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O'Connor RA, Doherty M, Ryan-Enright T, Gaynor K. Perspectives of autistic adolescent girls and women on the determinants of their mental health and social and emotional well-being: A systematic review and thematic synthesis of lived experience. Autism 2024; 28:816-830. [PMID: 38145308 DOI: 10.1177/13623613231215026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
LAY ABSTRACT Difficulties with mental health and low levels of well-being are more common among autistic girls and women than non-autistic people, but we do not fully understand why. Research does not focus enough on what autistic girls and women could tell us about this. This review aims to summarise the studies where autistic girls and women explain things that affect their mental health and well-being to help us understand how to prevent these difficulties from developing. Three research databases were searched to find possibly relevant studies. There were 877 studies found, which two researchers screened according to particular criteria. They found 52 studies that could be included in this review. One researcher evaluated the quality of these studies and extracted the key information from them. This review summarises the views of 973 autistic girls and women aged between 13 and 70+. The findings from the 52 studies were analysed, and we found many factors that affect the mental health and well-being of autistic girls and women. These factors fall into two categories: (1) difficulties living in a world not designed for autistic people and (2) the impact of stigma due to being autistic.
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Affiliation(s)
- Rachel Ag O'Connor
- School of Psychology, University College Dublin, Republic of Ireland
- Health Service Executive, Republic of Ireland
| | - Mary Doherty
- Brighton and Sussex Medical School, Brighton, UK
- Our Lady's Hospital, Navan, Republic of Ireland
| | - Theresa Ryan-Enright
- School of Psychology, University College Dublin, Republic of Ireland
- Health Service Executive, Republic of Ireland
| | - Keith Gaynor
- School of Psychology, University College Dublin, Republic of Ireland
- DETECT, Early Intervention Service, Blackrock, Republic of Ireland
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Grady S, Twomey C, Cullen C, Gaynor K. Does affect mediate the relationship between interpersonal trauma and psychosis? A systematic review and meta-analysis. Schizophr Res 2024; 264:435-447. [PMID: 38245930 DOI: 10.1016/j.schres.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/24/2023] [Accepted: 01/01/2024] [Indexed: 01/23/2024]
Abstract
INTRODUCTION The relationship between interpersonal trauma and psychosis is well established, and research is now focused on identifying mechanisms that may explain this relationship. Models of trauma and psychosis increasingly emphasize a broad range of affective processes, yet the overall effect of these affective processes is not well understood. AIM This review systematically examined the effect of any form of long-term affective dysfunction on the relationship between interpersonal trauma and psychosis. Where possible, it used meta-analytic techniques to quantify the overall magnitude of this effect. METHOD Searches were conducted using PsychINFO, MEDLINE and CINAHL databases, and eligible studies were appraised for methodological quality. Narrative synthesis and meta-analytic methods were used to evaluate evidence. RESULTS Twenty-nine studies met criteria for inclusion. Five affective mediators were found; depression, anxiety, affective dysregulation, loneliness and attachment. Findings from both the narrative synthesis (n = 29) and meta-analysis (n = 8) indicated that, overall, affect is a small but significant mediator of the relationship between interpersonal trauma and psychosis (pooled Cohen's d = 0.178; pooled 95 % CI: 0.022-0.334). CONCLUSIONS Overall, findings support affective pathways to psychosis, though highlight the need for further research on broader affective mediators (loneliness, shame). The small effect size found in the meta-analysis also points to the potential importance of non-affective mediators. Clinically, these findings highlight the value of treatment modalities that attend to multiple mechanisms in the relationship between interpersonal trauma and psychosis. Future research should focus on the interplay and causal sequence between these mechanisms to further understand pathways between interpersonal trauma and psychosis.
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Affiliation(s)
- Shelley Grady
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland.
| | - Conal Twomey
- Dept. of Psychology, St Patrick's University Hospital, Dublin, Ireland
| | - Clare Cullen
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
| | - Keith Gaynor
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland; DETECT, Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland
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French Á, Gaynor K, Nearchou F, Raftery S, O'Dwyer B, Hennessy E. Parents' Information Needs in Relation to Adolescent Self-Harm: Perspectives of Parents and Professionals. Arch Suicide Res 2023:1-16. [PMID: 37950673 DOI: 10.1080/13811118.2023.2279524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2023]
Abstract
OBJECTIVE Discovering that an adolescent is self-harming is extremely distressing for parents and this distress can be compounded by lack of easily accessible and well targeted information on what they can do to help. Some research has even suggested that parental distress can be an obstacle to seeking professional help. This paper describes two studies that sought to identify the information needs of parents in the immediacy of discovering self-harm and in ongoing efforts to support their child. METHOD Study 1: on-line survey of 128 parents who had experienced their child's self-harm; study 2: two-round Delphi method with 29 professionals who provide therapeutic interventions to adolescents who self-harm. The primary aim of both studies was to elicit views on parents' information needs in relation to supporting adolescents who self-harm. RESULTS There was a high level of agreement between parents and professionals on the needs for information on topics such as: communication, psychoeducation, managing emotional responses, parenting strategies and interventions. The professionals also emphasized the need for parents to practice self-care and the value of teaching alternative coping strategies to adolescents. Parents placed greater emphasis than professionals on the need for information on future therapeutic needs. CONCLUSION Despite the agreement between parents and professionals on most of the information needed, there were sufficient differences in emphasis to confirm the importance of consulting with both groups. The findings can be used to develop information sources that are specifically tailored to the needs of parents at all stages of adolescent self-harm.
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Gaynor K, McNamara R, O'Connor R, Schmieder L, Somers E, Hennessy E. Qualitative analysis of the cognitive triad in a sample of the general population in response to the COVID-19 pandemic. Psychiatry Res 2023; 327:115414. [PMID: 37604042 DOI: 10.1016/j.psychres.2023.115414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/26/2023] [Accepted: 08/11/2023] [Indexed: 08/23/2023]
Abstract
This paper explored cognitive responses to the COVID-19 pandemic in those selfreporting depressive symptoms during a period of realistic health, economic and social threat. Negative cognitions are a key therapy target for evidence-based psychological interventions. A cross-sectional survey was conducted with a convenience sample from the general population between December 2020 and February 2021. Adult respondents (n = 555) completed open text-box questions which provided prompts of the cognitive triad: "I am…/I am not…"; "Other people are…/Other people are not…"; "The world is…". These qualitative data were analysed using reflexive thematic analysis. Thematic responses were compared between people who self-reported moderate depressive symptoms (n = 223) and those who did not (n = 332). Fourteen independent themes were identified. Those self-reporting depressive symptoms described significantly fewer positive cognitions across all three aspects of the cognitive triad, X2 = 60.40 p < 0.01; X2 = 10.51 p < 0.05; X2 = 12.22 p < 0.01. Those self-reporting depressive symptoms also reported more self-referent negative cognitions. These data highlighted that an absence of positive cognitions differentiated the two groups more greatly than negative cognitions. These data have implications for the cognitive targets in psychological therapies in realistic high-stress situations. This paper explored cognitive responses to the COVID-19 pandemic in those selfreporting depressive symptoms during a period of realistic health, economic and social threat. Negative cognitions are a key therapy target for evidence-based psychological interventions. A cross-sectional survey was conducted with a convenience sample from the general population between December 2020 and February 2021. Adult respondents (n = 555) completed open text-box questions which provided prompts of the cognitive triad: "I am…/I am not…"; "Other people are…/Other people are not…"; "The world is…". These qualitative data were analysed using reflexive thematic analysis. Thematic responses were compared between people who self-reported moderate depressive symptoms (n = 223) and those who did not (n = 332). Fourteen independent themes were identified. Those self-reporting depressive symptoms described significantly fewer positive cognitions across all three aspects of the cognitive triad, X2 = 60.40 p < 0.01; X2 = 10.51 p < 0.05; X2 = 12.22 p < 0.01. Those self-reporting depressive symptoms also reported more self-referent negative cognitions. These data highlighted that an absence of positive cognitions differentiated the two groups more greatly than negative cognitions. These data have implications for the cognitive targets in psychological therapies in realistic high-stress situations.
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Affiliation(s)
- Keith Gaynor
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland; DETECT, Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland.
| | - Roisin McNamara
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | | | - Luisa Schmieder
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Ellen Somers
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Eilis Hennessy
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
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Schmieder L, Gaynor K, Lynch J, D'Alton P. Perceived injustice and its impact on psychological distress in cancer patients and survivors. Support Care Cancer 2023; 31:433. [PMID: 37392203 DOI: 10.1007/s00520-023-07833-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 05/23/2023] [Indexed: 07/03/2023]
Abstract
PURPOSE Perceived injustice is a novel psychosocial construct that reflects negative cognitive appraisals of unfairness, externalized blame and the irreparability and severity of one's loss. Previous research has highlighted the negative impact of perceived injustice on recovery and mental health outcomes, particularly in pain-related samples. This study aimed to (i) explore the role of perceived injustice on psychological outcomes in a general cancer population and (ii) describe demographic and psychosocial characteristics associated with perceptions of injustice. METHODS The study employed a cross-sectional, observational design. Using a purposive convenience sampling technique, individuals that have or have had cancer completed an online survey assessing perceived injustice (IEQ), psychological distress (HADS), mental adjustment to cancer (Mini-MAC) and satisfaction with care (PSCC) (N = 121). RESULTS Levels of perceived injustice were high with 43.2% of the sample scoring in the clinical range. Hierarchical regression analyses showed that perceived injustice contributed unique variance to the prediction of anxiety and depression. Low satisfaction with care, being under the age of 40 and not having children were identified as significant predictors of perceived injustice. Satisfaction with care did not significantly moderate the association between perceived injustice and mental health outcomes but directly impacted anxiety levels. CONCLUSION Cancer patients reporting high levels of perceived injustice are at greater risk of feeling psychologically distressed. Prevention and management of injustice perceptions may require interventions targeting specific negative attributions, as well as cancer care in general. Further implications for healthcare practice are discussed.
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Affiliation(s)
- Luisa Schmieder
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Keith Gaynor
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Julie Lynch
- Department of Psychology, St. Vincent's University Hospital, Dublin, Ireland
| | - Paul D'Alton
- Department of Psychology, St. Vincent's University Hospital, Dublin, Ireland
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Delz AK, Gaynor K, O'Connor R, Schmieder L, Somers E. A confirmatory factor analysis of a cognitive model of COVID-19 related anxiety and depression. Acta Psychol (Amst) 2023; 234:103861. [PMID: 36774772 PMCID: PMC9910022 DOI: 10.1016/j.actpsy.2023.103861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
The mental health impact of the COVID-19 pandemic has been significant, with many regions across the globe reporting significant increases in anxiety, depression, trauma, and insomnia. This study aims to validate a potential cognitive model of maintenance factors of COVID-19 related distress by examining psychological predictors of distress, and their goodness-of-fit as a coherent model. Participants from the general population (n = 555) were recruited using a cross-sectional on-line survey design, assessing Demographic factors, Anxiety, Depression, Loneliness, COVID-19 related distress, Trauma Cognitions related to COVID-19, Rumination, Safety Behaviours, Personality Factors, and Mental Effort related to COVID-19. A series of stepwise linear regressions found that components of the model were significant and accounted for a large percentage of variance when examining Covid-19 related distress (R2 = 0.447 Covid Stress Scale), Anxiety (R2 = 0.536 DASS-Anxiety Subscale) and Depression (R2 = 0.596 Depression DASS-subscale). In a confirmatory factor analysis, Loneliness, Post-Traumatic Cognitions about Self, Post-Traumatic Cognitions about the World, Emotional Stability, and Mental Effort related to COVID-19 loaded onto a single factor. The final model showed adequate fit (CFI = 0.990, TLI = 0.983, RMSEA = 0.053 (0.027-0.080), GFI = 0.986, SRMR = 0.0216, χ2 = 23.087, p = .006). The results highlight the importance of cognitive factors, such as post-traumatic cognitions, rumination, and mental effort in maintaining COVID-19 related distress.
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Affiliation(s)
| | - Keith Gaynor
- DETECT, Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland.
| | - Rachael O'Connor
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Luisa Schmieder
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Ellen Somers
- School of Psychology, University College Dublin, Dublin, Ireland
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Molumby M, Gaynor K, Guerin S, McNamara R. Examining Attitudes to Psilocybin: Should Candidates for Medical Psilocybin be Required to Pass a Contextual Suitability Test? Journal of Humanistic Psychology 2022. [DOI: 10.1177/00221678221110331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Due to increasing evidence of efficacy in treating mental health disorders, psilocybin may become a legal medicinal drug. This study tested the validity of Carhart-Harris and Nutt’s (2017) model of extra-pharmacological (EP) factors. It examined whether such factors should be considered in any psychological suitability test for medicinally prescribed psilocybin. Two hundred nineteen participants (101 self-identified females, 109 males, seven nonbinary people, and two who preferred not to say), in an age range of 18 to 68 years, completed three online measures of personality— Set, Setting, and Intention—and the Attitudes Toward Psilocybin (ATP) scale. The sample was equally divided between those who had used psychedelics (52.1%) and those who had no previous psychedelic use (47.5%). A series of stepwise linear regressions were run to examine whether EP factors predicted ATP scores. The ATP scale was tested for reliability, construct validity, and determinant validity and was deemed an appropriate measure. A model consisting of a positive Set, Openness to Experience, and lower Extraversion significantly predicted ATP scores. These findings supported the EP model and suggested that a suitability test may be a useful tool when determining whether a prescription of psilocybin is an appropriate course of treatment.
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Affiliation(s)
- Mark Molumby
- School of Psychology, University College Dublin, Newman Building, Belfield Campus, Dublin 4, Ireland
| | - Keith Gaynor
- School of Psychology, University College Dublin, Newman Building, Belfield Campus, Dublin 4, Ireland
| | - Suzanne Guerin
- School of Psychology, University College Dublin, Newman Building, Belfield Campus, Dublin 4, Ireland
| | - Róisín McNamara
- School of Psychology, University College Dublin, Newman Building, Belfield Campus, Dublin 4, Ireland
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Cahill J, Cullen P, Gaynor K. The case for change: aviation worker wellbeing during the COVID 19 pandemic, and the need for an integrated health and safety culture. Cogn Technol Work 2022; 25:75-117. [PMID: 35992312 PMCID: PMC9382631 DOI: 10.1007/s10111-022-00711-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/21/2022] [Indexed: 06/15/2023]
Abstract
The workplace is an important setting for health protection, health promotion and disease prevention. Currently, health and wellbeing approaches at an aviation organisational level are not addressing both human and safety needs. This issue has been intensified since the COVID 19 pandemic. This paper reports on the findings of a survey pertaining to aviation worker wellbeing and organisational approaches to managing wellbeing and mental health. The survey was administered at two different time periods during the COVID 19 pandemic (2020 and 2021). Collectively, feedback was obtained from over 3000 aviation workers. Survey feedback indicates that aviation workers are experiencing considerable challenges in relation to their health and wellbeing. These challenges are not being adequately addressed at an organisational level, which creates risk both from an individual and flight safety perspective. The descriptive findings of both surveys along with a regression analysis is used to make a principled case for augmenting the existing approach to managing aviation worker wellbeing (including mental health), at both an organisational and regulatory level. It is argued that aviation organisations, with the support of the regulator should implement a preventative, ethical and evidence-based strategy to managing wellbeing and mental health risk. Critically, aviation organisations need to advance and integrated health, wellbeing, and safety culture. This necessitates an alignment of human, business, and safety objectives, as articulated in concepts of corporate social responsibility (CSR) and responsible work. Critically, this approach depends on trust and the specification of appropriate protections, so that aviation workers feel safe to routinely report wellbeing levels and challenges, and their impact on operational safety.
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Affiliation(s)
- Joan Cahill
- Centre for Innovative Human Systems, School of Psychology, Trinity College Dublin (TCD), Dublin, Ireland
| | - Paul Cullen
- Centre for Innovative Human Systems, School of Psychology, Trinity College Dublin (TCD), Dublin, Ireland
| | - Keith Gaynor
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
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Lynch J, D'Alton P, Gaynor K. Evaluating the role of perceived injustice in mental health outcomes in cervical cancer care. Support Care Cancer 2022; 30:6215-6223. [PMID: 35445867 PMCID: PMC9022611 DOI: 10.1007/s00520-022-07060-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/11/2022] [Indexed: 12/05/2022]
Abstract
Purpose
Perceived injustice is a novel psychosocial construct which reflects negative cognitive appraisals of blame, unfairness, and the severity and irreparability of one’s loss. Experiences of injustice are increasingly recognised as a key determinant of recovery outcomes in healthcare. The aim of this study was to explore the impact of perceived injustice on psychological outcomes amongst a group of cancer patients and survivors who received false-negative smear results under a National Cervical Cancer Screening Programme (CervicalCheck). Methods Women who received false-negative smear results who were involved in the CervicalCheck controversy in Ireland completed online measures of perceived injustice (IEQ), psychological distress (depression and anxiety as measured by the HADS), and satisfaction with care (PSCC) (n = 144). Results Rates of psychological distress in this sample were high, with 76% scoring in the clinical range for anxiety, 51% in the clinical range for depression, and 88% in the clinical range for perceived injustice. Hierarchical regression analyses revealed that perceived injustice contributed unique variance to the prediction of depression and anxiety. Satisfaction with care significantly moderated the association between perceived injustice and depression. Conclusions Cancer patients who report high levels of perceived injustice are at greater risk for experiencing psychological distress. The relationship between perceived injustice and depression may vary as a function of satisfaction with care. Addressing issues of perceived injustice in the psychosocial and rehabilitative care of cancer patients may support the early identification of those at risk of significant psychological distress and enhance intervention success. Implications for policy and practice in healthcare are discussed. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-022-07060-z.
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Affiliation(s)
- Julie Lynch
- School of Psychology, University College Dublin, Dublin, Ireland.
| | - Paul D'Alton
- Department of Psychology, St. Vincent's University Hospital, Dublin, Ireland
| | - Keith Gaynor
- School of Psychology, University College Dublin, Dublin, Ireland
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Yalvaç EBK, Gaynor K. Emotional dysregulation in adults: The influence of rumination and negative secondary appraisals of emotion. J Affect Disord 2021; 282:656-661. [PMID: 33445088 DOI: 10.1016/j.jad.2020.12.194] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/30/2020] [Accepted: 12/26/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Emotional dysregulation is commonly discussed as a transdiagnostic factor in clinical populations. The present study aims to investigate cognitive factors (rumination and negative appraisals of emotion) in the maintenance of emotional dysregulation in a normative sample in order to partially validate a cognitive model of emotional dysregulation and to examine the potential clinical relevance of addressing cognitive factors in the treatment of emotional dysregulation. METHODS People who were 18 or older were asked to participate via a university research system and social media. Participants (N = 216) were asked to fill out online surveys regarding emotional dysregulation, rumination and negative secondary appraisals of emotion. RESULTS People who had higher emotional dysregulation levels displayed a greater tendency to ruminate and were more prone to negative secondary appraisals of emotion. There was a positive association between rumination and negative secondary appraisals of emotion, and this association was mediated by emotional dysregulation. LIMITATIONS The present study was solely based on self-report measurements and the collected data were cross-sectional. CONCLUSIONS The present study showed that a wide spectrum of experiences of emotional dysregulation occurred in a normative sample. The significant mediation highlighted the maintaining role of rumination and negative appraisals in emotional dysregulation. These data highlight the importance of addressing cognitive factors in emotional dysregulation.
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Affiliation(s)
| | - Keith Gaynor
- School of Psychology, University College Dublin, Ireland.
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Lynch J, D'Alton P, Gaynor K. Exploring the psychological impact of the cervical cancer screening failures on women in Ireland: A qualitative study. Psychooncology 2021; 30:1167-1171. [PMID: 33580726 DOI: 10.1002/pon.5635] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Julie Lynch
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Paul D'Alton
- Department of Psychology, St. Vincent's University Hospital, Dublin, Ireland
| | - Keith Gaynor
- School of Psychology, University College Dublin, Dublin, Ireland
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Jackson D, Lawoyin R, Gaynor K, Clarke M, Browne S, Renwick L, Sutton M, Turner N, Kinsella A, Waddington JL, Larkin C, O'Callaghan E. Is the duration of untreated psychosis temporally stable? Eur Psychiatry 2020; 23:97-9. [DOI: 10.1016/j.eurpsy.2007.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2007] [Revised: 08/17/2007] [Accepted: 08/22/2007] [Indexed: 10/22/2022] Open
Abstract
AbstractAlthough there is some evidence that duration of untreated psychosis (DUP) is geographically stable, few have examined whether the phenomenon is temporally stable. We examined DUP in two cohorts within two discrete time periods (1995–1999 and 2003–2005) spanning a decade in the same geographically defined community psychiatric service with no early intervention programme. Patients were diagnosed by Structured Clinical Interview for DSM (SCID) and we determined the DUP using the Beiser Scale. The DUP of the 240 participants did not differ significantly between study periods.
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Gaynor K, Dooley B, Lawlor E, Lawoyin LR. Predicting uptake of group CBT in a first-episode psychosis cohort. Cogn Behav Ther 2013; 43:105-10. [PMID: 24365201 DOI: 10.1080/16506073.2013.858766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Many people with psychosis do not engage in psychological treatments when offered. We examined variables that predicted uptake of group cognitive behavioural therapy (CBT) in first-episode psychosis. We assessed all consenting consecutive referrals over a 2-year period. T-tests and logistic regressions examined factors which predicted uptake. The suitability for short-term CBT scale (SSCT) and negative symptoms successfully differentiated engagement and non-engagement. A model combining negative symptoms and the SSCT significantly predicted uptake of group CBT. Attention has not been paid to poor uptake of psychological treatments in psychosis. This may have a greater impact on outcomes than treatment effectiveness.
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Affiliation(s)
- Keith Gaynor
- a Psychology Department , St John of God Hospital , Stillorgan , Co. Dublin , Ireland
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Gaynor K, Brown JSL. Self-referrers to community workshops: Who are they and why do some participants not consult with their GP about their mental health difficulties? J Ment Health 2013; 22:227-36. [DOI: 10.3109/09638237.2012.734646] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gaynor K, Ward T, Garety P, Peters E. The role of safety-seeking behaviours in maintaining threat appraisals in psychosis. Behav Res Ther 2012; 51:75-81. [PMID: 23261708 DOI: 10.1016/j.brat.2012.10.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 10/22/2012] [Accepted: 10/31/2012] [Indexed: 11/28/2022]
Abstract
AIM This study investigated the interaction between appraisals and safety behaviours in the maintenance of psychotic symptoms. METHOD The study recruited a population who had persistent psychotic experiences but who had no 'need-for-care' (Persistence group; n = 39) as well as a population who had a diagnosed psychotic disorder and were receiving current treatment (Impairment group; n = 28). The participants were assessed on semi-structured interviews of appraisals and safety behaviours and on anxiety and depression questionnaires. RESULTS The two groups did not differ in total or first rank psychotic experiences, but the Persistence group showed less anomaly-related distress, depression and anxiety than the Impairment group. As predicted, the Impairment group displayed more threat appraisals and safety behaviours than the Persistence group, with a greater frequency of safety behaviours being related to higher levels of threat appraisals and anomaly-related distress. Threat appraisals mediated the relationship between safety behaviours and anomaly-related distress, suggesting that threat appraisals may maintain distress, a defining feature of Impairment status. CONCLUSIONS These data provide support for the cognitive model of psychosis in suggesting that cognitive and behavioural factors are key in differentiating non-clinical anomalous experiences from clinical psychotic status. These data suggest that therapy should target threat appraisals and safety-seeking behaviours in order to decrease distress.
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Affiliation(s)
- Keith Gaynor
- Department of Psychology, Institute of Psychiatry, King's College London, De Crespigny Park, London, UK.
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Gaynor K, Dooley B, Lawlor E, Lawoyin R, O'Callaghan E. Group cognitive behavioural therapy as a treatment for negative symptoms in first-episode psychosis. Early Interv Psychiatry 2011; 5:168-73. [PMID: 21535424 DOI: 10.1111/j.1751-7893.2011.00270.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM We aimed to test the idea that there is an early critical time period during a psychotic illness when patients may be more responsive to psychological treatment attention. METHODS We tested this hypothesis by comparing the treatment responsiveness to group cognitive behavioural therapy (CBT) of 25 first-episode psychosis participants (FEP) and 15 patients with currently stable psychosis (n = 40). RESULTS Following 12 sessions of outpatient-based group CBT, there were significant decreases in positive, depressive and anxiety symptoms, and an improvement in quality of life for both groups. However, negative symptoms only improved in the FEP group. CONCLUSION Considering the pernicious nature of negative symptoms as well as the difficulties in treating them, this study provides some support for the concept of early intervention with CBT.
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Affiliation(s)
- Keith Gaynor
- Schools of Psychology, University College Dublin Cluain Mhuire Service, Blackrock, Ireland.
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17
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Abstract
IntroductionVan Os et al. (2009) have proposed a Proneness-Persistence-lmpairment model to explain the psychosis continuum, and cognitive models of psychosis have suggested that appraisals of anomalous experiences may be key in determining ‘need for care’.ObjectivesThe present study investigated the interaction between appraisals and safety behaviours in the maintenance of impairing psychotic symptoms.AimsIt was predicted that individuals with psychotic symptoms without a need for care would display fewer threat appraisals and safety behaviours than their clinical counterparts, and that these variables would predict distress.MethodsThe study recruited people with persistent psychotic experiences but who had no-need-for-care (Persistence group; n = 39) and individuals diagnosed with a psychotic disorder who were receiving current treatment (Impairment group; n = 28). The participants were assessed on semi-structured interviews of appraisals and safety behaviours in relation to their psychotic experiences and on anxiety and depression questionnaires.ResultsBoth groups had similar levels of psychotic symptoms in the last month, including first rank symptoms. However there was a large significant difference between Impairment and Persistence groups in threat appraisals and safety behaviours, with the Persistence group reporting higher levels of both. A mediation analysis found that threat appraisals mediated the relationship between safety behaviours and anomaly-related distress, suggesting that threat appraisals may maintain anomaly-related distress, a defining feature of Impairment status.ConclusionsThese data provide support for the cognitive model of psychosis, with threat appraisals potentially playing a major role in the transition from non-clinical anomalous experiences to clinical psychotic status.
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Abstract
AIM To examine the relationship between cognitive deterioration and the duration of untreated psychosis (DUP) in a first-episode psychosis sample. METHOD We assessed a consecutive sample of first-episode psychosis participants (N = 50) with measures of cognitive deterioration and DUP. RESULTS Using correlations and stepwise linear regressions, we found strong relationships between DUP and measures of cognitive deterioration. CONCLUSIONS The length of DUP predicted cognitive deterioration. These results highlight a potential DUP grace period (>6 months) in which significant cognitive deterioration may be averted.
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Affiliation(s)
- Keith Gaynor
- School of Psychology, University College Dublin, Dublin, Ireland.
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19
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Abstract
BACKGROUND calcium and vitamin D deficiency are common in elderly people and lead to increased bone loss, with an enhanced risk of osteoporotic fractures. Although hip fractures are a serious consequence, few therapeutic measures are given for primary or secondary prevention. A combination of calcium and vitamin D may not be the most effective treatment for all patients. OBJECTIVE to investigate the effects of hypovitaminosis D on the calcium-parathyroid hormone endocrine axis, bone mineral density and fracture type, and the optimal role of combination calcium and vitamin D therapy after hip fracture in elderly patients. DESIGN a population-based, prospective cohort study. METHODS 150 elderly subjects were recruited from the fast-track orthogeriatric rehabilitation ward within 7 days of surgery for hip fracture. This ward accepts people who live at home and are independent in activities of daily living. All subjects had a baseline medical examination, biochemical tests (parathyroid hormone, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D) and were referred for bone densitometry. RESULTS at 68%, the prevalence of hypovitaminosis D (25-hydroxyvitamin D<30 nmol/l) was high. However, only half the patients had evidence of secondary hyperparathyroidism, the rest having a low to normal level of parathyroid hormone ('functional hypoparathyroidism'). Patients with secondary hyperparathyroidism and hypovitaminosis D had a higher mean corrected calcium, higher 1,25-dihydroxyvitamin D, lower hip bone mineral density and an excess of extracapsular over intracapsular fractures than the 'functional hypoparathyroid' group (P<0.01). CONCLUSION there is a high prevalence of hypovitaminosis D in active, elderly people living at home who present with a hip fracture. However, secondary hyperparathyroidism occurs in only half of these patients. This subgroup attempts to maintain calcium homeostasis but does so at the expense of increased bone turnover, leading to amplified hip bone loss and an excess of extracapsular over intracapsular fractures. Combination calcium and vitamin D treatment may be effective in preventing a second hip fracture in these patients, but its role in patients with hypovitaminosis D without secondary hyperparathyroidism and 'vitamin D-replete' subjects needs further evaluation.
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Affiliation(s)
- O Sahota
- Ageing and Disability Research Unit, B Floor Medical School, Queen's Medical Centre, University Hospital, Nottingham NG7 2UH, UK. opinder@
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Eppich HM, Foxall R, Gaynor K, Dombkowski D, Miura N, Cheng T, Silva-Arrieta S, Evans RH, Mangano JA, Preffer FI, Scadden DT. Pulsed electric fields for selection of hematopoietic cells and depletion of tumor cell contaminants. Nat Biotechnol 2000; 18:882-7. [PMID: 10932160 DOI: 10.1038/78504] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Purging of tumor cells and selection of stem cells are key technologies for enabling stem cell transplantation and stem cell gene therapy. Here we report a strategy for cell selection based on physical properties of the cells. Exposing cells to an external pulsed electric field (PEF) increases the natural potential difference across the cell membrane until a critical threshold is reached and pore formation occurs, resulting in fatal perturbation of cell physiology. Attaining this threshold is a function of the applied field intensity and cell size, with larger cells porated at lower field intensities than smaller cells. Since hematopoietic stem cells are smaller than other hematopoietic cells and tumor cells, we found that exposure of peripheral blood mononuclear cells (PBMCs) to PEFs caused stepwise elimination of monocytes without affecting the function of smaller lymphocyte populations. Mobilized peripheral blood exposed to PEFs was enriched for CD34+/CD38- cells and stem cell function was preserved. Furthermore, PEF treatment was able to selectively purge blood preparations of tumor cells and eradicate transplantable tumor.
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Affiliation(s)
- H M Eppich
- Science Research Laboratory Inc., Somerville, MA 02143, USA
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21
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Gardner JP, Rosenzweig M, Marks DF, Harper D, Gaynor K, Fallon RJ, Wall DA, Johnson RP, Scadden DT. T-lymphopoietic capacity of cord blood-derived CD34+ progenitor cells. Exp Hematol 1998; 26:991-9. [PMID: 9728935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Umbilical cord blood contains an abundance of CD34+ hematopoietic progenitor cells and has been used in transplantation as an alternative to adult bone marrow or mobilized peripheral blood. Although efficient myelomonocytic, erythroid, and B lymphoid differentiation has been shown in highly purified cord blood CD34+ mononuclear cells lacking expression of lineage-specific antigens, generation of functional T cells has not been previously documented. Exploiting two recently developed, complementary thymic stromal monolayer systems, we show here that immature hematopoietic progenitor cells (CD34+lineage-) from human and rhesus monkey cord blood mononuclear cells undergo T lymphopoiesis in a manner that recapitulates T cell ontogeny in vivo. After 2 weeks of proliferation, cultures contained myeloid [corrected] cells and discrete populations of CD4+CD8+ (double-positive) immature T lymphocytes, followed after an additional 2 weeks by the appearance of single-positive CD4+CD8- and CD4-CD8+ T cells that coexpressed CD3. The T lymphoid phenotype was confirmed at the transcriptional level by the presence of the lymphoid-restricted genes RAG-2 and T cell receptor. T cells generated from cord blood progenitors in these systems exhibited immunofunction as assessed by alloreactive responses in mixed lymphocyte reactions. These findings were comparable between human and rhesus progenitor cells and closely resemble previous data using adult bone marrow CD34+ cells in these models. Together, these observations demonstrate that cord blood contains abundant lymphoid progenitors that undergo T lymphopoiesis in vitro, suggesting the full multipotentiality of this stem cell source and its validity in investigating T lymphoid differentiation.
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Affiliation(s)
- J P Gardner
- Division of Experimental Hematology, AIDS Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, USA
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Woods M, O’Donnell LJD, Battistini B, Warner T, Vane J, Fartming MG, Yaqoob J, Wu JJ, Norris LA, Khan MI, Keeling PWN, Maguire D, O’Sullivan G, Harvey B, Curran B, Xin∘ Y, Kay EW, Leader M, Henry K, Crosbie O, Norris S, Costello P, O’Farrelly C, Hegarty J, Kennedy B, Duggan M, Plant R, Kenny-Walsh EK, Cotter P, Whelton MJ, Yaqoob J, Khan MI, Maloney M, Noonan N, Keeling PWN, Buckley M, Hamilton H, Beattie S, O’Morain C, McNamara B, Cuffe J, O’Sullivan G, Harvey B, Barry RA, O’Morain C, Collins DA, O’Sullivan GC, Collins JK, Shanahan F, Skelly MM, Mulcahy HE, Troy A, Connell T, Duggan C, Duffyt MJ, Sheahan K, O’Donoghue DP, Buckley M, Xia HX, Hyde D, O’Morain C, O’Brien MG, Fitzgerald EF, Lee G, Shanahan F, O’Sullivan GC, Hussey AJ, Boyle TJ, Garrihy B, Clinton OP, McAnena OJ, Cuffe J, McNamara B, O’Sulllvan G, Harvey B, Corby H, Donnelly V, O’Herlihy C, O’Connell PR, Deignan T, Kelly J, O’Farrelly C, Breslin NP, MacDonnell C, O’Morain C, O’Keeffe J, Mills K, Srinivasan U, Willoughby R, Feighery C, Twohig B, Gaynor K, O’Regan PF, Duggan S, Redmond HP, McCarthy J, Bouchier-Hayes D, Ma QY, Williamson KE, Rowlands BJ, Tobin A, Pilkington R, O’Donnell M, O’Shea E, Conroy A, Kaminski G, Walsh A, Temperley IJ, Kelleher D, Weir DG, Barry MK, Mulligan ED, Stokes MA, O’Riordain MG, Gorey TF, McGeeney KF, Fitzpatrick JM, Watson RWG, Redmond HP, Wang JH, Campbell F, Bouchier-Hayes D, Bennett D, Kavanagh E, Gorman PO, Twohig B, O’Regan P, Shanahan F, Yassin MMI, McCaigue M, Parks TG, Rowlands BJ, D’Sa AABB, Norris S, Lawlor M, McElwaine S, O’Farrelly C, Hegarty J, Heneghan MA, Kerins M, Goulding J, Egan EL, Stevens FM, McCarthy CF, Quirke M, Eustace-Ryan AM, O’Regan PF, Khan MI, Yaqoob J, Qureshi S, Aziz E, Maree A, Collins S, Browne T, Ahmed S, Sullibhan BO, Smith P, Walker F, O’Connor F, Sweeney E, O’Morain C, Farrell RJ, Morrint M, Goggins M, McNulty JG, Weir DG, Kelleher D, Keeling PWN. Irish Society of Gastroenterology. Ir J Med Sci 1995. [PMCID: PMC7102063 DOI: 10.1007/bf02967835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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