The purpose of the present study was to ascertain if environmentally sensitive patients would demonstrate different memory deficit patterns than psychiatric patients on objectively measurable memory tasks. One-hundred sixteen patients were surveyed; 56 environmentally sensitive patients were compared to 60 psychiatric patients. All subjects were administered a Wechsler Adult Intelligence Scale-Revised screen, the Wechsler Memory Scale-Revised and the Harrell-Butler Comprehensive Neurocognitive Screen after history of head injury was ruled out. Results indicate a significantly different pattern of memory dysfunction between the environmental patients and the psychiatric patients, indicating two different etiologies. A screening device derived from the coefficients from a Canonical Analysis is proposed to distinguish between the two populations in the absence of blood serum levels of environmental toxins or poisons. The detrimental effects of misdiagnosis and the beneficial effects of accurate diagnosis of environmental illness are discussed.

Psychiatric patients, particularly schizophrenics, tend to be less accurate decoders of facial expressions than normals. The involvement of three basic information processing stages in this deficit was investigated: attention; encoding; and processing. Psychiatric inpatients, classified by diagnosis and severity of pathology, and nonpatient controls were administered seven facial cue decoding tasks. Orientation of attention was assessed through rate of diversion of gaze from the stimuli. Encoding was assessed using simple tasks, requiring one contrast of two facial stimuli and selection from two response alternatives. Processing was assessed using a more complex task, requiring several contrasts between stimulus faces and selection from numerous response alternatives. Residualized error scores were used to statistically control for effects of attention on task performance. Processing task performance was evaluated using ANCOVA to control for effects of encoding. Schizophrenics were characterized by generalized information processing deficit while affective disorder subjects evidenced impairment only in attending. Attention impairments in both groups were related to severity of psychopathology. Problems in encoding and processing were related only to a schizophrenic diagnosis. Their decoding deficits appeared attributable to general visuospatial discrimination impairment rather than repression-sensitization defenses or the affective connotation of cues. Adequacy of interpersonal functioning was associated with measures of attending and processing but not encoding. The measures of encoding, however, may have lacked adequate discriminating power due to low difficulty.

The primary aim of this study was to investigate the content and extent of psychotherapy patients’ disclosures to their spouses or significant others about their experiences in therapy, the perceived impact of disclosure about therapy on the spousal relationship, and its perceived impact on the therapeutic relationship and on treatment satisfaction. Adult psychotherapy patients (N = 84) in individual treatment, who identified themselves as either married or in a significant romantic relationship completed the Disclosure About Therapy Inventory – Revised (DATI-R; Khurgin-Bott & Farber, 2014), a revision of the Disclosure About Therapy Inventory (see Khurgin-Bott & Farber, 2011). This 52-question survey was designed to explore the extent and content of patients’ disclosures to their therapists, and the extent and content of their disclosures about therapy to their spouses or significant others (“partners”). The DATI-R also includes three outcome measures: the Revised Dyadic Adjustment Scale (RDAS; Busby, Christensen, Crand, & Larson, 1995) measures the quality of participants’ relationships with their partners, the Working Alliance Inventory – Short Revised (WAI-SR; Hatcher & Gillaspy, 2006) assesses the quality of their relationships (alliances) with their therapists, and the outcome items of the Disclosure to Therapist Inventory-III (DTI-III) assess their satisfaction with their treatment. Findings indicate that overall, patients were very disclosing to their therapists and moderately disclosing to their partners about their therapy. No demographic variables (including gender, marital status, duration of psychotherapy, and duration of marriage/relationship) were significantly associated with or predictive of the extent of patients’ self-disclosure about therapy. A significant positive association was found between the extent of disclosure to partners about therapy and the extent of self-disclosure to therapists. Greater extent of disclosure about therapy to partners was also associated with better quality of therapeutic alliances and with higher relationship satisfaction (with partners). Additionally, the quality of therapeutic alliances was strongly predictive of better treatment outcomes. These findings suggest that married (or coupled) patients in individual psychotherapy may benefit from the open discussion of their experiences in therapy with their spouses or significant others, or at least that such openness is characteristic of patients in satisfactory relationships (both therapeutic and marital). These findings are discussed in the context of the methodological limitations of the current study and the particular characteristics of the sample, and clinical implications and directions for future research are explored.

This is an exploratory follow-up study of the clientele of the Psychiatric Crisis Unit, a short-term, crisis-oriented inpatient psychiatric ward. The main objective of the research was to test the following null hypothesis: there are no significant differences between those individuals who attempt to gain aftercare treatment as opposed to those individuals who do not following discharge from the Crisis Unit. A sample of fifty-one voluntary patients who consented to participate in the study was used in testing this hypothesis. Each subject completed the Minnesota Multiphasic Personality Inventory (M.M.P.I.) and a sociological questionnaire while in the Crisis Unit, and a follow-up questionnaire was administered via telephone or personal contact approximately one month after discharge. The follow-up information was used to determine whether the subject fell into the "aftercare” or “no-aftercare” group. Data collection lasted from July 1, 1970 to December 15, 1970. The data revealed that there were significant differences between the groups and, thus, the null hypothesis was rejected. The ten M.M.P.I. scales revealed no significant differences between the groups on the individual scales. However, when examined collectively, the aftercare group scored higher than the no-aftercare group on all scales except Self-Sufficiency (which is scored in the opposite direction, corroborating the tendency in the other scales). A discriminant function correctly classified seventy-three percent of the subjects. These results indicate that the aftercare subjects probably viewed themselves as “needing” more help. The significant predictor variables found included prior familial and personal experiences similar to those bringing the subject to the Unit, employment status, age, diagnostic designation, length of hospitalization, referral planning, and self-ratings on a mood scale which was administered upon discharge from the Crisis Unit. These variables were obtained with less effort than the psychological test data. It was found that the aftercare group (compared to the other group) was younger, had a higher rate of unemployment, and had a higher rate of familial and prior personal experiences. They were also diagnosed more frequently as psychotic, with depression ranking second, and rated themselves lower on the mood scale scores. However, the difference between the before and after mood scale scores revealed that these subjects felt they had “gained” more than the no-aftercare subjects. The no-aftercare group was diagnosed more frequently as depressed, with behavior/character disorders ranking second. They tended to rate themselves higher on the mood scale scores. However, the differences between the before and after mood scale scores revealed that they had not “progressed” as much as the aftercare subjects. Although not statistically significant, it was found that the aftercare subjects were hospitalized two days longer than the subjects of the no-aftercare group. More significant is the fact that the aftercare group had a higher rate of rehospitalization than the no-aftercare group. Data collected concerning the referral process revealed that aftercare subjects were more frequently referred for treatment than were subjects of the no-aftercare group. It was speculated that those subjects who perceived themselves and/or were perceived as being "sicker" would seek further help after discharge from the Crisis Unit. The findings also suggested that not all patients need or perceived themselves as needing further help.

published_or_final_version / Medicine / Master / Doctor of Medicine

No description available.

The individualization and medicalization of the emotional distress of those given psychiatric diagnoses deny the social, political, and economic context in which the presenting behaviours arose and leads away from making changes to society. Some people who are psychiatrically labelled join in groups for solidarity in the face of being stigmatized. In these groups the members can resist the disempowerment and helplessness learned in the psychiatric system. With co-researchers from a self-help group this study gives expression to the usually silenced voices of psychiatrized people. Feminist and standpoint theories, co-cultural and living systems theories form a framework for this narrative study. A structural narrative method is used to analyze the stories, found in the transcripts of six individual interviews, told by the co-researchers about their experiences in psychiatric services and in the recovery process. The stories reveal how the ideology and practices of psychiatry use stigma, oppression and the creation of the identity of psychiatric patient for control and management. The stories also reveal the reality of hope for recovery through the support of peers and from the role models of those who have significantly recovered their mental health. Two focus group interviews were conducted with members of the self-help group where suggestions for programs were developed to address issues raised within the groups and in the individual interviews. The findings of the research will be reported to the self-help group who will use the study to back proposals for the funding of recovery-oriented programs. When social workers and other mental health professsionals recognize the importance of supporting the process of recovery, consumer/survivor-run programs will be acknowledged as effective and integral parts of any mental health system

This study was aimed at evaluating effects of psycho education on medication compliance and symptom management for clients with bipolar affective disorder attending community psychiatric clinics in the Ethekwini Health District of KwaZulu-Natal Province. A quantitative study was done using a quasi-experimental design. A one group pre-test and post-test design was used to assess the effects of psycho education. The population of the study were all clients with bipolar affective disorder attending Escoval House community psychiatric clinic and its satellite clinic (Austerville). Systematic sampling was used to select clients to participate in the study and a total of forty clients were selected. Two self-administered questionnaires were used to collect data. Clients were assessed in areas of their knowledge, medication compliance and symptom management (Pre-test). The group was then exposed to six sessions of psycho education, and they were assessed again a week after the psycho education (post-test) using the same instruments. The data was analyzed using the Statistical Package for Social Sciences (SPSS). Descriptive statistics were used to analyse participants' characteristics and some selected variables. Cross tabulations, chi-squares and paired t-tests were used on dependent variables and on social variables of interest to compare the changes in scores and means respectively and lastly to determine the relationship of social variables and the dependent variables. The findings of this study revealed that psycho education improved respondents' knowledge about their illness and symptom management techniques (with P-values ranging from 0.0001- 0.03), psycho education also improved medication compliance with P-value =0.000, but it did not affect the respondents' ability to use new techniques in managing their symptoms (with P-values ranging from 0.125- 0.75). / Thesis (M.A.)-University of KwaZulu-Natal, 2005.

Counselor physical attractiveness has been shown to affect subject perceptions and expectations. One characteristic which is particularly at odds with the attractiveness ideal is obesity. This study examined the potential effect of counselor obesity level on subjects' perceptions, expectations, and willingness to pursue counseling. Two hundred twenty-five students (146 women and 79 men) participated. Each subject rated one of six randomly selected counselor descriptions, including a photograph when appropriate, on the dependent measures (i.e., Counselor Rating Form-Short Version, Personal Problem Inventory, and questions rating physical attractiveness and willingness to pursue counseling). The data were analyzed using 2 (Gender of Counselor) X 3 (Obesity Level: Obese, Nonobese, Control) and 2 (Gender of Counselor) X 3 (Obesity Level) X 2 (Gender of Subject) ANOVA and MANOVA techniques, as appropriate. Male subjects perceived obese counselors to be less expert than did females. No other statistically significant differences based on Counselor Obesity Level were identified. Instead, main effects for both Gender of Counselor and Gender of Subject were obtained. Generally, the woman counselor was rated more positively than the man. Also, women subjects generally gave more positive ratings than did men. While the effects identified were statistically significant, their small effect sizes and small mean differences may limit their practical effect. Obesity level does not appear to affect how counselors are perceived or treated, particularly when they are moderately obese. / Department of Counseling Psychology and Guidance Services

Clinical judgment faith bias is a hypothesized tendency for clinicians to make more pathological judgments for clients with socially nonnormative faith than for otherwise identical clients with socially normative faith. To test for clinical judgment faith bias, Dillman’s (2007) Tailored Design method for mail and internet surveys was employed. A random sample of 141 psychologists in clinical practice completed a series of questionnaires measuring clinician religiousness and spirituality, view of faith helpfulness, multicultural awareness and knowledge, and diagnostic and prognostic judgments of a clinical vignette describing a client with Generalized Anxiety Disorder and two manipulated attributes: magnitude of faith (low, moderate, or high) and type of faith (religious or spiritual). Five multivariate multiple regression analyses were conducted, with a series of follow-up multivariate tests. The results of the analyses were not significant. The magnitude of faith in the vignette did not influence the diagnostic or prognostic judgments of clinicians, clinicians did not make significantly different judgments for religious cases than for spiritual cases, and faith magnitude did not interact with faith type. Furthermore, clinician attributes did not appear to affect clinical judgments in any way. Implications are discussed for theory, research and clinical practice. / Department of Counseling Psychology and Guidance Services