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Wrightson-Hester AR, Anderson G, Dunstan J, McEvoy PM, Sutton CJ, Myers B, Egan S, Tai S, Johnston-Hollitt M, Chen W, Gedeon T, Mansell W. An Artificial Therapist (Manage Your Life Online) to Support the Mental Health of Youth: Co-Design and Case Series. JMIR Hum Factors 2023; 10:e46849. [PMID: 37477969 PMCID: PMC10403793 DOI: 10.2196/46849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/26/2023] [Accepted: 06/17/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The prevalence of child and adolescent mental health issues is increasing faster than the number of services available, leading to a shortfall. Mental health chatbots are a highly scalable method to address this gap. Manage Your Life Online (MYLO) is an artificially intelligent chatbot that emulates the method of levels therapy. Method of levels is a therapy that uses curious questioning to support the sustained awareness and exploration of current problems. OBJECTIVE This study aimed to assess the feasibility and acceptability of a co-designed interface for MYLO in young people aged 16 to 24 years with mental health problems. METHODS An iterative co-design phase occurred over 4 months, in which feedback was elicited from a group of young people (n=7) with lived experiences of mental health issues. This resulted in the development of a progressive web application version of MYLO that could be used on mobile phones. We conducted a case series to assess the feasibility and acceptability of MYLO in 13 young people over 2 weeks. During this time, the participants tested MYLO and completed surveys including clinical outcomes and acceptability measures. We then conducted focus groups and interviews and used thematic analysis to obtain feedback on MYLO and identify recommendations for further improvements. RESULTS Most participants were positive about their experience of using MYLO and would recommend MYLO to others. The participants enjoyed the simplicity of the interface, found it easy to use, and rated it as acceptable using the System Usability Scale. Inspection of the use data found evidence that MYLO can learn and adapt its questioning in response to user input. We found a large effect size for the decrease in participants' problem-related distress and a medium effect size for the increase in their self-reported tendency to resolve goal conflicts (the proposed mechanism of change) in the testing phase. Some patients also experienced a reliable change in their clinical outcome measures over the 2 weeks. CONCLUSIONS We established the feasibility and acceptability of MYLO. The initial outcomes suggest that MYLO has the potential to support the mental health of young people and help them resolve their own problems. We aim to establish whether the use of MYLO leads to a meaningful reduction in participants' symptoms of depression and anxiety and whether these are maintained over time by conducting a randomized controlled evaluation trial.
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Affiliation(s)
- Aimee-Rose Wrightson-Hester
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
- School of Arts and Humanities, Edith Cowan University, Perth, Australia
| | | | - Joel Dunstan
- Curtin Institute for Data Science, Curtin University, Perth, Australia
| | - Peter M McEvoy
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
- Centre for Clinical Interventions, North Metropolitan Health Service, Nedlands, Australia
| | - Christopher J Sutton
- Centre for Biostatistics, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Bronwyn Myers
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Parow, South Africa
- Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Sarah Egan
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Sara Tai
- Department of Clinical Psychology, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | | | - Wai Chen
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Mental Health Service, Fiona Stanley Hospital, Perth, Australia
- Curtin Medical School, Curtin University, Perth, Australia
- Centre of Excellence in Medical Biotechnology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand
| | - Tom Gedeon
- Optus-Curtin Centre of Excellence in AI, School of Electronic Engineering, Computing and Mathematical Sciences, Curtin University, Perth, Australia
| | - Warren Mansell
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
- Department of Clinical Psychology, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
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Just D, Tai S, Palmier-Claus J. A systematic review of policy and clinical guidelines on positive risk management. J Ment Health 2023; 32:329-340. [PMID: 34006184 DOI: 10.1080/09638237.2021.1922643] [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] [Indexed: 10/21/2022]
Abstract
BACKGROUND National policies and guidelines advocate that mental health practitioners employ positive risk management in clinical practice. However, there is currently a lack of clear guidance and definitions around this technique. Policy reviews can clarify complex issues by qualitatively synthesising common themes in the literature. AIMS To review and thematically analyse national policy and guidelines on positive risk management to understand how it is conceptualised and defined. METHOD The authors completed a systematic review (PROSPERO: CRD42019122322) of grey literature databases (NICE, NHS England, UK Government) to identify policies and guidelines published between 1980 and April 2019. They analysed the results using thematic analysis. RESULTS The authors screened 4999 documents, identifying 7 eligible policies and 19 guidelines. Qualitative synthesis resulted in three main themes: i) the conflicting aims of positive risk management; ii) conditional positive risk management; and iii) responsible positive risk management. CONCLUSIONS Analysis highlighted discrepancies and tensions in the conceptualisation of positive risk management both within and between policies. Documents described positive risk management in different and contradictory terms, making it challenging to identify what it is, when it should be employed, and by whom. Five policies offered only very limited definitions of positive risk management.
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Affiliation(s)
- Daniela Just
- School of Health Sciences, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Sara Tai
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Jasper Palmier-Claus
- Spectrum Centre for Mental Health Research, University of Lancaster, Lancaster, UK.,Lancashire and South Cumbria, NHS Foundation Trust, Lancashire, UK
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Kinderman P, Allsopp K, Zero R, Handerer F, Tai S. Minimal use of ICD social determinant or phenomenological codes in mental health care records. J Ment Health 2023; 32:216-225. [PMID: 34264781 DOI: 10.1080/09638237.2021.1952944] [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] [Indexed: 10/20/2022]
Abstract
BACKGROUND We have previously argued that psychiatric diagnosis, by focusing on pathology, minimises the role of psychosocial factors. Despite suggestions that traditional diagnosis is the only way to access treatment services, we have recommended standardised use of existing codes for possible social determinants and precise description of psychological phenomena. AIMS This study examines the current use of social determinant and phenomenological codes in mental health care records. METHODS Data provided by a local NHS Trust included 21,701 cases with a first contact date between 01 January 2015 and 01 January 2016, 4656 of whom received a primary diagnosis. RESULTS Overall, codes for possible social determinants were used on only 43 occasions, for 39 individuals (0.8% of the 4656 people receiving a primary diagnosis). Comparison with relevant baseline frequencies revealed a highly significant under-reporting of key social determinants. 19 cases (0.4% of 4.656) used codes for precise description of specific psychological phenomena. CONCLUSIONS Available ICD codes for social determinants and specific psychological phenomena are under-used in clinical practice.
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Affiliation(s)
- Peter Kinderman
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Kate Allsopp
- Complex Trauma and Resilience Research Unit (C-TRU), Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Rosie Zero
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Fritz Handerer
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Sara Tai
- School of Health Sciences, University of Manchester, Manchester, UK
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Handerer F, Kinderman P, Tai S. Diagnostic labels: the problem is the signified not the signifier. Lancet Psychiatry 2022; 9:e31. [PMID: 35717968 DOI: 10.1016/s2215-0366(22)00111-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Fritz Handerer
- Division of Psychology and Mental Health, The University of Manchester, Manchester, M13 9PL, UK.
| | - Peter Kinderman
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Sara Tai
- Division of Psychology and Mental Health, The University of Manchester, Manchester, M13 9PL, UK
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Handerer F, Kinderman P, Shafti M, Tai S. A Scoping Review and Narrative Synthesis Comparing the Constructs of Social Determinants of Health and Social Determinants of Mental Health: Matryoshka or Two Independent Constructs? Front Psychiatry 2022; 13:848556. [PMID: 35492698 PMCID: PMC9046700 DOI: 10.3389/fpsyt.2022.848556] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/10/2022] [Indexed: 11/21/2022] Open
Abstract
Background Many health research policies invoke the construct of Social Determinants of Health, and more recently the construct of Social Determinants of Mental Health. While frequently referred to in the literature, it is unclear how these constructs relate to each other. Some commentators conceptualise the Determinants of Mental Health as a subgroup of the Determinants of general Health and others describe the Determinants of Mental Health as an autonomous construct. The current review investigates the relationship between both constructs. Methods Comprehensive literature searches were conducted for both constructs separately within seven electronic databases. A template analysis was conducted to compare the conceptualisations of the Social Determinants of Health and the Social Determinants of Mental Health. Results Of 4250 search results, 50 papers (25 for each construct) fulfilled our inclusion criteria and were incorporated into a narrative synthesis. Discussions of the Social Determinants of both general and Mental Health listed the same determinants. Both constructs were conceptualised on multiple levels and factors. Stress and health behaviour were also described as mediators for both constructs. The constructs differed, however, with respect to two components of their aetiologies and epistemologies. First, the causal mechanisms invoked for the Determinants of general Health followed predominantly direct pathways, in contrast to indirect pathways for the Social Determinants of Mental Health. Second, the Social Determinants of Mental Health were reported to influence mental health mediated through individuals' perceptions and appraisal processes. Appraisal processes were considered of far less relevance in the construct of Social Determinants of Health. Conclusion The constructs of Social Determinants of Health and Social Determinants of Mental Health align in many respects but differ on important aetiological and epistemological grounds. Similar social factors are considered important, but whereas physical health conditions are primarily conceptualised to be driven by objective realities, mental health is explained mainly in terms of perception of these realities. This differentiation between physical and mental health is in line with a modern understanding of mind-body-dualism, the naturalistic dualism after Chalmers. Differentiating the Social Determinants of Mental Health from the Social Determinants of Health might bear relevance for policy making and research.
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Affiliation(s)
- Fritz Handerer
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Peter Kinderman
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Matina Shafti
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Sara Tai
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
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Affiliation(s)
- Charlotte Phillips
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Sara Tai
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Katherine Berry
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
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Handerer F, Kinderman P, Tai S. The need for improved coding to document the social determinants of health. Lancet Psychiatry 2021; 8:653. [PMID: 34303405 DOI: 10.1016/s2215-0366(21)00208-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Fritz Handerer
- Division of Psychology and Mental Health, University of Manchester, Manchester, M13 9PL, UK.
| | - Peter Kinderman
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Sara Tai
- Division of Psychology and Mental Health, University of Manchester, Manchester, M13 9PL, UK
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Tai S, Remark R, Laface I, Del Valle DM, Torres J, Rahman A, Laird RM, Porter C, Riddle M, Murray JA, Choung R, Sato T, Plevy S, Merad M, Colombel J, Gnjatic S, Mortha A. A5 GM-CSF AUTOANTIBODIES: PREDICTORS OF CROHN’S DISEASE DEVELOPMENT AND A NOVEL THERAPEUTIC APPROACH. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Crohn’s disease (CD) is a heterogenous, chronic inflammatory disorder driven by a combination of genetic, environmental, and microbiota-dependent risk factors. Mononuclear phagocytes (MNP) are crucial cells that maintain intestinal homeostasis. An important cytokine for MNP survival and function is granulocyte-macrophage colony stimulating factor (GM-CSF). Interestingly, several studies reported CD-associated genetic risk variants within the GM-CSF receptor and its downstream signaling components. Furthermore, high titers of autoantibodies specific to GM-CSF can be detected in CD patients. Taken together, this data suggests an important role for GM-CSF in abrogation of CD development in a subgroup of patients.
Aims
This study sought to investigate the function of GM-CSF autoantibodies in CD.
Methods
We retrospectively quantified and characterized GM-CSF autoantibodies in sera of 220 CD, 200 ulcerative colitis (UC) patients, and 220 healthy controls (HC) sampled at 3 time points prior to disease diagnosis and one time point after diagnosis. ELISA was used to determine GM-CSF autoantibody titers and isotypes followed by in vitro multiplexed mass cytometry (CyTOF) neutralization assays on peripheral blood mononuclear cells. Flow cytometry and CyTOF were used to map the profile of immune cells isolated from inflamed and non-inflamed CD mucosa.
Results
Our data demonstrates that GM-CSF autoantibodies are specific to CD, significantly elevated up to 7 years prior to diagnosis of disease, and correlate with disease location, severity, and complications at the time of diagnosis. Moreover, in contrast to GM-CSF autoantibodies in pulmonary alveolar proteinosis patients, CD-associated autoantibodies neutralize GM-CSF via specific recognition of post-translational modifications (PTM), affecting MNP function. Removal of PTM enabled GM-CSF to escape autoantibody binding and restored MNP response to GM-CSF in the presence of neutralizing antibodies, indicating a potential therapeutic avenue. Furthermore, we identified group 3 innate lymphoid cells (ILC3) as a major source of GM-CSF in the healthy intestinal tract, suggesting intriguing crosstalk of MNP and ILC3 across the GM-CSF-GM-CSFR axis.
Conclusions
Our results identify GM-CSF autoantibodies as predictive serological biomarker for CD in a subgroup of patients presenting with severe and complicated form of disease at the time of diagnosis. The presence of GM-CSF autoantibodies precedes the onset of CD by several years and likely abrogates homeostatic immune cell crosstalk involving ILC3 and MNP, suggesting the development of a pre-diseased state in CD patients.
Funding Agencies
CIHRDr. Edward Ketchum Graduate Scholarship
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Affiliation(s)
- S Tai
- Immunology, University of Toronto, Toronto, ON, Canada
| | - R Remark
- Icahn School of Medicine Mount Sinai, New York, NY
| | - I Laface
- Icahn School of Medicine Mount Sinai, New York, NY
| | | | - J Torres
- Icahn School of Medicine Mount Sinai, New York, NY
| | - A Rahman
- Immunomonitoring Core at Mount Sinai, New York, NY
| | - R M Laird
- Naval Medical Research Center, Silver Spring, MD
| | - C Porter
- Naval Medical Research Center, Silver Spring, MD
| | - M Riddle
- Naval Medical Research Center, Silver Spring, MD
| | - J a Murray
- Gastroenterology, The Mayo Clinic, Rochester, MN
| | - R Choung
- Gastroenterology, The Mayo Clinic, Rochester, MN
| | - T Sato
- Janssen Research and Development LLC, Raritan, NJ
| | - S Plevy
- Janssen Research and Development LLC, Raritan, NJ
| | - M Merad
- Icahn School of Medicine Mount Sinai, New York, NY
| | - J Colombel
- Icahn School of Medicine Mount Sinai, New York, NY
| | - S Gnjatic
- Icahn School of Medicine Mount Sinai, New York, NY
| | - A Mortha
- Immunology, University of Toronto, Toronto, ON, Canada
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Just D, Palmier-Claus JE, Tai S. Positive risk management: Staff perspectives in acute mental health inpatient settings. J Adv Nurs 2021; 77:1899-1910. [PMID: 33491803 DOI: 10.1111/jan.14752] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 10/01/2020] [Revised: 11/28/2020] [Accepted: 12/16/2020] [Indexed: 11/30/2022]
Abstract
AIMS To explore inpatient staff's understanding and implementation of positive risk management. BACKGROUND Risk management is an essential skill for staff working in acute mental health inpatient settings. National policies advocate the use of positive risk management as a form of collaborative, recovery-focused risk management. However, little is known about how staff understand, operationalize, and use positive risk management in practice. DESIGN Qualitative reflexive thematic analysis study. METHODS The authors recruited a purposive sample of healthcare professionals working in acute inpatient settings (N = 16) in 2019 across three National Health Service Trusts in the North-West of England. Participants completed semi-structured interviews which were analysed using reflexive thematic analysis. RESULTS The analysis generated three themes: (a) within staff barriers; (b) within service user barriers; and (c) delivery in practice. CONCLUSION Understanding and implementation of positive risk management was dependant on multiple factors, including staffs' beliefs about mental health, levels of worry and anxiety, and amount of experience and seniority. Staff were more likely to use positive risk management with service users that they perceived as being trustworthy and less risky. Use of positive risk management was reliant on the support practitioners received, how able they were to view situations from multiple perspectives, and the degree to which they felt able to prioritize positive risk management. IMPACT Although staff expressed the desire and intention to practice positive risk management, the current study highlights challenges around operationalization and implementation. The authors discuss the clinical implications of the findings.
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Affiliation(s)
- Daniela Just
- School of Health Sciences, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Jasper E Palmier-Claus
- Spectrum Centre for Mental Health Research, University of Lancaster, Lancashire, UK.,Lancashire and South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Sara Tai
- School of Health Sciences, University of Manchester, Manchester, UK
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Churchman A, Mansell W, Tai S. Experiences of adolescents and their guardians with a school-based combined individual and dyadic intervention. British Journal of Guidance & Counselling 2020. [DOI: 10.1080/03069885.2020.1862052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Anamaria Churchman
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- Mode Rehabilitation, Bredbury, UK
| | - Warren Mansell
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Sara Tai
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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Churchman A, Mansell W, Tai S. A process-focused case series of a school-based intervention aimed at giving young people choice and control over their attendance and their goals in therapy. British Journal of Guidance & Counselling 2020. [DOI: 10.1080/03069885.2020.1815650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Anamaria Churchman
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- Mode Rehabilitation, Bredbury, UK
| | - Warren Mansell
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Sara Tai
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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Zhu ZW, Tang JJ, Chai XP, Fang ZF, Liu QM, Hu XQ, Xu DY, Tang L, Tai S, Wu YZ, Zhou SH. [Comparison of heart failure and COVID-19 in chest CT features and clinical characteristics]. Zhonghua Xin Xue Guan Bing Za Zhi 2020; 48:467-471. [PMID: 32129583 DOI: 10.3760/cma.j.cn112148-20200218-00093] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To identify the characteristics including clinical features and pulmonary computed tomography (CT) features of heart failure and COVID-19. Methods: This study was a retrospective study. A total of 7 patients with heart failure and 12 patients with COVID-19 in the Second Xiangya Hospital of Central South University between December 1, 2019 and February 15, 2020 were enrolled. The baseline clinical and imaging features of the two groups were statistically analyzed. Results: There was no significant difference in age and sex between the two groups(both P>0.05), but the incidence of epidemiological contact history, fever or respiratory symptoms in the COVID-19 group was significantly higher than that in the heart failure group (12/12 vs. 0, P<0.001; 12/12 vs. 4/7, P=0.013). While the proportion of cardiovascular diseases and impaired cardiac function was significantly less than that of the heart failure group(2/12 vs.7/7, P<0.001;0 vs.7/7, P<0.001). For imaging features, both groups had ground-glass opacity and thickening of interlobular septum, but the ratio of central and gradient distribution was higher in patients with heart failure than that in patients with COVID-19 (4/7 vs. 1/12, P=0.04). In heart failure group, the ratio of the expansion of pulmonary veins was also higher (3/7 vs. 0,P=0.013), and the lung lesions can be significantly improved after effective anti-heart failure treatment. Besides, there were more cases with rounded morphology in COVID-19 group(9/12 vs. 2/7, P=0.048). Conclusions: More patients with COVID-19 have epidemiological history and fever or respiratory symptoms. There are significant differences in chest CT features, such as enlargement of pulmonary veins, lesions distribution and morphology between heart failure and COVID-19.
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Affiliation(s)
- Z W Zhu
- Department of Cardiology, Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - J J Tang
- Department of Cardiology, Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - X P Chai
- Emergency Depratment, Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Z F Fang
- Department of Cardiology, Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Q M Liu
- Department of Cardiology, Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - X Q Hu
- Department of Cardiology, Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - D Y Xu
- Department of Cardiology, Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - L Tang
- Department of Cardiology, Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - S Tai
- Department of Cardiology, Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Y Z Wu
- Department of Radiology,Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - S H Zhou
- Department of Cardiology, Second Xiangya Hospital of Central South University, Changsha 410011, China
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13
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Jenkins H, Reid J, Williams C, Tai S, Huddy V. Feasibility and Patient Experiences of Method of Levels Therapy in an Acute Mental Health Inpatient Setting. Issues Ment Health Nurs 2020; 41:506-514. [PMID: 32271643 DOI: 10.1080/01612840.2019.1679928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/24/2022]
Abstract
This study sought to investigate the feasibility and acceptability of a flexible psychotherapeutic approach - the Method of Levels (MOL) - in an acute mental health inpatient setting. A multi methods approach was used. The feasibility of implementation was investigated by examining the referral rate and the attendance patterns of participants. The acceptability of MOL was explored using a thematic analysis of participant interviews and by recording attendance patterns of participants. Inpatient staff consistently referred patients and the majority of eligible people accepted invitations for therapy. Thematic analysis of peoples' experiences of the therapy generated themes that described participants' experiences of MOL in contrast to routine NHS care, having spent meaningful time with the therapist, and having gained something from the session. The referral rate and uptake of MOL therapy indicates that the resource was appropriate for the setting and acceptable to most participants. Qualitative analyses indicated that participants were comfortable with the therapists' approach, felt understood, and there was a meaningful quality to their interaction. Participants also valued the opportunity to reflect and generate new perspectives of their difficulties. Further research is required to determine the effectiveness of the approach and its translational value beyond this pilot investigation.
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Affiliation(s)
- Hannah Jenkins
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Jordan Reid
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Claire Williams
- North East London Foundation Trust, Goodmayes Hospital, Ilford, United Kingdom
| | - Sara Tai
- School of Psychological Sciences, University of Manchester, Manchester, United Kingdom
| | - Vyv Huddy
- Clinical Psychology Unit, University of Sheffield, Cathedral Court, Sheffield, United Kingdom
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Churchman A, Mansell W, Tai S. A school-based case series to examine the feasibility and acceptability of a PCT-informed psychological intervention that combines client-led counselling (Method of levels) and a parent–child activity (Shared goals). British Journal of Guidance & Counselling 2020. [DOI: 10.1080/03069885.2020.1757622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Anamaria Churchman
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- Mode Rehabilitation, Phoenix House, Bredbury, UK
| | - Warren Mansell
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Sara Tai
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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Alsawy S, Tai S, McEvoy P, Mansell W. 'It's nice to think somebody's listening to me instead of saying "oh shut up"'. People with dementia reflect on what makes communication good and meaningful. J Psychiatr Ment Health Nurs 2020; 27:151-161. [PMID: 31449719 DOI: 10.1111/jpm.12559] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 05/06/2019] [Revised: 07/10/2019] [Accepted: 08/23/2019] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: People with dementia experience cognitive decline which can affect their ability to communicate with others and consequently getting their needs met. Loneliness and social isolation are associated with depression and anxiety, while difficulties communicating may magnify such difficulties. Enhancing meaningful interactions may support maintenance of valued relationships and positive wellbeing. Although previous research has examined communicative experiences, this has been from the perspectives of professionals or caregivers. Exploring meaningful communication from the perspectives of people with dementia is crucial in supporting relationships and wellbeing. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: People with dementia can be active participants in research. They are aware of their cognitive impairments as well as social interactions and features constituting meaningful communications. People with dementia recognized carers' attempts to understand and empathize with them; allowing them to feel valued and heard, empowering them to maintain interactions. Alternatively, feeling dismissed, inferior or pressured to provide 'correct' responses deterred them from further conversations. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: People with dementia have an awareness of their relationships, communications and preferences. Thus, it is imperative to respect this population and make attempts to understand their communication as they sense this effort even when miscommunications occur. Embrace qualities that facilitate person-centred care within communications is vital as this can preserve valued relationships, support one's needs and enhance wellbeing. Such features include active listening, empathizing, being physically and mentally present, spending time to know the individual and sharing experiences, thoughts and emotions. Abstract Introduction Social isolation can be problematic for people with dementia; understanding what makes communication meaningful may reduce such risk. Scientific rationale Previous research has examined caregivers' or professionals' experiences of meaningful communication. Understanding this from the perspectives of people with dementia could enhance their interactions and wellbeing. Aim Exploring what makes communication meaningful from the perspective of people with dementia. Methods Nine dyadic interactions between a person with dementia and a family carer were filmed. Individuals with dementia watched the footage and reflected on their communications in semi-structured interviews. Results Three superordinate themes emerged. Themes 'sharing moments of emotional connection' and 'empowering one's ability to communicate' related to the experience of feeling connected, understood, valued and heard, allowing further communication. Conversely, 'inhibitors to communication' related feeling disempowered and reduced interactions. Discussion Even when carers could not understand what people with dementia attempted to communicate, their efforts to interact with them were valued and considered meaningful as they reinforce their sense of connectedness. Implications for practice Embracing a person-centred approach by actively attuning to the person and continuously attempting to empathize and understand persons with dementia can help preserve important relationships and allow the person to feel valued and interpersonally connected.
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Affiliation(s)
- Sarah Alsawy
- CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Sara Tai
- CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Phil McEvoy
- Six Degrees Social Enterprise, Southwood House, Salford, UK
| | - Warren Mansell
- CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Gaffney H, Mansell W, Tai S. Agents of change: Understanding the therapeutic processes associated with the helpfulness of therapy for mental health problems with relational agent MYLO. Digit Health 2020; 6:2055207620911580. [PMID: 32206331 PMCID: PMC7079311 DOI: 10.1177/2055207620911580] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 02/07/2020] [Indexed: 11/15/2022] Open
Abstract
Objective To understand the therapeutic processes associated with the helpfulness of an online relational agent intervention, Manage Your Life Online (MYLO). Methods Fifteen participants experiencing a mental health related problem used Manage Your Life Online for 2 weeks. At follow-up, the participants each identified two helpful and two unhelpful questions posed by Manage Your Life Online within a single intervention session. Qualitative interviews were conducted and analyzed using thematic and content analysis to gain insight into the process of therapy with Manage Your Life Online. Results MYLO appeared acceptable to participants with a range of presenting problems. Questions enabling free expression, increased awareness, and new insights were key to a helpful intervention. The findings were consistent with the core processes of therapeutic change, according to Perceptual Control Theory, a unifying theory of psychological distress. Questions that elicited intense emotions, were repetitive, confusing, or inappropriate were identified as unhelpful and were associated with disengagement or loss of faith in Manage Your Life Online. Conclusions The findings provide insight into the likely core therapy processes experienced as helpful or hindering and outlines further ways to optimize acceptability of Manage Your Life Online.
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Affiliation(s)
- Hannah Gaffney
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Warren Mansell
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Sara Tai
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
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Davenport K, Hardy G, Tai S, Mansell W. Individual experiences of psychological-based interventions for bipolar disorder: A systematic review and thematic synthesis. Psychol Psychother 2019; 92:499-522. [PMID: 30175881 DOI: 10.1111/papt.12197] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/25/2018] [Revised: 08/03/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To conduct a thematic synthesis to evaluate qualitative studies exploring individuals' experiences of psychological-based interventions for bipolar disorder (BD). METHOD A systematic search of relevant databases (Web of Science, PsycINFO, MEDLINE, CINAHL) was conducted using predefined search terms related to 'Bipolar' 'Qualitative method', 'Psychological-based interventions' and 'Adults'. Studies meeting the inclusion criteria were selected and were then evaluated using established quality appraisal criteria. A thematic synthesis was used to synthesize the findings. RESULTS From the thematic synthesis, nine analytical themes were derived from the 10 identified research studies. These were helpful and unhelpful aspects of the intervention, increased knowledge of BD, mood recognition, control of moods, change of perspective, mood stability, empowerment, improved relationships and lifestyle changes. CONCLUSIONS Findings from the review suggest there were characteristics of psychological-based interventions that individuals with BD valued and which helped facilitate areas of positive change, such as feeling empowered and in control of their moods and other aspects of their lives. However, there were also elements that individuals did not find as helpful and therefore reflects the challenge of a one-size-fits-all model or plan of interventions, compared to a wider recognition of the individuals as being the agent of their recovery. Future qualitative research is needed to explore individual experiences across a range of psychological interventions, in order to further understand the therapeutic processes, which may facilitate recovery. PRACTITIONER POINTS Psychological-based interventions for BD need to consider facilitating and measuring empowerment in individuals, rather than focusing just on mood stability. Clinicians with expertise and knowledge in BD should provide timely information to individuals and their families to help increase their understanding of the diagnosis.
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Gaffney H, Mansell W, Tai S. Conversational Agents in the Treatment of Mental Health Problems: Mixed-Method Systematic Review. JMIR Ment Health 2019; 6:e14166. [PMID: 31628789 PMCID: PMC6914342 DOI: 10.2196/14166] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/30/2019] [Accepted: 07/18/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The use of conversational agent interventions (including chatbots and robots) in mental health is growing at a fast pace. Recent existing reviews have focused exclusively on a subset of embodied conversational agent interventions despite other modalities aiming to achieve the common goal of improved mental health. OBJECTIVE This study aimed to review the use of conversational agent interventions in the treatment of mental health problems. METHODS We performed a systematic search using relevant databases (MEDLINE, EMBASE, PsycINFO, Web of Science, and Cochrane library). Studies that reported on an autonomous conversational agent that simulated conversation and reported on a mental health outcome were included. RESULTS A total of 13 studies were included in the review. Among them, 4 full-scale randomized controlled trials (RCTs) were included. The rest were feasibility, pilot RCTs and quasi-experimental studies. Interventions were diverse in design and targeted a range of mental health problems using a wide variety of therapeutic orientations. All included studies reported reductions in psychological distress postintervention. Furthermore, 5 controlled studies demonstrated significant reductions in psychological distress compared with inactive control groups. In addition, 3 controlled studies comparing interventions with active control groups failed to demonstrate superior effects. Broader utility in promoting well-being in nonclinical populations was unclear. CONCLUSIONS The efficacy and acceptability of conversational agent interventions for mental health problems are promising. However, a more robust experimental design is required to demonstrate efficacy and efficiency. A focus on streamlining interventions, demonstrating equivalence to other treatment modalities, and elucidating mechanisms of action has the potential to increase acceptance by users and clinicians and maximize reach.
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Affiliation(s)
- Hannah Gaffney
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Warren Mansell
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Sara Tai
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
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Churchman A, Mansell W, Al‐Nufoury Y, Tai S. A qualitative analysis of young people's experiences of receiving a novel, client‐led, psychological therapy in school. Couns Psychother Res 2019. [DOI: 10.1002/capr.12259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Anamaria Churchman
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre University of Manchester Manchester UK
- MODE Rehabilitation Phoenix House Bredbury UK
| | - Warren Mansell
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre University of Manchester Manchester UK
| | - Yasmin Al‐Nufoury
- Faculty of Science, Natural Sciences and Psychology Liverpool John Moores University Liverpool UK
| | - Sara Tai
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Manchester Academic Health Science Centre University of Manchester Manchester UK
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Warwick H, Tai S, Mansell W. Living the life you want following a diagnosis of bipolar disorder: A grounded theory approach. Clin Psychol Psychother 2019; 26:362-377. [DOI: 10.1002/cpp.2358] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 01/23/2019] [Accepted: 01/24/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Helen Warwick
- School of Health Sciences, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science CentreThe University of Manchester Manchester UK
| | - Sara Tai
- School of Health Sciences, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science CentreThe University of Manchester Manchester UK
| | - Warren Mansell
- School of Health Sciences, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science CentreThe University of Manchester Manchester UK
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Griffiths R, Mansell W, Edge D, Tai S. Sources of Distress in First-Episode Psychosis: A Systematic Review and Qualitative Metasynthesis. Qual Health Res 2019; 29:107-123. [PMID: 30066602 DOI: 10.1177/1049732318790544] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In this study, we aim to increase our understanding of the self-reported sources of distress among people who have experienced first-episode psychosis. Following a systematic literature search, 33 relevant studies containing first-person accounts of first-episode psychosis were identified, which were synthesized using thematic analysis. Two interrelated superordinate themes were identified: intrapersonal distress and interpersonal distress. Participants reported multiple, diverse, and multifaceted sources of distress across both themes. These were substantially different from those routinely recognized and targeted in clinical practice. This review suggests that practitioners who maintain a stance of genuine curiosity about the potential sources of distress for this population will be perceived as more helpful. The findings also highlight the importance of being service user-led when planning and delivering mental health care. Additional clinical and research implications are discussed.
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Affiliation(s)
- Robert Griffiths
- 1 Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Warren Mansell
- 2 The University of Manchester, Manchester, United Kingdom
| | - Dawn Edge
- 2 The University of Manchester, Manchester, United Kingdom
| | - Sara Tai
- 2 The University of Manchester, Manchester, United Kingdom
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Shillito JA, Lea J, Tierney S, Cleator J, Tai S, Wilding JPH. Why I eat at night: A qualitative exploration of the development, maintenance and consequences of Night Eating Syndrome. Appetite 2018; 125:270-277. [PMID: 29454015 DOI: 10.1016/j.appet.2018.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/04/2016] [Revised: 12/20/2017] [Accepted: 02/06/2018] [Indexed: 11/29/2022]
Abstract
Night Eating Syndrome (NES), as a diagnosis, presents as a combination of disordered eating, sleep and mood. Patients identified as having both NES and obesity demonstrate poorer outcomes in terms of weight loss compared to those with NES only. However, research focusing on psychological factors associated with NES remains relatively underdeveloped. This study aimed to explore the relationship between NES and the experience of emotion from the perspective of patients accessing a weight management service. Ten adults who met diagnostic criteria for moderate or full NES took part in a semi-structured interview. Data were analysed using a constructivist approach to grounded theory. A core concept to emerge from the analysis was termed 'emotional hunger'; reflecting an urge or need to satiate a set of underlying unmet emotional needs. It was underpinned by the following interrelated themes: (1) Cultivating a dependency on food; (2) Relying on food to regulate emotions; (3) Understanding the significance of night-time; (4) Acknowledging the consequences of night eating. This study provides an in-depth understanding of the relationship between NES and the experience of emotion from the perspective of patients attending a weight management service. Results have potential to inform future service development, particularly around the adoption of a more holistic approach to night eating behaviours.
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Affiliation(s)
- James A Shillito
- School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK.
| | - James Lea
- School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK
| | - Stephanie Tierney
- Royal College of Nursing Research Institute, University of Warwick, Coventry, CV4 7AL, UK
| | - Jacqueline Cleator
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, M13 9PL, UK
| | - Sara Tai
- School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK
| | - John P H Wilding
- Department of Obesity and Endocrinology, University of Liverpool, Merseyside, L7 8TX, UK
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Griffiths AW, Wood AM, Tai S. The prospective role of defeat and entrapment in caregiver burden and depression amongst formal caregivers. Personality and Individual Differences 2018. [DOI: 10.1016/j.paid.2017.08.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Aim This review considers the theoretical literature concerning communication between a person with dementia and a person without dementia. Methods Theoretical accounts of communication between a person with dementia and a person without dementia were identified through database searches, hand searching of reference lists and contacting experts in the topic area. Results Twenty-one articles were included in the final review, yielding 18 different theoretical accounts of communication in the context of dementia. Thematic synthesis showed that four categories could account for the majority of the material described in these theories, even though they were derived from very different perspectives. These categories were mutuality, personhood, anxiety reduction and environmental considerations. Discussion The four categories identified in the thematic synthesis were reminiscent of Kitwood’s theory of person-centred dementia care. Different interpretations of this finding are considered. Most theoretical accounts focused on the relational aspects of communication. This meant that societal and individual accounts of communication in the context of dementia were relatively impoverished in terms of theory. Conclusions There is widespread agreement regarding the important components of good quality communication in the context of dementia. This suggests exciting opportunities for collaboration between apparently disparate bodies of literature. Individual and societal accounts of communication in the context of dementia are relatively neglected and would benefit from more research.
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Grealish A, Tai S, Hunter A, Emsley R, Murrells T, Morrison AP. Does empowerment mediate the effects of psychological factors on mental health, well-being, and recovery in young people? Psychol Psychother 2017; 90:314-335. [PMID: 28035741 DOI: 10.1111/papt.12111] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 02/17/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES There is consensus that empowerment is key to recovery from mental health problems, enabling a person to take charge of their life and make informed choices and decisions about their life. However, little is known about the mechanisms through which empowerment affects mental health in young people. The current study involved young people aged 16-29 years and examined empowerment as a potential mediator of the relationship between psychological factors (psychosocial, cognition, coping, and control) and mental health, well-being, and recovery from personal problems. METHODS A cross-sectional, Internet-based questionnaire study recruited 423 young people aged between 16 and 29 attending universities in England (n = 336) and Ireland (n = 87). Psychological factors, mental well-being, empowerment, and recovery from personal problems were measured using self-report measures. RESULTS Mediation analysis in both the single and one over-arching mediator models revealed that empowerment mediates the relationship between psychological factors (psychosocial, self-efficacy, thinking style, coping, and control) and mental health, well-being, and recovery from general life problems. CONCLUSIONS This study demonstrates the importance of empowerment, showing that it mediates the relationship between psychological processes and mental health, well-being, and recovery in young people. Clinical implications for working with young people within mental health services, and facilitating their empowerment are discussed. PRACTITIONER POINTS Empowerment is currently a poorly defined concept. This study demonstrates how empowerment mediates the relationship between psychological processes and mental health, well-being, and recovery in young people. Clinicians working with young people might benefit from a structured means of understanding and assessing the different ways in which individuals manage their thinking styles. Empowerment in young people is influenced by the manner in which clinicians facilitate them in establishing social networks in support of employment, education, family/social relations and to encourage young people to take an assertive role in their own care.
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Affiliation(s)
- Annmarie Grealish
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, UK
| | - Sara Tai
- School of Psychological Sciences, University of Manchester, UK
| | - Andrew Hunter
- School of Nursing & Midwifery, National University of Ireland Galway, Ireland
| | - Richard Emsley
- Centre for Biostatistics, Institute of Population Health, University of Manchester, UK
| | - Trevor Murrells
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, UK
| | - Anthony P Morrison
- School of Psychological Sciences, University of Manchester, UK.,Greater Manchester West Mental Health NHS Foundation Trust, UK
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Palmier-Claus J, Griffiths R, Murphy E, Parker S, Longden E, Bowe S, Steele A, French P, Morrison A, Tai S. Cognitive behavioural therapy for thought disorder in psychosis. Psychosis 2017. [DOI: 10.1080/17522439.2017.1363276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jasper Palmier-Claus
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Robert Griffiths
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Elizabeth Murphy
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Sophie Parker
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Eleanor Longden
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Samantha Bowe
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Ann Steele
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Paul French
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Anthony Morrison
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Sara Tai
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
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Abstract
We conducted this study to explore personal accounts of making choices about taking medication prescribed for the treatment of psychosis (neuroleptics). There are costs and benefits associated with continuing and discontinuing neuroleptics. Service users frequently discontinue neuroleptics; therefore, we specifically considered these decisions. We used a grounded theory approach to analyze transcripts from interviews with 12 participants. We present a preliminary grounded theory of the processes involved in making choices about neuroleptic medication. We identified three tasks as important in mediating participants' choices: (a) forming a personal theory of the need for, and acceptability of taking, neuroleptic medication; (b) negotiating the challenges of forming alliances with others; and (c) weaving a safety net to safeguard well-being. Progress in the tasks reflected a developmental trajectory of becoming an expert over time and was influenced by systemic factors. Our findings highlight the importance of developing resources for staff to facilitate service user choice.
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Affiliation(s)
- Gabrielle Le Geyt
- 1 University of Manchester, Manchester, UK
- 2 North Staffordshire Combined Healthcare NHS Trust, Newcastle, UK
| | | | - Sara Tai
- 1 University of Manchester, Manchester, UK
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Wade M, Tai S, Awenat Y, Haddock G. A systematic review of service-user reasons for adherence and nonadherence to neuroleptic medication in psychosis. Clin Psychol Rev 2017; 51:75-95. [DOI: 10.1016/j.cpr.2016.10.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 09/09/2016] [Accepted: 10/26/2016] [Indexed: 12/18/2022]
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Wang ZD, Jiang XM, Zhong XY, Kang PC, Li CL, Su ZL, Tai S, Hua CX, Cui YF. [Combined multiple artery-first approach to pancreatoduodenectomy]. Zhonghua Wai Ke Za Zhi 2016; 54:854-858. [PMID: 27806780 DOI: 10.3760/cma.j.issn.0529-5815.2016.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical application of combined multiple artery-first approach to pancreatoduodenectomy. Methods: The clinical data of 53 patients who were diagnosed with peripancreatic head tumor at Department of Biliary-Pancreatic Surgery of Second Affiliated Hospital of Harbin Medical University between June 2013 and June 2015 was retrospectively analyzed.Pancreatic enhanced CT scan, magnetic resonance cholangiopancreatography, ultrasonography and tumor marker detection were applied for all the patients preoperatively.The 53 patients were operated by combined multiple artery-first approach(superior+ posterior approach, superior+ inferior approach, posterior+ inferior approach, superior+ posterior+ inferior approach) according to individualized therapeutic concept.And 42 patients underwent pancreatoduodenectomy, 9 patients underwent palliative operation and 2 patients just received exploratory operation. Results: Forty-two peripancreatic head tumor patients underwent pancreatoduodenectomy by applying combined multiple artery-first approach.The median operation time and intraoperative blood loss were (5.4±3.1)hours and (366±297)ml and the harvested lymph node and duration of hospital stay were 19±5 and (14.0±5.6)days.Nine patients underwent "total mesopancreas excision" and the rate of postoperative pancreatic fistula and R0 resection were 38.1% and 88.1%. Anomalous origin hepatic right artery was detected in one patients during the operation and no death occurred within 30 days postoperatively. Conclusion: According to the tumor location and patient's condition, individualistically applying combined multiple artery-first approach can reduce intraoperative blood loss, terminate unnecessary surgery, detect anomalous origin artery, make the tumor resection more radical and pancreatoduodenectomy more safety.
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Affiliation(s)
- Z D Wang
- Department of Biliary-Pancreatic Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
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Joyce E, Tai S, Gebbia P, Mansell W. What are People's Experiences of a Novel Cognitive Behavioural Therapy for Bipolar Disorders? A Qualitative Investigation with Participants on the TEAMS Trial. Clin Psychol Psychother 2016; 24:712-726. [PMID: 27654637 DOI: 10.1002/cpp.2040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 08/12/2016] [Accepted: 08/18/2016] [Indexed: 01/04/2023]
Affiliation(s)
- Emmeline Joyce
- Greater Manchester West Mental Health NHS Foundation Trust; Manchester United Kingdom
- The University of Manchester; Manchester United Kingdom
| | - Sara Tai
- The University of Manchester; Manchester United Kingdom
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Ince P, Haddock G, Tai S. A systematic review of the implementation of recommended psychological interventions for schizophrenia: Rates, barriers, and improvement strategies. Psychol Psychother 2016; 89:324-50. [PMID: 26537838 DOI: 10.1111/papt.12084] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [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: 07/09/2014] [Revised: 08/27/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE A systematic review of the literature exploring if the UK recommendations for psychological interventions for schizophrenia were being met was carried out. Rates of implementation for cognitive behavioural therapy (CBT) and family intervention (FI) were compared. The barriers against implementation and described strategies aimed at improving implementation were reviewed. METHODS A literature search of electronic bibliography databases (Psychinfo, Medline, Pubmed, AMED, CINHAL, and EMBASE), reference and citation lists, the Evaluation and Review of NICE Implementation (ERNIE) database, a manual search of Clinical Psychology Forum, governmental reports, charity, and service user group reports was conducted. RESULTS Twenty-six articles met the inclusion criteria, 11 provided data on implementation rates, 13 explored the barriers to implementation, and 10 gave information about improvement strategies. Rates of implementation varied from 4% to 100% for CBT and 0% to 53% for FI, and studies varied in the methodology used and quality of the articles. Previously reported barriers to implementation were found, with organisational barriers being most commonly followed by barriers met by staff members and service users. Implementation strategies discovered included training packages for CBT, FI, and psychosocial interventions as well as empirical evidence suggesting methods for engagement with service users. CONCLUSIONS Rates of implementation for CBT and FI are still below recommended levels with wide variation of rates found. This suggests inequalities in the provision of psychological interventions for schizophrenia are still present. Previously identified barriers to implementation were confirmed. Attempted implementation strategies have been met with modest success. PRACTITIONER POINTS Inequalities in the provision of psychological therapies for schizophrenia persist. Good quality cognitive behavioural therapy and FI training do not ensure implementation. Collaboration at all levels of healthcare is needed for effective implementation.
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Affiliation(s)
- Paul Ince
- School of Psychological Sciences and Clinical Psychology Department, Manchester Mental Health and Social Care Trust, University of Manchester, UK
| | - Gillian Haddock
- School of Psychological Sciences and Clinical Psychology Department, Manchester Mental Health and Social Care Trust, University of Manchester, UK
| | - Sara Tai
- School of Psychological Sciences and Clinical Psychology Department, Manchester Mental Health and Social Care Trust, University of Manchester, UK
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Morrissey K, Kinderman P, Pontin E, Tai S, Schwannauer M. Web based health surveys: Using a Two Step Heckman model to examine their potential for population health analysis. Soc Sci Med 2016; 163:45-53. [DOI: 10.1016/j.socscimed.2016.06.053] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 05/18/2016] [Accepted: 06/29/2016] [Indexed: 11/28/2022]
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Kinderman P, Hagan P, King S, Bowman J, Chahal J, Gan L, McKnight R, Waldon C, Smith M, Gilbertson J, Tai S. The feasibility and effectiveness of Catch It, an innovative CBT smartphone app. BJPsych Open 2016; 2:204-209. [PMID: 27703777 PMCID: PMC4995173 DOI: 10.1192/bjpo.bp.115.002436] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 03/18/2016] [Accepted: 04/19/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The widespread use of smartphones makes effective therapies such as cognitive-behavioural therapy (CBT) potentially accessible to large numbers of people. AIMS This paper reports the usage data of the first trial of Catch It, a new CBT smartphone app. METHOD Uptake and usage rates, fidelity of user responses to CBT principles, and impact on reported negative and positive moods were assessed. RESULTS A relatively modest proportion of people chose to download the app. Once used, the app tended to be used more than once, and 84% of the user-generated content was consistent with the basic concepts of CBT. There were statistically significant reductions in negative mood intensity and increases in positive mood intensity. CONCLUSIONS Smartphone apps have potential beneficial effects in mental health through the application of basic CBT principles. More research with randomised controlled trial designs should be conducted. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
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Affiliation(s)
- Peter Kinderman
- , MA, MSc, PhD, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Paul Hagan
- , BA, MBA, Computer Services, University of Liverpool, Liverpool, UK
| | - Sophie King
- , BSc, University of Liverpool, Liverpool, UK
| | | | | | - Li Gan
- , University of Liverpool, Liverpool, UK
| | | | | | - Matthew Smith
- , BA, Computer Services, University of Liverpool, Liverpool, UK
| | - John Gilbertson
- , BSc, Computer Services, University of Liverpool, Liverpool, UK
| | - Sara Tai
- , BA, MSc, D.Clin.Psy, School of Psychological Sciences, University of Manchester, Manchester, UK
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Tai S, Hyatt WS, Gu C, Franks LN, Vasiljevik T, Brents LK, Prather PL, Fantegrossi WE. Repeated administration of phytocannabinoid Δ(9)-THC or synthetic cannabinoids JWH-018 and JWH-073 induces tolerance to hypothermia but not locomotor suppression in mice, and reduces CB1 receptor expression and function in a brain region-specific manner. Pharmacol Res 2015; 102:22-32. [PMID: 26361728 DOI: 10.1016/j.phrs.2015.09.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [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: 07/23/2015] [Revised: 09/05/2015] [Accepted: 09/06/2015] [Indexed: 01/30/2023]
Abstract
These studies probed the relationship between intrinsic efficacy and tolerance/cross-tolerance between ∆(9)-THC and synthetic cannabinoid drugs of abuse (SCBs) by examining in vivo effects and cellular changes concomitant with their repeated administration in mice. Dose-effect relationships for hypothermic effects were determined in order to confirm that SCBs JWH-018 and JWH-073 are higher efficacy agonists than ∆(9)-THC in mice. Separate groups of mice were treated with saline, sub-maximal hypothermic doses of JWH-018 or JWH-073 (3.0mg/kg or 10.0mg/kg, respectively) or a maximally hypothermic dose of 30.0mg/kg ∆(9)-THC once per day for 5 consecutive days while core temperature and locomotor activity were monitored via biotelemetry. Repeated administration of all drugs resulted in tolerance to hypothermic effects, but not locomotor effects, and this tolerance was still evident 14 days after the last drug administration. Further studies treated mice with 30.0mg/kg ∆(9)-THC once per day for 4 days, then tested with SCBs on day 5. Mice with a ∆(9)-THC history were cross-tolerant to both SCBs, and this cross-tolerance also persisted 14 days after testing. Select brain regions from chronically treated mice were examined for changes in CB1 receptor expression and function. Expression and function of hypothalamic CB1Rs were reduced in mice receiving chronic drugs, but cortical CB1R expression and function were not altered. Collectively, these data demonstrate that repeated ∆(9)-THC, JWH-018 and JWH-073 can induce long-lasting tolerance to some in vivo effects, which is likely mediated by region-specific downregulation and desensitization of CB1Rs.
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Affiliation(s)
- S Tai
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - W S Hyatt
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - C Gu
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - L N Franks
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - T Vasiljevik
- Department of Medicinal Chemistry, School of Pharmacy, University of Kansas, Lawrence, KS, USA
| | - L K Brents
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - P L Prather
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - W E Fantegrossi
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
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Briggs TWR, Hanna SA, Kayani B, Tai S, Pollock RC, Cannon SR, Blunn GW, Carrington RWJ. Metal-on-polyethylene versus metal-on-metal bearing surfaces in total hip arthroplasty. Bone Joint J 2015; 97-B:1183-91. [DOI: 10.1302/0301-620x.97b9.34824] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 11/05/2022]
Abstract
The long term biological effects of wear products following total hip arthroplasty (THA) are unclear. However, the indications for THA are expanding, with increasingly younger patients undergoing the procedure. This prospective, randomised study compared two groups of patients undergoing THA after being randomised to receive one of two different bearing surfaces: metal-on-polyethylene (MoP) n = 22 and metal-on-metal (MoM) n = 23. We investigated the relationship between three variables: bearing surface (MoP vs MoM), whole blood levels of chromium (Cr) and cobalt (Co) and chromosomal aberrations in peripheral lymphocyte pre-operatively and at one, two and five years post-surgery. Our results demonstrated significantly higher mean cobalt and chromium (Co and Cr) blood levels in the MoM group at all follow-up points following surgery (p < 0.01), but there were no significant differences in the chromosomal aberration indices between MoM and MoP at two or five years (two years: p = 0.56, p = 0.08, p = 0.91, p = 0.51 and five years: p = 0.086, p = 0.73, p = 0.06, p = 0.34) for translocations, breaks, loss and gain of chromosomes respectively. Regression analysis showed a strong linear relationship between Cr levels and the total chromosomal aberration indices in the MoM group (R2 = 0.90016), but this was not as strong for Co (R2 = 0.68991). In the MoP group, the analysis revealed a poor relationship between Cr levels and the total chromosomal aberration indices (R2 = 0.23908) but a slightly stronger relationship for Co (R2 = 0.64292). Across both groups, Spearman’s correlation detected no overall association between Co and Cr levels and each of the studied chromosomal aberrations. There remains no clear indication which THA bearing couple is the most biocompatible, especially in young active patients. While THA continues to be very successful at alleviating pain and restoring function, the long-term biological implications of the procedure still require further scrutiny. Cite this article: Bone Joint J 2015;97-B:1183–91.
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Affiliation(s)
- T. W. R. Briggs
- Royal National Orthopaedic Hospital, Brockley
Hill, Stanmore, Middlesex, HA7
4LP, UK
| | - S. A. Hanna
- Joint Replacement Institute, University
of Western Ontario, London, Ontario, N6G
2V4, Canada
| | - B. Kayani
- Royal National Orthopaedic Hospital, Brockley
Hill, Stanmore, Middlesex, HA7
4LP, UK
| | - S. Tai
- East and North Hertfordshire NHS Trust, Coreys
Mill Lane, Stevenage, SG1
4AB, UK
| | - R. C. Pollock
- Royal National Orthopaedic Hospital, Brockley
Hill, Stanmore, Middlesex, HA7
4LP, UK
| | - S. R. Cannon
- Royal National Orthopaedic Hospital, Brockley
Hill, Stanmore, Middlesex, HA7
4LP, UK
| | - G. W. Blunn
- Institute of Orthopaedics and Musculoskeletal
Science, Royal National Orthopaedic Hospital, Brockley
Hill, Stanmore, Middlesex, HA7
4LP, UK
| | - R. W. J. Carrington
- Royal National Orthopaedic Hospital, Brockley
Hill, Stanmore, Middlesex, HA7
4LP, UK
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Kinderman P, Tai S, Pontin E, Schwannauer M, Jarman I, Lisboa P. Causal and mediating factors for anxiety, depression and well-being. Br J Psychiatry 2015; 206:456-60. [PMID: 25858180 DOI: 10.1192/bjp.bp.114.147553] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [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] [Received: 02/24/2014] [Accepted: 10/06/2014] [Indexed: 11/23/2022]
Abstract
Background The relationship between well-being and mental ill health is complex; people may experience very low levels of well-being even in the absence of overt mental health problems. Aims This study tested the hypothesis that anxiety, depression and well-being have different causal determinants and psychological mediating mechanisms. Method The influence of causal and mediating factors on anxiety, depression and well-being were investigated in a cross-sectional online questionnaire survey hosted on a UK national broadcasting website. Results Multivariate conditional independence analysis of data from 27 397 participants revealed different association pathways for the two constructs. Anxiety and depression were associated with negative life events mediated by rumination; low levels of subjective well-being were associated with material deprivation and social isolation, mediated by adaptive coping style. Conclusions Our findings support the 'two continua' model of the relationship between psychological well-being and mental health problems, with implications for both treatment and prevention.
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Affiliation(s)
- Peter Kinderman
- Peter Kinderman, PhD, Institute of Psychology, Health and Society, University of Liverpool; Sara Tai, ClinPsyD, School of Psychological Science, Manchester; Eleanor Pontin, DClinPsych, Institute of Psychology, Health and Society, University of Liverpool; Matthias Schwannauer, PhD, School of Health in Social Science, Edinburgh; Ian Jarman, PhD, Paulo Lisboa, PhD, School of Computing and Mathematical Sciences, Liverpool John Moores University, Liverpool, UK
| | - Sara Tai
- Peter Kinderman, PhD, Institute of Psychology, Health and Society, University of Liverpool; Sara Tai, ClinPsyD, School of Psychological Science, Manchester; Eleanor Pontin, DClinPsych, Institute of Psychology, Health and Society, University of Liverpool; Matthias Schwannauer, PhD, School of Health in Social Science, Edinburgh; Ian Jarman, PhD, Paulo Lisboa, PhD, School of Computing and Mathematical Sciences, Liverpool John Moores University, Liverpool, UK
| | - Eleanor Pontin
- Peter Kinderman, PhD, Institute of Psychology, Health and Society, University of Liverpool; Sara Tai, ClinPsyD, School of Psychological Science, Manchester; Eleanor Pontin, DClinPsych, Institute of Psychology, Health and Society, University of Liverpool; Matthias Schwannauer, PhD, School of Health in Social Science, Edinburgh; Ian Jarman, PhD, Paulo Lisboa, PhD, School of Computing and Mathematical Sciences, Liverpool John Moores University, Liverpool, UK
| | - Matthias Schwannauer
- Peter Kinderman, PhD, Institute of Psychology, Health and Society, University of Liverpool; Sara Tai, ClinPsyD, School of Psychological Science, Manchester; Eleanor Pontin, DClinPsych, Institute of Psychology, Health and Society, University of Liverpool; Matthias Schwannauer, PhD, School of Health in Social Science, Edinburgh; Ian Jarman, PhD, Paulo Lisboa, PhD, School of Computing and Mathematical Sciences, Liverpool John Moores University, Liverpool, UK
| | - Ian Jarman
- Peter Kinderman, PhD, Institute of Psychology, Health and Society, University of Liverpool; Sara Tai, ClinPsyD, School of Psychological Science, Manchester; Eleanor Pontin, DClinPsych, Institute of Psychology, Health and Society, University of Liverpool; Matthias Schwannauer, PhD, School of Health in Social Science, Edinburgh; Ian Jarman, PhD, Paulo Lisboa, PhD, School of Computing and Mathematical Sciences, Liverpool John Moores University, Liverpool, UK
| | - Paulo Lisboa
- Peter Kinderman, PhD, Institute of Psychology, Health and Society, University of Liverpool; Sara Tai, ClinPsyD, School of Psychological Science, Manchester; Eleanor Pontin, DClinPsych, Institute of Psychology, Health and Society, University of Liverpool; Matthias Schwannauer, PhD, School of Health in Social Science, Edinburgh; Ian Jarman, PhD, Paulo Lisboa, PhD, School of Computing and Mathematical Sciences, Liverpool John Moores University, Liverpool, UK
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Velligan DI, Tai S, Roberts DL, Maples-Aguilar N, Brown M, Mintz J, Turkington D. A randomized controlled trial comparing cognitive behavior therapy, cognitive adaptation training, their combination and treatment as usual in chronic schizophrenia. Schizophr Bull 2015; 41:597-603. [PMID: 25193976 PMCID: PMC4393683 DOI: 10.1093/schbul/sbu127] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Following baseline assessment, 166 patients in medication maintenance at a community mental health center who were experiencing both persistent positive symptoms of schizophrenia and impairments in functioning were randomized to 1 of 4 treatments for 9 months: (1) Cognitive Behavior Therapy for psychosis (CBTp)-a therapy designed to identify and alter reasoning and appraisal biases that contribute to the formation and maintenance of positive symptoms, (2) Cognitive Adaptation Training (CAT)-a treatment using environmental supports including signs, alarms, checklists and the organization of belongings established at weekly home visits to compensate for impairments in cognitive functioning and improve everyday functional outcomes, (3) Multi-modal Cognitive treatment-a combination of CBTp and CAT, and (4) Treatment as Usual. Data on symptoms and functional outcomes were obtained every 3 months. A mixed effects regression model with repeated measures using a 2 (CAT/no CAT) × 2 (CBT/no CBT) design indicated that functioning as measured by the Multnomah Community Ability Scale improved more in groups receiving CAT than other treatment groups. Auditory hallucinations and associated distress improved slightly more in groups receiving CAT. In this study, CBTp did not improve outcomes. Combining CAT with CBTp did not improve outcomes more than CAT alone.
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Affiliation(s)
- Dawn I Velligan
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, San Antonio, TX;
| | - Sara Tai
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - David L Roberts
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, San Antonio, TX
| | - Natalie Maples-Aguilar
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, San Antonio, TX
| | - Matt Brown
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, San Antonio, TX
| | - Jim Mintz
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, San Antonio, TX
| | - Douglas Turkington
- School of Neurology, Neurobiology and Psychiatry, Newcastle University, Newcastle upon Tyne, UK
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Abstract
Previous research has suggested that defeat (conceptualized as a failed social struggle) and entrapment (conceptualized as a perceived inability to escape from aversive situations) form a single construct that reliably predicts psychopathological outcomes in clinical and community settings. However, scales designed to assess defeat and entrapment measure the constructs separately, whereas recent evidence suggests a single scale would be appropriate. Existing scales may also be too lengthy to have clinical utility. The present study developed and evaluated a scale that measured both defeat and entrapment. Exploratory and confirmatory factor analyses demonstrated that defeat and entrapment were best defined by a single factor, and 8 items were selected that best represented this construct to form the short scale. The scale had high internal consistency (α = .88 to .94), showed criterion validity with hopelessness (r = .45 to .93) and incremental validity for caregiver burden when controlling for depression and positive symptoms of psychosis when controlling for hopelessness (β = .45 to .60). Additionally, the scale had excellent test-retest reliability using single measures absolute agreement intraclass correlation coefficients across 12 months (ricc = .88 to .92) within 4 samples: people with posttraumatic stress disorder, people with psychosis, care home employees, and people from community settings. The scale demonstrated known group validity through discrimination between clinical and nonclinical groups of participants. This scale could be implemented within therapeutic settings to help clinicians identify patients experiencing defeat and entrapment, and incorporate these factors into their clinical assessment and case formulations for treatment.
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Affiliation(s)
| | | | - John Maltby
- College of Medicine, Biological Sciences and Psychology
| | | | | | - Sara Tai
- School of Psychological Sciences
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Palmier-Claus JE, Dodd A, Tai S, Emsley R, Mansell W. Appraisals to affect: Testing the integrative cognitive model of bipolar disorder. Br J Clin Psychol 2015; 55:225-35. [PMID: 25816887 DOI: 10.1111/bjc.12081] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 08/09/2014] [Revised: 02/11/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Cognitive models have suggested that extreme appraisals of affective states and maladaptive affect regulation strategies are important in the development of bipolar symptomatology. Little is known about the pathway by which these appraisals and behaviours interact in the formation of activated and depressed affective states. This study tested the predictions that (1) ascent behaviours mediate the relationship between positive appraisals of activated mood and activation; and (2) descent behaviours mediate the relationship between negative appraisals of activated mood and depression. METHOD A total of 52 individuals with a DSM-IV diagnosis of bipolar I or II disorder (confirmed by structured interview) completed biweekly assessments of affect regulation behaviours and mood for 4 weeks. Positive and negative appraisals of affective states were assessed at baseline through the Hypomanic Attitudes and Positive Prediction Inventory. Multilevel mediation analysis was used to explore the data. RESULTS Ascent behaviours partially mediated the relationship between positive appraisals of activated mood and activation. Descent behaviours, but not negative appraisals of activated mood, predicted levels of depression indicating the absence of a mediation effect. CONCLUSION The results suggest that positive appraisals of activated mood can escalate activation in individuals with bipolar disorder. Such appraisals may be inherently rewarding and reinforcing directly elevating levels of activation, whilst increasing individuals' use of ascent behaviours. The results are consistent with the view that appraisals and behaviours should be targeted during cognitive behavioural therapy for bipolar disorder. PRACTITIONER POINTS It may be beneficial to target positive appraisals of activated mood in cognitive behavioural therapy for mania. Cognitive behavioural therapists may also wish to focus on identifying and targeting individuals' use of ascent behaviours to reduce highly activated states.
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Affiliation(s)
- Jasper E Palmier-Claus
- Section for Clinical & Health Psychology, School of Psychological Science, University of Manchester, UK
| | - Alyson Dodd
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, UK
| | - Sara Tai
- Section for Clinical & Health Psychology, School of Psychological Science, University of Manchester, UK
| | - Richard Emsley
- Centre for Biostatistics, Institute of Population Health, University of Manchester, UK
| | - Warren Mansell
- Section for Clinical & Health Psychology, School of Psychological Science, University of Manchester, UK
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Mansell W, Tai S, Clark A, Akgonul S, Dunn G, Davies L, Law H, Morriss R, Tinning N, Morrison AP. A novel cognitive behaviour therapy for bipolar disorders (Think Effectively About Mood Swings or TEAMS): study protocol for a randomized controlled trial. Trials 2014; 15:405. [PMID: 25344393 PMCID: PMC4219108 DOI: 10.1186/1745-6215-15-405] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 10/08/2014] [Indexed: 12/04/2022] Open
Abstract
Background Existing psychological therapies for bipolar disorders have been found to have mixed results, with a consensus that they provide a significant, but modest, effect on clinical outcomes. Typically, these approaches have focused on promoting strategies to prevent future relapse. An alternative treatment approach, termed ‘Think Effectively About Mood Swings’ (TEAMS) addresses current symptoms, including subclinical hypomania, depression and anxiety, and promotes long-term recovery. Following the publication of a theoretical model, a range of research studies testing the model and a case series have demonstrated positive results. The current study reports the protocol of a feasibility randomized controlled trial to inform a future multi-centre trial. Methods/Design A target number of 84 patients with a diagnosis of bipolar I or II disorder, or bipolar disorder not-otherwise-specified are screened, allocated to a baseline assessment and randomized to either 16 sessions of TEAMS therapy plus treatment-as-usual (TAU) or TAU. Patients complete self-report inventories of depression, anxiety, recovery status and bipolar cognitions targeted by TEAMS. Assessments of diagnosis, bipolar symptoms, medication, access to services and quality of life are conducted by assessors blind to treatment condition at 3, 6, 12 and 18 months post-randomization. The main aim is to evaluate recruitment and retention of participants into both arms of the study, as well as adherence to therapy, to determine feasibility and acceptability. It is predicted that TEAMS plus TAU will reduce self-reported depression in comparison to TAU alone at six months post-randomization. The secondary hypotheses are that TEAMS will reduce the severity of hypomanic symptoms and anxiety, reduce bipolar cognitions, improve social functioning and promote recovery compared to TAU alone at post-treatment and follow-up. The study also incorporates semi-structured interviews about the experiences of previous treatment and the experience of TEAMS therapy that will be subject to qualitative analyses to inform future developments of the approach. Discussion The design will provide preliminary evidence of efficacy, feasibility, acceptability, uptake, attrition and barriers to treatment to design a definitive trial of this novel intervention compared to treatment as usual. Trial registration This trial was registered with Current Controlled Trials (ISRCTN83928726) on registered 25 July 2014.
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Affiliation(s)
| | | | | | | | | | | | | | - Richard Morriss
- The Psychosis Research Unit, GMW Mental Health NHS Foundation Trust, Harrop House, Bury New Road, Prestwich, Manchester M25 3BL, UK.
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Ince P, Tai S, Haddock G. Using plain English and behaviourally specific language to increase the implementation of clinical guidelines for psychological treatments in schizophrenia. J Ment Health 2014; 24:129-33. [DOI: 10.3109/09638237.2014.958213] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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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Marshell R, Kearney-Ramos T, Brents LK, Hyatt WS, Tai S, Prather PL, Fantegrossi WE. In vivo effects of synthetic cannabinoids JWH-018 and JWH-073 and phytocannabinoid Δ9-THC in mice: inhalation versus intraperitoneal injection. Pharmacol Biochem Behav 2014; 124:40-7. [PMID: 24857780 DOI: 10.1016/j.pbb.2014.05.010] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 05/06/2014] [Accepted: 05/14/2014] [Indexed: 11/20/2022]
Abstract
Human users of synthetic cannabinoids (SCBs) JWH-018 and JWH-073 typically smoke these drugs, but preclinical studies usually rely on injection for drug delivery. We used the cannabinoid tetrad and drug discrimination to compare in vivo effects of inhaled drugs with injected doses of these two SCBs, as well as with the phytocannabinoid Δ(9)-tetrahydrocannabinol (Δ(9)-THC). Mice inhaled various doses of Δ(9)-THC, JWH-018 or JWH-073, or were injected intraperitoneally (IP) with these same compounds. Rectal temperature, tail flick latency in response to radiant heat, horizontal bar catalepsy, and suppression of locomotor activity were assessed in each animal. In separate studies, mice were trained to discriminate Δ(9)-THC (IP) from saline, and tests were performed with inhaled or injected doses of the SCBs. Both SCBs elicited Δ(9)-THC-like effects across both routes of administration, and effects following inhalation were attenuated by pretreatment with the CB1 antagonist/inverse agonist rimonabant. No cataleptic effects were observed following inhalation, but all compounds induced catalepsy following injection. Injected JWH-018 and JWH-073 fully substituted for Δ(9)-THC, but substitution was partial (JWH-073) or required relatively higher doses (JWH-018) when drugs were inhaled. These studies demonstrate that the SCBs JWH-018 and JWH-073 elicit dose-dependent, CB1 receptor-mediated Δ(9)-THC-like effects in mice when delivered via inhalation or via injection. Across these routes of administration, differences in cataleptic effects and, perhaps, discriminative stimulus effects, may implicate the involvement of active metabolites of these compounds.
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Affiliation(s)
- R Marshell
- Department of Pharmacology & Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W, Markham Street - Mail 638, Little Rock, AR 72205-7199, United States
| | - T Kearney-Ramos
- Department of Pharmacology & Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W, Markham Street - Mail 638, Little Rock, AR 72205-7199, United States
| | - L K Brents
- Department of Pharmacology & Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W, Markham Street - Mail 638, Little Rock, AR 72205-7199, United States
| | - W S Hyatt
- Department of Pharmacology & Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W, Markham Street - Mail 638, Little Rock, AR 72205-7199, United States
| | - S Tai
- Department of Pharmacology & Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W, Markham Street - Mail 638, Little Rock, AR 72205-7199, United States
| | - P L Prather
- Department of Pharmacology & Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W, Markham Street - Mail 638, Little Rock, AR 72205-7199, United States
| | - W E Fantegrossi
- Department of Pharmacology & Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W, Markham Street - Mail 638, Little Rock, AR 72205-7199, United States.
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Griffiths AW, Wood AM, Maltby J, Taylor PJ, Tai S. The prospective role of defeat and entrapment in depression and anxiety: a 12-month longitudinal study. Psychiatry Res 2014; 216:52-9. [PMID: 24529814 DOI: 10.1016/j.psychres.2014.01.037] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [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: 03/26/2013] [Revised: 11/08/2013] [Accepted: 01/26/2014] [Indexed: 10/25/2022]
Abstract
The concepts of "defeat" (representing failed social struggle) and "entrapment" (representing an inability to escape from a situation) have emerged from the animal literature, providing insight into the health consequences of low social rank. Evolutionary models suggest that these constructs co-occur and can lead to the development of mental disorders, although there is limited empirical evidence supporting these predictions. Participants (N=172) were recruited from economically deprived areas in North England. Over half of participants (58%) met clinical cut-offs for depression and anxiety, therefore we conducted analyses to establish whether participant outcomes were dependent on baseline defeat and entrapment levels. Participants completed measures of defeat, entrapment, depression and anxiety at two time-points twelve months apart. Factor analysis demonstrated that defeat and entrapment were best defined as one factor, suggesting that the experiences co-occurred. Regression analyses demonstrated that changes in depression and anxiety between T1 and T2 were predicted from baseline levels of defeat and entrapment; however, changes in defeat and entrapment were also predicted from baseline depression and anxiety. There are implications for targeting perceptions of defeat and entrapment within psychological interventions for people experiencing anxiety and depression and screening individuals to identify those at risk of developing psychopathology.
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Affiliation(s)
- Alys Wyn Griffiths
- School of Psychological Sciences, Coupland Building 1, University of Manchester, Oxford Road, Manchester, England M13 9PL, UK.
| | - Alex M Wood
- School of Psychological Sciences, Coupland Building 1, University of Manchester, Oxford Road, Manchester, England M13 9PL, UK; Behavioural Science Centre, Stirling Management School, 3Y8 Cottrell Building, University of Stirling, Stirling, Scotland FK9 4LA, UK
| | - John Maltby
- College of Medicine, Biological Sciences and Psychology, Henry Wellcome Building, Leicester University, Lancaster Road, Leicester, England LE1 9HN, UK
| | - Peter J Taylor
- Institute of Psychology, Health & Society, Whelan Building, University of Liverpool, Liverpool, England L69 3GB, UK
| | - Sara Tai
- School of Psychological Sciences, Coupland Building 1, University of Manchester, Oxford Road, Manchester, England M13 9PL, UK
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Kinderman P, Schwannauer M, Pontin E, Tai S. Psychological processes mediate the impact of familial risk, social circumstances and life events on mental health. PLoS One 2013; 8:e76564. [PMID: 24146890 PMCID: PMC3797803 DOI: 10.1371/journal.pone.0076564] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 08/27/2013] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Despite widespread acceptance of the 'biopsychosocial model', the aetiology of mental health problems has provoked debate amongst researchers and practitioners for decades. The role of psychological factors in the development of mental health problems remains particularly contentious, and to date there has not been a large enough dataset to conduct the necessary multivariate analysis of whether psychological factors influence, or are influenced by, mental health. This study reports on the first empirical, multivariate, test of the relationships between the key elements of the biospychosocial model of mental ill-health. METHODS AND FINDINGS Participants were 32,827 (age 18-85 years) self-selected respondents from the general population who completed an open-access online battery of questionnaires hosted by the BBC. An initial confirmatory factor analysis was performed to assess the adequacy of the proposed factor structure and the relationships between latent and measured variables. The predictive path model was then tested whereby the latent variables of psychological processes were positioned as mediating between the causal latent variables (biological, social and circumstantial) and the outcome latent variables of mental health problems and well-being. This revealed an excellent fit to the data, S-B χ(2) (3199, N = 23,397) = 126654.8, p<.001; RCFI = .97; RMSEA = .04 (.038-.039). As hypothesised, a family history of mental health difficulties, social deprivation, and traumatic or abusive life-experiences all strongly predicted higher levels of anxiety and depression. However, these relationships were strongly mediated by psychological processes; specifically lack of adaptive coping, rumination and self-blame. CONCLUSION These results support a significant revision of the biopsychosocial model, as psychological processes determine the causal impact of biological, social, and circumstantial risk factors on mental health. This has clear implications for policy, education and clinical practice as psychological processes such as rumination and self-blame are amenable to evidence-based psychological therapies.
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Affiliation(s)
- Peter Kinderman
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
| | - Matthias Schwannauer
- School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Eleanor Pontin
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
| | - Sara Tai
- School of Psychological Science, University of Manchester, Manchester, United Kingdom
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Pontin E, Schwannauer M, Tai S, Kinderman P. A UK validation of a general measure of subjective well-being: the modified BBC subjective well-being scale (BBC-SWB). Health Qual Life Outcomes 2013; 11:150. [PMID: 24004726 PMCID: PMC3868314 DOI: 10.1186/1477-7525-11-150] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 08/31/2013] [Indexed: 11/29/2022] Open
Abstract
Background The BBC Subjective Well-being scale (BBC-SWB) is a recently developed questionnaire designed to measure people’s subjective experiences across the wide breadth of domains commonly included in definitions of well-being. Although it has previously been shown to be a reliable and valid measure of subjective well-being in the general population with good psychometric properties, a limitation of the initial version was that it was developed using responses on a 4-point Likert-style scale. This paper presents the psychometric properties, validity and reliability of a revised version of the scale conducted using 5-point Likert-style responses and tests the hypothesis that the scale measures three underlying dimensions of well-being; psychological; physical health; and relationships. Methods A sample of 23,341 participants completed the revised BBC-SWB as part of an on-line open-access battery of self-report measures. Confirmatory factor analysis was used to test the pre-hypothesised three factor structure, and internal consistency was investigated using Cronbach’s alpha. Concurrent validity was assessed through analysis of correlations with demographic variables, scores on the Goldberg Anxiety and Depression Scales, and the List of Threatening Experiences Questionnaire. Results Confirmatory factor analysis supported three factor structure of the measure in the whole sample and for subsamples of males and females. Both the total 24-item scale and the three subscales had good internal consistency, showed no evidence of floor and ceiling effects and correlated significantly with measures of concurrent validity. Conclusions This study provided further confirmation of the validity and utility of the BBC Subjective Well-being scale. The modified version is a reliable and valid measure for the online assessment of subjective well-being in the general population with good psychometric properties.
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Affiliation(s)
- Eleanor Pontin
- Institute of Psychology, Health and Society, University of Liverpool, Waterhouse Building, Liverpool L69 3GL, UK.
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Hutton P, Kelly J, Lowens I, Taylor PJ, Tai S. Self-attacking and self-reassurance in persecutory delusions: a comparison of healthy, depressed and paranoid individuals. Psychiatry Res 2013; 205:127-36. [PMID: 22939521 DOI: 10.1016/j.psychres.2012.08.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [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] [Received: 08/10/2011] [Revised: 07/30/2012] [Accepted: 08/11/2012] [Indexed: 01/22/2023]
Abstract
Previous research has found that reduced self-reassurance and heightened verbal 'self-attacking' of a sadistic and persecutory nature are both associated with greater subclinical paranoia. Whether these processes are also linked to clinical paranoia remains unclear. To investigate this further, we asked 15 people with persecutory delusions, 15 people with depression and 19 non-psychiatric controls to complete several self-report questionnaires assessing their forms and functions of self-attacking. We found that people with persecutory delusions engaged in more self-attacking of a hateful nature and less self-reassurance than non-psychiatric controls, but not people with depression. Participants with persecutory delusions were also less likely than both healthy and depressed participants to report criticising themselves for self-corrective reasons. Hateful self-attacking, reduced self-reassurance and reduced self-corrective self-criticism may be involved in the development or maintenance of persecutory delusions. Limitations, clinical implications and directions for future research are discussed.
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Affiliation(s)
- Paul Hutton
- Psychosis Research Unit, Psychology Department, Trust HQ, Greater Manchester West Mental Health Foundation NHS Trust, Bury New Road, Prestwich M25 3BL, United Kingdom.
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Liu Y, Li X, Yang C, Tai S, Zhang X, Liu G. UPLC-MS-MS Method for Simultaneous Determination of Caffeine, Tolbutamide, Metoprolol, and Dapsone in Rat Plasma and its Application to Cytochrome P450 Activity Study in Rats. J Chromatogr Sci 2012; 51:26-32. [DOI: 10.1093/chromsci/bms100] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Dodd AL, Mansell W, Morrison AP, Tai S. Bipolar vulnerability and extreme appraisals of internal states: a computerized ratings study. Clin Psychol Psychother 2011; 18:387-96. [PMID: 21887812 DOI: 10.1002/cpp.779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A recent integrative cognitive model proposed that multiple, extreme, personalized, positive and negative appraisals of internal states predispose to maintain and exacerbate bipolar symptoms. This study aimed to directly assess conviction in a range of positive and negative appraisals of internal states suggested by the model, by using a laboratory-based computerized task. In a student sample (n = 68), a history of hypomania was associated with more positive and less negative appraisals of internal states, and a history of depression was associated with more negative appraisals and less positive appraisals of internal states. The sample was then split into three groups for comparison: bipolar risk (n = 18), depression risk (n = 20) and controls (n = 30). Relative to controls, the bipolar risk group made more extreme ratings of catastrophic appraisals of low activation states and tended to make more extreme ratings of appraisals of high activation states. The depression risk group scored higher on a range of negative appraisals of low activation states. These findings provide tentative support for the role of both positive and negative, extreme, personalized appraisals of internal states in hypomania and depression.
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Affiliation(s)
- Alyson L Dodd
- All School of Psychological Sciences, University of Manchester, UK.
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Dodd AL, Mansell W, Morrison AP, Tai S. Extreme appraisals of internal states and bipolar symptoms: The Hypomanic Attitudes and Positive Predictions Inventory. Psychol Assess 2011; 23:635-645. [DOI: 10.1037/a0022972] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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