Verbal information transfer in real-life: when mothers worry about their child starting school

Verbal information transfer, one of Rachman’s three pathways to fear, may be one way in which vulnerability for anxiety may be transmitted from parents to children. A community sample of mothers and their preschool-aged children (N = 65) completed observational tasks relating to the child starting school. Mothers were asked to tell their child about social aspects of school; then children completed a brief play assessment involving ambiguous, school-based social scenarios. Mothers completed self-report questionnaires on social anxiety symptoms, general anxiety and depressive symptoms as well as a questionnaire on child anxiety symptoms and indicated whether they were personally worried about their child starting school. There was a significant difference in the information given to children about school between mothers who stated they were worried and those who stated they were not, with mothers who were worried more likely to mention unresolved threat, use at least one anxiety-related word, and show clear/consistent negativity (all ps < .01). Significant associations were also found between the emotional tone of mothers’ descriptions of school and children’s own representations of school. These findings support the theory that the information mothers give to their child may be influenced by their own concerns regarding their child, and that this verbal information affects child representations

Investigating Trajectories of Social Recovery in Individuals with First Episode Psychosis:A Latent Class Growth Analysis

Background Social disability is a hallmark of severe mental illness yet individual differences and factors predicting outcome are largely unknown. Aim To explore trajectories and predictors of social recovery following a first episode of psychosis (FEP). Method A sample of 764 individuals with FEP were assessed on entry into early intervention in psychosis (EIP) services and followed up over 12 months. Social recovery profiles were examined using latent class growth analysis. Results Three types of social recovery profile were identified: Low Stable (66%), Moderate-Increasing (27%), and High-Decreasing (7%). Poor social recovery was predicted by male gender, ethnic minority status, younger age at onset of psychosis, increased negative symptoms, and poor premorbid adjustment. Conclusions Social disability is prevalent in FEP, although distinct recovery profiles are evident. Where social disability is present on entry into EIP services it can remain stable, highlighting a need for targeted intervention. Declaration of interest Non

Assessing social recovery of vulnerable youth in global mental health settings: a pilot study of clinical research tools in Malaysia

Background A social recovery approach to youth mental health focuses on increasing the time spent in valuable and meaningful structured activities, with a view to preventing enduring mental health problems and social disability. In Malaysia, access to mental health care is particularly limited and little research has focused on identifying young people at risk of serious socially disabling mental health problems such as psychosis. We provide preliminary evidence for the feasibility and acceptability of core social recovery assessment tools in a Malaysian context, comparing the experiential process of engaging young Malaysian participants in social recovery assessments with prior accounts from a UK sample. Methods Nine vulnerable young people from low-income backgrounds were recruited from a non-government social enterprise and partner organisations in Peninsular Malaysia. Participants completed a battery of social recovery assessment tools (including time use, unusual experiences, self-schematic beliefs and values). Time for completion and completion rates were used as indices of feasibility. Acceptability was examined using qualitative interviews in which participants were asked to reflect on the experience of completing the assessment tools. Following a deductive approach, the themes were examined for fit with previous UK qualitative accounts of social recovery assessments. Results Feasibility was indicated by relatively efficient completion time and high completion rates. Qualitative interviews highlighted the perceived benefits of social recovery assessments, such as providing psychoeducation, aiding in self-reflection and stimulating goal setting, in line with findings from UK youth samples. Conclusions We provide preliminary evidence for the feasibility and acceptability of social recovery assessment tools in a low-resource context, comparing the experiential process of engaging young Malaysian participants in social recovery assessments with prior accounts from a UK sample. We also suggest that respondents may derive some personal and psychoeducational benefits from participating in assessments (e.g. of their time use and mental health) within a social recovery framework

Views of young people in Malaysia on mental health, help-seeking and unusual psychological experiences

Aim Mental health problems are prevalent among young people in Malaysia yet access to specialist mental health care is extremely limited. More context‐specific research is needed to understand the factors affecting help‐seeking in youth, when mental health problems typically have first onset. We aimed to explore the attitudes of vulnerable young Malaysians regarding mental health problems including unusual psychological experiences, help‐seeking and mental health treatment. Methods In the present study, nine young people (aged 16–23 years) from low‐income backgrounds participated in a semi‐structured interview about their perspectives on mental health problems, unusual psychological experiences and help‐seeking. Results Four themes were developed using thematic analysis. “Is it that they [have] family problems?” reflected participants' explanatory models of mental health problems. “Maybe in Malaysia” was concerned with perceptions of Malaysian culture as both encouraging of open sharing of problems and experiences, but also potentially stigmatizing. “You have to ask for help” emphasized the importance of mental health help‐seeking despite potential stigma. “It depends on the person” addressed the challenges of engaging with psychological therapy. Conclusions We conclude that young people in Malaysia may hold compassionate, non‐stigmatizing views towards people experiencing mental health problems and a desire to increase their knowledge and understandings. Yet societal stigma is a perceived reputational risk that may affect mental health problem disclosure and help‐seeking. We suggest that efforts to improve mental health literacy would be valued by young Malaysians and could support reduced stigma and earlier help‐seeking

Persecutory delusions: Effects of cognitive bias modification for interpretation and the Maudsley Review Training Programme on social anxiety, jumping to conclusions, belief inflexibility and paranoia

Background and objectives: The Threat Anticipation Model (Freeman, 2007) implicates social anxiety, jumping to conclusions (JTC) and belief inflexibility in persecutory delusions. We investigated whether Cognitive Bias Modification for Interpretation (CBM-I; Turner et al., 2011) improves social anxiety by targeting negative interpretation bias of ambiguous social information. We determined whether the Maudsley Review Training Programme (MRTP; Waller et al., 2011) improves JTC, belief inflexibility and paranoia. We also explored effects of CBM-I on JTC/belief inflexibility and paranoia, as well as the MRTP on social anxiety. Methods: Twelve participants from Early Intervention and Recovery Services in East Anglia completed measures of social anxiety, paranoia, JTC and belief inflexibility. A concurrent multiple baseline case series design was used. Results: Three of twelve participants improved in social anxiety following CBM-I, paranoia improved in 6/12 cases. CBM-I had no effect on JTC/belief inflexibility. The MRTP improved JTC and/or belief inflexibility in 9/12 cases, while improving paranoia for 6/12 individuals. The MRTP improved social anxiety in one case. Limitations: The small sample size and large effects necessary for single case series designs limit the generality of findings. These are discussed in more detail. Conclusions: This study suggests that whilst both CBM-I and the MRTP may have a positive impact on paranoia and social anxiety, the effects on JTC/belief inflexibility are largely specific to the MRTP. Relationships between social anxiety, JTC, belief inflexibility and paranoia existed in 10/12 individuals, supporting the Threat Anticipation Model

Clinical Psychologists’ Experience of Cultivating Reflective Practice in Trainee Clinical Psychologists during Supervision: A Qualitative Study

Reflective practice is regarded as an essential competency to maintain high clinical standards by various professional bodies and is therefore emphasised within healthcare training programmes including Clinical Psychology. Clinical supervision is seen as the most common and useful way to encourage reflective practice in healthcare professionals but there is limited evidence on effective strategies for its development. Given this, this research aims to investigate the experience of clinical psychologist supervisors’ in developing reflective skills in trainee clinical psychologists. Six themes have been derived by using thematic analysis and the findings are discussed along with implications and future research directions

The effect of cues on young children's abilities to discriminate among thoughts, feelings and behaviours

Objective: To determine if cues help young children discriminate among thoughts, feelings and behaviours. Participants: Ninety-six children aged 4–7 years from three schools in Norwich, UK. Design: Within each age band (4, 5, 6, 7), children were randomised to the cue or the no cue condition on a stratified basis ensuring that equal numbers of boys and girls from each school were in each of the eight cells (cue condition×age). Cues were glove puppets and post boxes. The effect of IQ was controlled. Measures: A discrimination task, in which children were asked to identify a thought, a feeling and a behaviour from each of six brief stories, and a brief IQ assessment were administered to children individually. Results: There was a significant effect of age and cue condition on performance; older children and those who were presented with the cue performed better. There were no gender differences and no interaction between cue condition and age. Conclusion: Many young children discriminated among thoughts, feelings and behaviours suggesting that they may be able to engage in this aspect of cognitive behaviour therapy. Simple cues (puppets and posting boxes) improved children’s performance and these may be useful therapeutic tools with young children