assoziierte habituelle Variablen sind sowohl mit Leistungs- als auch Stressindikatoren in einem OP-Setting verbunden. Die situative – hier experimentell variierte – Kontrollierbarkeit wirkt sich auf diese Indikatoren aus. Daraus ergeben sich ggf. Möglichkeiten, Aus- und Weiterbildungsangebote in Full-Scale-Simulatoren einerseits individuell an die Teilnehmerpersönlichkeit anzupassen. Andererseits könnten Lernerfolge von Trainingsmaßnahmen durch die gezielte Schaffung situativer Kontrollierbarkeit optimiert werden.

Research with geriatric populations suggests high levels of clinical depression and greater financial and psychological costs of treatment in long-term care facilities with more restrictive care. Research on learned helplessness, a construct separate from depression, suggests learned helplessness and perceived control are useful theories for the study of elder depression, but the relationship between depression and learned helplessness in this population is not clear. This cross-sectional quantitative study examined the relationship between depression and learned helplessness by comparing residents over age 65 in less restrictive assisted living (n =42) versus those in more restrictive skilled nursing facilities (n =63). Data were collected using the Geriatric Depression Scale, the Helplessness subscale of the Cognitive Distortion Scales, and the Learned Helplessness and Instrumental Helplessness subscales of the Multi-Score Depression Inventory. Between-group ANOVA results confirmed a higher level of depression and state learned helplessness, but not trait learned helplessness, in restrictive skilled nursing residents when compared to those in less restrictive assisted living residents. There were positive correlations between learned helplessness, instrumental helplessness, and depression regardless of level of nursing care, and a positive correlation between perceived control and depression regardless of level of facility care. Identifying state learned helplessness and depression in long-term, restrictive care facilities can promote positive social change through increased awareness, intervention, and treatment to improve individual quality of life and maximize internalization of perceived control of the decision making process for elders.

Social connectedness, learned helplessness, and alienation characteristics as related to graduate/dropout behavior for residents in alcohol abuse programs. Purpose The purpose of the study was to determine the extent to which a set of predictor variables would discriminate between a group who successfully completed an alcohol substance abusers program from the group who failed i.e. (relapsed) to complete the program. The predictor variables were cognitive and affective measures for social connectedness, learned helplessness, and alienation characteristics. A preliminary step compared the total sample to the norm groups from the FIRO-B and the MMPI. Sample and Measurements Sixty-three subjects from two intermediate treatment groups from San Joaquin County (CA.) programs were selected as the sample group. Three months sobriety post treatment was selected as the successful completion criterion. The FIROB measured social connectedness, the MMPI measured alcohol addiction, alienation characteristics, and defensive response set. The ASQ was employed to measure "learned helplessness". Findings One sample t-test disclosed deviance between the sample group and the norm group for five of six scales of social connectedness. The respondents reported less need for inclusion and affection and more "control wanted" than the norm group on indicators from the FIRO-B. The sample also indicated greater addiction (MAC scale), "defensiveness" (validity scales), and alienation characteristics (Pd. clinical scale and Pd. research scales) from the MMPI. The sample group endorsed more familial discord, authority problems, social imperturbability, social alienation, and self-alienation. Three MMPI measures, the MacAndrew Alcoholism scale, the K scale (defensiveness), and the self-alienation research scale reliably differentiated graduates from dropouts using the t-test for independent means. The highest correlations between variables were indicated for alienation characteristics and defensiveness as indicated by the validity scales. A multiple regression analysis disclosed that addiction (MacAndrew Alcoholism Scale) correlated r = .34 with graduate status. Conclusions Within this sample those variables most predictive of at risk behavior (relapse potential) were addiction, defensiveness, and self-alienation characteristics. The graduate means were more aberrant than the dropouts in each of these categories.

[pt] Nesta tese buscamos compreender, inicialmente, como o ódio participa da estruturação psíquica, estando presente em todo humano, uma vez habitado pela linguagem. A partir desta compreensão, interrogamo-nos acerca das possibilidades de intervenção, pela via psicanalítica, nesta dimensão odienta, o que nos levou ao entendimento de que a pretensão analítica se limita a manejar a participação do ódio na travessia da experiência do sujeito. Dissecado, tal afeto contribui para elevar à lucidez a dimensão real, o impossível da constituição do falante de modo a permitir sustentar de modo afirmativo seu desamparo estrutural. Apontamos com isso o aspecto inelutável do ódio constitutivo e a positividade de sua apreensão. A partir desse encontro, outras possibilidades se apresentam fazendo frente às vias de gozo do ódio ao semelhante, o que não significa esgotá-lo. O novo que se apresenta decorre precisamente do encontro com o real, ponto em que o sujeito acata a impossibilidade de respostas à interrogação sobre si que ele dirige ao Outro. Com isso, pode construir suas próprias vias desejantes. A partir destas conclusões foi possível aproximar a experiência em questão da noção de política no sentido resgatado por Hanna Arendt da pólis grega, política como liberdade e possibilidade de fazer algo novo no mundo. Especificamos a noção de política ao pensá-la pela via da amizade, sendo essa desligada da noção de amizade fraterna e universalista e pensada como respeito à diferença, o que possibilita a vida coletiva. Entendemos que, ao se desprender da exigência de constituir unidade com o outro, resultado esperado de um processo analítico do qual o ódio participa, é possível ao sujeito viver na perspectiva da política da amizade. / [en] In this thesis, we seek to understand, initially, how hate participates in psychic structure, being present in every human once inhabited by language. Based on this understanding, we asked ourselves about the possibilities of intervention, via psychoanalysis, in this hateful dimension, which led us to the understanding that the analytical pretension is limited to handling the participation of hate in the crossing of the subject s experience. Dissected, such affection contributes to raise lucidity to the real dimension, the impossible of the speaker s constitution and allows sustaining in an affirmative way his structural helplessness. With this we point out the ineluctable aspect of constitutive hatred and the positivity of its apprehension. From this meeting, other possibilities are presented, facing the paths of enjoyment of hatred of the similar, which does not mean exhausting it. The new that presents itself stems precisely from the encounter with the real, at which point the subject accepts the impossibility of answering the question about himself that he addresses to the Other. With that, he can build his own desiring paths. Based on these conclusions, it was possible to approximate the experience in question to the notion of politics in the sense rescued by Hanna Arendt from the Greek polis, politics as freedom and the possibility of doing something new in the world. We need the notion of politics even more when thinking about it through friendship, which is disconnected from the notion of fraternal and universalist friendship and thought of as respect for difference, which makes collective life possible. We understand that by letting go of the requirement to constitute unity with the other, the expected result of an analytical process in which hate participates, it is possible for the subject to live in the perspective of the politics of friendship.

The goal of this study was to investigate if participation in collaborative professional development workshops - on learned helplessness, self-efficacy, and metacognition - would impact teachers' beliefs in their capacity to address students' helplessness. The underlying assumption was that, with deeper understanding of the theoretical background upon which instructional practices should be constructed, teachers would develop a stronger belief that, through their pedagogical practices, they could impact students' individual learning outcomes as well as the classroom environment. In order to achieve this endeavor, an eight-week intervention was conducted in a low-achieving and low SES public school in Rio de Janeiro, Brazil. The study's design, development, implementation, and evaluation were oriented by guidelines derived from the formative and design experiment methodology. The study benefited from quantitative and qualitative data collection and analysis methods. Triangulation of data showed strong consistency between quantitative and qualitative findings. After the intervention, participating teachers acknowledged implementing the theories in their classrooms. Reported impacts included (a) strengthened teachers' beliefs about their capacity for effective teaching in this school environment; (b) increases in teachers' instructional efficacy and metacognitive abilities; (c) increased capacity to exercise reflective practice through evidence- based self-evaluations; (d) increased capacity to create comprehensive lesson plans including the Nine Events of Instruction (Gagne, 1985), the MUSIC Model of Academic Motivation (Jones, 2009), and metacognitive strategies (Schraw, 1998). As teachers implemented the strategies in their classes, they reported positive impacts on the students' interests, attitudes towards classroom activities, and efforts to achieve. / Ph. D.

The relationship of attributional style to anxiety and depression in children and adolescents has received little attention in comparison to studies conducted with adult populations. However, preliminary studies suggest that children and adolescents evidence similar attributional style patterns to those expressed by adults. This study further examines the relationship of anxiety and depression to attributional style to determine the utility and applicability of the adult model to children and adolescents. In addition, this study examines the accuracy of obtaining attributional style ratings using hypothetical events (i.e., questionnaire method) versus real-life events. Further, this study was designed to study the relationship of emotional measures of anxiety and depression (Le., Children's Depression Inventory and Revised Children's Manifest Anxiety Scale) versus cognitive measures of anxiety and depression (Negative Affect Self-Statement Questionnaire). It was hypothesized that real life events (as measured by the Specific Life Events Schedule; SLES) would prove to be a concurrently valid measure of attributional style in relation to hypothetical events presented through a questionnaire method (as measured by the Children's Attributional Style Questionnaire; CASQ). As well, it was predicted that real life events of the SLES would prove to be a more accurate measure of attributional style than hypothetical life events of the CASQ, in relation to achieved depression scores. Furthermore, it was predicted that certain indices of attributional style and negative self-statements would prove to be significant predictors of depression (as measured by the CDI) and anxiety scores (as measured by the RCMAS). / Master of Science

The current study investigated the impact of Learned Helplessness (LH) training on normal (N), depressed (D), and bulimic (B) female college students (N=135). Participants were selected through a screening procedure using an eating behavior questionnaire and the Beck Depression Inventory (BDI; Beck, 1971) as the primary instruments. Bulimic subjects met the DSM-III criteria for that disorder, and depressed subjects met a criterion of 20 or above on the BDI. Normal subjects had BDI scores below 10 and endorsed 1 or less of the critical items regarding eating behavior which had been used to select bulimic subjects. A11 three groups were matched for weight, height, and age. Each category of subjects was divided into three groups which were exposed to Learned Helplessness (LH), Contingent Feedback (CF), or No Training Control (NTC) conditions. Dependent measures included performance on an anagram test (latency and errors), performance prediction and performance satisfaction questionnaires, and a Self-Statement Test. Results indicated no difference in anagram performance following LH training relative to CF and NTC conditions for normal and bulimic subjects, although depressed subjects demonstrated longer response latency and more errors as a function of training (LH>CF). NTC subjects did not differ significantly from the other conditions, however. Ratings of performance satisfaction differed as a function of training condition in the expected directions. Bulimic subjects demonstrated an interesting pattern of declining ratings of performance satisfaction across training trials within the CF condition. Also, bulimic subjects were found to make more errors on anagrams of nonfood words relative to food words, although this pattern was not reliably related to training condition. Self-Statement Test items did not produce the expected group x training condition effects. The present findings provide limited support for the experimental hypothesis that ineffective coping in stressful situations, mediated by cognitive self-statements, is a useful model for understanding bulimia. Methodological issues are discussed, particularly issues related to subject classification. The present study was likely confounded by the presence of depression (i.e., high BDI scores) among the bulimic subjects. Future research should systematically‘ address the relationship between bulimia and depression. / Ph. D.

Thesis (MPhil (Old and New Testament))--University of Stellenbosch, 2005. / This paper attempts an exploration and description of a hermeneutic of learned helplessness. Drawing on insights from both psychology and theology, it problematises the interaction that an individual believer can develop with the Bible and living a life of faith. Attempts to account for this situation involve biblical interpretation, the church and the pastoral care context. The body of the paper consists of four chapters, describing the four pillars supporting a hermeneutic of learned helplessness. The first chapter highlights certain of the difficulties that develop when the authority of the Bible is abused. The second chapter looks at the vocation of the pastor, and notes how lack of accountability and limited self-awareness can result in inadequate and harmful biblical interpretation. The third chapter highlights the negative effects of the neglect of emotion on individual faith and interaction with the biblical text, referring specifically to women. Finally, the fourth chapter identifies the tendency to regard morality as expressed primarily through behaviour, and to use the Bible as a book of rules. The combination of these four factors generates an environment in which a hermeneutic of learned helplessness can quickly develop in a Christian believer. This paper is an attempt to more clearly define my observations following work in the context of pastoral care and counselling. It is hoped that by clarifying the nature of the problem, this will prove to be the first step toward finding possible solutions.

Vitiligo is an idiopathic, non-contagious and often familial depigmentation disorder affecting both sexes equally. The mostly progressive and patchy loss of the inherited skin colour is not only a cosmetical problem, it has a profound impact on the patient's well-being. Stigmatisation and rejection often causes depression, self-consciousness, sexual problems and an impaired quality of life. To further substantiate earlier investigations and to introduce new aspects, we utilised the Dermatology Life Quality Index (DLQI), the Beck Depression Inventory (BDI) and the Adjustment to Chronic Skin Disorders Questionnaire (ACS) with its sub-scales on Social anxiety/avoidance, Helplessness and Anxious-depressive Mood in 422 patients and 55 healthy controls. We also included 103 children, their parents and 18 controls by using the Children's Dermatology Life Quality Index (CDLQI) and an adapted version of the ACS. We found that patients with vitiligo experience high levels of stigmatisation. They have an impaired quality of life and are more socially anxious/avoidant, helpless and (anxious-) depressive compared to healthy controls. The results correlate with disease severity, avoidant behaviour/hiding of vitiligo and the belief that psychological stress influences the disease. Female patients are generally more affected. Treatment with pseudocatalase PC-KUS improves quality of life and reduces anxious-depressive mood. Children also suffer from stigmatisation and an impaired quality of life. Parents are more socially anxious and helpless compared to the control group.