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Arntz A, Jacob GA, Lee CW, Brand-de Wilde OM, Fassbinder E, Harper RP, Lavender A, Lockwood G, Malogiannis IA, Ruths FA, Schweiger U, Shaw IA, Zarbock G, Farrell JM. Effectiveness of Predominantly Group Schema Therapy and Combined Individual and Group Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial. JAMA Psychiatry 2022; 79:287-299. [PMID: 35234828 PMCID: PMC8892362 DOI: 10.1001/jamapsychiatry.2022.0010] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
IMPORTANCE Schema therapy (ST), delivered either in an individual or group format, has been compared with other active treatments for borderline personality disorder (BPD). To our knowledge, the 2 formats have not been compared with treatment as usual (TAU) or with each other. Such comparisons help determine best treatment practices. OBJECTIVE To evaluate whether ST is more effectively delivered in a predominantly group or combined individual and group format and whether ST is more effective than optimal TAU for BPD. DESIGN, SETTING, AND PARTICIPANTS In this multicenter, 3-arm randomized clinical trial conducted at 15 sites in 5 countries (Australia, Germany, Greece, the Netherlands, and the UK), outpatients aged 18 to 65 years who had BPD were recruited between June 29, 2010, and May 18, 2016, to receive either predominantly group ST (PGST), combined individual and group ST (IGST), or optimal TAU. Data were analyzed from June 4, 2019, to December 29, 2021. INTERVENTIONS At each site, cohorts of 16 to 18 participants were randomized 1:1 to PGST vs TAU or IGST vs TAU. Both ST formats were delivered over 2 years, with 2 sessions per week in year 1 and the frequency gradually decreasing during year 2. Assessments were collected by blinded assessors. MAIN OUTCOMES AND MEASURES The primary outcome was the change in BPD severity over time, assessed with the Borderline Personality Disorder Severity Index (BPDSI) total score. Treatment retention was analyzed as a secondary outcome using generalized linear mixed model survival analysis. RESULTS Of 495 participants (mean [SD] age, 33.6 [9.4] years; 426 [86.2%] female), 246 (49.7%) received TAU, 125 (25.2%) received PGST, and 124 (25.0%) received IGST (1 of whom later withdrew consent). PGST and IGST combined were superior to TAU with regard to reduced BPD severity (Cohen d, 0.73; 95% CI, 0.29-1.18; P < .001). For this outcome, IGST was superior to TAU (Cohen d, 1.14; 95% CI, 0.57-1.71; P < .001) and PGST (Cohen d, 0.84; 95% CI, 0.09-1.59; P = .03), whereas PGST did not differ significantly from TAU (Cohen d, 0.30; 95% CI, -0.29 to 0.89; P = .32). Treatment retention was greater in the IGST arm than in the PGST (1 year: 0.82 vs 0.72; 2 years: 0.74 vs. 0.62) and TAU (1 year: 0.82 vs 0.73; 2 years: 0.74 vs 0.64) arms, and there was no significant difference between the TAU and PGST arms (1 year: 0.73 vs 0.72; 2 years: 0.64 vs 0.62). CONCLUSIONS AND RELEVANCE In this randomized clinical trial, IGST was more effective and had greater treatment retention compared with TAU and PGST. These findings suggest that IGST is the preferred ST format, with high retention and continuation of improvement in BPD severity after the completion of treatment. TRIAL REGISTRATION trialregister.nl Identifier: NTR2392.
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Affiliation(s)
- Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Gitta A. Jacob
- Department of Clinical Psychology and Psychotherapy, Institute for Psychology, University of Freiburg, Freiburg, Germany
| | - Christopher W. Lee
- Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | | | - Eva Fassbinder
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany,Department of Psychiatry and Psychotherapy, Christian-Albrechts University of Kiel, Kiel, Germany
| | - R. Patrick Harper
- Bradford District Care NHS Foundation Trust, Bradford, United Kingdom
| | - Anna Lavender
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | | | - Ioannis A. Malogiannis
- First Department of Psychiatry, Eginition Hospital, Medical School, Athens University, Athens, Greece
| | - Florian A. Ruths
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Ulrich Schweiger
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Ida A. Shaw
- Schema Therapy Institute Midwest, Indianapolis, Indiana
| | - Gerhard Zarbock
- Institut für Verhaltenstherapie Ausbildung Hamburg GmbH (Institute for Training in Cognitive Behavioral Therapy), Hamburg, Germany
| | - Joan M. Farrell
- Schema Therapy Institute Midwest, Indianapolis, Indiana,Department of Clinical Psychology, Indiana University–Purdue University, Indianapolis
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Wetzelaer P, Farrell J, Evers SMAA, Jacob GA, Lee CW, Brand O, van Breukelen G, Fassbinder E, Fretwell H, Harper RP, Lavender A, Lockwood G, Malogiannis IA, Schweiger U, Startup H, Stevenson T, Zarbock G, Arntz A. Correction to: Design of an international multicentre RCT on group schema therapy for borderline personality disorder. BMC Psychiatry 2022; 22:216. [PMID: 35337286 PMCID: PMC8957113 DOI: 10.1186/s12888-022-03825-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Pim Wetzelaer
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscienc, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Joan Farrell
- grid.257413.60000 0001 2287 3919Department of Psychology, Indiana University-Purdue University Indianapolis, Administrative Office, 402 N Blackford, LD 124, Indianapolis, IN 46202 USA ,Center for Borderline Personality Disorder Treatment & Research, Indianapolis, USA
| | - Silvia M. A. A. Evers
- grid.5012.60000 0001 0481 6099Department of Health Services Research, CAPHRI School of Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands ,grid.416017.50000 0001 0835 8259Trimbos Institute, The Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Gitta A. Jacob
- grid.5963.9Department of Clinical Psychology and Psychotherapy, Institute for Psychology, University of Freiburg, Engelbergerstrasse 41, 79085 Freiburg, Germany
| | - Christopher W. Lee
- grid.1025.60000 0004 0436 6763Department of Psychology and Exercise Science, Murdoch University, 90 South St, Murdoch, WA 6153 Australia
| | - Odette Brand
- grid.487405.a0000 0004 0407 9940De Viersprong, The Netherlands Institute for Personality Disorders, De Beeklaan 2, Postbus 7, 4661 EP Halsteren, The Netherlands
| | - Gerard van Breukelen
- grid.5012.60000 0001 0481 6099Department of Methodology and Statistics, Faculty of Health Medicine and Life Sciences, Maastricht University, Peter Debyeplein 1, P.O. Box 616, 6200 MD Maastricht, The Netherlands ,grid.5012.60000 0001 0481 6099Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Eva Fassbinder
- grid.4562.50000 0001 0057 2672Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Heather Fretwell
- Midtown Mental Health/ Eskenazi Health, 5610 Crawfordsville Rd Suite 22, Indianapolis, IN 46224 USA ,grid.257413.60000 0001 2287 3919Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA
| | | | - Anna Lavender
- grid.37640.360000 0000 9439 0839South London and Maudsley NHS Foundation Trust, London, UK
| | - George Lockwood
- Schema Therapy Institute Midwest, 471 West South Street, Suite 41C, Kalamazoo, MI 49007 USA
| | - Ioannis A. Malogiannis
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, Eginition Hospital, Medical School, Athens University, 72-74, Vas. Sofias Ave, 115 28 Athens, Greece ,Greek Society of Schema Therapy, 17, Sisini str, 115 28 Athens, Greece
| | - Ulrich Schweiger
- grid.4562.50000 0001 0057 2672Klinik für Psychiatrie und Psychotherapie, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Helen Startup
- grid.37640.360000 0000 9439 0839South London and Maudsley NHS Foundation Trust, London, UK
| | - Teresa Stevenson
- Peel and Rockingham Kwinana Mental Health Service, Cnr Clifton and Ameer Street, P.O. Box 288, Rockingham, WA 6968 Australia
| | - Gerhard Zarbock
- grid.491925.2IVAH GmbH (Institute for Training in CBT), Hans-Henny-Jahnn-Weg 51, 22085 Hamburg, Germany
| | - Arnoud Arntz
- grid.5012.60000 0001 0481 6099Department of Clinical Psychological Science, Faculty of Psychology and Neuroscienc, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands ,grid.7177.60000000084992262Department of Clinical Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, The Netherlands
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Harduar Morano L, Bunn T, Lackovic M, Lavender A, Dang G, Chalmers J, Li Y, Zhang L, Flammia D. Occupational heat-related illness emergency department visits and inpatient hospitalizations in the southeast region, 2007-2011. Am J Ind Med 2015; 58:1114-25. [PMID: 26305997 DOI: 10.1002/ajim.22504] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Heat-related illness (HRI) is an occupational health risk for many outdoor, and some indoor, workers. METHODS Emergency department (ED) and inpatient hospitalization (IH) data for 2007-2011 from nine southeast states were analyzed to identify occupational HRI numbers and rates, demographic characteristics, and co-morbid conditions. RESULTS There were 8,315 occupational HRI ED visits (6.5/100,000 workers) and 1,051 IHs (0.61/100,000) in the southeast over the study period. Out-of-state residents comprised 8% of ED visits and 12% of IHs. Rates for both, ED visits and IHs were significantly elevated in males and blacks. Younger workers had elevated rates for ED visits, while older workers had higher IH rates. CONCLUSIONS This is the first study to evaluate occupational HRI ED visits and IHs in the southeast region and indicates the need for enhanced heat-stress prevention policies in the southeast. Findings from this study can be used to direct state health department tracking and evaluation of occupational HRI.
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Affiliation(s)
- L. Harduar Morano
- University of North Carolina at Chapel Hill; Gillings School of Global Public Health; Department of Epidemiology; Chapel Hill North Carolina
| | - T.L. Bunn
- University of Kentucky; College of Public Health; Kentucky Injury Prevention and Research Center; Lexington Kentucky
| | - M. Lackovic
- Louisiana Department of Health and Hospitals; Office of Public Health; New Orleans Louisiana
| | - A. Lavender
- Georgia Department of Public Health; Atlanta Georgia
| | - G.T.T. Dang
- Florida Department of Health, Division of Disease Control and Health Protection; Occupational and Environmental Epidemiology Branch; Raleigh North Carolina
| | - J.J. Chalmers
- Division of Disease Control and Health Protection, Florida Department of Health; Bureau of Epidemiology; Tallahassee Florida
| | - Y. Li
- Tennessee Department of Health; Division of Family Health and Wellness; Nashville Tennessee
| | - L. Zhang
- Mississippi State Department of Health; Office of Health Data and Research; Jackson Mississippi
| | - D.D. Flammia
- Virginia Department of Health; Division of Environmental Epidemiology; Richmond Virginia
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Wetzelaer P, Farrell J, Evers SMAA, Jacob GA, Lee CW, Brand O, van Breukelen G, Fassbinder E, Fretwell H, Harper RP, Lavender A, Lockwood G, Malogiannis IA, Schweiger U, Startup H, Stevenson T, Zarbock G, Arntz A. Design of an international multicentre RCT on group schema therapy for borderline personality disorder. BMC Psychiatry 2014; 14:319. [PMID: 25407009 PMCID: PMC4240856 DOI: 10.1186/s12888-014-0319-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 10/27/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Borderline personality disorder (BPD) is a severe and highly prevalent mental disorder. Schema therapy (ST) has been found effective in the treatment of BPD and is commonly delivered through an individual format. A group format (group schema therapy, GST) has also been developed. GST has been found to speed up and amplify the treatment effects found for individual ST. Delivery in a group format may lead to improved cost-effectiveness. An important question is how GST compares to treatment as usual (TAU) and what format for delivery of schema therapy (format A; intensive group therapy only, or format B; a combination of group and individual therapy) produces the best outcomes. METHODS/DESIGN An international, multicentre randomized controlled trial (RCT) will be conducted with a minimum of fourteen participating centres. Each centre will recruit multiple cohorts of at least sixteen patients. GST formats as well as the orders in which they are delivered to successive cohorts will be balanced. Within countries that contribute an uneven number of sites, the orders of GST formats will be balanced within a difference of one. The RCT is designed to include a minimum of 448 patients with BPD. The primary clinical outcome measure will be BPD severity. Secondary clinical outcome measures will include measures of BPD and general psychiatric symptoms, schemas and schema modes, social functioning and quality of life. Furthermore, an economic evaluation that consists of cost-effectiveness and cost-utility analyses will be performed using a societal perspective. Lastly, additional investigations will be carried out that include an assessment of the integrity of GST, a qualitative study on patients' and therapists' experiences with GST, and studies on variables that might influence the effectiveness of GST. DISCUSSION This trial will compare GST to TAU for patients with BPD as well as two different formats for the delivery of GST. By combining an evaluation of clinical effectiveness, an economic evaluation and additional investigations, it will contribute to an evidence-based understanding of which treatment should be offered to patients with BPD from clinical, economic, and stakeholders' perspectives. TRIAL REGISTRATION Netherlands Trial Register NTR2392. Registered 25 June 2010.
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Affiliation(s)
- Pim Wetzelaer
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Joan Farrell
- Department of Psychology, Indiana University-Purdue University Indianapolis, Administrative Office, 402 N Blackford, LD 124, Indianapolis, IN 46202 USA ,Center for Borderline Personality Disorder Treatment & Research, Indianapolis, USA
| | - Silvia MAA Evers
- Department of Health Services Research, CAPHRI School of Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands ,Trimbos Institute, The Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Gitta A Jacob
- Department of Clinical Psychology and Psychotherapy, Institute for Psychology, University of Freiburg, Engelbergerstrasse 41, 79085 Freiburg, Germany
| | - Christopher W Lee
- Department of Psychology and Exercise Science, Murdoch University, 90 South St, Murdoch, WA 6153 Australia
| | - Odette Brand
- De Viersprong, The Netherlands Institute for Personality Disorders, De Beeklaan 2, Postbus 7, 4661 EP Halsteren, The Netherlands
| | - Gerard van Breukelen
- Department of Methodology and Statistics, Faculty of Health Medicine and Life Sciences, Maastricht University, Peter Debyeplein 1, P.O. Box 616, 6200 MD Maastricht, The Netherlands ,Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Eva Fassbinder
- Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Heather Fretwell
- Midtown Mental Health/ Eskenazi Health, 5610 Crawfordsville Rd Suite 22, Indianapolis, IN 46224 USA ,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA
| | | | - Anna Lavender
- South London and Maudsley NHS Foundation Trust, London, UK
| | - George Lockwood
- Schema Therapy Institute Midwest, 471 West South Street, Suite 41C, Kalamazoo, MI 49007 USA
| | - Ioannis A Malogiannis
- 1st Department of Psychiatry, Eginition Hospital, Medical School, Athens University, 72-74, Vas. Sofias Ave, 115 28 Athens, Greece ,Greek Society of Schema Therapy, 17, Sisini str, 115 28 Athens, Greece
| | - Ulrich Schweiger
- Klinik für Psychiatrie und Psychotherapie, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Helen Startup
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Teresa Stevenson
- Peel and Rockingham Kwinana Mental Health Service, Cnr Clifton and Ameer Street, Rockingham, P.O. Box 288, WA 6968 Australia
| | - Gerhard Zarbock
- IVAH GmbH (Institute for Training in CBT), Hans-Henny-Jahnn-Weg 51, 22085 Hamburg, Germany
| | - Arnoud Arntz
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands ,Department of Clinical Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, The Netherlands
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DeJong H, Oldershaw A, Sternheim L, Samarawickrema N, Kenyon MD, Broadbent H, Lavender A, Startup H, Treasure J, Schmidt U. Quality of life in anorexia nervosa, bulimia nervosa and eating disorder not-otherwise-specified. J Eat Disord 2013; 1:43. [PMID: 24999421 PMCID: PMC4081766 DOI: 10.1186/2050-2974-1-43] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 10/31/2013] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This study aimed to assess differences in Quality of Life (QoL) across eating disorder (ED) diagnoses, and to examine the relationship of QoL to specific clinical features. RESULTS 199 patients with a diagnosed ED completed the Clinical Impairment Assessment (CIA) [Cognitive Behavior Therapy and Eating Disorders, 315-318, 2008] and the Eating Disorders Examination (EDE) [Int J Eat Disord 6:1-8]. Differences between diagnostic groups were examined, as were differences between restrictive and binge-purge subtypes. CIA scores and EDE scores were positively correlated and higher in groups with binge-purge behaviours. CIA scores were not correlated with BMI, illness duration or frequency of bingeing/purging behaviours, except in the binge-purge AN group, where CIA scores negatively correlated with BMI. CONCLUSIONS Patients with EDs have poor QoL and impairment increases with illness severity. Patients with binge/purge diagnoses are particularly impaired. It remains unclear which clinical features best predict the degree of impairment experienced by patients with EDs.
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Affiliation(s)
- Hannah DeJong
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, De Crespigny Park, PO 59, London SE5 8AF, England
| | - Anna Oldershaw
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, De Crespigny Park, PO 59, London SE5 8AF, England
| | - Lot Sternheim
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, De Crespigny Park, PO 59, London SE5 8AF, England
| | - Nelum Samarawickrema
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, De Crespigny Park, PO 59, London SE5 8AF, England
| | - Martha D Kenyon
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, De Crespigny Park, PO 59, London SE5 8AF, England
| | - Hannah Broadbent
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, De Crespigny Park, PO 59, London SE5 8AF, England
| | - Anna Lavender
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Helen Startup
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Janet Treasure
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, De Crespigny Park, PO 59, London SE5 8AF, England
| | - Ulrike Schmidt
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, De Crespigny Park, PO 59, London SE5 8AF, England
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Lavender A, Startup H, Naumann U, Samarawickrema N, Dejong H, Kenyon M, van den Eynde F, Schmidt U. Emotional and social mind training: a randomised controlled trial of a new group-based treatment for bulimia nervosa. PLoS One 2012; 7:e46047. [PMID: 23118850 PMCID: PMC3485274 DOI: 10.1371/journal.pone.0046047] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 08/28/2012] [Indexed: 11/18/2022] Open
Abstract
Objective There is a need to improve treatment for individuals with bulimic disorders. It was hypothesised that a focus in treatment on broader emotional and social/interpersonal issues underlying eating disorders would increase treatment efficacy. This study tested a novel treatment based on the above hypothesis, an Emotional and Social Mind Training Group (ESM), against a Cognitive Behavioural Therapy Group (CBT) treatment. Method 74 participants were randomised to either ESM or CBT Group treatment programmes. All participants were offered 13 group and 4 individual sessions. The primary outcome measure was the Eating Disorder Examination (EDE) Global score. Assessments were carried out at baseline, end of treatment (four months) and follow-up (six months). Results There were no differences in outcome between the two treatments. No moderators of treatment outcome were identified. Adherence rates were higher for participants in the ESM group. Discussion This suggests that ESM may be a viable alternative to CBT for some individuals. Further research will be required to identify and preferentially allocate suitable individuals accordingly. Trial Registration ISRCTN61115988
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Affiliation(s)
- Anna Lavender
- Eating Disorders Service, South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, United Kingdom.
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Kenyon M, Samarawickrema N, Dejong H, Van den Eynde F, Startup H, Lavender A, Goodman-Smith E, Schmidt U. Theory of mind in bulimia nervosa. Int J Eat Disord 2012; 45:377-84. [PMID: 22212956 DOI: 10.1002/eat.20967] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2011] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study aimed to investigate theory of mind (ToM) in individuals with bulimia nervosa (BN), an area neglected by empirical research despite social functioning difficulties in this disorder and evidence of ToM deficits in people with anorexia nervosa (AN). METHOD ToM was assessed in 48 BN and 34 Eating Disorder Not Otherwise Specified BN-type (EDNOS-BN) outpatients and 57 healthy controls (HCs) using the Reading the Mind in the Eyes and the Reading the Mind in the Films (RMF), an ecologically valid task novel to BN research. RESULTS Overall performance in BN and EDNOS-BN groups was equivalent to HCs on both tasks. Individuals with BN had enhanced negative emotion recognition on the RMF. DISCUSSION Individuals with AN and BN have distinct socio-cognitive profiles. Further research into social cognition is required to establish the link between interpersonal difficulties and psychopathology in people with BN.
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Affiliation(s)
- Martha Kenyon
- Section of Eating Disorders, Department of Psychological Medicine, King's College London, Institute of Psychiatry, London, United Kingdom.
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Lavender A. Psychiatric rehabilitation. British Journal of Clinical Psychology 2012. [DOI: 10.1111/j.2044-8260.1995.tb01483.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Van den Eynde F, Samarawickrema N, Kenyon M, DeJong H, Lavender A, Startup H, Schmidt U. A study of neurocognition in bulimia nervosa and eating disorder not otherwise specified-bulimia type. J Clin Exp Neuropsychol 2011; 34:67-77. [PMID: 22059531 DOI: 10.1080/13803395.2011.621891] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Neurocognition in bulimia nervosa (BN) is under-researched. This study investigated aspects of attention (d2-Letter Cancellation Task), inhibitory control (Stroop and go/no-go task), and decision making (Game of Dice Task) in 40 people with BN, 30 with eating disorder not otherwise specified-BN type (EDNOS-BN), and 65 healthy controls (HCs). The National Adult Reading Test (NART) and Depression Anxiety Stress Scale (DASS-21) were also administered. Analyses of covariance (covariates: age, NART, and DASS-21) showed that people with BN and EDNOS-BN performed as well as HCs on all tasks. Attention task performance was poorer in the EDNOS-BN than in the BN group.
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Affiliation(s)
- Frederique Van den Eynde
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK.
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Dejong H, Van den Eynde F, Broadbent H, Kenyon MD, Lavender A, Startup H, Schmidt U. Social cognition in bulimia nervosa: a systematic review. Eur Psychiatry 2011; 28:1-6. [PMID: 21920709 DOI: 10.1016/j.eurpsy.2011.07.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 07/05/2011] [Accepted: 07/10/2011] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Clinical accounts and previous evidence suggest that socio-emotional impairments may be present in people with bulimia nervosa (BN). The aim of this paper was to systematically review studies of social cognition, and to evaluate whether social cognitive deficits exist in BN. METHOD Keywords were identified using an existing model of social cognition (Green et al., 2007) [16], and used to search for relevant papers in three online databases. Records were then screened according to a priori inclusion/exclusion criteria. RESULTS Five papers reporting seven social cognition tasks were identified as pertinent to the review. All involved either theory of mind ability or emotional processing skills. Participants with BN had impaired performance on the Levels of Emotional Awareness Scale and showed greater attentional bias than controls on an emotional Stroop task. There were no overall group differences for any other tasks, although there were small differences for some specific test items. CONCLUSIONS Basic social cognition does not appear to be impaired in people with BN. Future research should make use of more complex, ecologically valid measures, and consider the relationship between task performance and everyday social functioning.
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Affiliation(s)
- H Dejong
- King's College London, Institute of Psychiatry, Section of Eating Disorders, PO 59, De Crespigny Park, SE5 8AF London, United Kingdom.
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Roberts M, Lavender A, Tchanturia K. Measuring self-report obsessionality in anorexia nervosa: Maudsley Obsessive-Compulsive Inventory (MOCI) or obsessive-compulsive inventory-revised (OCI-R)? Eur Eat Disord Rev 2010; 19:501-8. [PMID: 22021125 DOI: 10.1002/erv.1072] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Self-report measures are often used in research and clinical practise as they efficiently gather a large amount of information. With growing numbers of self-report measures available to target single constructs, it is important to revisit one's choice of instrument to be sure that the most valid and reliable measure is employed. The Maudsley Obsessive-Compulsive Inventory (MOCI) and the Obsessive-Compulsive Inventory-Revised (OCI-R) were administered to 223 female participants: 30 inpatients with anorexia nervosa (AN), 62 community cases with AN, 69 community cases weight restored from AN and 62 healthy controls. Both measures distinguished between clinical and healthy groups; however, the OCI-R showed superior internal reliability. Additionally, the OCI-R measures six (to the MOCI's four) obsessive-compulsive constructs, and uses a more sensitive response format (likert scale vs. categorical). It is recommended that the OCI-R be employed as the self-report instrument of choice for assessing obsessive-compulsive pathology in those with AN.
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Affiliation(s)
- Marion Roberts
- Institute of Psychiatry, Department of Psychological Medicine, King's College London, UK
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12
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Abstract
OBJECTIVES Future thinking is an important domain of cognitive functioning, with reduced ability to imagine positive future events associated with hopelessness in depression and parasuicide. Rumination has been shown to exacerbate negative cognitive biases in depression, and to reduce likelihood estimations for positive future events. We examine the hypothesis that, in depressed patients, rumination would reduce the ability to imagine positive future events, whilst increasing the ability to imagine negative future events. METHOD The ability to imagine positive and negative future events was assessed using the future thinking paradigm (MacLeod, Rose, & Williams, 1993). Depressed and nondepressed participants completed the future thinking task after being randomly allocated to either a rumination or distraction manipulation (Nolen-Hoeksema & Morrow, 1993). Mood was measured before and after the manipulation. Participants also completed a standard verbal fluency task. RESULTS In the depressed group, compared to distraction, rumination increased both negative and positive future thinking, although the effect was only significant for negative future thinking once baseline levels of hopelessness were controlled for. These findings are consistent with the prediction that rumination would increase negative future thinking, but inconsistent with the prediction that rumination would reduce positive future thinking. Previous findings that, compared to controls, depressed patients generated fewer positive future events were replicated. CONCLUSION Ruminative self-focus leads to greater negative future thinking in depressed patients, further confirming that rumination exacerbates negative cognitive biases in depression. The relationship between rumination and positive future thinking was unexpected, but might potentially reflect a general priming of self-related information by rumination.
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Abstract
OBJECTIVES Similarities in patterns of cognition and behaviour between patients with eating disorders and those with obsessive-compulsive disorder (OCD) have long been recognized, and comorbidity between these disorders has been shown to be high. However, there has been little investigation of the cognitive content shared between eating disorders and OCD. It has been suggested that a cognitive analysis of the overlap between the disorders may help to increase understanding of each, and have potentially useful clinical implications. The present study aimed to investigate the presence of obsessive-compulsive beliefs and magical ideation (MI) in a group of eating-disordered participants. METHOD One hundred seventy-seven volunteers with a history of or current eating disorder completed the Obsessive Beliefs Questionnaire (OBQ), the Interpretation of Intrusions Inventory (IlI) and the Magical ideation scale (MIS). RESULTS Eating-disordered participants demonstrated levels of the beliefs measured comparable to or higher than those with OCD. CONCLUSIONS The results supported the hypothesis that the belief domains investigated are relevant to eating-disordered individuals. This has interesting theoretical and clinical implications. Further research will be required to elucidate the role of these types of cognitions in the relationship between eating disorders and OCD, and to clarify their role in the psychopathology of eating disorders.
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Affiliation(s)
- Anna Lavender
- Department of Psychology, Institute of Psychiatry, King's College London, UK.
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14
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Johnston O, Startup H, Lavender A, Godfrey E, Schmidt U. Therapeutic writing as an intervention for symptoms of bulimia nervosa: effects and mechanism of change. Int J Eat Disord 2010; 43:405-19. [PMID: 19544556 DOI: 10.1002/eat.20714] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study explored the effects on bulimic symptomatology of a writing task intended to reduce emotional avoidance. METHOD Eighty individuals reporting symptoms of bulimia completed, by e-mail, a therapeutic or control writing task. Participants completed questionnaires on bulimic symptoms, mood, and potential moderating and mediating factors, and were followed up after 4 and 8 weeks. Writing content was explored using a word count package and qualitative framework analysis. RESULTS Bulimic symptoms decreased in both groups, although in both groups the number of participants who improved was approximately equal to the number who did not improve. Symptom decreases were associated with increases in perceived mood regulation abilities, and decreases in negative beliefs about emotions. Participants preferred internet delivery to face to face discussion. DISCUSSION For individuals experiencing symptoms of bulimia, the effects of therapeutic writing did not differ significantly from effects of a control writing task.
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Affiliation(s)
- Olwyn Johnston
- Department of Psychology, Institute of Psychiatry, King's College London, United Kingdom.
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15
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Boddington SJA, Lavender A. Treatment models for couples therapy: A review of the outcome literature and the Dodo's verdict. ACTA ACUST UNITED AC 2007. [DOI: 10.1080/02674659508405539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Nosaka K, Muthalib M, Lavender A, Laursen PB. Attenuation of muscle damage by preconditioning with muscle hyperthermia 1-day prior to eccentric exercise. Eur J Appl Physiol 2006; 99:183-92. [PMID: 17089155 DOI: 10.1007/s00421-006-0331-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2006] [Indexed: 10/24/2022]
Abstract
This study investigated the hypothesis that muscle damage would be attenuated in muscles subjected to passive hyperthermia 1 day prior to exercise. Fifteen male students performed 24 maximal eccentric actions of the elbow flexors with one arm; the opposite arm performed the same exercise 2-4 weeks later. The elbow flexors of one arm received a microwave diathermy treatment that increased muscle temperature to over 40 degrees C, 16-20 h prior to the exercise. The contralateral arm acted as an untreated control. Maximal voluntary isometric contraction strength (MVC), range of motion (ROM), upper arm circumference, muscle soreness, plasma creatine kinase activity and myoglobin concentration were measured 1 day prior to exercise, immediately before and after exercise, and daily for 4 days following exercise. Changes in the criterion measures were compared between conditions (treatment vs. control) using a two-way repeated measures ANOVA with a significance level of P < 0.05. All measures changed significantly following exercise, but the treatment arm showed a significantly faster recovery of MVC, a smaller change in ROM, and less muscle soreness compared with the control arm. However, the protective effect conferred by the diathermy treatment was significantly less effective compared with that seen in the second bout performed 4-6 weeks after the initial bout by a subgroup of the subjects (n = 11) using the control arm. These results suggest that passive hyperthermia treatment 1 day prior to eccentric exercise-induced muscle damage has a prophylactic effect, but the effect is not as strong as the repeated bout effect.
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Affiliation(s)
- K Nosaka
- School of Exercise, Biomedical and Health Sciences, Edith Cowan University, 100 Joondalup Drive, Joondalup, WA, 6027, Australia.
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17
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Abstract
Access to the proximal interphalangeal joint of the finger for arthroplasty is difficult without detaching its stabilizers or dividing the tendons that cross it, which then require repair and slow rehabilitation. We describe a method that conserves both, so facilitating post-operative rehabilitation.A C-shaped incision is made on the dorsum of the finger. The lateral bands of the extensor expansion are separated from the central slip proximally to the extensor hood. They are then retracted to expose the condyles of the proximal phalanx, which are excised. The PIP joint is then dislocated between the central slip and a lateral band allowing the remainder of the head to be excised. The middle and proximal phalanges are then prepared to accept the prosthesis. The prosthesis is then inserted and the joint is reduced. The lateral bands of the extensor mechanism are sutured back to the central slip before the skin is closed.
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Affiliation(s)
- N R Fahmy
- Department of Orthopaedic Surgery, Stepping Hill Hospital, Stockport, UK
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18
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Abstract
The sensory role of the intact and ruptured anterior cruciate ligament was studied by the use of cortical evoked potentials during arthroscopy. This showed a response from the intact ligament in four patients that was reproducible. This response was consistent with those obtained from stimulation of the ipsilateral posterior tibial nerve. No response was elicited from either the femoral or tibial stump of ruptured ligaments using the same technique in six patients who had ruptured their anterior cruciate ligament (two femoral and four mid-substance ruptures). We believe that this demonstrates that there is no functional nervous tissue within the anterior cruciate ligament after rupture.
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Buckley SC, Lavender A, Lynch PG, Wharton MR. Orthopaedic clinical note. Patella metastases: a case report. J R Coll Surg Edinb 1997; 42:122-3. [PMID: 9114685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Here we report the first noted case of a small cell carcinoma of the lung (oat cell carcinoma) presenting as metastases in the patella. Malignancies of the patella, primary or secondary, are rare. First presentation of a malignancy with metastases in the patella has only been recorded once previously.
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Affiliation(s)
- S C Buckley
- Department of Orthopaedics, Royal Preston Hospital, Fulwood, Preston, UK
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20
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Abstract
This paper is concerned with how quality might be assured in mental health services. It includes an account of why a concern with quality and quality assurance procedures are now high on the agenda of the Health Service. A quality assurance programme requires a decision about what elements of a service to monitor, what information is relevant, how it can be collected, and a system for acting on the results. This paper provides a brief review of the kind of information that has been considered relevant and the methods that have been used to collect it. In addition, the principles underlying good and comprehensive quality assurance programmes will be outlined and the development of a particular system, known as QUARTZ, which has attempted to incorporate these principles, described briefly.
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Affiliation(s)
- A Lavender
- Clinical Psychological Training Scheme, Solomons Centre, Southborough, Tunbridge Wells, Kent, UK
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21
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Walsh PN, Conliffe C, Abdulkadir AS, Kelehan P, Conroy R, Foley M, Lenehan P, Murphy JF, Stronge J, Cantwell B, Wright C, Millward M, Carpenter M, Lennard T, Wilson R, Home C, Corbett AR, O’Sullivan G, Collins JK, Doran M, McDermott EWM, Mercer P, Smyth P, O’Higgins NJ, Duffy MJ, Reilly D, McDermott E, Faul C, Fennelly JJ, O’Higgins N, Lowry S, Russell H, Atkinson R, Hickey I, O’Brien F, O’Mahony A, O’Donoghue M, Pomeroy M, Prosser ES, Barker F, Casey M, Carroll K, Davis M, Duffy G, O’Kennedy R, Smyth PPA, O’Carroll D, Hetherton AM, Coveney E, McAlister V, Murray MJ, Brayden DJ, O’Hora A, Street J, O’Leary J, Pollock AM, Crowley M, Healy I, Murphy J, Landers R, Burke L, O’Brien D, Annis P, Hogan J, Kealy W, Lewis FA, Doyle CT, Callaghan M, Whelan A, Feighery C, Bresnihan B, Kelleher D, Reams G, Murphy A, Hall N, Casey EB, Mulherin D, Doherty E, Yanni G, Wallace E, Jackson J, Bennett M, Tighe O, Mulcahy H, O’Donoghue D, Croke DT, Cahill RJ, Beattie S, Hamilton H, O’Morain C, Corridan B, Collins RA, O’Morain CA, Fitzgerald E, Gilvarry JM, Leader M, Fielding JF, Johnson BT, Lewis SA, Love AHG, Johnston BT, Collins JSA, McFarland RJ, Johnston PW, Collins BJ, Kilgallen CM, Murphy GM, Markey GM, McCormack JA, Curry RC, Morris TCM, Alexander HD, Edgar S, Treacy M, O’Connell MA, Weir DG, Sheehan J, O’Loughlin G, Traynor O, Walsh N, Xia HX, Daw MA, Keane CT, Dupont C, Gibson G, McGinnity E, Walshe J, Carmody M, Donohoe J, McGrath P, O’Moore R, Kieran E, Rogers S, McKenna KE, Walsh M, Bingham EA, Hughes AE, Nevin NC, Todd DJ, Stanford CF, Callender ME, Burrows D, Paige DG, Allen GE, O’Brien DP, Gough DB, Phelan C, Given HF, Kamal SZ, Kehoe S, Coldicott S, Luesley D, Ward K, MacDonnell HF, Mullins S, Gordon I, Norris LA, Devitt M, Bonnar J, Sharma SC, Sheppard BL, Fitzsimons R, Kingston S, Garvey M, Hoey HMCV, Glasgow JFT, Moore R, Robinson PH, Murphy E, Murphy JFA, Wood AE, Sweeney P, Neligan M, MacLeod D, Cunnane G, Kelly P, Corcoran P, Clancy L, Drury RM, Drury MI, Powell D, Firth RGR, Jones T, Ferris BF, O’Flynn W, O’Donnell J, Kingston SM, Cunningham F, Hinds GME, McCluskey DR, Howell F, O’Mahony M, Devlin J, O’Reilly O, Buttanshaw C, Jennings S, Keane ER, Foley-Nolan C, Ryan FM, Taylor M, Lyons RA, O’Kelly F, Mason J, Carroll D, Doherty K, Flynn M, O’Dwyer R, Gilmartin JJ, McCarthy CF, Armstrong C, Mannion D, Feely T, Fitzpatrick G, Cooney CM, Aleong JC, Rooney R, Lyons J, Phelan DM, Joshi GP, McCarroll SM, Blunnie WP, O’Brien TM, Moriarty DC, Brangan J, Kelly CP, Kenny P, Gallagher H, McGovern E, Luke D, Lowe D, Rice T, Phelan D, Lyons JB, Lyons FM, McCoy DM, McGinley J, Hurley J, McDonagh P, Crowley JJ, Donnelly SM, Tobin M, Fitzgerald O, Maurer BJ, Quigley PJ, King G, Duly EB, Trinick TR, Boyle D, Wisdom GB, Geoghegan F, Collins PB, Goss C, Younger K, Mathias P, Graham I, MacGowan SW, Sidhu P, McEneaney DJ, Cochrane DJ, Adgey AAJ, Anderson JM, Moriarty J, Fahy C, Lavender A, Lynch L, McGovern C, Nugent AM, Neely D, Young I, McDowell I, O’Kane M, Nicholls DP, McEneaney D, Nichols DP, Campbell NPS, Campbell GC, Halliday MI, O’Donnell AF, Lonergan M, Ahearne T, O’Neill J, Keaveny TV, Ramsbottom D, Boucher-Hayes D, Sheahan R, Garadaha MT, Kidney D, Freyne P, Gearty G, Crean P, Singh HP, Hargrove M, Subareddy K, Hurley JP, O’Rourke W, O’Connor C, FitzGerald MX, McDonnell TJ, Chan R, Stinson J, Hemeryck L, Feely J, Chopra MP, Sivner A, Sadiq SM, Abernathy E, Plant L, Bredin CP, Hickey P, Slevin G, McCrory K, Long M, Conlon P, Walker F, Fitzgerald P, O’Neill SJ, O’Connor CM, Quigley C, Donnelly S, Southey A, Healy E, Mulcahy F, Lyons DJ, Keating J, O’Mahony C, Roy D, Shattock AG, Hillary IB, Waiz A, Hossain R, Chakraborthy B, Clancy LP, O’Reilly L, Byrne C, Costello E, O’Shaughnessy E, Cryan B, Farrell J, Walshe JJ, Mellotte GJ, Ho CA, Morgan SH, Bending MR, Bonner J. Inaugural national scientific medical meeting. Ir J Med Sci 1993. [PMCID: PMC7101915 DOI: 10.1007/bf02942100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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22
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Abstract
The importance of different perspective views for the recognition of model heads was studied. In experiment 1 subjects were instructed to learn the appearance of six heads placed individually on a turntable free to rotate through 360 degrees. Subjects did not distribute their time evenly but focussed their inspection on particular views (the full face view and a view close to the profile). Despite differential inspection of these two views during the learning phase, the face, half profile, and profile views were recognized with equal efficiency in a subsequent recognition task with static views. Experiment 2 used the inspection paradigm to investigate view preference during the recognition of heads from memory. In this experiment subjects were asked to learn the appearance of three heads each seen rotating at an even speed. In a subsequent retrieval task the subjects actively inspected six model heads on the turntable and were asked to differentiate the three heads previously seen rotating from three novel heads. The pattern of inspection in this retrieval task was equivalent to that in experiment 1. Results suggest that during the encoding into memory subjects construct descriptions of specific prototypical views of the head and that descriptions of these same views are preferentially utilised during recognition.
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Affiliation(s)
- M H Harries
- Department of Psychology, University of St Andrews, Fife, Scotland, UK
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23
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Abstract
There are few controlled studies investigating the effects of nurses changing from uniforms to everyday clothes. A quasi-experimental design was used where patient behaviour was measured before and after such a change and in which some degree of control was achieved by assessing the major sources of bias (i.e. medication, ward practices, etc.). The results suggest that the change in dress led to a decrease in deviant behaviour (particularly violent incidents) and patient estrangement and an increase in the number of nurses in whom patients could confide. These changes in behaviour appeared to be the result of changes in the nature of the relationships/interactions between patients and staff brought about by the change in nurse dress.
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Abstract
This study attempted to use feedback from the Model Standards Questionnaires (a series designed to measure the quality of care) to improve care on a psychiatric hospital's rehabilitation wards. Both a controlled and quasi-experimental design were used. The controlled design provided evidence that feedback from the Questionnaire concerned with the Individual Programmes of Treatment and Care led to improvements in these practices but not for the remaining three questionnaires. The quasi-experimental design indicated that the significant generalised improvement in care, over all questionnaires, was most likely due to the feedback.
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Affiliation(s)
- A Lavender
- Department of Psychology, Maidstone Hospital, Kent
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25
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Hemming H, Cook M, Gilbert KA, Lavender A. Gaze patterns of mentally retarded adults in two contrasting environments. Am J Ment Defic 1979; 83:561-5. [PMID: 443271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Two matched samples of mentally retarded adults were video recorded on two occasions, before and after one group was transferred to a different type of hospital, and their gaze patterns analyzed. Overall, only slight changes after transfer were found, but analysis according to amount of looking at the interviewer on the first occasion showed that those transferred subjects who initially looked little of the time significantly increased their amount of looking after transfer. Some correlations with the Adaptive Behavior Scale were also reported.
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