Childhood Trauma in Clozapine-Resistant Schizophrenia : Prevalence, and Relationship With Symptoms

Background and Hypothesis: The role of early adversity and trauma is increasingly recognized in psychosis but treatments for trauma and its consequences are lacking. Psychological treatments need to understand the prevalence of these experiences, the relationship with specific symptoms and identify potentially tractable processes that may be targeted in therapy. It was hypothesized that greater adversity, and specifically abuse rather than neglect, would be associated with positive symptoms and specifically hallucinations. In addition, negative beliefs would mediate the relationship with positive symptoms. Study Design: 292 Patients with treatment resistant psychosis completed measures of early adversity as well as current symptoms of psychosis. Study Results: Early adversity in the form of abuse and neglect were common in one-third of the sample. Adversity was associated with higher levels of psychotic symptoms generally, and more so with positive rather than negative symptoms. Abuse rather than neglect was associated with positive but not with negative symptoms. Abuse rather than neglect was associated with hallucinations but not delusions. Abuse and neglect were related to negative beliefs about the self and negative beliefs about others. Mediation demonstrated a general relationship with adversity, negative-self, and other views and overall psychotic symptoms but not in relation to the specific experience of abuse and hallucinations. Females were more likely to be abused, but not neglected, than males. Conclusions: Whilst most relationships were modest, they supported previous work indicating that adversity contributes to people with psychosis experiencing distressing symptoms especially hallucinations. Treatments need to address and target adversity

The impact of posting selfies and gaining feedback (‘likes’) on the psychological wellbeing of 16-25 year olds

Social media, and particularly posting ‘selfies’ have become fully incorporated into young people’s lives. Research indicates that posting selfies may impact upon self esteem and that feedback in the form of ‘likes’ may change how young people feel about themselves. To date, however, most research has been cross sectional or qualitative limiting conclusions about causality. Further, it has taken place in non naturalistic environments, with no longer term follow up and limited outcome variables. This experimental study explored the impact of posting selfies and receiving feedback (‘likes’) on Instagram on broader aspects of the psychological well-being of young people. Participants (n = 59) aged 16-25 were randomly allocated to one of three conditions for a 7-day intervention (no selfie-posting; posting selfies without feedback; posting selfies with feedback) and completed measures at baseline, after the intervention and at one week follow up. ‘Likes’ were delivered through an app. The intervention had no impact on self-esteem or mood. Posting no selfies resulted in a greater improvement in appearance satisfaction over the study compared to posting selfies (regardless of feedback). In contrast, posting selfies with feedback resulted in a greater improvement in face satisfaction during the intervention although this dropped back to baseline by follow up. To conclude the impact of selfies may vary depending upon which outcome variable is measured and when

The impact of posting selfies and gaining feedback (‘likes’) on the psychological wellbeing of 16-25 year olds: An experimental study

Social media, and particularly posting ‘selfies’ have become fully incorporated into young people’s lives. Research indicates that posting selfies may impact upon self esteem and that feedback in the form of ‘likes’ may change how young people feel about themselves. To date, however, most research has been cross sectional or qualitative limiting conclusions about causality. Further, it has taken place in non naturalistic environments, with no longer term follow up and limited outcome variables. This experimental study explored the impact of posting selfies and receiving feedback (‘likes’) on Instagram on broader aspects of the psychological well-being of young people. Participants (n = 59) aged 16-25 were randomly allocated to one of three conditions for a 7-day intervention (no selfie-posting; posting selfies without feedback; posting selfies with feedback) and completed measures at baseline, after the intervention and at one week follow up. ‘Likes’ were delivered through an app. The intervention had no impact on self-esteem or mood. Posting no selfies resulted in a greater improvement in appearance satisfaction over the study compared to posting selfies (regardless of feedback). In contrast, posting selfies with feedback resulted in a greater improvement in face satisfaction during the intervention although this dropped back to baseline by follow up. To conclude the impact of selfies may vary depending upon which outcome variable is measured and when

Peripherally Inserted Central catheter iNnovation to reduce Infections and Clots (the PICNIC trial): a randomised controlled trial protocol

Introduction Peripherally inserted central catheters (PICCs) are vital for the delivery of medical therapies, but up to 30% of PICCs are associated with complications such as deep vein thrombosis or infection. The integration of antimicrobial and hydrophobic catheter materials, and pressure-activated valves, into polyurethane PICCs are innovations designed to prevent infective and/or thrombotic complications.Methods and analysis A multicentre, parallel group, superiority randomised controlled trial with two experimental arms ((1) hydrophobic PICC (with pressure-activated valve); (2) chlorhexidine gluconate-impregnated PICC (with external clamp)) and one control group ((3) conventional polyurethane PICC (with external clamp)). Recruitment of 1098 adult and paediatric patients will take place over 2 years at three tertiary-referral hospitals in Queensland, Australia. Patients are eligible for inclusion if their PICC is to be inserted for medical treatment, with a vascular size sufficient to support a 4-Fr PICC or larger, and with informed consent. The primary outcome is PICC failure, a composite of thrombotic (venous thrombosis, breakage and occlusion) and infective complications (PICC-associated bloodstream infection and local infection). Secondary outcomes include: all-cause PICC complication; thrombotic complications; infective complications; adverse events (local or systemic reaction); PICC dwell time; patient/parent satisfaction; and healthcare costs. Differences between both intervention groups and the control group will be compared using Cox proportional hazards regression. Effect estimates will be presented as HRs with corresponding 95% CI.Ethics and dissemination Ethical approval from Queensland Health (HREC/QCHQ/48682) and Griffith University (Ref. No. 2019/094). Results will be published.Trial registration number ACTRN12619000022167