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Biomedical subjects

R Shafran

Publications and source records attributed to R Shafran.

At least 19 recordsLinked to original sources
PubMed2004

Thought-action fusion: a review.

The cognitive bias of "Thought Action Fusion" (TAF) has received significant research attention in the past decade. The review addresses the assessment of TAF, its place in cognitive theories of obsessional difficulties, and the evidence demonstrating that TAF is relevant to disorders beyond Obsessive Compulsive Disorder (OCD). Data on the components of TAF, its extension to positive outcomes and its role in the aetiology, maintenance and treatment of OCD are reviewed. It is concluded that the moral form of TAF is less robust than the likelihood form and that scales may be best used as a starting point in identifying beliefs and conducting experimental investigations. It is also suggested that the scales be amended to include harm avoidance, which would also increase their clinical utility.

Cognition↗
PubMed2003

The interpretation of symptoms of severe dietary restraint.

A recent cognitive-behavioural theory of eating disorders proposes that people with eating disorders interpret symptoms of dietary restraint in terms of control. The primary aim of the present study was to test this hypothesis. A second aim was to test the hypothesis derived from clinical observation that people with eating disorders view these symptoms positively. Forty-four participants meeting DSM-IV criteria for a clinical eating disorder and 80 control participants with no history of an eating disorder completed an ambiguous scenario paradigm and self-report measures of eating disorder features and depression. Patients with eating disorders were significantly more likely to interpret symptoms of dietary control in terms of control, providing support for the cognitive-behavioural theory. There was only partial support for the second hypothesis. The implications for the new cognitive-behavioural theory and therapy are discussed.

Adult↗
PubMed2001

Perfectionism and psychopathology: a review of research and treatment.

Clinical experience suggests that perfectionism can impede the successful treatment of psychological disorders. This review examines the concept of perfectionism, critically evaluates its assessment, reviews the association between existing measures of perfectionism and psychopathology, and considers the impact of perfectionism on treatment. It is concluded that existing measures do not reflect the original construct of perfectionism and that, consequently, new measures are needed. The evidence reviewed indicates that high personal standards are specifically elevated in patients with eating disorders and beliefs about others' high standards for the self are associated with a broad range of psychopathology. The importance of examining mean scares across studies (as well as associations between variables within studies) is emphasized. There has been no systematic evaluation of the treatment of perfectionism despite existing cognitive-behavioral treatment protocols.

Anxiety Disorders↗
PubMed2000

Post-event processing in social anxiety.

A psychometric study was conducted in order to collect basic information about post-event processing in social anxiety. It was found that such processing occurs commonly after an anxiety-evoking or embarrassing social event and post-event processing scores were significantly correlated (r = 0.40) with social anxiety. The recollections of the social event tended to be recurrent and intrusive, interfering with concentration. Post-event processing was associated with the avoidance of similar social situations. The results are discussed in terms of the Clark and Wells model of social phobia.

Adult↗
PubMed1999

A cognitive behavioural theory of anorexia nervosa.

A cognitive behavioural theory of the maintenance of anorexia nervosa is proposed. It is argued that an extreme need to control eating is the central feature of the disorder, and that in Western societies a tendency to judge self-worth in terms of shape and weight is superimposed on this need for self-control. The theory represents a synthesis and extension of existing accounts. It is 'new', not so much because of its content, but because of its exclusive focus on maintenance, its organisational structure and its level of specification. It is suggested that the theory has important implications for treatment.

Adolescent↗
PubMed1999

Multiple pathways to inflated responsibility beliefs in obsessional problems: possible origins and implications for therapy and research.

The purpose of this paper is to consider the possible origins of an inflated sense of responsibility which occupies an important place in the cognitive theory of obsessive compulsive disorder (Rachman, S. (1993). Obsessions, responsibility, and guilt. Behaviour Research and Therapy, 31, 149-154. Salkovskis, P. M. (1985). Obsessional-compulsive Problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23 (5), 571-583). Clinical experience and consideration of current cognitive conceptualisations of obsessions and obsessive compulsive disorder suggest a number of possibilities, each of which is described after a brief introduction to the concept itself. While there are reasons to believe that some general patterns can be identified, the origins of obsessional problems are best understood in terms of complex interactions specific to each individual.

Cognitive Behavioral Therapy↗
PubMed1999

A cognitive distortion associated with eating disorders: thought-shape fusion.

OBJECTIVES: The primary objective of this study was to describe and investigate a cognitive distortion associated with eating psychopathology. This distortion, termed 'thought-shape fusion', is said to occur when merely thinking about eating a forbidden food increases the person's estimate of their shape or weight, elicits a perception of moral wrongdoing and makes the person feel fat. DESIGN: Two studies were conducted. The first was a psychometric study and the second utilized a within-participants experimental design. METHODS: In Study 1, thought-shape fusion was assessed in a sample of 119 undergraduate students using a questionnaire. In Study 2, 30 students with high thought-shape fusion scores participated in an experiment designed to elicit the distortion. RESULTS: Thought-shape fusion was found to be significantly associated with measures of eating disorder psychopathology. The questionnaire used to measure thought-shape fusion had high internal consistency, a good factor structure accounting for 46.2% of the variance and predictive validity. The results from Study 2 indicated that the distortion can be elicited under experimental conditions, produces negative emotional reactions and prompts the urge to engage in corrective behaviour (e.g. neutralizing/checking). This corrective behaviour promptly reduces the negative reactions. CONCLUSION: The results of the two studies indicate that the concept of thought-shape fusion is coherent, unifactorial and measurable. It is associated with eating disturbance and elicits negative emotional and behavioural responses.

Adult↗
PubMed1998

Treating adolescent obsessive-compulsive disorder: applications of the cognitive theory.

The recent cognitive theory of obsessions suggests that catastrophic misinterpretations of the significance of one's unwanted intrusive thoughts gives rise to, and maintains, obsessions (Rachman, Behaviour Research and Therapy, 1997). It follows from this that provision of benign interpretations of the significance of intrusions is likely to challenge and weaken the catastrophic appraisals. This article describes the application of this theory to two adolescents with obsessive-compulsive disorder (OCD). The adolescents were provided with an alternative, benign interpretation of the significance of intrusive thoughts and images using a thought suppression paradigm. It is concluded that a personal demonstration using the thought suppression paradigm is a helpful clinical tool for the cognitive treatment of obsessions in adolescent OCD.

Adolescent↗
PubMed1998

Claustrophobia and the magnetic resonance imaging procedure.

We examined fear induced by the magnetic resonance imaging (MRI) procedure in 80 adult patients who were undergoing the procedure for the first time. Participants completed self-report measures of claustrophobia, anxiety sensitivity, thoughts about the scan, and pain. Participants were assessed pre- and postscan, and at 1-month follow-up. Twenty-five percent of the participants experienced moderate to severe anxiety during the MRI scan. Prescan scores on the Claustrophobia Questionnaire (CLQ: Rachman and Taylor, 1993) significantly predicted participants' distress during the scan: pain and anxeity sensitivity did not. Furthermore, CLQ scores discriminated between participants who reported panic during the scan and participants who did not report panic. A brief screening instrument consisting of six items from the 29-item CLQ is suggested. This brief screening instrument administered prior to the scan may help identify in advance those people who are most likely to experience claustrophobic fear and, in particular, those who panic during the MRI procedure.

Adult↗
PubMed1997

Enterotoxigenic Escherichia coli (ETEC) in hospitalised Arab infants from Judea area--west bank, Israel.

Enterotoxigenic Escherichia coli and other related enterotoxigenic species were isolated from 176 (44%) of 399 infants hospitalised in 'Caritas Baby Hospital' in Bethlehem, during April-December 1993. Ninety four of the patients infected by ETEC, were clinically evaluated. Most of them suffered from diarrhoea, quite often with fever and vomiting. Dehydration occurred in 58.3% of the patients and failure to thrive (FTT) in 28.5% of them. Severe illness resulted in marasmus in five patients and in the death of two others. Most of the ETEC strains (84%) were of ST toxin type. Correlation was found between the degree of toxigenity and the severity of the gastroenteritis. The most prevalent ETEC "O' serogroups were 0-6, 0-20, 0-8, 0-86, 0-126, 0-128 and 0167. Colonization Factors Antigens (CFAs) were identified in 36% of the isolates, CFAI was characteristic of group 0-126 and 0-128. In the principal O-groups there were high percentages of sensitivity to the antibiotics ceftriaxone, nalidixic-acid, gentamicin and norfloxacin, with resistance to anoxycillin, tetracycline and cotrimoxazole.

Anti-Bacterial Agents↗
PubMed1997

The manipulation of responsibility in obsessive-compulsive disorder.

It has been suggested that appraisal of intrusive thoughts in terms of responsibility for harm lies at the core of obsessional complaints. Clinical observation, psychometric data and the effects of manipulating responsibility for threat in compulsive checkers and normal samples have supported this formulation. The purpose of the present study was to manipulate responsibility in 36 obsessional participants with varied phenomenology. Responsibility was manipulated indirectly by varying the presence/absence of the experimenter during a behavioural task. The manipulation was successful in influencing reports of perceived responsibility for threat. In the high responsibility condition; estimates of the urge to neutralize, discomfort and probability of threat were all significantly higher than in the low responsibility condition; estimates of responsibility for thoughts and the control over the threat did not change significantly between the conditions. There was no significant interaction between the responsibility manipulation and the type of compulsion. The results are interpreted as providing support for a cognitive-behavioural formulation which emphasizes the role of responsibility appraisal in obsessive-compulsive disorder.

Adult↗
PubMed1996

Investigation into the relationship between personality traits and OCD: a replication employing a clinical population.

The relationship between obsessional personality traits and Obsessive Compulsive Disorder (OCD) has long been the subject of debate. Although clinicians have asserted for nearly a hundred years that such a relationship exists, empirical investigations have failed to provide consistent support; however, none of these empirical investigations have undertaken analyses that control for the effect of mood variables. Employing a non-clinical sample, Rosen and Tallis (1995) [Behaviour, Research and Therapy, 4, 445-450] found that when mood variables are taken into account, a unique relationship between obsessional traits and obsessional symptoms emerges. A replication was undertaken on a large group of individuals with OCD. After the effects of depression and anxiety were removed from a correlational analysis, obsessional symptoms were found to be significantly associated with obsessional and passive aggressive traits. Obsessive Compulsive Disorder was not associated with any other grouping of traits as specified in the DSM-III-R (Axis II) classification system.

Adolescent↗
PubMed1995

Perceived responsibility: structure and significance.

Given the postulated significance of inflated responsibility in obsessive compulsive disorder (OCD), there is a need for clarification of the concept itself and a means for measuring such responsibility. Two psychometric studies were conducted in order to develop a reliable self-report scale. In the first study 291 students completed the specially constructed Responsibility Appraisal Questionnaire (RAQ). Four factors emerged: responsibility for harm, responsibility in social contexts, a positive outlook towards responsibility, and thought-action fusion (TAF). In the second study, 234 students completed a revised RAQ. Four comparable factors emerged, and the TAF subscale correlated significantly with measures of obsessionality, guilt, and depression. The correlations between TAF and obsessionality and guilt remained significant even after BDI scores were controlled. It is concluded that the broad concept of inflated responsibility needs to be qualified; the connection between inflated responsibility and OCD appears to be situation-specific and idiosyncratic. There is more inflated responsibility than there is OCD. The measured concept of inflated responsibility is multifactorial (harm, social, positive, and TAF), not unitary. The TAF factor appears to be particularly significant in OCD.

Adult↗
PubMed1995

Consistency of behavior: expect the unexpected.

Clinicians and lay people mistakenly expect behavior to be consistent across time and situations. However, the presence of a psychological disorder can cause large and seemingly inexplicable fluctuations in patient behavior. These fluctuations intrinsically are aversive, and increase the burden on family members. This article outlines the clinical implications of inconsistency in patient behavior. A practical set of guidelines for the mental health worked is issued.

Cost of Illness↗
PubMed1995

Epidemiological aspects of enterotoxigenic Escherichia coli diarrhoea in infants in the Jerusalem area.

BACKGROUND: As most of the clinical laboratories in Israel do not use toxigenicity testing as a routine procedure in cases of Escherichia coli gastroenteritis, current information regarding clinical and epidemiological aspects of infection by enterotoxigenic E. coli (ETEC) is lacking. This survey aimed at retrieving that information by conducting routine enterotoxigenicity tests in a clinical laboratory for patients suspected of E. coli gastroenteritis. METHODS: The survey population included 415 children < or = 2.5 years old with gastroenteritis, during the second half of 1992. Fresh first stool cultures were checked daily for toxigenicity by ELISA. Thereafter the serotypes, and the colonization factor antigens (CFAs) were evaluated for the ETEC strains. RESULTS: in 86 of the 415 children (20.7%) we found ETEC. Half these strains would have not been reported as pathogenic without this routine toxigenicity test. CFA were defined in 48 (55.8%) of the ETEC strains. The most common serogroups were O-153, O-6, O-126, and O-128.

Agglutination Tests↗
PubMed1995

Obsessive-compulsive symptoms and the family.

A questionnaire study of 98 family members of individuals with obsessive-compulsive symptoms revealed that 60% of the family members were involved to some extent in rituals with the affected family member. Nearly all family members reported at least some degree of interference in their lives. Information was also gathered about the sort of rituals in which members were involved, how they responded to the demands of the affected relative to engage in the rituals, their beliefs and knowledge about compliance, and the degree to which the rituals interfered in their lives. The study highlights the possible need for support, advice, and education for family members of persons with obsessive-compulsive symptoms.

Adolescent↗
PubMed1993

The reduction of claustrophobia--II: Cognitive analyses.

A clinical experiment comparing methods of fear reduction in claustrophobia was used as the basis for analysing the relationships between a number of cognitive variables and the reduction of claustrophobia. Both the number and believability of negative cognitions present were associated with fear reduction and return of fear; this was also found when considering the number of body sensations experienced. High fear and panic were always accompanied by these phenomena whilst zero fear was never reported in the presence of believable cognitions and body sensations. An absence of believable cognitions post-test was accompanied by an absence of claustrophobia in 10/13 subjects. Specifically, removal of belief in any of the cognitions "I will be trapped", "I will suffocate" and/or "I will lose control" was associated with removal of belief in all the other cognitions and a dramatic reduction in claustrophobia. Belief in one of these central cognitions was associated with the maintenance of fear. We conclude that it is possible to conceptualize claustrophobia as comprising a number of cognitions centred on key thoughts of trappedness, suffocation and loss of control.

Adaptation, Psychological↗