Impact of rurality and substance use on young people at ultra high risk for psychosis.

Background: Longitudinal research into early intervention for youth at ultra high risk (UHR) for psychosis demonstrates beneficial outcomes including increased treatment compliance and greater participation in education and the workforce. Despite known barriers for rural youth accessing mental health services, research comparing urban and rural UHR youth is lacking. The study included an examination of the impact of substance use on functioning of UHR youth.

A randomised controlled trial of cognitive behaviour therapy versus non-directive reflective listening for young people at ultra high risk of developing psychosis: The detection and evaluation of psychological therapy (DEPTh) trial.

Background: Intervention trials for young people at ultra high risk (UHR) for psychosis have shown cognitive behaviour therapy (CBT) to have promising effects on treating psychotic symptoms but have not focused on functional outcomes. We hypothesized that compared to an active control, CBT would: (i) reduce the likelihood of, and/or delay, transition to psychosis; (ii) reduce symptom severity while improving social functioning and quality of life, whether or not transition occurred.

Method: This was a single-blind randomised controlled trial for young people at UHR for psychosis comparing CBT to an active control condition, Non Directive Reflective Listening (NDRL), both in addition to standard care, with a 6month treatment phase and 12months of follow-up.

The relationship between internalized stigma, negative symptoms and social functioning in schizophrenia: the mediating role of self-efficacy.

The broad aim of the present study was to gain a greater understanding of the processes that contribute to negative symptoms and social functioning in schizophrenia. More specifically, a theoretical model was proposed predicting that self-efficacy would mediate the relationship between internalized stigma and both negative symptoms and social functioning in schizophrenia. Initial analyses revealed that all variables were correlated.

Patient characteristics associated with GP referral to the Access to Allied Psychological Services Program: a case-control study.

Background: GPs have referred patients for psychological treatment under the Better Outcomes in Mental Health Care, Access to Allied Psychological Services (ATAPS) Program since 2003. It is not known how GPs might select patients for referral. We explored which characteristics identified ATAPS patients compared to usual GP patients.

Mood state dependency of dysfunctional attitudes in bipolar affective disorder.

Introduction: Studies of cognitive styles among euthymic people with bipolar affective disorder (BAD) without use of mood induction techniques to access those cognitive styles give misleading impressions of normality of those cognitions. The aim of this study was to assess dysfunctional attitudes of participants with BAD, and control participants with no previous psychiatric histories, after mood inductions.

Methods: Sad and happy moods were induced within 49 BAD and 37 controls.

Doing Anger Differently: two controlled trials of percussion group psychotherapy for adolescent reactive aggression.

This study evaluates efficacy and effectiveness of 'Doing Anger Differently' (DAD), a group treatment for reactively aggressive 12-15 year old males. DAD uses percussion exercises to aid treatment. Study 1 compared a ten-week treatment with a waitlist control at pre, post and 6 month (treatment group only) follow-up.

Insight, social functioning and readmission to hospital in patients with schizophrenia-spectrum disorders: prospective associations.

It has been claimed that insight is capable of predicting important clinical outcomes among people with schizophrenia. However, the supporting evidence is sparse. Although many cross-sectional studies have been undertaken, only prospective studies can provide convincing evidence.

The criterion and discriminant validity of the Referential Thinking (REF) scale.

The Referential Thinking (REF) scale was designed to be a comprehensive self-report measure of both simple and guilty ideas of reference in the general population. One aim of the present study was to test the proposed interpretations of REF scores by comparing REF scores with ratings of delusions among psychotic patients. A 2nd aim was to test whether REF scores are better predicted by the severity of patients' delusions of reference (DoRs) than by the severity of their auditory verbal hallucinations (AVHs), thus supporting the scores' ability to discriminate between proneness to the 2 different symptoms.

Autobiographical memory specificity in borderline personality disorder: associations with co-morbid depression and intellectual ability.

Objectives: The results of studies of autobiographical recall in borderline personality disorder (BPD) have so far been inconsistent. The aims of the present study were to clarify this relationship by comparing memory specificity in BPD individuals, both with and without comorbid depression, to healthy controls; and to test whether differences between BPD individuals and healthy controls are mediated by differences in general intelligence and years of education.

Method: Depressed (N=22) and non-depressed (N=9) patients who met criteria for BPD were matched by age and gender with healthy controls (N=29).

Delusions of reference: a new theoretical model.

Introduction: Although delusions of reference are one of the most common psychotic symptoms, they have been the focus of little research, possibly because they have been considered to be integral to persecutory delusions. Evidence has now emerged that there are two kinds of delusion of reference. One of these, referential delusions of communication, which involves beliefs that others are communicating in subtle, nonverbal ways, is the focus of this paper.

The role of effort, cognitive expectancy appraisals and coping style in the maintenance of the negative symptoms of schizophrenia.

The aim of the present study was to assess the role of psychological factors, specifically effort, coping, and negative expectancy appraisals, in addition to executive functioning and depression, in accounting for negative symptoms broadly defined. Fifty inpatients with acute schizophrenia participated in a study with a cross-sectional design. All of the psychological variables had significant partial correlations with some of the measures of negative symptoms when depression was controlled.

Immediate source-monitoring, self-focused attention and the positive symptoms of schizophrenia.

Previous research suggests that tendencies to misattribute one's own thoughts to an external source, as assessed by an immediate source-monitoring test, are associated with auditory verbal hallucinations (AVHs). However, recent research suggests that such tendencies are associated instead with symptoms of thought interference. The main aim of the present study was to examine whether such tendencies are differentially associated with different types of thought interference, with AVHs, or with both.

Referential delusions of communication and reality discrimination deficits in psychosis.

Background: There appear to be two kinds of delusion of reference, which vary independently: delusions of observation and delusions of communication. It has been suggested that delusions of communication might derive from an impairment in reality discrimination, though the impairment would be centred on non-verbal channels in delusions of communication as opposed to verbal channels in auditory hallucinations.

Method: Patients (N=64) with acute psychotic symptoms were recruited according to a 2 x 2 design: presence versus absence of delusions of communication crossed with presence versus absence of auditory hallucinations.

Referential delusions of communication and interpretations of gestures.

Gestures are an important aspect of non-verbal communication, but people with schizophrenia have poor comprehension of them. However, the tests of gesture comprehension that have been used present only scenes in which interpersonal meaning is communicated, though there is evidence that people with psychotic disorders tend to perceive communications where none were intended. Such mistakes about non-verbal behaviour are the hallmark of a subtype of delusions of reference identified as delusions of communication.

Insight and recovery from acute psychotic episodes: the effects of cognitive behavior therapy and premature termination of treatment.

Research suggests that insight in schizophrenia is only weakly responsive to targeted psychosocial interventions. One of the aims of the present study was to examine the effects on insight of cognitive behavior therapy (CBT) for acutely psychotic patients. A second aim was to test predictions drawn from research on recovery styles that patients who reject psychological assistance will show a reduction in insight while those who continue to accept psychological assistance will show increases in insight over time.

The role of self-blame for trauma as assessed by the Posttraumatic Cognitions Inventory (PTCI): a self-protective cognition?

The Posttraumatic Cognitions Inventory (PTCI) assesses cognitions hypothesised to be associated with poor recovery from traumatic experiences and the maintenance of PTSD. The validity of the PTCI has received good support but doubts have been raised about its Self-BLAME subscale. The main aim of the present study was to test the ability of the PTCI subscales to discriminate between traumatised individuals with and without PTSD and to predict posttraumatic symptom severity.

On two kinds of delusion of reference.

Although delusions of reference are one of the most common psychotic symptoms, they have been the focus of little research. The aims of the present research were, first, to determine whether it is possible to identify different kinds of referential delusions reliably and, if so, to investigate associations among them and between these delusions and other positive psychotic symptoms. Participants with a diagnosis of schizophrenia (n=57) were recruited from a volunteer register (n=26) and from inpatient psychiatric wards (n=31).

North Wales randomized controlled trial of cognitive behaviour therapy for acute schizophrenia spectrum disorders: two-year follow-up and economic evaluation.

Background: There is good evidence now that cognitive behaviour therapy (CBT) is effective in the treatment of people suffering from schizophrenia. There is also some evidence that the benefits of CBT persist after the end of treatment and that the direct costs of providing CBT as an adjunct to standard care are no higher than the direct costs of standard care alone. The aims of the present study were to discover if the benefits of CBT for acute schizophrenia which were found 1 year after index admission persist for another year, and to evaluate the comparative costs of providing CBT.

The role of overgeneral autobiographical memory in the development of adult depression following childhood trauma.

Objective: Overgeneral autobiographical memory (AM) has been associated with episodes of clinical depression in adults and also with reported experience of childhood sexual abuse (CSA). This study investigated whether AM has a role in the development of adult depression in survivors of CSA and whether it is related to circumstances of CSA.

Method: A community sample of women who reported a history of CSA (N = 41) completed the autobiographical memory test and were interviewed about any adult episodes of depression using the Schedule for Affective Disorders and Schizophrenia-Lifetime.

Risk factors for transition to first episode psychosis among individuals with 'at-risk mental states'.

Recently developed criteria have been successful at identifying individuals at imminent risk of developing a psychotic disorder, but these criteria lead to 50-60% false positives. This study investigated whether measures of family history, peri-natal complications, premorbid social functioning, premorbid personality, recent life events and current symptoms would be able to improve predictions of psychosis in a group of young, help-seeking individuals who had been identified as being at risk. Individuals (N=74) were followed up at least 1 year after initial assessment.

Anomalous experiences and the contents of persecutory delusions during acute psychotic episodes.

Criteria for judging the presence of persecutory delusions, and theoretical distinctions between different kinds of persecutory delusions, depend on the identification of the contents of such delusions. The first aim of this study was to assess whether contents can be assessed reliably. It has been suggested that anomalous experiences are involved in the formation and maintenance of delusions.

Time is of the essence: A selective review of the fall and rise of brief therapy research.

For compelling reasons of equity and the advance of public health, brief psychotherapy has become the dominant format in both practice and research. One consequence of this is the apparent decline of a distinct stream of brief therapy research. However, much of the agenda formerly identified with that research stream is of increasing importance to the field.

The concurrent validity of the Global Assessment of Functioning (GAF).

Background: Few studies of the validity of the Global Assessment of Functioning (GAF) have been published and none has shown how GAF ratings are associated with concurrent ratings of symptoms and social functioning. This article provides such data.

Method: Patients suffering from schizophrenia were assessed at admission to hospital and at six- and 12-month follow-up, using the GAF, the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS) and the Social Behaviour Schedule.