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Our research team implemented and evaluated a 12-week manual-based intervention focused on sustaining recovery for youth with psychosis, as they transitioned from Early Psychosis Intervention (EPI) to community-based care teams. The study employed a mixed methods prospective cohort design. Statistically significant improvement in functioning was observed for the intervention group participants only; as well as observed improvements in self-esteem and quality of life (SQLS), compared to the comparison group who demonstrated a significant decline in functioning. The qualitative findings revealed a sense of optimism about the future and the value of realistic goal-setting in the intervention group. Keywords: Early Psychosis, Transitional Intervention, Recovery, Functioning, Goal-Setting

Ensuring the financial security of individuals recovering from first episode psychosis is imperative, but disability income programs can be powerful disincentives to employment, compromising the social and occupational aspects of recovery. Survival analysis and Cox regression analysis were used to examine the rate at which individuals served by early intervention for psychosis (EIP) services apply for government disability income benefits and factors that predict rate of application. Health records for 558 individuals served by EIP programs were reviewed. Within the first year of receiving services 30% will make application for disability income; 60% will do so by 5 years. Rate of application is predicted by rate of hospital admission, financial status and engagement in productivity roles at the time of entry to EIP service. The findings suggest the need to examine the extent to which the recovery goals of EI services are undermined by early application for government income support. They also suggest the need to develop best practice guidelines related to ensuring the economic security of individuals served.

Resume La logique du type associatif de 91 gestionnaires canadiens anglophones de sexe feminin et 92 gestionnaires canadiens anglophones de sexe masculin a ete comparee au moyen d'une analyse du contenu des antecedents et consequents (methode Triandis et al.; 1972) relatifs a 11 valeurs de travail et 10 valeurs personnelles. Les echantillons de ces gestionnaires de la Fonction Publique du Canada etaient semblables pour l'age, le statut socioeconomique et les annees d'experience en gestion. Une recension des ecrits suggere qu'il n'y a pas de difference quant a leur orientation aux valeurs en ce qui concerne les categories expressives vs. instrumentales. L'analyse du contenu dans ces categories demontre que la connotation de ces concepts de valeurs etaient equivalents pour ces gestionnaires, quelque soit leur sexe. Le Rho = 0.91 pour les antecedents et 0.97 pour les consequences pour les gestionnaires femmes vs. hommes, nous donnent une estimation de cette equivalence. Ces resultats sont interpretes comme refletant un haut niveau de similitude de fonctionnement et une equivalence interne dans les schemes de reference dans la culture subjective (la logique du type associatif) des hommes et des femmes gestionnaires a l'interieur de la Fonction Publique.

Resume Resumen Patients (N=135) with binge eating disorder (BED) were randomized to a control condition or to one of two 16-session group treatments: group cognitive–behavioral therapy (GCBT) or group psychodynamic interpersonal psychotherapy (GPIP). The two treatments performed equally well, and each resulted in reduced days binged compared with the wait-list control condition. Twelve-month follow-up indicated that improvements were maintained in days binged and in other outcome variables. For women who completed GPIP, higher attachment anxiety was related to improvements in days binged by posttreatment. On the other hand, for women who completed GCBT, lower attachment anxiety was associated with improvements in days binged by posttreatment. Higher attachment avoidance was related to dropping out of GCBT. Although both GPIP and GCBT reduced binge eating, the results indicated that individual outcomes differ across treatments based on level of attachment anxiety and avoidance. Zusammenfassung Bin...

This study compares the motivation and the quality of criticism responses of 697 undergraduates who were divided into three levels of situation legitimacy (high, moderate, and low) and two levels (top versus bottom 40 percent) of anxiety related to previous generalized assertiveness behaviours. The impact of gender was also studied. The results showed the legitimacy of the situation for a critical response (preassessed with peer hold-out groups) significantly affected participants' motivation to criticize as well as the quality of their critical responses, notwithstanding the poor quality of all criticism responses. Anxiety related to previous global assertiveness was related to high motivation but not to quality of criticism responses. There were no gender effects. Results are interpreted within an avoidance learning paradigm wherein the connotative meaning of criticism is incongruent with harmonious long-term relationships so that it is suppressed until virtually forced by the specifics of highly legitimate situations.

Background In much of the world, general practitioners (GPs) are the health professionals most frequently initially contacted when a young person is developing psychosis. However little is known about their expertise in assessing psychosis and its risk. Methods To assess the diagnostic patterns and treatment practices related to psychosis of GPs working in a range of health care systems, questionnaires were mailed to 12,516 randomly selected GPs in seven countries: Canada, Australia, New Zealand, England, Norway, Austria and the Czech Republic. Sites were defined as gatekeeping or non-gatekeeping, based on the primary care health system in effect at each site. A gatekeeping system (GK) is one which mandates that patients see a GP before in order to be referred to a specialist. By contrast, in a non-gatekeeping (nGK) system, individuals can seek help directly from specialists without authorization by a GP. Results Twenty-two percent (n = 2784) GPs responded to the mailed questionnaire. They reported low prevalence of early psychosis seen in general practice. Using awareness of functional decline as a prognostic sign as a proxy, gatekeeping (GK) GPs were found to be superior in their knowledge of the signs and symptoms of early psychosis than were non-gatekeeping GPs. GP's with less knowledge as to early psychosis were more likely to refer individuals with suspected psychosis to specialists. GP's reported a preference for access to specialized outpatient services as compared with obtaining continuous medical education relevant to early psychosis. The duration of maintenance treatment recommended by GP's was less than that recommended in international guidelines. GP's also underestimated the risk for relapse after a first episode of psychosis. Conclusions As GPs were largely unaware of features of early psychosis, such as functional decline, this should be the target of educational programs for GP's. However, the incidence of psychosis is low and GP's express a preference for access to appropriate referral over continuing medical education. Therefore, the development of specializ ed services for the assessment and care of patients who are in the early stages of developing schizophrenia may be warranted.

Young people coping with first episode schizophrenia may be predisposed to illness engulfment whereby the illness entirely defines self-concept. They require psychosocial intervention to preserve an identity distinct from illness, promote hopefulness, and minimise the impact of stigma, enabling them to embrace a healthy sense of self and an optimistic future. The purpose of this study was to evaluate a group intervention designed to promote healthy self-concepts by reducing self-stigmatisation and engulfment among young adults recovering from first episode schizophrenia. Participants at two first episode psychosis clinics, one in Toronto and one in Ottawa, were assigned to one of two groups: intervention plus treatment as usual, or a control with only treatment as usual. A repeated measures analysis revealed that immediately post-intervention, the treatment group significantly improved on engulfment, hope, and quality of life measures compared with the control. No improvement was observed in self-concept, self-esteem, self-efficacy, and stigma. Intervening early in the course of the illness to address engulfment and self-stigmatisation may enable young people to acquire positive attitudes toward themselves and the future. Future longitudinal data are needed to determine whether this intervention will prevent the development of chronicity and demoralisation over time.