British Journal of Clinical Psychology

Tallis, Frank

doi: 10.1111/j.2044-8260.1993.tb01056.xpmid: 8251956

Primary hypothyroidism is a relatively common endocrine disorder that develops insidiously and can mimic depression. Between 8 and 14 per cent of patients diagnosed as depressed may have some degree of hypothyroidism. It is recommended that clinical psychologists equip themselves with sufficient knowledge to recognize the disorder. Primary hypothyroidism is described with respect to its causes, course, investigation and treatment. Suggestions are made to help psychologists determine whether a medical referral is appropriate.

Midence, Kenny; Fuggle, Peter; Davies, Sally C.

doi: 10.1111/j.2044-8260.1993.tb01057.xpmid: 8251957

This paper reviews the literature on the psychological and social aspects of Sickle Cell Disease (SCD) and discusses the clinical implications of its impact on children and their families. Sickle Cell Disease is a family of blood diseases including sickle cell anaemia (SS), SC disease (SC), and sickle B thalassaemia (SBThal). Research on the psychological and social aspects of SCD, particularly in the UK, has been limited and of varying methodological quality. The psychosocial adaptation of children and adolescents with SCD and their families has been associated with the personality and developmental stage of the child, family attitudes and behaviour, socioeconomic status, and social and environmental support. Concerns about the quality of interpersonal relationships within families have also led to investigations of family characteristics and social networks, and some research studies have pointed to different ways of coping associated with specific network and family structures.

Barker, Chris; Pistrang, Nancy; Shapiro, David A.; Davies, Suzanne; Shaw, Irene

doi: 10.1111/j.2044-8260.1993.tb01058.xpmid: 8251958

This study of BBC Television's ‘You in Mind’ series provides preliminary evidence for the benefits of a mass media approach to preventive mental health. The series was seen by a large national audience who appraised it positively. It had a greater impact in the area of understanding problems as opposed to seeing what to do about them, and a greater impact on the viewer's perceptions of the problems of people the viewers knew, as opposed to the problems of the viewers themselves. Measures of intentions to change behaviour, even when corrected for over‐reporting, suggest that a significant minority of the audience had changed or intended to change their behaviour as a result of the series. However, no specific pre‐post changes in coping or help‐seeking were found. These findings are discussed in terms of the potential and limitations of the mass media for mental health promotion.

Clare, I. C. H.; Gudjonsson, G. H.

doi: 10.1111/j.2044-8260.1993.tb01059.xpmid: 8251959

In order to assess a criminal suspect's ability to make a reliable statement, performance on three measures—interrogative suggestibility, confabulation and acquiescence—may be used. This paper presents preliminary data on these measures for people with mild learning disabilities (Full Scale IQ (FSIQ): 57–75). It was found that they were more suggestible than their average ability counterparts (FSIQ: 83–111) because they were much more susceptible to ‘leading questions’. They also confabulated more and were more acquiescent. Overall, the data emphasized their potential vulnerability to giving erroneous testimony during interrogations.

Ball, Christopher J.; Scott, Nichola; McLaren, Paul M.; Watson, J. P.

doi: 10.1111/j.2044-8260.1993.tb01060.xpmid: 8251960

Mini‐Mental State Examination scores were compared in an adult psychiatric population when the test was performed face to face and over a Low‐Cost VideoConferencing System (LCVC). The minor changes to the instrument that are required to make it compatible with the LCVC are described. The high correlations achieved between the test scores in the two conditions suggests that this cognitive screening test may be reliably performed in this group of patients over the LCVC.

Spence, Sharon E.; Godfrey, Hamish P. D.; Knight, Robert G.; Bishara, Samir N.

doi: 10.1111/j.2044-8260.1993.tb01061.xpmid: 8251961

This study examined social skills in 14 closed head injured (CHI) patients who were assessed at four months post‐injury and compared with 19 orthopaedic control (OC) patients. Social skills deficits were found to be more common in the CHI patients, of whom over half were classified as socially unskilled. CHI patients displayed poorer social skills in the earlier (but not later) part of an extended social interaction, indicating that they make a poor first impression. It is suggested that poor initial impression formation skills may be one reason why CHI patients fail to establish and maintain friendships. Implications of these findings for patient management are discussed. Close others of CHI patients reported higher levels of mood disturbance. Higher levels of close other hostility were associated with social skills deficits in CHI patients.

Cramer, Duncan; Kupshik, Gary

doi: 10.1111/j.2044-8260.1993.tb01062.xpmid: 8251962

Ellis's rational–emotive theory postulates that since irrational statements augment emotional distress, replacing irrational with rational statements should lessen distress. This hypothesis was tested in the initial stages of psychotherapy by having 13 and 14 clinical out‐patients respectively repeat for one minute either rational or irrational statements about their major presenting psychological problem. The distinction by Ellis & Harper (1975) that ‘inappropriate’ emotions differ qualitatively from ‘appropriate’ emotions was also examined. Although the experimental intervention had no effect on a post‐test measure of irrational beliefs, patients repeating rational statements had significantly lower appropriate and inappropriate negative emotions at post‐test, suggesting that inappropriate emotions do not differ qualitatively from appropriate emotions and that making rational statements may lower emotional distress in patients. Patients reiterating irrational statements showed no change in emotions, implying that these kinds of irrational cognitions may have already been present.

Joseph, Steve; Yule, William; Williams, Ruth; Hodgkinson, Peter

doi: 10.1111/j.2044-8260.1993.tb01063.xpmid: 8251963

The aim of the present study was to explore the psychometric properties of the Impact of Events Scale. Evidence is presented that the scale is composed of two major factors tapping intrusion and avoidance which are associated with greater psychological distress.

Broek, M. D.; Bradshaw, C. M.; Szabadi, E.

doi: 10.1111/j.2044-8260.1993.tb01064.xpmid: 8251964

Nelson's (1976) Modified Wisconsin Card Sorting Test (MCST) was evaluated and the utility of the conventional criterion and new threshold scores for identifying patients with frontal lobe disorder assessed. Measures of perseveration and other indices of performance on the MCST were not found to discriminate between patients with frontal and non‐frontal lobe lesions, using either the conventional criterion or new threshold scores. In addition there were no significant differences between left‐ and right‐sided lesioned patients. However, the task was found to have high specificity (98.7 per cent) and good sensitivity (45.6 per cent) to lesions irrespective of site indicating that it may be a useful screening test. The present findings are consistent with recent research with the original Wisconsin Test, that suggests that card‐sorting performance may not be as differentially sensitive to frontal lobe disorder as has been thought hitherto.

Wright, Simon; Young, Andrew W.; Hellawell, Deborah J.

doi: 10.1111/j.2044-8260.1993.tb01065.xpmid: 8251965

We report sequential Cotard and Capgras delusions in the same patient, KH, and offer a simple hypothesis to account for this link. The Cotard delusion occurred when KH was depressed and the Capgras delusion arose in the context of persecutory delusions. We suggest that the Cotard and Capgras delusions reflect different interpretations of similar anomalous experiences, and that the persecutory delusions and suspiciousness that are often noted in Capgras cases contribute to the patients' mistaking a change in themselves for a change in others (‘they are impostors’), whereas people who are depressed exaggerate the negative effects of the same change whilst correctly attributing it to themselves (‘I am dead’). This explains why there might be an underlying similarity between delusions which are phenomenally distinct.