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":"97 1","pages":"122-137"},"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":"97 1","pages":"104-121"},"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":"97 1","pages":"91-103"},"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":"10.1111/papt.12497","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This paper outlines the adaptation process of the original programme to online-remote delivery and describes the feedback from participants in the programme.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"97 S1","pages":"16-30"},"PeriodicalIF":2.6,"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}
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":"10.1111/papt.12496","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"97 S1","pages":"91-104"},"PeriodicalIF":2.6,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12496","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. E. M. Aerts, M. J. N. Rijckmans, S. Bogaerts, A. van Dam
Objective
Developing good interpersonal relationships is one of the main impediments for people with an antisocial personality disorder (ASPD). However, in treatment of psychiatric disorders, establishing a strong therapeutic alliance (TA) is important for effective treatment. Nevertheless, there is little knowledge on how to establish this TA with this challenging patient group. This study investigates which factors are important in TA development.
Method
For this study, a qualitative research methodology is applied. In-depth interviews with therapists experienced in treating ASPD were conducted and analysed through thematic analysis.
Results
The analysis revealed six themes important in alliance formation: the patient's needs, regulating interpersonal dynamics, connective attitude, connective skills, treatment process and treatment goals. Each theme is defined including aspects of the recommended therapeutic attitude and required skills for therapists working with patients with ASPD.
Conclusions
This study determined that, for therapists working with patients with ASPD, several key factors are essential in establishing a strong TA. These factors include the ability to be firm, authentic, non-judgmental and genuinely involved. An attentive presence is crucial, in which the therapist takes initiative in establishing contact and makes the patient feel that he is truly seen as an autonomous and equal person. In doing so, the therapist needs to provide clarity and structure while remaining perceptive to boundary violations. The therapist must be able to set limits using a clear yet kind tone of voice. Furthermore, it was notable that an intensive appeal is made to the therapist's reflective capacity in these treatments.
{"title":"Establishing an optimal working relationship with patients with an antisocial personality disorder. Aspects and processes in the therapeutic alliance","authors":"J. E. M. Aerts, M. J. N. Rijckmans, S. Bogaerts, A. van Dam","doi":"10.1111/papt.12492","DOIUrl":"10.1111/papt.12492","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Developing good interpersonal relationships is one of the main impediments for people with an antisocial personality disorder (ASPD). However, in treatment of psychiatric disorders, establishing a strong therapeutic alliance (TA) is important for effective treatment. Nevertheless, there is little knowledge on how to establish this TA with this challenging patient group. This study investigates which factors are important in TA development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>For this study, a qualitative research methodology is applied. In-depth interviews with therapists experienced in treating ASPD were conducted and analysed through thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis revealed six themes important in alliance formation: the patient's needs, regulating interpersonal dynamics, connective attitude, connective skills, treatment process and treatment goals. Each theme is defined including aspects of the recommended therapeutic attitude and required skills for therapists working with patients with ASPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study determined that, for therapists working with patients with ASPD, several key factors are essential in establishing a strong TA. These factors include the ability to be firm, authentic, non-judgmental and genuinely involved. An attentive presence is crucial, in which the therapist takes initiative in establishing contact and makes the patient feel that he is truly seen as an autonomous and equal person. In doing so, the therapist needs to provide clarity and structure while remaining perceptive to boundary violations. The therapist must be able to set limits using a clear yet kind tone of voice. Furthermore, it was notable that an intensive appeal is made to the therapist's reflective capacity in these treatments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"96 4","pages":"999-1014"},"PeriodicalIF":3.4,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10159769","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}
Guided by the ecosystem theory model framework, we aimed to explore the influence of three ecological dimensions (social, family and psychological factors) on suicidal intention in people with severe mental illness (SMI). We hypothesized that three factors influence suicidal intention, and that psychological factors may play a mediating role in the influence of social and family factors on suicidal intention.
Methods
We collected 994 patients with SMI aged 18 and above from May 2021 to March 2022 in the Fourth Hospital of Fuzhou City. We used logistic regression to analyse the association between social, family, psychological factors and suicidal intention. Furthermore, we explored the mediating effects among the influencing factors.
Results
Younger male patients with schizophrenia were more likely to have suicidal intention due to psychosocial family factors (p < .05). Social factors (poor interpersonal relations, social retreat, social activities outside the home), family factors (parental functions, activities within the family, family functions), psychological factors (anxiety, depression, interest in the outside world, overt aggression, lack of accountability and planning) were all independent risk factors for suicidal intention in patients. Mediation analysis showed anxiety and depression mediated the role of social and family factors on suicidal intention (p < .05).
Conclusion
Social, family and psychological factors were important risk factors for suicidal intention, with anxiety and depression being partial mediators for suicidal intention. Therefore, interventions that enhance family and social functioning and reduce anxiety and depression may be effective in reducing suicidal intention in SMI.
{"title":"The risk of suicidal intention in severe mental illness: An ecological perspective","authors":"Yawen Lin, Qinfei Wei, Suping Luo, Xiaoying Ye, Fuhao Zheng, Liuyan Zheng, Xinyue Lu, Huangyuan Li, Siying Wu","doi":"10.1111/papt.12495","DOIUrl":"10.1111/papt.12495","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Guided by the ecosystem theory model framework, we aimed to explore the influence of three ecological dimensions (social, family and psychological factors) on suicidal intention in people with severe mental illness (SMI). We hypothesized that three factors influence suicidal intention, and that psychological factors may play a mediating role in the influence of social and family factors on suicidal intention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We collected 994 patients with SMI aged 18 and above from May 2021 to March 2022 in the Fourth Hospital of Fuzhou City. We used logistic regression to analyse the association between social, family, psychological factors and suicidal intention. Furthermore, we explored the mediating effects among the influencing factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Younger male patients with schizophrenia were more likely to have suicidal intention due to psychosocial family factors (<i>p</i> < .05). Social factors (poor interpersonal relations, social retreat, social activities outside the home), family factors (parental functions, activities within the family, family functions), psychological factors (anxiety, depression, interest in the outside world, overt aggression, lack of accountability and planning) were all independent risk factors for suicidal intention in patients. Mediation analysis showed anxiety and depression mediated the role of social and family factors on suicidal intention (<i>p</i> < .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Social, family and psychological factors were important risk factors for suicidal intention, with anxiety and depression being partial mediators for suicidal intention. Therefore, interventions that enhance family and social functioning and reduce anxiety and depression may be effective in reducing suicidal intention in SMI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"96 4","pages":"1044-1061"},"PeriodicalIF":3.4,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10527239","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}
Adi Lavi-Rotenberg, Yogev Kivity, Libby Igra, Dana Atzil-Slonim, Ilanit Hasson-Ohayon
Objective
Although the clinical significance of the therapeutic alliance (TA) is well documented, the literature regarding the establishment of TA and the relation between client–therapist agreement on it to short-term outcome among various diagnostic groups—and specifically among clients diagnosed with serious mental illness (SMI)—is sparse. The aim of the present study was to examine the effect of client diagnosis on the abovementioned TA characteristics.
Method
Dyadic analyses of session-by-session (SBS) data were used to compare clients diagnosed with schizophrenia and clients diagnosed with emotional disorders (based on a clinical interview) in their TA characteristics.
Results
TA as initially rated by clients was stronger in the emotional disorders group than in the schizophrenia group. Higher TA ratings, regardless of whether these were provided by the therapist or the client, predicted better subsequent functioning in the emotional disorders group, whereas in the schizophrenia group, this association was observed only among good-outcome cases.
Conclusions
Establishing TA, having client–therapist agreement on it, and having clients derive therapeutic benefit from it might be more challenging with clients with schizophrenia than with clients with emotional disorders. Special attention should be given to specific challenges and needs regarding clients' diagnosis in order to enhance favourable therapy outcomes.
{"title":"A dyadic session-by-session assessment of therapeutic alliance and short-term outcome among clients with schizophrenia in comparison with clients with emotional disorders","authors":"Adi Lavi-Rotenberg, Yogev Kivity, Libby Igra, Dana Atzil-Slonim, Ilanit Hasson-Ohayon","doi":"10.1111/papt.12494","DOIUrl":"10.1111/papt.12494","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Although the clinical significance of the therapeutic alliance (TA) is well documented, the literature regarding the establishment of TA and the relation between client–therapist agreement on it to short-term outcome among various diagnostic groups—and specifically among clients diagnosed with serious mental illness (SMI)—is sparse. The aim of the present study was to examine the effect of client diagnosis on the abovementioned TA characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Dyadic analyses of session-by-session (SBS) data were used to compare clients diagnosed with schizophrenia and clients diagnosed with emotional disorders (based on a clinical interview) in their TA characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TA as initially rated by clients was stronger in the emotional disorders group than in the schizophrenia group. Higher TA ratings, regardless of whether these were provided by the therapist or the client, predicted better subsequent functioning in the emotional disorders group, whereas in the schizophrenia group, this association was observed only among good-outcome cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Establishing TA, having client–therapist agreement on it, and having clients derive therapeutic benefit from it might be more challenging with clients with schizophrenia than with clients with emotional disorders. Special attention should be given to specific challenges and needs regarding clients' diagnosis in order to enhance favourable therapy outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"96 4","pages":"1029-1043"},"PeriodicalIF":3.4,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10149923","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}
Laura P. Strachan, Georgie Paulik, Lynne Roberts, Peter M. McEvoy
Objectives
Post-traumatic stress is common among people who hear voices (auditory verbal hallucinations), many of whom hear trauma-related voices, whereby voice content is related to past trauma. Preliminary evidence suggests that imagery rescripting (ImRs) may more effectively reduce post-traumatic stress and voices compared to treatments that are based on existing models of PTSD or positive symptoms. No known studies have explored the potential maintaining factors of trauma-related voices in relation to ImRs. We aimed to uncover insights into the factors that maintain trauma-related voices and how ImRs may influence such factors by exploring voice hearers' explanations of voices and experiences of change throughout ImRs.
Design
Thematic analytical methodology was used due to the study's critical epistemological framework.
Methods
Semi-structured interviews explored relationships between trauma and voices, and experiences of change and stability throughout ImRs in a transdiagnostic sample (N = 10) who underwent 10–18 weekly ImRs sessions. Thematic analysis was used to develop themes.
Results
Two themes captured explanations of voices, which suggested voices may have counterproductive protective functions. Three themes captured psychological experiences during ImRs, which reflected concepts such as freedom to experience emotions, and experiences of justice, closure and grieving. Three themes described the outcomes of ImRs, reflecting concepts such as increased confidence, coping, perceived safety and voices becoming less powerful.
Conclusions
Trauma-related voices may have underlying protective functions and ImRs may support emotional expression, adaptive trauma re-appraisals and improve self-worth and coping self-efficacy. These change processes may have clinical implications in ImRs and other treatments for trauma-affected voice hearers.
{"title":"Voice hearers' explanations of trauma-related voices and processes of change throughout imagery rescripting: A qualitative exploration","authors":"Laura P. Strachan, Georgie Paulik, Lynne Roberts, Peter M. McEvoy","doi":"10.1111/papt.12491","DOIUrl":"10.1111/papt.12491","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Post-traumatic stress is common among people who hear voices (auditory verbal hallucinations), many of whom hear trauma-related voices, whereby voice content is related to past trauma. Preliminary evidence suggests that imagery rescripting (ImRs) may more effectively reduce post-traumatic stress and voices compared to treatments that are based on existing models of PTSD or positive symptoms. No known studies have explored the potential maintaining factors of trauma-related voices in relation to ImRs. We aimed to uncover insights into the factors that maintain trauma-related voices and how ImRs may influence such factors by exploring voice hearers' explanations of voices and experiences of change throughout ImRs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Thematic analytical methodology was used due to the study's critical epistemological framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews explored relationships between trauma and voices, and experiences of change and stability throughout ImRs in a transdiagnostic sample (<i>N</i> = 10) who underwent 10–18 weekly ImRs sessions. Thematic analysis was used to develop themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two themes captured explanations of voices, which suggested voices may have counterproductive protective functions. Three themes captured psychological experiences during ImRs, which reflected concepts such as freedom to experience emotions, and experiences of justice, closure and grieving. Three themes described the outcomes of ImRs, reflecting concepts such as increased confidence, coping, perceived safety and voices becoming less powerful.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Trauma-related voices may have underlying protective functions and ImRs may support emotional expression, adaptive trauma re-appraisals and improve self-worth and coping self-efficacy. These change processes may have clinical implications in ImRs and other treatments for trauma-affected voice hearers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"96 4","pages":"982-998"},"PeriodicalIF":3.4,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10316180","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}
This paper outlines the theoretical and empirical basis for compassion focused therapy (CFT) for psychosis, the gaps in the current knowledge and research, as well as some of the challenges for addressing gaps. It will guide the direction of future work and the steps needed to develop and advance this approach.
Method
This paper reviews evidence of how evolutionary models such as social rank theory and attachment theory have greatly contributed to our understanding of psychosis and provide a clear rationale and evidence base for the mechanisms of change in CFT for psychosis. It reviews the evidence for outcomes of compassion training more generally, and early feasibility evaluations of CFT for psychosis.
Results
The process evidence shows that people with psychosis have highly active social rank and threat systems, and the benefits of switching into attachment and care systems, which can support emotion regulation and integrative mind states. The outcomes evidence shows that compassion training impacts not only psychological outcomes, but also physiological outcomes such as neural circuits, immune system, and the autonomic nervous system. Within the psychosis field, outcomes research is still in the early days, but there are good indications of feasibility and a clear path forward for the next steps.
Conclusions
CFT for psychosis is an approach that integrates biopsychosocial processes, an integration that's evidenced across each aspect of the model, from theoretical foundations (evolution-informed) to interventions (e.g., body/breath training and relational techniques), to evaluation. Future RCTs are required to understand the effects on biopsychosocial outcomes for people with psychosis.
{"title":"Position paper – CFT for psychosis","authors":"Charles Heriot-Maitland","doi":"10.1111/papt.12490","DOIUrl":"10.1111/papt.12490","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This paper outlines the theoretical and empirical basis for compassion focused therapy (CFT) for psychosis, the gaps in the current knowledge and research, as well as some of the challenges for addressing gaps. It will guide the direction of future work and the steps needed to develop and advance this approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This paper reviews evidence of how evolutionary models such as <i>social rank theory</i> and <i>attachment theory</i> have greatly contributed to our understanding of psychosis and provide a clear rationale and evidence base for the mechanisms of change in CFT for psychosis. It reviews the evidence for outcomes of compassion training more generally, and early feasibility evaluations of CFT for psychosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The <i>process</i> evidence shows that people with psychosis have highly active social rank and threat systems, and the benefits of switching into attachment and care systems, which can support emotion regulation and integrative mind states. The <i>outcomes</i> evidence shows that compassion training impacts not only psychological outcomes, but also physiological outcomes such as neural circuits, immune system, and the autonomic nervous system. Within the psychosis field, outcomes research is still in the early days, but there are good indications of feasibility and a clear path forward for the next steps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CFT for psychosis is an approach that integrates biopsychosocial processes, an integration that's evidenced across each aspect of the model, from theoretical foundations (evolution-informed) to interventions (e.g., body/breath training and relational techniques), to evaluation. Future RCTs are required to understand the effects on biopsychosocial outcomes for people with psychosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54539,"journal":{"name":"Psychology and Psychotherapy-Theory Research and Practice","volume":"97 1","pages":"59-73"},"PeriodicalIF":3.4,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/papt.12490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9988468","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}
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