Intrinsic motivation in schizophrenia: Relationships to cognitive function, depression, anxiety, and personality.

The goal of the current project was to assess subjective reports of intrinsic motivation and their relationship to cognitive function, mood, and personality in schizophrenia. The authors used the Motivational Trait Questionnaire to examine 3 components of intrinsic motivation (personal mastery, competitive excellence, motivation related to anxiety). They also examined fluid intelligence, context processing, and working memory, as well as self-reports of mood and personal traits related to motivation. Participants were 66 individuals with schizophrenia or schizoaffective disorder and 44 healthy controls. Self-reports of personal mastery and competitive excellence did not differ between controls and individuals with schizophrenia, though patients did report significantly higher motivation related to anxiety. Among controls, but not patients, self-reports of intrinsic motivation were strongly related to cognitive performance. In contrast, both controls and patients showed similar strong relationships between self-reports of intrinsic motivation and related measures of mood and personality. These results are not consistent with the hypothesis that motivational deficits in schizophrenia reflect impairments in intrinsic motivation. However, they do suggest that the normal relationship between self-reports of intrinsic motivation and cognitive function is disrupted in schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neighborhood safety and social involvement: Associations with parenting behaviors and depressive symptoms among African-American and Euro-American mothers.

The relation between neighborhood characteristics and parenting and the mediating role of maternal depressive symptoms was examined among African American and Euro-American mothers of kindergarten children. Mothers' ratings of neighborhood safety were related to disciplinary strategies for both African American and Euro-American mothers but not to expressions of affection. Interviewers' ratings of safety were related to mothers' use of hostile socialization strategies. Both mothers' and interviewers' reports of safety were linked with maternal depressive symptoms. Depressive symptoms mediated the relation between neighborhood safety and inconsistent discipline, suggesting that the influence of safety on inconsistent discipline was due to its impact on maternal depression. Although there were similarities across ethnic groups, the relation between social involvement and mothers' withdrawal of interactions with their children differed across groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The time course and significance of cannabis withdrawal.

Withdrawal symptoms following cessation of heavy cannabis (marijuana) use have been reported, yet their time course and clinical importance have not been established. A 50-day outpatient study assessed 18 marijuana users during a 5-day smoking-as-usual phase followed by a 45-day abstinence phase. Parallel assessment of 12 ex-users was obtained. A withdrawal pattern was observed for aggression, anger, anxiety, decreased appetite, decreased body weight, irritability, restlessness, shakiness, sleep problems, and stomach pain. Onset typically occurred between Days 1-3, peak effects between Days 2-6, and most effects lasted 4-14 days. The magnitude and time course of these effects appeared comparable to tobacco and other withdrawal syndromes. These effects likely contribute to the development of dependence and difficulty stopping use. Criteria for cannabis withdrawal are proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Protection, Dissociation, and Internal Roles: Modeling and Treating the Effects of Child Abuse.

This article presents a theory of the long-term effects of child abuse that emphasizes the development of internal working models of protection. The theory proposes that abused children do not receive adequate caregiver protection and do not form internal representations of an effective protector. As a result, they have ongoing difficulty defending themselves against interpersonal aggression and internal self-criticism. The model integrates current research and theory in attachment behavior, developmental psychopathology, trauma, dissociation, and experiential psychotherapy. It accounts for many of the clinical symptoms presented by adult survivors of child abuse and suggests specific strategies for treatment. The author provides 3 examples of psychotherapy interventions derived from the model, distinguishes protection and "rescuing", and suggests directions for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Engagement in psychological treatment for functional neurological symptoms--Barriers and solutions.

This naturalistic study explores how many patients with functional neurological symptoms referred for specialist psychotherapy engage with and complete treatment, and whether routinely recorded demographic or clinical features predict engagement. Of 77 consecutive patients referred, 14.3% were considered unsuitable for therapy and excluded from between group comparisons, 23.4% did not attend any appointments, 20.8% unilaterally discontinued therapy, and 41.6% completed treatment. 66.6% of patients starting therapy completed. Older patients were more likely to engage in or complete therapy (p = .05). There were no significant differences between groups in terms of specific functional symptoms, comorbidity, predisposing, precipitating and perpetuating, or social factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Burnout Patterns in Rehabilitation: Short-Term Changes in Job Conditions, Personal Resources, and Health.

This longitudinal study reports the patterning of the burnout symptoms and the changes in employees' job conditions, personal resources, and psychological health 4 months after a rehabilitation intervention. The data were gathered by means of questionnaires before and after a rehabilitation period. Four patterns were identified: not burned out (n = 55), exhausted and cynical (n = 36), burned out (n = 26), and low professional efficacy (n = 18). These patterns differed in terms of job resources, personal resources, and depression. There were both positive and negative changes detected in participants' psychological health and job resources at the follow-up. The study shows the importance of identifying different burnout patterns in order to focus rehabilitation activities more effectivel (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist Variables That Predict Symptom Change in Psychotherapy With Chronically Depressed Outpatients.

The present study examines the contribution of psychotherapist variables to change in depressive symptoms in a large clinical trial comparing the efficacy of the cognitive-behavioral analysis system of psychotherapy, the antidepressant nefazodone, and the combination of both in the treatment of chronic depression. Greater change on the Hamilton Rating Scale for Depression (HRSD) was associated with greater emphasis on the therapeutic relationship, lower overall psychotherapy caseload, therapist psychodynamic orientation, and supervisory status. There was no relationship between HRSD change and therapist sex, age, or years of experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Screening for Obsessive and Compulsive Symptoms: Validation of the Clark-Beck Obsessive-Compulsive Inventory.

The 25-item Clark-Beck Obsessive-Compulsive Inventory (CBOCI) was developed to assess the frequency and severity of obsessive and compulsive symptoms. The measure uses a graded-response format to assess core symptom features of obsessive-compulsive disorder (OCD) based on Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria and current cognitive-behavioral formulations. Revisions were made to the CBOCI on the basis of psychometric and item analyses of an initial pilot study of clinical and nonclinical participants. The construct validity of the revised CBOCI was supported in a subsequent validation study involving OCD, nonobsessional clinical, and nonclinical samples. A principal-factor analysis of the 25 items found 2 highly correlated factors of Obsessions and Compulsions. OCD patients scored significantly higher on the measure than nonobsessional anxious, depressed, and nonclinical samples. The questionnaire had strong convergent validity with other OCD symptom measures but more modest discriminant validity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive mediation of rape's mental, physical and social health impact: Tests of four models in cross-sectional data.

Four nested, theoretically specified, increasingly complex models were tested representing cognitive mediation of rape's effects on mental, physical, and social health. Data were cross-sectional (N = 253 rape survivors). Outcomes were standardized assessments of social maladjustment, physical, and psychological symptoms, including posttraumatic stress disorder (PTSD). The best-fitting model was not fully cognitively mediated. Personological and rape characteristics influenced the level of self-blame experienced and the intensity of maladaptive beliefs about self and others. Self-blame and maladaptive beliefs predicted psychological distress, which strongly influenced all health outcomes. Self-ratings of rape memory characteristics contributed little to predicting postrape distress. The model accounted for 56% of the variance in general distress, including 91% of psychological symptom severity; 54% of PTSD symptoms; 65% of social maladjustment; and 17% of physical symptoms. Longitudinal replication is planned. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dietary and Dietary-Depressive Subtypes of Bulimia Nervosa Show Differential Symptom Presentation, Social Impairment, Comorbidity, and Course of Illness.

Research suggests that women with bulimia nervosa can be classified into dietary and dietary-depressive subtypes and that the latter show greater eating pathology, social impairment, comorbidity, and treatment nonresponse. The authors sought to replicate this subtyping scheme with an independent sample and to generate further evidence for the validity of this distinction. Analysis revealed dietary and dietary-depressive subtypes and indicated that the latter reported more current eating pathology, social impairment, and treatment seeking as well as greater psychiatric comorbidity and bulimic symptom persistence over a 5-year follow-up. This subtyping scheme had stronger concurrent and predictive validity than the purging-nonpurging distinction. Results provide further evidence for the reliability and validity of this subtyping scheme and suggest it has important clinical implications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)