Motivational enhancement and schema focused cognitive behaviour therapy in the treatment of chronic eating disorders

A day hospital program for the treatment of patients with long-term anorexia nervosa (AN) is described. This program forms part of a comprehensive system of day programs that reflect and incorporate patients' varying degrees of readiness for change and attempt to match patients' readiness for change to the interventions offered in treatment. Preliminary outcome data are presented, showing clinically valuable changes of motivation in this group

The role of metacognition in self-critical rumination: an investigation in individuals presenting with low self-esteem

Background: No research, to date, has directly investigated the role of metacognition in self-critical rumination and low self-esteem. Aim: To investigate the presence of metacognitive beliefs about self-critical rumination; the goal of self-critical rumination and its stop signal; and the degree of detachment from intrusive self-critical thoughts. Method: Ten individuals reporting both a self-acknowledged tendency to judge themselves critically and having low self-esteem were assessed using metacognitive profiling, a semi-structured interview. Results: All participants endorsed both positive and negative metacognitive beliefs about self-critical rumination. Positive metacognitive beliefs concerned the usefulness of self-critical rumination as a means of improving cognitive performance and enhancing motivation. Negative metacognitive beliefs concerned the uncontrollability of self-critical rumination and its negative impact on mood, motivation and perception of self-worth. The primary goal of engaging in self-critical rumination was to achieve a better or clearer understanding of a given trigger situation or to feel more motivated to resolve it. However, only four participants were able to identify when this goal had been achieved, which was if the trigger situation were not to occur again. Participants unanimously stated that they were either unable to detach from their self-critical thoughts or could do so some of the time with varying degrees of success. More often than not, though, self-critical thoughts were viewed as facts, would rarely be seen as distorted or biased, and could take hours or days to dissipate. Conclusions: These findings provide preliminary evidence that specific facets of metacognition play a role in the escalation and perseveration of self-critical rumination

Development of burnout over time and the causal order of the three dimensions of burnout among male and female GPs. A three-wave panel study

<p>Abstract</p> <p>Background</p> <p>A good understanding of the aetiology and development of burnout facilitates its early recognition, prevention and treatment. Since the prevalence and onset of this health problem is thought to differ between men and women, sex must be taken into account. This study aims to assess the prevalence and development of burnout among General Practitioners (GPs). In this population the prevalence of burnout is high.</p> <p>Methods</p> <p>We performed a three-wave longitudinal study (2002, 2004, 2006) in a random sample of Dutch GPs. Data were collected by means of self-report questionnaires including the Maslach Burnout Inventory. Our final sample consisted of 212 GPs of which 128 were male. Data were analyzed by means of SPSS and LISREL.</p> <p>Results</p> <p>Results indicate that about 20% of the GPs is clinically burned out (but still working). For both sexes, burnout decreased after the first wave, but increased again after the second wave. The prevalence of depersonalization is higher among men. With regard to the process of burnout we found that for men burnout is triggered by depersonalization and by emotional exhaustion for women.</p> <p>Conclusions</p> <p>As regards the developmental process of burnout, we found evidence for the fact that the aetiological process of burnout, that is the causal order of the three burnout dimensions, differs between men and women. These sex differences should be taken into account in vocational training and policy development, especially since general practice is feminizing rapidly.</p

Neural evidence of the allophonic mode of speech perception in adults with dyslexia

Item does not contain fulltextObjective: A growing body of evidence suggests that individuals with dyslexia perceive speech using allophonic rather than phonemic units and are thus sensitive to phonetic variations that are actually irrelevant in the ambient language. This study investigated speech perception difficulties in adults with dyslexia using behavioural and neural measurements with stimuli along a place-of-articulation continuum with well-defined allophonic boundaries. Adults without dyslexia served as control participants. Methods: Categorical perception of a/b(sic) - d(sic)/place-of-articulation continuum was evaluated using both identification and discrimination tasks. In addition to these behavioural measures, mismatch negativity (MMN) was recorded for stimuli that came from either similar or different phoneme categories. Results: The adults with dyslexia exhibited less consistent labelling than controls, but no heightened sensitivity to allophonic contrasts was observed at the behavioural level. Neural measurements revealed that stimuli from different phoneme categories elicited MMNs in both the adults with dyslexia and controls, whereas stimuli from the same category elicited an MMN in the adults with dyslexia only. Conclusion: The finding that adults with dyslexia have heightened sensitivity to allophonic contrasts in the form of neural activation supports the allophonic explanation of dyslexia. Significance: Sensitivity to allophonic contrasts may be a valuable marker for dyslexia