The present study addressed some of the peripheral statements emanating from Kiesler’s (Kiesler, Bernstein & Anchin, 1976) core communications theory by examining (1) a specific component of the communication style of the obsessive personality, (2) the distinctive emotional engagements the obsessive personality elicits when interacting with others, and (3) a situational determinant that is hypothesized to trigger relatively intense expression of the obsessive’s self-defeating communication style, as well as a higher level of state anxiety. Specifically, the study examined the effects of a high or low status interviewer upon one expressive measure of speech and upon relationship consequences for groups of psychometcially-defined obsessives and non-obsessives. The speech measure used was the revised edition of the Modifiers category of the Psycholinguistic Scoring System for the Obsessive Personality (Kiesler, Moulthrop & Todd, 1972). Modifiers, representing expressions of doubt and uncertainty, were hypothesized to occur more frequently in psychometrically-identified obsessive personalities, particularly in the high status interviewer condition. The emotional reactions evoked in others by an indecisive communication style were assessed by the Impact Message Inventory-Modifier Scale (Greenwood, 1976). It was hypothesized that more intense emotional reactions synonymous with an indecisive communication style would be elicited in observers by the obsessives, particularly in the high status interviewer condition. A wide range of emotional reactions evoked by the obsessive personality were assessed using the Impact Message Inventory (Kiesler, Anchin, Perkins, Chirico, Kyle & Federman, 1976). Finally, the state anxiety of all subjects was assessed before and after the experimental interview using the Anxiety-State Scale of the State Trait Anxiety Inventory (Speilberger, Gorsuch & Lushene, 1970). Here again it was predicted that obsessives would display a higher level of state anxiety, especially in the high-status interviewer condition. None of the experimental hypotheses were supported. The results for the predictions were discussed. It was suggested that the experimental analogue situation may not have been appropriate in some respects, particularly with regard to whether the subject selection criteria were adequate in producing a theoretically and clinically relevant group of subjects. Suggestions were offered to mitigate the possible flaws in the present analogue study. It was noted that the nature of the communication task appears to play a large role in the distinctive communication behavior that is evoked and, therefore, that communication task variables should be investigated in future studies. Finally, it was recommended that single-case design studies, using actual obsessive patients, might be the most viable strategy to study theoretical constructs vis a vis the obsessive personality.

No description available.

In this study brainstem auditory evoked potentials (BAEPs), median nerve conduction velocities (CV) and early somatosensory evoked potentials ( SEPs), were employed as indices of neural conduction properties in a group of young insulin dependent diabetics (five males and five females) and a group of nondiabetic controls (five males and five females). The median nerve CV was determined from 64 summated nerve responses recorded at the elbow. The nerve was stimulated at the wrist using 0.2 msec square wave electrical pulses. The SEP was recorded from scalp electrodes using the same median nerve stimulation technique as for the CV measure. The BAEPs were produced by recording responses to 7 0 dB SL clicks delivered to the right ear at a rate of 10 per second. Measures of central transmission time were determined from each of the EP modalities. The time interval between BAEP waves I and V determined the BAEP CTT. SEP waves P9 to Pl4 determined the earliest SEP CTT measure. Comparisons between the two diagnostic groups yielded the following results: The diabetic group evidenced a significant (p = 0, 02) slowing of the median nerve, 53 meters per second for the diabetic group versus 59 meters per second for the nondiabetic group. With height covaried out, only the SEP Pl4 latency showed a significant diagnostic group difference. More interesting were the findings for the principal SEP CTT measure. The diabetic group had significantly (p = 0.01) longer CTTs from P9 to Pl4, 5.0 msec as opposed to 4,2 msec for the nondiabetic group. The diabetic group also had significantly (p = 0.03) longer CTTs for the BAEP, 4.2 msec versus 4.0 msec for the nondiabetic group. Although the magnitude of the diagnostic group differences are small, the median nerve CV, SEP CTT, and BAEP CTT measures indicate that diabetic neuropathy is pervasive, occurring centrally, as well as peripherally, as early as young adulthood in juvenile onset, insulin dependent diabetics.

The question of how humans clearly perceive speech, which is anything but clear when analyzed acoustically, has prompted researchers to look at the phenomenon of phonetic ambiguity. In adults, phonetic ambiguity perception has been shown to be aided by the listener using expectations due to the saliency (i.e., familiarity of the ambiguous word or phrase) and to pre-exposure (i.e., priming) to the items prior to testing. Priming makes the subject aware of the alternative (i.e., unfamiliar or rare) member of a phonetic ambiguity pair. In the present study, thirty-two 4 and 5 year olds were exposed to a tape containing familiar and rare ambiguity members and control items. One-half of them were primed. Results indicated that there was a strong beneficial effect of priming and saliency. The results of the present study were also compared with a previous adult study; this revealed a great deal of similarity between the two groups, implying 4 and 5 year olds can and do employ the same linguistic cues as adults.

There are speculations that disabled readers may fail to correctly decode written words because they are insensitive to language's phonetic form. This insensitivity is presumed by some to be due to a speech perceptual deficit. The purpose of the current study was to assess differences between disabled and non-disabled adolescents and elementary school students in their perceptual accuracy in decoding phonetically ambiguous speech. The effects of two processing factors derived from previous research, priming and word form (e.g., Spencer & Carter, 1982), were also examined to assess how perceptual processes may differ between groups. Clinical evidence of some verbal problems persisting in adolescent disabled populations and evidence of compensatory differences between elementary and adolescent readers on earlier phonetic coding tasks prompted the inclusion of alI four age group by reading group combinations. Results reveal no reading group differences of either age grouping. The results are discussed in terms of design considerations, previous pertinent speech perception research, and similarity of responses to those of normal subjects in Spencer and Carter (1982) and Carter and Zoller (1983). With an examination of two dependent measures and a qualitative analysis of errors, no reading group differences were found. Therefore, it Is suggested that explanations involving speech perception may not appropriately address the problems of disabled readers with problems in word decoding.

Background: The research project aims to explore the mental representations therapists have about their patients and therapy between sessions (Intersession Experience, ISE) through exploratory mixed method sequential design. The study aims to gain an understanding of the way UK therapists make sense of their ISE; review the themes within an existing measure of ISE; explore the associations between aspects of therapist ISE and alliance for a series of UK therapists; and gain explanatory qualitative feedback to contextualise quantitative findings. Method: The research project employed a three stage mixed method design. Phase one comprised exploratory qualitative interviews of UK therapists about their ISE, analysed using a semantic level Thematic Analysis (Braun & Clarke, 2006). Phase two comprised a series of single case time series analysis designs where therapists completed a measure of their ISE and alliance weekly over the course of therapy. Phase three comprised explanatory deductive qualitative interviews about phase two findings. Results: ISE may be instrumental for therapy; ISE can be spontaneous or planned, may affect in-session processes and may impact on therapist wellbeing. Intersession thoughts were associated with problem solving, re-experiencing aspects of therapy and internal reflection. Positive emotional ISE preceded increases in alliance ratings. Negative emotional ISE and alliance were bi-directionally negatively associated within the sample. Explanatory phase three themes suggest ISE as an indicator of need for intervention (E.g. supervision), transference of patient difficulties and to help therapy progress. Conclusion: Therapist ISE may be conceptualised as ‘unfinished business’ and appears to relate to emotional processing of in-session content in the form of right brain activation (Kahneman’s system 1) or instrumental problem solving and reflection in the form of left brain processing (Kahneman’s system 2). ISE may hold implications for the therapeutic relationship, in-session processes and therapist wellbeing. ISE appears to be an important process variable linked to the therapeutic alliance and warrants further exploration in the form of patient/therapist dyads, exploration of ISE across therapy phases and the association to patient outcomes and therapist wellbeing.

Overview This thesis reviewed forensic aspects of Intellectual Disabilities (ID) and Autism Spectrum Disorder (ASD). Chapter two was a case study where an individual with ID and ASD who exhibited forensic/Challenging Behaviour (CB) was assessed and intervention offered. Chapter three then focussed on the assessment of people with ID and ASD by critiquing the Wechsler Adult Intelligence Scale (WAIS), version 3 and 4 (WAIS-III & WAIS-IV) (Wechsler, 1997; Wechsler, 2008a, 2008b, 2008c) and discussed application issues for people with ID and ASD. Chapter 4 and 5 examined intervention in more depth. Chapter 4 applied Weiner’s (1985, 1993) theory of achievement, motivation and emotion as a way of understanding contextual intervention and Chapter 5 examined the effect of psychotherapeutic interventions on CB. Chapter Two The case study discussed in chapter two examined explanations of violence and diagnoses. ASD and an ID were identified as useful neurodevelopmental diagnoses that could be used as a framework to understand the individual’s needs. Some explanations of violence were related to features of these diagnoses. Social factors were also identified as increasing risk. Violence was modelled by a key male figure during childhood development which appeared to have been retained as a template of acceptable behaviour, supporting the work of Bandura on social learning (1973). This, and the experience of being a victim of this violence, also supported the work of Douglas, Hart, Webster and Belfrage (2013) who indicated that social factors can increase the risk of violence. In turn this affected attachment supporting the work of Bowlby (1980). The behavioural approach (Cipani & Schock, 2010) was also applied to identify functions of violence. A psychotherapeutic intervention was offered to improve one aspect of emotional recognition, face perception, with the aim of enabling him to comprehend visual feedback from the environment, make interpretations about the emotions experienced by others, and modify his behaviour accordingly. There was little difference to his level of skills following the intervention. It was concluded that particular skills development may be difficult for someone with a neurodevelopmental difficulty if the biological structures are not there to support that skill, or skills may take a long time to develop. In this case it was concluded that the best intervention was to consider a placement for him in an appropriate environment that would cater for his ASD and ID related needs. Comments were made about the quality of assessments and for improvements to be considered to formulation and intervention. Chapter Three Chapter three was a critique of the WAIS, a tool widely used as part of the process to identify whether someone has an ID. This may determine if an individual may be unfit to plead in court or to determine the services appropriate for that individual’s needs. The review focussed on the most recent version, WAIS-IV (Wechsler, 2008a, 2008b, 2008c) but also referred to other versions in particular the WAIS-III (Wechsler, 1997). The conclusion was there were some flaws to the assessments that required further research and also some omissions in the epistemology. The critique examined different aspects of validity and reliability. The examination of convergent validity yielded mixed results with some positive correlations with other tests and some weak correlations. This difference could be caused by some tests measuring different aspects of ‘g’. The consequences of differences can be significant, for example the scores of the Wechsler Intelligence Scale for Children, version 4 (WISC-IV) (Wechsler, 2003) and the WAIS-IV scores could differ by up to 10 points and could mean individuals moving from a children’s to an adult service could become ineligible for the same levels of support. The results for test-retest reliability were good in the short term but more research was recommended to determine if the latest version of the WAIS would be reliable in the long term. The ‘Flynn effect’ (Flynn, 2007) indicated that levels of intelligence were rising so the WAIS-IV compensated for this and currently measures intelligence at around 3 points lower than the WAIS-III. The stability of this effect was unclear. The results for internal reliability were good although more research independent of the WAIS was recommended. The application of the WAIS for individuals with an ASD and ID was considered with the WAIS being found to be a limited tool for discriminating between categories of ASD, although what can be expected is an uneven profile. It was also unclear how useful the WAIS was to discriminate between individuals with a substance misuse/abuse disorder and normal controls. There were also difficulties with the application of the WAIS to individuals with ID. Difficulties measuring intelligence at lower levels were identified as scores can be unstable. Research was also recommended to provide a comprehensive view of the effect upon results of variables such as nationality, gender and age. Chapter Four Chapter four was an empirical research project investigating Weiner’s (1985, 1993) theory of achievement, motivation and emotion as a means of understanding the responses of unqualified nursing staff to clients with ASD exhibiting CB. One hundred and twenty seven unqualified nursing staff responded to an Attributional Style Questionnaire (ASQ) (Dagnan & Cairns, 2004) and questions based on a vignette. The quantitative results found weak support for Weiner’s model. There was weak evidence for the effect of demographic variables and the type of client (ASD or ID) and the type of service (ASD or Mental Health/ID) did not affect the results. Qualitative data was themed and coded according to Braun and Clarke (2006) and Boyatzis (1998) and provided an insight into the psychological processes influencing staff responses to CB. The results suggested that intervention was influenced by staff, patient and contextual variables. A recommendation was made for a contemporary exploration of the topic and to improve the validity and reliability of the ASQ. Chapter Five Chapter five was a systematic review of psychotherapeutic interventions aimed at reducing the CB exhibited by people with ID only due to a paucity of research using people with ASD as participants. A systematic literature search was conducted using 5 databases, a search of relevant journals and contact made with experts. From this 8 papers met the inclusion/exclusion criteria and these were analysed qualitatively. Three types of psychotherapeutic intervention were used within the ten papers, Cognitive Behavioural Therapy (CBT), “Soles of the Feet” meditation and Solution-Focussed Brief Therapy. All types of psychotherapeutic intervention reduced CB although the results of studies using CBT were mixed. There were shortcomings to these conclusions; these were methodological issues such as a need to ensure the consistency of outcome measures and the types of CB used to measure change. The effect of intervention may have been modified by variables such as length of treatment, the context and intrapersonal variables. Conclusions The chapters of this research thesis indicated that neurodevelopmental factors influenced forensic/CB, although social role models, attachment and trauma were also significant. Assessments were important as they may affect fitness to plead and services/treatment offered. Assessments such as the WAIS are supported by research although further research has been recommended. The use of the WAIS with people with ASD and ID was limited as people with ASD appear to exhibit uneven profiles when completing the WAIS and there were inaccuracies when using the WAIS with people with lower levels of intelligence. The difficulties people with ASD have with social communication skills can also affect performance and support is needed when administering assessments. Intervention for people with a neurodevelopmental difficulty can also be successful. Consideration is needed regarding appropriate intervention for each individual, how long before the intervention is effective, the context including the type of support offered and how that affects outcomes, intrapersonal variables such as intelligence, and whether the treatment includes one to one support. More research of an improved quality is required to determine the effectiveness of both assessment and treatment including contextual based treatment such as the interaction between staff and patients within an institutional setting. Considering these further would improve the service for this client group and contribute to a reduction of risk.

Valid and reliable measures of Acceptance and Commitment Therapy's (ACT) purported mechanism(s) of change are paramount in establishing its incremental validity above other extant psychological therapies. However, the most widely used general measure of psychological flexibility and the six ACT processes of which it is composed of, the Acceptance and Action Questionnaire (AAQ-II), has been significantly criticised, principally in terms of being a conflated distress measure due to having items with poor face and content validity. Theoretically, there has also been debate about whether ACT's 'hexaflex' model, which conceptually underpins the AAQ-II and other ACT process measures, is comprised of fewer than six distinct processes as per current ACT theory. The overall aim of our study was therefore to: 1) develop a new general measure of ACT processes; 2) test the measure's validity and reliability; and 3) establish whether the measure's factor structure accords with Hayes et al.'s (2011) clustering of ACT's six processes into three dyadic processes. The measure was named the Comprehensive assessment of ACT processes ('CompACT'). Using a Delphi-consensus methodology, ACT experts (N= 10) rated the face and content validity of 106 items. Items were taken from existing ACT process measures and two mindfulness measures, as well as generated by ourselves and the ACT experts within our study. Items which failed to reach pre-defined ratings thresholds were removed and remaining items were re-rated until a pre-defined consensus threshold was reached. After three rounds, an initial 37-item version of the CompACT was produced. The CompACT was then disseminated to a non-clinical sample of participants (N = 377) mainly via social media. Participants also completed other measures to assess different aspects of the CompACT's validity. A three-factor structure was found to be the most stable for a 30-itemed version of the CompACT. An examination of the distribution and contents of item loadings also confirmed that the CompACT's three factors could be defined in accordance with Hayes et al's. (2011) three dyadic ACT processes. The CompACT performed in theoretically predicted ways against measures of other related and distinct constructs, and was mostly comparable to the AAQ-II in terms of its magnitude of associations with these other measures, with the exception of a distress measure. The CompACT's associations with these measures also supported ACT's central hypothesis: higher levels of psychological inflexibility are associated with higher levels of distress and lower levels of health and wellbeing. Overall, the CompACT shows initial promise as a comprehensive measure of ACT processes, and more generally as a measure of psychological flexibility. The psychometrically viability of Hayes et al.'s (2011) three dyadic ACT processes as a conceptual model for the CompACT further strengthens previous suggestions that ACT's clinical model may be composed of fewer than six distinct processes. The CompACT was adjudged by ACT experts to possess items with better face and content validity than the AAQ-II. However, in order to be considered as a viable alternative measure to the AAQ-II, further testing of the CompACT's psychometric properties is needed.

Introduction: The concept of pornography addiction, although widely accepted, continues to be debated, and as such no diagnostic criteria exist. Opponents and proponents of pornography continue to cite evidence that supports the claim that pornography is either harmful or beneficial, respectively. However, a review of the literature pertaining to pornography use revealed conceptual and methodological shortcomings which limit the conclusions made in the existing literature base. Without adequate research to further our understanding of the complex relationship individuals have with pornography, we risk pathologising or condoning behaviours that are legal and consensual, which may cause distress for some individuals, or even divert attention from deeper issues, such as an individual’s thinking styles and feelings of shame. Researchers acknowledge that people’s relationship with pornography is complex (Hardy, 1998) and individuals experience it in different ways, for example the time spent viewing pornography, the environment in which they view it, who they view it with, and the genre of pornography they watch (Attwood, 2005; Hald & Malamuth, 2008; Malamuth, Addison, & Koss, 2000; Poulsen, Busby, & Galovan, 2013; Reid, Li, Gilliland, Stein, & Fong, 2011). Given that additional variables may be involved when people pathologise their pornography use, particularly rigidity of thinking (Reid et al., 2009), it is worth investigating such variables further to help discern differences between those who pathologise their pornography use and those who do not. Aims: The overall aim of this study was to explore whether thinking styles impact on the meaning given to pornography use. The primary objective was to compare participants who perceived their pornography use to be problematic (porn addict) with individuals who did not (non-addict) on the following dependent variables: thinking styles, shame, levels of desirability responding, levels of religiosity, and perceived effects of pornography use. As this was an exploratory approach a two-tailed hypothesis was employed. The secondary objective was to capture in-depth qualitative experiences participants had with pornography, and pornography addiction. Design: This study used a mixed-method sequential explanatory design (MMSE), using questionnaires to collect quantitative data and interviews to collect qualitative data. Method: Participants (n=265) were recruited from both UK National Health Service (NHS) and non-NHS sites. For non-NHS participants, the questionnaires were made available online and advertised through social media. NHS recruitment occurred at a specialist sexual health clinic and was advertised using posters displayed in relevant clinical areas. The study predominantly employed a maximum-variation sampling technique. This is a purposive sampling technique used for this research to ensure that an eclectic sample of diverse demographics was captured. Quantitative data was collected using a demographic questionnaire and four validated measures; the Inventory of Cognitive Distortions (Yurica & DiTomasso, 2001), the Test of Self-Conscious Affect-3 (Tangney, Dearing, Wagner, & Gramzow, 2000), the Balanced Inventory of Desirable Responding (Paulhus, 1991; 1998), and the Pornography Consumption Effects Scale (Hald & Malamuth, 2008). All interviews were conducted either through the audio function on Skype© or over the telephone. Results: Participants reported themselves as belonging to one of three groups; addicts, somewhat addicts, or non-addicts. MANOVA analyses revealed that groups significantly differed in their propensity for cognitive distortions, reported effects of their pornography use, the impact of their religious beliefs, and time spent viewing pornography. Significant differences were not found for the shame scales, or for social desirability. Multinomial logistical regression revealed that negative impact of pornography on participants’ lives in general, on their sex life, dysfunctional thinking styles (overall and externalisation of self-worth, magnification and fortune telling, minimisation and arbitrary inferences, and perfectionism), and impact of religious beliefs significantly predicted group membership. Furthermore, regression analysis supported the hypothesis that thinking styles mediated the relationship between time spent viewing pornography and the overall negative impact of pornography. Qualitative results supported these findings, and thinking styles were revealed to influence the discourses participants had regarding pornography. Primary themes identified were participants’ relationship with pornography and perceived causation of pornography addiction, significance of social norms, and impact of expert opinion. Furthermore, although absent in the quantitative findings, the concept of shame was raised as an influential factor in the pathologising of pornography use, thus supporting the notion that a conflict in values, paired with a relatively inflexible cognitive style, may lead to pathologising, and shame will be a product of that process. Discussion: This study demonstrates the role thinking styles play in how people evaluate their pornography use. Thinking styles both predict whether an individual perceives their pornography use to be problematic or not, and are evident in the discourses people use when discussing their pornography use and the concept of pornography addiction. Specifically, individuals with a propensity for rigid thinking styles are more likely to negatively evaluate their pornography use. Furthermore, the similarities and differences apparent in group comparisons can be understood within a values theoretical framework; it may be that individuals with rigid thinking styles are more likely to endorse particular values that are incongruent with their pornography use behaviours. Conversely, individuals with more flexible thinking styles may be more likely to endorse values which are not incongruent with their pornography use behaviours. This is important from a research and treatment perspective, as it may not be the behaviour itself (pornography use) that is problematic and the target for intervention, but the cognitive framework individuals use in relation to the behaviour. Current treatment offered to those who self-report as pornography addicts often ignore the role of thinking styles and values. In light of this study’s findings, thinking styles should be a focus in future research and treatment as it may help to reduce cognitive dissonance and engender agency.

Objective This study aims to compare the outcome and psychiatric morbidity of the forensic mental observation referrals, in the two legally created groups of awaiting trial detainees – the ‘singles’ representing the minor violent and non-violent offenders versus the ‘panels’, representing the seriously violent offenders. Method A cross-sectional, retrospective record review of 200 cases, spanning from January 2010 to August 2010, of all individuals admitted to the Forensic unit of Sterkfontein Hospital, for 30 days psychiatric observation. The Pearson’s Chi squared test for categorical data was used to determine statistical significance. Results Of 110 ‘singles’ 49 (44.55%) were found fit for trial and 40 (40.4%) criminally responsible, whereas of the 90 ‘panel’ cases 60 (66.67%) were fit for trial and 57 (64.77%) were criminally responsible. (p = 0.002 and 0.001 respectively) Conclusion Those charged with seriously violent offences appear to be more likely to be found both fit and responsible, compared to those charged with less serious offences.