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Mansell C, Yang M, Tyrer P. Effect of drama training on self-esteem and personality strengths: A feasibility case control study of nidotherapy. Int J Soc Psychiatry 2024:207640241239540. [PMID: 38509044 DOI: 10.1177/00207640241239540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
BACKGROUND Although there are many case reports and qualitative studies on the likely positive effects of drama on mental health there have been few quantitative studies with mentally ill patients. AIMS To assess the effect of drama training in patients receiving nidotherapy with a range of mental and personality disorders on changes in self-esteem and personality strengths over a 1-month period compared with two control groups, one with similar mental disorders and another without, who had similar assessments but no acting involvement. METHOD A total of 19 patients were recruited from a mental health charity with current significant mental illness (active group: n = 6) (b) a control group of patients with current mental illness who were not involved in acting (n = 5), and an additional control group with no current mental illness (n = 8) The patients involved in drama were taking part in nidotherapy, an environmental intervention. Two self-rating scales, the Rosenberg Self-Esteem Scale (RSES) and Abbreviated Personality Strengths Scale (APSS) recorded changes in self-esteem and personality strengths at base-line and after 1 month in the participants. Random effects modelling was used to analyse the data. RESULTS The intervention group showed positive improvement in personality strengths (p = .009) compared to the control group that had no mental illness, and also improved more than the control group with mental illness but not to a significant degree (p = .16). Self-esteem recorded with the Rosenberg scale was lower in those in the acting group at baseline compared with the other two groups (p = .088) but after acting training improved by 29% to be equivalent to the control groups. CONCLUSIONS Despite the limited numbers in this study, and the consequent inability to make firm conclusions about the efficacy of drama therapy as part of nidotherapy, the findings suggest that larger trials of this approach are feasible and worth exploring. .
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Affiliation(s)
- Chelsea Mansell
- Lincoln Medical School, University of Lincoln and Nottingham, UK
| | - Min Yang
- Swinburne University of Technology, Melbourne, VIC, Australia
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Peter Tyrer
- Division of Psychiatry, Imperial College, London, UK
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Li M, Zhu Y, Li S, Wu B. HG-PerCon: Cross-view contrastive learning for personality prediction. Neural Netw 2024; 169:542-554. [PMID: 37952390 DOI: 10.1016/j.neunet.2023.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/24/2023] [Accepted: 10/25/2023] [Indexed: 11/14/2023]
Abstract
Personality prediction task not only helps us to better understand personal needs and preferences but also is essential for many fields such as psychology and behavioral economics. Current personality prediction primarily focuses on discovering personality traits through user posts. Additionally, there are also methods that utilize psychological information to uncover certain underlying personality traits. Although significant progress has been made in personality prediction, we believe that current solutions still overlook the long-term sustainability of personality and are constrained by the challenge of capturing consistent personality-related clues across different views in a simple and efficient manner. To this end, we propose HG-PerCon, which utilizes user representations based on historical semantic information and psychological knowledge for cross-view contrastive learning. Specifically, we design a transformer-based module to obtain user representations with long-lasting personality-related information from their historical posts. We leverage a psychological knowledge graph which incorporates language styles to generate user representations guided by psychological knowledge. Additionally, we employ contrastive learning to capture the consistency of user personality-related clues across views. To evaluate the effectiveness of our model, and our approach achieved a reduction of 2%, 4%, and 6% in RMSE compared to the second-best baseline method.
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Affiliation(s)
- Meiling Li
- Beijing Key Laboratory of Intelligence Telecommunication Software and Multimedia, Beijing University of Posts and Telecommunications, Beijing 100876, PR China
| | - Yangfu Zhu
- Beijing Key Laboratory of Intelligence Telecommunication Software and Multimedia, Beijing University of Posts and Telecommunications, Beijing 100876, PR China
| | - Shicheng Li
- School of Computer Science and Technology, WuHan University, WuHan 430072, PR China
| | - Bin Wu
- Beijing Key Laboratory of Intelligence Telecommunication Software and Multimedia, Beijing University of Posts and Telecommunications, Beijing 100876, PR China.
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Tyrer P, Duggan C, Yang M, Tyrer H. The effect of environmental change, planned and unplanned life events on the long-term outcome of common mental disorders. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02520-1. [PMID: 37428194 DOI: 10.1007/s00127-023-02520-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE To examine the nature of positive and negative environmental change on clinical outcome in 210 patients presenting with anxiety and depression and followed up over 30 years. METHODS In addition to clinical assessments, major environmental changes, particularly after 12 and 30 years, were recorded in all patients by a combination of self-report and taped interviews. Environmental changes were separated into two major groups, positive or negative, determined by patient opinion. RESULTS In all analyses positive changes were found to be associated with better outcome at 12 years with respect to accommodation (P = 0.009), relationships (P = 007), and substance misuse (P = 0.003), with fewer psychiatric admissions (P = 0.011) and fewer social work contacts at 30 years (P = 0.043). Using a consolidated outcome measure positive changes were more likely than negative ones to be associated with a good outcome at 12 and 30 years (39% v 3.6% and 30.2% v 9.1%, respectively). Those with personality disorder at baseline had fewer positive changes (P = 0.018) than others at 12 years and fewer positive occupational changes at 30 years (P = 0.041). Service use was greatly reduced in those with positive events with 50-80% more time free of all psychotropic drug treatment (P < 0.001). Instrumental positive change had greater effects than imposed changes. CONCLUSIONS Positive environmental change has a favourable impact on clinical outcome in common mental disorders. Although studied naturalistically in this study the findings suggest that if harnessed as a therapeutic intervention, as in nidotherapy and social prescribing, it would yield therapeutic dividends.
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Affiliation(s)
- Peter Tyrer
- Division of Psychiatry, Imperial College, London, UK.
| | - Conor Duggan
- Department of Forensic Psychotherapy, University of Nottingham, Nottingham, UK
| | - Min Yang
- School of Public Health, Sichuan University, Chengdu, China
- Faculty of Health, Art and Design, Swinburne University of Technology, Melbourne, Australia
| | - Helen Tyrer
- Division of Psychiatry, Imperial College, London, UK
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Bach B, Mulder R. Clinical Implications of ICD-11 for Diagnosing and Treating Personality Disorders. Curr Psychiatry Rep 2022; 24:553-563. [PMID: 36001221 DOI: 10.1007/s11920-022-01364-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW The International Classification of Diseases 11th revision (ICD-11) introduced a new approach to personality disorders and related traits. This paper reviews recent literature on the assessment of ICD-11 personality disorders and implications for clinical diagnosis, decision-making, and treatment. RECENT FINDINGS We reviewed findings on two measures developed for the ICD-11 model of personality dysfunction and six inventories for the ICD-11 trait specifiers. The psychometric qualities of these tools are promising, and they allow for both rapid screening and fine-grained assessment. Implications for clinical diagnosis and treatment of personality disorders are reviewed including utility for forensic practice. Based on evidence and our experience, we provide some recommendations for severity- and trait-informed interventions. Initial evidence supports the available instruments for assessing ICD-11 personality disorders. More research is needed including development of clinician-rating forms and diagnostic interviews as well as treatment protocols and trials based on the new ICD-11 classification.
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Affiliation(s)
- Bo Bach
- Center for Personality Disorder Research (CPDR), Psychiatric Research Unit, Region Zealand Psychiatry, Fælledvej 6, Bygning 3, 4200, Slagelse, Denmark. .,Department of Psychology, University of Southern Denmark, Odense, Denmark.
| | - Roger Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Sharp C. New data toward fulfilling the promise of the ICD-11 severity criterion. Personal Ment Health 2022; 16:93-98. [PMID: 35581693 DOI: 10.1002/pmh.1549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 11/06/2022]
Abstract
Great progress has been made in furthering our understanding of the long-term course of personality pathology. However, our knowledge about the long-term outcomes of personality disorder, thus far, is based on a polythetic and categorical definition of personality disorder. This special issue brings together a set of papers reporting on the results of the 30-year prospective study, the Nottingham Study of Neurotic Disorder, in addition to presenting a study protocol for a future study, the Boston (UK) Personality Project, and results from a study of lived experience of individuals who have been in treatment for personality challenges. Together, these papers highlight the value in viewing personality pathology not as a categorically defined disorder, but as a severity criterion related to functioning. This special issue paves the way for considering how to further refine and conceptualize the general severity criterion common to all manifestations (types) of personality disorder.
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Affiliation(s)
- Carla Sharp
- Department of Psychology, University of Houston, Houston, Texas, USA
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Jha M, Barrett B, Brewin C, Bowker G, Harwood N, Jalil I, Crawford M, Phull J, Allen K, Duggan C, Yang M, Tyrer P. Matching ICD-11 personality status to clinical management in a community team-The Boston (UK) Personality Project: Study protocol. Personal Ment Health 2022; 16:130-137. [PMID: 35474611 DOI: 10.1002/pmh.1544] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/02/2022] [Accepted: 04/05/2022] [Indexed: 01/19/2023]
Abstract
Epidemiological studies show 30% to 50% of all patients in community mental health teams have personality disorders. These are normally comorbid with other psychiatric disorders, often as Galenic syndromes, and are seldom identified. In the Boston (UK) Personality Project all patients under a community health service in Boston in Lincolnshire will be asked to agree to have their personality status assessed using scales recording the new ICD-11 classification, together with clinical ratings, social function and satisfaction. A control group of 100 patients from an adjacent service of similar demographics (Spalding) will also have similar ratings but no personality assessments. Changes in clinical status, social function and service satisfaction will be made after 6 and 12 months in both groups. The patients in the Boston group will be offered matched interventions using a stepped care approach for both the severity of disorder and its domain structure. These interventions will include shorter versions of existing psychological treatments, environmental therapies including nidotherapy, adaptive and acceptance models, drug reduction and social prescribing. Full costs of psychiatric care will be measured in both groups. The main hypothesis is that greater awareness of personality function will lead to better clinical outcomes and satisfaction.
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Affiliation(s)
- Mithilesh Jha
- Lincolnshire Partnership NHS Foundation Trust, St George's, Lincoln, UK
| | | | - Chris Brewin
- Department of Psychology, University College Hospital, London, UK
| | - Geoff Bowker
- Lincolnshire Partnership NHS Foundation Trust, St George's, Lincoln, UK
| | - Nick Harwood
- Lincolnshire Partnership NHS Foundation Trust, St George's, Lincoln, UK
| | - Iram Jalil
- Lincolnshire Partnership NHS Foundation Trust, St George's, Lincoln, UK
| | - Mike Crawford
- Division of Psychiatry, Commonwealth Building, Imperial College, London, UK
| | - Jaspreet Phull
- Lincolnshire Partnership NHS Foundation Trust, St George's, Lincoln, UK
| | - Katherine Allen
- Birmingham and Solihull Mental Health Foundation Trust, Uffculme Centre, Birmingham, UK
| | | | - Min Yang
- West China School of Public Health, Sichuan University, Chengdu, China.,Faculty of Health, Art and Design, Swinburne, University of Technology, Melbourne, Sydney, Australia
| | - Peter Tyrer
- Lincolnshire Partnership NHS Foundation Trust, St George's, Lincoln, UK.,Kings Health Economics, King's College London, London, UK
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