Over recent years multi-sensory stimulation (MSS) has become an increasingly popular approach to care and is used in several centres throughout Europe. This popularity could be explained by the limited alternatives available to staff and a widely held belief that MSS is a friendly and highly humane approach. A randomized controlled trial was therefore essential to evaluate the effectiveness and extent of the benefits of MSS. To assess whether MSS is more effective in changing the behaviour, mood and cognition of older adults with dementia than a control of activity (playing card games, looking at photographs, doing quizzes, etc.). A total of 136 patients from three countries [United Kingdom (UK), the Netherlands and Sweden] were randomized to MSS or activity groups. Patients participated in eight 30-minute sessions over 4 weeks. Ratings of behaviour and mood were taken before, during and after sessions to investigate immediate effects. Pre-, mid-, post-trial and follow-up assessments were taken to investigate any generalization of effects to cognition and behaviour and mood at home/on the ward or at the day hospital. There were limited short-term improvements for both the MSS and activity groups immediately after sessions, and limited short-term improvements between the groups during sessions. There were no significant differences between the groups when assessing change in behaviour, mood or cognition at home/on the ward or at the day hospital. In the UK, however, behaviour at the day hospital for both groups remained stable during the trial but deteriorated once the sessions had stopped, and active/disturbed behaviour at home improved but likewise deteriorated once sessions had stopped. Overall, MSS was found to be no more effective than an activity in changing the behaviour, mood or cognition of patients with dementia in the short- or long-term.
In this paper Rachman's concept of emotional processing was extended and a model highlighting the psychological operations underpinning processing was specified. Using this model, the aim was to investigate, by means of a questionnaire, whether patients with panic disorder (n=50) have more emotional processing difficulties than two samples of healthy controls (London, n=406; Aberdeen, n=125). The panic disorder group did have significantly more emotional processing difficulties than the control groups, showing a marked tendency to control feelings of anger, unhappiness and anxiety. Three emotional processing dimensions distinguished the panic from the control groups: greater control of emotional experiences ('smothering' or 'bottling up' emotions), greater awareness of feelings and more difficulties in labelling emotions. The authors hypothesise that emotional processing deficits act as a vulnerability factor for developing panic attacks.
The Emotional Processing Scale (EPS) is a 38-item, eight-factor self-report questionnaire designed to measure emotional processing styles and deficits. Scale development is an ongoing process and our aim was to (i) refine the scale by trying out items from a new item pool and (ii) shorten the scale to enhance its clinical and research utility. Fifteen new items were added to the original 38-item pool. The resulting 53-item scale was administered to four groups (N=690) (mental health, healthy controls, pain patients, and general medical practice attendees). Exploratory factor analysis was used to explore the underlying factor structure. Maximum likelihood (ML) factor analysis was used to guide the process of item selection and scale reduction. Four of the previous eight factors remained in similar form, two of the original factors were discarded, and one new factor emerged incorporating items from two previous factors. The revised version of the scale (EPS-25) has a 25-item five-factor structure. Internal reliability was moderate to high for all five factors. The psychometric properties of the revised scale appear promising, particularly in relation to the detection of differences between diagnostic groups.
The objective of this study was to report on the development and preliminary psychometric evaluation of an emotional processing scale, a 38-item self-report questionnaire designed to identify emotional processing styles and deficits. An initial item pool derived from a conceptual model and clinical observations was piloted on clinical and community samples (n=150). The resulting 45-item scale was administered to patients with psychological problems, psychosomatic disorders, and physical disease, and to healthy individuals (n=460). Exploratory factor analysis was used to explore the underlying factor structure. Maximum likelihood factor analysis yielded an eight-factor solution relating to styles of emotional experience (Lack of Attunement, Discordant, and Externalized), mechanisms controlling the experience and expression of emotions (Suppression, Dissociation, Avoidance, and Uncontrolled), and signs of inadequate processing (Intrusion). Internal reliability was moderate to high for six of eight factors. Preliminary findings suggested satisfactory convergent validity. Overall, the psychometric properties of this scale appear promising. Work is in progress to refine the scale by incorporating additional items and by conducting further psychometric evaluations on new samples.
While prolonged exposure is considered one of the “gold standard” and recommended treatments for post traumatic stress disorder (PTSD), it has been poorly utilised in clinical practice. Individuals with PTSD often find it too distressing to confront memories, and therapists may be uncomfortable using the therapy. A new Emotional Processing Therapy is described in which an emotional approach to prolonged exposure provides individuals with a new insight into how trauma is processed. A conceptual analysis of exposure suggests that it is exposure to distressing emotional experiences which is a key element. Viewing it as an emotion-based therapy, allows the creative addition of new emotional elements. Through exploring the individual’s emotional processing style, previously learned and unhelpful patterns can be addressed, and the addition of an “emotional preparation” phase helps them understand why it is important to face emotionally distressing memories before exposure sessions begin. Emotional Processing Therapy is intuitive and makes sense to those affected by PTSD. It is framed in an emotional context and is presented as part of a lifestyle change that may reduce the likelihood of psychological problems developing in the future.