Biomedical subjects
C R Brewin
Publications and source records attributed to C R Brewin.
State and trait differences in depressive self-perceptions.
A number of investigators have interpreted a tendency for depressed people to recall more negative than positive self-referent adjectives as evidence for a depressive self-schema made up of predominantly negative characterological information. We sought to confirm this account by eliciting the subjective self-perceptions of the depressed. Depressed patients and controls were required to rate whether or not a series of positive and negative adjectives applied to them during the previous week, at any time, and generally. The depressed distinguished clearly between these questions and, although describing themselves currently in largely negative terms, described their general state as equally composed of positive and negative elements.
Self-criticism in adulthood and recalled childhood experience.
We investigated in a sample of 75 medical students the hypothesis that higher levels of self-criticism, a major vulnerability factor for depression, are related to retrospective reports of less satisfactory parenting, even when the potentially confounding factors of mood state and social desirability response set are controlled. At each of 2 measurement times, there were significant cross-sectional correlations between parental ratings and both depression and self-criticism, but the associations with self-criticism were no longer significant when depression was controlled. However, even after controlling for the effects of mood state and social desirability, persons with high levels of self-criticism at both measurement points (high trait self-criticism subjects) reported significantly worse relationships with their mothers than did the remaining subjects. They were also more likely to report below average relationships with both parents jointly.
Attributions and relapse in opiate addicts.
This study investigated whether attributions of opiate addicts would predict both their ability to abstain from future use and their reactions to abstinence violations. Measures of generalized beliefs about responsibility for positive and negative outcomes and specific attributions about relapse episodes were elicited from 80 addicts at the time of admission for inpatient detoxification and treatment. Addicts who at admission attributed to themselves greater responsibility for negative outcomes and who attributed relapse episodes to more personally controllable factors were subsequently (at 6-month follow-up) more likely either to be completely abstinent or to contain the effects of temporary lapses into opiate use.
Causal beliefs about depression in depressed patients, clinical psychologists and lay persons.
Non-depressed lay persons have been shown to have extensive and accurate knowledge about depression (Rippere, 1977, 1980 a, b, 1981 a) that is underpinned by a structure that resembles current academic theories of the disorder (Furnham & Kuyken, 1991). In this study a semi-structured interview schedule and a number of rating scales were used to determine and compare the nature and extent of depressed patients', clinical psychologists', and lay persons' beliefs about the causes of depression. We confirmed that depressed patients and non-depressed lay persons alike have relatively extensive beliefs about the causes of depression which are comparable to those held by clinical psychologists. However, depressed patients tend to endorse biological explanations of the causes of depression to a greater extent than clinical psychologists. In contrast, clinical psychologists assign a more important causal role to unconscious processes and childhood vulnerability factors than do either depressed patients or non-depressed lay controls.
Attribution and expressed emotion in the relatives of patients with schizophrenia.
Indexes of expressed emotion (EE) in 58 relatives of patients with schizophrenia were related to those relatives' spontaneously expressed causal beliefs about the illness and about related symptoms and behaviors. Relatives made attributions predominantly to factors external, universal, and uncontrollable from their own perspective, and to factors internal, universal, and uncontrollable from the patient's perspective. Low-EE relatives were similar in their attributions to emotionally overinvolved relatives. Compared with these two groups, critical and/or hostile relatives made more attributions to factors personal to and controllable by the patient. Subsequent analyses suggested that hostile relatives were further characterized by making more attributions to factors internal to the patient and by making attributions with fewer causal elements.
From Freud to cognitive science: a contemporary account of the unconscious.
We present an account of two influential approaches to the unconscious; those of Freud and of cognitive science. It is argued that although Freud's ideas require updating in some respects, in other ways many of them have stood the test of time. We describe the similarities and differences between the two approaches and the attention each pays to innate cognitive and emotional competencies. Finally, we provide a contemporary cognitive account of the unconscious that attempts to combine the best both approaches within an information-processing framework.
Causal attributions and psychiatric symptoms in survivors of the Herald of Free Enterprise disaster.
The aim of the present study was to explore the relationship between causal attributions and psychiatric symptoms in those who survived the capsizing of the Herald of Free Enterprise ferry, two years following the disaster. Internal and controllable attributions for disaster-related experience are strongly related to poorer psychological outcome.
Explanations by professional care staff, optimism and helping behaviour: an application of attribution theory.
It is demonstrated first that staff explanations of problem behaviour can be reliably coded using a modified form of the Attributional Style Questionnaire; and second, that staff explanations are related through staff optimism to anticipated helping behaviour. This supports the hypothesis that, in professional staff, an important determinant of helping is optimism arising from attributions of a patient's problems. The influence of affective judgements, as emphasized in Weiner's (1986) theory of helping behaviour, is not supported.
The assessment of psychiatric disability in the community. A comparison of clinical, staff, and family interviews.
Assessments of some of the symptoms and behaviour problems of long-term psychiatric patients living in the community were obtained independently from clinical interviews with such patients, and from interviews with day staff, residential staff and families caring for them. In general, interviews with residential staff and family members revealed much higher levels of symptoms and behaviour problems than either of the other two interviews. These findings have implications for research and clinical practice including the fact that adequate assessments should include the testimony of family or residential staff.
Patient preferences and randomised clinical trials.
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Needs for care among the relatives of long-term users of day care. A report from the Camberwell High Contact Survey.
We report the results of a survey of the burdens and needs for items of care of 45 supporters of long-term users of psychiatric day care facilities in Camberwell. The supporters reported high levels of disturbed behaviour and low levels of self-care skills in the attenders. They were also subject to high levels of social and economic burden, not all of which could be attributed to the attenders' problems. The needs assessment identified a large number of unmet needs, although the supporters themselves were largely resigned to their situation and expressed little dissatisfaction with the services they were offered. The advantage of conducting this kind of assessment of supporters' needs as a routine part of clinical practice was discussed.
Cognitive change processes in psychotherapy.
Several types of cognitive-behavioral therapy are now practiced that use different sets of theoretical concepts and propose different kinds of change mechanisms. None, however, is directly grounded in experimental research in cognitive and social psychology, and few address basic issues such as the relevance of conscious versus nonconscious cognitive processes and the validity of the self-report data on which therapy depends. Put forward in this article is a model that describes the conscious and nonconscious processing of emotional stimuli and distinguishes between knowledge that is verbally accessible and knowledge that can only be recovered by exposure to situational cues. Also proposed are three mechanisms of cognitive change that involve altering verbally accessible knowledge, the accessibility of nonconscious situational memories, and self-regulatory strategies. These mechanisms are related to the current practices of behavioral and cognitive-behavioral therapists.
The problems of people in long-term psychiatric day care. An introduction to the Camberwell High Contact Survey.
The aims of the Camberwell High Contract Survey (CHCS) were to develop and test a systematic needs assessment procedure and use it to evaluate the services provided to long-term users of day centres and sheltered residential accommodation (excluding hospital wards). This paper describes the background to the study, the sample of 145 attenders and their characteristics, their clinical and social problems and the care provided for them.
Needs for care among the long-term mentally ill: a report from the Camberwell High Contact Survey.
We report the results of a survey of the needs for items of care of 145 long-term users of psychiatric day-hospitals and day-centres in Camberwell. The overall ratio of met to unmet need was almost exactly 5:1. Need was shown to vary according to chronicity, degree of participation, and placement in day-hospital or day-centre. Specific areas of functioning and specific types of care were identified in which there was significant overprovision or underprovision. The utility of our measures, and their ability to identify clinically significant unmet need, are discussed.
Social comparison and depression.
It has been suggested that a central factor in depression is the experience of feeling different from others. This study set out to examine the relationship between pre-attributional consensus judgments, perceived trait discrepancy from others, and depression. As predicted, low consensus judgments concerning hypothetical events and negative self-evaluations relative to others were associated with depression. These results are discussed in terms of related work on attribution theory and social comparison processes.