ABSTRACT This study explores relationships between internalised stereotypes (IS) and emotional dy... more ABSTRACT This study explores relationships between internalised stereotypes (IS) and emotional dysfunction in people with psychosis who are not taking antipsychotic medication. Cross-sectional and longitudinal data for 66 participants were tested for relationships between IS, emotional dysfunction and insight at baseline and three months. IS and insight at baseline were compared between those with psychological and other causal models of psychosis. High levels of IS were associated with depression and social anxiety at baseline. Internalised stereotypes contributed to the variance in depression over time. Participants who reported a psychological causal model for their psychotic experiences had significantly lower levels of stigma. Findings support a stigma model of emotional dysfunction in people with psychosis replicating previous findings in an antipsychotic free group. Research is required to demonstrate effective interventions for IS in those with psychosis.
ABSTRACT Childhood trauma is linked to an increased risk of developing psychosis in adulthood. Th... more ABSTRACT Childhood trauma is linked to an increased risk of developing psychosis in adulthood. The extent and severity of trauma experienced is known to correlate with the intensity or presence of specific psychotic symptoms. The relative impact of types of abuse and neglect (sexual, physical, emotional) is unknown. Cluster analysis was used to create natural groupings of similarity based on Childhood Trauma Questionnaire Scores (CTQ) in a sub-sample of 51 anti-psychotic-free patients with diagnoses of Schizophrenia Spectrum Disorders from the ACTION trial. The derived clusters were compared on the Positive and Negative Syndrome Scale (PANSS) scores. Two clusters emerged: one characterized by abuse and the other by neglect. The abuse group was found to have significantly higher positive symptoms scores (p < 0.05). This is the first investigation of this concept in an un-medicated cohort that distinguished between trauma types using natural groupings in the data, and therefore, a more ecologically valid means of exploring the existence of a traumatic psychosis subgroup.
ABSTRACT Aims: Recent evidence regarding over-estimation of the efficacy of antipsychotics and un... more ABSTRACT Aims: Recent evidence regarding over-estimation of the efficacy of antipsychotics and under-estimation of their toxicity, as well as emerging data regarding alternative treatment options, suggest it may be time to introduce patient choice. However, only a small number of studies have reported on the efficacy of interventions for psychological interventions such as cognitive therapy. Early results suggest that cognitive therapy may be an effective, well-tolerated treatment for people who choose not to take antipsychotics. We report on the rationale and design for a multi-site randomised, controlled trial of cognitive therapy for people with a schizophrenia spectrum diagnosis who choose not to take antipsychotics.
BackgroundAlthough antipsychotic medication is the first line of treatment for schizophrenia, man... more BackgroundAlthough antipsychotic medication is the first line of treatment for schizophrenia, many service users choose to refuse or discontinue their pharmacological treatment. Cognitive therapy (CT) has been shown to be effective when delivered in combination with antipsychotic medication, but has yet to be formally evaluated in its absence. This study evaluates CT for people with psychotic disorders who have not been taking antipsychotic medication for at least 6 months.MethodTwenty participants with schizophrenia spectrum disorders received CT in an open trial. Our primary outcome was psychiatric symptoms measured using the Positive and Negative Syndromes Scale (PANSS), which was administered at baseline, 9 months (end of treatment) and 15 months (follow-up). Secondary outcomes were dimensions of hallucinations and delusions, self-rated recovery and social functioning.ResultsT tests and Wilcoxon's signed ranks tests revealed significant beneficial effects on all primary and ...
Background: There is an emerging evidence base of in-session process research in Motivational Int... more Background: There is an emerging evidence base of in-session process research in Motivational Interviewing (MI). Investigations have mostly taken place in the USA, have progressed from frequency to sequential analysis, and focused on change talk and change outcomes. Research focusing on how a therapist behaves in the presence of counter-change talk is rare but pertinent, since managing resistance is a central feature of the MI model. This investigation aims to discover if and how MI-specific therapist strategies affect immediate client counter-change talk. Method: Secondary analysis of 50 recorded MI sessions from a British randomised controlled trial were rated using a sequential behavioural coding manual for speech. Baseline counter-change talk was identified and subsequent therapist and client behaviours were coded and categorised for transitional analysis, to establish the probability of specific client behaviours following specific therapist behaviours. Results: Following basel...
ABSTRACT This study explores relationships between internalised stereotypes (IS) and emotional dy... more ABSTRACT This study explores relationships between internalised stereotypes (IS) and emotional dysfunction in people with psychosis who are not taking antipsychotic medication. Cross-sectional and longitudinal data for 66 participants were tested for relationships between IS, emotional dysfunction and insight at baseline and three months. IS and insight at baseline were compared between those with psychological and other causal models of psychosis. High levels of IS were associated with depression and social anxiety at baseline. Internalised stereotypes contributed to the variance in depression over time. Participants who reported a psychological causal model for their psychotic experiences had significantly lower levels of stigma. Findings support a stigma model of emotional dysfunction in people with psychosis replicating previous findings in an antipsychotic free group. Research is required to demonstrate effective interventions for IS in those with psychosis.
ABSTRACT Childhood trauma is linked to an increased risk of developing psychosis in adulthood. Th... more ABSTRACT Childhood trauma is linked to an increased risk of developing psychosis in adulthood. The extent and severity of trauma experienced is known to correlate with the intensity or presence of specific psychotic symptoms. The relative impact of types of abuse and neglect (sexual, physical, emotional) is unknown. Cluster analysis was used to create natural groupings of similarity based on Childhood Trauma Questionnaire Scores (CTQ) in a sub-sample of 51 anti-psychotic-free patients with diagnoses of Schizophrenia Spectrum Disorders from the ACTION trial. The derived clusters were compared on the Positive and Negative Syndrome Scale (PANSS) scores. Two clusters emerged: one characterized by abuse and the other by neglect. The abuse group was found to have significantly higher positive symptoms scores (p < 0.05). This is the first investigation of this concept in an un-medicated cohort that distinguished between trauma types using natural groupings in the data, and therefore, a more ecologically valid means of exploring the existence of a traumatic psychosis subgroup.
ABSTRACT Aims: Recent evidence regarding over-estimation of the efficacy of antipsychotics and un... more ABSTRACT Aims: Recent evidence regarding over-estimation of the efficacy of antipsychotics and under-estimation of their toxicity, as well as emerging data regarding alternative treatment options, suggest it may be time to introduce patient choice. However, only a small number of studies have reported on the efficacy of interventions for psychological interventions such as cognitive therapy. Early results suggest that cognitive therapy may be an effective, well-tolerated treatment for people who choose not to take antipsychotics. We report on the rationale and design for a multi-site randomised, controlled trial of cognitive therapy for people with a schizophrenia spectrum diagnosis who choose not to take antipsychotics.
BackgroundAlthough antipsychotic medication is the first line of treatment for schizophrenia, man... more BackgroundAlthough antipsychotic medication is the first line of treatment for schizophrenia, many service users choose to refuse or discontinue their pharmacological treatment. Cognitive therapy (CT) has been shown to be effective when delivered in combination with antipsychotic medication, but has yet to be formally evaluated in its absence. This study evaluates CT for people with psychotic disorders who have not been taking antipsychotic medication for at least 6 months.MethodTwenty participants with schizophrenia spectrum disorders received CT in an open trial. Our primary outcome was psychiatric symptoms measured using the Positive and Negative Syndromes Scale (PANSS), which was administered at baseline, 9 months (end of treatment) and 15 months (follow-up). Secondary outcomes were dimensions of hallucinations and delusions, self-rated recovery and social functioning.ResultsT tests and Wilcoxon's signed ranks tests revealed significant beneficial effects on all primary and ...
Background: There is an emerging evidence base of in-session process research in Motivational Int... more Background: There is an emerging evidence base of in-session process research in Motivational Interviewing (MI). Investigations have mostly taken place in the USA, have progressed from frequency to sequential analysis, and focused on change talk and change outcomes. Research focusing on how a therapist behaves in the presence of counter-change talk is rare but pertinent, since managing resistance is a central feature of the MI model. This investigation aims to discover if and how MI-specific therapist strategies affect immediate client counter-change talk. Method: Secondary analysis of 50 recorded MI sessions from a British randomised controlled trial were rated using a sequential behavioural coding manual for speech. Baseline counter-change talk was identified and subsequent therapist and client behaviours were coded and categorised for transitional analysis, to establish the probability of specific client behaviours following specific therapist behaviours. Results: Following basel...
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Papers by Laura Drage