Journal Publications (Papers)

Monday, 05 September 2011 13:09

Campaign appears to influence subjective experience of stigma

Principal institute author Justine Schneider

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:51

Introduction to Counterpoint

Principal institute author Jennifer Clegg

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:49

Vulnerability and protection talk: Systemic therapy process with people with intellectual disability

Principal institute author Jennifer Clegg

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:47

'Just being selfish for my own sake': balancing the views of young adults with intellectual disabilities and their carers in transition planning

Principal institute author Jennifer Clegg

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:45

Constructing adulthood in discussions about the futures of young people with moderate-profound intellectual disabilities

Principal institute author Jennifer Clegg

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:39

Nidotherapy in the treatment of substance misuse, psychosis and personality disorder: secondary analysis of a controlled trial

Principal institute author Peter Tyrer

Aims and method: To examine the clinical outcome and bed usage in patients with comorbid substance misuse and psychosis. The patients were randomised to ordinary assertive outreach team care or to enhanced assertive outreach with nidotherapy. Ratings of clinical symptoms, social function, engagement with services, bed usage (primary outcome after 1 year) and economic costs were assessed at baseline and at 6 and 12 months after randomisation. Results: Patients referred to nidotherapy had similar reduction in symptoms and engagement, with marginal superiority in social function (P = 0.045). There was a 110% reduction in hospital bed use after 1 year compared with control assertive care (P = 0.03). The mean cost savings for each patient allocated to nidotherapy was £14 705 per year, mainly as a consequence of reduced psychiatric bed use. Clinical implications Nidotherapy shows promise in the treatment of substance misuse and psychosis and may reduce hospital bed usage.

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:36

An exploratory analysis of the NEO-FFI and DSM personality disorders using multivariate canonical correlation

Principal institute author Conor Duggan

It has been argued that some of the difficulties in the Diagnostic and Statistical Manual of Mental Disorders (DSM) personality disorders might be overcome by examining their association with measures of general personality such as the Neuroticism, Extroversion and other Five-Factor Inventory (NEO-FFI) model. The study explored associations between the NEO-FFI and DSM personality disorder in 85 male offenders referred to a personality disorder unit. Although simple correlation showed the expected associations, multivariate canonical correlation revealed more complex and novel associations such as the finding that borderline personality disorder has a more robust conceptual relationship than antisocial personality disorder with the NEO-FFI. Overall, the NEO-FFI can be used to conceptualize most DSM personality disorders

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:33

State of the art in the pharmacologic treatment of borderline personality disorder

Principal institute author Ken Silk

This article reviews the most recent studies of the pharmacologic treatment of borderline personality disorder (BPD). Although research continues using randomized controlled trials with a placebo arm as well as active medication, meta-analyses and systematic reviews have revealed that the use of any specific medication or medication class in BPD remains at best uncertain and inconclusive. Studies indicate that the selective serotonin reuptake inhibitors have fallen out of favor, and researchers have turned their attention to the study of mood stabilizers and atypical antipsychotics. Thus, it is not surprising that trends in prescribing appear to be shifting toward the use of these two classes over the selective serotonin reuptake inhibitors; yet we remain without any medication that has a specific indication for treatment of BPD or an indication for any symptom that is seen as part of the BPD syndrome.

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:31

The asylum, the workhouse and the voice of the insane poor in 19th Century England

Principal institute author Peter Bartlett

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:28

The origins and essence of US social policy: on taxonomies, time and transfers

Principal institute author Nick Manning

Our understanding of US social policy has not been advanced by the classification of welfare states that has dominated social policy analysis in recent years. But in biology and cosmology we can find useful examples of the way in which we can develop more theoretically informed and dynamic classifications. A common feature has been the incorporation of time and developmental paths into classification. The way in which social and political developments unfold over time is particularly important in social policy and, in the case of the USA, this has enabled us to understand that social policies can and have changed, with a rich mix of progressive and regressive policies evolving and receding over the decades. In view of the dominance of the USA in world affairs and the global transfer of resources, ideas and polices across regions, this more subtle analysis of the nature of US social policy is essential.

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:26

Structures of confinement in 19th Century asylums, using England and Ontario as a comparative study

Principal institute author Peter Bartlett

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:23

Silence and sodomy: the creation of homosexual identity in law

Principal institute author Peter Bartlett

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:21

Severe learning disability and transition to adulthood

Principal institute author Jennifer Clegg

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:19

Psychiatric treatment: in the absence of law?

Principal institute author Peter Bartlett

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:17

Professionals' perceptions of interprofessional working in community mental health teams

Principal institute author Patrick Callaghan

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:12

Mental incapacity and mental health: the development of legal reform and the need for joined-up thinking

Principal institute author Peter Bartlett

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:10

Madness and asylums in modern Europe

Principal institute author Peter Bartlett

Published in Journal Publications (Papers)

Thursday, 25 August 2011 10:01

Living with uncertain knowledge and partial information

Principal institute author Jennifer Clegg

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:58

Legal madness in the 19th Century

Principal institute author Peter Bartlett

Legal sources remain under-exploited in the history of madness, and the legal character of some documents is sometimes unrecognized. This article examines the interrelations between legal and medical histories of madness, and discusses use and availability of nineteenth-century legal source materials relating to criminal insanity, mental incapacity, and the confinement of the insane.

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:50

Is Post-Traumatic Stress Disorder a helpful concept with intellectual disability?

Principal institute author Jennifer Clegg

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:47

Histories of trauma in client members of therapeutic communities

Principal institute author Mark Freestone

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:45

Eye movement desensitization and reprocessing (EMDR): An update

Principal institute author Stephen Regel

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:41

Exploring the meaning of trauma with adults with intellectual disabilities

Principal institute author Jennifer Clegg

Previous research investigating post-traumatic stress disorder assumed that adults with intellectual disabilities would react to trauma in the same way as those in the non-disabled population. This study explored the personal experience of trauma in a small group of adults with intellectual disabilities.

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:38

English mental health reform: lessons from Ontario?

Principal institute author Peter Bartlett

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:36

Does the Therapeutic Community work?

Principal institute author Nick Manning

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:34

Death, disability and dogma

Principal institute author Jennifer Clegg

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:31

Comparisons of psychotropic drug prescribing patterns in acute psychiatric wards across Europe

Principal institute author Patrick Callaghan

To compare prescribed daily doses (PDDs) of psychotropic drugs in several European centres. Method: A one-day census of psychotropic drug prescriptions to 613 patients in 39 acute psychiatric wards in ten countries. Results: Patients in Spain were on most drugs; patients in Germany were on the fewest. Chlorpromazine equivalents in Denmark, England, Germany and Spain were at high levels as were diazepam equivalents in Belgium, Finland, The Netherlands and Norway. Newer anti-psychotics were used in the majority of centres, although older anti-psychotics were used commonly in three centres. Conclusion: The high doses of psychotropic drugs patients receive in some centres may be having little additional therapeutic effect and could increase their risk of side effects. The use of older anti-psychotics in some centres may be causing side effects that could be reduced by using newer anti-psychotics.

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:27

Changes in attitudes to personality disorder on a DSPD unit

Principal institute author Patrick Callaghan

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:19

Challenging behaviour and insecure attachment

Principal institute author Jennifer Clegg

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:15

Bullying and people with severe intellectual disability

Principal institute author Jennifer Clegg

Although bullying has been shown to reduce quality of life in many spheres, anti-bullying strategies have yet to be incorporated into services for adults with severe intellectual disability (ID). The present study employed a survey of staff and parent concerns about 54 previously surveyed students who had left a school for pupils with severe ID. A content analysis of follow-up interviews was performed in 10 cases. Staff identified 19% of the survey sample as bullying others and 11% as being picked on. Neither gender nor communication ability had an impact. There was no significant change in bully or victim status over time, although some people did change. Parents or staff raised bully/victim problems in more than half of the interviews. There is sufficient evidence of bullying behaviour to warrant the adoption of anti-bullying strategies.

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:10

Beyond ethical individualism

Principal institute author Jennifer Clegg

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:07

Attitude to personality disorder among prison officers working in a dangerous and severe personality disorder unit

Principal institute author Patrick Callaghan

Published in Journal Publications (Papers)

Thursday, 25 August 2011 09:05

A prospective evaluation of the theory of planned behaviour and the transtheoretical model of change on exercise in young people

Principal institute author Patrick Callaghan

Published in Journal Publications (Papers)

Thursday, 25 August 2011 08:59

Applicability, reliability and validity of the psychopathy checklist - revised in offenders with intellectual disabilities: some initial findings

Principal institute author Catrin Morrissey

Published in Journal Publications (Papers)

Thursday, 25 August 2011 08:53

A hermeneutic approach to research ethics

Principal institute author Jennifer Clegg

This article argues that the interpretative and negotiating approach of hermeneutic ethics can inform research into the experiences of people with learning disability more usefully than bioethics. Terms and ideas are defined; philosophers and researchers who have employed them are described; arguments for and against the proposition are considered; it concludes by summarizing the position and its implications. Two final reflections pose questions researchers may find it fruitful to consider, or to discuss with users, carers and professionals.

Published in Journal Publications (Papers)

Thursday, 25 August 2011 08:48

A cross-sectional snapshot of therapeutic community client members

Principal institute author Nick Manning

Published in Journal Publications (Papers)

Thursday, 25 August 2011 07:54

Capacity, treatment and human rights

Principal institute author Peter Bartlett

Published in Journal Publications (Papers)

Thursday, 25 August 2011 07:51

Parent ratings of school behaviour in children at risk of Attention Deficit/Hyperactivity Disorder

Principal institute author Kapil Sayal

To investigate whether parents are accurate informants of child hyperactivity symptoms and impairment at school. Method: Parents of a community sample of 93 children with pervasive hyperactivity completed rating scales about their child's behaviour at home and school. These were compared with teacher ratings. Results: Parent ratings about school correlate more closely with parent (home) than teacher ratings. Such ratings systematically under-estimate teacher ratings and are influenced by the child's behaviour at both home and school as well as parental mental health. However, a parental report of impairment for the child at school is likely to be accurate. Conclusion: There are limitations in relying on parental accounts of school behaviour if teacher ratings are unavailable. As such ratings may under-identify children with ADHD and discrepancies between parent and teacher ratings may reflect actual differences in behaviour, this suggests that ratings are required from both sets of informants.

Published in Journal Publications (Papers)

Thursday, 25 August 2011 07:47

The test of compulsion in mental health law: capacity, therapeutic benefit and dangerousness as possible critieria

Principal institute author Peter Bartlett

Published in Journal Publications (Papers)

Thursday, 25 August 2011 07:41

Identification of children at risk of ADHD: a school-based intervention

Principal institute author Kapil Sayal

In many countries, the majority of children who have Attention Deficit/Hyperactivity Disorder (ADHD) are undiagnosed and there is limited recognition of child mental health problems in primary care. Teachers may be well placed to identify unrecognised children and to facilitate their referral to specialist services. Despite this, there has been limited intervention research addressing teacher identification of ADHD. This study aims to examine whether an educational intervention about ADHD for teachers improves their recognition of children at risk of ADHD.

Published in Journal Publications (Papers)

Thursday, 25 August 2011 07:38

The role of parental burden in child mental health service use: longitudinal study

Principal institute author Kapil Sayal

To examine the relative contributions of symptom severity, functional impairment, and parental burden in predicting the use of specialist child mental health services over a 4-year period.

Published in Journal Publications (Papers)

Thursday, 25 August 2011 07:35

Parental concerns about their child's emotions and behaviour and referral to specialist services: general population survey

Principal institute author Kapil Sayal

Childhood psychiatric disorders are common and are associated with heavy use of health services. Up to a third of children and adolescents attending primary care and paediatric outpatient departments have clinically significant psychopathology. Only a minority of these children reach specialist mental health services, partly because the presenting complaint is rarely psychological, so their disorders may not be recognised. Child mental health services may reject inappropriate referrals leading to frustration among referrers and families. Although medical professionals often depend on parental concerns to identify affected children, we do not know how predictive they are. We used empirical data from the 1999 British child and adolescent mental health survey to examine how predictive parental perceptions of psychological difficulties were of psychiatric disorder and to provide simple strategies to aid clinicians in identifying children requiring referral.

Published in Journal Publications (Papers)

Thursday, 25 August 2011 07:31

Applicability, reliability and validity of the psychopathy checklist - revised in offenders with intellectual disabilities: some initial findings

Principal institute author Catrin Morrissey

As a part of a larger study, the Psychopathy Checklist-Revised (PCL-R) was used to assess psychopathy in 203 individuals from three UK National Health Service settings for offenders with intellectual disabilities (ID): a high security hospital, a medium and low security hospital and a community based service. The PCL-R was rated from file review combined with a clinician interview. Internal consistency and inter-rater reliability were acceptable, and broadly comparable to that reported for other offender populations. The instrument was also associated in largely expected ways with level of security, and with measures of antisocial personality disorder, risk, and current behavioural functioning, providing some preliminary indications of convergent validity. However, further empirical investigation is required before the PCL-R can be used with confidence to make clinical and risk-based decisions in this population.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 15:57

Who comes into therapeutic communities? A description of the characteristics of a sequential sample of client members admitted to 17 therapeutic communties

Principal institute author Chris Evans

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 15:53

Using a school based intervention to challenge stigmatising attitudes

Principal institute author Vicky Baldwin

The aim of the study was to assess the effectiveness of a school-based intervention involving a professional theatre company in increasing teenagers' knowledge about mental health issues, and promoting positive attitudes towards people with mental health problems. The study design was a non-controlled intervention study. Secondary school pupils knowledge about, and attitudes towards, mental health problems, were measured before and after an educational intervention using the “Mindout for Mental Health” quiz. Pupils' median quiz score was greater following the intervention than before it. Following the intervention there was an increase in the proportion of pupils giving correct responses to questions regarding the incidence of mental health problems, the symptoms of mental health problems, and, to a lesser extent the risk of violence perpetrated by people with mental health problems. In contrast, the proportion of students who correctly responded to questions about the discrimination faced by those with mental health problems decreased between baseline and follow-up. The author conclude that school-based interventions that are both educational and experiential have the potential to improve knowledge about mental health problems and decrease stigmatizing attitudes among 13-14-year-old pupils.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 15:33

The Personal Concerns Inventory (Offender Adaption): Measuring and enhancing motivation to change

Principal institute author Mary McMurran

Measuring offenders' motivation for treatment is important for selection and monitoring treatment engagement, yet few psychometrically robust measures of motivation exist. The Personal Concerns Inventory (PCI) was developed to assess motivation to change in people with addictive behaviours. It focuses on identifying goals in a wide variety of life areas, and two profiles have consistently been identified--adaptive and maladaptive. This study aimed to adapt the PCI for use with offenders and assess its suitability. Following amendment, 11 men serving prison sentences were interviewed using the PCI (Offender Adaptation, OA). Personal concerns related to self-change, and partner, family, and relationships were most commonly identified. Scores suggested that offenders show adaptive and maladaptive profiles, similar to those previously identified. The PCI (OA) has promise for use with offenders, although the issue of whether the PCI (OA) is better viewed as a measure of motivation or a motivational enhancer remains for further research.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 15:24

The effectiveness of dementia care mapping in intellectual disability residential services

Principal institute author Sue Jaycock

This article is presented as a follow-up to exploratory work published in this journal in 2001. It describes a study that aimed to assess the effectiveness of dementia care mapping in supporting practice improvement in intellectual disability residential services. An average of 9 hours of observational data was collected using dementia care mapping in relation to 14 adults with severe or profound intellectual disabilities. Sixteen interviews were also undertaken with staff over a 4 month period.The findings provided a detailed picture of the activities and interactions between the participants involved in the study and raised some issues about ‘organizational culture’ when developing person-centred approaches.They have helped strengthen the case that care mapping has the potential to be a useful addition to the existing repertoire of tools to support effective practice improvement and person-centred planning.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 15:21

Temporal reliability of psychological assessment for patients in a special hospital with severe personality disorder

Principal institute author Conor Duggan

Background:The new programme for assessing those with dangerous and severe personality disorder relies heavily on psychological assessments of personality disorder and risk. Methods:The temporal reliability of assessments of psychopathy (PCL-R), risk (HCR-20) and personality was assessed using the International Personality Disorder Examination (IPDE) in 15 randomly selected male prisoners in a high secure hospital carried out at intervals varying between a mean of nine and 19 months after initial assessments by a variety of assessors. Results:Using the intra-class correlation coefficient the agreement varied between0.57 (HCR-20), 0.58 (PCL-R) and 0.38-0.70 for IPDE personality disorders, with the best agreement for antisocial personality disorder (0.70). Comment: These levels of agreement are consistent with other recent work on temporal reliability of personality instruments but are a little too low for confidence in these measures alone in the assessment process.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 14:43

Subsyndromal and syndromal symptoms in the longitudinal course of bipolar disorder

Principal institute author Richard Morriss

To describe the course of bipolar disorder over 18 months in 204 patients receiving mental healthcare.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 14:29

Self-management in mental health: questions for service providers and commissioners

Principal institute author Justine Schneider

Mental healthcare is constantly seeking means to become more effective and more user-friendly. Self-management methodologies offer opportunities to meet many people’s needs appropriately, quickly and without stigma.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 14:19

Neural correlates of theory of mind and empathy: an fMRI study in a non-verbal task

Principal institute author Birgit Vollm

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 14:12

Maternal self-esteem after successful treatment for fertility

Principal institute author Cris Glazebrook

To [1] investigate self-esteem during pregnancy after previous infertility and [2] establish the relationship among self-esteem, anxiety during pregnancy, and parenting self-efficacy.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 14:08

Involving service-users in schizophrenia research: the challenge of patient-centredness

Principal institute author Victoria Tischler

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 14:05

Involving patients in schizophrenia research: The challenge of patient-centredness

Principal institute author Victoria Tischler

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 14:04

Individual characteristics predisposing patients to aggression in a forensic psychiatric hospital

Principal institute author Michael Daffern

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 13:54

Homeless children and parents: short-term mental health outcome

Principal institute author Victoria Tischler

Homeless families are an increasing but marginalised part of society. They have diverse and complex needs that have often not been addressed by the available services. There is some evidence that psychosocial factors continue to be detrimental to the mental health of these families even after rehousing.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 13:50

DSM-IV and dangerous and severe personality disorder - an essay

Principal institute author Nick Manning

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 13:45

Cognitive-behavioural therapy for severe and recurrent bipolar disorders

Principal institute author Richard Morriss

To compare the effectiveness of treatment as usual with an additional 22 sessions of cognitive-behavioural therapy (CBT).

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 13:36

Affective determinants of treatment engagement in violent offenders

Principal institute author Kevin Howells

Affective factors are likely to play a major role in determining the extent to which offenders are able to engage with, and benefit from, treatment. In this article, it is argued that the relationship between affect and treatment engagement may be understood in three ways: the access the client has to emotional states, the ability to express such states, and the willingness of the client to do this in the therapeutic session. It is suggested that affective determinants of treatment readiness can be understood with reference to models of emotional regulation and that attention to these affective factors in the early stages of treatment is likely to promote engagement, reduce attrition, and consequently improve treatment outcomes for violent offenders.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 13:33

Assertive outreach: policy and reality

Principal institute author Justine Schneider

This survey set out to profile the case-loads of assertive outreach teams in North East England, to discover whether they were reaching the people for whom they were meant. A survey of case-loads of 29 assertive outreach teams was carried out using the MARC-2, HoNOS and GAS instruments. Findings were compared with earlier surveys of the case-loads of community mental health teams in parts of the same region.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 13:29

Service users and other stakeholders' evaluation of a liaison mental health service in an A&E department and a general hospital setting

Principal institute author Patrick Callaghan

Liaison mental health care has been an emerging specialism of mental health nursing in the UK since the early 1990s. Studies have so far looked only briefly at service user evaluation. A qualitative study involving 47 interviews with service user and professional stakeholders was undertaken to determine what is important to stakeholders in a liaison mental health-care service. The largest group of stakeholders interviewed were service users. Analysis of the data was undertaken using the service user interviews to guide the development of themes. The majority of the issues identified were raised by both service users and professionals. The three key themes were, the practicalities of the service including waiting time, the staffing profile and receiving the service, which included issues such as the opportunity to talk and outcomes. The findings provide new information regarding what service users and other stakeholders expect from a liaison mental health service and important areas to consider when offering a satisfactory service.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 13:00

Controlled drinking goals for offenders

Principal institute author Mary McMurran

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 12:52

Bayesian belief network for quality assessment: application to employment officer support

Principal institute author Justine Schneider

Background: "Supported" employment stipulates that disabled people should have real jobs for real pay. This paper models kinds of supported employment, assesses how the support and placement features affect its outcomes and its quality from the perspective of the employees, and provides a dynamic model to help explore what types of interventions might promote greater social inclusion for people with learning and other disabilities.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 12:51

How is personality disorder linked to dangerousness? A putative role for early-onset alcohol abuse

Principal institute author Rick Howard

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 12:46

A comparison of offenders with intellectual disability across three levels of security

Principal institute author Todd Hogue

A number of authors have described, with disparate results, the prevalence of people with intellectual disability and their characteristics, in a range of offender cohorts defined by service use. These have included high security, a range of criminal justice services and community services. There is a need for research comparing cohorts of offenders with intellectual disabilities across different settings.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 12:41

Personality across the ethnic divide in Singapore: Are 'Chinese traits' uniquely Chinese?

Principal institute author Rick Howard

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 12:37

Fatigue Intervention by Nurses Trial - the FINE Trial

Principal institute author Richard Morriss

A randomised controlled trial of nurse led self-help treatment for patients in primary care with chronic fatigue syndrome; study protocol [ISRCTN 74156610]

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 12:29

Assessment and immediate management of people at risk of harming themselves

Principal institute author Richard Morriss

The ability of health professionals and other professionals in contact with people at risk of committing suicide to assess and respond appropriately to suicide risk is central to any public health programme to reduce suicide in the local population. The sharing of similar concepts concerning suicide risk is essential if services staffed by different professionals from different agencies are going to communicate effectively and respond appropriately to an individual risk of suicide. This contribution outlines the clinical assessment and management of suicide risk in an individual (whatever their sociodemographic background or diagnosis), outlining factors that make the risk of suicide, as opposed to self-harm or mental illness, more or less likely. The assessment of a person who has recently self-harmed is also covered. Immediate management of suicide is outlined, ranging from how to conduct the interview, releasing emotion, specific approaches to bolster self-esteem and hopefulness, ensuring safety and providing support through family and professionals. A categorization of risk, used successfully in studies of mass-training health professionals to assess and manage patients at risk of suicide (STORM studies) is offered, ranging from low to very high risk. The level of risk assessed is allied to a clear action plan for each category of risk. In this way staff will know what the management implications are in terms of managing suicide risk (but not other clinical needs) based on the assessment of category of risk. Finally, the issue of acquiring these clinical skills is discussed briefly.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 12:24

Motivating convicted sex offenders into treatment: A pilot study

Principal institute author Mary McMurran

Sex offenders who refuse a place on a sex offender treatment programme are estimated to make up about half the prison sex offender population in England and Wales. This pilot study used the Personal Concerns Inventory-Offender Adaptation (PCI-OA), a semi-structured motivational assessment (or motivational interview), further adapting it for treatment refusers. The study examined the effectiveness of the PCI-OA (TR) with nine prisoners who had refused sex offender treatment (the treatment group) compared with nine refuser who received no intervention (the control group). Participants were convicted adult male sex offenders serving prison sentences in a special prison for sex offenders in Wales. The treatment group were at least 0.6 times as likely to show a positive motivational shift towards sex offender treatment as the untreated group. The practice implications of these results are discussed, and further evaluation of the PCI-OA (TR) is recommended.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 12:21

Effects of remorse and shame and criminal justice experience on judgements about a sex offender

Principal institute author Kevin Howells

The effect of the expression of remorse or shame on judgements about a man who committed a sexual offence, and on recommended punishment, was investigated. The effect of previous criminal justice experience on judgements and recommendations was also examined. Participants were students completing courses in justice studies. The offender was generally judged more harshly when no emotional reaction was shown, but remorse and shame did not differ in their effects. Ratings of the offender and victim were influenced by participants' level of criminal justice experience. There was no relationship between type of sentence recommended and criminal justice experience, or between type of sentence recommended and emotional expression. The results are discussed in terms of the representation of remorse and shame and of the perceived relevance of these emotions for the rehabilitation of offenders.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 12:17

A randomised controlled trial of an interactive educational computer package for children with asthma

Principal institute author Cris Glazebrook

The purpose of this study was to evaluate the impact and acceptability of an educational multimedia program designed to promote self-management skills in children with asthma.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 12:09

Misunderstanding the intentions of others

Principal institute author Rhiannon Corcoran

An exploratory study of the cognitive etiology of persecutory delusions in very late-onset schizophrenia-like psychosis.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 12:03

The alcohol-related questionnaire

Principal institute author Mary McMurran

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 12:01

Staff gender ratio and aggression in a forensic psychiatric hospital

Principal institute author Michael Daffern

Gender balance in acute psychiatric inpatient units remains a contentious issue. In terms of maintaining staff and patient safety, ‘balance’ is often considered by ensuring there are ‘sufficient’ male nurses present on each shift. In an ongoing programme of research into aggression, the authors investigated reported incidents of patient aggression and examined the gender ratio on each shift over a 6-month period. Contrary to the popular notion that a particular gender ratio might have some relationship with the likelihood of aggressive incidents, there was no statistically significant difference in the proportion of male staff working on the shifts when there was an aggressive incident compared with the shifts when there was no aggressive incident. Further, when an incident did occur, the severity of the incident bore no relationship with the proportion of male staff working on the shift. Nor did the gender of the shift leader have an impact on the decision to seclude the patient or the likelihood of completing an incident form following an aggressive incident. Staff confidence in managing aggression may be influenced by the presence of male staff. Further, aspects of prevention and management may be influenced by staff gender. However, results suggest there is no evidence that the frequency or severity of aggression is influenced by staff gender ratio.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 11:53

Impact of a multimedia intervention 'Skinsafe' on patients' knowledge and protective behaviour

Principal institute author Cris Glazebrook

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 11:50

Evaluating STORM skills training for managing people at risk of suicide

Principal institute author Richard Morriss

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 11:37

Turning theory into practice

Principal institute author Richard Morriss

Rationale, feasibility and external validity of an exploratory randomized controlled trial of training family practitioners in reattribution to manage patients with medically unexplained symptoms (MUST)

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 11:30

SureStart graduates: predictors of attainment on starting school

Principal institute author Justine Schneider

Background: We report the analysis of the services used and the outcomes for children who used four Sure Start programmes prior to starting school in 2003. Methods: A cohort study compared the intervention group both to classmates who lived in the areas covered by Sure Start but did not access it, and to a random sample of children in the same Local Education Authority who did not have access because they lived outside these areas. The impact of service use variables on various outcomes for users was explored using multiple linear regression analysis. Results: No differences were found in school attainment between users and non-users on average. However, in one of the four areas, users' outcomes were consistently worse. By contrast, in one area, they appeared to be marginally superior on non-academic developmental scores. When we controlled for between-area differences, we also found an association between high use of Sure Start and personal and social development scores. Implications: Much of the variation in outcomes remains to be explained. Tentative findings suggest stronger associations between Sure Start use and better non-academic developmental outcomes. These findings add to our understanding of the impact of focused, high-quality pre-school provision. Methodological issues raised include rater bias, recruitment bias and a need to measure both frequency and type of service use.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 11:26

Identification of children with ADHD: a school-based intervention

Principal institute author Kapil Sayal

In many countries, the majority of children who have Attention Deficit/Hyperactivity Disorder (ADHD) are undiagnosed and there is limited recognition of child mental health problems in primary care. Teachers may be well placed to identify unrecognised children and to facilitate their referral to specialist services. Despite this, there has been limited intervention research addressing teacher identification of ADHD. This study aims to examine whether an educational intervention about ADHD for teachers improves their recognition of children at risk of ADHD.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 11:17

Barriers to the identification of children with Attention Deficit/Hyperactivity Disorder

Principal institute author Kapil Sayal

In most countries, the majority of children with attention deficit/hyperactivity disorder (ADHD) are undiagnosed. In the United Kingdom, a major barrier to accessing specialist services is the limited recognition of disorders by general practitioners. However, it is unclear whether there are also barriers at other stages of the help-seeking process. For children with ADHD, this study aims to examine the correlates of the different stages of help-seeking. Method: Children with ADHD (n = 232) were identified from the 1999 British Child and Adolescent Mental Health Survey. Rates and correlates of parental recognition of child mental health problems and contact with services for these problems were examined. Children who had used particular types of services were compared with those who had not. Results: Most (80%) parents of children with ADHD recognise that their child has a problem although few (35%) construe this in terms of hyperactivity. The impact of the symptoms on key adults, rather than child factors, best predicted parental recognition of problems. Most parents had been in contact with education-based professionals but few had consulted primary care for these problems or had sought help from relevant specialist health services. Parental recognition of problems and perceived burden, rather than child factors, were the main correlates of contact with services. Parental views that their child has hyperactivity were associated with greater severity of symptoms. Conclusions: The main barrier to care for ADHD is the limited presentation of these problems to primary care. The majority of parents discuss their concerns with professionals based in education services. There is a need for parental education about ADHD and for health service input to support education professionals in their contact with concerned parents.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 11:07

Annotation: pathways to care for children with mental health problems

Principal institute author Kapil Sayal

Although many children with mental health problems are in contact with primary health care services, few receive appropriate help. Methods: Using a pathways to care model, this paper systematically reviews the literature relating to access to services. It separates out the various stages of help-seeking: parental perception of problems, use of primary care services, recognition within primary care, and referral to or use of specialist health services. Results: Following parental awareness of child symptoms, parental perception of problems is the key initial step in the help-seeking process. Although children with mental health problems or disorders are regular attenders within primary care and most parents acknowledge that it is appropriate to discuss concerns about psychosocial issues in this setting, few children are presented with mental health symptoms even if their parents have such concerns. Subsequently, less than half of children with disorders are recognised in primary care. Amongst recognised children, about half are referred to specialist services. Overall, up to one-third of children with disorders receive services for mental health problems. Factors such as the type and severity of disorder, parental perceptions, child age and gender, and family and social background factors determine which affected children access services. Conclusions: As there are inequities in patterns of service use, a greater emphasis on developing resources at population and primary care levels is required. Barriers involving parental perceptions and expression of concerns within consultations should be minimised at these levels. This requires both public education approaches and improved training and specialist support for primary care services to enhance their ability to provide for these children.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 10:56

Reasoning under uncertainty; heuristic judgements in patients with persecutory delusions or depression

Principal institute author Rhiannon Corcoran

The substantial literature examining social reasoning in people with delusions has, to date, neglected the commonest form of decision making in daily life. We address this imbalance by reporting here the findings of the first study to explore heuristic reasoning in people with persecutory delusions.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 10:50

Two studies on the prevalence and validity of personality disorder in three forensic intellectual disability samples

Principal institute author Todd Hogue

There is an extensive research literature on the association between personality disorder, antisocial personality disorder, and risk of future violent and sexual offences. Several studies have found an elevated prevalence of personality disorder diagnoses amongst those individuals with severe mental illness and criminal populations. While there has been some work on the prevalence of personality disorder among intellectual disability populations, it has been criticised as being unreliable and inconsistent. The present authors have taken account of these criticisms and recommendations in this comparison of 164 offenders with intellectual disability across three settings – community, medium/low secure, and high secure. In Study 1, DSM-IV diagnoses were made on the basis of four information sources: file review, interview with clinician, observations by care staff, and the Structured Assessment of Personality Interview. Across the samples, total prevalence of PD was 39.3%. The most common diagnosis was antisocial personality disorder. There was a higher rate of diagnosis in the high security setting, with no significant differences between the other two settings. There was no diagnosis of dependent PD, indicating that assessors were not overly influenced by the developmental disability itself. In Study 2 it was found that increase in severity of PD (as indicated by PCL-R scores and/or the number of PD diagnoses) showed a strong lawful relationship with instruments predicting future violence (VRAG, RM 2000/V) and a weaker relationship with instruments predicting future sexual offences (Static-99, RM 2000/S). The results indicate the utility of PD classification in this client group and that a number of individuals with PD classification are being managed successfully in community settings. These findings have considerable implications for staffing, both in terms of which individuals can be treated by these services and staff training.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 10:37

Pain thresholds and tender points count as predictors of new chronic widespread pain in psychologically distressed subjects

Principal institute author Richard Morriss

Tender points are a general measure of distress both in the community and in clinic subjects. It has been suggested that multiple tender points should be regarded as the early stages of somatisation of distress. Similarly, recent evidence suggests that chronic widespread pain (CWP) is one manifestation of the somatisation of distress.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 10:29

Brief psycho-education for people with personality disorder - a pilot study

Principal institute author Conor Duggan

Objective: To test the hypothesis that the therapeutic alliance is not compromised by engaging in a psychoeducation programme that informs about personality disorder.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 10:15

The meaning of anger for Australian indigenous offenders: The significance of context

Principal institute author Kevin Howells

The problem of over representation of Indigenous offenders in Australian prisons highlights the need for effective tertiary intervention programs within correctional settings as a way of reducing Indigenous re-incarceration. This study seeks to explore meanings of anger within an Indigenous context that might inform the development of more acceptable and potentially more effective rehabilitation programs. A methodology that acknowledges the importance of narrative, context, and culture was devised to explore how anger as an emotion is understood and experienced by a group of Indigenous men in a South Australian prison. Although some of the major themes reflected experiences of anger common to many offenders, it was evident that for these Indigenous men, anger was experienced within a broad social and political context that imbued the experience of anger with layers of culturally specific meaning. It is suggested that these layers of meaning constitute sufficient difference to warrant further exploration.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 10:12

Interventions for helping people recognise early signs of recurrence in bipolar disorder

Principal institute author Richard Morriss

To compare the effectiveness of an EWS intervention plus treatment as usual (TAU ) versus TAU (involving and not involving a psychological therapy) on time to manic, depressive and all bipolar episodes (the primary outcome), hospitalisation, functioning, depressive and manic symptoms.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 10:01

Computerised cognitive behaviour therapy for depression and anxiety update: a systematic review and economic evaluation

Principal institute author Michael Ferriter

The aim of this review was to evaluate computerised cognitive behaviour therapy (CCBT) for the treatment of anxiety, depression, phobias, panic and obsessive;compulsive behaviour (OCD). The software packages to be considered include Beating the Blues (BtB), Overcoming Depression: a five areas approach, FearFighter (FF), Cope and BT Steps. Other packages or programmes incorporating CCBT were also considered.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 09:50

The role of psychological factors in predicting the onset of chronic widespread pain: results from a prospective population-based study

Principal institute author Richard Morriss

Objective: Chronic widespread pain (CWP) is strongly associated with psychosocial distress both in a clinical setting and in the community. The aim of this study was to determine the contribution of measures of psychosocial distress, health-seeking behaviour, sleep problems and traumatic life events to the development of new cases of CWP in the community.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 09:44

Killing gay men 1976-2001

Principal institute author Peter Bartlett

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 09:39

The relationships among insight, social support and depression in psychosis

Principal institute author Rhiannon Corcoran

We assessed the role of satisfaction with social support as a mediating factor in the relationship between insight and depression in psychosis. Forty inpatients with schizophrenia-spectrum disorders self-completed measures of insight, social support, and depression. Results showed a curvilinear relationship between insight and satisfaction with support: those with high and low insight tended to have higher satisfaction with support than those with moderate insight. Satisfaction also had a negative relationship with depression. We found no direct relationship between insight and depression. This was consistent with satisfaction with social support mediating the relationship between global insight and depression.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 09:34

Moderation of psychosocial risk factors through dysfunction of the hypothalamic-pituitary-adrenal stress axis in the onset of chronic widespread musculoskeletal pain: Findings of a population-based prospective cohort study

Principal institute author Richard Morriss

Objective: To test the hypothesis that abnormalities in the hypothalamic–pituitary–adrenal (HPA) stress-response system would act as an effect moderator between HPA function and the onset of chronic widespread pain (CWP).

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 09:29

Beyond body, beyond words: cognitive analytic music therapy in forensic psychiatry

Principal institute author Stella Compton Dickinson

New approaches to the treatment of personality disordered offences

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 09:25

Working with adults with personality disordered clients in the community: a multi-agency interview study

Principal institute author Nick Huband

Aims and method: To explore the impact of adults with personality disorder on the professional groups that support them. Staff (n=72) from five agencies participated in interviews focusing on reactions to short case vignettes representing the three personality disorder clusters.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 09:20

What's the point? Towards a methodology for assessing the function of psychiatric inpatient aggression

Principal institute author Michael Daffern

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 09:12

To move or not to move - that is the question! Some reflections on the transfer of patients in the face of uncertainty

Principal institute author Conor Duggan

While there are explicit criteria denoting those who are appropriate for admission to the new dangerous with severe personality disorder (DSPD) services in England and Wales, there are no corresponding criteria to identify those who should leave. In the absence of explicit criteria, two likely areas of evaluation are examined in this paper. The first of these concerns an assessment of the risk that these individuals might pose after their discharge from high secure DSPD hospital units. The second examines the impact of the interventions employed, specifically whether or not these are effective in reducing the risk that such individuals might pose on release. As there are few empirical data to inform clinical decision making in either of these areas, it is unlikely that DSPD designated individuals will be able to progress to lower levels of security unless these gaps in the evidence are addressed.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 09:10

The role of perspective taking in anger arousal

Principal institute author Kevin Howells

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 09:07

The relationships between personality disorders and social problem solving in adults

Principal institute author Mary McMurran

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 09:05

The predictive validity and practical utility of structured schemes used to assess risk for aggression in psychiatric inpatient settings

Principal institute author Michael Daffern

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 08:56

The NICE guidelines for the management of PTSD in adults and children in primary and secondary care - a review

Principal institute author Stephen Regel

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 08:51

The care home activity project: does introducing an occupational therapy programme reduce depression in care homes?

Principal institute author Justine Schneider

The primary aim of the study was to test the hypothesis that depression severity in care homes for older people would be reduced by an occupational therapy programme. This was a feasibility study for a cluster randomised controlled trial and involved four intervention and four control homes in northern England. In each intervention home a registered occupational therapist worked full-time for one year delivering an individualised programme to participants. Pre- and post-intervention data for the Geriatric Mental State-Depression Scale (primary outcome measure) were obtained for 143 participants. Secondary outcomes included dependency and quality of life. No significant intervention effects were found in any of the quantitative outcome measures, though qualitative interviews showed the intervention was valued by many participants, staff and relatives. Therapist ratings and qualitative interviews suggested that the intervention was beneficial to some participants but no distinctive characteristics were found that might enable prediction of likely benefit on initial assessment. This exploratory study provides no evidence that this intervention produced benefits in terms of depression, dependency or quality of life. Lack of prior power calculations means these are not definitive findings; but numbers were sufficient to perform the required analyses and data did not suggest effects that would have reached statistical significance with a larger sample. This study highlights issues for consideration in providing such services in care homes.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 08:33

Social problem-solving plus psycho-education for adults with personality disorder: a pragmatic randomised controlled trial

Principal institute author Nick Huband

Aims: To determine the effectiveness of a problem-solving intervention for adults with personality disorder in the community under conditions resembling routine clinical practice.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 08:26

Rethinking clinical placements for mental health nursing students

Principal institute author Patrick Callaghan

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 08:22

Readiness for treatment in high risk offenders with personality disorders

Principal institute author Kevin Howells

Low engagement and non-completion of therapeutic interventions are important issues in the treatment and rehabilitation of offenders and mentally disordered offenders. Such factors influence a range of outcomes, including the reduction of clinical and criminogenic needs. In this paper it is proposed that low engagement and non-completion are usefully viewed as a consequence of low readiness for treatment. The dimensions of readiness are summarized (from the Multifactor Offender Readiness Model) and applied to high risk offenders with severe personality disorders. A readiness analysis has implications for the assessment and treatment of this patient/offender population and is useful in identifying future research and clinical priorities.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 08:14

Psychological therapies for borderline personality disorder

Principal institute author Michael Ferriter

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 08:12

Psychological debriefing in cross cultural contexts: ten implications for practice

Principal institute author Stephen Regel

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 08:06

Protocol for THREAD (THREshold for Anti-depressants)

Principal institute author Richard Morriss

Study: A randomised controlled trial to determine the clinical and cost-effectiveness of anti-depressants plus supportive care alone, for mild to moderate depression in UK general practice.

Published in Journal Publications (Papers)

Wednesday, 24 August 2011 07:59

Post trauma support in the workplace

Principal institute author Stephen Regel

The current status and practice of critical incident stress management (CISM) and psychological debriefing (PD) within organisations in the United Kingdom.

Published in Journal Publications (Papers)

Friday, 19 August 2011 16:16

Minor physical anomalies across ethnic groups in a first episode psychosis sample

Principal institute author Tuhina Lloyd

Published in Journal Publications (Papers)

Friday, 19 August 2011 16:13

Managers' views on supported employment

Principal institute author Justine Schneider

Published in Journal Publications (Papers)

Friday, 19 August 2011 15:58

Introductory comments to the special issue [High Risk Offenders with Personality Disorders: Conceptual and Scientific Bases]

Principal institute author Kevin Howells

Published in Journal Publications (Papers)

Friday, 19 August 2011 15:54

Emotional and behavioural problems in offenders with intellectual disability: comparative data from three forensic services

Principal institute author Todd Hogue

Published in Journal Publications (Papers)

Friday, 19 August 2011 15:51

Current perspectives on assessment and therapy with survivors of torture: the use of a cognitive behavioural approach

Principal institute author Stephen Regel

Published in Journal Publications (Papers)

Friday, 19 August 2011 15:44

Costs of occupational therapy in residential homes and its impact on service use

Principal institute author Justine Schneider

The Care Home Activity Project was a feasibility study examining the effect of occupational therapy on levels of depression and quality of life of residents in care homes. This paper describes the costs of the one year occupational therapy intervention, the use and cost of services received by the residents both before and after the intervention and compares these with the services received by a control group over the same period. Eight homes in northern England were included in the study with four homes receiving the services of a full-time occupational therapist, the remaining four acting as the control group. Services received by residents in both groups were recorded at the beginning and end of the one year study. The cost of the occupational therapy intervention was computed from published unit costs with adjustments for travel, equipment costs and methods of working. There was a significant increase in the likelihood of using social services in the intervention homes. This could be explained by previously unrecognised needs being revealed by the therapists. There may have been a reduction in health costs in the intervention group. At 2005 levels, the net cost of providing the occupational therapy service was £16 (E23) per resident per week. This study demonstrates that occupational therapy is feasible in residential homes at modest cost. It may uncover unmet needs for some services. Future studies should match groups for hospital use at baseline.

Published in Journal Publications (Papers)

Friday, 19 August 2011 15:37

Concluding comments (to the special issue, high risk offenders with personality disorders: conceptual and scientific bases)

Principal institute author Kevin Howells

Published in Journal Publications (Papers)

Friday, 19 August 2011 15:24

Computerised cognitive behaviour therapy for obsessive-compulsive disorder: A systematic review

Principal institute author Michael Ferriter

Background: Computer-guided therapy is an innovative treatment strategy that could have an important role in the future of psychological treatment. This paper summarises the available published evidence that assesses the effectiveness of a computerised cognitive behaviour therapy (CCBT) for obsessive-compulsive disorder (OCD). Methods: Fifteen electronic bibliographic databases including Medline, Embase, the Cochrane Library, Cinahl, PsycINFO, Biological Abstracts, HMIC and NHS CRD databases were comprehensively searched in March 2004: [‘obsessive compulsive disorder’ (text and indexed terms)] AND [‘cognitive therapy’ (text and indexed terms)] AND [‘computer’ (text and indexed terms)]. Reference lists of included studies, guidelines, generic research, trials registers and specialist mental health sites were hand-searched. Results: The search produced 149 citations from which we identified two RCTs and two single-arm studies with relevant data. All four studies used one software programme – BTSteps.In the large RCT, YBOCS effect sizes for BTSteps, therapist-led cognitive behaviour therapy (TCBT) and relaxation (RLX) were 0.84, 1.22, and 0.35, respectively. The smaller RCT found significantly better outcomes with brief scheduled support compared to brief on-demand phone support. Conclusions: BTSteps was as good as TCBT for reducing time spent in rituals and obsessions and for improving the Work and Social Adjustment Scale (WSA), and was superior to RLX treatment. The available evidence also showed that improvement of OCD persisted beyond the end of CCBT. TCBT was more effective than CCBT for all patients overall though not in those who went on to start self-exposure. Such a system has the potential to widen the access to CBT in general and considerably shorten clinician-guided care.

Published in Journal Publications (Papers)

Friday, 19 August 2011 15:21

Characteristics of offenders referred to a medium secure NHS personality disorder service: the first five years

Principal institute author John Milton

Aim:To evaluate use of selection criteria for admission to a dedicated personality disorder service within medium secure hospital provision in the UK, and to test for features that discriminate between those admitted and those rejected.

Published in Journal Publications (Papers)

Friday, 19 August 2011 15:19

A systematic review of the soteria paradigm for the treatment of people diagnosed with schizophrenia

Principal institute author Michael Ferriter

Published in Journal Publications (Papers)

Friday, 19 August 2011 14:58

Assessing the functions of aggression in psychiatric inpatients

Principal institute author Michael Daffern

Published in Journal Publications (Papers)

Friday, 19 August 2011 14:47

Assessment implications of "What Works" research for Dangerous and Severe Personality Disorder (DSPD) service evaluation

Principal institute author Calvin Langton

A policy initiative intended to address the risk posed by individuals considered dangerous and severely personality disordered has seen the introduction of specialized services for high-risk offenders in secure settings within both the mental health and prison systems in the UK. Accompanying these developments has been an explicit research agenda which includes among its priorities treatment evaluation research with these newly identified dangerous and severe personality disorder (DSPD) offenders. This article discusses a number of key concepts identified from the psychotherapy outcome literature and relates their significance for evaluation research designs to principles drawn from the “What Works” criminological literature with the aim of informing research initiatives within the DSPD service.

Published in Journal Publications (Papers)

Friday, 19 August 2011 14:37

A Slovak adaption of CORE-OM (Clinical Outcomes in Routine Evaluation - Outcome Measure)

Principal institute author Chris Evans

Published in Journal Publications (Papers)

Friday, 19 August 2011 14:34

A probabilistic cost effectiveness analysis of psychological therapies including dialetical behaviour therapy for borderline personality disorder

Principal institute author Michael Ferriter

Published in Journal Publications (Papers)

Friday, 19 August 2011 14:31

Alcohol consumption in pregnancy as a risk factor for later mental health problems

Principal institute author Kapil Sayal

There has been increasing interest in recent years about the possible mental health risks for offspring as a result of prenatal alcohol exposure. In particular, there is considerable controversy about whether there is a safe threshold for alcohol consumption during pregnancy and whether international policy recommendations are based on evidence. This article briefly summarises the existing literature in relation to mental health outcomes in childhood, adolescence and early adulthood following prenatal alcohol exposure. It also highlights some of the possible pitfalls in the interpretation of observational epidemiological data.

Published in Journal Publications (Papers)

Friday, 19 August 2011 14:10

A comparison of adults with anti-social personality traits with and without conduct disorder

Principal institute author Nick Huband

Thirty individuals meeting both childhood and adult criteria (ASPD) were compared with 39 meeting adult antisocial criteria only (ASS). Few differences were found between the two groups on the measures examined, although those in the ASPD group appeared more severe and had higher anger scores on the STAXI-2 psychometric test. This failure to find clinically important differences between the two groups is in agreement with previous reports and needs to be taken into account in future revisions of ASPD in DSM.

Published in Journal Publications (Papers)

Friday, 19 August 2011 14:03

A clinical service for those with dangerous and severe personality disorder

Principal institute author Todd Hogue

Recent political initiatives have increased the focus on providing clinical services for personality disordered individuals. Increased attention on those identified as having dangerous and severe personality disorder (DSPD) has led to the piloting of specialist services to trial new assessments and interventions for the DSPD group in both health and prison settings. This article outlines the development and provision of clinical services for those within The Peaks, the DSPD pilot service within Rampton Hospital. The Peaks, the first new-build health-based unit, aims to provide a comprehensive service specifically focused on addressing the full range of clinical and criminogenic needs of those within the DSPD group. The philosophical underpinnings of the unit and the practical components of the service provided are described.

Published in Journal Publications (Papers)

Friday, 19 August 2011 13:58

QTc-interval abnormalities in a forensic population

Principal institute author Michael Ferriter

Aim: To investigate the prevalence of QT-interval abnormalities and associated known risk factors for fatal cardiac arrhythmias in a sample of forensic patients.

Published in Journal Publications (Papers)

Friday, 19 August 2011 13:53

Prenatal alcohol exposure and gender differences in childhood mental health problems: a longitudinal population-based study

Principal institute author Kapil Sayal

Published in Journal Publications (Papers)

Friday, 19 August 2011 13:24

Homeless mothers: Is there a relationship between coping strategies, mental health and goal achievement?

Principal institute author Victoria Tischler

Published in Journal Publications (Papers)

Friday, 19 August 2011 13:11

Predictive validity of the PCL-R for offenders with intellectual disability in a high security hospital: Institutional aggression

Principal institute author Catrin Morrissey

Psychopathy has emerged as one of the constructs most predictive of violence risk in the forensic field. The Psychopathy Checklist-Revised (PCL-R) has previously been found to have acceptable reliability and validity in a sample of offenders with intellectual disability, but its predictive validity in this group has yet to be established. This prospective study examined the relative ability of the PCL-R and two other instruments, the Historical Clinical Risk-20 (HCR-20) and the Emotional Problem Scales' Behaviour Ratings Scale, to predict officially recorded institutional aggression. A sample of 60 offenders with intellectual disability in a high security forensic psychiatric setting was followed up for a period of 12 months. The PCL-R 20-item total, the PCL-R 13-item total, and PCL-R Factor 1 and Factor 2 scores did not significantly predict any type of aggressive behaviour. In contrast, the two more clinically based measures significantly predicted both interpersonal physical and verbal/property aggression. A primary justification for using the PCL-R in forensic settings is the evidence for its association with violence. Further studies examining the relationship between psychopathy, aggression, and violent recidivism in broader samples of offenders with ID are therefore imperative.

Published in Journal Publications (Papers)

Friday, 19 August 2011 13:03

Changes in brain function during acute cannabis intoxication.

Principal institute author Rick Howard

Preliminary findings suggest a mechanism for cannabis-induced violence.

Published in Journal Publications (Papers)

Friday, 19 August 2011 12:57

A matter of necessity? Enforced treatment under the Mental Health Act

Principal institute author Peter Bartlett

This case concerned the substantive prerequisites for involuntary treatment under the Mental Health Act 1983 (MHA). The parties agreed that following the European Court of Human Rights ruling in Herczegfalvy v. Austria, treatment for mental disorder could be enforced only if it were ‘medically necessary’. At the core of the decision in Haddock was how this phrase is to be construed. In particular, did Herczegfalvy require a two-part approach to the issue, first identifying with some certainty the disorder afflicting the patient and then determining whether the proposed treatment was necessary for that disorder, or could ‘medical necessity’ instead be determined as a single, multi-faceted question? Also at issue was the court's appropriate process and standard of review in such matters. Because of developments in the factual evidence and in the relevant case law during the litigation, a variety of other factors were considered, most particularly the relevance of a review tribunal's classification of mental disorder to the court's view of an individual's diagnosis.

Published in Journal Publications (Papers)

Friday, 19 August 2011 12:54

The interaction between individual characteristics and the function of aggression in forensic psychiatric inpatients

Principal institute author Michael Daffern

Aggression occurs regularly on many psychiatric wards; its assessment, prevention and management are fundamental aspects of contemporary psychiatric inpatient treatment. In response to the need to understand aggression in this context a considerable body of research has accumulated, clarifying the demographic and clinical characteristics of patients that contribute to an increased propensity for aggressive behaviour. Concurrent research has identified a range of situational demands, antecedent interactions, functions and precipitants to aggressive behaviour. Rarely has research attempted to understand how these predisposing characteristics sensitise a patient to environmental events, or predispose a patient to act aggressively for particular purposes. This article describes the results of a study that examined the interaction of demographic, clinical, affective and behavioural characteristics with the function of aggressive behaviour. Results revealed several statistically significant relationships. In these instances, the individual characteristics evidently predisposed patients to an increased risk of aggression that satisfied or attempted to satisfy certain functions. Awareness of these associations might assist in the delineation of methods for managing a patient during hospitalisation; patients could be assisted to satisfy psychological needs and staff may be able to provide psychiatric treatment in a manner that reduces the likelihood of aggression.

Published in Journal Publications (Papers)

Friday, 19 August 2011 12:39

Aggressive behaviour in high risk personality disordered inpatients during prison and on admission to hospital

Principal institute author Michael Daffern

The frequency of aggressive behaviour before and during admission to a hospital unit designed to treat patients identified as dangerous and as having a severe personality disorder (DSPD) was examined. Accounting for differences in recording procedures and time at risk, results showed a comparable frequency of aggressive behaviour across environments. Although the limited number of patients available to study and methodological issues prevent definitive conclusions, reactions to admission and exposure to the therapeutic context appeared inconsistent, some patients demonstrating stability or improvement, others appearing to worsen or react negatively to admission. Neither psychopathy nor severity of personality disorder interacted with admission and exposure to the new environment to impact on the course of aggressive behaviour. Results emphasise the need for staff to prepare for the inevitability of aggression in this group of patients during the lengthy, demanding and complex treatment process, and to consider the potential for a various reactions to admission, including deterioration, which may mean an increase in dangerousness or an aggravation of the personality disorder.

Published in Journal Publications (Papers)

Friday, 19 August 2011 11:58

The Violent Offender Treatment Programme (VOTP): development of a treatment programme for violent patients in a high security psychiatric hospital

Principal institute author Louise Braham

Published in Journal Publications (Papers)

Friday, 19 August 2011 11:43

Improvement and decline of cognitive function in schizophrenia over one year: a longitudinal investigation using latent growth modelling

Principal institute author Sue Jaycock

Background: Long-term follow-up studies of people with schizophrenia report stability of cognitive performance; less is known about any shorter-term changes in cognitive function.

Published in Journal Publications (Papers)

Friday, 19 August 2011 11:41

Prospects for a cognitive-developmental account of psychotic experiences

Principal institute author Rhiannon Corcoran

Published in Journal Publications (Papers)

Friday, 19 August 2011 10:56

Predictive validity of the PCL-R for offenders with intellectual disability in a high security hospital: Treatment progress

Principal institute author Catrin Morrissey

Background Among mainstream offenders, the severe personality disorder of psychopathy has considerable importance as a construct. The disorder has long been associated with failure to make treatment progress. Previous work has identified that psychopathy as a disorder occurs in samples of offenders with intellectual disability (ID), and suggests that the Psychopathy Checklist – Revised (PCL-R: Hare, 1991, 2003) as a measure of the disorder has adequate reliability and validity (Morrissey et al., 2005). The present study aimed to compare the predictive power of the PCL-R in relation to treatment progress with a more general assessment of violence risk, the HCR-20 (Webster, Douglas, Eaves, & Hart, 1997).

Published in Journal Publications (Papers)

Friday, 19 August 2011 10:54

Neuroaffective processing in criminal psychopaths: Brain event-related potentials reveal task-specific anomalies

Principal institute author Rick Howard

Published in Journal Publications (Papers)

Friday, 19 August 2011 10:45

A preliminary study of a measure of role-play competence in Psychodynamic Interpersonal Therapy

Principal institute author Chris Evans

We report a 15-item role-play competence measure. Ratings by three judges of 34 role plays from psychodynamic interpersonal therapy training showed good inter-rater (.73-.79) and internal reliability (.84-.96). Validity was supported as scores were statistically significantly associated with psychotherapy experience. Most participants achieved satisfactory ratings supporting the training.

Published in Journal Publications (Papers)

Friday, 19 August 2011 10:29

Altered emotional decision-making in prisoners with borderline personality disorder

Principal institute author John Milton

Published in Journal Publications (Papers)

Friday, 19 August 2011 10:11

Measuring motivation for therapy and motivation for change in adult prisoners

Principal institute author Mary McMurran

Published in Journal Publications (Papers)

Friday, 19 August 2011 10:08

Epidemiology of ADHD in the community

Principal institute author Kapil Sayal

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting around 5% of school-aged hildren. However, in the UK, the majority of children with ADHD remain undiagnosed. This article reviews the epidemiology of ADHD in terms of its prevalence, correlates, recognition and outcomes with regard to community and clinical samples.

Published in Journal Publications (Papers)

Friday, 19 August 2011 10:01

Partial defences to murder under review

Principal institute author Andy Bickle

Published in Journal Publications (Papers)

Friday, 19 August 2011 09:58

Levels of anxiety and sources of stress in adults with autism

Principal institute author Alinda Gillott

Clinical reports suggest that anxiety is a pertinent issue for adults with autism. We compared 34 adults with autism with 20 adults with intellectual disabilities, utilizing informant-based measures of anxiety and stress. Groups were matched by age, gender and intellectual ability. Adults with autism were almost three times more anxious than the comparison group and gained significantly higher scores on the anxiety subscales of panic and agoraphobia, separation anxiety, obsessive-compulsive disorder and generalized anxiety disorder. In terms of sources of stress, significant differences between the two groups were also found, and stress was found to correlate with high anxiety levels for the autism group, particularly the ability to cope with change, anticipation, sensory stimuli and unpleasant events. That is, the more anxious the individual with autism, the less likely they were able to cope with these demands. This has important implications for clinicians in terms of both assessment and treatment.

Published in Journal Publications (Papers)

Friday, 19 August 2011 09:50

Tensions around inclusion: reframing the moral horizon

Principal institute author Jennifer Clegg

Inclusion is one of four policies for people with disabilities in the UK. Criticisms of its three key attributes – mainstreaming, independent living and employment – are reviewed. This study of 28 young people, most with severe intellectual disabilities, investigated engagement with inclusion at their transition to adult services. Data were collected from the young people where possible; from their carers, mostly parents; and from professionals responsible for brokering transition. Narrative analysis of this material investigated ways in which respondents did or did not engage with the goals of inclusion as defined in various policy documents.

Published in Journal Publications (Papers)

Friday, 19 August 2011 09:41

Evaluation of screening in children referred for an ADHD assessment

Principal institute author Kapil Sayal

Although guidance from the National Institute for Clinical Excellence recommends the improved identification of children with ADHD, clinical resources are limited. Amongst children (n = 119) referred over the question of ADHD, we evaluated the utility of screening (using parent and teacher questionnaires) prior to offering an ADHD assessment. The introduction of screening contributed to an increase in the proportion of assessed children receiving a clinical diagnosis of ADHD. Although screening of referred children prior to assessment can optimise the use of specialist clinical resources in the identification of children with ADHD, false positives remain common.

Published in Journal Publications (Papers)

Friday, 19 August 2011 09:23

Careers in academic forensic psychiatry

Principal institute author Simon Gibbon

Published in Journal Publications (Papers)

Friday, 19 August 2011 09:20

Proposed reforms to partial defences and their implications for mentally disordered defendants

Principal institute author Andy Bickle

Published in Journal Publications (Papers)

Friday, 19 August 2011 09:17

Casenote: The Minister of Justice does have a responsibility to provide offending behaviour programmes in prison

Principal institute author Andy Bickle

Casenote: The Minister of Justice does have a responsibility to provide offending behaviour programmes in prison - submissions to the contrary are lacking in realism!

Published in Journal Publications (Papers)

Friday, 19 August 2011 09:14

Audit of statutory urgent treatment at a high secure hospital

Principal institute author Andy Bickle

Published in Journal Publications (Papers)

Friday, 19 August 2011 08:55

Referrals for expert psychiatric opinion on dangerous offenders

Principal institute author Andy Bickle

A survey of instructions regarding defendants liable on conviction to a statutory assessment of dangerousness.

Published in Journal Publications (Papers)

Friday, 19 August 2011 08:04

Assessment of caring and its effects in young people

Principal institute author Stephen Joseph

Development of the Multi-dimensional Assessment of Caring Activities Checklist (MACA-YC18) and the Positive and Negative Assessment of Caring Outcomes (PANOC-YC20)

Published in Journal Publications (Papers)

Tuesday, 10 May 2011 15:22

The nursing gaze: power relations in a study of nurse-resident interactions in learning disability

Principal institute author Patrick Callaghan

The researchers observed nurse-resident interactions in learning disability units in Hong Kong and interviewed a purposeful sample of nurses who had varying levels of interaction.

Published in Journal Publications (Papers)

publications

Journal Publications (Papers) (155)