12 research outputs found
Emotion awareness and cognitive behavioural therapy in young people with autism spectrum disorder
Young people with autism spectrum disorder experience high levels of emotional problems, including anxiety and depression. Adapted cognitive behavioural therapy is recommended for such difficulties. However, no evidence suggests whether emotion awareness is important in treatment outcome for young people on the autism spectrum. This study aimed to investigate the potential differences in emotion awareness between (1) young people on the autism spectrum and typically developing youth and (2) young people on the autism spectrum with and without experience of cognitive behavioural therapy. Three groups (aged 11â20âyears) participated: (1) typically developing young people ( nâ=â56); (2) young people on the autism spectrum with no experience of cognitive behavioural therapy ( nâ=â23); and (3) young people on the autism spectrum who had attended cognitive behavioural therapy ( nâ=â33). All participants completed the Emotion Awareness Questionnaireâ30 item version. Young people on the autism spectrum differed significantly from typically developing young people on the emotional awareness measure. Young people on the autism spectrum who had attended cognitive behavioural therapy scored significantly lower on the Differentiating Emotions subscale, and significantly higher on the Attending to Othersâ Emotions subscale, compared to young people on the autism spectrum who had not attended cognitive behavioural therapy. This study highlights the importance of psycho-educational components of cognitive behavioural therapy when adapting for young people on the autism spectrum. </jats:p
Examining the emotional and psychological experiences of people with heart failure
Aims and objectives: The aims of this study were to understand the emotional and psychological experiences of patients with heart failure in a busy NHS service and make recommendations for how best to support this population. Background: People with heart failure often experience depression, anxiety and other emotional and psychological difficulties. Their quality of life is reduced. Qualitative studies attempting to understand this have reported conflicting findings. Design: A qualitative approach was taken, with some supporting quantitative data. Methods: Ten participants were asked to complete the PHQâ9 and GADâ7, and rate their level of concern about their mood, anxiety, quality of life and social functioning. They completed a semi-structured interview about their experience of living with heart failure and the emotional and psychological impact of this. The interview was analysed thematically. Results: Participants scored in the moderate range on both depression and anxiety measures. They were more concerned about their mood, anxiety, quality of life and social functioning now than before the onset of heart failure. The themes present in the interview data were: changes to self and others; emotional reactions; thoughts about death; expectations for the future; and hospital experiences. Conclusions: Some people with heart failure report moderate levels of depression and anxiety, and significant changes in their lives; they display varying emotional reactions to these. People have clear expectations for the future and impose limits on their life. Services can make changes to support this population. Suggestions for doing this are made. </jats:sec
Analysis of copy number variations at 15 schizophrenia-associated loci
Background: A number of copy number variants (CNVs) have been suggested as susceptibility factors for schizophrenia. For some of these the data remain equivocal, and the frequency in individuals with schizophrenia is uncertain. Aims: To determine the contribution of CNVs at 15 schizophrenia-associated loci (a) using a large new data-set of patients with schizophrenia (n = 6882) and controls (n = 6316), and (b) combining our results with those from previous studies. Method: We used Illumina microarrays to analyse our data. Analyses were restricted to 520 766 probes common to all arrays used in the different data-sets. Results: We found higher rates in participants with schizophrenia than in controls for 13 of the 15 previously implicated CNVs. Six were nominally significantly associated (P<0.05) in this new data-set: deletions at 1q21.1, NRXN1, 15q11.2 and 22q11.2 and duplications at 16p11.2 and the Angelman/Prader-Willi Syndrome (AS/PWS) region. All eight AS/PWS duplications in patients were of maternal origin. When combined with published data, 11 of the 15 loci showed highly significant evidence for association with schizophrenia (P<4.1Ă10â4). Conclusions: We strengthen the support for the majority of the previously implicated CNVs in schizophrenia. About 2.5% of patients with schizophrenia and 0.9% of controls carry a large, detectable CNV at one of these loci. Routine CNV screening may be clinically appropriate given the high rate of known deleterious mutations in the disorder and the comorbidity associated with these heritable mutations
The DECRYPT trial: Study protocol for a phase II randomised controlled trial of cognitive therapy for post-traumatic stress disorder (PTSD) in youth exposed to multiple traumatic stressors
Background: Post-traumatic stress disorder (PTSD) is a distressing and disabling condition that affects significant numbers of children and adolescents. Youth exposed to multiple traumas (eg, abuse, domestic violence) are at particular risk of developing PTSD. Cognitive therapy for PTSD (CT-PTSD), derived from adult work, is a theoretically informed, disorder-specific form of trauma-focused cognitiveâbehavioural therapy. While efficacious for child and adolescent single-event trauma samples, its effectiveness in routine settings with more complex, multiple trauma-exposed youth has not been established. The Delivery of Cognitive Therapy for Young People after Trauma randomised controlled trial (RCT) examines the effectiveness of CT-PTSD for treating PTSD following multiple trauma exposure in children and young people in comparison with treatment as usual (TAU). Methods/design: This protocol describes a two-arm, patient-level, single blind, superiority RCT comparing CT-PTSD (n=60) with TAU (n=60) in children and young people aged 8â17 years with a diagnosis of PTSD following multiple trauma exposure. The primary outcome is PTSD severity assessed using the Childrenâs Revised Impact of Event Scale (8-item version) at post-treatment (ie, approximately 5âmonths post-randomisation). Secondary outcomes include structured interview assessment for PTSD, complex PTSD symptoms, depression and anxiety, overall functioning and parent-rated mental health. Mid-treatment and 11-month and 29-month post-randomisation assessments will also be completed. Processâoutcome evaluation will consider which mechanisms underpin or moderate recovery. Qualitative interviews with the young people, their families and their therapists will be undertaken. Cost-effectiveness of CT-PTSD relative to TAU will be also be assessed. Ethics and dissemination: This trial protocol has been approved by a UK Health Research Authority Research Ethics Committee (East of EnglandâCambridge South, 16/EE/0233). Findings will be disseminated broadly via peer-reviewed empirical journal articles, conference presentations and clinical workshops. Trial registration: ISRCTN12077707. Registered 24 October 2016 (http://www.isrctn.com/ISRCTN12077707). Trial recruitment commenced on 1 February 2017. It is anticipated that recruitment will continue until June 2021, with 11-month assessments being concluded in May 2022
Socialization to the model in adolescent cognitive behavioural therapy:measurement and insights
Socializing a client to the cognitive behavioural model is advised in almost every cognitive behavioural therapy (CBT) textbook, but there is limited evidence for whether socialization is measurable or important. The aim of the study was to pilot a written and interview-based measure of socialization to investigate whether socialization to the model can be measured in a sample of young people who have completed CBT. Sixteen participants (mean age 14.9 years, 75% female) completed a semi-structured socialization interview and a novel written measure of socialization. Treating clinicians were asked to provide subjective ratings of participant socialization. The structure and content of these measures was examined. A moderate but nonsignificant correlation was found between the novel written measure of socialization and clinician rating of socialization (r = .37). The concept of âsocializationâ is not well understood and the socialization interview presented mixed, unclear results. This may be due to issues with the design, but may also be that socialization, as currently understood, is more complex than can be captured in this way. The important aspect of this study is introducing the concept of measuring socialization and factors that may be important in future research. Socialization to the model is an important construct within CBT but at present is a challenging concept to measure. Future research will need to focus on operationalizing the concept further and refining measures so that it can be accurately captured. Understanding which therapist and client behaviours contribute to the process of socialization could conceivably improve outcomes, but this cannot be done until this area is understood more fully
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Characteristics of complex posttraumatic stress disorder ( PTSD ) in young people with PTSD following multiple trauma exposure
Publication status: PublishedBackground: Complex PTSD (CPTSD) is a relatively new diagnosis. The objective of the present study was to investigate how trauma characteristics, comorbid psychopathology and cognitive and social factors experienced by children and adolescents with a posttraumatic stress disorder (PTSD) diagnosis following exposure to multiple traumatic events differs between those who meet the criteria for CPTSD and those who do not. Method: The present research used baseline data from the DECRYPT trial (BMJ Open, 2021, 11, e047600). Participants (n = 120) were aged 8â17 years and had exposure to multiple traumas and a PTSD diagnosis. The data collected comprised selfâreport and parent/caregiverâreport questionnaires and interviews. Three primary analyses were conducted, comparing number of trauma types, prevalence of sexual trauma and prevalence of intrafamilial abuse between the CPTSD and PTSDâonly groups. A range of comorbid psychopathology and cognitive and social factors were compared between the groups in an exploratory secondary analysis. All analyses were preregistered. Results: The CPTSD group (n = 72, 60%) had a significantly higher frequency of sexual trauma than the PTSDâonly group (n = 48, 40%). The groups did not significantly differ on number of trauma types or prevalence of intrafamilial abuse. From the secondary analysis, the CPTSD group were found to have significantly higher scores on measures of negative postâtraumatic cognitions, depression and panic. These results were replicated in correlation analyses using a continuous measure of CPTSD symptoms. Conclusions: A large proportion of youth exposed to multiple traumatic events met criteria for CPTSD. Sexual trauma appears to be related to CPTSD symptoms. Youth with CPTSD appear to have greater severity of comorbid depression and panic symptoms, as well as more negative postâtraumatic cognitions. Further investigation could focus on the directionality and mechanisms for these associations