A group of 24 "new chronic" schizophrenic inpatients was compared with a group ... more A group of 24 "new chronic" schizophrenic inpatients was compared with a group of 19 daypatients matched for duration of current care; both had spent between 1 and 6 years in continuous inpatient or daypatient care. The groups were compared on a variety of clinical, demographic, and social variables to identify specific variables that might distinguish the new chronic inpatient group. Despite a few nonsignificant trends in the data, the groups were found not to differ significantly on any variables. Both groups had long psychiatric histories with many previous hospital admissions, presented many negative symptoms of schizophrenia at interview, were quite disabled in terms of self-care and speech skills, had a low incidence of behavioural disturbance and had few contacts outside of the hospital. The majority of both groups expressed a clear preference for community care. The results therefore highlight the urgent need for more comprehensive and detailed assessment of patients in relation to decisions about retention in or discharge from inpatient hospital care and also the need to identify objective predictors of the success of such decisions.
It has long been known that labels, such as mental health diagnoses, can lead people to jump to d... more It has long been known that labels, such as mental health diagnoses, can lead people to jump to damaging and erroneous conclusions. The recent Germanwings plane crash led to media stories attributing what happened to the pilot’s depression, and many concluded that there needed to be better ways of excluding depressed people from being pilots.
Page 1. Behavioural and Cognitive Psychotherapy, 2001, 29, 255 Cambridge University Press. Printe... more Page 1. Behavioural and Cognitive Psychotherapy, 2001, 29, 255 Cambridge University Press. Printed in the United Kingdom Reviewers Thank you to all those who participated in the review process for Behavioural and Cognitive Psychotherapy during 2000. Martin Antony Gisli Gudjonsson Mike Lucock Karen Rowa Christine Barrowclough Ann Hackmann Warren Mansell Sandra Sagrati Joanne Barton Gillian Haddock Isaac Marks Stefan Schuller Ivy Blackburn John Hall Gerald Matthews Jan Scott ...
Many individuals have positive experiences of voice-hearing (VH). However, current assessment too... more Many individuals have positive experiences of voice-hearing (VH). However, current assessment tools do not capture positive aspects of VH as comprehensively as they do negative aspects. This may li...
Background: Client disclosure of emotionally salient information to a therapist may be an importa... more Background: Client disclosure of emotionally salient information to a therapist may be an important factor in the effectiveness of Cognitive Behavioural Therapy for Psychosis (CBTp). The present study explores how people engaging with CBTp make sense of sharing emotionally salient information with a therapist and considers how mental health stigma may influence how participants decide whether to share information. Methods: Eight participants were recruited for semi-structured interviews lasting 30–75 minutes. Interpretive Phenomenological Analysis was used. Results: Two main themes were identified. I am responsible for controlling the negative impact of disclosure refers to participants’ awareness that sharing distressing experiences may have negative consequences. Participants worried about being judged, such as being seen as abnormal or having the potential to harm others. They also worried about feeling shamed or distressed. Non-disclosure may be a way of avoiding these fears. Th...
The attitudes of mental health workers toward individuals with mental health conditions can impac... more The attitudes of mental health workers toward individuals with mental health conditions can impact the quality of care they provide. Negative attitudes among mental health workers seem particularly common in response to people diagnosed with borderline personality disorder (BPD). The current review aimed to identify and review the literature regarding mental health workers' attitudes toward individuals diagnosed with BPD, specifically focusing on studies comparing workers' attitudes toward BPD with attitudes toward other mental health diagnoses. The findings suggest that mental health workers have more negative attitudes toward individuals labeled as having BPD than toward individuals with other diagnoses, such as depression. This is likely due to factors associated with the label itself, in addition to workers' perceptions of BPD symptoms and previous experiences of delivering treatment. The implications of these findings are considered, with a particular focus on how m...
OBJECTIVES Cognitive Behavioural Therapy for Psychosis (CBTp) demonstrates variable and at times ... more OBJECTIVES Cognitive Behavioural Therapy for Psychosis (CBTp) demonstrates variable and at times mild to moderate effect sizes, thus its therapeutic processes are important to explore. Establishing a secure therapeutic relationship is one such key process where barriers may exist, including those related to psychotic symptoms and associated stigma. This review synthesizes the available qualitative research pertaining to the experience of the therapeutic relationship from the perspective of those experiencing psychosis. METHODS A systematic review was under-taken using PRISMA guidelines. Search terms included variants of 'psychosis', 'therapy' and 'qualitative'. PsycInfo, CINAHL, EmBase, MedLine and Web of Science were searched and reference lists were hand-scanned. Yardley's quality appraisal tool was utilized and Noblit and Hare's 7-stage process for conducting a meta-ethnographic review. A line-of-argument synthesis is presented. RESULTS Fourteen papers were identified using inclusion and exclusion criteria. Twelve papers were deemed to have satisfactory quality. The line-of-argument synthesis used attachment theory to propose four semi-distinct stages to establishing a therapeutic relationship; beginning; safety, hope and trust; the practicalities of therapy; branching out. Findings suggest that the therapist's persona and use of CBTp techniques such as collaboration and shared agency over the process were important in establishing for the patient a sense of self as normal, equal and worthwhile. CONCLUSIONS Attachment security may be an important strand of CBTp and warrants further research and clinical investigation as a process and an outcome. Future research can benefit from increased transparency regarding researcher positionality as a potential source of bias.
The first stage of this project aims to identify assessment measures which include items on voice... more The first stage of this project aims to identify assessment measures which include items on voice-hearing by way of a systematic review. The second stage is the development of a brief framework of categories of positive experiences of voice hearing, using a triangulated approach, drawing on views from both professionals and people with lived experience. The third stage will involve using the framework to identify any positve aspects of voice-hearing included in the voice hearing assessments identified in stage 1.
Background: There is strong evidence to suggest that anxiety is associated with paranoia in clini... more Background: There is strong evidence to suggest that anxiety is associated with paranoia in clinical and non-clinical samples. However, no research to date has directly manipulated anxiety to investigate if state-anxiety has a causal role in state-paranoia in clinical populations. Aims: To investigate whether an anxious-mood induction leads to greater paranoia than a neutral-mood induction in people experiencing psychosis and paranoia and, if so, whether this is predicted by anxiety over and above other variables. Method: 22 participants with a psychosis-spectrum diagnosis took part in a two condition cross-over experimental design. Participants underwent a neutral-mood and an anxious-mood induction with levels of state-anxiety, state-affect and state-paranoia being measured before and after each condition. Results: State-paranoia was significantly higher after the anxious condition compared with the neutral condition. State-anxiety and negative-affect were significant predictors of...
SynopsisHostels for the homeless contain many who are disabled by chronic mental illness but have... more SynopsisHostels for the homeless contain many who are disabled by chronic mental illness but have little access to rehabilitation services. One approach to solving this problem might be to measure the needs of hostel residents in a standardized way and use this information as a basis for planning interventions. This study attempted to use the MRC Needs for Care Assessment Schedule to measure the needs of 46 mentally ill residents of Oxford hostels. It aimed to determine if a standardized assessment could be used in these difficult settings and if the needs it identified could form a useful basis for planning future interventions. Although it was possible to use the schedule, and although the pattern of need identified appeared broadly to reflect conditions in the hostels, it was not felt that the information produced was of sufficient quality to assist in planning services. The authors postulate that underlying this deficiency is the failure of the schedule to take sufficient account of the views of staff and residents.
A group of 24 "new chronic" schizophrenic inpatients was compared with a group ... more A group of 24 "new chronic" schizophrenic inpatients was compared with a group of 19 daypatients matched for duration of current care; both had spent between 1 and 6 years in continuous inpatient or daypatient care. The groups were compared on a variety of clinical, demographic, and social variables to identify specific variables that might distinguish the new chronic inpatient group. Despite a few nonsignificant trends in the data, the groups were found not to differ significantly on any variables. Both groups had long psychiatric histories with many previous hospital admissions, presented many negative symptoms of schizophrenia at interview, were quite disabled in terms of self-care and speech skills, had a low incidence of behavioural disturbance and had few contacts outside of the hospital. The majority of both groups expressed a clear preference for community care. The results therefore highlight the urgent need for more comprehensive and detailed assessment of patients in relation to decisions about retention in or discharge from inpatient hospital care and also the need to identify objective predictors of the success of such decisions.
It has long been known that labels, such as mental health diagnoses, can lead people to jump to d... more It has long been known that labels, such as mental health diagnoses, can lead people to jump to damaging and erroneous conclusions. The recent Germanwings plane crash led to media stories attributing what happened to the pilot’s depression, and many concluded that there needed to be better ways of excluding depressed people from being pilots.
Page 1. Behavioural and Cognitive Psychotherapy, 2001, 29, 255 Cambridge University Press. Printe... more Page 1. Behavioural and Cognitive Psychotherapy, 2001, 29, 255 Cambridge University Press. Printed in the United Kingdom Reviewers Thank you to all those who participated in the review process for Behavioural and Cognitive Psychotherapy during 2000. Martin Antony Gisli Gudjonsson Mike Lucock Karen Rowa Christine Barrowclough Ann Hackmann Warren Mansell Sandra Sagrati Joanne Barton Gillian Haddock Isaac Marks Stefan Schuller Ivy Blackburn John Hall Gerald Matthews Jan Scott ...
Many individuals have positive experiences of voice-hearing (VH). However, current assessment too... more Many individuals have positive experiences of voice-hearing (VH). However, current assessment tools do not capture positive aspects of VH as comprehensively as they do negative aspects. This may li...
Background: Client disclosure of emotionally salient information to a therapist may be an importa... more Background: Client disclosure of emotionally salient information to a therapist may be an important factor in the effectiveness of Cognitive Behavioural Therapy for Psychosis (CBTp). The present study explores how people engaging with CBTp make sense of sharing emotionally salient information with a therapist and considers how mental health stigma may influence how participants decide whether to share information. Methods: Eight participants were recruited for semi-structured interviews lasting 30–75 minutes. Interpretive Phenomenological Analysis was used. Results: Two main themes were identified. I am responsible for controlling the negative impact of disclosure refers to participants’ awareness that sharing distressing experiences may have negative consequences. Participants worried about being judged, such as being seen as abnormal or having the potential to harm others. They also worried about feeling shamed or distressed. Non-disclosure may be a way of avoiding these fears. Th...
The attitudes of mental health workers toward individuals with mental health conditions can impac... more The attitudes of mental health workers toward individuals with mental health conditions can impact the quality of care they provide. Negative attitudes among mental health workers seem particularly common in response to people diagnosed with borderline personality disorder (BPD). The current review aimed to identify and review the literature regarding mental health workers' attitudes toward individuals diagnosed with BPD, specifically focusing on studies comparing workers' attitudes toward BPD with attitudes toward other mental health diagnoses. The findings suggest that mental health workers have more negative attitudes toward individuals labeled as having BPD than toward individuals with other diagnoses, such as depression. This is likely due to factors associated with the label itself, in addition to workers' perceptions of BPD symptoms and previous experiences of delivering treatment. The implications of these findings are considered, with a particular focus on how m...
OBJECTIVES Cognitive Behavioural Therapy for Psychosis (CBTp) demonstrates variable and at times ... more OBJECTIVES Cognitive Behavioural Therapy for Psychosis (CBTp) demonstrates variable and at times mild to moderate effect sizes, thus its therapeutic processes are important to explore. Establishing a secure therapeutic relationship is one such key process where barriers may exist, including those related to psychotic symptoms and associated stigma. This review synthesizes the available qualitative research pertaining to the experience of the therapeutic relationship from the perspective of those experiencing psychosis. METHODS A systematic review was under-taken using PRISMA guidelines. Search terms included variants of 'psychosis', 'therapy' and 'qualitative'. PsycInfo, CINAHL, EmBase, MedLine and Web of Science were searched and reference lists were hand-scanned. Yardley's quality appraisal tool was utilized and Noblit and Hare's 7-stage process for conducting a meta-ethnographic review. A line-of-argument synthesis is presented. RESULTS Fourteen papers were identified using inclusion and exclusion criteria. Twelve papers were deemed to have satisfactory quality. The line-of-argument synthesis used attachment theory to propose four semi-distinct stages to establishing a therapeutic relationship; beginning; safety, hope and trust; the practicalities of therapy; branching out. Findings suggest that the therapist's persona and use of CBTp techniques such as collaboration and shared agency over the process were important in establishing for the patient a sense of self as normal, equal and worthwhile. CONCLUSIONS Attachment security may be an important strand of CBTp and warrants further research and clinical investigation as a process and an outcome. Future research can benefit from increased transparency regarding researcher positionality as a potential source of bias.
The first stage of this project aims to identify assessment measures which include items on voice... more The first stage of this project aims to identify assessment measures which include items on voice-hearing by way of a systematic review. The second stage is the development of a brief framework of categories of positive experiences of voice hearing, using a triangulated approach, drawing on views from both professionals and people with lived experience. The third stage will involve using the framework to identify any positve aspects of voice-hearing included in the voice hearing assessments identified in stage 1.
Background: There is strong evidence to suggest that anxiety is associated with paranoia in clini... more Background: There is strong evidence to suggest that anxiety is associated with paranoia in clinical and non-clinical samples. However, no research to date has directly manipulated anxiety to investigate if state-anxiety has a causal role in state-paranoia in clinical populations. Aims: To investigate whether an anxious-mood induction leads to greater paranoia than a neutral-mood induction in people experiencing psychosis and paranoia and, if so, whether this is predicted by anxiety over and above other variables. Method: 22 participants with a psychosis-spectrum diagnosis took part in a two condition cross-over experimental design. Participants underwent a neutral-mood and an anxious-mood induction with levels of state-anxiety, state-affect and state-paranoia being measured before and after each condition. Results: State-paranoia was significantly higher after the anxious condition compared with the neutral condition. State-anxiety and negative-affect were significant predictors of...
SynopsisHostels for the homeless contain many who are disabled by chronic mental illness but have... more SynopsisHostels for the homeless contain many who are disabled by chronic mental illness but have little access to rehabilitation services. One approach to solving this problem might be to measure the needs of hostel residents in a standardized way and use this information as a basis for planning interventions. This study attempted to use the MRC Needs for Care Assessment Schedule to measure the needs of 46 mentally ill residents of Oxford hostels. It aimed to determine if a standardized assessment could be used in these difficult settings and if the needs it identified could form a useful basis for planning future interventions. Although it was possible to use the schedule, and although the pattern of need identified appeared broadly to reflect conditions in the hostels, it was not felt that the information produced was of sufficient quality to assist in planning services. The authors postulate that underlying this deficiency is the failure of the schedule to take sufficient account of the views of staff and residents.
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Papers by Lorna Hogg