614 research outputs found
Exploring compassion: a meta-analysis of the association between self-compassion and psychopathology
Compassion has emerged as an important construct in studies of mental health and psychological therapy. Although an increasing number of studies have explored relationships between compassion and different facets of psychopathology there has as yet been no systematic review or synthesis of the empirical literature. We conducted a systematic search of the literature on compassion and mental health. We identified 20 samples from 14 eligible studies. All studies used the Neff Self Compassion Scale (Neff 2003, a). We employed meta-analysis to explore associations between self-compassion and psychopathology using random effects analyses of Fisher's Z correcting for attenuation arising from scale reliability. We found a large effect size for the relationship between compassion and psychopathology of r= -0.54 (95%CI = -0.57 to -0.51; Z=-34.02; p<.0001). Heterogeneity was significant in the analysis. There was no evidence of significant publication bias. Compassion is an important explanatory variable in understanding mental health and resilience. Future work is needed to develop the evidence base for compassion in psychopathology, and explore correlates of compassion and psychopathology
Sleep quality and paranoia: the role of alexithymia, negative emotions and perceptual anomalies
Recent evidence suggests that sleep problems are associated with psychotic like experiences including paranoia. However, the mechanisms underpinning this association are not well understood and thus studies modelling hypothesised mediating factors are required. Alexithymia, the inability to recognise and describe emotions within the self may be an important candidate. In two separate studies we sought to investigate factors mediating the relationship between sleep quality and paranoia using a cross-sectional design. Healthy volunteers without a mental health diagnosis were recruited (study 1, N= 401, study 2, N= 402). Participants completed a series of measures assessing paranoia, negative emotions, alexithymia and perceptual anomalies in an online survey. In study 1, regression and mediation analyses showed that the relationship between sleep quality and paranoia was partially mediated by alexithymia, perceptual anomalies and negative affect. In contrast, study 2 found that the relationship between sleep quality and paranoia was fully mediated by negative affect, alexithymia and perceptual anomalies. The link between sleep quality and paranoia is unclear and reasons for discrepant results are discussed. Novel findings in this study include the link between alexithymia and paranoia
Psychological aspects of relapse in schizophrenia
Following a review of the relevant literature a Cognitive Behavioural
treatment protocol for the prevention of relapse in schizophrenia is presented.
This treatment protocol is investigated in a 12-month non-blind randomised
controlled trial comparing Cognitive Behavioural Therapy and Treatment as
Usual (CBT + TAU) versus Treatment as Usual (TAU) alone. Three studies of
treatment outcome are described: relapse and admission, remission and social
functioning, and psychological distress. 144 participants with a DSM-IV
Schizophrenia spectrum disorder were randomised to receive either CBT +
TAU (n = 72) or TAU alone (n = 72). 11 participants dropped out (6 from
CBT + TAU, 5 from TAU alone) leaving a completers sample of 133.
Participants were assessed at entry, 12-weeks, 26-weeks, and 52 weeks. CBT
was delivered over two stages: a 5-session engagement phase which was
provided between entry and 12-weeks, and a targeted CBT phase which was
delivered on the appearance of early signs of relapse. Over 12-months CBT +
TAU was associated with significant reductions in relapse and admission rate.
The clinical significance of the reduced relapse and admission rate amongst
the CBT + TAU group was investigated. First, receipt of CBT + TAU was
associated with improved rates of remission over 12-months. Second,
clinically significant improvements in social functioning were investigated.
Again, receipt of CBT + TAU was associated with clinically significant
improvements in prosocial activities. However, receipt of CBT + TAU was
not associated with improvements in psychological distress over 12-months.
The theory underpinning the cognitive behavioural treatment protocol
predicted that negative appraisals of self and psychosis represent a cognitive
vulnerability to relapse. This hypothesis was investigated during the present
2
Abstract
study. After controlling for clinical, treatment and demographic variables,
negative appraisals of self and entrapment in psychosis were associated with
increased vulnerability to relapse, whilst negative appraisals of self were
associated with reduced duration to relapse. Finally, an explorative study of
changes in negative appraisals of psychosis and self over time, which were
associated with relapsers versus non-relapsers from the TAU alone group, was
conducted. This study found a strong association between the experience of
relapse, increasing negative appraisals of psychosis and self, and the
development of psychological co-morbidity in schizophrenia. Results of
treatment outcome and theoretical analyses are discussed in terms of their
relevance to the further development of psychological models and treatments
for psychosis
Clinician perceptions of sleep problems, and their treatment, in patients with non-affective psychosis
Aims and method: To assess clinicians’ views about their understanding and treatment of sleep problems in people with non-affective psychosis. An online survey was emailed to adult mental health teams in two NHS trusts.
Results: One hundred and eleven clinicians completed the survey. All clinicians reported disrupted sleep in their patients, and endorsed the view that sleep and psychotic experiences each exacerbate the other. However, most clinicians (n = 92, 82%) assessed sleep problems informally, rather than using standard assessment measures. There was infrequent use of the recommended cognitive-behavioural treatments for sleep problems such as persistent insomnia, with the approaches typically used being sleep hygiene and medications instead.
Clinical implications: Clinicians recognise the importance of sleep in psychosis, but the use of formal assessments and recommended treatments is limited. Barriers to treatment implementation identified by the clinicians related to services (e.g. lack of time), patients (e.g. their lifestyle) and environmental features of inpatient settings
“It’s like a charge – either fuses you or burns you out”: an interpretative phenomenological analysis of extreme mental states in meditation context
Meditation, an ancient Eastern spiritual practice, is increasingly being practised in the West where its benefits for mental and physical health have been established. Extreme mental states that can be encountered in the context of meditation have also been reported and often have been labelled as psychosis or spiritual emergency. This study aimed for more nuanced understanding of the phenomena. Interpretative phenomenological analysis was employed to explore the meaning-making of three meditation teachers from different philosophical traditions. The teachers described phenomenology of various extreme mental states, explained their nature according to their traditions and discussed ways of helping persons who experience these. Significance was given to having a spiritual teacher to provide guidance and support. The study highlights the importance of acknowledging the diverse understandings of the phenomena and cultivating a non-judgemental attitude towards it, which could help clinicians and meditation teachers work together to support persons experiencing these
Psychosis or spiritual emergency? A Foucauldian discourse analysis of case reports of extreme mental states in the context of meditation
Meditation is becoming increasingly popular in the West and research on its effects is growing. While studies point to various benefits of meditation on mental and physical health, reports of extreme mental states in the context of meditation have also been published. This study employed Foucauldian discourse analysis to examine how the experience of extreme mental states has been constructed in case reports and what kind of practices were employed to address them. The study analyses how extreme mental states associated with meditation are framed within the scientific literature and how such differential framings may affect the meaning making and help-seeking of persons experiencing these states. A systematic scientific literature search identified 22 case studies of extreme mental states experienced by practitioners of various types of meditation. The analysis suggests a discursive divide between two dominant framings: a biomedical discourse which constructs such experiences as psychiatric symptoms and an alternative discursive, which understands them as spiritual emergencies. Both approaches offered distinct therapeutic avenues. This divide maps onto the disciplinary divides within the mental health field more generally, which may obscure a better understanding of these experiences. However, the two discourses are not necessarily mutually exclusive and authors of three articles chose to blend them for their case reports. A supportive environment could help those experiencing extreme state integrate them into their lives. Our findings encourage collaboration between clinicians, therapists and spiritual teachers in order to make a range of approaches available
Tertiary specific disease of the lung: an analysis of cases having special reference to clinical characteristics
Forty-six cases of tertiary syphilitic disease of
the lung are analysed from the clinical view- point:
the clinical features of the individual cases have
been separated piecemeal, grouped together, examined,
and, where possible, have been correlated with pathological fact. If the method has successfully
elucidated the clinical characteristics of a little
known condition, the purpose of this thesis has been
achieved,and, with the hope that springs eternal, it
is now concluded
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