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PubMed2002

A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims.

The purpose of this study was to compare cognitive-processing therapy (CPT) with prolonged exposure and a minimal attention condition (MA) for the treatment of posttraumatic stress disorder (PTSD) and depression. One hundred seventy-one female rape victims were randomized into 1 of the 3 conditions, and 121 completed treatment. Participants were assessed with the Clinician-Administered PTSD Scale, the PTSD Symptom Scale, the Structured Clinical Interview for DSM-IV, the Beck Depression Inventory, and the Trauma-Related Guilt Inventory. Independent assessments were made at pretreatment, posttreatment, and 3 and 9 months posttreatment. Analyses indicated that both treatments were highly efficacious and superior to MA. The 2 therapies had similar results except that CPT produced better scores on 2 of 4 guilt subscales.

Adult↗

PubMed1996

Cognitive bias in procedural justice: formation and implications of illusory correlations in perceived intergroup fairness.

Illusory correlations in procedural justice were investigated in 2 experiments. After receiving information describing the fair and unfair treatment of 2 groups' members by police, participants judged the fairness of each group's treatment. Illusory correlations formed in both experiments, resulting in erroneous associations between the smaller group and the infrequent type of treatment. In Experiment 2, participants made harsher guilt judgements of members of the group perceived as receiving relatively favorable treatment. Mediational evidence suggests that differences in guilt judgments reflected attempts to compensate for perceived injustice, creating real differences in group treatment. The benefit of incorporating cognitive biases in models of procedural justice is discussed.

Adult↗

PubMed2001

Chronic and temporarily activated causal uncertainty beliefs and stereotype usage.

In 3 studies, we examined the hypothesis that the effects of stereotype usage on target judgments are moderated by causal uncertainty beliefs and related accuracy goal structures. In Study 1, we focused on the role of chronically accessible causal uncertainty beliefs as predictors of a target's level of guilt for an alleged academic misconduct offense. In Study 2, we examined the role of chronic causal uncertainty reduction goals and a manipulated accuracy goal; in Study 3, we investigated the role of primed causal uncertainty beliefs on guilt judgments. In all 3 studies, we found that activation of causal uncertainty beliefs and accuracy concerns was related to a reduced usage of stereotypes. Moreover, this reduction was not associated with participants' levels of perceived control, depression, state affect, need for cognition, or personal need for structure. Results are discussed in terms of their implications for the model of causal uncertainty and, more generally, in terms of the motivational processes underlying stereotype usage.

Adult↗

PubMed2002

Putting the brakes on prejudice: on the development and operation of cues for control.

A model concerning the establishment and operation of cues for control was developed and tested to understand how control can be exerted over (automatic) prejudiced responses. Cues for control are stimuli that are associated with prejudiced responses and the aversive consequences of those responses (e.g., guilt). In Experiments 1 and 2, 3 events critical to the establishment of cues occurred: behavioral inhibition, the experience of guilt, and retrospective reflection. In Experiment 3, the presentation of already-established cues for control did, as expected, produce behavioral inhibition. In Experiment 4, participants were provided with an experience in which cues could be established. Later presentation of those cues in a different task resulted in behavioral inhibition and less racially biased responses.

Adult↗

PubMed2004

Cognitive trauma therapy for battered women with PTSD (CTT-BW).

This article describes a second treatment-outcome study of cognitive trauma therapy for battered women with posttraumatic stress disorder (PTSD; CTT-BW). CTT-BW includes trauma history exploration: PTSD education; stress management; exposure to abuse and abuser reminders; self-monitoring of negative self-talk; cognitive therapy for guilt; and modules on self-advocacy, assertiveness, and how to identify perpetrators. One hundred twenty-five ethnically diverse women were randomly assigned to immediate or delayed CTT-BW. PTSD remitted in 87% of women who completed CTT-BW, with large reductions in depression and guilt and substantial increases in self-esteem. White and ethnic minority women benefited equally from CTT-BW. Similar treatment outcomes were obtained by male and female therapists and by therapists with different levels of education and training. Gains were maintained at 3- and 6-month follow-ups.

Adolescent↗

PubMed1981

Possible relationship between psycho-emotional factors and haemodynamic patterns in the pathogenesis of mild blood pressure elevation.

1. Psycho-emotional profiles were compared with invasive haemodynamic findings in a population sample of 37 young men (mean age 27 years) with mild blood pressure elevation and in 21 matched normotensive controls. 2. In comparison with normotensive controls, subjects with hyperkinetic blood pressure elevation had higher irritability levels, more guilt feelings and more psychic distressful symptoms. 3. In subjects with blood pressure elevation and normokinetic circulation structural vascular changes were found, and their psycho-emotional profiles showed high irritability levels but not significantly increased guilt or anxiety. 4. These results indicate a relationship between psychological factors and haemodynamic patterns in mild blood pressure elevation. A psychosomatic aetiology in hyperkinetic blood pressure elevation is suggested, and the psychological findings are compatible with a gradual development from hyperkinetic to normokinetic blood pressure elevation.

Adult↗

PubMed2003

The meaning of respite care to mothers of children with learning disabilities: two Irish case studies.

There is a growing interest in Ireland in the nature and significance of respite care for carers and those for whom they care. The relationship of individual stress with caring full time for a child who is learning disabled is well documented. Provision of respite care is seen as an important means of alleviating individual carer stress. Yet, the apparent benefits of respite care have been called into question. The present study looks at this issue within the context of respite service provision in Ireland for young people with learning disabilities. A phenomenological approach was used to explore the views of two mothers on respite care and, in particular, its personal significance for them within the context of their caring relationship for their children. The authors found that for these two mothers, whilst some of the predicted benefits of respite care were present, for example improved social activity, their use of respite care and the experience of separation initiated feelings of guilt and appeared to engender a degree of emotional stress. It is argued that providers of respite services in Ireland need to consider how they can support parents who use respite care so that they see its use as a mark of caring for their child and thereby alleviate such feelings of guilt.

Adaptation, Psychological↗

PubMed2000

[Negative delusional identity with schizophrenic psychoses. Case studies of phemonology and pathogenesis].

With schizophrenics negative delusional identities constitute one way of psychotic alteration of self-identification. The main notion is of being a personification of evil. In a cross-cultural comparison study we found in the Austrian sample 13 patients with negative delusional identities. Our present study is based on detailed interviews and evaluations of medical records of this sample. Our aim was to draft a typology of delusional identities as a basic requirement for a phenomenology of the negative manifestations. Further investigative goals were the efforts of self-explanation undertaken by the patients with regard to their altered condition, the search for a pathogenetic transitional series and the functional value of the new identities. According to our estimation the basic mood on which negative delusional identities are founded is timid and dejected. Further basic requirements are a disturbed conscience of the ego and the concurrence of grandeur and guilt ideas. Half of our patients imagined to be reincarnations of negative biblical figures, three regarded themselves as possessed, two attributed their identities to heredity. Despite of diverse situative points of departure a common pathogenetic transitional series emerged for all patients. From a functional point of view a negative delusional identity seems to offer some kind of protection from further structural disintegration as well as relief from feelings of guilt--all that however at the price of structural deformations with dynamic depletion.

Adult↗

PubMed2001

[Transcultural study of the altruistic anxiety - comparison between sociophobia and Tai-jin-kyôfu].

We feel guilty to whom we have injured. So the guiltiness has an aspect, namely, "to whom". In the transcultural psychiatry this aspect is often discussed, because it shows directly, which ethical value is supposed to be violated. In comparison with that less attention was paid to another aspect, namely, "through which" we fall into guilt. Therefore this aspect can still give a new viewpoint for problems of the guilt to the transcultural psychiatry. In order to focus this rather neglected aspect, the altruistic anxiety of the German sociophobic patient is compared with that of the Japanese "Tai-jin-kyôfu" patient. In this study we find a transcultural difference in a proportion of two basic ways of the human life, namely, voluntary doing and involuntary becoming.

Adult↗

PubMed2006

[Neurobiological determinism: questionable inferences on human freedom of choice and forensic criminal responsibility].

Several authors argue that criminal behavior is generally caused by neurobiological deficits. Based on this neurobiological perspective of assumed causality, the concept of free will is questioned, and the theory of neurobiological determinism of all human behavior is put forward, thus maintaining that human beings are not responsible for their actions, and consequently the principle of guilt should be given up in criminal law. In this context the controversial debate on determinism and indeterminism, which has been held for centuries, has flared up anew, especially within the science of criminal law. When critically examining the current state of research, it becomes apparent that the results do not support the existence of a universally valid neurobiological causality of criminal behavior, nor a theory of an absolute neurobiological determinism. Neither is complete determination of all phenomena in the universe--as maintained--the logical conclusion of the principle of causality, nor is it empirically confirmed. Analyzed methodically, it cannot be falsified, and thus, as a theory which cannot be empirically tested, it represents a dogma against which plausible objections can be made. The criticism of the concept of free will, and even more so of human accountability and criminal responsibility, is not put forward in a valid way. The principle of relative determinism--the evaluation of the degree of determinism of personality factors potentially reducing criminal responsibility, which includes concrete observations and analysis of behavior--thus remains a central and cogent approach to the assessment of criminal responsibility. To sum up, the theories proposed by some authors on the complete neurobiological determinism of human behavior, and the subsequent impossibility of individual responsibility and guilt, reveal both methodical misconception and a lack of empirical foundation.

Aggression↗

PubMed1986

[Regional prospective study of psychiatric sequelae of legal abortion].

117 (45%) of the 263 women of German nationality who underwent socially indicated abortions in the postal-code area 2300 (Kiel) in the first quarter of 1982 were investigated before the abortion as well as one year later. As far as age, marital status and number of children were concerned, these women did not differ significantly from the other 55%. One year later information was collected on the women's emotional adjustment by means of a questionnaire concerning feelings of guilt and loss, personal reports of adjustment process and the investigator's judgement. According to the findings, 79% of the women had adjusted without any problems, 14% were still in a state of emotional imbalance, 7% were clearly impaired emotionally and in their everydays functioning. 21% of the women, who had adjustment problems, had already been more depressive before the abortion. One year later, they were also more depressive than the other women, more dissatisfied with their lives in general and with their sex lives. They were in greater doubt as to whether they had made the right decision, showed less inclination to consider a further abortion and reported stronger post-abortive feelings of guilt. Significantly connected with later emotional difficulties were low social class, a difficult financial situation, lack of intrapsychic differentiation between sex and reproduction, no partner or negative relation with partner and partner disagreements, particularly in the case where the male partner was more in favour of abortion than the woman. Statistically insignificant, although tendencially noticeable were social isolation, non-employment and pre-pregnancy psychical problems. Age, marital status, number of children, simultaneous abortion/sterilisation, previous abortions, a broken home in the patient's youth had no effect on the emotional adjustment after the abortion. The common factor of all variables predicting post-abortive emotional problems seems to be an external motivation for abortion together with a greater ambivalence towards the pregnancy.

Abortion, Legal↗

PubMed1992

Inadvertent hypnosis during interrogation: false confession due to dissociative state; mis-identified multiple personality and the Satanic cult hypothesis.

Induction of a dissociative state followed by suggestion during interrogation caused a suspect to develop pseudo-memories of raping his daughters and of participation in a baby-murdering Satanic cult. The pseudo-memories coupled with influence from authority figures convinced him of his guilt for 6 months. During this time, the suspect, the witnesses, and all the evidence in the case were studied. No evidence supported an inference of guilt and substantial evidence supported the conclusion that no crime had been committed. An experiment demonstrated the suspect's extreme suggestibility. The conclusion reached was that the cult did not exist and the suspect's confessions were coerced-internalized false confessions. During the investigation, 2 psychologists diagnosed the suspect as suffering from a dissociative disorder similar to multiple personality. Both psychologists were predisposed to find Satanic cult activity. Each concluded that the disorder was due to "programming" by the non-existent Satanic cult.

Adult↗

PubMed2005

Context counts: long-term sequelae of premarital intercourse or abstinence.

An individual's first sexual experience is a highly salient and meaningful event, with potential to shape sexual scripts and the affect associated with sexual expression. Using data from the National Health and Social Life Survey, we tested abstinence-only advocates; assertions that premarital sex results in psychological and physical harm such as sexual dysfunction, sex guilt, poor health, sexually transmitted diseases, and poor life satisfaction. The first vaginal intercourse was premarital in 82.9% of the sample. Average age at first intercourse was 17.7 years. Relationship status as first intercourse was not consistently associated with later psychological or physical health outcomes. If the first experience was prepubertal, forced, with a blood relative or stranger, or the result of peer pressure, drugs, or alcohol, poorer psychological and physical health outcomes in adulthood were reported consistently. There is little evidence that premarital sex per se is disastrous for later sexual functioning or sex guilt; insofar as first sexual experiences are related to later functioning, the context of the experience is the crucial element.

Adult↗

PubMed1998

Nightmare after trauma as paradigm for all dreams: a new approach to the nature and functions of dreaming.

Nightmares, far from being unsuccessful dreams or exceptions to rules about dreams, can be considered paradigms for all dreaming. They allow us to follow exactly how a disturbance or perturbation is handled by the processing systems in our minds. The data considered here consists of dream series in the weeks and months immediately following trauma in adults--in other words, nightmares and dreams occurring as the trauma resolves. It appears the traumatized person may dream first about the actual trauma (though not always), then, very quickly, the dreams appear to deal with the dominant emotion. Dreams of being overwhelmed by a tidal wave or being swept up by a whirlwind are common after almost any trauma. Clearly, such dreams are not about the sensory input from the actual trauma. Rather, the dreams are about the dominant emotion. The dreams contextualize (find a picture context for) the emotional concern. After trauma, the dominant emotion is usually first terror and fear, then often followed by guilt (such as survivor guilt). This too is pictured in the dream series. The same pattern of contextualizing an emotional concern can be seen in stressful situations, in pregnancy, or in patients whose lives are dominated by one emotion. This pattern is paradigmatic for all dreams, but it may be difficult to detect in "ordinary" dreams, because there may be a number of other relatively smaller emotional concerns present, as opposed to the one clear-cut dominant one (as after trauma). A theory of dreaming is sketched out based on these data which suggests that overall dreaming makes connections more broadly than waking in the nets of the mind, and that the connections are not made randomly but guided by the dreamer's emotional concerns. It is also suggested that the making of connections may be functional for the organism in the sense of "weaving in," or integrating, new material.

Adolescent↗

PubMed1994

Shame and the superego. Clinical and theoretical considerations.

The conception of the superego as a set of compromise formations characterized by the calamity of parental disapproval and the striving of winning or regaining parental love and approval facilitates the awareness that shame and guilt are affects with similar fantasied contents. This paper explores the clinical value of this emphasis on similar fantasied contents of shame and guilt for analytic work with adults.

Adult↗

PubMedDate not supplied

A comparison of the Alcohol Use Disorder Identification Test (AUDIT) in general population surveys in nine European countries.

AIMS: This study explored the suitability of the Alcohol Use Disorder Identification Test (AUDIT) for cross-national comparable estimates of problem drinking in general populations. On the item level the focus is on responsiveness to cross-national and gender differences. For the set of items the focus is on intercorrelations between items, indicating to what extent the AUDIT constitutes a scale. METHODS: General population surveys from nine European countries were included. Cross-tabulations were used to analyse cross-national and gender differences in scores on the items. Reliability analysis was used to analyse intercorrelations between the items. RESULTS: The items 'blackouts' (men and women) and 'guilt and remorse' (women) are the most frequently reported consequences. Gender differences tended to be smaller for 'guilt and remorse' and 'concern of others', and largest for 'morning drinking'. The reliability analysis shows that in eight of the nine countries frequency of drinking lowers the alpha. Injury and concern of others lead to a lower internal consistency in three countries. CONCLUSIONS: There was sufficient variation between countries in the pattern of responses and variation in gender differences to conclude that the set of consequence items was responsive to national and gender differences in problem drinking. Frequency of drinking was not a good indicator of problem drinking. The country differences in item total correlations of consequences might be due to differences in how these items are interpreted. Decisions on which items to include in an instrument to allow comparison of estimates of problem drinking cross-nationally require studies on how these items are interpreted in general populations of different countries.

Adolescent↗

PubMed1992

The bereaved caregiver: a prospective study of changes in well-being.

This study analyzes short-term bereavement adaptation among caregivers to spouses or parents with a progressive dementia, assessing changes in depression, mastery, overload, and guilt to examine the impact of bereavement on caregivers, and the characteristics of caregiver experience that affect bereavement adaptation. The bereavement group, as compared with active caregivers, dropped substantially in overload and increased in mastery and guilt. Depression showed a curvilinear trend, declining from the time of death and then rising to preloss levels by the end of the year. Caregiver stressors, baseline adaptation, relationship difficulties, and psychological preparation were all related to changes in well-being.

Aged↗

PubMed2001

Profile of discrete emotions in affective disorders in older primary care patients.

PURPOSE: This research examined whether the frequencies of specific emotions are associated with major and minor depression in older primary care patients. DESIGN AND METHODS: Older primary care patients (N = 146), prescreened with a depression questionnaire, completed a diagnostic interview and an emotions questionnaire. RESULTS: Controlling for age, sex, and other psychiatric and medical illnesses, major depressives differed from nondepressed controls in nine emotions; minor depressives differed from controls in four emotions. Major depressives differed from the controls more in sadness, joy, and interest--but not anger, fear, or guilt--than in comparison sets of emotions. Minor depressives differed from the controls more in sadness and inner-directed hostility--but not guilt, anger, fear, joy, or interest--than in comparison sets of emotions. IMPLICATIONS: The frequencies of discrete emotions are differentially associated with major and minor depression; future research is needed to determine their specific diagnostic and treatment implications.

Age Factors↗