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Self-confidence
Kinds of Self-confidence Selected AbstractsConsumer Self-Confidence in Searching for InformationJOURNAL OF CONSUMER AFFAIRS, Issue 1 2009CÄZILIA LOIBL Consumer behavior is often driven by the extent to which consumers feel confident regarding their decisions, which frequently hinge, especially in high-stakes situations, on their information search. This article examines a multidimensional self-confidence concept to explore how consumer self-confidence influences information search. Findings of a mail survey document that high-confidence consumers engage in more intensive search activities and that demographic patterns shape consumer self-confidence scores. The findings empirically support a multidimensional measurement of self-confidence to predict search behavior and suggest avenues to enhance the self-confidence needed to produce positive marketplace experiences. [source] ORIGINAL RESEARCH,ED PHARMACOTHERAPY: Psychosocial Outcomes and Drug Attributes Affecting Treatment Choice in Men Receiving Sildenafil Citrate and Tadalafil for the Treatment of Erectile Dysfunction: Results of a Multicenter, Randomized, Open-Label, Crossover StudyTHE JOURNAL OF SEXUAL MEDICINE, Issue 4 2006FRCGP, John Dean MBBS ABSTRACT Introduction., Although sildenafil citrate (sildenafil) and tadalafil are efficacious and well-tolerated treatments for erectile dysfunction (ED), preference studies have shown that patients may favor one medication over the other. Aim., To determine whether psychosocial outcomes differed when men with ED received tadalafil compared with sildenafil. Main Outcome Measures., Measures included a treatment preference question, Psychological and Interpersonal Relationship Scales (PAIRS), and Drug Attribute Questionnaire. Methods., Randomized, open-label, crossover study. After a 4-week baseline, men with ED (N = 367; mean age = 54 years; naïve to type 5 phosphodiesterase inhibitor therapy) were randomized: tadalafil for 12 weeks then sildenafil for 12 weeks or vice versa (8-week dose optimization/4-week assessment phases). During dose optimization, patients started with 10 mg tadalafil, or 25 or 50 mg sildenafil and could titrate to their optimal dose (10 or 20 mg tadalafil; 25, 50, or 100 mg sildenafil). Medications were taken as needed. Patients completing both 12-week periods chose which medication to continue during an 8-week extension. Results., Of 291 men completing both treatment periods, 71% (N = 206) chose tadalafil and 29% (N = 85) chose sildenafil (P < 0.001) for the 8-week extension. When taking tadalafil compared with sildenafil men had higher mean endpoint scores on PAIRS Sexual Self-Confidence (tadalafil = 2.91 vs. sildenafil = 2.75; P < 0.001) and Spontaneity (tadalafil = 3.32 vs. sildenafil = 3.17; P < 0.001) Domains and a lower mean endpoint score on Time Concerns Domain (tadalafil = 2.2 vs. sildenafil = 2.59; P < 0.001). The two most frequently chosen drug attributes to explain treatment preference were ability to get an erection long after taking the medication and firmness of erections. Tadalafil and sildenafil were well tolerated with 12 (3.3%) patients discontinuing for an adverse event. Conclusions., As measured with PAIRS, men with ED had higher sexual self-confidence and spontaneity and less time concerns related to sexual encounters when treated with tadalafil compared with sildenafil. These psychosocial outcomes may help explain why more men (71%) preferred tadalafil for the treatment of ED in this clinical trial. Dean J, Hackett GI, Gentile V, Pirozzi-Farina F, Rosen RC, Zhao Y, Warner MR, and Beardsworth A. Psychosocial outcomes and drug attributes affecting treatment choice in men receiving sildenafil citrate and tadalafil for the treatment of erectile dysfunction: Results of a multicenter, randomized, open-label, crossover study. J Sex Med 2006;3:650,661. [source] A STUDY OF BIOETHICAL KNOWLEDGE AND PERCEPTIONS IN KOREABIOETHICS, Issue 6 2010YOUNG-JOON PARK ABSTRACT This study assessed the knowledge and perception of human biological materials (HBM) and biorepositories among three study groups in South Korea. The relationship between the knowledge and the perception among different groups was also examined by using factor and regression analyses. In a self-reporting survey of 440 respondents, the expert group was found more likely to be knowledgeable and positively perceived than the others. Four factors emerged: Sale and Consent, Flexible Use, Self-Confidence, and Korean Bioethics and Biosafety Action restriction perception. The results indicate that those who are well aware of the existence of biobanks were more positively inclined to receive the Sale and Consent perception. As a result of the need for high quality HBMs and the use of appropriate sampling procedures for every aspect of the collection and use process, the biorepository community should pay attention to ethical, legal, and policy issues. [source] A Life Jacket or an Art of Living: Inequality in Social Competence EducationCURRICULUM INQUIRY, Issue 2 2003Geert T. M. Ten Dam After a period in which the emphasis in education was on "the basics," increasing attention has been paid at the turn of the century to the "moral task of education" in the Netherlands. Schools are not only expected to prepare students for further education and/or the labour market but also for participating in society in the broadest sense, for example, in politics, care, and culture. In this article we will focus on one aspect of students' development as a task of the school, namely, the furthering of students' social competence. Six case studies were conducted in which projects aimed at social competence were analysed in general secondary education and prevocational education. The results show that in the general secondary education projects the emphasis was on the meaning of changes in society for students and the contribution they can make to such changes (social competence in education as an "art of living"). The prevocational education projects focused on improving the chances of students at school and in society by developing aspects of social competence that they have not acquired at home or earlier in their school careers, such as self-confidence and social and communicative skills (social competence as a "life jacket"). We interpret these different focuses in terms of the production and reproduction of social inequality and discuss how such reproduction processes can be countered in the context of educating for social competence. [source] Competence of New Emergency Medicine Residents in the Performance of Lumbar PuncturesACADEMIC EMERGENCY MEDICINE, Issue 7 2005Richard L. Lammers MD Abstract Background: Medical students are taught some procedural skills during medical school, but there is no uniform set of procedures that all students learn before residency. Objective: To determine the level of competence in the performance of a lumbar puncture (LP) by new postgraduate year 1 (PGY1) emergency medicine (EM) residents. Methods: An observational study was conducted at three EM residencies with 42 PGY1 residents who recently graduated from 26 various medical schools. The LP procedure was divided into 26 major and 44 minor steps to create a scoring protocol. The model, procedure, and scoring protocol were validated by experienced emergency physicians. Subjects performed the procedure without interruption or feedback on an LP training model using a standard LP kit. A step was scored as "performed correctly" if two of the three evaluators concurred. Pre- and poststudy questionnaires assessed subjects' prior instruction and clinical experience with LP, self-confidence, sense of relevance, motivation, and fatigue. Results: Subjects completed an average of 14.8 (57%; 95% confidence interval [95% CI] = 53% to 61%) of the major steps (range: 4,26) and 19.1 (43%; 95% CI = 42% to 45%) of the minor steps (range: 7,28) in 14.3 minutes (range: 3,22). Sixty-nine percent failed to obtain cerebrospinal fluid from the model. Subjects' levels of confidence changed slightly on a five-point scale from 2.8 ("little-to-some") before the test to 2.5 after the test. Eighty-three percent of the subjects previously performed LPs on patients during medical school (average attempts = 2.2; range: 0,10), but only 40% of those who did so were supervised by an attending during their first attempt. Conclusions: In the cohort studied, new PGY1 EM residents had not attained competence in performing LPs from training in medical school. Most new PGY1 residents probably require training, practice, and close, direct supervision of this procedure by attending physicians until the residents demonstrate competent performance. [source] Working under cover: performance-related self-confidence among members of contextually devalued groups who try to passEUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY, Issue 3 2006Manuela Barreto This paper experimentally examines the effects of passing (versus revealing) a contextually devalued identity on performance-related self-confidence. An experimental scenario was developed on the basis of the results of a pilot study. Studies 1 and 2 (total N,=,255) experimentally manipulate passing versus revealing a contextually devalued identity, to an ingroup or an outgroup partner. The results show that, although passing makes participants believe that their partner has more positive expectations of them, it also undermines performance-related self-confidence. Moreover, the results show that negative self-directed affect (i.e., guilt and shame) mediated the negative effect of passing on performance-related self-confidence. Copyright © 2006 John Wiley & Sons, Ltd. [source] The Golden Freeway: a preliminary evaluation of a pilot study advancing information technology as a social intervention for boys with Duchenne muscular dystrophy and their familiesHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2004Jennifer Soutter BSc PhD Abstract Established information technology was used in an attempt to reduce social isolation by providing each family who had a child with Duchenne muscular dystrophy with a personal computer, and e-mail and Internet connectivity. Seventy-four of the 88 families in the north of England (i.e. Cumbria, Durham, Northumberland, Teesside, and Tyne and Wear) with a boy with Duchenne muscular dystrophy who was diagnosed before January 2000 had the equipment installed. Evaluations of equipment usage and parental perceptions of the project were carried out at 3 and 12 months post-installation. Results from quantitative and qualitative interviews with parents indicated that benefits accrued to the families and to the boys themselves: family relationships can be extended, and the boys can acquire a degree of independence which, according to parents' views, can boost self-confidence and self-esteem. As hoped, social isolation was felt to have been reduced, and an occupation, interest and enjoyment provided. The greatest use of the computer was for schoolwork with siblings sharing in this. Cost proved to be a problem for a number of families. For the project team, there were unexpected aspects: creating an e-community was more difficult than anticipated, more training was required and not all families would ever use the equipment to its fullest. However, families did emphasise the value of the project as a way of opening the world for their sons. [source] Learning from research on the information behaviour of healthcare professionals: a review of the literature 2004,2008 with a focus on emotionHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 3 2009Ina Fourie Objective:, A review, focusing on emotion, was conducted of reported studies on the information behaviour of healthcare professionals (2004,2008). Findings were intended to offer guidelines on information services and information literacy training, to note gaps in research and to raise research interest. Method:, Databases were searched for literature published from January 2004 to December 2008 and indexed on eric, Library and Information Science Abstracts, medline, PsycINFO, Social Services Abstracts, Sociological Abstracts, Health Source: Nursing/Academic Edition; Library, Information Science & Technology Abstracts; Psychology and Behavioral Sciences Collection; Social Work Abstracts; SocINDEX with Full Text; SPORTDiscus; cinhal; and the ISI Web of Knowledge databases. Key journals were manually scanned and citations followed. Literature was included if reporting on issues concerning emotion. Results:, Emotion in information behaviour in healthcare contexts is scantily addressed. This review, however, offers some insight into the difficulty in identifying and expressing information needs; sense making and the need to fill knowledge gaps; uncertainty; personality and coping skills; motivation to seeking information; emotional experiences during information seeking; self-confidence and attitude; emotional factors in the selection of information channels; and seeking information for psychological or emotional reasons. Conclusion:, Suggestions following findings, address information literacy programs, information services and research gaps. [source] Which neuroreceptors mediate the subjective effects of MDMA in humans?HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 8 2001A summary of mechanistic studies Abstract In preclinical studies, 3,4-methylenedioxymethamphetamine (MDMA, ,Ecstasy') has been shown to release serotonin (5-HT), dopamine and norepinephrine. However, the role of these neurotransmitters and their corresponding receptor sites in mediating the subjective effects of MDMA has not yet been studied in humans. Therefore, we investigated the effects of three different neuroreceptor pretreatments on the subjective, cardiovascular and adverse effects of MDMA (1.5 mg/kg orally) in 44 healthy human volunteers. Pretreatments were: the selective serotonin reuptake inhibitor citalopram (40 mg intravenously) in 16 subjects, the 5-HT2 antagonist ketanserin (50 mg orally) in 14 subjects, and the D2 antagonist haloperidol (1.4 mg intravenously) in 14 subjects. Each of these studies used a double-blind placebo-controlled within-subject design and all subjects were examined under placebo, pretreatment, MDMA and pretreatment plus MDMA conditions. Citalopram markedly reduced most of the subjective effects of MDMA, including positive mood, increased extraversion and self-confidence. Cardiovascular and adverse effects of MDMA were also attenuated by citalopram. Haloperidol selectively reduced MDMA-induced positive mood but had no effect on other subjective effects of MDMA or the cardiovascular or adverse responses to MDMA. Ketanserin selectively reduced MDMA-induced perceptual changes and emotional excitation. These results indicate that the overall psychological effects of MDMA largely depend on carrier-mediated 5-HT release, while the more stimulant-like euphoric mood effects of MDMA appear to relate, at least in part, to dopamine D2 receptor stimulation. The mild hallucinogen-like perceptual effects of MDMA appear to be due to serotonergic 5-HT2 receptor stimulation. Copyright © 2001 John Wiley & Sons, Ltd. [source] The effect of tadalafil on psychosocial outcomes in Swedish men with erectile distress: a multicentre, non-randomised, open-label clinical studyINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 11 2006K. S. FUGL-MEYER Summary A multicentre, non-randomised, open-label study assessed whether personal distress caused by erectile dysfunction (ED) affected psychosocial outcomes of tadalafil treatment. Eligible Swedish men at least 18 years old reporting ,3-month history of ED were stratified into two groups (manifest or mild/no distress) based upon a distress question administered at enrolment. Tadalafil 20 mg was taken as needed for 8 weeks. The primary outcome was the difference between the two distress groups in change from baseline in the Psychological and Interpersonal Relationship Scales (PAIRS) spontaneity domain. Secondary outcome measures were PAIRS sexual self-confidence and time concerns domains, Life Satisfaction (LiSat-11) checklist and a Global Assessment of Treatment Response. The study also assessed tolerability. Of 662 men enrolled, 88% had manifest distress and 12% had mild/no distress. Baseline-to-endpoint changes for PAIRS domains were not significantly different between groups. Baseline-to-endpoint changes in LiSat-11 items were not significantly different between groups except for satisfaction with sexual life. Compared with men without ED, below normal baseline satisfaction with partner relationship and family life were normalised at endpoint. Over 90% of men reported improved erection and ability to engage in sexual activity. The most common treatment-emergent adverse events were headache, myalgia, dyspepsia, flushing and back pain. One man discontinued because of myalgia; 630 (95%) completed the study. In conclusion, erectile distress levels vary among patients with ED and distress can affect intra-familiar aspects of life, which may have implications for clinical practise. However, distress does not appear to hinder improvement in both mechanical and psychosocial outcomes of tadalafil treatment. [source] Effectiveness of simulation on health profession students' knowledge, skills, confidence and satisfactionINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 3 2008Susan Laschinger Abstract Background, Despite the recent wave of interest being shown in high-fidelity simulators, they do not represent a new concept in healthcare education. Simulators have been a part of clinical education since the 1950s. The growth of patient simulation as a core educational tool has been driven by a number of factors. Declining inpatient populations, concerns for patient safety and advances in learning theory are forcing healthcare educators to look for alternatives to the traditional clinical encounter for skill acquisition for students. Objective, The aim of this review was to identify the best available evidence on the effectiveness of using simulated learning experiences in pre-licensure health profession education. Inclusion criteria,Types of studies: This review considered any experimental or quasi-experimental studies that addressed the effectiveness of using simulated learning experiences in pre-licensure health profession practice. In the absence of randomised controlled trials, other research designs were considered for inclusion, such as, but not limited to: non-randomised controlled trials and before-and-after studies. Types of participants: This review included participants who were pre-licensure practitioners in nursing, medicine, and rehabilitation therapy. Types of intervention(s)/phenomena of interest: Studies that evaluated the use of human physical anatomical models with or without computer support, including whole-body or part-body simulators were included. Types of outcome measures, Student outcomes included knowledge acquisition, skill performance, learner satisfaction, critical thinking, self-confidence and role identity. Search strategy, Using a defined search and retrieval method, the following databases were accessed for the period 1995,2006: Medline, CINAHL, Embase, PsycINFO, HealthSTAR, Cochrane Database of Systematic Reviews and ERIC. Methodological quality, Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using the standardised critical appraisal instruments for evidence of effectiveness, developed by the Joanna Briggs Institute. Disagreements were dealt with by consultations with a third reviewer. Data collection, Information was extracted from each paper independently by two reviewers using the standardised data extraction tool from the Joanna Briggs Institute. Disagreements were dealt with by consultation with a third reviewer. Data synthesis, Due to the type of designs and quality of available studies, it was not possible to pool quantitative research study results in statistical meta-analysis. As statistical pooling was not possible, the findings are presented in descriptive narrative form. Results, Twenty-three studies were selected for inclusion in this review including partial task trainers and high-fidelity human patient simulators. The results indicate that there is high learner satisfaction with using simulators to learn clinical skills. The studies demonstrated that human patient simulators which are used for teaching higher level skills, such as airway management, and physiological concepts are useful. While there are short-term gains in knowledge and skill performance, it is evident that performance of skills over time after initial training decline. Conclusion, At best, simulation can be used as an adjunct for clinical practice, not a replacement for everyday practice. Students enjoyed the sessions and using the models purportedly makes learning easier. However, it remains unclear whether the skills learned through a simulation experience transfer into real-world settings. More research is needed to evaluate whether the skills acquired with this teaching methodology transfer to the practice setting such as the impact of simulation training on team function. [source] Capitalising on learning: an exploration of the MBA as a vehicle for developing career competenciesINTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT, Issue 1 2003Jane Sturges This article reports the findings of a study of Canadian MBA graduates that explores the skills, knowledge and capabilities which they gained from the programme within the context of a career-competency framework. It concludes that the development of knowing-why career competencies (relating to career values, meanings and motivations) were the most important outcome of the course for the graduates. Knowing-how career competencies (relating to skills and job-related knowledge) were also valued highly. Increased self-confidence was a valuable form of career capital for the graduates, although the antecedents and consequences of this appear to be somewhat different for men and women. [source] The Practical Approach to Lung Health in South Africa (PALSA) intervention: respiratory guideline implementation for nurse trainersINTERNATIONAL NURSING REVIEW, Issue 4 2006A. Bheekie d.pharm Aim:, This paper describes the design, facilitation and preliminary assessment of a 1-week cascade training programme for nurse trainers in preparation for implementation of the Practical Approach to Lung Health in South Africa (PALSA) intervention, tested within the context of a pragmatic cluster randomized controlled trial in the Free State province. PALSA combines evidence-based syndromic guidelines on the management of respiratory disease in adults with group educational outreach to nurse practitioners. Background:, Evidence-based strategies to facilitate the implementation of primary care guidelines in low- to middle-income countries are limited. In South Africa, where the burden of respiratory diseases is high and growing, documentation and evaluation of training programmes in chronic conditions for health professionals is limited. Method:, The PALSA training design aimed for coherence between the content of the guidelines and the facilitation process that underpins adult learning. Content facilitation involved the use of key management principles (key messages) highlighted in nurse-centred guidelines manual and supplemented by illustrated material and reminders. Process facilitation entailed reflective and experiential learning, role-playing and non-judgemental feedback. Discussion and results:, Preliminary feedback showed an increase in trainers' self-awareness and self-confidence. Process and content facilitators agreed that the integrated training approach was balanced. All participants found that the training was motivational, minimally prescriptive, highly nurse-centred and offered personal growth. Conclusion:, In addition to tailored guideline recommendations, training programmes should consider individual learning styles and adult learning processes. [source] Non-psychiatric hospitalization of people with mental illness: systematic reviewJOURNAL OF ADVANCED NURSING, Issue 8 2009Cindy Diamond Zolnierek Abstract Title.,Non-psychiatric hospitalization of people with mental illness: systematicreview. Aim., This paper is a report of a literature review of the evidence regarding outcomes experienced by severely mentally ill individuals hospitalized in general medical-surgical settings for non-psychiatric conditions. Background., Severely mentally ill individuals experience chronic medical illnesses at a rate greater than the general population. When hospitalized in non-psychiatric settings, they tend to be experienced as ,difficult' by nurses and to have longer lengths of stay. Data sources., The CINAHL and PUBMED databases were searched from 1 to 9 March 2008 to identify studies published between 1998 and 2008 investigating outcomes among people with mental illness hospitalized for non-psychiatric illness in general hospitals. Methods., Included studies were those published in English in peer reviewed journals and investigating patient outcomes. The studies were reviewed for relevance and inclusion criteria; the methodological quality of studies was not evaluated. Results., Twelve studies met inclusion criteria. All studies examining length of stay, costs of care or resource utilization showed increased measures for patients with psychiatric comorbidity. Interventions described included psychiatric liaison psychiatry and nursing, which failed to demonstrate improvement in outcomes. Conclusion., Nurses play a pivotal role in improving the inpatient care of this vulnerable population, but they struggle in their attempts to do so. Research to determine the best approaches to promote nurses' knowledge, positive attitudes and self-confidence in caring for patients with psychiatric comorbidity is needed. Investigation of the patient perspective on the inpatient experience might also provide insight for designing effective care processes. [source] Critical thinking dispositions in baccalaureate nursing studentsJOURNAL OF ADVANCED NURSING, Issue 2 2006Kyung Rim Shin EdD RN FAAN Aim., This paper reports an investigation into the critical thinking disposition of students enrolled in a baccalaureate nursing programme at a university in Korea. Background., Critical thinking may be summarized as a skilled process that conceptualizes and applies information from observation, experience, reflection, inference and communication in a technical manner. It is more of a rational act used as an instrument rather than as a result. Critical thinking is a core competency in nursing and has been widely discussed in nursing education. However, the results of previous research on the effectiveness of nursing education in improving students' critical thinking have been inconsistent. Methods., A longitudinal design was used with a convenience sample of 60 nursing students; 32 students participated four times in completing a questionnaire each March from 1999 to 2002. The California Critical Thinking Disposition Inventory was administered to measure disposition to critical thinking. Results., There was a statistically significant improvement in critical thinking disposition score by academic year (F = 7·54, P = 0·0001). Among the subscales, open-mindedness, self-confidence, and maturity also showed a statistically significant difference by academic year (P = 0·0194, 0·0041, 0·0044). Conclusion., Teaching strategies to enhance critical thinking should be developed, in addition to further research on the effect of the nursing curriculum on students' critical thinking. Moreover, survey instruments could be adjusted to incorporate characteristics of the Korean culture. [source] Improving homework compliance in the treatment of generalized anxiety disorderJOURNAL OF CLINICAL PSYCHOLOGY, Issue 5 2002Robert L. Leahy Generalized anxiety disorder is a chronic condition characterized by beliefs that worry prepares and protects, but that excessive worry is out of control. In this article, I review the cognitive-behavioral model of generalized anxiety, focusing specifically on problems related to excessive worrying. Noncompliance in self-help homework is reflected in the patient's excessive focus on negative feelings, difficulty identifying automatic thoughts, demand for immediate results, and the belief that worries are realistic. Interventions for these problems are illustrated in the case of the treatment of a patient characterized by persistent worries, low self-confidence, procrastination, and avoidance. © 2002 Wiley Periodicals, Inc. J Clin Psychol/In Session 58: 499,511, 2002. [source] A computer attitude scale for computer science freshmen and its educational implicationsJOURNAL OF COMPUTER ASSISTED LEARNING, Issue 5 2005G.E. Palaigeorgiou Abstract The successful integration of computers in educational environments depends, to a great extent, on students' attitudes towards them. Widely used computer attitude scales (CASs) focus on the beliefs of typical computer users and do not reveal the more refined attitudes of groups that use computers extensively and develop unique relations with them. This study presents the development and validation of a CAS especially designed for computer science freshmen (CASF). The scale consists of five factors, namely, self-confidence in previous knowledge, hardware usage anxiety, computer engagement, fears of long-lasting negative consequences of computer use and evaluation of positive consequences of computers in personal and social life. Using an analytic computer experience construct, the scale's components were related to multiple aspects of students' computer experience. CASF responses can inform a variety of instructional decisions and classroom management strategies for the first phase of the students' studies. [source] Consumer Self-Confidence in Searching for InformationJOURNAL OF CONSUMER AFFAIRS, Issue 1 2009CÄZILIA LOIBL Consumer behavior is often driven by the extent to which consumers feel confident regarding their decisions, which frequently hinge, especially in high-stakes situations, on their information search. This article examines a multidimensional self-confidence concept to explore how consumer self-confidence influences information search. Findings of a mail survey document that high-confidence consumers engage in more intensive search activities and that demographic patterns shape consumer self-confidence scores. The findings empirically support a multidimensional measurement of self-confidence to predict search behavior and suggest avenues to enhance the self-confidence needed to produce positive marketplace experiences. [source] Market mavenism and consumer self-confidenceJOURNAL OF CONSUMER BEHAVIOUR, Issue 3 2008Ronald A. Clark The purpose of this study was to test hypothesized associations between market mavenism and consumer self-confidence (CSC). A survey of 190 US consumers provided the data. The results showed significant relationships between mavenism and several dimensions of CSC, and regression analysis emphasized the relationships with two of these: information acquisition (confidence in the ability to obtain and use marketplace information) and social outcomes decision making (confidence in obtaining positive reactions from others). These findings both enrich our knowledge of the psychology of market mavenism by suggesting some motivations for these behaviors and suggest marketing strategies can be fine-tuned to appeal more effectively to this important segment of consumers. Copyright © 2008 John Wiley & Sons, Ltd. [source] Antecedents of consumer relative preference for interpersonal information sources in pre-purchase searchJOURNAL OF CONSUMER BEHAVIOUR, Issue 5 2005Mehdi Mourali Abstract Past research has demonstrated clearly the importance of pre-purchase information search within the buying process. Scholars have identified several sources used by consumers in order to obtain information relevant to their purchase situation. Among the various information sources, interpersonal non-commercial sources seem to play an important role in consumers' choice decisions. The present study examines potential antecedents of consumer relative preference for interpersonal information search. The proposed antecedents include personality traits such as individuals' susceptibility to interpersonal influence, their need for cognition and their self-confidence, as well as individual differences in product knowledge and perceived risk associated with the purchase of a specific product. Using structural equation modelling on survey data (419 respondents), seven hypotheses , describing relationships between the diverse variables of the model , were tested. The results indicate that consumer relative preference for interpersonal information search was significantly influenced by consumers' susceptibility to interpersonal influence, their need for cognition, their self-confidence and their product knowledge. Consumers' product knowledge also influenced their perceived risk, which did not affect their preference for interpersonal search significantly. Copyright © 2005 John Wiley & Sons, Ltd. [source] A11. The influence of the media on eating disordersJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2000S. Almond Background The cause of eating disorders is multifactorial. One of these is sociocultural factors which include family, peers and the media. It has been suggested that constant media pressures can lead to body dissatisfaction, which may result in distorted eating patterns. Aims To review the role of the media in relation to eating disorders Results There has been a shift in the media portrayal of the 'ideal' body size for women, from the voluptuous curved figure of Marilyn Monroe in the 1950s to a thinner 'waif-like' look of Kate Moss in the 1980s. In the mass media shape and weight define perfection. Women perceive themselves as being bigger than they actually are. Their figure deviates from the ideal thus resulting in self body dissatisfaction. 'All I see is these pretty models, I wish I could look like one of them.' ( Wertheim et al. 1997 ) The 'ideal' body image is far from the physiologic norm. Supermodels are born with a specific body type and what the public doesn't understand is that they cannot diet to achieve it. 'Women don't set out to be anorexic, they begin by thinking they're too fat because everywhere they go the media is telling them that they are right' ( Barrett, 1997) Products are often advertised displaying the ideal body shape in the hope that it will enhance the product and create body dissatisfaction. Purchasing the product is perceived as a positive step towards reaching the 'perfect' body image. Concern surrounds the appearance of such advertisements in magazines aimed at adolescent girls, as at this age they are particularly vulnerable to the influences of the media. Stice and Shaw (1994) stated that exposure to the thin 'idea' may have a negative effect on emotions leading to body dissatisfaction. Such emotions include depression, stress, guilt, shame, insecurity, unhappiness, and lower self-confidence. A study by Schotte et al. (1990) indicated that negative emotions can disrupt eating behaviour. Dieters watching a frightening film increased their food intake, whereas nondieters did not. Conclusion The media are not solely responsible for eating disorders but they do contribute by promoting the 'ideal' physique. There is some resistance to media messages, as the majority of people do not develop distorted eating patterns. [source] Creativity Defined: Implicit Theories in the Professions of Interior Design, Architecture, Landscape Architecture, and EngineeringJOURNAL OF INTERIOR DESIGN, Issue 1 2002Margaret Portillo Ph.D. ABSTRACT The purpose of this study was to examine implicit theories of creativity in related fields through a mail survey of 3 1 3 professors randomly selected from accredited programs in interior design, architecture, landscape architecture, and engineering. To describe a highly creative practitioner in their respective fields, the respondents completed the Gough Adjective Check List (ACL), scored with the Domino creativity scale (Cr). The interior design professors generated a profile of the creative practitioner that obtained a significantly higher mean score than did the architecture or engineering groups on the ACL-Cr scale. No other significant differences on the creativity scale appeared between groups. Exploratory analyses of individual ACL-Cr items found considerable agreement as to what constituted creativeness in implicit theories. At least 75 percent of the respondents in each group described the creative practitioner in their respective fields as imaginative, inventive, and adventurous. Disciplinary differences among groups surfaced in 21 traits on the ACL-Cr scale that were statistically significant in areas of artistic creativity, scientific creativity, intelligence, self-confidence, and task orientation. Further, the creative interior design practitioner was perceived as significantly more individualistic and original than in the other three fields, and sixteen other traits significantly differentiated interior design profiles from those posited in architecture, landscape architecture, or engineering. By promoting a scholarship of integration, findings reveal perceived traits of the creative practitioner in allied fields and advance interdisciplinary understanding. Design educators are encouraged to reflect on their own implicit theories of creativity and those of their students to acknowledge underlying assumptions about creativity that can influence innovation and collaboration. [source] Firm value, managerial confidence, and investments: The case of ChinaJOURNAL OF LEADERSHIP STUDIES, Issue 3 2008Bei Ye The purpose of this article is to test empirically the impact of Chinese managerial confidence on firm value through investment decisions. We use a simultaneous equation model, which treats firm value, investments, and managerial confidence as endogenous to the firm. With a sample of 329 Chinese listed firms and a confidence measure based on management shareholding, the 3SLS regression results show significant interactions among the three variables. Firm value has a positive impact on managerial confidence while the latter's impact on the former turns from positive to negative at a certain point. The results suggest a non-monotonic relationship between managerial self-confidence and firm value and imply an optimal level of managerial confidence. Therefore, while the leader selection process encourages confident talents to become decision-makers, proper measures are required to prevent the confidence transformed into overconfidence. [source] Variations in the Understanding of Interpersonal Behavior: Adherence to the Interpersonal Circle as a Moderator of the Rigidity,Psychological Well-Being RelationJOURNAL OF PERSONALITY, Issue 2 2010Terence J. G. Tracey ABSTRACT The idiothetic structure of interpersonal trait perceptions was examined as it moderated the interpersonal rigidity,psychological well-being relation. The focus was on the extent to which individuals' perceptions of the similarity of interpersonal behavior fits (i.e., adhered to) the normative interpersonal circle. In two samples of college students, individual differences in adherence to the interpersonal circle moderated the relation of interpersonal rigidity with various indices of psychological well-being. We found that those individuals whose perceptions of interpersonal traits were better represented by the interpersonal circle had negative relations between interpersonal rigidity and satisfaction with life, self-confidence, self-liking, and complementarity and positive relations with interpersonal problems. The results suggest that adherence to the interpersonal circle may be a new means of viewing traitedness and that cognitive interpretation of traits may have an important moderating function. [source] Introducing dental students to clinical patient care: The complete denture prosthodontics transition clinicJOURNAL OF PROSTHODONTICS, Issue 3 2003Lisa A. Lang DDS Using complete denture treatment as an introduction to clinical patient care for dental students, the purposes of the Complete Denture Prosthodontics Transition Clinic at the University of Colorado School of Dentistry are to reduce the time lapse between the preclinical complete denture prosthodontics course and the first denture patient experience, and to encourage development of student self-confidence and skills. In the 2002 spring semester, faculty at the University of Colorado School of Dentistry initiated the Complete Denture Prosthodontics Transition Clinic for DS-II (second-year) dental students, as an introduction to clinical patient care. Each patient was assigned to a team of two dental students. Three Division of Prosthodontics faculty members staffed each clinic session, providing a student-to-faculty ratio of approximately 6.6:1 and a patient-to-faculty ratio of approximately 3.3:1. All DS-II students in the Class of 2004 delivered their first complete dentures no later than 8 months (average, 184 days) after the last day of the preclinical complete denture prosthodontics course. The time from the diagnostic appointment through the denture placement appointment averaged 39 days for patients treated in this program, compared with an average of 98 days or more for previous classes. The program was successful in achieving the goal of reducing the time lapse between the preclinical complete denture prosthodontics course and the first denture patient experience. [source] Mental Health Problems Among Single Mothers: Implications for Work and Welfare ReformJOURNAL OF SOCIAL ISSUES, Issue 4 2000Rukmalie Jayakody Welfare reform's emphasis on work and self-sufficiency assumes that poor single mothers are similar in their status and functioning to the rest of the population. However, we find that their status is quite distinct. Logistic regression results reveal that the likelihood of working is 25% lower for those with a psychiatric disorder. Mental health problems may prevent women from undertaking the tasks necessary to find employment, or women with these problems may lack the self-confidence needed to take on new challenges. Our findings suggest that mental health problems among single mothers deserve greater attention as a barrier to self-sufficiency and highlight the need for more effective intervention and treatment efforts to improve economic and social outcomes. [source] Experience of Middle- and Old-Aged Women's AgingNURSING & HEALTH SCIENCES, Issue 3 2002Seung Eun Chung Many studies on aging have explored the effects of disease and other problems on the elderly. These studies have resulted in a view of aging that focuses on losses. How aging is perceived may affect the adaptation of the elderly to life changes. Therefore, there needs to be a better understanding of aging from the perspective of the middle-aged and older-aged adults. This qualitative study used a hermeneutic phenomenological approach to discover meaning in the aging experience. The purpose of this study was to explore the experience of middle-aged and older-aged women. Participants consisted of 10 women (five middle-aged women and five older-aged women) aged 40 years or more who lived in Chongiu. Multiple strategies for data collecting were utilized including an in-depth face-to-face interview and an analysis of the literature on aging, based on Van Manen's methodology of phenomenological research. The following themes emerged: (i) middle-aged women: changing of physical shape, the attachment of youth, loss of self-confidence, and preparing for one's own old age; (ii) old-aged women: changing of physical function, being ousted from the younger generation, rhythmical pattern of life and death, and reflection on life. [source] Long-Term Outcomes of a Telephone Intervention After an ICDPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 11 2005CYNTHIA M. DOUGHERTY Background: The purpose of this study was to determine the long-term benefits of participating in a structured, 8-week educational telephone intervention delivered by expert cardiovascular nurses post-ICD. The intervention was aimed to (1) increase physical functioning, (2) increase psychological adjustment, (3) improve self-efficacy in managing the challenges of ICD recovery, and (4) lower levels of health care utilization over usual care in the first 12 months post-ICD. This article reports on the 6- and 12-month outcomes of the nursing intervention trial. Methods and Results: A two-group (N = 168) randomized control group design was used to evaluate intervention efficacy with persons receiving an ICD for the secondary prevention of sudden cardiac arrest. Measures were obtained at baseline, 6 and 12 months post hospitalization. Outcomes included (1) physical functioning (Patient Concerns Assessment [PCA], Short Form Health Survey [SF-12], ICD shocks), (2) psychological adjustment (State-Trait Anxiety Inventory [STAI], Centers for Epidemiologic Studies,Depression [CES-D], fear of dying), (3) self-efficacy (Sudden Cardiac Arrest,Self-Efficacy [SCA-SE], Sudden Cardiac Arrest,Behavior [SCA-B], Sudden Cardiac Arrest,Knowledge [SCA-K]), and (4) health care utilization (emergency room [ER] visits, outpatient visits, hospitalizations). Using repeated measures ANOVA, the 6- and 12-month benefits of the intervention over usual care were in reductions in physical concerns (P = 0.006), anxiety (P = 0.04), and fear of dying (P = 0.01), with enhanced self-confidence (P = 0.04) and knowledge (P = 0.001) to manage ICD recovery. There were no statistically significant differences between the groups on total outpatient visits, hospitalizations, or ER visits over 12 months. Conclusion: A structured 8-week post-hospital telephone nursing intervention after an ICD had sustained 12-month improvements on patient concerns, anxiety, fear of dying, self-efficacy, and knowledge. Results may not apply to individuals with congestive heart failure who receive an ICD for primary prevention of sudden cardiac arrest. [source] Aftermath of a Patient's Suicide: A Case StudyPERSPECTIVES IN PSYCHIATRIC CARE, Issue 1 2003Sharon M. Valente PhD TOPIC. Nurse psychotherapists often feel poorly prepared to cope with a patient's death by suicide. The psychotherapist may identify with the family, feel sad at the death, and be plagued by feelings of guilt and responsibility. PURPOSE. A case study illustrates the meaning of the loss to the therapist and the influence on professional identity, self-confidence, and self-esteem. SOURCES. Case study and review of the literature from Medline, psychinfo, and CINAHL. CONCLUSIONS. Therapists experience their own grief as a lack of omnipotence over suicide, and the fear of their colleagues' responses. Understanding bereavement and factors influencing bereavement may help therapists facilitate and reduce negative consequences of their own grief. [source] Proceedings of the 20th Annual Conference of the Japanese Association for Adolescent Psychotherapy, 16 November 2002, Tokyo, JapanPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2003Article first published online: 28 AUG 200 Inpatient treatment of obsessive,compulsive disorder in a child and adolescent psychiatry ward M. USAMI National Center of Neurology and Psychiatry, Kohnodai Hospital, Chiba, Japan This is a case report of a 13-year-old-boy (2nd grade in junior high school). His father had poor communication; his mother was a very fragile woman. The boy had been overprotected by his parents, as long as he responded to their expectations. He did not have any other siblings. He played well with his friends since he was young, and did not have problems until the 1st term (from April to July) of 1st grade in junior high school. However, in September he started to have difficulties going well with his friends, and going to school. He spent most of his time in his room, and began to repeat checking and hand-washing frequently. Even at midnight, he forced his mother to touch the shutter from outside of the house for many times. He also ritually repeated to touch his mother's body, after he licked his hands, for over an hour. He became violent, when his parents tried to stop him. In April, year X, his parents visited our hospital for the first time. From then, his mother could not tolerate her son's coerciveness any longer. His father explained to the boy that ,your mother has been hospitalized', and she started to live in the next room to the boy's without making any noise. After 3 months he noticed that his mother was not hospitalized, and he got very excited. He was admitted to our hospital with his family and relatives, in October, year X. At the initial stage of hospitalization he showed distrust and doubt towards the therapist and hospital. He had little communication with other boys and did not express his feelings. Therefore, there was a period of time where he seemed to wonder whether he could trust the treatment staff or not. During his interviews with his therapist he repeated only ,I'm okay' and did not show much emotional communication. For the boy, exposing himself was equivalent to showing his vulnerability and incompleteness. Therefore, the therapist considered that he was trying to denying his feelings to avoid this. The therapist set goals for considering his own feelings positively and expressing them appropriately. Also, the therapist carried out behavioral restrictions towards him. He hardly had any emotional communication with the staff, and his peer relationship in the ward was superficial. Therefore, he gradually had difficulty spending his time at the end of December On the following day in which he and the therapist decided to return to his house for the first time, he went out of the ward a few days before without permission. From thereon it was possible for him to share feelings such as hostility and aggression, dependence and kindness with the therapist. The therapist changed his role from an invasive one to a more protective one. Then, his unsociability gradually faded. He also developed good peer relationships with other boys in the ward and began to express himself feeling appropriately. He was also able to establish appropriate relations with his parents at home, and friends of his neighborhood began to have normal peer relationships again. During childhood and adolescence, boys with obsessive,compulsive disorder are known to have features such as poor insight and often involving their mothers. We would like to present this case, through our understanding of dynamic psychiatry throughout his hospitalization, and also on the other therapies that were performed. Psychotherapy with a graduate student that discontinued after only three sessions: Was it enough for this client? N. KATSUKI Sophia University, Tokyo, Japan Introduction: Before and after the psychotherapy, SWT was administrated in this case. Comparing these two drawings, the therapist was provided with some ideas of what kind of internal change had taken place inside this client. Referring to the changes observed, we would like to review the purposes and the ways of the psychotherapy, as well as the adequacy of the limited number of the sessions (vis-a-vis result attained.) Also we will discuss later if any other effective ways could be available within the capacities of the consulting system/the clinic in the university. Case: Ms. S Age 24 years. Problems/appeal: (i) awkwardness in the relationship with the laboratory colleagues; (ii) symptoms of sweating, vomiting and quivering; and (iii) anxiety regarding continuing study and job hunting. Diagnosis: > c/o PTSD. Psychotherapeutic setting: At the therapy room in the clinic, placed at the university, 50 min-session; once a week; paralleled with the medical treatment. Process: (1) Since she was expelled from the study team in the previous year, it has become extremely difficult for her to attend the laboratory (lab) due to the aforementioned symptoms. She had a feeling of being neglected by the others. When the therapist suggested that she compose her mental confusions in the past by attending the therapy room, she seemed to be looking forward to it, although she said that she could remember only a few. (2) She reported that she overdosed on sedatives, as she could not stop irritating. She was getting tough with her family, also she slashed the mattress of her bed with a knife for many times. She complained that people neither understood nor appreciated her properly. and she said that she wanted revenge on the leader of the lab by punishing him one way or other. (3) Looking back the previous session, she said ,I had been mentally mixed up at that time, but I feel that now I can handle myself, as I stopped the medication after consulting the psychiatrist. According to what she said, when she disclosed the occurrences in the lab to her mother, she felt to be understood properly by her mother and felt so relieved. and she also reported that she had been sewing up the mattress which she slashed before, without any reason. She added, " although I don't even know what it means, I feel that this work is so meaningful to me, somehow". Finally, she told that she had already made her mind to cope with the situation by herself from now on, although it might result in a flinch from the real solution. Situations being the above, the session was closed. Swt: By the remarkable changes observed between the two drawings, the meanings of this psychotherapy and its closure to the client would be contemplated. Question of how school counselors should deal with separation attendant on students' graduation: On a case in which the separation was not worked through C. ASAHARA Sophia University, Tokyo, Japan Although time limited relationship is one of the important characteristics in school counseling, the question of separation attendant on it has not been much discussed based on specific cases. This study focuses on the question of separation through looking at a particular case, in which the separation was not worked through, and halfway relationship continued even after the student's graduation and the counselor's resignation. I was a part time school counselor at a junior high school in Tokyo. The client was a 14-year-old female student, who could not go to her classroom, and spent a few hours in a sick bay when she came to school. She was in the final grade and there was only half a year left before graduation when we first met, and we started to see each other within a very loose structure. As her personality was hyper-vigilant and defensive, it took almost 2 months before I could feel that she was nearer. Her graduation was the first occasion of separation. On that occasion, I found that there had been a discrepancy between our expectations; while I took it for granted that our relationship would end with the graduation, she expected to see me even after she graduated, and she actually came up to see me once in a while during the next year. A year later, we faced another occasion of separation, that was my resignation. Although I worried about her, all I have done for her was to hand a leaflet of a counseling office, where I work as a part time counselor. Again I could not refer to her feelings or show any concrete directions such as making a fixed arrangement. After an occasional correspondence for the next 10 months (about 2 years after her graduation), she contacted me at the counseling office asking for a constant counseling. Why could I not deal with both occasions? and how did that affect the client thereafter? There were two occasions of separation. At the time of the client's graduation, I seemed to be enmeshed in the way of separation that is peculiar to the school setting. In general in therapeutic relationship, mourning work between counselor and client is regarded as being quite important. At school, however, separation attendant on graduation is usually taken for granted and mourning work for any personal relationship tends to be neglected. Graduation ceremony is a big event but it is not about mourning over one's personal relationships but separation from school. That may be why I did not appreciate how the client counted on our relationship. At the time of my resignation I was too worried about working through a change from very loose structure which is peculiar to the school setting to a usual therapeutic structure (fees are charged, and time, place are fixed). That is why I did nothing but give her a leaflet. In this way, we never talked about her complex feelings such as sadness or loneliness, which she was supposed to experience on separation. Looking at the aforementioned process from the client's viewpoint, it can be easily imagined that she could not accept the fact of separation just because she graduated. and later, she was forced to be in double-bind situation, in which she was accepted superficially (handed a leaflet), while no concrete possibility was proposed concerning our relationship (she could never see me unless she tries to contact me.) As a result, she was left alone and at a loss whether she could count on me or not. The halfway situation or her suspense was reflected in her letter, in which she appeared to be just chatting at first sight, but between the lines there was something more implying her sufferings. Above discussion suggests that in some case, we should not neglect the mourning work even in a school setting. To whom or how it is done is the next theme we should explore and discuss in the future. For now, we should at least be conscious about the question of separation in school setting. Study of the process of psychotherapy with intervals for months M. TERASHIMA Bunkyo Gakuin University, Tokyo, Japan This is a report on the process of psychotherapy of an adolescent girl who showed manic and depressive state. At the time of a depressed state, she could not go to a college and withdrew into home, and the severe regressive situation was shown. Her therapy began at the age of 20 and she wanted to know what her problem was. The process of treatment went on for 4 years but she stopped coming to sessions for several months because of failure of the therapist. She repeated the same thing twice. After going through these intervals the client began to remember and started to talk about her childhood , suffering abusive force from her father, with vivid impressions. They once were hard for her to accept, but she began to establish the consistent figure of herself from past to present. In this case, it could be thought that the intervals of the sessions had a certain role, with which the client controlled the structure of treatment, instead of an attack against the therapist. Her object relation, which is going to control an object offensively, was reflected in these phenomena. That is, it can be said that the ambivalence about dependency , difficult to depend but desirous of the object , was expressed. Discontinuation of the sessions was the product of the compromise formation brought about the ambivalence of the client, and while continuing to receive this ambivalence in the treatment, the client started to realize discontinuance of her memories and then advanced integration of her self-image. For the young client with conflict to dependence such as her, an interval does not destroy the process of treatment but in some cases it could be considered as a therapeutic element. In the intervals the client could assimilate the matter by herself, that acquired by the sessions. Psychotherapy for a schizoid woman who presented eccentric speech and behaviour M. OGASAWARA Osaka University Graduate School of Medicine, Osaka, Japan Case presentation: A case of a 27-year-old woman at the beginning of therapy. Life history: She had been having a wish for death since she was in kindergarten and she had been feeling strong resistance to do the same as others after school attendance. She had a history of ablutomania from the age of 10,15, but the symptom disappeared naturally. and she said that she had been eliminated from groups that she tried to enter. After graduating a junior college, she changed jobs several times without getting a full-time position. Present history: Scolded by her boy friend for her coming home too late one day, she showed confusion such as excitement, self-injury or terror. She consulted a psychiatrist in a certain general hospital, but she presented there eccentric behaviours such as tense facial expression, stiffness of her whole body, or involuntary movement of limbs. and because she felt on bad terms with the psychiatrist and she had come to cause convulsion attacks in the examination room, she was introduced to our hospital. Every session of this psychotherapy was held once a week and for approximately 60 min at a time. Treatment process: She sometimes presented various eccentric attitudes, for example overturning to the floor with screaming (1), going down on her knees when entrance at the door (5), entering with a knife in her mouth and hitting the wall suddenly (7), stiffening herself just outside the door without entering the examination room (9), taking out a knife abruptly and putting it on her neck (40), exclaiming with convulsion responding to every talk from the therapist (41), or stiffening her face and biting herself in the right forearm suddenly (52). She also repeated self-injuries or convulsion attacks outside of the examination room in the early period of the therapy. Throughout the therapy she showed hypersensitivity for interpersonal relations, anxiety about dependence, terror for self-assertion, and avoidance for confrontation to her emotional problems. Two years and 6 months have passed since the beginning of this therapy. She ceased self-injury approximately 1 year and 6 months before and her sense of obscure terror has been gradually reduced to some extent. Discussion: Her non-verbal wariness and aggression to the therapist made the sessions full of tension and the therapist felt a sense of heaviness every time. In contrast, she could not express aggression verbally to the therapist, and when the therapist tried to identify her aggression she denied it. Her anxiety, that she will be thoroughly counterattacked to self-disintegration if she shows aggression to other persons, seems to be so immeasurably strong that she is compelled to deny her own aggression. Interpretations and confrontations by the therapist make her protective, and occasionally she shows stronger resistance in the shape of denial of her problems or conversion symptoms (astasia, aphonia, or involuntary movements) but she never expresses verbal aggression to the therapist. and the therapist feels much difficulty to share sympathy with her, and she expresses distrust against sympathetic approach of the therapist. However, her obvious disturbance that she expresses when she feels the therapist is not sympathetic shows her desire for sympathy. Thus, because she has both strong distrust and desire for sympathy, she is in a porcupine dilemma, which is characteristic of schizoid patients as to whether to lengthen or to shorten the distance between herself and the therapist. This attitude seems to have been derived from experience she might have had during her babyhood and childhood that she felt terror to be counterattacked and deserted when she showed irritation to her mother. In fact, existence of severe problems of the relationship between herself and her mother in her babyhood and childhood can be guessed from her statement. Although she has been repeating experiences to be excluded from other people, she shows no attitude to construct interpersonal relationship actively. On the contrary, by regarding herself to be a victim or devaluating other persons she externalizes responsibility that she herself should assume essentially. The reason must be that her disintegration anxiety is evoked if she recognizes that she herself has problems; that is, that negative things exist inside of her. Therefore, she seems to be inhibited to get depressive position and obliged to remain mainly in a paranoid,schizoid position. As for the pathological level, she seems to have borderline personality organization because of frequent use of mechanisms to externalize fantastically her inner responsibility. For her high ability to avoid confronting her emotional problems making the most of her verbal ability, every intervention of the therapist is invalidated. So, it seems very difficult for her to recognize her own problems through verbal interpretations or confrontation by the therapist, for the present. In general, it is impossible to confront self problems without containing negative emotions inside of the self, but her ability seemed to be insufficient. So, to point out her problems is considered to be very likely to result in her confusion caused by persecution anxiety. Although the therapy may attain the stage on which verbal interpretation and confrontation work better some day, the therapist is compelled to aim at promoting her ability to hold negative emotion inside of herself for the time being. For the purpose, the therapist is required to endure the situation in which she brings emotion that makes the therapist feel negative counter-transference and her process to experience that the therapeutic relation itself would not collapse by holding negative emotion. On supportive psychotherapy with a male adolescent Y. TERASHIMA Kitasato University Health Care Center, Kanagawa, Japan Adolescent cases sometimes show dramatic improvements as a consequence of psychotherapy. The author describes how psychotherapy can support an adolescent and how theraputic achievements can be made. Two and a half years of treatment sessions with a male adolescent patient are presented. The patient was a 19-year-old man, living with his family. He had 5 years of experience living abroad with his family and he was a preparatory school student when he came to a mental clinic for help. He was suffering from not being able to sleep well, from difficulties concerning keeping his attention on one thing, and from fear of going to distant places. He could barely leave his room, and imagined the consequence of overdosing or jumping out of a window. He claimed that his life was doomed because his family moved from a town that was familiar to him. At the first phase of psychotherapy that lasted for approximately 1 year, the patient seldom responded to the therapist. The patient was basically silent. He told the therapist that the town he lives in now feels cold or that he wants to become a writer. However, these comments were made without any kind of explanation and the therapist felt it very difficult to understand what the patient was trying to say. The sessions continued on a regular basis. However, the therapist felt very useless and fatigued. Problems with the patient and his family were also present at this phase of psychotherapy. He felt unpleasant at home and felt it was useless to expect anything from his parents. These feelings were naturally transferred to the therapist and were interpreted. However, interpretation seemed to make no changes in the forms of the patient's transference. The second phase of psychotherapy began suddenly. The patient kept saying that he did not know what to talk about. However, after a brief comment made by the therapist on the author of the book he was reading, the patient told the therapist that it was unexpected that the therapist knew anything of his favorite writer. After this almost first interaction between the patient and the therapist, the patient started to show dramatic changes. The patient started to bring his favorite rock CDs to sessions where they were played and the patient and the therapist both made comments on how they felt about the music. He also started asking questions concerning the therapist. It seemed that the patient finally started to want to know the therapist. He started communicating. The patient was sometimes silent but that did not last long. The therapist no longer felt so useless and emotional interaction, which never took place in the first phase, now became dominant. The third phase happened rapidly and lasted for approximately 10 months. Conversations on music, art, literature and movies were made possible and the therapist seldom felt difficulties on following the patient's line of thought. He started to go to schools and it was difficult at first but he started adjusting to the environment of his new part-time jobs. By the end of the school year, he was qualified for the entrance to a prestigious university. The patient's problems had vanished except for some sleeping difficulties, and he did not wish to continue the psychotherapy sessions. The therapist's departure from the clinic added to this and the therapy was terminated. The patient at first reminded the therapist of severe psychological disturbances but the patient showed remarkable progress. Three points can be considered to have played important roles in the therapy presented. The first and the most important is the interpretation by behavior. The patient showed strong parental transference to the therapist and this led the therapist to feel useless and to feel fatigue. Content analysis and here-and-now analysis seemed to have played only a small part in the therapy. However, the therapist tried to keep in contact with the patient, although not so elegant, but tried to show that the therapist may not be useless. This was done by maintaining the framework of the therapy and by consulting the parents when it was considered necessary. Second point is the role that the therapist intentionally took as a model or target of introjection. With the help of behavioral interpretation that showed the therapist and others that it may not be useless, the patient started to introject what seemed to be useful to his well being. It can be considered that this role took some part in the patient going out and to adjust to the new environment. Last, fortune of mach must be considered. The patient and the therapist had much in common. It was very fortunate that the therapist knew anything about the patient's favorite writer. The therapist had some experience abroad when he was young. Although it is a matter of luck that the two had things in common, it can be said that the congeniality between the patient and the therapist played an important role in the successful termination of the therapy. From the physical complaint to the verbal appeal of A's recovery process to regain her self-confidence C. ITOKAWA and S. KAZUKAWA Toyama Mental Health Center, Toyama, Japan This is one of the cases at Toyama Mental Health Center about a client here, we will henceforth refer to her simply as ,A'. A was a second grade high school student. We worked with her until her high school graduation using our center's full functions; counseling, medical examination and the course for autogenic training (AT). She started her counseling by telling us that the reason for her frequent absences from school began because of stomach pains when she was under a lot of stress for 2 years of junior high school, from 2nd grade to 3rd grade. Due to a lack of self confidence and a constant fear of the people around her, she was unable to use the transportation. She would spend a large amount of time at the school infirmary because she suffered from self-diagnosed hypochondriac symptoms such as nausea, diarrhea and a palpitation. She continued that she might not be able to have the self-confidence to sit still to consult me on her feelings in one of our sessions. A therapist advised her to take the psychiatric examination and the use of AT and she actually saw the medical doctor. In counseling (sessions), she eventually started to talk about the abuse that started just after her entering of junior high school; she approached the school nurse but was unable to tell her own parents because she did not trust them. In doing so, she lost the rest of her confidence, affecting the way she looked at herself and thought of how others did. At school she behaved cheerfully and teachers often accused her of idleness as they regarded this girl's absences along with her brightly dyed hair and heavy make-up as her negligent laziness. I, as her therapist, contacted some of the school's staff and let them know of her situation in detail. As the scolding from the teachers decreased, we recognized the improvement of her situation. In order to recover from the missed academic exposure due to her long absence, she started to study by herself. In a couple of months her physical condition improved gradually, saying ,These days I have been doing well by myself, haven't I?' and one year later, her improved mental condition enabled her to go up to Tokyo for a concert and furthermore even to enjoy a short part-time job. She continued the session and the medical examination dually (in tangent) including the consultation about disbelief to the teachers, grade promotion, relationships between friends and physical conditions. Her story concentrated on the fact that she had not grown up with sufficiently warm and compassionate treatment and she could not gain any mental refuge in neither her family nor her school, or even her friends. Her prospects for the future had changed from the short-ranged one with no difficulty to the ambitious challenge: she aimed to try for her favorite major and hoped to go out of her prefecture. But she almost had to give up her own plan because the school forced her to change her course as they recommended. (because of the school's opposition with her own choice). So without the trust of the teachers combined with her low self-esteem she almost gave up her hopes and with them her forward momentum. In this situation as the therapist, I showed her great compassion and discussed the anger towards the school authorities, while encouraging this girl by persuading her that she should have enough self-confidence by herself. Through such sessions, she was sure that if she continued studying to improve her own academic ability by herself she could recognize the true meaning of striving forward. and eventually, she received her parents' support who had seemed to be indifferent to her. At last she could pass the university's entrance exams for the school that she had yearned to attend. That girl ,A' visited our center 1 month later to show us her vivid face. I saw a bright smile on her face. It was shining so brightly. [source] | ||||||||||||||||||||||||||||||||||||||||