Social Adversity in the Etiology of Psychosis: A Review of the Evidence

Despite increasing evidence for the role of psychosocial factors in the onset and continuance of psychosis, the experiences involved are still largely considered the result of a biogenetic anomaly for which medication is the first-line treatment response. This review summarizes the extensive literature demonstrating that adverse events involving trauma, loss, stress, and disempowerment have a central etiological role in psychosis. Evidence is further presented to show that many neurological changes traditionally considered indicative of a disease process can in fact be accounted for as secondary effects to the physiology of stress or the residual of long-term neuroleptic prescription. Particular emphasis is given to the traumagenic neurodevelopmental model of psychosis, which illustrates how many of the structural and functional cerebral anomalies observed in adult patients with psychosis (including dopamine dysregulation, atrophy, hippocampal damage, and overactivity of the hypothalamic–adrenal–pituitary axis) closely correspond to those in the brains of abused children. Finally, research is discussed that demonstrates how trauma may manifest in characteristic symptoms of psychosis, particularly hallucinations and delusions. It is suggested that if social adversities are of central importance in psychosis, then psychotherapy that addresses the long term sequelae of those adversities should be considered an essential aspect of treatment

Psychological type profile and work-related psychological health of clergy serving in the Diocese of Chester

This study examines the psychological type profile and work-related psychological health of ninety-nine clergy serving the Diocese of Chester alongside normative data for the Church of England published in previous studies. The data demonstrated that these clergy share the general psychological type profile of Church of England clergy, with preferences for introversion (60%), intuition (55%), feeling (57%), and judging (76%). Compared with the normative data they show slightly better work related psychological health, with lower levels of emotional exhaustion in ministry and higher levels of satisfaction in ministry. The relevance of such profiling is discussed for the wider Church

Linking clergy psychological type profile and church growth in the Diocese of Chester : a pilot study

Two recent studies (one in England and one in Australia) have linked church growth and church decline with the psychological type profile of church leaders. The present study, conducted within the Diocese of Chester, compares the psychological type profile of two groups of clergy who had served in the same parishes for five years or more: 29 leading declining churches and 19 leading growing churches. The data found a significantly higher preference for perceiving among those leading growing churches, although there were no significant differences in terms of the orientations, the perceiving process, or the judging process

Assessing and Reporting the Adverse Effects of Antipsychotic Medication: A Systematic Review of Clinical Studies, and Prospective, Retrospective, and Cross-Sectional Research

Objective: Adverse effects (AEs) of antipsychotic medication have important implications for patients and prescribers in terms of wellbeing, treatment adherence and quality of life. This review summarises strategies for collecting and reporting AE data across a representative literature sample to ascertain their rigour and comprehensiveness. Methods: A PsycINFO search, following PRISMA Statement guidelines, was conducted in English-language journals (1980–July 2014) using the following search string: (antipsychotic* OR neuroleptic*) AND (subjective effect OR subjective experience OR subjective response OR subjective mental alterations OR subjective tolerability OR subjective wellbeing OR patient perspective OR self-rated effects OR adverse effects OR side-effects). Of 7,825 articles, 384 were retained that reported quantified results for AEs of typical or atypical antipsychotics amongst transdiagnostic adult, adolescent, and child populations. Information extracted included: types of AEs reported; how AEs were assessed; assessment duration; assessment of the global impact of antipsychotic consumption on wellbeing; and conflict of interest due to industry sponsorship. Results: Neurological, metabolic, and sedation-related cognitive effects were reported most systematically relative to affective, anticholinergic, autonomic, cutaneous, hormonal, miscellaneous, and non-sedative cognitive effects. The impact of AEs on patient wellbeing was poorly assessed. Cross-sectional and prospective research designs yielded more comprehensive data about AE severity and prevalence than clinical or observational retrospective studies. 3 Conclusions: AE detection and classification can be improved through the use of standardised assessment instruments and consideration of subjective patient impact. Observational research can supplement information from clinical trials to improve the ecological validity of AE data

On-Line Analysis of Electron Back Scatter Diffraction Patterns. I. Texture Analysis of Zone Refined Polysilicon

A technique has been developed for determining crystal orientations on-line from bulk polycrystalline materials using wide angle back scatter electron diffraction patterns. The patterns were imaged on a phosphor screen and viewed using a low light level television camera. A computer generated cursor superimposed on the diffraction pattern, permitted the coordinates of zone axes to be determined. These were interpreted by the computer to yield the crystal orientation. The accuracy of the technique for absolute orientation was shown to be of the order 1° and the precision for relative orientation better than 0.5°. The technique was used to investigate texture and nearest neighbour orientation relationships in polysilicon, recrystallised using a graphite strip heater technique. It was shown that the orientations become less random as the recrystallisation front proceeded along the specimen

The driving mechanisms of particle precipitation during the moderate geomagnetic storm of 7 January 2005

International audienceThe arrival of an interplanetary coronal mass ejection (ICME) triggered a sudden storm commencement (SSC) at ~09:22 UT on the 7 January 2005. The ICME followed a quiet period in the solar wind and interplanetary magnetic field (IMF). We present global scale observations of energetic electron precipitation during the moderate geomagnetic storm driven by the ICME. Energetic electron precipitation is inferred from increases in cosmic noise absorption (CNA) recorded by stations in the Global Riometer Array (GLORIA). No evidence of CNA was observed during the first four hours of passage of the ICME or following the sudden commencement (SC) of the storm. This is consistent with the findings of Osepian and Kirkwood (2004) that SCs will only trigger precipitation during periods of geomagnetic activity or when the magnetic perturbation in the magnetosphere is substantial. CNA was only observed following enhanced coupling between the IMF and the magnetosphere, resulting from southward oriented IMF. Precipitation was observed due to substorm activity, as a result of the initial injection and particles drifting from the injection region. During the recovery phase of the storm, when substorm activity diminished, precipitation due to density driven increases in the solar wind dynamic pressure (Pdyn) were identified. A number of increases in Pdyn were shown to drive sudden impulses (SIs) in the geomagnetic field. While many of these SIs appear coincident with CNA, SIs without CNA were also observed. During this period, the threshold of geomagnetic activity required for SC driven precipitation was exceeded. This implies that solar wind density driven SIs occurring during storm recovery can drive a different response in particle precipitation to typical SCs

Dissociation, victimisation, and their associations with voice hearing in young adults experiencing first-episode psychosis

Background: It has been proposed that voice hearing, even in the context of psychosis, is associated with high levels of dissociation - especially amongst individuals with a history of childhood abuse. This thesis studies these relationships using more rigorous research methods than have been applied in much existing observational work, and contributes original evidence for understanding the incidence of, and associations between, voice hearing, dissociation, and life adversity (particularly childhood sexual abuse: CSA) in a first-episode psychosis sample. Study 1 and 2: Evaluates current knowledge on associations between (1) voice hearing and dissociation, and (2) voice hearing and CSA using systematic, critical literature review. Both studies found strong associations between key variables, although methodological limitations in the literature preclude assumptions of causal relationships. Study 3: Employs self-report measures and a retrospective case-control design to assess voice hearing, dissociation, psychological distress, and adversity exposure within a pseudo-random sample of voice hearers (n=31) and non-voice hearing controls (n=31). CSA and dissociation were significantly higher amongst case participants. Dissociation retained a significant association with voice hearing when controlling for pre-illness adversity exposures and psychological distress. Study 4: Employs self-report measures and a cross-sectional between-groups design to assess dissociation, distress, and voice phenomenology within a pseudo-random sample of voice hearers with (n=23) and without (n=23) self-reported CSA exposure. CSA severity was associated with higher dissociation. Both groups reported similar voice characteristics, although CSA survivors perceived voices as more omnipotent. Emotional responses to voices showed strongest associations with psychological distress when controlling for dissociation and adversity exposure. Summary: Considerable heterogeneity was apparent for all measures between and within groups of voice hearers and non-voice hearers, and voice hearers with and without CSA exposure. Associations between voice hearing and dissociation remain significant when controlling for adversity exposure and the type of stress, anxiety, and depression that occurs in the more general context of psychosis. However, while dissociation increases the likelihood of voice hearing per se, psychological distress has stronger associations for experiencing voices as negative. The datasets are interpreted within the context of wider clinical/conceptual debates around the role of dissociation, distress, and adverse life events in psychosis, and are used to generate recommendations for both therapeutic intervention and future research

Improving community mental health services: The need for a paradigm shift

Background: It is now over half a century since community care was introduced in the wake of the closure of the old asylum system. This paper considers whether mental health services,regardless of location,can be genuinely effective and humane without a fundamental paradigm shift. Data: A summary of research on the validity and effectiveness of current mental health treatment approaches is presented. Limitations: The scope of the topic was too broad to facilitate a systematic review or meta-analyses,although reviews with more narrow foci are cited. Conclusions: The move to community care failed to facilitate a more psychosocial,recovery-focused approach,instead exporting the medical model and its technologies,often accompanied by coercion,into a far broader domain than the hospital. There are,however,some encouraging signs that the long overdue paradigm shift may be getting closer

Multiplicity in the experience of voice-hearing: A phenomenological inquiry

Although it is recognized that voice-hearers often report a large number and variety of voices there have been few investigations of this multiplicity. Understanding the phenomenology of voice-hearing can provide a firm foundation for theorizing about its causes. In this international online survey of voice-hearers, details were elicited of the content of up to five utterances associated with up to five voices from each respondent. The contents were independently rated and associated with characteristics of each voice such as its perceived age, whether it had changed over time, and whether it was of a familiar person. We investigated predictors (e.g., diagnoses, voice gender, age first heard) of utterance negativity, length, and whether voices referred to themselves. The average number of voices reported was approximately four. The majority were perceived as male and had negative content. Child-aged voices were significantly less negative than all other voices except those perceived as being elderly. Multi-level analyses indicated that there was significant variability at the level of different utterances within voices but variability was more prominent at the level of different voices within an individual. The data were inconsistent with general cognitive models for hearing voices such as the misattribution of inner speech and were more congruent with a dissociation model of voice-hearing. Our findings support approaches based on subtype or dimensional methods of classifying voices, and additionally indicate that research and clinical assessment may benefit from more systematic assessment of multiplicity