Search

Background: Stigma of mental health conditions hinders recovery and well-being. The Honest, Open, Proud (HOP) program shows promise in reducing stigma but there is uncertainty about the feasibility of a randomized trial to evaluate a peer-delivered, individual adaptation of HOP for psychosis (Let's Talk). Methods: A multi-site, Prospective Randomized Open Blinded Evaluation (PROBE) design, feasibility randomised controlled trial (RCT) comparing the peer-delivered intervention (Let's Talk) to treatment as usual (TAU). Follow-up was 2.5 and 6 months. Randomization was via a web-based system, with permuted blocks of random size. Up to 10 sessions of the intervention over 10 weeks were offered. The primary outcome was feasibility data (recruitment, retention, intervention attendance). Primary outcomes were analyzed by intention to treat. Safety outcomes were reported by as treated status. The study was prospectively registered: https://doi.org/10.1186/ISRCTN17197043. Results: 149 patients were referred to the study and 70 were recruited. 35 were randomly assigned to intervention + TAU and 35 to TAU. Recruitment was 93% of the target sample size. Retention rate was high (81% at 2.5 months primary endpoint), and intervention attendance rate was high (83%). 21% of 33 patients in Let's talk + TAU had an adverse event and 16% of 37 patients in TAU. One serious adverse event (pre-randomization) was partially related and expected. Conclusions: This is the first trial to show that it is feasible and safe to conduct a RCT of HOP adapted for people with psychosis and individual delivery. An adequately powered trial is required to provide robust evidence. [ABSTRACT FROM AUTHOR]

Background and Hypothesis The role of early adversity and trauma is increasingly recognized in psychosis but treatments for trauma and its consequences are lacking. Psychological treatments need to understand the prevalence of these experiences, the relationship with specific symptoms and identify potentially tractable processes that may be targeted in therapy. It was hypothesized that greater adversity, and specifically abuse rather than neglect, would be associated with positive symptoms and specifically hallucinations. In addition, negative beliefs would mediate the relationship with positive symptoms. Study Design 292 Patients with treatment resistant psychosis completed measures of early adversity as well as current symptoms of psychosis. Study Results Early adversity in the form of abuse and neglect were common in one-third of the sample. Adversity was associated with higher levels of psychotic symptoms generally, and more so with positive rather than negative symptoms. Abuse rather than neglect was associated with positive but not with negative symptoms. Abuse rather than neglect was associated with hallucinations but not delusions. Abuse and neglect were related to negative beliefs about the self and negative beliefs about others. Mediation demonstrated a general relationship with adversity, negative-self, and other views and overall psychotic symptoms but not in relation to the specific experience of abuse and hallucinations. Females were more likely to be abused, but not neglected, than males. Conclusions Whilst most relationships were modest, they supported previous work indicating that adversity contributes to people with psychosis experiencing distressing symptoms especially hallucinations. Treatments need to address and target adversity. [ABSTRACT FROM AUTHOR]

Purpose: Research suggests that the way an individual understands a health difficulty can influence their subsequent behaviour. The aim of this study was to explore the psychometric properties of a new causal belief questionnaire for people who have experience of psychosis. We also planned to provide an overview of current causal beliefs within this group and to explore the relationship between these beliefs and the perceived helpfulness of treatment and the treatment accessed. Methods: Three hundred and eleven service‐users with experience of psychosis completed a questionnaire designed to explore how they understand the cause of their difficulties. Additional information was collected about different aspects of treatment. Results: The results of the exploratory factor analysis indicated a two‐factor solution comprising a psychosocial and biogenetic scale. Individuals in this study endorsed a variety of different causes, with an overall preference for psychosocial explanations. No relationships were established between beliefs and perceptions about the helpfulness of treatment. Individuals who had accessed cognitive behavioural therapy were more likely to endorse the psychosocial factor. Conclusions: Individuals with psychosis consider a number of factors to be important in relation to the development of their experiences. These beliefs should be explored as part of the therapeutic process as this appears to be important to the individual and could potentially help inform treatment decisions. Practitioner points: The causal belief questionnaire captured two underlying constructs relating to psychosocial and biogenetic causes. Individuals within this group endorsed a range of factors; however, they prefer psychosocial causes overall. There was an indication that some aspects of an individual's beliefs were associated with the treatment they accessed. [ABSTRACT FROM AUTHOR]

Findings suggest that the way an individual understands their experiences has important consequences on subsequent health behaviour. One aspect of an individual's understanding is what they believe has caused their experiences. This has been associated with treatment outcome and attitudes towards mental health problems. The aim of this systematic review was to examine the impact of causal beliefs on treatment outcome and stigma in people experiencing psychosis. Three main databases were searched and 21 articles that investigated various aspects of treatment outcome, and stigma in relation to causal beliefs was included in the review. Overall, there were a small number of replicated findings which limits the interpretation of results. There is an indication that causal explanations are associated with various treatment outcomes, including attitudes towards treatment and satisfaction with therapeutic relationships as well as internalized stigma. Spiritual beliefs appeared to be adopted as a coping mechanism and a way to reduce stigma but did not appear to be associated with treatment outcome. Individuals with psychosis do appear to develop causal beliefs that may be associated with engagement with services and treatment, as well as impacting on their attitudes towards themselves and others with mental illness. This may have important implications for clinical practice. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message Individuals who have experience of psychosis develop their own subjective causal explanations, and these can be complex and contradictory., An individual's causal explanation may influence how they engage with services and treatment, as well as providing a way of coming to terms with their difficulties., Causal explanations may also contribute to the experience of stigma, which is often a significant barrier to recovery for this client group. [ABSTRACT FROM AUTHOR]