The psychological mindedness assessment procedure - validation study of a Dutch version.

Objective: The Psychological Mindedness Assessment Procedure [PMAP; McCallum, M. & Piper, W. E.

An integrative perspective on psychotherapeutic treatments for borderline personality disorder.

Although there is an abundance of literature on the psychotherapeutic treatment of borderline pathology, little is known about differences and similarities between treatments of borderline personality disorder (BPD). Potential differences and similarities are especially important in the absence of evidence of the superiority of one treatment over the other (e.g.

How therapists cope with clients' traumatic experiences.

An initial finding of high emotional stress in trauma therapists working in a specialized trauma institute led to three empirical studies on trauma-related therapist reactions. The purpose of these studies was to investigate the relation between high emotional burden and burnout, and the trauma-specific processes described by the concepts "secondary traumatic stress", "vicarious traumatization" and "traumatic countertransference". The initial qualitative/quantitative study examined how a group of specialized trauma therapists (N=63) coped with clients' traumatic experiences.

Assessment of the burden of disease among inpatients in specialized units that provide psychotherapy.

The burden of disease of 1,651 inpatients in the Netherlands who had complex personality problems and personality disorders and who were treated in specialized units that provide psychotherapy was compared with the burden of disease of patients with other mental and physical conditions. Patients completed the EuroQol EQ-5D, a generic quality-of-life questionnaire. The mean EQ-5D index score was .

Prevalence of psychiatric function disorders in psychogeriatric patients at referral to nursing home care--the relation to cognition, activities of daily living and general details.

Objectives: This prospective, observation study (from June 2001 to October 2002) estimated the prevalence and co-occurrence of psychiatric function disorders (PFDs) in psychogeriatric patients suffering from cognitive function disorders at referral to clinical as well as non-clinical (transmural) psychogeriatric programmes. It is expected that PFDs, both total and individual, are positively related to the cognitive function disorders as well as the activities of daily living (ADL) handicaps. This expectation will be adjusted for general details particularly gender, age, marital status, domicile and type of primary caregiver.

Alexithymia does not predict the persistence of medically unexplained physical symptoms.

Background: Alexithymia is thought to be associated with the development of medically unexplained physical symptoms (UPS). So far little research has been published on alexithymia as a risk factor for the persistence of UPS.

Objective: To determine the clinical outcome in UPS patients and to study the relative importance of alexithymia in predicting that outcome.

Childhood adversities as risk factors for alexithymia and other aspects of affect dysregulation in adulthood.

Background: Affect regulation is assumed to be a biologically based function that can become disrupted by inadequate parenting and by traumatic experiences. We studied the relation between the perceived parental parenting style, and sexual and physical abuse, with alexithymia, dissociation, anxiety and depression.

Methods: In a cross-sectional study psychiatric outpatients were administered a structured interview on childhood physical and sexual abuse and they completed a number of questionnaires about the parenting styles of their parents, and about alexithymia, dissociation and mood pathology.

Attitudes and distress levels in women at risk to carry a BRCA1/BRCA2 gene mutation who decline genetic testing.

Genetic testing enables women at risk for hereditary breast and/or ovarian cancer to find out whether they have inherited the gene mutation, and if so, to opt for undergoing frequent surveillance and/or prophylactic surgery. However, the option to know about one's genetic status is not always seen as a benefit by women at risk. Motives for declining genetic testing were explored in 13 women at 25% or 50% risk to be a BRCA1/BRCA2 mutation carrier, who participated in a surveillance program for breast/ovarian cancer (the non-tested group).

Group cohesion and working alliance: prediction of treatment outcome in cardiac patients receiving cognitive behavioral group psychotherapy.

Background: Various definitions of both group cohesion and working alliance are used in theories on group psychotherapy, making the study of their relative contribution to the treatment outcome difficult. In this study, two different, nonoverlapping questionnaires were used to explore the relationship between group cohesion, working alliance and treatment outcome in a time-limited, structured cognitive behavioral group psychotherapy aiming at the reduction of coronary risk factors.

Methods: After having undergone percutaneous transluminal coronary angioplasty, 42 patients were treated with the aim to reduce exhaustion, anxiety, hostility and depression.

The assessment of alexithymia: a critical review of the literature and a psychometric study of the Toronto Alexithymia Scale-20.

Objective: The objectives were to give an overview of studies on the validity of the Toronto Alexithymia Scale (TAS-20) and to present data regarding the validity of the TAS-20.

Methods: The literature on the psychometric properties of the TAS-20 was reviewed and a study was conducted of its psychometric properties in a sample of students and a sample of psychiatric outpatients using a statistical method allowing identification of a stable factor structure.

Results: The review revealed that the majority of studies on the TAS-20 were conducted with nonpatient samples.

One year follow-up of women opting for presymptomatic testing for BRCA1 and BRCA2: emotional impact of the test outcome and decisions on risk management (surveillance or prophylactic surgery).

Genetic testing enables women at risk for hereditary breast and/or ovarian cancer to find out whether they have inherited the gene mutation (BRCA1/BRCA2), and if so, to opt for frequent surveillance and/or prophylactic surgery (bilateral mastectomy and/or oophorectomy). Here, a follow-up is described for 63 healthy women at 50% risk of being a BRCA1/BRCA2 mutation carrier who underwent genetic testing. The course of distress and problems regarding body image and sexuality up to 1 year after disclosure of the test-outcome were described separately for mutation carriers undergoing mastectomy (n = 14), for mutation carriers opting for surveillance (n = 12) and for non-mutation carriers (n = 37).

Men at risk of being a mutation carrier for hereditary breast/ovarian cancer: an exploration of attitudes and psychological functioning during genetic testing.

Males with a BRCA1/BRCA2 mutation are not at greatly increased risk for cancer, whereas their (grand)daughters, and other female relatives who carry the mutation, are. Males from BRCA1/BRCA2 families may opt for genetic testing to confirm whether or not they may have transmitted the mutation to their children and, if so, to inform them at an appropriate age about the genetic risk and its implications. The psychological implications of genetic testing for men at risk of being a BRCA1/BRCA2 mutation carrier have received little attention.

Psychological impact of receiving a BRCA1/BRCA2 test result.

Mutation analysis for autosomal dominant hereditary breast/ovarian cancer genes (BRCA1/BRCA2) became an important technique for women at risk of carrying these mutations. Healthy female mutation carriers have a high lifetime risk for breast and/or ovarian cancer and may opt for frequent breast and ovary surveillance or prophylactic surgery (mastectomy and/or oophorectomy). Psychological distress was assessed in 78 healthy women at risk of having inherited a BRCA1/BRCA2 mutation opting for genetic testing and 56 partners several weeks prior to ("pre-test") and after ("post-test") learning about their DNA test result.

Is alexithymia a risk factor for unexplained physical symptoms in general medical outpatients?

Objective: Alexithymia is presumed to play an important predisposing role in the pathogenesis of medically unexplained physical symptoms. However, no research on alexithymia has been done among general medical outpatients who present with medically unexplained physical symptoms as their main problem and in which anxiety and depression have been considered as possible confounding factors. This study investigated whether patients with medically unexplained physical symptoms are more alexithymic than those with explained symptoms and whether, in patients with unexplained symptoms, alexithymia is associated with subjective health experience and use of medical services.

Measuring overall defensive functioning with the Defense Style Questionnaire: a comparison of different scoring methods.

The evidence for the division of defenses measured with the Defense Style Questionnaire (DSQ) into immature, neurotic, and mature types appears to be lacking. We hypothesized that defenses can be represented unidimensionally. Classical multidimensional scaling was applied to the maturity ratings of items given by 279 experts.

Presymptomatic testing for BRCA1 and BRCA2: how distressing are the pre-test weeks? Rotterdam/Leiden Genetics Working Group.

Presymptomatic DNA testing for autosomal dominant hereditary breast/ovarian cancer (HBOC) became an option after the identification of the BRCA1 and BRCA2 genes in 1994-1995. Healthy female mutation carriers have a high lifetime risk for breast cancer (56-87%) or ovarian cancer (10-60%) and may opt for intensive breast and ovary surveillance or prophylactic surgery (mastectomy/oophorectomy). We studied general and cancer related distress in 85 healthy women with a 25% or 50% risk of being carrier of a BRCA1/BRCA2 gene mutation and 66 partners in the six to eight week period between genetic counselling/blood sampling and disclosure of the test result.

Perceived parental attitude, alexithymia and defense style in psychiatric outpatients.

Background: Although it is the clinical impression that alexithymia may be due to disturbances in the early parent-child relationship and that it is associated with primitive defense mechanisms, a possible association with neurotic defense mechanisms, such as repression and reaction formation, has also been mentioned. However, empirical studies on these and related issues are scarce. The aim of this study was to determine the association between perceived parental attitude, defense mechanisms and alexithymia.

Distress in individuals facing predictive DNA testing for autosomal dominant late-onset disorders: comparing questionnaire results with in-depth interviews. Rotterdam/Leiden Genetics Workgroup.

In 50% risk carriers for Huntington disease (n = 41), hereditary cerebral hemorrhage with amyloidosis Dutch-type (n = 9) familial adenomatous polyposis coli (n = 45) and hereditary breast and ovarian cancer (n = 24), pretest intrusion and avoidance (Impact of Event Scale), anxiety and depression (Hospital Anxiety and Depression Scale), feelings of hopelessness (Beck Hopelessness Scale), and psychological complaints (Symptom Checklist) were assessed to determine their psychological well-being. The manner of discussing the genetic disorder, the test, and its implications during a semistructured interview (reflecting on one's emotions without getting carried away or dismissing or minimizing the subject) was judged in terms of coherence. Participants at risk for neurodegenerative disorders had higher anxiety and depression scores and more psychological complaints than did those at risk for cancer syndromes.

Psychological sequelae of cancer diagnosis: a meta-analytical review of 58 studies after 1980.

Objective: In a review of the literature from 1980 to 1994 on psychological and psychiatric problems in patients with cancer, the prevalence, severity, and the course of these problems (i.e., depression, anxiety, and general psychological distress) were studied with the help of meta-analyses and qualitative analyses.

Exposure and participant modelling in a case of injection phobia.

Background: From the literature it appears that there may be two types of injection phobia, (1) the 'vasovagal' type, and (2) the 'resistant' type. The first type is characterized by a diphasic cardiovascular response during or after injection and by a tendency to react in a passive, nonresisting way when injected. The second type is characterized by strong, sometimes violent resistance and no vasovagal reaction to an injection.

Psychological aspects of non-cardiac chest pain.

Approximately 30% of patients visiting a cardiologist for the first time with complaints of chest pain appear to have normal coronary arteries. These patients generally have a higher prevalence of atypical chest pain, are relatively young, often female, in most cases suffer from panic disorder and have high scores on depression and anxiety scales. In this article some of the recent studies conducted in this particular line of research are reviewed and some possible explanations for the relationship between complaints and non-cardiac findings are presented.

Psychological and knowledge factors related to delay of help-seeking by patients with acute myocardial infarction.

Survival of an acute myocardial infarction (AMI) and subsequent prognosis are highly dependent on the time between onset of symptoms and medical intervention. The purpose of this study is to investigate which psychological and cardiovascular knowledge factors may contribute to the time the AMI patient takes to decide to seek medical help (patient delay). Three hundred patients took part in the study.

Effects of psychological treatment on cancer patients: a critical review.

Twenty-two studies on the effects of psychological treatment on cancer patients are reviewed. Only studies that compared one or more experimental conditions with at least one control group have been considered. The studies were evaluated with respect to a) research methods, b) psychological interventions, and c) results.