Developing practice in cancer rehabilitation.

This module explores the concept of rehabilitation and supportive care in a cancer context. It examines policy and practice that inform rehabilitation in cancer care in England and considers how rehabilitation and supportive care issues can be addressed in clinical practice.

Assessment of dysfunctional working models of self and others in schizophrenic patients: a summary of data collected in nine nations. International Research Group.

Objective: To investigate the cross-cultural feasibility of a new scale for assessing dysfunctional working models of self and others, and to evaluate its discriminative power.

Method: Schizophrenic patients (N=351), non-psychotic patients (N= 86) and non-clinical subjects (N= 511) collected in 10 centres completed the DWM-S. Current psychopathology was assessed by means of the BPRS.

Transhistorical variations in personality and their association with experiences of parental rearing.

A population sample comprised of 765 subjects (367 males and 398 females), in the age range of 15-81 years, completed the EMBU, a reliable questionnaire aimed at assessing experiences of parental rearing, and the TCI, a self-report questionnaire aimed at assessing dimensions of temperament and character. The study had three main aims: 1) to verify, on a larger scale, previous findings suggesting the occurrence of significant associations between experiences of parental rearing and aspects of temperament and character, 2) to assess possible variations in temperament and character in cohorts of subjects who have grown up in different historical epochs, and 3) to investigate to what extent transgenerational differences in parental rearing are detectable in different associations with various dimensions of personality. Several, albeit small, significant and meaningful associations between experiences of parental rearing and both temperament and character dimensions have been found, adding support to the robustness of previously reported results obtained in an independent smaller series.

Development and preliminary application of a new scale for assessing dysfunctional working models of self and others (DWM-S) in severely disturbed patients.

Although several suggestions have been made concerning the content and characteristics of cognitive/emotive schemata held by people with different disorders, there is still a scarcity of suitable instruments for verifying or measuring such constructs. This is particularly true of schemata postulated to be present in patients with personality disorders or a schizophrenic disorder. This article deals with the development of a new scale for assessing dysfunctional internal working models of self and others (DWM-S) in psychiatric patients.

Perceived parental rearing behaviour in patients with a schizophrenic disorder and its relationship to aspects of the course of the illness.

A total of 57 patients of both sexes (27 women and 30 men) with a definite diagnosis of a schizophrenic disorder completed the EMBU, a Swedish instrument designed to assess the experience of parental behaviour, that has been extensively used in cross-national studies. As in previous studies in different patient populations, three factors, 'rejection', 'emotional warmth' and 'overprotection', have been taken into account. The results obtained in the patient group were compared with those obtained in a control sample of healthy Swedish subjects.

Cognitive therapy with schizophrenic patients.

Cognitive therapy has emerged as a feasible and valuable complement to the treatment of patients suffering from a schizophrenic disorder. It can be carried out at various levels and with different goals in mind and its use is not in conflict with concomitant and strictly individualized medication. In the article some of the approaches most commonly used are pointed out and some of the results of various approaches are highlighted.

Cognitive therapy in the treatment of patients with borderline personality disorders.

Cognitive therapy, originally conceived for the treatment of emotional illnesses, has been successively used also in treating patients with more severe mental disorders. In this article, the results obtained by Shearin & Linehan (this volume) in a few controlled trials of dialectical behavior therapy in patients with borderline personality disorders are discussed. Differences between the treatment approach followed by Shearin & Linehan, which focuses on the modification of specific behaviors, and that favored by the author, which is aimed at restructuring dysfunctional working models of self and environment, are highlighted.

The distinction between unipolar and bipolar mood disorders. A 25-years perspective.

The paper deals with a critical appraisal of the state of art of the distinction between bipolar (manic-depressive) and unipolar recurrent affective disorders. However already propounded several years earlier by Leonhard, a distinction between bipolar and unipolar affective disorders has first been taken into general consideration during the last quarter of a century. It is currently firmly established in the most widely accepted international classification systems, and is taken into account in the major psychiatric textbooks.

Determinants of recall of parental rearing behavior. The influence of age or loss of parents by separation or death.

In a study of 562 psychiatric inpatients and 251 healthy controls, relationships between age of proband and related life events (divorce of parents, death of a parent) and the perceived parental rearing have been investigated. The inverse relationships obtained could be explained by the higher number of divorced parents among younger subjects with negatively experienced parental rearing practices on the one hand and an idealization of the parents who had died on the other hand. In psychiatric patients these relationships and differences were more pronounced pointing to the importance of parental rearing as a vulnerability factor for mental problems during adulthood.

An interactionistic integrating view of depressive disorders and their treatment.

The development of a depressive disorder is often considered from the perspective of biological causation, mental processes, or with a focus on possible social determinants, even though the possible concomitance of factors belonging to the different domains is generally acknowledged. In this article, a further development of an interactional model previously described is presented. The model is focused on the concept of individual vulnerability, which is assumed to result from a continuous interplay of the individuals with their environment, and from the effect of factors belonging to different domains that interact.

[The EMBU project--a multinational study of the importance of parental child rearing behavior for the development of psychopathologic phenomena].

The influence of childhood experience on psychological development is discussed from various scientific viewpoints. Against this background, the origin of the cross-cultural, multinational EMBU Project on the relationship between upbringing in the family and psychopathology is described. It becomes obvious that a systematic, cross-cultural, and theory-orientated approach can bring significant material for the development of psychiatric theory.

Patterns of course in patients with a cross-sectional diagnosis of schizoaffective disorder.

The authors conducted a longitudinal study on two samples of patients, fulfilling Research Diagnostic Criteria for schizoaffective disorder and for major affective disorder, respectively. The long-term course in patients defined cross-sectionally as schizoaffective was very heterogeneous. Ten different patterns of course were identified.

The importance of Karl Leonhard's classification of endogenous psychoses.

In this paper the author highlights the importance that the classificatory work carried out by Leonhard has had for recent international developments in the classification of mental disorders. In particular, the diagnostic relevance of a distinction between bipolar and unipolar affective disorders and the separation of the cycloid psychotic disorders from other major psychoses is underscored.

Cross-national generalizability of dimensions of perceived parental rearing practices: Hungary and The Netherlands; a correction and repetition with healthy adolescents.

In a previous study, an attempt was undertaken to examine whether dimensions of parental rearing style as measured with the Egna Minnen Beträffande Uppfostran (EMBU) on dimensions of Rejection, Emotional Warmth, Overprotection, and Favoring Subject can be generalized from Dutch adult samples, for whom they were originally interpreted from factor analyses, to an Hungarian adult sample. The findings suggested either differences in the meaning of the constructs between Hungarians and the Dutch or the presence of errors of translation in the Hungarian version. To rule out the possibility of inadequate translation, the Hungarian item-content was cross-checked by our Hungarian coworkers and, after reformulating several items, used for obtaining new data with a sample of adolescents.

The early family situation of Hungarian depressed patients.

In a series of fifty depressed patients and 258 controls possible differences in the early family situation as concerns parental rearing practices have been investigated by means of the Swedish EMBU inventory. The results show that the depressive experienced their parents as more "rejecting", more "overprotecting" and less "emotionally warm" as compared to their normal counterparts.

A theoretical framework for linking the experience of dysfunctional parental rearing attitudes with manifest psychopathology.

The results of several investigations suggest a possible relationship between a subject's experience of the rearing attitudes of his parents and the later development of various kinds of psychopathological disorders. Most studies, however, are based on small populations and on dubious assumptions about linear causal relationships between parental rearing practices and poorly defined mental disorders. This article gives a theoretical background to a comprehensive multinational study of rearing practices and psychopathology, now in progress.

The concept of cycloid psychotic disorder.

The concept of cycloid psychosis or cycloid psychotic disorder has been used in the European psychiatric literature for almost half a century. However, it has now for the first time been comprised into the 10th revision of the World Health Organization's International Classification of Diseases (ICD-10) that is currently in the phase of field trials. In this article evidence is presented that supports the independence of cycloid psychotic disorder from other major psychotic disorders.