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PubMed1998

Depressive thinking and dysfunctional schematic mental models.

OBJECTIVES: To examine the replicability and generalizability of findings suggesting that mood-dependent negative thinking in depression reflects changes in the schematic mental models through which the world is interpreted, rather than a generalized increase in accessibility of negative constructs. DESIGN: Depressed and non-depressed samples were compared on a sentence completion task concerning anticipated outcomes of social approval or success. This task was designed so that the schematic mental models view predicted more positive completions from depressed participants, the construct accessibility view predicting the opposite. METHODS: A total of 98 depressed participants (scoring > 15 on the Center for Epidemiologic Studies Depression Scale; CESD) from a depressive self-help organization, and 50 non-depressed controls (CESD < 16) completed the CESD, Sentence Completion Task and the Dysfunctional Attitude Scale (DAS). RESULTS: Depressed participants made more positive completions in the Sentence Completion Task, and scored higher on the DAS than controls. Subanalyses suggested that the depressed group's increased positive completions were accounted for largely by those currently in psychiatric treatment; these participants also showed greater evidence of dysfunctional schematic models on DAS. CONCLUSIONS: For depressed participants in psychiatric treatment, results replicate previous findings, supporting the view that negative depressive thinking reflects a change in schematic mental models through which the world is interpreted. Results are inconsistent with predictions from the construct accessibility view. The results have methodological implications for the use of the sentence completion task in future studies.

Adult↗

PubMed1989

Anxiety, supervision and a space for thinking: some narcissistic perils for clinical psychologists in learning psychotherapy.

The process of learning psychotherapy involves narcissistic dangers--there may be injuries to self-esteem and self-image, especially when working with certain kinds of disturbed and hostile patients. Some patients will unconsciously recreate, in the transference, representations of early damaging experiences with parents, but now reversed with the therapist as the victim. It is vital for the trainee to be helped to understand these powerful interactional pressures. There are aspects of the professional culture and ideals of clinical psychologists (and possibly of some psychiatrists and social workers as well) which may make them particularly vulnerable in work with the hostile patient. It is argued that the function of supervision is not to teach a technique directly, but to create a 'space for thinking'--a kind of thinking which is more akin to maternal reverie, as described by Bion, than problem solving.

Anxiety↗

PubMed1992

Psychological theories of delusional thinking: in search of integration.

Psychological theories approach the problem of delusional thinking in psychosis from a range of perspectives. Recent attention has focused on the attributional style of sufferers; research points towards the relevance of cognitive deficits; the potential value of cognitive therapy in reducing delusional thinking is being explored; and psychodynamic theories argue for the role of defence mechanisms. Aspects of these approaches are reviewed and ideas for integration discussed within the vulnerability-stress model of psychosis. Implications for therapy are noted.

Cognition Disorders↗

PubMed2002

The effects of catastrophic thinking about pain on attentional interference by pain: no mediation of negative affectivity in healthy volunteers and in patients with low back pain.

BACKGROUND: Previous studies have shown that catastrophic thinking about pain enhances attentional interference in healthy volunteers. OBJECTIVE: To investigate whether the attentional effects of pain catastrophizing can be accounted for by the more general predisposition of negative affectivity. METHODS: Sixty-seven pain-free students participated in the first experiment, and 33 patients with chronic low back pain participated in the second experiment. In both experiments, participants performed an auditory reaction time task while being exposed to a series of threatening electrocutaneous stimuli. Retardation in reaction times to auditory probes during pain was taken as an index of the attentional interruption by pain. Participants also completed self-report instruments of negative affectivity and pain catastrophizing. RESULTS: In both experiments, pain catastrophizing enhanced attentional interference by pain. This effect was most pronounced immediately after the onset of the electrocutaneous stimulus. The effect remained after controlling for the effects of negative affectivity. CONCLUSIONS: Catastrophic thinking about pain enhances attentional interruption by pain in normal samples, as well as in clinical samples of patients with chronic back pain. This effect is specific to pain catastrophizing and cannot be explained by the more general disposition of negative affectivity.

Adult↗

PubMed1987

The nature of overinclusive thinking in schizophrenia.

Schizophrenics were compared with neurotic controls on four tests of categorical thinking in an attempt to discover the nature of overinclusive thinking. The tests provided both verbal and nonverbal measures of conceptual loosening, the proportion of out-of-category items, distortion of the internal structure of a category and any tendency towards overcategorization. The results showed that schizophrenics were relatively worse on nonverbal than on verbal categories with, in particular, a greater degree of conceptual loosening and a tendency towards overcategorization. The most striking abnormality emerged during observation of the actual sorting strategy itself. Schizophrenics tackled the task in a way which suggests that they lack the ability to form a Gestalt of the task.

Adult↗

PubMed1996

Psychotherapy, revelation, science, and deep thinking.

Psychodynamic psychotherapy has evolved in the 30 years since John Nemiah was the author's mentor in the endeavor. It has always occupied an epistemologic position somewhere between the scientific standard of physics and the postmodern or poststructuralist view that the search for truth using language is totally futile. However, the awkward niche that psychotherapeutic practice occupies is closer to literary imagination than "hard science." The use of such imagination was presented 25 years ago by John Nemiah in his paper on "Deep Thinking." The poet's "revelation ... not discovered by the rational intellect alone" often imparts in psychotherapeutic practice a compelling urgency toward a previously unrealized choice. Such vision is, however, always located at the periphery of acceptable scientific theory. Psychotherapists persist, often with doubts, because their place is reflective of humanity's awkwardness. Evolution and civilization mutually enfold the human ability to resonate to the anguish of others as well. A species altruism directed toward repair of human problems is coupled with the skills of affectively linked "deep thinking." There is a continuing marginalization of such efforts, which now need to be cared for deeply.

Humans↗

PubMed1975

The lure of magic thinking.

The development of the thinking processes from childhood to maturity is analyzed and three stages are distinguished: the magic omnipotent stage of the preschool child, the development of the realistic ego, and the future-directed value-building superego. The role of the lure to return to the magic thinking in our culture is described.

Age Factors↗

PubMedDate not supplied

Fostering critical thinking skills in students with learning disabilities: an instructional program.

An instructional unit was developed to enhance the critical thinking skills of middle school and high school students with learning disabilities by teaching them the principles of scientific reasoning. Student-teacher dialogues were used to engage the students in an active process of critical inquiry. Students analyzed everyday information presented in brief magazine articles and advertisements by applying the principles of the scientific method. The students made statistically significant improvements in their ability to (a) identify the principal claim made in an article or advertisement, (b) graph the relevant data, and (c) evaluate the claims made in the article and explain their support or rejection of the claims based on data. After the instructional unit, the overall performance of the special education students exceeded that of a control group composed of regular education students who had not received instruction in critical thinking.

Adolescent↗

PubMed1988

The 'think test': a further technique to elicit hyperventilation.

Hyperventilation can undermine cardiovascular homeostasis by generating autonomic imbalance, sympathetic dominance, hypokalaemia, and intracellular alkalosis with calcium ion shifts. The role of hyperventilation in episodic disorders such as arrhythmia and coronary vasospasm can be difficult to identify if the patient does not present in an attack and so a provocation challenge is required. Today, the standard challenge is the forced hyperventilation provocation test (FHPT). A capnograph enables the resting end-tidal PCO2 to be compared with the level 3 min after the period of overbreathing. We report the use of a patient-specific challenge. After the FHPT, the subject is invited to close his eyes and think about the circumstances of an attack, feelings and sensations experienced (breathing is not mentioned) or topics that were seen to disturb the rhythm of breathing when the medical history was taken. A fall of end-tidal PCO2 of 10 mmHg or more lasting at least one minute was taken as a positive response. Out of 57 patients with cardiovascular symptoms suggesting a hypocapnic influence, resting hypocapnia (end-tidal PCO2 = 30 mmHg) was present in 3 (5%). Of the remaining 54, the FHPT was positive in 16 (30%) and the 'think test' in 33 (61%). This suggests that patient-specific stimulation has advantages over an unspecific challenge in testing for episodic hypocapnia.

Adult↗

PubMedDate not supplied

In search of tools to aid logical thinking and communicating about medical decision making.

To have real-time impact on medical decision making, decision analysts need a wide variety of tools to aid logical thinking and communication. Decision models provide a formal framework to integrate evidence and values, but they are commonly perceived as complex and difficult to understand by those unfamiliar with the methods, especially in the context of clinical decision making. The theory of constraints, introduced by Eliyahu Goldratt in the business world, provides a set of tools for logical thinking and communication that could potentially be useful in medical decision making. The author used the concept of a conflict resolution diagram to analyze the decision to perform carotid endarterectomy prior to coronary artery bypass grafting in a patient with both symptomatic coronary and asymptomatic carotid artery disease. The method enabled clinicians to visualize and analyze the issues, identify and discuss the underlying assumptions, search for the best available evidence, and use the evidence to make a well-founded decision. The method also facilitated communication among those involved in the care of the patient. Techniques from fields other than decision analysis can potentially expand the repertoire of tools available to support medical decision making and to facilitate communication in decision consults.

Carotid Stenosis↗

PubMed1998

Evaluating critical thinking skills in a scenario-based community health course.

This study evaluated the influence of a scenario-based community health course on the ability of senior nursing students (N = 54) to address complex problems seen in the community health setting. In addition, we examined whether students' scores on the Watson-Glaser Critical Thinking Appraisal (WGCTA) questionnaire would differ depending on the size of the educational institution they attended before enrollment in a school of nursing and whether the types of electives (liberal arts or science) previously taken would influence the scores. Sign ficant improvements were seen on the Interpretation and Evaluation subscales and on the total critical thinking score from pretest to posttest for students who completed the course. Also students who completed nursing prerequisites in midsized, 4-year universities (10,000 to 30,000 students) had higher pretest mean scores on the majority of WGCTA subscales than did other students.

Adult↗

PubMed1988

Primary process thinking and anxiety in children.

The relationship between primary process thinking and two measures of anxiety was investigated in fourth- and fifth-grade children. Holt's Scoring System for Primary Process Responses on the Rorschach was the measure of primary process thinking. The major hypotheses were supported for boys in that frequency of expression of primary process material was positively related to behavioral manifestations of anxiety as measured by the Teacher's Rating Scale. Also, controlled access to and integration of primary process was negatively related to teacher's ratings of anxiety. There were no significant results for girls. Primary process measures were not related to the State-Trait Anxiety Inventory for Children. Possible reasons for the different relationships between the primary process measures and the anxiety measures are discussed.

Anxiety↗

PubMed2005

Construct validity of the psychological inventory of criminal thinking styles in relationship to the PAI, disciplinary adjustment, and program completion.

We evaluated the convergent and discriminant validity of the Psychological Inventory of Criminal Thinking Styles (PICTS; Walters, 1995) in a group of 199 maximum security prisoners. As anticipated, the PICTS Confusion scale correlated with the Personality Assessment Inventory (PAI; Morey, 1991) Negative Impression scale, whereas the PICTS Defensiveness scale paralleled the PAI Positive Impression scale. Also as predicted, a greater portion of the PICTS thinking style scales correlated with the PAI Antisocial Features scale than correlated with the PAI Somatic Complaints, Anxiety, Depression, Mania, Paranoia, and Schizophrenia scales. When the PICTS composite scales were converged onto behavioral indexes, modest statistically significant relationships surfaced between the PICTS Reactive scale and a record of disciplinary infractions and between the PICTS Proactive scale and program completion.

Adult↗

PubMedDate not supplied

Critical thinking and analysis: a model for written assignments.

The purpose of this article is to propose a model for critical analysis which can be incorporated into nurse education to enhance nurses' understanding of the concepts and to assist students in undertaking academic assignments. It provides a definition and conceptualization of critical thinking and critical analysis, and highlights the differences, similarities and interrelationships between them. The model suggests that there are 10 components of critical analysis. This provides the first step for developing further research on the content of the model, i.e. certain components are accepted and those which are unsuitable are rejected. The model assists the development of educational strategies to promote critical analysis skills, which are an essential element of the autonomous, critical thinking nurse practitioner.

Education, Nursing↗

PubMedDate not supplied

Critical thinking at the bedside: a practical perspective.

This article provides a comprehensive review of critical thinking from both a theoretical and, more importantly, a practical perspective. The theoretical detail with regard to critical thinking is extensive. The many models developed from the literature are often too complex and difficult to interpret in relation to clinical practice situations. If theory cannot be integrated into practice then its value to nursing should be questioned. The task now is to formalize and cement the connections between the two concepts at the bedside.

Attitude of Health Personnel↗

PubMed2001

Future-directed thinking in eating disorders.

OBJECTIVES: The aim of the study was to examine future-directed thinking in individuals with eating disorders, given the possible role of such cognitions in the maintenance of anorexia nervosa and bulimia nervosa. METHOD: Twenty-six anorexics, 18 bulimics and 34 female controls were interviewed using the 'Future Thinking Task', assessing quantitative and qualitative aspects of positive and negative anticipated events. RESULTS: Patients with anorexia nervosa had similar levels of positive future-oriented cognitions and significantly more negative future-oriented cognitions than controls. The most common positive themes in this group concerned the social/interpersonal and leisure/pleasure domains. The negative theme most commonly mentioned by anorexics was that of their own health, followed by the social/interpersonal domain, whereas controls were most preoccupied with achievement/failure and a broad range of other issues. Bulimics had significantly fewer positive future-oriented cognitions and significantly more negative future-oriented cognitions than controls, most commonly concerning the patient's own health. CONCLUSION: In anorexia nervosa, anticipated positive future outcomes may to some extent help to maintain the disorder; however, these patients are also highly preoccupied with the possibility of negative future outcomes, i.e. a failure of recovery. Bulimia nervosa sufferers are relatively hopeless about their future. The clinical implications of these findings are discussed.

Adult↗

PubMed2001

Collaborating with the unconscious other. The analysand's capacity for creative thinking.

The analysand's capacity for making use of psychoanalytic treatment has been a subject of importance since the beginning of psychoanalysis. The author addresses an aspect of the difficulty encountered by analysands in achieving a psychic state that allows the creative use of free association, dreams, parapraxes and other spontaneous phenomena occurring during the course of treatment. He suggests that a very specific state of mind is essential to both the psychoanalytic process and the creative process. Using theoretical concepts derived from Freud, Klein and Bion, he develops the idea of an internal object relationship, 'the collaboration with the unconscious other', which forms the basis for both creative thinking and the psychoanalytic function of the personality. Creative thinking is distinguished from artistic endeavour and discussed as a universal potential, on which growth in psychoanalysis depends. The term 'unconscious other' is meant to signify the subjective experience of a foreign presence within oneself from which both spontaneous creative inspiration and involuntary psychic phenomena are felt to emanate. The author presents clinical material to suggest that paranoid-schizoid and depressive anxieties form obstacles to collaborating with the unconscious other, and must be worked through in order to achieve an analytic process.

Creativity↗

PubMed1985

Thinking as a narcissistic resistance.

Verbal thought occupies a preeminent place in psychoanalytic theory and practice. The patient keeps out of conscious awareness, ultimately, what is unrepresentable, therefore unthinkable. The analyst helps the patient find ways to think about the unthinkable, both to reconstruct the past and free himself from it. The patient's role in this process involves a challenge comparable to the analyst's, in balancing and shifting between free association and objectifying thought. His capacity to progressively adapt his thinking and language to meet these therapeutic needs is a sensitive indicator that the narcissistic disturbance is healing. Conversely, incapacity to do so results in therapeutic stalemate or incomplete treatment.

Adult↗