Hearing impairment and psychosis revisited.

The previously reported but still poorly investigated link between deafness or hearing impairment (DHI) and the onset of positive psychotic experiences was investigated prospectively in a general population sample. Of the 109 DHI subjects at baseline, 11 (10.1%) displayed psychotic experiences at T(2) versus 137 (2.

Coping with depression and vulnerability to mania: a factor analytic study of the Nolen-Hoeksema (1991) Response Styles Questionnaire.

Objectives: To assess the factor structure of the Nolen-Hoeksema (1991) Response Styles Questionnaire (RSQ), and to investigate the relationship between coping with depression and other measures of affective symptomatology in a student sample.

Design: A factor analytic study of the RSQ followed by an investigation of the relationship between RSQ scale scores and measures of affective symptomatology.

Method: Five hundred twenty-eight undergraduate students completed a battery of questionnaires comprising the RSQ, Beck Depression Inventory, Hypomania Personality Questionnaire, Positive and Negative Affect Scale and the Dysfunctional Attitudes Scale.

Perceived relationships with parents and paranoid delusions: comparisons of currently ill, remitted and normal participants.

Background: Paranoid delusions are associated with abnormal attributions and abnormal beliefs about the self. Some researchers have also reported an association between paranoid beliefs and abnormal attachment representations.

Sampling And Methods: Perceptions of relationships with the family of origin were measured in 14 currently ill paranoid patients, 9 remitted paranoid patients and 15 healthy controls, using two methods: the Parental Bonding Instrument (PBI), and the Relationship with Family of Origin Scale (REFAMOS), an interview-based assessment.

Delusional discourse: an investigation comparing the spontaneous causal attributions of paranoid and non-paranoid individuals.

Research into the nature of attributional reasoning in paranoia has for the most part been restricted to questionnaire-based approaches. This fails to address the issue of whether a distinctive attributional style underpins the everyday talk of paranoid individuals. This study aimed to investigate whether attributional models of paranoid delusions applied to spontaneous attributions generated in the discourse of 12 paranoid and 12 non-paranoid speakers.

The effects of emotional salience on thought disorder in patients with bipolar affective disorder.

Background: This study aimed to explore the effects of emotionally salient material on thought disorder in patients with bipolar affective disorder.

Method: Seventy-one participants (20 manic, 15 depressed, 16 currently well patients and 20 non-psychiatric-controls) were interviewed in two conditions: an emotionally salient interview and a non-salient interview. Speech samples were rated using the Scale for the Assessment of Thought, Language and Communication.

Cognitive therapy for the prevention of psychosis in people at ultra-high risk: randomised controlled trial.

Background: Advances in the ability to identify people at high risk of developing psychosis have generated interest in the possibility of preventing psychosis.

Aims: To evaluate the efficacy of cognitive therapy for the prevention of transition to psychosis.

Method: A randomised controlled trial compared cognitive therapy with treatment as usual in 58 patients at ultra-high risk of developing a first episode of psychosis.

Persecutory beliefs, attributions and theory of mind: comparison of patients with paranoid delusions, Asperger's syndrome and healthy controls.

Schizophrenia patients with persecutory delusions and patients with Asperger's syndrome were compared using two measures of theory of mind (ToM; the ability to infer mental states in other people), the Hints task, and the Reading the Mind in the Eyes task, and a new measure of attributional style (style of inferring the causes of important events), the Attributional Style Structured Interview (ASSI). Paranoid beliefs were measured using Fenigstien and Vanable's Paranoia Scale (PS). The deluded group had the highest scores on the Paranoia Scale but the scores of the Asperger's group's were higher than those of the controls.

The cerebellum and decision making under uncertainty.

This study aimed to identify the neural basis of probabilistic reasoning, a type of inductive inference that aids decision making under conditions of uncertainty. Eight normal subjects performed two separate two-alternative-choice tasks (the balls in a bottle and personality survey tasks) while undergoing functional magnetic resonance imaging (fMRI). The experimental conditions within each task were chosen so that they differed only in their requirement to make a decision under conditions of uncertainty (probabilistic reasoning and frequency determination required) or under conditions of certainty (frequency determination required).

Persecutory delusions and the determination of self-relevance: an fMRI investigation.

Background: People with persecutory delusions regard ambiguous data in the social domain as self-relevant and selectively attend to threatening information. This study aimed to characterize these social cognitive biases in functional neuroanatomical terms.

Method: Eight schizophrenic patients with active persecutory delusions and eight matched normal controls underwent functional magnetic resonance imaging while determining the self-relevance of ambiguous self-relevant or unambiguous other-relevant neutral and threatening statements.

Cognitive-behavioural therapy in first-episode and early schizophrenia. 18-month follow-up of a randomised controlled trial.

Background: The initial phase of a trial of cognitive-behavioural therapy (CBT) for acutely ill patients with schizophrenia of recent onset showed that it speeded recovery.

Aims: To test the hypothesis that CBT in addition to treatment as usual (TAU) during the first or second acute episode of schizophrenia will confer clinical benefit over a follow-up period.

Method: This was an 18-month follow-up of a multicentre prospective trial of CBT or supportive counselling administered as an adjunct to TAU, compared with TAU alone, for patients hospitalised for an acute episode of schizophrenia of recent onset.

The evolution of insight, paranoia and depression during early schizophrenia.

Background: How insight, paranoia and depression evolve in relation to each other during and after the first episode of schizophrenia is poorly understood but of clinical importance.

Method: Serial assessments over 18 months were made using multiple instruments in a consecutive sample of 257 patients with first episode DSM-IV non-affective psychosis. Repeated measures of paranoia, insight, depression and self-esteem were analysed using structural equation modelling, to examine the direction of relationships over time after controlling for confounds.

Patient education to encourage graded exercise in chronic fatigue syndrome. 2-year follow-up of randomised controlled trial.

Background: An earlier trial demonstrated good outcomes after 1 year for patients with chronic fatigue syndrome (CFS) who received an educational intervention designed to encourage graded activity.

Aims: To determine 2-year outcomes for the same treated patients and the response to treatment of patients formerly in the control condition.

Method: Patients in the treatment groups (n=114) were followed up at 2 years; 32 patients from the control group were offered the intervention after 1 year and were assessed 1 year later.

Patients' understanding and participation in a trial designed to improve the management of anti-psychotic medication: a qualitative study.

Background: Combining qualitative methods alongside randomised controlled trials in the health field has been advocated but has only been used rarely in mental health services research. The aim of this study was to illuminate patients' understanding of the nature and purpose and outcomes of a trial designed to improve the management of neuroleptic medication.

Methods: Qualitative interviews were carried out with a group of patients participating in a trial comparing a psycho-educational and therapeutic alliance intervention in managing anti-psychotic medication.

Self-responsibility and the self-serving bias: an fMRI investigation of causal attributions.

We use causal attributions to infer the most likely cause of events in the social world. Internal attributions imply self-responsibility for events. The self-serving bias describes the tendency of normal subjects to attribute the causation of positive events internally ("I am responsible em leader ") and negative events externally ("Other people or situational factors are responsible em leader ").

Guilty as charged: A response to Anthony S. David.

Reading a review of one's own work can be a very unsettling experience. It is not just that the limitations of one's efforts are publicly highlighted. In this case it was also the discovery that the book that I thought I had written is not quite the same as the book that the reviewer appears to have read.

The best laid schemas of paranoid patients: autonomy, sociotropy and need for closure.

Some theories implicate abnormal self-schemas in the development of psychosis in general and in paranoid delusions in particular. Patients with delusions may also be highly intolerant of ambiguity. No study has yet compared remitted and currently ill paranoid patients on schema measures, or on tolerance of ambiguity.

Predicting postdischarge opiate abstinence from admission measures of motivation and confidence.

Admission scores from a model comprising 3 motivation factors concerning the cessation of heroin use and a confidence scale concerning postdischarge abstinence were tested for their ability to predict postdischarge outcomes in patients beginning inpatient opiate detoxification. Statistically significant prediction of abstinence from heroin 30 days after discharge and the number of heroin-free days in the 3 months following admission was based on the confidence scale and a factor concerned with externally imposed constraints on continued heroin use. The single-scale confidence measure made the largest contribution to each prediction, indicating that such scales may be potentially useful outcome predictors for postdischarge abstinence.

Health beliefs link to duration of untreated psychosis and attitudes to later treatment in early psychosis.

Background: Health beliefs influence health behaviours and have been shown to influence outcomes in a variety of illnesses, treatments and preventative interventions.

Aims: We aimed to measure health beliefs in first episode psychosis with the hypotheses that their structure would resemble that in physical illness (diabetes) and would correlate with prior duration of untreated psychosis and later attitudes to treatment.

Method: The Multidimensional Health Locus of Control scale was used in a sample of 50 people with schizophrenia during the first episode and at 18-month follow-up, 51 diabetic controls and 51 normal controls.

Childhood trauma and hallucinations in bipolar affective disorder: preliminary investigation.

Background: Strong evidence exists for an association between childhood trauma, particularly childhood sexual abuse, and hallucinations in schizophrenia. Hallucinations are also well-documented symptoms in people with bipolar affective disorder.

Aims: To investigate the relationship between childhood sexual abuse and other childhood traumas and hallucinations in people with bipolar affective disorder.

Phobic anxiety in 11 nations. Part I: Dimensional constancy of the five-factor model.

The Fear Survey Schedule-III (FSS-III) was administered to a total of 5491 students in Australia, East Germany, Great Britain, Greece, Guatemala, Hungary, Italy, Japan, Spain, Sweden, and Venezuela, and submitted to the multiple group method of confirmatory analysis (MGM) in order to determine the cross-national dimensional constancy of the five-factor model of self-assessed fears originally established in Dutch, British, and Canadian samples. The model comprises fears of bodily injury-illness-death, agoraphobic fears, social fears, fears of sexual and aggressive scenes, and harmless animals fears. Close correspondence between the factors was demonstrated across national samples.

The perceived expressed emotion in staff scale.

Recent research has highlighted the role of expressed emotion by ward staff in determining the well-being of psychiatric inpatients. Existing methods of assessing staff expressed emotion involve standardized interviews and are expensive and time-consuming. We report the development of a questionnaire measure of expressed emotion in staff as perceived by patients.

Theory of mind deficits in bipolar affective disorder.

Background: Bipolar affective disorder patients often show cognitive deficits that are similar to those found in schizophrenia patients. Theory of mind (the ability to understand others' mental states) is compromised in currently ill schizophrenia patients. This study aimed to establish whether similar deficits are found in bipolar patients.

Hypomanic traits and response styles to depression.

Objectives: To test the hypothesis that the manic defence involves specific response styles to depression, namely distraction and indulging in dangerous activities.

Design: A correlational study was conducted with undergraduate participants assessed for hypomanic traits using Eckblad and Chapman's Hypomanic Personality Scale.

Method: Participants also completed the Beck Depression Inventory, and an expanded version of Nolen-Hoeksema's Response Styles Questionnaire.

Randomised controlled trial of cognitive-behavioural therapy in early schizophrenia: acute-phase outcomes.

Background: Cognitive-behavioural therapy (CBT) improves persistent psychotic symptoms.

Aims: To test the effectiveness of added CBT in accelerating remission from acute psychotic symptoms in early schizophrenia.

Method: A 5-week CBT programme plus routine care was compared with supportive counselling plus routine care and routine care alone in a multi-centre trial randomising 315 people with DSM-IV schizophrenia and related disorders in their first (83%) or second acute admission.