"Technically well, but not really": carers' constructions of recovery from psychosis

Background: The recovery movement has become highly influential in research and services for people who experience psychosis. However the precise meaning of recovery from psychosis is contested, and there are concerns that the language of the recovery movement may be co-opted to serve other priorities. Aims: To investigate carers' constructions of the meaning of recovery from psychosis. Method: A qualitative study, using synthetic discursive psychology to analyse transcripts of semi-structured interviews with seven carers recruited from an Early Intervention in Psychosis service, where recovery approaches were practised. Results: We found medical accounts of recovery to be highly influential used both frequently and as a key reference point, even when describing alternative, non-medical accounts of recovery. Such alternative accounts of recovery in the data were fragementary and participants tended to use such accounts to signal some kind of trouble or disruption. Conclusions: Explanations of the objectives of recovery approaches cannot escape comparison with a medical repertoire of recovery. Such explanations may benefit from illustration using personal accounts of recovery that contain concrete detail. Creating conditions of safe uncertainty around the meaning of recovery may be an important aim for clinicians and services

"Technically well, but not really": carers' constructions of recovery from psychosis

Background: The recovery movement has become highly influential in research and services for people who experience psychosis. However the precise meaning of recovery from psychosis is contested, and there are concerns that the language of the recovery movement may be co-opted to serve other priorities. Aims: To investigate carers' constructions of the meaning of recovery from psychosis. Method: A qualitative study, using synthetic discursive psychology to analyse transcripts of semi-structured interviews with seven carers recruited from an Early Intervention in Psychosis service, where recovery approaches were practised. Results: We found medical accounts of recovery to be highly influential used both frequently and as a key reference point, even when describing alternative, non-medical accounts of recovery. Such alternative accounts of recovery in the data were fragementary and participants tended to use such accounts to signal some kind of trouble or disruption. Conclusions: Explanations of the objectives of recovery approaches cannot escape comparison with a medical repertoire of recovery. Such explanations may benefit from illustration using personal accounts of recovery that contain concrete detail. Creating conditions of safe uncertainty around the meaning of recovery may be an important aim for clinicians and services

"From the same mad planet": a grounded theory of service users' accounts of the relationship within professional peer support

Purpose: Peer support (PS)_workers are being employed despite uncertain evidence for clinical and cost-effectiveness. Psychological theories have been proposed to explain the mechanisms of PS but these lack empirical validation and specificity to professional PS. This was an exploratory study developing a substantive interpretive grounded theory of service-users' experience of professional PS work. Methodology: Constructivist grounded theory was used throughout. Semi-structured interviews were conducted with ten service-users who had engaged with a professional PS worker. Findings: Three overarching themes were constructed. 'The process of disclosure' describes how disclosure of mental health difficulties, experiences as a service-user and wider disclosure about life experiences, interests and values facilitate the development of a shared identity with the PS worker. 'The product of disclosure' highlights the sense of being understood as a result of the disclosure and marks a deepening of the relationship. 'Dual roles' describes the tenuous position of holding both a professional relationship and friendship. Research implications and limitations: Future research should seek to refine the theory developed and compare the effects of therapist self-disclosure with that found within PS. There were limitations within the study, including limited diversity within the sample as well as difficulties with recruitment. Originality/value: This study connects service users' accounts of receiving PS with existing psychological theory to move towards an understanding of the relationship between receivers and providers of professional PS

Mind over matter: testing the efficacy of an online randomized controlled trial to reduce distraction from smartphone use

Evidence suggests a growing call for the prevention of excessive smartphone and social media use and the ensuing distraction that arises affecting academic achievement and productivity. A ten-day online randomized controlled trial with the use of smartphone apps, engaging participants in mindfulness exercises, self-monitoring and mood tracking, was implemented amongst UK university students (n = 143). Participants were asked to complete online pre-and post-intervention assessments. Results indicated high effect sizes in reduction of smartphone distraction and improvement scores on a number of self-reported secondary psychological outcomes. The intervention was not effective in reducing habitual behaviours, nomophobia, or time spent on social media. Mediation analyses demonstrated that: (i) emotional self-awareness but not mindful attention mediated the relationship between intervention effects and smartphone distraction, and (ii) online vigilance mediated the relationship between smartphone distraction and problematic social media use. The present study provides preliminary evidence of the efficacy of an intervention for decreased smartphone distraction and highlights psychological processes involved in this emergent phenomenon in the smartphone literature. Online interventions may serve as complementary strategies to reduce distraction levels and promote insight into online engagement. More research is required to elucidate the mechanisms of digital distraction and assess its implications in problematic use

The role of family and personality traits in Internet gaming disorder: a mediation model combining cognitive and attachment perspectives

Background and aims: Gaming disorder was recently recognized as a mental health disorder by the World Health Organization and included in the International Classification of Diseases. Extensive research has been conducted with regard to psychosocial correlates and comorbidity, less so for the developmental mechanisms and the processes leading to the disorder. The association between family factors, personality traits, and gaming has been studied independently but not in combination. To fill this gap in knowledge, this study examined (a) the association between parental acceptance–rejection theory and Internet gaming disorder (IGD) and (b) the mediating and moderating effect of core self-evaluations (CSE), a personality construct, on the aforementioned variables. Methods: The study was quantitative and involved young adults members of online gaming communities (N = 225). Results: The results showed that parental rejection is associated with the occurrence of IGD, only through the mediating effect of CSE. The moderation model was not confirmed. Discussion: Findings bridge early emotional deficits with CSE personality traits and IGD, based on two widely acknowledged theoretical frameworks. In addition, they highlight the importance of the father’s role in upbringing. Conclusions: These frameworks combine cognitive and attachment perspectives and a process-oriented approach to the development and maintenance of IGD. The implications of these findings are discussed in relation to (a) the mechanisms leading to the disorder and (b) providing an evidence base for therapeutic interventions for IGD to go beyond abstinence and include self-esteem enhancement and efficacy contingencies. Directions for future research are also provided in this study

The role of recreational online activities in school-based screen time sedentary behaviour interventions for adolescents: a systematic and critical literature review

Sedentary behaviours are highly associated with obesity and other important health outcomes in adolescence. This paper reviews screen time and its role within school-based behavioural interventions targeting adolescents between the years 2007 and 2019. A systematic literature review following PRISMA guidelines was conducted across five major databases to identify interventions targeting screen time—in addition to TV/DVD viewing. The review identified a total of 30 papers analysing 15 studies across 16 countries aiming at addressing reduction of recreational screen time (internet use and gaming) in addition to television/DVD viewing. All of the interventions focused exclusively on behaviour change, targeting in the majority both reduction of sedentary behaviours along with strategies to increase physical activity levels. A mix of intervention effects were found in the reviewed studies. Findings suggest aiming only for reduction in time spent on screen-based behaviour within interventions could be a limited strategy in ameliorating excessive screen use, if not targeted, in parallel, with strategies to address other developmental, contextual and motivational factors that are key components in driving the occurrence and maintenance of adolescent online behaviours. Additionally, it raises the need for a differential treatment and assessment of each online activity within the interventions due to the heterogeneity of the construct of screen time. Recommendations for enhancing the effectiveness of school-based sedentary behaviour interventions and implications for public policy are discussed

A discursive psychology analysis of emotional support for men with colorectal cancer

Recent research into both masculinity and health, and the provision of social support for people with cancer has focussed upon the variations that may underlie broad assumptions about masculine health behaviour. The research reported here pursues this interest in variation by addressing the discursive properties of talk about emotional support, by men with colorectal cancer - an understudied group in the social support and cancer literature. Semi-structured interviews were conducted with eight men with colorectal cancer, and the transcripts analysed using an intensive discursive psychology approach. From this analysis two contrasting approaches to this group of men’s framing of emotional support in the context of cancer are described. First, talk about cancer was positioned as incompatible with preferred masculine identities. Second, social contact that affirms personal relationships was given value, subject to constraints arising from discourses concerning appropriate emotional expression. These results are discussed with reference to both the extant research literature on masculinity and health, and their clinical implications, particularly the advice on social support given to older male cancer patients, their families and friends

Policy recommendations for preventing problematic internet use in schools: a qualitative study of parental perspectives

Parenting in the digital age has been characterized as one of the most challenging tasks of the modern era. Parents are ambivalent about their mediating role. However, problematic aspects of adolescent online use have not been adequately addressed in education. The present study investigated parental perceptions of intervention needs within schools to prevent excessive/problematic use, enhance parent–child communication, and reduce family conflicts. Nine interviews with parents of adolescents residing in the UK were carried out and analyzed utilizing thematic analysis. Three main themes emerged as parental proposals: (i) schools as digital education providers and prevention hubs, (ii) provision of mental health literacy to raise awareness, resolve ambiguity regarding impacts and mitigate excessive use and impacts, and (iii) psychoeducation and upskilling. The third theme related to impacts from time spent on screens (time displacement), content-related impacts, and context-related impacts. The present study offers recommendations for media literacy during adolescence beyond e-safety (i.e., addressing interpersonal communication problems, privacy vs. disclosure issues), based on parents’ views, and provides new insights for media and emotional health literacy collaboration efforts. Future work should investigate the feasibility and effectiveness of such interventions to support the emotional health of young people and prevent problematic internet use escalation

A ‘control model’ of social media engagement in adolescence: a grounded theory analysis

Adolescents actively use social media, which engages them cognitively, emotionally, and behaviorally. However, the underlying psychological mechanisms of engagement have not been adequately addressed. The present study examined adolescents’ psychological processes as these develop in their everyday interactions via social media. The sample comprised six focus groups with 42 adolescents from UK-based schools. Data were analyzed using constructivist grounded theory. The resulting concepts related to individual, social, and structurally related processes, highlighting a synergy between the processes underlying use and a gradual reduction of control as individual, social, and structurally led processes emerge, conceptualized as the ‘control model’ of social media engagement. The findings highlight a controlling aspect in engagement and a dynamic interplay between the processes as mutually determining the quality and the intensity of the interaction. Recommendations are provided for examining control as a main emotional, cognitive, and behavioral mechanism in problematic and/or addictive social media and smartphone use