Staff expectations and views of cognitive behaviour therapy (CBT) for adults with intellectual disabilities.

Background: The role of support workers and other professionals in the psychotherapeutic process has been commented upon but not as yet been systematically investigated.

Method: To explore their views and expectations of cognitive behaviour therapy (CBT) for adults with intellectual disabilities, eleven paid support workers and professionals were recruited and interviewed before the CBT sessions commenced for their service users and nine took part in the second interview that took place after nine sessions.

Results: Thematic Analysis of the interview transcripts indicates that staff members do not perceive CBT as a long-term solution for psychological problems have little knowledge of CBT and do not feel included in the process.

Clinical presentation and early care relationships in 'poor-me' and 'bad-me' paranoia.

OBJECTIVE. To test the proposal that 'poor-me' (PM) and 'bad-me' (BM) paranoia can be differentiated in terms of (1) current emotional experience and presence of grandiose delusions and (2) early caregiving and threats to self-construction. METHOD.

A consideration of developmental egocentrism in anorexia nervosa.

Recent research has suggested that normal adolescent processes are important in understanding psychosis, and that young adult individuals with psychosis are often struggling to develop an individual and autonomous self (the "fundamental task" of adolescence). The current paper explores the utility of considering normative adolescent developmental processes in understanding anorexia nervosa. Data were collected from 31 female young-adults with symptoms of anorexia nervosa, 26 female comparison young-adults and 71 female adolescents on measures of adolescent egocentrism.

The balance of power in therapeutic interactions with individuals who have intellectual disabilities.

Objectives: Establishing a collaborative relationship is a cornerstone of cognitive behavioural therapy (CBT). Increasingly CBT is being offered to people with intellectual disabilities who may have problems with receptive and expressive communication, and a history of disadvantage or discrimination in their relationships with those in positions of power. Consequently, they may have difficulty establishing a collaborative interaction with their therapist.

Subtypes of paranoia in a nonclinical sample.

Introduction: Previous research has proposed that there may be subtypes of paranoia with different patterns of performance on symptom and clinical measures. However, there has been little empirical examination of whether distinct subtypes actually exist. Recent research has suggested that paranoia can be found in normal individuals and exists on a continuum.

Social anxiety and the shame of psychosis: a study in first episode psychosis.

Social anxiety disorder (SaD) or social phobia is a co-morbid affective disorder in schizophrenia, present in up to one in three individuals. We employ 'social rank' theory to predict that one pathway to social anxiety in schizophrenia is triggered by the anticipation of a catastrophic loss of social status that the stigma of schizophrenia can entail. A group of 79 people with a first episode of psychosis were assessed for social anxiety: hypotheses were tested comparing 23 socially anxious and 56 non-anxious patients on measures of cognitive appraisals of shame/stigma of psychosis and perceived social status, controlling for depression, psychotic symptoms and general psychopathology.

Frequent aggression and attribution of hostile intent in people with mild to moderate intellectual disabilities: an empirical investigation.

We investigated whether aggressive individuals have an attributional bias of hostile intent compared to nonaggressive peers. We compared 43 frequently aggressive individuals who had mild to moderate intellectual disabilities with 46 nonaggressive controls on an attributional task. The aggressive participants attributed significantly more hostile intent to protagonists and indicated that they would respond more aggressively than did the controls to provocative scenes, but only when the threat was to themselves.

Socioemotional understanding and frequent aggression in people with mild to moderate intellectual disabilities.

Aggression in a proportion of people with intellectual disabilities is often assumed to be due to social-cognitive deficits. We reported on two studies in which we compared the emotion recognition and perspective-taking abilities of 43 frequently aggressive individuals and 46 nonaggressive peers. No difference was found between the groups' ability to label facial affect.

The future of cognitive-behavioural therapy for psychosis: not a quasi-neuroleptic.

Some 20 trials of cognitive - behavioural therapy (CBT) for psychosis have re-established psychotherapy as a credible treatment for psychosis. However, it is not without its detractors and problems, including uncertainty about the nature of its active ingredients. We believe that the way forward is to abandon the neuroleptic metaphor of CBT for psychosis and to develop targeted interventions that are informed by the growing understanding of the interface between emotion and psychosis.

Interpersonal and role-related schema influence the relationship with the dominant 'voice' in schizophrenia: a comparison of three models.

Background: Auditory hallucinations in psychosis often contain critical evaluations of the voice-hearer (for example, attacks on self-worth). A voice-hearer's experience with their dominant voice is a mirror of their social relationships in general, with experiences of feeling low in rank to both voices and others being associated with depression. However, the direction of the relationship between psychosis, depression and feeling subordinate is unclear.

The person in recovery from acute and severe psychosis: the role of dependency, self-criticism, and efficacy.

The role of 3 personality dimensions (i.e., dependency, self-criticism, and efficacy) in recovery from an acute and severe psychosis was examined.

Adapting to the challenge of psychosis: personal resilience and the use of sealing-over (avoidant) coping strategies.

Background: Avoidance coping (e.g. sealing over) is common in people recovering from psychosis, but it is not understood why some individuals 'seal over'.

Acting on command hallucinations and dangerous behavior: a critique of the major findings in the last decade.

Command hallucinations (CH) have recently become the focus of research into positive symptoms of schizophrenia. The importance of CH has become clear for theoretical and practical reasons, because CH are regarded as potentially the most dangerous symptoms of schizophrenia. The aim is to critically review research that has attempted to better understand CH and develop theories that may predict behavior and shape psychological treatments.

Cognitive therapy for command hallucinations: randomised controlled trial.

Background: Command hallucinations are a distressing and high-risk group of symptoms that have long been recognised but little understood, with few effective treatments. In line with our recent research, we propose that the development of an effective cognitive therapy for command hallucinations (CTCH) would be enhanced by applying insights from social rank theory.

Aims: We tested the efficacy of CTCH in reducing beliefs about the power of voices and thereby compliance, in a single-blind, randomised controlled trial.

The effects of the psychiatric label 'borderline personality disorder' on nursing staff's perceptions and causal attributions for challenging behaviours.

Objectives: The aim of the study was to investigate how the psychiatric label 'borderline personality disorder' (BPD) affected staff's perceptions and causal attributions about patients' behaviour.

Methods And Design: The study utilized a within-participants questionnaire methodology and participants comprised qualified mental health nursing staff. The questionnaire contained descriptions of challenging behaviour in which the patient was described with a diagnosis of depression, schizophrenia or BPD.

Predicting engagement with services for psychosis: insight, symptoms and recovery style.

Background: Treatment non-adherence and service disengagement are commonly attributed to impaired insight. There is evidence that recovery style (i.e.

Measuring vulnerability to threats to self-construction: the self and other scale.

Following a constructivist approach, we propose two dimensions or styles of self-construction that are related to different types of vulnerability to psychopathology. We have called these an 'insecure self' style associated with fear of exclusion, indifference, and rejection by significant others, and an 'engulfed self' style associated with fear of intrusion, control, and possession by significant others. In this paper, we report the psychometric properties of a new 14-item questionnaire, the Self and Other Scale (SOS), which is designed to measure the two types of threat vulnerability.

Contingent reinforcement or defending the self? A review of evolving models of aggression in people with mild learning disabilities.

This paper examines the changing approaches to working with people with a moderate to mild learning disability, who are frequently aggressive. Long-held assumptions about the lack of inter-personal understanding and impulsiveness continue to play a central role in clinical assessment and intervention for this group. Yet, there is a lack of controlled studies indicating the influence of such factors in frequent aggression.

A new scale (SES) to measure engagement with community mental health services.

The need for a measure of engagement with Community Mental Health Services has been identified. This article reports on the development and preliminary psychometric evaluation of a scale, Service Engagement Scale (SES), to measure engagement with community mental health services. Five Community Psychiatric Nurses completed the SES for 66 clients receiving Assertive Outreach services with an ICD-10 diagnosis of schizophrenia.