5,511 research outputs found
Schizophrenia – time to commit to policy change
Schizophrenia is recognised as one of the most complex and profound mental health conditions, steeped in both myth and reality. Efforts needs to be multifaceted, including policy development, treatment guidance and scientific innovation, with all stakeholders working together to ensure meaningful progress. This report delves into the unique needs of people with schizophrenia, exploring supportive measures for their well-being, practical and attainable recommendations for change. The message to all nations, policy makers, payers and healthcare professionals is clear: strive for excellence, but most importantly – start somewhere
Alcohol Addiction Recovery Experiences Among Christian African Immigrants
AbstractThe problem of alcohol addiction is heightened when other psychological factors are present, such as the stress of acculturation. The purpose of this research was to describe the experiences of Christian African immigrants in America who have used faith-based treatment approaches while in recovery from alcoholism and to determine how their faith may have been a way of coping with their recovery. In this hermeneutic qualitative phenomenological study, data were collected through semi-structured interviews with eight participants. The data were analyzed to explore the experiences of Christian African acculturating to America who endorse a faith-based approach to their recovery, and the following three main categories emerged: (a) acculturation stress and its relationship to alcoholism; (b) factors that affected recovery; and (c) integrating psychological, spiritual, and medical factors in recovery. In addition, 13 subcategories emerged: (a) job and settlement stress; (b) using alcohol to cope; (c) stress from helping people at home country; (d) culture shock, accent, communication, and respect differences; (e) social drinking/peer pressure; (f) family support; (g) church and related activities support; (h) personal faith/spiritual growth support; (i) spiritual leaders and relationship support; (j) role of spirituality; (k) the place of psychology and therapy; (l) the role of medication; and spiritual support system. The findings of this research will provide a better understanding of the experiences of participants who have endorsed faith as crucial to their recovery. This has potential implications for positive social change by providing a clearer understanding of this phenomenon, which can help with addiction counseling, especially for the population of the study
Taser and Social, Ethnic and Racial Disparities research programme
Report from the 'Taser use and its association with social, ethnic and racial disparities in policing (TASERD)' research project. The research project was initiated by the National Police Chiefs’ Council and commissioned by the College of Policing, after their Officer and Staff Safety Review (OSSR) in 2019 found there was growing evidence to suggest that Tasers were being used disproportionately in society. It was carried out by researchers from Keele University, UCL, The University of Exeter and Staffordshire University.National Police Chiefs’ CouncilLondon’s Mayor's Office for Policing and Crime (MOPAC
An examination of the verbal behaviour of intergroup discrimination
This thesis examined relationships between psychological flexibility, psychological inflexibility, prejudicial attitudes, and dehumanization across three cross-sectional studies with an additional proposed experimental study. Psychological flexibility refers to mindful attention to the present moment, willing acceptance of private experiences, and engaging in behaviours congruent with one’s freely chosen values. Inflexibility, on the other hand, indicates a tendency to suppress unwanted thoughts and emotions, entanglement with one’s thoughts, and rigid behavioural patterns. Study 1 found limited correlations between inflexibility and sexism, racism, homonegativity, and dehumanization. Study 2 demonstrated more consistent positive associations between inflexibility and prejudice. And Study 3 controlled for right-wing authoritarianism and social dominance orientation, finding inflexibility predicted hostile sexism and racism beyond these factors. While showing some relationships, particularly with sexism and racism, psychological inflexibility did not consistently correlate with varied prejudices across studies.
The proposed randomized controlled trial aims to evaluate an Acceptance and Commitment Therapy intervention to reduce sexism through enhanced psychological flexibility. Overall, findings provide mixed support for the utility of flexibility-based skills in addressing complex societal prejudices. Research should continue examining flexibility integrated with socio-cultural approaches to promote equity
The Divided Self: Internal Conflict in Literature, Philosophy, Psychology, and Neuroscience
This thematic project examines the notion of self-division, particularly in terms of the conflict between cognition and metacognition, across the fields of philosophy, psychology, and, most recently, the cognitive and neurosciences. The project offers a historic overview of models of self-division, as well as analyses of the various problems presented in theoretical models to date. This work explores how self-division has been depicted in the literary works of Edgar Allan Poe, Don DeLillo, and Mary Shelley. It examines the ways in which artistic renderings alternately assimilate, resist, and/or critique dominant philosophical, psychological, and scientific discourses about the self and its divisions. This dissertation argues that the internal conflict portrayed by the writers of these literary characters is conscious: it is the conflict of the metacognitive “I” against akratic impulses, unwanted cognitions, and, ultimately, consciousness as a whole
The Council of Europe’s Framework of Competences for Democratic Culture: Hope for democracy or an allusive Utopia?
Democracies around the world are increasingly polarized along political and cultural lines. To address these challenges, in 2016, the Council of Europe (CoE) produced a model of twenty competences for democratic culture. In 2018, this same model became the basis of the Reference Framework of Competences for Democratic Culture (RFCDC). The RFCDC provides pedagogical instructions to help implement these competences. Together, I call this set of materials “the Framework”.
This thesis begins with the premise that utopia has long played an important role in the way power is maintained or resisted in democratic education. It questions the assumption that democratic culture can be cultivated instrumentally through policy- based competences without imposing power on subjects and views this assumption to be utopian. It thus excavates the potential utopian ideals at play in the Framework using ‘hidden utopias’ as a conceptual lens and method, which draws inspiration from the theories of Michèl Foucault, Ernst Bloch and Ruth Levitas.
It investigates how using ‘hidden utopias’ as a theoretical lens might facilitate a deeper understanding of the nature and purpose of the Framework, how implicit utopias might be at play, how this could be problematic and how these theories might shed light on the application of the Framework in pedagogical contexts. The contribution of this thesis is to make visible potential utopias at the heart of the Framework. It suggests that making implicit utopias visible in democratic education can help educators and learners engage with these discourses in critical and innovative ways and think beyond them
Pragmatic randomised controlled trial of guided self-help versus individual cognitive behavioural therapy with a trauma focus for post-traumatic stress disorder (RAPID)
This is the final version. Available on open access from the NIHR Journals Library via the DOI in this recordData availability: All available data can be obtained from the corresponding author.BACKGROUND: Guided self-help has been shown to be effective for other mental conditions and, if effective for post-traumatic stress disorder, would offer a time-efficient and accessible treatment option, with the potential to reduce waiting times and costs. OBJECTIVE: To determine if trauma-focused guided self-help is non-inferior to individual, face-to-face cognitive-behavioural therapy with a trauma focus for mild to moderate post-traumatic stress disorder to a single traumatic event. DESIGN: Multicentre pragmatic randomised controlled non-inferiority trial with economic evaluation to determine cost-effectiveness and nested process evaluation to assess fidelity and adherence, dose and factors that influence outcome (including context, acceptability, facilitators and barriers, measured qualitatively). Participants were randomised in a 1 : 1 ratio. The primary analysis was intention to treat using multilevel analysis of covariance. SETTING: Primary and secondary mental health settings across the United Kingdom's National Health Service. PARTICIPANTS: One hundred and ninety-six adults with a primary diagnosis of mild to moderate post-traumatic stress disorder were randomised with 82% retention at 16 weeks and 71% at 52 weeks. Nineteen participants and ten therapists were interviewed for the process evaluation. INTERVENTIONS: Up to 12 face-to-face, manualised, individual cognitive-behavioural therapy with a trauma focus sessions, each lasting 60-90 minutes, or to guided self-help using Spring, an eight-step online guided self-help programme based on cognitive-behavioural therapy with a trauma focus, with up to five face-to-face meetings of up to 3 hours in total and four brief telephone calls or e-mail contacts between sessions. MAIN OUTCOME MEASURES: Primary outcome: the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, at 16 weeks post-randomisation. Secondary outcomes: included severity of post-traumatic stress disorder symptoms at 52 weeks, and functioning, symptoms of depression, symptoms of anxiety, alcohol use and perceived social support at both 16 and 52 weeks post-randomisation. Those assessing outcomes were blinded to group assignment. RESULTS: Non-inferiority was demonstrated at the primary end point of 16 weeks on the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [mean difference 1.01 (one-sided 95% CI -∞ to 3.90, non-inferiority p = 0.012)]. Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, score improvements of over 60% in both groups were maintained at 52 weeks but the non-inferiority results were inconclusive in favour of cognitive-behavioural therapy with a trauma focus at this timepoint [mean difference 3.20 (one-sided 95% confidence interval -∞ to 6.00, non-inferiority p = 0.15)]. Guided self-help using Spring was not shown to be more cost-effective than face-to-face cognitive-behavioural therapy with a trauma focus although there was no significant difference in accruing quality-adjusted life-years, incremental quality-adjusted life-years -0.04 (95% confidence interval -0.10 to 0.01) and guided self-help using Spring was significantly cheaper to deliver [£277 (95% confidence interval £253 to £301) vs. £729 (95% CI £671 to £788)]. Guided self-help using Spring appeared to be acceptable and well tolerated by participants. No important adverse events or side effects were identified. LIMITATIONS: The results are not generalisable to people with post-traumatic stress disorder to more than one traumatic event. CONCLUSIONS: Guided self-help using Spring for mild to moderate post-traumatic stress disorder to a single traumatic event appears to be non-inferior to individual face-to-face cognitive-behavioural therapy with a trauma focus and the results suggest it should be considered a first-line treatment for people with this condition. FUTURE WORK: Work is now needed to determine how best to effectively disseminate and implement guided self-help using Spring at scale. TRIAL REGISTRATION: This trial is registered as ISRCTN13697710. FUNDING: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 14/192/97) and is published in full in Health Technology Assessment; Vol. 27, No. 26. See the NIHR Funding and Awards website for further award information.National Institute for Health and Care Research (NIHR
A comparison of the effectiveness of cognitive behavioural interventions based on delivery features for elevated symptoms of depression in adolescents: A systematic review
This is the final version. Available on open access from Wiley via the DOI in this record. Data availability statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.Background
Depression is a public health problem and common amongst adolescents. Cognitive behavioural therapy (CBT) is widely used to treat adolescent depression but existing research does not provide clear conclusions regarding the relative effectiveness of different delivery modalities.
Objectives
The primary aim is to estimate the relative efficacy of different modes of CBT delivery compared with each other and control conditions for reducing depressive symptoms in adolescents. The secondary aim is to compare the different modes of delivery with regard to intervention completion/attrition (a proxy for intervention acceptability).
Search Methods
The Cochrane Depression, Anxiety and Neurosis Clinical Trials Register was searched in April 2020. MEDLINE, PsycInfo, EMBASE, four other electronic databases, the CENTRAL trial registry, Google Scholar and Google were searched in November 2020, together with reference checking, citation searching and hand-searching of two databases.
Selection Criteria
Randomised controlled trials (RCTs) of CBT interventions (irrespective of delivery mode) to reduce symptoms of depression in young people aged 10–19 years with clinically relevant symptoms or diagnosis of depression were included.
Data Collection and Analysis
Screening and data extraction were completed by two authors independently, with discrepancies addressed by a third author. CBT interventions were categorised as follows: group CBT, individual CBT, remote CBT, guided self-help, and unguided self-help. Effect on depressive symptom score was estimated across validated self-report measures using Hedges' g standardised mean difference. Acceptability was estimated based on loss to follow-up as an odds ratio. Treatment rankings were developed using the surface under the cumulative ranking curve (SUCRA). Pairwise meta-analyses were conducted using random effects models where there were two or more head-to-head trials. Network analyses were conducted using random effects models.
Main Results
Sixty-eight studies were included in the review. The mean age of participants ranged from 10 to 19.5 years, and on average 60% of participants were female. The majority of studies were conducted in schools (28) or universities (6); other settings included primary care, clinical settings and the home. The number of CBT sessions ranged from 1 to 16, the frequency of delivery from once every 2 weeks to twice a week and the duration of each session from 20 min to 2 h. The risk of bias was low across all domains for 23 studies, 24 studies had some concerns and the remaining 21 were assessed to be at high risk of bias. Sixty-two RCTs (representing 6435 participants) were included in the pairwise and network meta-analyses for post-intervention depressive symptom score at post-intervention. All pre-specified treatment and control categories were represented by at least one RCT. Although most CBT approaches, except remote CBT, demonstrated superiority over no intervention, no approaches performed clearly better than or equivalent to another. The highest and lowest ranking interventions were guided self-help (SUCRA 83%) and unguided self-help (SUCRA 51%), respectively (very low certainty in treatment ranking). Nineteen RCTs (3260 participants) were included in the pairwise and network meta-analyses for 6 to 12 month follow-up depressive symptom score. Neither guided self-help nor remote CBT were evaluated in the RCTs for this time point. Effects were generally attenuated for 6- to 12-month outcomes compared to posttest. No interventions demonstrated superiority to no intervention, although unguided self-help and group CBT both demonstrated superiority compared to TAU. No CBT approach demonstrated clear superiority over another. The highest and lowest ranking approaches were unguided self-help and individual CBT, respectively. Sixty-two RCTs (7347 participants) were included in the pairwise and network meta-analyses for intervention acceptability. All pre-specified treatment and control categories were represented by at least one RCT. Although point estimates tended to favour no intervention, no active treatments were clearly inferior. No CBT approach demonstrated clear superiority over another. The highest and lowest ranking active interventions were individual CBT and group CBT respectively. Pairwise meta-analytic findings were similar to those of the network meta-analysis for all analyses. There may be age-based subgroup effects on post-intervention depressive symptoms. Using the no intervention control group as the reference, the magnitudes of effects appear to be larger for the oldest age categories compared to the other subgroups for each given comparison. However, they were generally less precise and formal testing only indicated a significant difference for group CBT. Findings were robust to pre-specified sensitivity analyses separating out the type of placebo and excluding cluster-RCTs, as well as an additional analysis excluding studies where we had imputed standard deviations.
Authors' Conclusions
At posttreatment, all active treatments (group CBT, individual CBT, guided self-help, and unguided self-help) except for remote CBT were more effective than no treatment. Guided self-help was the most highly ranked intervention but only evaluated in trials with the oldest adolescents (16–19 years). Moreover, the studies of guided self-help vary in the type and amount of therapist support provided and longer-term results are needed to determine whether effects persist. The magnitude of effects was generally attenuated for 6- to 12-month outcomes. Although unguided self-help was the lowest-ranked active intervention at post-intervention, it was the highest ranked at follow-up. This suggests the need for further research into whether interventions with self-directed elements enable young people to maintain effects by continuing or revisiting the intervention independently, and whether therapist support would improve long-term outcomes. There was no clear evidence that any active treatments were more acceptable to participants than any others. The relative effectiveness of intervention delivery modes must be taken into account in the context of the needs and preferences of individual young people, particularly as the differences between effect sizes were relatively small. Further research into the type and amount of therapist support that is most acceptable to young people and most cost-effective would be particularly useful.Jacobs FoundationNational Institute for Health and Care Research (NIHR
Impact of the Completed South Carolina Post Critical Incident Seminar on the Well-Being of the Law Enforcement Participants
The purpose of this grounded theory study was to discover the impact of the completed South Carolina Post Critical Incident Seminar (SC PCIS) on the participants’ well-being, and the impact on the peer team members. Critical stress events or traumatic loss of life did have a significant impact on the law enforcement officer and those that were associated with that officer. The theory that guides this was study was the general strain theory; it allowed for the relationship between the duration, severity, and certainty of the stressors that had a negative influence on the well-being of those that attend the SC PCIS process. Research showed that unaddressed stressors lead to rapid and drastic effects on the psychological and physiological aspects of the law enforcement officer. These stressors could quickly and rapidly overwhelm traditional coping skills leading to a decline in overall well-being and quality of life. The ability to identify a program that addresses the efforts to improve well-being and create long-lasting benefits was vital for all parties that interact with the law enforcement officer. The qualitative study did involve semi-structured interviews with peer team members that interacted with all participants on multiple occasions at the SC PCIS seminar. The grounded theory was used in the data analysis strategies. The completed study showed that there was a positive impact on the well-being of the participants that completed the program. The impact of the SC PCIS on the peer team members was positive as well
Introduction to Psychology
Introduction to Psychology is a modified version of Psychology 2e - OpenStax
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