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British Journal of Medical Psychology 70, 177-184, 1997
This paper focuses on the loss of intimacy and mutuality in the relationship when one partner has Alzheimer's disease and suggests that the paradigm of anticipatory grief described in terminal care work may need to be reconsidered in relation to organic brain disease. An attempt is made to link some of the psychoanalytic literature of grief and the experience of clinicians in old age psychiatry working with patients and their relatives. Mention is made of implications for management. The paper includes illustrative clinical material.
British Journal of Medical Psychology 70, 149-157, 1997
The aim of this study was to examine interpersonal problems among panic disorder with agoraphobia patients before and after treatment. Patients (N = 46) suffering from panic disorder with moderate or severe agoraphobia and considering agoraphobia as their main problem were randomly assigned to receive either cognitive therapy or guided mastery therapy in a six-week in-patient group programme. The Inventory of Interpersonal Problems (IIP) and various symptom measures were administered at pre-treatment and at one-year follow-up. Two IIP subscales were derived from factor analysis of the present data: affiliation problems and power problems. The overall pattern of results supported a state model of interpersonal problems. At pre-treatment, the scores on the affiliation problems subscale were clearly related to nonspecific state characteristics, that is, to depression and general anxiety. From pre-treatment to follow-up, levels of interpersonal problems decreased significantly. Pre-treatment depression was a powerful predictor of change in interpersonal problems from pre-treatment to one-year follow-up. On the other hand, interpersonal problems at pre-treatment failed to pred