Processes of Change in Psychotherapy for Narcissistic Personality Disorder.

The present study aims at determining the role for outcome of potential processes of change in psychotherapy for narcissistic personality disorder (NPD). They were examined on three levels: the content, the process, and the relationship. A total of 161 patients suffering with NPD were recruited in a naturalistic setting as part of the present study. They underwent a long- term clarification-oriented psychotherapy. Sessions 15, 20, and 25 were video- or audio-recorded and analyzed with an observer-rated instrument that measures the quality of the interaction processes from the patient's and therapist's perspectives. Different self-report measures were used to assess therapy outcomes. In-session improvement was observed in both patient and therapist processes across sessions. Patient improvement in the three levels of processes was systematically related with outcome. Only partial relationships were found between therapist improvement and outcome. The present study represents the first systematic insight into core changes in patients with NPD undergoing psychotherapy

Disability Costs and Equivalence Scales in the Older Population in Great Britain

We use a standard of living (SoL) approach to estimate older people's disability costs, using data on 8000 individuals from the U.K. Family Resources Survey. We extend previous research in two ways. First, by allowing for a more flexible relationship between SoL and income, the structure of the estimated disability cost and equivalence scale is not dictated by a restrictive functional form assumption. Second, we allow for the latent nature of disability and SoL, addressing measurement error in the disability and SoL indicators in surveys. We find that disability costs are strongly related to severity of disability, and vary with income in absolute and proportionate terms. Older people above the median disability level require an extra �99 per week (2007 prices) on average to reach the SoL of an otherwise similar person at the median. Costs faced by older people in the highest decile of disability average �180

Logarithmic rate dependence in deforming granular materials

Rate-independence for stresses within a granular material is a basic tenet of many models for slow dense granular flows. By contrast, logarithmic rate dependence of stresses is found in solid-on-solid friction, in geological settings, and elsewhere. In this work, we show that logarithmic rate-dependence occurs in granular materials for plastic (irreversible) deformations that occur during shearing but not for elastic (reversible) deformations, such as those that occur under moderate repetitive compression. Increasing the shearing rate, \Omega, leads to an increase in the stress and the stress fluctuations that at least qualitatively resemble what occurs due to an increase in the density. Increases in \Omega also lead to qualitative changes in the distributions of stress build-up and relaxation events. If shearing is stopped at t=0, stress relaxations occur with \sigma(t)/ \sigma(t=0) \simeq A \log(t/t_0). This collective relaxation of the stress network over logarithmically long times provides a mechanism for rate-dependent strengthening.Comment: 4 pages, 5 figures. RevTeX

Blaming the victim, all over again: Waddell and Aylward's biopsychosocial (BPS) model of disability

The biopsychosocial (BPS) model of mental distress, originally conceived by the American psychiatrist George Engel in the 1970s and commonly used in psychiatry and psychology, has been adapted by Gordon Waddell and Mansell Aylward to form the theoretical basis for current UK Government thinking on disability. Most importantly, the Waddell and Aylward version of the BPS has played a key role as the Government has sought to reform spending on out-of- work disability benefits. This paper presents a critique of Waddell and Aylward’s model, examining its origins, its claims and the evidence it employs. We will argue that its potential for genuine inter-disciplinary cooperation and the holistic and humanistic benefits for disabled people as envisaged by Engel are not now, if they ever have been, fully realized. Any potential benefit it may have offered has been eclipsed by its role in Coalition/Conservative government social welfare policies that have blamed the victim and justified restriction of entitlements

High Resolution K-band Spectroscopy of MWC 480 and V1331 Cyg

We present high resolution (R=25,000-35,000) K-band spectroscopy of two young stars, MWC 480 and V1331 Cyg. Earlier spectrally dispersed (R=230) interferometric observations of MWC 480 indicated the presence of an excess continuum emission interior to the dust sublimation radius, with a spectral shape that was interpreted as evidence for hot water emission from the inner disk of MWC 480. Our spectrum of V1331 Cyg reveals strong emission from CO and hot water vapor, likely arising in a circumstellar disk. In comparison, our spectrum of MWC 480 appears mostly featureless. We discuss possible ways in which strong water emission from MWC 480 might go undetected in our data. If strong water emission is in fact absent from the inner disk, as our data suggest, the continuum excess interior to the dust sublimation radius that is detected in the interferometric data must have another origin. We discuss possible physical origins for the continuum excess.Comment: 29 pages, 5 figures, to appear in Ap

Drug use among British Bangladeshis in London: a macro-structural perspective focusing on disadvantages contributing to individuals’ drug use trajectories and engagement with treatment services

Aims: The main aim of our study was to produce an understanding of factors contributing to drug-using trajectories among men and women from a Bangladeshi background living in East London. Methods: Fifteen semi-structured, one-to-one interviews were conducted with male and female Bangladeshi drug users accessing treatment services. A macro-structural lens was adopted to interpret participants’ accounts of their drug use and explored the intersecting factors that at a micro, meso, and macro level impacted on their drug-using trajectories. Findings: Problem drug use (heroin and crack cocaine) among participants was the result of inter-related factors such as their friendship networks and the embeddedness of drugs in drug-using networks, the structural disadvantages participants experienced, and the need for concealment of their drug use which impacted on participants’ effective utilisation of drug treatment services. Problem drug use was a functional way of responding to and dealing with social, economic, and cultural disconnection from mainstream institutions as participants faced severe multiple disadvantages engendering stigma and shame. Conclusions: We propose a ‘life-focused’ intervention aimed at creating extra opportunities and making critically-needed resources available in the marginalised environment of the study’s participants, which are key to restoring and maintaining agency and sustaining well-being

Identity work and the `unemployed' worker: age, disability and the lived experience of the older unemployed

This article seeks to explore how older individuals negotiate and manage their self-identity in relation to work while situated without paid employment. After reviewing the current positions of the older unemployed in the UK, noting the substantial overlap between age and disability, we turn our attention to conceptualizing the lived experiences of individuals through exploring `identity work' as a means of understanding a non-working work identity. Based upon focus group interviews, our empirical analysis focuses on key dimensions of participants' identity practice and how they sought to manage the following social processes: imposed identities; crafting working identities; and contesting unfavourable working identities.The conclusion contextualizes the findings against a backdrop of increasing individualistic discourses underpinning approaches to employability, closes with the policy implications arising from this study, and makes suggestions for future research agendas. </jats:p