Co-editor vacancy for Counselling Psychology Review

The authors' objective was to explore aspects of trauma associated with severity of posttraumatic stress disorder (PTSD) in Vietnam veterans. Several ratings of stress exposure and symptom severity were administered to 40 patients with combat-related PTSD. A significant relationship was observed between exposure to atrocities and the impact of PTSD on veterans' lives, as measured by the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. Exposure to atrocities was also significantly correlated with current symptom severity. In contrast, combat exposure alone was not significantly associated with overall symptom severity. Both atrocity and combat exposure, however, were significantly related to reexperiencing symptoms. The data suggest that the enduring effect and severity of PTSD symptoms on an individual are associated more with exposure to brutal human death and suffering than the threat of death associated with combat.

Youths with conduct disorder extract an inordinate amount of time and money from the U.S. judicial system and taxpayers, yet studies pertaining to this population have been few. This study was undertaken to examine the co-occurrence of personality disorders and conduct disorder in a group of incarcerated children and adolescents and to raise the issue of the possibility of antisocial personality disorder in persons under the age of 18 years. One hundred incarcerated juvenile offenders aged 11-17 years were randomly selected and then interviewed with the Diagnostic Interview for Children and Adolescents--Revised and the Structured Clinical Interview for DSM-III-R Personality Disorders to establish their psychiatric diagnoses. Eighty-seven percent of the group met the criteria for conduct disorder. Among those diagnosed as having conduct disorder, the only comorbid personality disorder that was present with significant frequency was antisocial personality disorder. The other comorbid personality disorder diagnoses that appeared most frequently were the borderline, narcissistic, paranoid, passive-aggressive, and dependent types. Borderline personality disorder was observed more frequently in the females than in the males with conduct disorder. The findings suggest that by using DSM-III-R criteria for adult personality disorders, one finds a considerable number of personality disorders in a young population with conduct disorder. The findings also show that youths manifest signs of antisocial personality disorder before they are 18 years of age, raising the question of how age should be incorporated into the diagnosis of personality disorder as DSM-IV is being prepared.

The authors examined the effects of wartime stressors in a sample of 69 Vietnam veterans who were psychiatric inpatients in a Veterans Administration hospital. Participation in atrocities and the cumulative exposure to combat stressors, each independently of the other, conferred a significant risk for posttraumatic stress disorder. In contrast, the effect of these war experiences on the onset of panic, major depression, and mania was not significant. The results indicate that extreme stressors are uniquely linked with posttraumatic stress disorder's characteristic cluster of symptoms but challenge DSM-III's implicit assumption that the reexperienced trauma is the stressor responsible for posttraumatic stress disorder.

AimResearch is frequently cited as core to counselling psychology. Yet we know little about where counselling psychologists publish their own findings. The present study aims to answer the following two research questions: (1) Where do UK-based counselling psychologists disseminate their research? (2) To what extent do counselling psychologists disseminate their research in British Psychological Society outlets?MethodA systematic review examining research by UK-based counselling psychologists published in journals directly relevant to counselling psychology between January 2010 and December 2012. Counselling psychologists’ individual publication lists were examined for research disseminated in additional specialist journals. Finally, two case studies of research active counselling psychologists were completed to gain a qualitative picture of counselling psychology dissemination.ResultsThe review elicited 43 research articles by UK-based counselling psychologists in the last three years. Publication lists uncovered a further 24 research studies from specialist journals, making a total of 67 studies, completed by 40 counselling psychologists. The majority of articles were in Counselling and Psychotherapy ResearchandCounselling Psychology Review. The case studies both demonstrated the importance of overall attitudes towards research to dissemination.ConclusionAlthough the aim of the present study was to gain a picture of where counselling psychology research is disseminated, the limited volume of research seems to lead inevitably back to the debate on what the future of research in counselling psychology should look like, with mixed views on its importance for the field.

New Year's Greetings

Previous epidemiological studies of bulimia nervosa have generated differing estimates of the incidence and prevalence of the disorder. These differences are attributable, in part, to varying definitions of the illness and a range of methodologies. The authors sought to define the prevalence of bulimia nervosa in a nonclinical community sample, examine the clinical significance of DSM-III-R threshold criteria, and examine comorbidity. Subjects across Ontario (N = 8,116) were assessed with a structured interview, the World Health Organization Composite International Diagnostic Interview, with specific questions added for bulimia nervosa. Subjects who met DSM-III-R criteria for bulimia nervosa were compared with those who were missing only the frequency criterion (two or more binge-eating episodes per week for 3 months). In this sample, the lifetime prevalence of bulimia nervosa was 1.1% for female subjects and 0.1% for male subjects. The subjects with full- and partial-syndrome bulimia nervosa showed significant vulnerability for mood and anxiety disorders. Lifetime rates of alcohol dependence were high in the full-syndrome group. Rates of parental psychopathologies were high in both bulimic groups but tended to be higher in the subjects with full-syndrome bulimia nervosa. Both bulimic groups were significantly more likely to experience childhood sexual abuse than a normal female comparison group. This study confirms other prevalence estimates of bulimia nervosa and its comorbid diagnoses from studies that were based on sound methodologies. It also points to the arbitrary aspects of the frequency of binge eating as a diagnostic threshold criterion for the disorder.

Research on the epidemiology of bulimia nervosa has focused largely on the prevalence of the disorder. As methods have improved, consensus has increased regarding the prevalence rate among adolescent and young adult women--about 1%. However, the accuracy of this figure and its clinical significance must be questioned. In this synthesis of the epidemiological work to date, the authors review the literature from a clinical and research perspective. They recommend a shift in emphasis away from studies of the distribution of the disorder toward studies of the determinants of the whole spectrum of the disturbance that exists in the community.

Psychologists are increasingly interested in the life cycle as the unit for study and in such questions as whether adult development, like child development, is to be perceived as a succession of stages. A stage theory of adult life seems oversimplified for several reasons. First, the timing of life events is becoming less regular, age is losing its customary social meanings, and the trends are toward the fluid life cycle and an age-irrelevant society. Second, the psychological themes and preoccupations reported by young, middle-aged, and older persons are recurrent ones that appear and reappear in new forms and do not follow in a single fixed order. Third, intrapsychic changes occur slowly with age and not in stepwise fashion. These factors may have implications for the psychiatrist who, in helping the patient make a meaningful life story from a life history, deals always with issues of time, timing, and aging.

Suicide is a major public health concern accounting for 800 000 deaths globally each year. Although there have been many advances in understanding suicide risk in recent decades, our ability to predict suicide is no better now than it was 50 years ago. There are many potential explanations for this lack of progress, but the absence, until recently, of comprehensive theoretical models that predict the emergence of suicidal ideation distinct from the transition between suicidal ideation and suicide attempts/suicide is key to this lack of progress. The current article presents the integrated motivational–volitional (IMV) model of suicidal behaviour, one such theoretical model. We propose that defeat and entrapment drive the emergence of suicidal ideation and that a group of factors, entitled volitional moderators (VMs), govern the transition from suicidal ideation to suicidal behaviour. According to the IMV model, VMs include access to the means of suicide, exposure to suicidal behaviour, capability for suicide (fearlessness about death and increased physical pain tolerance), planning, impulsivity, mental imagery and past suicidal behaviour. In this article, we describe the theoretical origins of the IMV model, the key premises underpinning the model, empirical tests of the model and future research directions.

Target Complaints as Criteria of Improvement

You have just retired from editing Counselling Psychology Review, the in-house journal of the British Psychological Society, Division of Counselling Psychology. It seems an appropriate moment to interview you for Counselling Psychology Quarterly. In this interview I want to focus on a topic I know you are interested in, client-therapist boundary issues, and your experience editing the journal. But I'd like to start off at a slight tangent. What encouraged you to go into counselling psychology as a profession?

Review of Clinical and counseling psychology.

BackgroundThis paper examines how those within counselling psychology are constructing the profession within pertinent publications.MethodologyCritical discursive psychology was applied to texts within Counselling Psychology Review and Counselling Psychology Quarterly over the time period of 2007 to June 2009.FindingsThe four interpretive repertoires discerned were: ‘Opponent to the medical model,’ ‘Saviour of the people’, ‘Maturation’ and ‘Alliance to others’.ConclusionTogether these position the profession as viable contenders within the psychological arena and a voice against the political enhancement of the medical model which is constructed as context and value-free. Thus not only is the power of CBT and all it represents challenged but such a position moves towards ethical empowerment of the client. The analysis also tracked the development of socially constructed processes that position a group as having achieved the construction of a profession.

Counselling psychology is a relatively recent arrival on the professional psychological scene in Britain. This paper examines the ways in which this new branch of professional psychology has been constructed by the counselling psychology community. Articles which embodied this construction process from the 1990 and 1996 volumes of the journal Counselling Psychology Review were subjected to discourse analysis. The main themes of the 1990 articles concerned the construction of identity and legitimation, achieved largely through representations of similarity with and difference from related professions at a general level, whereas in the 1996 articles, the emphasis was on more fine-grained constructions of similarity and difference. Implications for the future construction of counselling psychology are considered.

Providing high-quality mental health nursing care should be an important and continuous preoccupation in the gerontological nursing field. As the proportion of elderly people in our society is growing, the emphasis on high-quality care will receive increasing attention from administrators, politicians, organized groups, researchers and clinical nurses. Recent findings illustrate unequivocally the important contribution of nurses to achieving the goal of high-quality geriatric care. However, the quality of care for the elderly with psychological difficulties has not been addressed. The objective of this article is to illustrate that while nurses can accomplish much to improve the well-being and mental health of the elderly, their skills are often underutilized. Psychotropic drugs are often the first-line interventions used by health-care professionals to treat mental health concerns of elderly persons. Alternative therapies that could be implemented and evaluated, such as psychological counselling, supportive counselling, education and life review, are infrequently used. Nevertheless, current scientific data suggest that it would be very advantageous if nurses were to play a dominant role in the care of elderly people who are depressed or experiencing sleep pattern disturbances. The same can be said about elderly chronic users of benzodiazepines, as well as those with cognitive impairment. Evidence for the use of psychotropic medications as a viable treatment option for the elderly both in the community and in the long-term care setting who are experiencing mental health challenges is examined. Alternative non-pharmacological approaches that nurses can use to augment care are also briefly discussed.