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Yu Y, Wu AMS, Wing YK, Chan JWY, Lau MMC, Lau JTF. Validation of the Revised Illness Perception Questionnaire of Obstructive Sleep Apnea among Elderly Chinese in the General Population. Sleep Breath 2023; 27:337-344. [PMID: 35377089 DOI: 10.1007/s11325-022-02598-y] [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: 10/25/2021] [Revised: 03/02/2022] [Accepted: 03/10/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The prevalence of under-diagnosis among individuals with obstructive sleep apnea (OSA) is alarming, and may be associated with perceptions regarding OSA. To facilitate future studies on OSA, this study validated the revised version of the Illness Perception Questionnaire (IPQ-R) for OSA in a general population. METHODS A random anonymous population-based telephone survey interviewed 580 adults aged ≥ 50 years in Hong Kong, who self-reported not having been told by doctors as having OSA, from February 5 to March 19, 2021. RESULTS The confirmatory factor analysis identified a modified 7-factor model (i.e., timeline chronic, consequence, personal control, treatment control, illness coherence, timeline cyclical, and emotional representation) that showed satisfactory model fit index and internal consistency. Nine items were removed from the original version because of low factor loadings. No floor and ceiling effects were observed. Convergent validity was supported by the positive associations between the consequence subscale with perceived negative outcomes of OSA and between the illness coherence subscale and perceived understanding of OSA symptoms. The participants tended to endorse the items of timeline chronic, treatment control, and illness coherence but not with those of emotional representations. The mean scores of the IPQ-R subscales differed by age and education level. CONCLUSION The modified IPQ-R of OSA showed acceptable psychometric properties. It is applicable to assessing illness perceptions of OSA in the Chinese general population aged ≥ 50 years not having received OSA diagnosis. The validated tool would support future studies and health practices related to OSA.
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Affiliation(s)
- Yanqiu Yu
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Anise M S Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Joey W Y Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Mason M C Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph T F Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
- Department of Psychology, School of Psychiatry, Wenzhou Medical University, Wenzhou, China.
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2
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Altman RAE, Tan EJ, Rossell SL. Factors Impacting Access and Engagement of Cognitive Remediation Therapy for People with Schizophrenia: A Systematic Review. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:139-151. [PMID: 36448242 PMCID: PMC9974655 DOI: 10.1177/07067437221129073] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
OBJECTIVES Neurocognitive deficits are central in schizophrenia. Cognitive remediation has proven effective in alleviating these deficits, with medium effect sizes. However, sizeable attrition rates are reported, with the reasons still uncertain. Furthermore, cognitive remediation is not part of routine mental health care. We conducted a systematic review to investigate factors that influence access and engagement of cognitive remediation in schizophrenia. METHODS We systematically searched the PubMed, Web of Science, and PsycINFO databases for peer-reviewed articles including a cognitive remediation arm, access, and engagement data, and participants with schizophrenia spectrum disorders aged 17-65 years old. Duplicates and studies without a distinct cognitive remediation component, protocol papers, single case studies, case series, and reviews/meta-analyses were excluded. RESULTS We included 67 studies that reported data on access and engagement, and extracted quantitative and qualitative data. Access data were limited, with most interventions delivered on-site, to outpatients, and in middle- to high-income countries. We found a median dropout rate of 14.29%. Only a small number of studies explored differences between dropouts and completers (n = 5), and engagement factors (n = 13). Dropouts had higher negative symptomatology and baseline self-efficacy, and lower baseline neurocognitive functioning and intrinsic motivation compared to completers. The engagement was positively associated with intrinsic motivation, self-efficacy, perceived usefulness, educational level, premorbid intelligence quotient, baseline neurocognitive functioning, some neurocognitive outcomes, and therapeutic alliance; and negatively associated with subjective cognitive complaints. Qualitative results showed good acceptability of cognitive remediation, with some areas for improvement. CONCLUSIONS Overall, access and engagement results are scarce and heterogeneous. Further investigations of cognitive remediation for inpatients, as well as remote delivery, are needed. Future clinical trials should systematically explore attrition and related factors. Determining influential factors of access and engagement will help improve the implementation and efficacy of cognitive remediation, and thus the recovery of people with schizophrenia.
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Affiliation(s)
- Rosalie Ariane Eva Altman
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Eric Josiah Tan
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
- Department of Mental Health, St Vincent's Hospital, Melbourne, Australia
| | - Susan Lee Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
- Department of Mental Health, St Vincent's Hospital, Melbourne, Australia
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3
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Wießner I, Falchi M, Palhano-Fontes F, Feilding A, Ribeiro S, Tófoli LF. LSD, madness and healing: Mystical experiences as possible link between psychosis model and therapy model. Psychol Med 2023; 53:1151-1165. [PMID: 34253268 DOI: 10.1017/s0033291721002531] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND For a century, psychedelics have been investigated as models of psychosis for demonstrating phenomenological similarities with psychotic experiences and as therapeutic models for treating depression, anxiety, and substance use disorders. This study sought to explore this paradoxical relationship connecting key parameters of the psychotic experience, psychotherapy, and psychedelic experience. METHODS In a randomized, double-blind, placebo-controlled, crossover design, 24 healthy volunteers received 50 μg d-lysergic acid diethylamide (LSD) or inactive placebo. Psychotic experience was assessed by aberrant salience (Aberrant Salience Inventory, ASI), therapeutic potential by suggestibility (Creative Imagination Scale, CIS) and mindfulness (Five Facet Mindfulness Questionnaire, FFMQ; Mindful Attention Awareness Scale, MAAS; Experiences Questionnaire, EQ), and psychedelic experience by four questionnaires (Altered State of Consciousness Questionnaire, ASC; Mystical Experiences Questionnaire, MEQ; Challenging Experiences Questionnaire, CEQ; Ego-Dissolution Inventory, EDI). Relationships between LSD-induced effects were examined. RESULTS LSD induced psychedelic experiences, including alteration of consciousness, mystical experiences, ego-dissolution, and mildly challenging experiences, increased aberrant salience and suggestibility, but not mindfulness. LSD-induced aberrant salience correlated highly with complex imagery, mystical experiences, and ego-dissolution. LSD-induced suggestibility correlated with no other effects. Individual mindfulness changes correlated with aspects of aberrant salience and psychedelic experience. CONCLUSIONS The LSD state resembles a psychotic experience and offers a tool for healing. The link between psychosis model and therapeutic model seems to lie in mystical experiences. The results point to the importance of meaning attribution for the LSD psychosis model and indicate that psychedelic-assisted therapy might benefit from therapeutic suggestions fostering mystical experiences.
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Affiliation(s)
- Isabel Wießner
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Marcelo Falchi
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Fernanda Palhano-Fontes
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Sidarta Ribeiro
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Luís Fernando Tófoli
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
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4
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Degnan A, Berry K, Vaughan M, Crossley N, Edge D. Engagement with services in Black African and Caribbean people with psychosis: The role of social networks, illness perceptions, internalized stigma, and perceived discrimination. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:1134-1153. [PMID: 35906819 PMCID: PMC9796907 DOI: 10.1111/bjc.12385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/24/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Research and policies in the United Kingdom have repeatedly highlighted the need to reduce ethnic disparities and improve engagement with mental health services among Black African and Caribbean people with psychosis. The aim of this study was to examine the role of social network characteristics and psychological factors in engagement with services in Black people with psychosis. METHODS A cross-sectional study was conducted with 51 Black African and Caribbean adults with non-affective psychosis and currently receiving care from mental health services in England. Measures were completed to examine relationships between social networks, illness perceptions, perceived racial or ethnic discrimination in services, internalized stigma, and current engagement with services from service user and staff perspectives. RESULTS Social network composition (ethnic homogeneity) moderately correlated with better service user and staff reported engagement. Greater perceived personal control over problems was associated with better staff reported engagement. Lower perceived ethnic or racial discrimination in services, and specific illness perceptions (higher perceived treatment control, greater self-identification with psychosis symptoms, more concern and greater emotional response related to problems) were associated with better service user reported engagement. Internalized stigma was not associated with service engagement. Multivariate regression analyses suggested that a more ethnically homogenous social network was the strongest predictor of better service user and staff reported engagement. CONCLUSIONS Psychosocial interventions that target social networks, perceived ethnic and racial discrimination in services, and illness perceptions may facilitate better engagement and improve outcomes. Further longitudinal studies are required to examine causal mechanisms.
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Affiliation(s)
- Amy Degnan
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
| | - Katherine Berry
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
| | - Matthew Vaughan
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
| | - Nick Crossley
- School of Social SciencesThe University of ManchesterManchesterUK
| | - Dawn Edge
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
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Rosenthal Oren R, Roe D, Hasson-Ohayon I, Roth S, Thomas EC, Zisman-Ilani Y. Beliefs About the Causes of Psychosis Among Persons With Psychosis and Mental Health Professionals: A Scoping Review. Psychiatr Serv 2021; 72:1178-1192. [PMID: 34126775 DOI: 10.1176/appi.ps.202000460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The beliefs that people with psychosis hold about causes of their illness (causal beliefs) can affect their choice to adhere to treatment and engage in mental health services. However, less is known about causal beliefs of mental health professionals (MHPs) and their impact on treatment adherence and service engagement. This review explored literature focusing on MHPs' causal beliefs and mapped the degree of concordance between their causal beliefs and those of people with psychosis. METHODS A systematic literature search of PubMed, Embase, Scopus, PsycINFO, and Applied Social Sciences Index Abstracts and a gray-literature search of PsyArXiv and MedNar yielded 11,821 eligible references. The first author reviewed all titles and abstracts, and the coauthors reviewed 10% (N=1,200). RESULTS Forty-two articles were included. Most articles indicated that MHPs tend to endorse biogenetic beliefs (9 of 15 articles assessing MHPs' beliefs, 60%), whereas people with psychosis tend to endorse psychosocial beliefs (16 of 31 articles, 52%) and other nonbiogenetic beliefs (in 8 of 31 articles, 26%). Most studies did not compare causal beliefs of people with psychosis and their treating MHP. Studies varied in design, setting, and measures. CONCLUSIONS MHPs and people with psychosis often hold complex views composed of different types of causal beliefs. However, a gap in causal beliefs between these groups appears to exist, which may affect the therapeutic relationship and pose barriers to treatment adherence. Future studies should address this gap by developing interventions that facilitate open communication about causal beliefs to promote treatment alliance and shared decision making.
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Affiliation(s)
- Rotem Rosenthal Oren
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (Rosenthal Oren, Roe); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon); Ginsburg Health Sciences Library, Temple University, Philadelphia (Roth); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Thomas, Zisman-Ilani)
| | - David Roe
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (Rosenthal Oren, Roe); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon); Ginsburg Health Sciences Library, Temple University, Philadelphia (Roth); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Thomas, Zisman-Ilani)
| | - Ilanit Hasson-Ohayon
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (Rosenthal Oren, Roe); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon); Ginsburg Health Sciences Library, Temple University, Philadelphia (Roth); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Thomas, Zisman-Ilani)
| | - Stephanie Roth
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (Rosenthal Oren, Roe); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon); Ginsburg Health Sciences Library, Temple University, Philadelphia (Roth); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Thomas, Zisman-Ilani)
| | - Elizabeth C Thomas
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (Rosenthal Oren, Roe); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon); Ginsburg Health Sciences Library, Temple University, Philadelphia (Roth); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Thomas, Zisman-Ilani)
| | - Yaara Zisman-Ilani
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (Rosenthal Oren, Roe); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon); Ginsburg Health Sciences Library, Temple University, Philadelphia (Roth); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Thomas, Zisman-Ilani)
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Bard S, Degnan A, Berry K, Edge D. Exploring the relationships between illness beliefs and psychosis symptoms among Black African and Caribbean people with non-affective psychosis. PSYCHOSIS 2021. [DOI: 10.1080/17522439.2020.1856173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Sam Bard
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Amy Degnan
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Katherine Berry
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Dawn Edge
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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7
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Illness representations in depression and their association with clinical and treatment outcomes: A systematic review of the literature. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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8
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Averous P, Charbonnier E, Dany L. Assessment of illness representations in mental disorders: A mini review. Encephale 2021; 47:137-142. [PMID: 33589282 DOI: 10.1016/j.encep.2020.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/10/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022]
Abstract
Health beliefs, and especially illness representations, have been widely used to understand clinical outcomes and psychosocial adjustment in people with physical diseases. However, this area of research has been under-explored in the field of mental health, and the few studies that have been conducted have used very different methods. Therefore, the aim of our study was to identify the tools and methods that have been used to evaluate illness representations in psychiatry. To this end, a mini review has been conducted and 58 articles were retained. This mini review highlights that the quantitative method is the most used, and that the scales mobilised are often adapted for the study, but not validated. Indeed, multiple modifications and adaptations have been made by the authors (e.g. deletion of subscales, addition of items), which lead to questions about the reliability of what is measured. In the future, it is essential to have a validated generic tool for mental disorders, which could be based on the Illness perceptions questionnaire for schizophrenia.
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Affiliation(s)
- P Averous
- Aix Marseille Univ, Aix-en-Provence, France; UNIV. NIMES, APSY-V, Nîmes cedex 1, France.
| | | | - L Dany
- Aix Marseille Univ, Aix-en-Provence, France; APHM, Timone, Service d'Oncologie Médicale, Marseille, France
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9
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Lau JTF, Dang L, Cheung RYH, Zhang MX, Chen JH, Wu AMS. The psychometric properties of the Revised Illness Perception Questionnaire (IPQ-R) regarding Internet gaming disorder in a general population of Chinese adults. J Behav Addict 2020; 9:654-663. [PMID: 32897871 PMCID: PMC8943670 DOI: 10.1556/2006.2020.00043] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/14/2020] [Accepted: 06/13/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Internet gaming disorder (IGD) has been recognized as a mental illness. Cognitive and emotional illness representations affect coping and health outcomes. Very little is known about such perceptions related to IGD, in both general and diseased populations. This study examined the psychometric properties of the Revised Illness Perception Questionnaire (IPQ-R) for IGD in a general population that included mostly non-cases while a small proportion of the sample was IGD cases. METHODS An anonymous cross-sectional telephone survey was conducted in a random sample of 1,501 Chinese community-dwelling adults (41.3% male; mean age = 40.42, SD = 16.85) in Macao, China. RESULTS The confirmatory factor analysis identified a modified 6-factor model (i.e., timeline cyclical, consequences, personal control, treatment control, illness coherence, and emotional representations) of 26 items that showed satisfactory model fit and internal consistency. Criterion-related validity was supported by the constructs' significant correlations with stigma (positive correlations: timeline cyclical, consequence, emotional representations; negative correlations: illness coherence). Ever-gamers, compared to never-gamers, reported higher mean scores in the subscales of personal control and illness coherence, and lower mean scores in time cyclical, consequence, and emotional representations. Among the sampled gamers, probable IGD cases were more likely than non-IGD cases to perceive IGD as cyclical and involved more negative emotions. CONCLUSIONS This study shows that the revised 26-item version of IPQ-R is a valid instrument for assessing illness representation regarding IGD in a general population of Chinese adults. It can be used in future research that examines factors of incidence and prevention related to IGD.
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Affiliation(s)
- Joseph T. F. Lau
- Centre for Health Behaviors Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Le Dang
- Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, Macau, China,Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macau, China,Faculty of Teacher Education, Pingdingshan University, South Weilai Road, Xinhua District, Pingdingshan, Henan, China
| | - Ray Y. H. Cheung
- Department of Applied Psychology, Faculty of Social Science, Lingnan University, Hong Kong, China
| | - Meng Xuan Zhang
- Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, Macau, China,Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macau, China
| | - Juliet Honglei Chen
- Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, Macau, China
| | - Anise M. S. Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, Macau, China,Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macau, China,Corresponding author. E-mail:
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10
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The role of gender as a moderator in the relationship between disease perception and coping with stress strategies among psychiatric patients. CURRENT PROBLEMS OF PSYCHIATRY 2020. [DOI: 10.2478/cpp-2020-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction: The perception of disease depends on the patient’s beliefs related to the nature of the illness, the previous personal or family experiences and his/her attitude to them. Patients try to understand and cope with health problems. The purpose of the present study was to answer the question which components of the relationship between the strategies for coping with stress and mental disease perception are moderated by gender.
Material and Methods: The study involved 98 patients with depressive disorders, anxiety disorders, schizophrenia, alcohol related disorders. The research of the variables was carried out using the COPE Inventory and Disease Perception Questionnaire.
Results: It has been noticed that in men, when their perception of the mental disorder as beneficial increases, the religious strategies for coping with stress become more frequent. Furthermore, the opposite sex pattern emerged. In the situation when an individual’s perception of the illness as a threat increased, female patients less frequently employed religious coping and planning. Furthermore, in women, when the perception of the mental disease as a weakness increases, the frequency of using emotional social support and acceptance decreases.
Conclusions: The result indicated that there are opposite patterns of gender specific coping strategy dependent on the mental illness perception.
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Averous P, Charbonnier E, Dany L. Relationship Between Illness Representations, Psychosocial Adjustment, and Treatment Outcomes in Mental Disorders: A Mini Review. Front Psychol 2020; 11:1167. [PMID: 32612557 PMCID: PMC7309516 DOI: 10.3389/fpsyg.2020.01167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/06/2020] [Indexed: 01/04/2023] Open
Abstract
Understanding and improving the psychosocial adjustments (e.g., quality of life, depression) and treatment outcomes (e.g., adherence, beliefs about treatments) of people with mental disorders are major health issues. The self-regulation model (SRM) postulates that illness representations play a central role on adjustment and treatment of people with physical illnesses. Recently, the SRM has been used with people with mental disorders. However, the manifestations of somatic and psychiatric disorders can be very different. Therefore, the use of SRM in the field of mental health is very complex. This difficulty, as well as the growing interest for illness representations in the field of mental health, justifies the utility to conduct a review on this topic. The current review shows that illness representations are related to psychosocial adjustment and/or treatment outcomes for people with various mental disorders [e.g., psychotic disorders, mood disorder, posttraumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD)]. However, some limitations to the applicability of SRM to mental disorders have been highlighted. These limitations should be considered in future studies.
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Affiliation(s)
- Priscillia Averous
- Aix Marseille Univ, LPS, Aix-en-Provence, France.,UNIV. NIMES, EA 7352 CHROME, Nîmes, France
| | | | - Lionel Dany
- Aix Marseille Univ, LPS, Aix-en-Provence, France.,APHM, Timone, Service d'Oncologie Médicale, Marseille, France
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12
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Psychometric evaluation of the illness perception questionnaire for schizophrenia in a Chinese population. Asian J Psychiatr 2020; 50:101972. [PMID: 32109801 DOI: 10.1016/j.ajp.2020.101972] [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] [Received: 09/04/2019] [Revised: 01/17/2020] [Accepted: 02/09/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Illness perceptions have been associated with patients' reactions to health threats and further health outcomes. The Illness Perception Questionnaire for Schizophrenia (IPQS)1 has been applied in different contexts. However, the validity and reliability of IPQS remain unknown in mainland China. AIMS AND OBJECTIVES To test the psychometric properties of the Chinese version of IPQS in mainland China. DESIGN A cross-sectional survey. METHODS A total of 200 community-dwelling patients with schizophrenia were surveyed in Beijing, China. The validity and reliability of the instrument were tested. As well as demographic data, the IPQS and the Knowledge About Schizophrenia Test (KAST)2 were also administered. RESULTS Factor analysis was utilised to refine the factor structure of the IPQS. The difference between IPQS and KAST denoted the discriminant validity. The subscale scores among patients of different illness duration, educational attainment, and medication adherence in the past two years were significantly different (P<0.05), indicating the known-group validity of the IPQS. Except for 'personal control' and 'burdensome effect', other subscales were internally consistent. Most of the subscales proved stable over a four-week period. CONCLUSION The Chinese version of IPQS can be used, with some refinements, to assess illness perceptions about schizophrenia for patients in future studies. This will provide empirical evidence for its generalizability and clinical utility and provide deeper insight into Chinese patients' illness perceptions about schizophrenia.
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Disease perception and coping strategies for stress in Polish patients with various mental disorders. CURRENT PROBLEMS OF PSYCHIATRY 2019. [DOI: 10.2478/cpp-2019-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction: Nowadays more and more people struggle with mental problems associated with fast pace of life and overpowering stress. Individuals affected by mental disorders frequently apply ineffective methods of coping with stress, and their attitudes towards the disease in fact strengthen the psychopathological symptoms. The purpose of the present study was to compare disease perception and coping strategies for stress in Polish patients with various types of mental disorders.
Material and Methods: The study involved 123 patients with depressive disorders, anxiety disorders, schizophrenia, alcohol related disorders, subjects detained due to psychoactive substance-induced psychotic disorders and amnestic syndromes, staying at Mental Healthcare Centre. Measurements of the variables were carried out using COPE Inventory and Disease Perception Questionnaire.
Results: The type of mental disorder differentiated the group with respect to the use of strategies aimed at seeking instrumental and emotional support, planning, positive reinterpretation, focus on emotions and substance use. There are significant differences between patients in the approach to illness as a task, weakness and threat.
Conclusions: The results show that the type of mental disorder is important in the context of the strategies used for coping with stress and the patients' approach to their condition.
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Greenwood K, Alford K, O’Leary I, Peters E, Hardy A, Cavanagh K, Field AP, de Visser R, Fowler D, Davies M, Papamichail A, Garety P. The U&I study: study protocol for a feasibility randomised controlled trial of a pre-cognitive behavioural therapy digital 'informed choice' intervention to improve attitudes towards uptake and implementation of CBT for psychosis. Trials 2018; 19:644. [PMID: 30458850 PMCID: PMC6247503 DOI: 10.1186/s13063-018-3023-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/26/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND At least 40% of people with psychosis have persistent distressing symptoms despite optimal medication treatment. Cognitive behaviour therapy for psychosis (CBTp) is the only NICE-recommended individual therapy for psychosis, with effects on symptoms, distress and quality of life. Yet <10% of service-users receive it and 94% of trusts struggle to provide it. Of those offered it, 22-43% refuse or do not attend. We have developed a new pre-CBTp informed choice intervention to address knowledge and attitudes that influence uptake and implementation and now want to test it in a feasibility trial. METHODS The design is a two-arm, feasibility randomised controlled trial (RCT), with 1:1 randomisation, stratified by participant group and site. Participants are 40 psychosis patients and 40 clinicians, who are ambivalent towards uptake or implementation of CBTp. Sites are community and inpatient services in Sussex and London. The intervention is a pre-CBT digital psychoeducation intervention designed to address identified knowledge and attitudinal barriers to uptake and implementation of CBTp, incorporating behaviour change mechanisms, and supported by animated introductory, patient and clinician stories. The comparator is the NHS choices website for CBT. The primary aim is to assess clinical feasibility (recruitment, randomisation, acceptability, use, delivery, outcome measurement, retention). A secondary aim is a preliminary evaluation of efficacy. Outcomes will be assessed at baseline, post intervention, and one-month follow-up (blind to treatment arm). The primary efficacy outcome is likelihood of offering/taking up CBTp. Secondary outcomes include knowledge and attitudes towards CBTp, illness perceptions, empowerment, psychological wellbeing (patients only) and CBTp implementation (clinicians only). Use of the intervention and CBT behaviours during the follow-up period will be recorded and captured in a feedback questionnaire. Use, acceptability and experience of outcome assessment will be explored in qualitative interviews with participants (n = 6 per group). The efficacy evaluation will report descriptive data, key model parameters and 95% highest probability density intervals in a Bayesian growth model. DISCUSSION This is the first feasibility trial of a digital 'informed choice' decision aid for the implementation of CBTp. If the trial proves feasible and demonstrates preliminary evidence of efficacy, a large multi-site trial will be warranted. TRIAL REGISTRATION ISRCTN registry, ISRCTN53107879 . Registered prospectively on 2 August 2017.
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Affiliation(s)
- Kathryn Greenwood
- R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital Site, Nevill Avenue, Hove, BN3 7HZ UK
- School of Psychology, University of Sussex, Pevensey Building, Falmer, Brighton, East Sussex BN1 9RP UK
| | - Katie Alford
- Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton, BN1 9RP UK
| | - Ian O’Leary
- R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital Site, Nevill Avenue, Hove, BN3 7HZ UK
| | - Emmanuelle Peters
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- PICuP Clinic, South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8NZ UK
| | - Amy Hardy
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX UK
| | - Kate Cavanagh
- School of Psychology, University of Sussex, Pevensey Building, Falmer, Brighton, East Sussex BN1 9RP UK
| | - Andy P. Field
- School of Psychology, University of Sussex, Pevensey Building, Falmer, Brighton, East Sussex BN1 9RP UK
| | - Richard de Visser
- School of Psychology, University of Sussex, Pevensey Building, Falmer, Brighton, East Sussex BN1 9RP UK
| | - David Fowler
- R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital Site, Nevill Avenue, Hove, BN3 7HZ UK
- School of Psychology, University of Sussex, Pevensey Building, Falmer, Brighton, East Sussex BN1 9RP UK
| | - Matthew Davies
- R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital Site, Nevill Avenue, Hove, BN3 7HZ UK
| | - Alexandra Papamichail
- R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital Site, Nevill Avenue, Hove, BN3 7HZ UK
| | - Philippa Garety
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX UK
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Hussain S, Imran N, Hotiana UA, Mazhar N, Asif A. Illness Perceptions in Patients of Schizophrenia: A Preliminary Investigation from Lahore, Pakistan. Pak J Med Sci 2017; 33:829-834. [PMID: 29067048 PMCID: PMC5648947 DOI: 10.12669/pjms.334.13128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background and Objective: Patient’s perception of their illness influences their healthcare decisions. The objectives of this study were to explore patient’s own beliefs about their illness (Schizophrenia) and perceived social support, and its impact on their attitudes toward pharmacological treatment in Lahore, Pakistan. Methods: This study was conducted at Mayo Hospital Lahore from March to September 2016. Hundred individuals suffering from Schizophrenia completed four questionnaires; a socio-demographic questionnaire, the Illness Perception Questionnaire for Schizophrenia(IPQ-S), Drug attitude Inventory-10 (DAI) and Multidimensional Scale of Perceived Social Support (PSS). Results: Stress, family problems, lack of friends & financial worries were endorsed strongly by patients as cause of their mental illness. Ambiguity regarding their mental illness duration and personal control was observed. Patients’ perceived significant negative consequences, negative emotional response, as well as had poor understanding of their mental illness and treatment effectiveness. Statistically significant gender differences in treatment control and illness coherence subscales of IPQS were observed. Drug attitude inventory was positively correlated with Treatment control subscale (p < .01) and negatively correlated with Illness coherence subscale of IPQS (p < .05). The negative consequences subscale and perceived social support was negatively correlated (p < .01). Conclusion: Patient’s perception about their own illness is predictor of their drug taking attitude and perceived social support. Study results should help to develop new interventions to correct inaccurate beliefs in patients with schizophrenia to improve illness outcome.
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Affiliation(s)
- Sadia Hussain
- Ms. Sadia Hussain, MSc Psychology. Intern Psychologist, Academic Department of Psychiatry & Behavioural Sciences King Edward Medical University/Mayo Hospital, Lahore, Pakistan
| | - Nazish Imran
- Dr. Nazish Imran, MBBS; FRCPsych; MRCPsych (London). Associate Professor, Child & Family Psychiatry Department. King Edward Medical University/Mayo Hospital, Lahore, Pakistan
| | - Usman Amin Hotiana
- Dr. Usman Amin Hotiana, MBBS; FCPS (Psy). Assistant Professor, King Edward Medical University/Mayo Hospital, Lahore, Pakistan Academic Department of Psychiatry & Behavioral Sciences
| | - Nauman Mazhar
- Dr. Nauman Mazhar, MBBS; MD(Psy); FCPS(Psy)Senior Registrar, Department of Psychiatry Services Hospital, Lahore, Pakistan
| | - Aftab Asif
- Prof. Aftab Asif, MBBS; MRCPsych Professor of Psychiatry, Academic Department of Psychiatry & Behavioural Sciences, King Edward Medical University/Mayo Hospital, Lahore, Pakistan
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Finzi-Dottan R, Dayan-Gazith E, Borosh T, Golubchik P. Involvement and Warmth of Fathers with Mental Illness: The Role of the Caregiving System, Parental Self-Efficacy, Social Support and Child Characteristics. Community Ment Health J 2016; 52:972-982. [PMID: 27137508 DOI: 10.1007/s10597-016-0011-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 04/28/2016] [Indexed: 12/01/2022]
Abstract
This study compares the levels and predictors of paternal warmth and involvement of 69 fathers with serious mental illness (SMI) and 69 matched non-clinical (NC) fathers in Israel. Findings show that the NC fathers were more involved with their children, whereas the SMI fathers reported more warmth and perceived their children as less difficult. The interactions that were found in the regression analyses highlight the differences between the two groups. Among the SMI fathers, but not the NC fathers, higher paternal self-efficacy was associated with increased father involvement, and lower family support was associated with decreased warmth.
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Affiliation(s)
- Ricky Finzi-Dottan
- School of Social Work, Bar Ilan University, 529002, Ramat Gan, Israel. .,Child and Adolescence Outpatient Clinic, Geha Mental Health Center, P.O.B. 102, 49100, Petah Tiqva, Israel.
| | | | - Tali Borosh
- School of Social Work, Bar Ilan University, 529002, Ramat Gan, Israel
| | - Pavel Golubchik
- Child and Adolescence Outpatient Clinic, Geha Mental Health Center, P.O.B. 102, 49100, Petah Tiqva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
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Carter L, Read J, Pyle M, Morrison AP. The Impact of Causal Explanations on Outcome in People Experiencing Psychosis: A Systematic Review. Clin Psychol Psychother 2016; 24:332-347. [PMID: 26805779 DOI: 10.1002/cpp.2002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 11/26/2015] [Accepted: 11/29/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Lucy Carter
- The University of Manchester; Manchester UK
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust; Manchester UK
| | - John Read
- Swinburne University; Melbourne Australia
| | - Melissa Pyle
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust; Manchester UK
| | - Anthony P. Morrison
- The University of Manchester; Manchester UK
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust; Manchester UK
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Symptoms and Etiological Attribution: A Cross-Sectional Study in Mexican Outpatients with Psychosis and Their Relatives. SCHIZOPHRENIA RESEARCH AND TREATMENT 2016; 2016:9549683. [PMID: 27413550 PMCID: PMC4927998 DOI: 10.1155/2016/9549683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/07/2016] [Accepted: 05/31/2016] [Indexed: 12/02/2022]
Abstract
This cross-sectional study aimed at identifying the most common attributions of their mental disorder in a Mexican patients who have experienced psychosis and their relatives and exploring how having experienced or not characteristic psychotic symptoms and their present clinical status might affect their etiological attributions. Past and current symptom profiles of 66 patients were as assessed with the SCID-I (Structured Clinical Interview for DSM-IV Axis I Disorders) and the PANSS (Positive and Negative Syndrome Scale), respectively. The etiological attribution of psychosis of patients (n = 62) and the relatives (n = 65) was assessed with the Angermeyer and Klusmann scale comprising 30 items into five categories: biology, personality, family, society, and esoteric. Patients and relatives attribute psychosis mainly to social factors. Relatives' attributions were not influenced by clinical profile of patients, whereas in the case of patients it was only current clinical status that showed a difference, with those in nonremission scoring higher personality and family factors. Acknowledging patients' and relatives' beliefs about mental disorders at onset and later on is particularly important in psychosis, a mental condition with severe and/or persistent symptoms, in order to promote better involvement in treatment and in consequence efficacy and recovery.
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Gómez-de-Regil L. Insight and illness perception in Mexican patients with psychosis. SCHIZOPHRENIA RESEARCH-COGNITION 2015; 2:33-38. [PMID: 29379759 PMCID: PMC5779292 DOI: 10.1016/j.scog.2015.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 01/21/2015] [Accepted: 01/26/2015] [Indexed: 11/19/2022]
Abstract
Background Insight and illness perception are two concepts of interest in the study of factors related to clinical outcome in patients with psychosis. Insight implies a risk of emotional distress for the patient. Illness perceptions, regardless of their accuracy, might be favorable or not to illness. Literature provides evidence of significant correlates of these factors with clinical outcome, but they are rarely included in a single study. Objectives 1) assessing insight and illness perception in a sample of Mexican patients who have experienced psychosis and, 2) analyzing how insight and illness perception relate to each other and how they relate to clinical status (i.e., positive, negative, and general psychopathology, depression, and anxiety). Methods Sixty-one participants (55.7% females) were recruited from a public psychiatric hospital; insight and illness perceptions were assessed with the SUMD and the Brief-IPQ, respectively. Clinical status was assessed with the PANSS, CDS and BAI scales. Results Participants showed good insight, favorable illness perceptions for the cognitive and comprehension dimensions, but unfavorable for the emotional dimension. Clinical status of sample was characterized by mild symptoms. Poor insight related to positive symptoms and general psychopathology. Cognitive and emotional perceptions of illness were significantly associated to most clinical status parameters, whereas comprehension showed no significant results. Conclusions The study not only replicates the significant association on insight and illness perception with clinical outcome, but shows how their patterns of interactions are different, reinforcing the idea that they are two distinct factors worthy of being habitually acknowledged in research and clinical practice.
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Affiliation(s)
- Lizzette Gómez-de-Regil
- Hospital Regional de Alta Especialidad de la Península de Yucatán, Calle 7, No. 433 por 20 y 22, Fracc, Altabrisa, Mérida, Yucatán, México, 97130. Tel.: + 52 999 942 7600; fax: + 52 999 254 3535.
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Gómez-de-Regil L. Causal attribution and illness perception: a cross-sectional study in Mexican patients with psychosis. ScientificWorldJournal 2014; 2014:969867. [PMID: 25525628 PMCID: PMC4267160 DOI: 10.1155/2014/969867] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/14/2014] [Indexed: 11/25/2022] Open
Abstract
Health psychology researchers have begun to focus greater attention on people's beliefs about health/illness since these beliefs can clearly affect behavior. This cross-sectional study aimed at (1) identifying the most common factors psychotic patients attribute their illness to and (2) assessing the association between causal attribution and illness perception (cognitive, emotional, and comprehensibility dimensions). Sixty-two patients (56.5% females) who had been treated for psychosis at a public psychiatric hospital in Mexico answered the Angermeyer and Klusmann Illness Attribution Scale and the Brief Illness Perception Questionnaire. Results showed that most patients attributed psychosis onset to social factors and that attribution to their personality might have an overwhelmingly negative effect on their lives. Acknowledging psychotic patient attributional beliefs and considering them in clinical practice could improve treatment efficacy and overall recovery success. This is particularly important in psychosis, since symptoms are often severe and/or persistent and require long-term treatment.
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Affiliation(s)
- Lizzette Gómez-de-Regil
- Hospital Regional de Alta Especialidad de la Península de Yucatán (HRAEPY), Calle 7, No. 433, por 20 y 22, Fraccionamiento Altabrisa, 97130 Merida, YUC, Mexico
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21
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Marcus E, Garety P, Weinman J, Emsley R, Dunn G, Bebbington P, Freeman D, Kuipers E, Fowler D, Hardy A, Waller H, Jolley S. A pilot validation of a modified Illness Perceptions Questionnaire designed to predict response to cognitive therapy for psychosis. J Behav Ther Exp Psychiatry 2014; 45:459-66. [PMID: 25011076 PMCID: PMC4157321 DOI: 10.1016/j.jbtep.2014.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/18/2014] [Accepted: 06/06/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Clinical responsiveness to cognitive behavioural therapy for psychosis (CBTp) varies. Recent research has demonstrated that illness perceptions predict active engagement in therapy, and, thereby, better outcomes. In this study, we aimed to investigate the psychometric properties of a modification of the Illness Perceptions Questionnaire (M-IPQ) designed to predict response following CBTp. METHODS Fifty-six participants with persistent, distressing delusions completed the M-IPQ; forty before a brief CBT intervention targeting persecutory ideation and sixteen before and after a control condition. Additional predictors of outcome (delusional conviction, symptom severity and belief inflexibility) were assessed at baseline. Outcomes were assessed at baseline and at follow-up four to eight weeks later. RESULTS The M-IPQ comprised two factors measuring problem duration and therapy-specific perceptions of Cure/Control. Associated subscales, formed by summing the relevant items for each factor, were reliable in their structure. The Cure/Control subscale was also reliable over time; showed convergent validity with other predictors of outcome; predicted therapy outcomes; and differentially predicted treatment effects. LIMITATIONS We measured outcome without an associated measure of engagement, in a small sample. Findings are consistent with hypothesis and existing research, but require replication in a larger, purposively recruited sample. CONCLUSIONS The Cure/Control subscale of the M-IPQ shows promise as a predictor of response to therapy. Specifically targeting these illness perceptions in the early stages of cognitive behavioural therapy may improve engagement and, consequently, outcomes.
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Affiliation(s)
- Elena Marcus
- King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
| | - Philippa Garety
- King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
| | - John Weinman
- King's College London, Institute of Pharmaceutical Science, 5th Floor Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH, UK.
| | - Richard Emsley
- Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester Academic Health Science Centre, 4.304 Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK.
| | - Graham Dunn
- Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester Academic Health Science Centre, 4.304 Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK.
| | - Paul Bebbington
- Division of Psychiatry, University College, London, 67-73 Riding House Street, London W1W 7EJ, UK.
| | - Daniel Freeman
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK.
| | - Elizabeth Kuipers
- King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
| | - David Fowler
- School of Psychology, University of Sussex, Pevensey Building, Falmer BN1 9QH, UK.
| | - Amy Hardy
- King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
| | - Helen Waller
- King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
| | - Suzanne Jolley
- King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
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Ko CJ, Smith P, Liao HY, Chiang HH. Searching for reintegration: life experiences of people with schizophrenia. J Clin Nurs 2013; 23:394-401. [PMID: 23829440 DOI: 10.1111/jocn.12169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2012] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to understand how people with chronic schizophrenia live with their illness experiences. BACKGROUND Schizophrenic clients in Taiwan have reported ineffective community care. As a long-term deteriorating disorder, schizophrenia represents an important issue for healthcare providers. DESIGN The research was conducted using an interpretative phenomenological approach, which stresses meaning and people's relationships with their surrounding world. METHODS Purposeful homogeneous sampling was used to recruit 15 participants who were interviewed individually. Interpretative phenomenological analysis was applied to the data. RESULTS The superordinate theme that emerged from this study was 'searching for reintegration'. Reflecting on, living with and learning from illness experiences represented a dynamic process for participants to reintegrate their lives. By reflecting on the suffering associated with their psychological experiences, participants were able to engage in developing different strategies to cope with schizophrenia. This learning process enabled them to believe in, and value, their lives. CONCLUSION Psychological experiences can break down people's inner worlds, but also open up possibilities for self-renewal. The cultural context exerts a powerful influence on the psychological comfort of people with schizophrenia and is therefore an area of possible concern. RELEVANCE TO CLINICAL PRACTICE This research focused on reintegrating process of people with schizophrenia and developing culturally sensitive nursing care.
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Affiliation(s)
- Chen-Ju Ko
- Department of Nursing, Tzu-Chi College of Technology, Hualien, Taiwan; School of Nursing, National Yang-Ming University, Taipei, Taiwan
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Federico MT, Priebe S, Fusco C, Strapelli N, Singh R, McCabe R. Communication about psychotic symptoms in long-term psychiatric illness. Psychopathology 2013; 46:233-40. [PMID: 23171869 DOI: 10.1159/000342259] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 07/13/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Communicating about psychotic symptoms can be challenging. This study aimed to identify (1) how psychiatrists and patients communicate about psychotic symptoms from a research and clinical perspective and (2) whether communication patterns depend on patients' symptom levels. SAMPLING AND METHODS Consultations between 27 psychiatrists and 100 patients with long-term schizophrenia/schizoaffective disorder in outpatient clinics were video-recorded, transcribed and coded. Symptoms were assessed on the Positive and Negative Syndrome Scale. Avoidance or engagement with psychotic symptoms was coded separately by researchers and three clinical psychiatrists. RESULTS Psychotic symptoms were not mentioned in 27% of consultations. Patients reported their absence in 34% of consultations and avoided talking about symptoms in 6%. Researchers rated psychiatrists as engaged in talking about psychotic symptoms in 15% of consultations and avoiding talking about them in 18% of consultations. Psychiatrists identified somewhat less avoidance (10%) and more engagement (23%). Psychiatrist avoidance was seen when the patient raised the topic and the psychiatrist gave brief responses and/or changed the topic. When psychiatrists engaged, they asked specific questions about symptoms, responded to patient concerns and provided explanations about symptoms. Psychotic symptoms were more often discussed with patients with more negative and general symptoms. CONCLUSIONS There is considerable variation in whether psychotic symptoms are discussed or not in outpatient consultations. Whether psychiatrists discuss psychotic symptoms is influenced by patients' symptoms; however, not by their psychotic symptoms but rather by the presence of negative and general symptoms. Psychiatrists' ratings of communication identify broadly similar patterns as detailed research analyses.
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Affiliation(s)
- M T Federico
- Neurosciences, Mental Health and Sensory Functions Department, Sapienza University, 2nd Medical School, Sant'Andrea Hospital, Rome, Italy
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Baines T, Wittkowski A. A Systematic Review of the Literature Exploring Illness Perceptions in Mental Health Utilising the Self-Regulation Model. J Clin Psychol Med Settings 2012; 20:263-74. [DOI: 10.1007/s10880-012-9337-9] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Birchwood M, Jackson C, Brunet K, Holden J, Barton K. Personal beliefs about illness questionnaire-revised (PBIQ-R): Reliability and validation in a first episode sample. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2012; 51:448-58. [DOI: 10.1111/j.2044-8260.2012.02040.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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