Cognitive Processes during Acute Psychosis: The Role of Heightened Responsibility and Catastrophic Misinterpretations

Background: This study investigated the role of cognitive mechanisms underlying obsessive compulsive and panic disorders in psychosis, and in particular, their possible contributions to acute psychosis. Method: A total of 90 participants were recruited comprising three equal-size groups, including two clinical groups (acute and stable) and one non-clinical matched control group. Symptom severity and distress was assessed using the PSYRATS, and questionnaire measures of anxiety and obsessive beliefs were administered to all participants. Results: Individuals with a diagnosis of psychosis reported significantly higher levels of obsessional beliefs and anxiety sensitivity than the non-clinical group. Furthermore, acutely psychotic patients reported a significantly higher sense of responsibility and catastrophic misinterpretation than the stable psychiatric controls, and than samples of OCD and GAD patients. Conclusions: Results suggest that these anxiety processes are particularly important during acute psychotic episodes, beyond the reported comorbidity. The theoretical and clinical implications of these findings, the limitations of the methodology employed, and suggestions for future research are discussed

The accordian and the deep bowl of spaghetti: Eight researchers' experiences of using IPA as a methodology

Since 1996 Interpretative Phenomenological Analysis (IPA) has grown rapidly and been applied in areas outside its initial “home” of health psychology. However, explorations of its application from a researcher's perspective are scarce. This paper provides reflections on the experiences of eight individual researchers using IPA in diverse disciplinary fields and cultures. The research studies were conducted in the USA, Malaysia, Australia, New Zealand, Ireland and the UK by researchers with backgrounds in business management, consumer behaviour, mental health nursing, nurse education, applied linguistics, clinical psychology, health and education. They variously explored media awareness, employee commitment, disengagement from mental health services, in-vitro fertilisation treatment, student nurses' experience of child protection, second language acquisition in a university context, the male experience of spinal cord injury and academics experience of working in higher education and women’s experiences of body size and health practices. By bringing together intercultural, interdisciplinary experiences of using IPA, the paper discusses perceived strengths and weaknesses of IPA

Work-life imbalance: informal care and paid employment

In the United Kingdom informal carers are people who look after relatives or friends who need extra support because of age, physical or learning disability or illness. The majority of informal carers are women and female carers also care for longer hours and for longer durations than men. Thus women and older women in particular, shoulder the burden of informal care. We consider the costs of caring in terms of the impact that these kinds of caring responsibilities have on employment. The research is based on the responses of informal carers to a dedicated questionnaire and in-depth interviews with a smaller sub-sample of carers. Our results indicate that the duration of a caring episode as well as the hours carers commit to caring impact on their employment participation. In addition carers’ employment is affected by financial considerations, the needs of the person they care for, carers’ beliefs about the compatibility of informal care and paid work and employers’ willingness to accommodate carers’ needs. Overall, the research confirms that informal carers continue to face difficulties when they try to combine employment and care in spite of recent policy initiatives designed to help them

The Accordion and the Deep Bowl of Spaghetti: Eight Researchers\u27 Experiences of Using IPA as a Methodology

Since 1996 Interpretative Phenomenological Analysis (IPA) has grown rapidly and been applied in areas outside its initial “home” of health psychology. However, explorations of its application from a researcher\u27s perspective are scarce. This paper provides reflections on the experiences of eight individual researchers using IPA in diverse disciplinary fields and cultures. The research studies were conducted in the USA, Malaysia, Australia, New Zealand, Ireland and the UK by researchers with backgrounds in business management, consumer behaviour, mental health nursing, nurse education, applied linguistics, clinical psychology, health and education. They variously explored media awareness, employee commitment, disengagement from mental health services, in-vitro fertilisation treatment, student nurses\u27 experience of child protection, second language acquisition in a university context, the male experience of spinal cord injury and academics experience of working in higher education and women’s experiences of body size and health practices. By bringing together intercultural, interdisciplinary experiences of using IPA, the paper discusses perceived strengths and weaknesses of IPA

Delivery suite assessment unit: auditing innovation in maternity triage

yesA Delivery Suite Assessment Unit (DSAU) has been established at a large Northern teaching hospital. This was as a recommendation of ASQUAM (achieving sustainable quality in maternity) to reduce antenatal admissions to delivery suite and provide a more appropriate environment for women attending for antenatal or labour assessment. The DSAU has also provided an effective teaching environment where skills such as effective telephone triage, diagnosis of labour and care of women with pre-labour spontaneous rupture of membranes (SROM) have been developed by junior staff. The first twelve months' audit results indicate that the establishment of the DSAU has been successful in reducing antenatal admissions to delivery suite by increasing the transfers of clients home, rather than to the antenatal wards. This may reflect the confidence of the highly skilled midwives working in this environment and the confidence women feel about their ability to obtain prompt and accurate advice over the telephone

The experience of family carers attending a joint reminiscence group with people with dementia: A thematic analysis

Reminiscence therapy has the potential to improve quality of life for people with dementia. In recent years reminiscence groups have extended to include family members, but carers' experience of attending joint sessions is undocumented. This qualitative study explored the experience of 18 family carers attending 'Remembering Yesterday Caring Today' groups. Semi-structured interviews were transcribed and subjected to thematic analysis. Five themes were identified: experiencing carer support; shared experience; expectations (met and unmet), carer perspectives of the person with dementia's experience; and learning and comparing. Family carers' experiences varied, with some experiencing the intervention as entirely positive whereas others had more mixed feelings. Negative aspects included the lack of respite from their relative, the lack of emphasis on their own needs, and experiencing additional stress and guilt through not being able to implement newly acquired skills. These findings may explain the failure of a recent trial of joint reminiscence groups to replicate previous findings of positive benefit. More targeted research within subgroups of carers is required to justify the continued use of joint reminiscence groups in dementia care

Feasibility study suggests no impact from protected engagement time on adverse events in mental health wards for older adults

Hospital adverse events, such as falls, violence and aggression, security, self-harm, and suicide, are difficult to manage in older people with dementia. The purpose of the present study was to determine whether protected engagement time (PET) resulted in lower adverse events and incidents compared to comparable non-PET wards for people admitted to inpatient older people's mental health wards. Ten inpatient wards for older people were included. Five followed a PET-management pathway, while five continued usual care. All adverse events and incidents were recorded in routine hospital records over 72 weeks. Data were gathered from these records and analysed as rate per person per week to assess differences in frequency and type of adverse events between wards. A total of 4130 adverse events were recorded. In the PET wards, a mean of 0.38 adverse events occurred per person per week compared to 0.40 in non-PET wards. No statistically-significant differences were found between PET and non-PET wards for adverse events (P = 0.93), or for adverse events of any particular type (P ≥ 0.15). Therefore, there is no evidence to suggest that PET has any impact on adverse events in older people's mental health wards. Further investigation with a larger cohort is warranted, using a definitive, phase 3, clinical trial

Development and clinimetric assessment of a nurse-administered screening tool for movement disorders in psychosis

Background: Movement disorders (MD) associated with exposure to antipsychotic drugs (AP). MD are common and stigmatising, but underdiagnosed. Methods: We developed a screening procedure for AP-MD for administration by mental health (MH) nurses. Item selection and content validity assessment were conducted by a panel of neurologists, psychiatrists and a MH nurse, who operationalised a 31-item screening procedure (ScanMove instrument). Inter-rater reliability was measured on ratings from ten MH nurses evaluating video-recordings of the procedure on 30 patients with psychosis. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of thirteen MH nurses of 635 community patients from MH services to diagnostic judgement of a MD neurologist based on the ScanMove instrument and a reference procedure comprising a selection of commonly used rating scales. Results: Inter-reliability analysis showed no systematic difference between raters in their prediction of any AP-MD category. On criterion validity testing, the ScanMove instrument showed good sensitivity for parkinsonism (94%) and hyperkinesia (89%), but not for akathisia (38%), whereas specificity was low for parkinsonism and hyperkinesia, and moderate for akathisia. Mixed effect regression models showed low concurrent validity of quantitative scores obtained from the ScanMove instrument. Conclusions: The ScanMove instrument demonstrated good feasibility and inter-rater reliability, and acceptable sensitivity as MH nurse-administered screening tool for parkinsonism and hyperkinesia