The aim of this study was to explore the relationship between affective disturbances and aberrant salience in the context of childhood trauma, attachment, and mentalization in an analogue study.
Methods
Using a cross-sectional design, an online community sample completed self-report measures of key variables. Structural equation modelling was used to test childhood trauma's influence on aberrant salience via a set of intermediate risk factors (depression, negative schizotypy, and insecure attachment). These intermediate risk factors were assumed to lead to the proximal risk factors of aberrant salience (i.e., disorganized schizotypy and disorganized attachment) depending on the vulnerability of mentalizing capacity to elevated stress.
Results
The sample (N = 1263) was 78% female and aged between 18 and 35 years. The tested models closely fitted the observed data, revealing significant pathways from childhood trauma to aberrant salience via the hypothesized pathways. The direct effect of childhood trauma on aberrant salience was significant.
Conclusion
Findings suggest that the pathway to aberrant salience may be characterized by disorganization of self-state and intersubjectivity as a function of diminishment in mentalizing ability. This may relate to changes in attachment organization and socio-cognitive capacity, which could constitute possible risk factors signalling development of aberrant salience.
{"title":"Pathways from childhood trauma to aberrant salience: A structural equation approach to mentalization model","authors":"Ercan Ozdemir, Angus MacBeth, Helen Griffiths","doi":"10.1111/papt.12503","DOIUrl":"10.1111/papt.12503","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study was to explore the relationship between affective disturbances and aberrant salience in the context of childhood trauma, attachment, and mentalization in an analogue study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a cross-sectional design, an online community sample completed self-report measures of key variables. Structural equation modelling was used to test childhood trauma's influence on aberrant salience via a set of intermediate risk factors (depression, negative schizotypy, and insecure attachment). These intermediate risk factors were assumed to lead to the proximal risk factors of aberrant salience (i.e., disorganized schizotypy and disorganized attachment) depending on the vulnerability of mentalizing capacity to elevated stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sample (<i>N</i> = 1263) was 78% female and aged between 18 and 35 years. The tested models closely fitted the observed data, revealing significant pathways from childhood trauma to aberrant salience via the hypothesized pathways. The direct effect of childhood trauma on aberrant salience was significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings suggest that the pathway to aberrant salience may be characterized by disorganization of self-state and intersubjectivity as a function of diminishment in mentalizing ability. This may relate to changes in attachment organization and socio-cognitive capacity, which could constitute possible risk factors signalling development of aberrant salience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41170675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Following its introduction in the early 1990s, cognitive behavioural therapy for psychosis (CBTp) has been evaluated in a large number of clinical trials and is now established as a recommended treatment in the UK National Health Service and elsewhere in the world. Meta-analyses, however, indicate modest effects compared to treatment as usual or comparison therapies such as supportive counselling. Here, we seek to identify factors impacting the effectiveness of CBTp, and avenues for future psychotherapy research that may improve outcomes.
Method
We outline two recent umbrella reviews and discuss factors likely to impact the effectiveness of CBTp.
Results
Modest effect sizes from meta-analyses mask heterogeneous outcomes, with some people benefiting and others possibly being harmed by therapy. Common factors such as the therapeutic alliance play an important role in determining outcomes but have been largely neglected by CBTp researchers. There is also the promise of improving outcomes by identifying and targeting the psychological mechanisms that either maintain psychotic symptoms (e.g. worry) or are causally implicated (e.g. trauma).
Conclusions
It is unlikely that everyone with psychosis will be equally responsive to the same therapeutic protocols. We need a new, personalised psychotherapy approach to CBTp research and practice, and can learn from research for anxiety and depression examining predictors of therapeutic response to inform treatment decisions. Precision psychological therapies informed by a combination of individual characteristics, common factors and a focus on specific mechanisms will require new research strategies and are likely to lead to improved outcomes for people with psychosis.
{"title":"Cognitive behavioural therapy for psychosis: The end of the line or time for a new approach?","authors":"Katherine Newman-Taylor, Richard Bentall","doi":"10.1111/papt.12498","DOIUrl":"10.1111/papt.12498","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Following its introduction in the early 1990s, cognitive behavioural therapy for psychosis (CBTp) has been evaluated in a large number of clinical trials and is now established as a recommended treatment in the UK National Health Service and elsewhere in the world. Meta-analyses, however, indicate modest effects compared to treatment as usual or comparison therapies such as supportive counselling. Here, we seek to identify factors impacting the effectiveness of CBTp, and avenues for future psychotherapy research that may improve outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We outline two recent umbrella reviews and discuss factors likely to impact the effectiveness of CBTp.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Modest effect sizes from meta-analyses mask heterogeneous outcomes, with some people benefiting and others possibly being harmed by therapy. Common factors such as the therapeutic alliance play an important role in determining outcomes but have been largely neglected by CBTp researchers. There is also the promise of improving outcomes by identifying and targeting the psychological mechanisms that either maintain psychotic symptoms (e.g. worry) or are causally implicated (e.g. trauma).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It is unlikely that everyone with psychosis will be equally responsive to the same therapeutic protocols. We need a new, personalised psychotherapy approach to CBTp research and practice, and can learn from research for anxiety and depression examining predictors of therapeutic response to inform treatment decisions. Precision psychological therapies informed by a combination of individual characteristics, common factors and a focus on specific mechanisms will require new research strategies and are likely to lead to improved outcomes for people with psychosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12498","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41179364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amelia Staton, David Dawson, Hannah Merdian, Anna Tickle, Tammy Walker
Objectives
Individuals with a diagnosis of FND report experiencing stigma in medical settings, however, there is a paucity of research exploring their experiences in psychological services. The aim of this research was to explore experiences of accessing UK psychological services, from the perspective of those with FND.
Methods
This study utilised a qualitative approach with data collected from semi-structured interviews (n = 15) and analysed using reflexive thematic analysis.
Results
One superordinate theme, ‘the stigmatised self within the therapeutic relationship’, and five interrelated subthemes were identified: ‘internalised stigma and self-doubt’, ‘selective disclosure to professionals’, ‘perceptions of psychological explanations’, ‘having to educate the professionals’ and ‘attunement and trust within the therapeutic relationship’. Positive therapeutic relationships were perceived to mitigate the impact of these perceived barriers. The conceptualisation of FND and the perception of how this was responded to by services and professionals was a central tenet throughout the related themes.
Conclusions
Intra-personal, interpersonal and organisational stigma impact access and engagement to psychological treatment. The findings of this study highlight the need for increased training provision for practitioners with a focus on actively challenging FND stigma within services at both an individual and systemic level.
{"title":"Functional neurological disorder: A qualitative study exploring individuals' experiences of psychological services","authors":"Amelia Staton, David Dawson, Hannah Merdian, Anna Tickle, Tammy Walker","doi":"10.1111/papt.12504","DOIUrl":"10.1111/papt.12504","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Individuals with a diagnosis of FND report experiencing stigma in medical settings, however, there is a paucity of research exploring their experiences in psychological services. The aim of this research was to explore experiences of accessing UK psychological services, from the perspective of those with FND.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study utilised a qualitative approach with data collected from semi-structured interviews (<i>n</i> = 15) and analysed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One superordinate theme, ‘the stigmatised self within the therapeutic relationship’, and five interrelated subthemes were identified: ‘internalised stigma and self-doubt’, ‘selective disclosure to professionals’, ‘perceptions of psychological explanations’, ‘having to educate the professionals’ and ‘attunement and trust within the therapeutic relationship’. Positive therapeutic relationships were perceived to mitigate the impact of these perceived barriers. The conceptualisation of FND and the perception of how this was responded to by services and professionals was a central tenet throughout the related themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Intra-personal, interpersonal and organisational stigma impact access and engagement to psychological treatment. The findings of this study highlight the need for increased training provision for practitioners with a focus on actively challenging FND stigma within services at both an individual and systemic level.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12504","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41163628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emily Piesse, Georgie Paulik, Danielle Mathersul, Lee Valentine, Ilias Kamitsis, Sarah Bendall
Objectives
Extensive research has shown voice hearing to be associated with symptoms of Post-Traumatic Stress Disorder (PTSD) and dissociation. However, most studies have adopted a quantitative design, using cross-sectional data sampling methods, precluding temporal relationships between variables from being defined.
Design
Using a qualitative design, this study sought to identify potential symptom relationships by addressing the research question: what is the nature of the temporal relationship between voices, dissociation and PTSD symptoms?
Methods
Seven voice hearers (aged 27 to 68 years) participated in a semi-structured interview exploring voice hearing, PTSD symptoms, and dissociation. The interviews were analysed using Interpretative Phenomenological Analysis.
Results
One superordinate theme was identified in the data. Voices were observed to occur in dynamic interrelationship with PTSD symptoms and dissociation, and were frequently experienced before and after PTSD symptoms and dissociative episodes.
Conclusions
Implications for theoretical understandings of voice hearing and future research are discussed.
{"title":"An exploration of the relationship between voices, dissociation, and post-traumatic stress disorder symptoms","authors":"Emily Piesse, Georgie Paulik, Danielle Mathersul, Lee Valentine, Ilias Kamitsis, Sarah Bendall","doi":"10.1111/papt.12493","DOIUrl":"10.1111/papt.12493","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Extensive research has shown voice hearing to be associated with symptoms of Post-Traumatic Stress Disorder (PTSD) and dissociation. However, most studies have adopted a quantitative design, using cross-sectional data sampling methods, precluding temporal relationships between variables from being defined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Using a qualitative design, this study sought to identify potential symptom relationships by addressing the research question: what is the nature of the temporal relationship between voices, dissociation and PTSD symptoms?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seven voice hearers (aged 27 to 68 years) participated in a semi-structured interview exploring voice hearing, PTSD symptoms, and dissociation. The interviews were analysed using Interpretative Phenomenological Analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One superordinate theme was identified in the data. Voices were observed to occur in dynamic interrelationship with PTSD symptoms and dissociation, and were frequently experienced before and after PTSD symptoms and dissociative episodes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Implications for theoretical understandings of voice hearing and future research are discussed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amy Hardy, Nadine Keen, David van den Berg, Filippo Varese, Eleanor Longden, Thomas Ward, Rachel M Brand
Background
Traumatic events, particularly childhood interpersonal victimisation, have been found to play a causal role in the occurrence of psychosis and shape the phenomenology of psychotic experiences. Higher rates of post-traumatic stress disorder (PTSD) and other trauma-related mental health problems are also found in people with psychosis diagnoses compared to the general population. It is, therefore, imperative that therapists are willing and able to address trauma and its consequences when supporting recovery from distressing psychosis.
Method
This paper will support this need by providing a state-of-the-art overview of the safety, acceptability and effects of trauma therapies for psychosis.
Results
We will first introduce how seminal cognitive-behavioural models of psychosis shed light on the mechanisms by which trauma may give rise to psychotic experiences, including a putative role for trauma-related emotions, beliefs and episodic memories. The initial application of prolonged exposure and eye movement and desensitation and reprocessing therapy (EMDR) for treating PTSD in psychosis will be described, followed by consideration of integrative approaches. These integrative approaches aim to address the impact of trauma on both post-traumatic stress symptoms and trauma-related psychosis. Integrative approaches include EMDR for psychosis (EMDRp) and trauma-focused Cognitive-Behavioural Therapy for psychosis (tf-CBTp). Finally, emerging dialogic approaches for targeting trauma-related voice-hearing will be considered, demonstrating the potential value of adopting co-produced (Talking with Voices) and digitally augmented (AVATAR) therapies.
Conclusion
We will conclude by reflecting on current issues in the area, and implications for research and clinical practice.
{"title":"Trauma therapies for psychosis: A state-of-the-art review","authors":"Amy Hardy, Nadine Keen, David van den Berg, Filippo Varese, Eleanor Longden, Thomas Ward, Rachel M Brand","doi":"10.1111/papt.12499","DOIUrl":"10.1111/papt.12499","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Traumatic events, particularly childhood interpersonal victimisation, have been found to play a causal role in the occurrence of psychosis and shape the phenomenology of psychotic experiences. Higher rates of post-traumatic stress disorder (PTSD) and other trauma-related mental health problems are also found in people with psychosis diagnoses compared to the general population. It is, therefore, imperative that therapists are willing and able to address trauma and its consequences when supporting recovery from distressing psychosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This paper will support this need by providing a state-of-the-art overview of the safety, acceptability and effects of trauma therapies for psychosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We will first introduce how seminal cognitive-behavioural models of psychosis shed light on the mechanisms by which trauma may give rise to psychotic experiences, including a putative role for trauma-related emotions, beliefs and episodic memories. The initial application of prolonged exposure and eye movement and desensitation and reprocessing therapy (EMDR) for treating PTSD in psychosis will be described, followed by consideration of integrative approaches. These integrative approaches aim to address the impact of trauma on both post-traumatic stress symptoms and trauma-related psychosis. Integrative approaches include EMDR for psychosis (EMDRp) and trauma-focused Cognitive-Behavioural Therapy for psychosis (tf-CBTp). Finally, emerging dialogic approaches for targeting trauma-related voice-hearing will be considered, demonstrating the potential value of adopting co-produced (Talking with Voices) and digitally augmented (AVATAR) therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We will conclude by reflecting on current issues in the area, and implications for research and clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12499","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41175193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many individuals with eating disorders (EDs) report the experience of an ‘Anorexic voice’ (AV). Negative experiences of loneliness are also often associated with EDs. This study sought to explore the relationship between experiences of loneliness, the frequency of the AV and the impact of this on ED symptom severity.
Design
165 individuals (mean age 27.54 years) who accessed online forums relating to EDs participated in this study. The sample included individuals who have experienced an AV [AV group (N = 141)] and those who have not [non-AV group (N = 23)].
Methods
The study utilised self-report measures via an online questionnaire to explore the predictive validity of loneliness and frequency of the AV on ED symptom severity.
Results
Confirmatory analysis (AV group only) demonstrated the significance of the independent variables individually predicting ED symptom severity. However, a significant interaction was not found between the two primary variables in predicting ED symptom severity, more significantly than the influence of either variable alone. Exploratory analysis considered the differences between the two groups (AV and Non-AV), as well as considering alternate predictors.
Conclusions
The findings offer insight into possible drivers behind engagement with the AV, as part of ED presentations in the community.
{"title":"An exploration of the relationship between loneliness, the severity of eating disorder-related symptoms and the experience of the ‘anorexic voice’","authors":"Mary-Jane Marffy, John Fox, Marc Williams","doi":"10.1111/papt.12502","DOIUrl":"10.1111/papt.12502","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Many individuals with eating disorders (EDs) report the experience of an ‘Anorexic voice’ (AV). Negative experiences of loneliness are also often associated with EDs. This study sought to explore the relationship between experiences of loneliness, the frequency of the AV and the impact of this on ED symptom severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>165 individuals (mean age 27.54 years) who accessed online forums relating to EDs participated in this study. The sample included individuals who have experienced an AV [AV group (<i>N</i> = 141)] and those who have not [non-AV group (<i>N</i> = 23)].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study utilised self-report measures via an online questionnaire to explore the predictive validity of loneliness and frequency of the AV on ED symptom severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Confirmatory analysis (AV group only) demonstrated the significance of the independent variables individually predicting ED symptom severity. However, a significant interaction was not found between the two primary variables in predicting ED symptom severity, more significantly than the influence of either variable alone. Exploratory analysis considered the differences between the two groups (AV and Non-AV), as well as considering alternate predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings offer insight into possible drivers behind engagement with the AV, as part of ED presentations in the community.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aaron Warner, Fiona Lobban, Carol Holland, Elizabeth Tyler, Geoff Settle, Verity Rhodes, Jasper Palmier-Claus
Objectives
The objective of this study is to explore what ageing well means to older adults with bipolar disorder.
Methods
Older adults with bipolar disorder took photographs of aspects of their lives that they felt represented ageing well. They then completed audio-recorded photo elicitation interviews to explore what it meant to age well with bipolar disorder in detail. Data were analysed using reflexive thematic analysis.
Results
Seventeen participants met the criteria for bipolar disorder I or II. The analysis resulted in four key themes to ageing well with bipolar disorder: (1) Lifelong learning – referring to how participants accumulated a wealth of knowledge about bipolar disorder and used this to maintain stability in later life; (2) Finding where you belong – relating to how participants prioritised finding new communities, utilised family support and refined their support networks over time to age well; (3) Recognising your value and worth – which involved participants using their strengths and experiences to support others; and (4) Continuity of support – older adults with bipolar disorder highlighted the benefits of continuous support that allowed them to be actively involved in their treatment.
Conclusions
Participants ageing with bipolar disorder identified unique challenges indicating that services require adaptation to meet their needs and support them to age well. Findings suggested that services should provide continuous care that allows this group to actively engage with their treatment, build upon their strengths, and develop meaningful connections with professionals and peers. This approach may enhance support for older adults with bipolar disorder and reduce the inequalities they experience.
{"title":"What does it mean to age well with bipolar disorder? A qualitative study using photo elicitation","authors":"Aaron Warner, Fiona Lobban, Carol Holland, Elizabeth Tyler, Geoff Settle, Verity Rhodes, Jasper Palmier-Claus","doi":"10.1111/papt.12501","DOIUrl":"10.1111/papt.12501","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to explore what ageing well means to older adults with bipolar disorder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Older adults with bipolar disorder took photographs of aspects of their lives that they felt represented ageing well. They then completed audio-recorded photo elicitation interviews to explore what it meant to age well with bipolar disorder in detail. Data were analysed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen participants met the criteria for bipolar disorder I or II. The analysis resulted in four key themes to ageing well with bipolar disorder: (1) <i>Lifelong learning</i> – referring to how participants accumulated a wealth of knowledge about bipolar disorder and used this to maintain stability in later life; (2) <i>Finding where you belong</i> – relating to how participants prioritised finding new communities, utilised family support and refined their support networks over time to age well; (3) <i>Recognising your value and worth</i> – which involved participants using their strengths and experiences to support others; and (4) <i>Continuity of support</i> – older adults with bipolar disorder highlighted the benefits of continuous support that allowed them to be actively involved in their treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Participants ageing with bipolar disorder identified unique challenges indicating that services require adaptation to meet their needs and support them to age well. Findings suggested that services should provide continuous care that allows this group to actively engage with their treatment, build upon their strengths, and develop meaningful connections with professionals and peers. This approach may enhance support for older adults with bipolar disorder and reduce the inequalities they experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12501","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41152432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Siobhan Collman, Charles Heriot-Maitland, Emmanuelle Peters, Oliver Mason
Objectives
Dimensional approaches suggest psychotic symptoms exist along a continuum, with psychotic-like experiences (PLEs) being an expression of a non-clinical psychosis phenotype. Existing research indicates self-criticism may contribute to symptom maintenance, frequency and distress, whereas self-compassion may act protectively. Associations between self-criticism, self-compassion and PLEs in the general population have received less attention. The present study sought to investigate these associations. It was hypothesised that PLE endorsement would be associated positively with self-criticism and negatively with self-compassion.
Design
Quantitative cross-sectional study. Data collected via an online questionnaire.
Methods
Five hundred thirty-one participants completed the Self-Compassion Scale (Short Form), the Forms of Self-Criticising/Attacking and Self-Reassuring Scale and the Transpersonal Experiences Questionnaire. Individuals with a psychosis-related diagnosis were excluded. The data were analysed using linear regression, accounting for the effects of demographic variables.
Results
Self-criticism subtype self-hatred was associated with PLEs. Subtype self-inadequacy was not. No association was found between self-compassion and PLEs. Educational attainment was negatively associated with PLE endorsement.
Conclusions
Self-criticism, but not self-compassion, is associated with PLE endorsement, suggesting they are separate factors with different relationships to PLEs. Further research is needed to confirm the direction of the interaction. Either way, psychological interventions (where needed) could target self-criticism and may be important in assessing psychosis risk.
{"title":"Investigating associations between self-compassion, self-criticism and psychotic-like experiences","authors":"Siobhan Collman, Charles Heriot-Maitland, Emmanuelle Peters, Oliver Mason","doi":"10.1111/papt.12500","DOIUrl":"10.1111/papt.12500","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Dimensional approaches suggest psychotic symptoms exist along a continuum, with psychotic-like experiences (PLEs) being an expression of a non-clinical psychosis phenotype. Existing research indicates self-criticism may contribute to symptom maintenance, frequency and distress, whereas self-compassion may act protectively. Associations between self-criticism, self-compassion and PLEs in the general population have received less attention. The present study sought to investigate these associations. It was hypothesised that PLE endorsement would be associated positively with self-criticism and negatively with self-compassion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Quantitative cross-sectional study. Data collected via an online questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Five hundred thirty-one participants completed the Self-Compassion Scale (Short Form), the Forms of Self-Criticising/Attacking and Self-Reassuring Scale and the Transpersonal Experiences Questionnaire. Individuals with a psychosis-related diagnosis were excluded. The data were analysed using linear regression, accounting for the effects of demographic variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Self-criticism subtype self-hatred was associated with PLEs. Subtype self-inadequacy was not. No association was found between self-compassion and PLEs. Educational attainment was negatively associated with PLE endorsement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Self-criticism, but not self-compassion, is associated with PLE endorsement, suggesting they are separate factors with different relationships to PLEs. Further research is needed to confirm the direction of the interaction. Either way, psychological interventions (where needed) could target self-criticism and may be important in assessing psychosis risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12500","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41141119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sheila Redfern, Benita Pursch, Thando Katangwe-Chigamba, Rumour Sopp, Karen Irvine, Eva A Sprecher, Theresa Schwaiger, Nick Midgley
Objective: In the context of the Covid-19 pandemic and subsequent lockdown restrictions, service providers faced significant challenges in delivering programmes to support their vulnerable service users. Foster carers-an already often isolated group of caregivers - were offered an adapted remote-delivery model of the Reflective Fostering Programme (Redfern et al., Adopt. Foster., 42, 2018, 234) from March 2020.
Method: This paper outlines the adaptation process of the original programme to online-remote delivery and describes the feedback from participants in the programme.
Results: The adaptation of the Reflective Fostering programme to online, remote delivery had both strengths and weaknesses - including wider access to foster carers who might struggle to attend in person and challenge a to maintaining a Mentalizing space online and ensuring confidentiality within a therapeutic space. The programme was overwhelmingly well received by foster carers in this format.
Conclusions: There are opportunities and challenges in the delivery of online therapeutic services, particularly those with a group format. This paper contributes initial reflections to what we hope will be a rapidly developing literature on best practice of supporting group services in an online format.
目标：在新冠肺炎大流行和随后的封锁限制的背景下，服务提供商在提供支持弱势服务用户的计划方面面临重大挑战。从2020年3月起，寄养照料者——一个已经经常被孤立的照料者群体——被提供了一个经过调整的反思性寄养计划的远程交付模式（Redfern et al.，Adopt.Fester.，422018234）。方法：本文概述了原始计划对在线远程交付的适应过程，并描述了该计划参与者的反馈。结果：将反思性寄养计划调整为在线远程交付既有优点也有缺点，包括更广泛地接触可能难以亲自参加的寄养照顾者，并挑战保持在线心理空间和确保治疗空间内的保密性。该方案在这种形式的寄养照顾者中获得了压倒性的好评。结论：在提供在线治疗服务方面存在机遇和挑战，特别是那些采用团体形式的服务。本文对我们希望迅速发展的以在线形式支持团体服务的最佳实践文献进行了初步思考。
{"title":"The Reflective Fostering Programme-Adapting a group parenting programme for online delivery in response to the COVID-19 pandemic in the United Kingdom.","authors":"Sheila Redfern, Benita Pursch, Thando Katangwe-Chigamba, Rumour Sopp, Karen Irvine, Eva A Sprecher, Theresa Schwaiger, Nick Midgley","doi":"10.1111/papt.12497","DOIUrl":"https://doi.org/10.1111/papt.12497","url":null,"abstract":"<p><strong>Objective: </strong>In the context of the Covid-19 pandemic and subsequent lockdown restrictions, service providers faced significant challenges in delivering programmes to support their vulnerable service users. Foster carers-an already often isolated group of caregivers - were offered an adapted remote-delivery model of the Reflective Fostering Programme (Redfern et al., Adopt. Foster., 42, 2018, 234) from March 2020.</p><p><strong>Method: </strong>This paper outlines the adaptation process of the original programme to online-remote delivery and describes the feedback from participants in the programme.</p><p><strong>Results: </strong>The adaptation of the Reflective Fostering programme to online, remote delivery had both strengths and weaknesses - including wider access to foster carers who might struggle to attend in person and challenge a to maintaining a Mentalizing space online and ensuring confidentiality within a therapeutic space. The programme was overwhelmingly well received by foster carers in this format.</p><p><strong>Conclusions: </strong>There are opportunities and challenges in the delivery of online therapeutic services, particularly those with a group format. This paper contributes initial reflections to what we hope will be a rapidly developing literature on best practice of supporting group services in an online format.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Adolescent mentalisation-based integrative therapy (AMBIT) is a whole-systems approach designed to enhance the effectiveness and coordination of care for clients experiencing severe and pervasive difficulties in social and health care settings, who have not responded to traditional clinical approaches. AMBIT is a team-based manualised method that primarily aims to bolster mental state understanding and discourse focused on the client within and between teams. Over 300 teams worldwide have been trained in and adhere to AMBIT principles.
Method: In this paper, we review and summarise the outcomes reported by eight AMBIT-informed teams that have published their findings with young people. Each report is discussed, and limitations of the data provided are identified.
Results: A synthesis of the findings across the studies suggests a generally positive impact of teams informed by AMBIT with moderate to large effect sizes on reducing symptoms and improving functionality.
Conclusions: This study suggests that AMBIT may be a promising approach for young people with multiple problems but further research is needed to identify the active mechanisms of change in complex helping systems.
{"title":"Outcomes for Adaptive Mentalization Based Integrative Treatment informed care for adolescents using a deployment-based approach.","authors":"Peter Fuggle, James Fairbairn, Peter Fonagy","doi":"10.1111/papt.12496","DOIUrl":"https://doi.org/10.1111/papt.12496","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent mentalisation-based integrative therapy (AMBIT) is a whole-systems approach designed to enhance the effectiveness and coordination of care for clients experiencing severe and pervasive difficulties in social and health care settings, who have not responded to traditional clinical approaches. AMBIT is a team-based manualised method that primarily aims to bolster mental state understanding and discourse focused on the client within and between teams. Over 300 teams worldwide have been trained in and adhere to AMBIT principles.</p><p><strong>Method: </strong>In this paper, we review and summarise the outcomes reported by eight AMBIT-informed teams that have published their findings with young people. Each report is discussed, and limitations of the data provided are identified.</p><p><strong>Results: </strong>A synthesis of the findings across the studies suggests a generally positive impact of teams informed by AMBIT with moderate to large effect sizes on reducing symptoms and improving functionality.</p><p><strong>Conclusions: </strong>This study suggests that AMBIT may be a promising approach for young people with multiple problems but further research is needed to identify the active mechanisms of change in complex helping systems.</p>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10235401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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