1
|
Lagdon S, Klencakova L, Schubotz D, Shannon C, Tully MA, Armour C, Jordan JA. Young People's Understanding of Coercive Control in Northern Ireland. J Child Adolesc Trauma 2023; 16:537-545. [PMID: 37593053 PMCID: PMC10427570 DOI: 10.1007/s40653-022-00508-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 08/19/2023]
Abstract
Coercive control and related research have progressed significantly in the past number of years, with an ever-growing evidence base adding to its construct. However, currently there is a lack of evidence on young people's knowledge and understanding of coercive control. We included a module of questions in the 2020 Northern Ireland Young Life and Life and Times survey (n = 2,069) with the aim of capturing baseline measurable data on understanding of coercive control within intimate relationships among 16-year olds. Only 16% (n = 325) of respondents had heard of the term coercive control and knew what it meant. Findings also revealed that females, compared to males, were less likely to have heard of coercive control. When the victim being subjected to the behaviours was portrayed as female as opposed to male there was stronger recognition of the associated risks, need for support, and the seriousness of the situation. Our study findings call to question young people's knowledge of unhealthy intimate relationship behaviours beyond blatant and deliberate acts of harm such as those described in the coercive control scenarios. Gender disparities in awareness of coercive control across the study sample also give cause for concern given the increased risk of intimate partner violence among women and girls as well as lower reporting and help seeking among male victims. Results solidify the necessity for dedicated preventative and intervention efforts which focus on intimate relationships and reflect the diverse needs and experiences of young people. Supporting young people to act on their own behalf is an important step change to empowerment within their own intimate relationships.
Collapse
Affiliation(s)
- Susan Lagdon
- School of Psychology, Ulster University, Northern Ireland, UK
| | - Lucia Klencakova
- School of Social Sciences, Education and Social Work, Queen’s University, Belfast, UK
| | - Dirk Schubotz
- School of Social Sciences, Education and Social Work, Queen’s University, Belfast, UK
| | - Ciaran Shannon
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, UK
| | - Mark A. Tully
- School of Health Sciences, Ulster University, Northern Ireland, UK
| | - Cherie Armour
- School of Psychology, Queen’s University Belfast, Northern Ireland, UK
| | - Julie-Ann Jordan
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, UK
| |
Collapse
|
2
|
Jordan JA, Shannon C, Browne D, Carroll E, Maguire J, Kerrigan K, Hannan S, McCarthy T, Tully MA, Mulholland C, Dyer KFW. Healthcare staff mental health trajectories during the COVID-19 pandemic: findings from the COVID-19 Staff Wellbeing Survey. BJPsych Open 2023; 9:e112. [PMID: 37345555 DOI: 10.1192/bjo.2023.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Cross-sectional studies have shown that the COVID-19 pandemic has had a significant impact on the mental health of healthcare staff. However, it is less well understood how working over the long term in successive COVID-19 waves affects staff well-being. AIMS To identify subpopulations within the health and social care staff workforce with differentiated trajectories of mental health symptoms during phases of the COVID-19 pandemic. METHOD The COVID-19 Staff Wellbeing Survey assessed health and social care staff well-being within an area of the UK at four time points, separated by 3-month intervals, spanning November 2020 to August 2021. RESULTS Growth mixture models were performed on the depression, anxiety and post-traumatic stress disorder longitudinal data. Two class solutions provided the best fit for all models. The vast majority of the workforce were best represented by the low-symptom class trajectory, where by symptoms were consistently below the clinical cut-off for moderate-to-severe symptoms. A sizable minority (13-16%) were categorised as being in the high-symptom class, a group who had symptom levels in the moderate-to-severe range throughout the peaks and troughs of the pandemic. In the depression, anxiety and post-traumatic stress disorder models, the high-symptom class perceived communication from their organisation to be less effective than the low-symptom class. CONCLUSIONS This research identified a group of health service staff who reported persistently high mental health symptoms during the pandemic. This group of staff may well have particular needs in terms of the provision of well-being support services.
Collapse
Affiliation(s)
- Julie-Ann Jordan
- PhD, IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, UK
| | - Ciaran Shannon
- DClinPsych, IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, UK
| | - Dympna Browne
- PhD, Belfast Health and Social Care Trust, Northern Ireland, UK
| | - Emma Carroll
- DClinPsych, Northern Health and Social Care Trust, Northern Ireland, UK
| | - Jennifer Maguire
- DClinPsych, PhD, South Eastern Health and Social Care Trust, Northern Ireland, UK
| | - Keith Kerrigan
- PhD, Northern Health and Social Care Trust, Northern Ireland, UK
| | - Sinead Hannan
- DClinPsych, Southern Health and Social Care Trust, Northern Ireland, UK
| | - Thomas McCarthy
- DClinPsych, Western Health and Social Care Trust, Northern Ireland, UK
| | - Mark A Tully
- PhD, School of Medicine, Ulster University, Northern Ireland, UK
| | - Ciaran Mulholland
- MD, IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, UK
| | - Kevin F W Dyer
- DClinPsych, PhD, IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, UK
| |
Collapse
|
3
|
Ghosh CC, McVicar D, Davidson G, Shannon C, Armour C. Exploring the associations between auditory hallucinations and psychopathological experiences in 10,933 patient narratives: moving beyond diagnostic categories and surveys. BMC Psychiatry 2023; 23:307. [PMID: 37131149 PMCID: PMC10155450 DOI: 10.1186/s12888-023-04780-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 04/12/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Previous research suggests that auditory hallucinations are prevalent within both the clinical and general populations. Yet, we know little about how these phenomena are associated with other psychopathology symptoms and experiences. The current study aids investigations towards preventing, predicting and more effectively responding to such distressing occurrences. There have been substantial efforts in the literature to propose models of auditory hallucination and attempts to verify them. However, many of these studies used survey methods that restrict the person's responses to a set of pre-defined criteria or experiences and do not allow exploration of potential important other symptoms beyond them. This is the first study to explore the correlates of auditory hallucination using a qualitative dataset consisting of unrestricted responses of patients about their lived experiences with mental illness. METHOD The study used a dataset consisting of 10,933 narratives from patients diagnosed with mental illnesses. For analysis, the study used correlation on the text-based data. This approach is an alternative to the knowledge-based approach where experts manually read the narratives and infer the rules and relationships from the dataset. RESULT This study found at least 8 correlates of auditory hallucination (small correlation coefficients), with the unusual ones being "pain." The study also found that auditory hallucinations were independent of obsessive thoughts and compulsive behaviours, and dissociation, in contrast with the literature. CONCLUSION This study presents an innovative approach to explore the possible associations between symptoms without the restrictions of (or outside the confines of) traditional diagnostic categories. The study exemplified this by finding the correlates of auditory hallucination. However, any other symptom or experience of interest can be studied similarly. Potential future directions of these findings are discussed in the context of mental healthcare screening and treatment.
Collapse
Affiliation(s)
| | - Duncan McVicar
- Queen's Management School, Queen's University Belfast, Belfast, UK
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
| | - Ciaran Shannon
- IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, UK
| | - Cherie Armour
- School of Psychology, Queen's University Belfast, Belfast, UK.
| |
Collapse
|
4
|
Shannon C, Lavelle J, Brown-Whitehorn T, Jacobstein C, Tsarouhas N, Molnar J, Cianferoni A, Lee J. CHARACTERIZING ANAPHYLAXIS IN INFANTS PRESENTING TO THE EMERGENCY DEPARTMENT. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.555] [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: 11/11/2022]
|
5
|
Hurvitz S, Kalinsky K, Tripathy D, Sledge G, Gradishar W, O'Shaughnessy J, Modi S, Park H, McCartney A, Frentzas S, Shannon C, Cuff K, Eek R, Martin Jimenez M, Curigliano G, Jerusalem G, Huang C, Press M, Lu J. 273TiP ACE-Breast-03: A phase II study patients with HER2-positive metastatic breast cancer whose disease is resistant or refractory to T-DM1, and/or T-DXd, and/or tucatinib-containing regimens treated with ARX788. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1857] [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: 11/30/2022] Open
|
6
|
Ghosh CC, McVicar D, Davidson G, Shannon C, Armour C. What can we learn about the psychiatric diagnostic categories by analysing patients' lived experiences with Machine-Learning? BMC Psychiatry 2022; 22:427. [PMID: 35751077 PMCID: PMC9233399 DOI: 10.1186/s12888-022-03984-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/20/2021] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To deliver appropriate mental healthcare interventions and support, it is imperative to be able to distinguish one person from the other. The current classification of mental illness (e.g., DSM) is unable to do that well, indicating the problem of diagnostic heterogeneity between disorders (i.e., the disorder categories have many common symptoms). As a result, the same person might be diagnosed with two different disorders by two independent clinicians. We argue that this problem might have resulted because these disorders were created by a group of humans (APA taskforce members) who relied on more intuition and consensus than data. Literature suggests that human-led decisions are prone to biases, group-thinking, and other factors (such as financial conflict of interest) that can enormously influence creating diagnostic and treatment guidelines. Therefore, in this study, we inquire that if we prevent such human intervention (and thereby their associated biases) and use Artificial Intelligence (A.I.) to form those disorder structures from the data (patient-reported symptoms) directly, then can we come up with homogenous clusters or categories (representing disorders/syndromes: a group of co-occurring symptoms) that are adequately distinguishable from each other for them to be clinically useful. Additionally, we inquired how these A.I.-created categories differ (or are similar) from human-created categories. Finally, to the best of our knowledge, this is the first study, that demonstrated how to use narrative qualitative data from patients with psychopathology and group their experiences using an A.I. Therefore, the current study also attempts to serve as a proof-of-concept. METHOD We used secondary data scraped from online communities and consisting of 10,933 patients' narratives about their lived experiences. These patients were diagnosed with one or more DSM diagnoses for mental illness. Using Natural Language Processing techniques, we converted the text data into a numeric form. We then used an Unsupervised Machine Learning algorithm called K-Means Clustering to group/cluster the symptoms. RESULTS: Using the data mining approach, the A.I. found four categories/clusters formed from the data. We presented ten symptoms or experiences under each cluster to demonstrate the practicality of application and understanding. We also identified the transdiagnostic factors and symptoms that were unique to each of these four clusters. We explored the extent of similarities between these clusters and studied the difference in data density in them. Finally, we reported the silhouette score of + 0.046, indicating that the clusters are poorly distinguishable from each other (i.e., they have high overlapping symptoms). DISCUSSION We infer that whether humans attempt to categorise mental illnesses or an A.I., the result is that the categories of mental disorders will not be unique enough to be able to distinguish one service seeker from another. Therefore, the categorical approach of diagnosing mental disorders can be argued to fall short of its purpose. We need to search for a classification system beyond the categorical approaches even if there are secondary merits (such as ease of communication and black-and-white (binary) decision making). However, using our A.I. based data mining approach had several meritorious findings. For example, we found that some symptoms are more exclusive or unique to one cluster. In contrast, others are shared by most other clusters (i.e., identification of transdiagnostic experiences). Such differences are interesting objects of inquiry for future studies. For example, in clear contrast to the traditional diagnostic systems, while some experiences, such as auditory hallucinations, are present in all four clusters, others, such as trouble with eating, are exclusive to one cluster (representing a syndrome: a group of co-occurring symptoms). We argue that trans-diagnostic conditions (e.g., auditory hallucinations) might be prime targets for symptom-level interventions. For syndrome-level grouping and intervention, however, we argue that exclusive symptoms are the main targets. CONCLUSION Categorical approach to mental disorders is not a way forward because the categories are not unique enough and have several shared symptoms. We argue that the same symptoms can be present in more than one syndrome, although dimensionally different. However, we need additional studies to test this hypothesis. Future directions and implications were discussed.
Collapse
Affiliation(s)
| | - Duncan McVicar
- grid.4777.30000 0004 0374 7521Queen’s Management School, Queen’s University Belfast, Belfast, United Kingdom
| | - Gavin Davidson
- grid.4777.30000 0004 0374 7521School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, United Kingdom
| | - Ciaran Shannon
- grid.413824.80000 0000 9566 1119IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, United Kingdom
| | - Cherie Armour
- grid.4777.30000 0004 0374 7521School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| |
Collapse
|
7
|
Bosqui T, Shannon C, Anderson R, Turkington A, Barrett S, McCaul R, Cooper S, O'Donnell D, Rushe T, Mulholland C. Neighbourhood effects on psychotic and depressive symptoms in the context of religious sectarianism in Northern Ireland: A data linkage study. Int J Soc Psychiatry 2022; 68:264-272. [PMID: 33349094 DOI: 10.1177/0020764020982642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The incidence of psychotic disorders is higher in ethnic minorities groups. The 'ethnic density effect', in which living in a neighbourhood with a low own-group proportion increases the risk of psychosis, is one explanatory factor. The density effect in the ethno-religious and sectarian context of Northern Ireland has been found to be reversed, particularly for Catholics, in which there is harmful effect of high own-group density areas. This is partly explained by high urbanicity, deprivation and unemployment, but is otherwise not well understood. AIMS This study aimed to examine the density effect at the level of symptomology (positive and negative psychosis symptoms and depressive symptoms) in a representative sample of people with a first episode of psychosis in Northern Ireland. METHOD Data linkage methodology was used drawing on data from the Northern Ireland First Episode Psychosis Study (NIFEPS) and the 2001 Census of Northern Ireland. RESULTS In total, 223 people between the ages of 18 to 64 were included in the study. A significant density effect was found for Catholics for total psychosis scores, but not for positive, negative and depressive symptoms, nor for general psychopathology, after adjusting for individual and area characteristics. The model accounted for just over 12% of the variance. No effect was found for Protestants. CONCLUSION The findings suggest that the density effect for Catholics is unrelated to the core features of psychosis (hallucinations, delusions and anhedonia) but rather to broader cognitive and emotional disturbances and area deprivation. Explanations of exposure to social adversity and inequality are proposed, with implications for public mental health and social policy.
Collapse
Affiliation(s)
- Tania Bosqui
- Department of Psychology, American University of Beirut, Beirut, Lebanon
| | | | | | | | | | | | - Stephen Cooper
- Department of Psychiatry, Queen's University Belfast, Belfast, UK
| | - Donna O'Donnell
- School of Psychology, Queen's University Belfast, Belfast, UK
| | - Teresa Rushe
- School of Psychology, Queen's University Belfast, Belfast, UK
| | | |
Collapse
|
8
|
Howie C, Hanna D, Shannon C, Davidson G, Mulholland C. The Structure of the Prodromal Questionnaire-16 (PQ-16): Exploratory and confirmatory factor analyses in a general non-help-seeking population sample. Early Interv Psychiatry 2022; 16:239-246. [PMID: 33761575 DOI: 10.1111/eip.13147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 01/26/2023]
Abstract
AIMS To examine the structure of the Prodromal Questionnaire (PQ-16) in a non-help-seeking population through exploratory factor analysis and confirmatory factor analysis. Previous studies have not looked at the structure of this self-report measure outside clinical settings. METHODS Participants (n = 1045) were recruited through Amazon's Mechanical Turk (MTurk), and then completed the PQ-16. The data set was split randomly in two, one being used for exploratory factor analysis (EFA) and the other for confirmatory factor analysis (CFA). A polychoric correlation matrix was created and EFA was used to explore the factor structure of the PQ-16. Four models were tested through CFA to determine best fit: one, two, three and four-factor models were all analysed. RESULTS EFA indicated a two-factor structure in the PQ-16 in a non-help-seeking population (with a mean age = 29.7 years). Factor 1 represented perceptual abnormalities/hallucinations and factor 2 general symptoms associated with psychosis-risk. CFA indicated that all the proposed models were suitable fits for the dataset. Fit indices for the three-factor model (factor 1 representing perceptual abnormalities/hallucinations, factor 2 unusual thought content, and factor 3 negative symptom) indicated that it appeared to be a better fit for the data than the one, two, and four factor models. CONCLUSIONS This study suggests that a three-factor model of the PQ-16 is a better fit than other proposed models in a non-help-seeking population. Future research of the structure of the PQ-16 in this population may benefit from recruiting subjects with a lower mean age than the current study.
Collapse
Affiliation(s)
- Clare Howie
- School of Medicine, Queen's University Belfast, Belfast, UK
| | - Donncha Hanna
- School of Psychology, Queen's University Belfast, Belfast, UK
| | | | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
| | - Ciaran Mulholland
- School of Medicine, Queen's University Belfast, Belfast, UK.,Northern Health and Social Care Trust, Antrim, UK
| |
Collapse
|
9
|
Lagdon S, Jordan JA, Devine P, Tully MA, Armour C, Shannon C. Public Understanding of Coercive Control in Northern Ireland. J Fam Violence 2022; 38:39-50. [PMID: 35035065 PMCID: PMC8744385 DOI: 10.1007/s10896-021-00355-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Coercive control is characterised by negative behaviours which intimidate, threaten, and humiliate a person or restrict a person's liberty. In addition to being a known risk factor for experiencing other forms of violence, research has linked coercive control to symptoms of psychological distress and suicidality. In the UK, coercive and controlling behaviours within intimate and familial relationships have been legislated as offending behaviours. However, there still exists a lack of international evidence on wider public knowledge and understanding of coercive control. The Northern Ireland Life and Times Survey (NILT) is an annual cross-sectional representative survey of social policy topics. Participants are adults aged 18 years or over. Concerning coercive control, respondents were presented with two relationship scenarios: obvious and less obvious coercive control. Following each scenario, respondents indicated their level of agreement to ten statements covering attitudes towards coercive control, victims of coercive control, talking about coercive control, and whether coercive control is a crime. Respondents indicated whether they had heard of the term 'coercive control'. Predictors of coercive control awareness were assessed using multinomial logistic regression. Mixed analysis of variance assessed if agreement levels to the ten statements varied by type of coercive control and victim gender. Most respondents said that they had heard of the term coercive control and knew what it meant. Those who had not heard of coercive control at all were more likely to be on a lower income, less qualified and younger, when compared to those who said they knew what the term meant. Significant interactions between coercive control type and victim gender were evident for all ten statements. While most respondents are aware of the term coercive control, a significant number have not and are therefore unlikely to recognise the signs of this type of abuse.
Collapse
Affiliation(s)
- Susan Lagdon
- School of Psychology, Ulster University, Coleraine, Northern Ireland UK
| | - Julie-Ann Jordan
- IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, UK
| | - Paula Devine
- School of Social Sciences, Education and Social Work, Queen’s University, Belfast, UK
| | - Mark A. Tully
- School of Health Sciences, Ulster University, Coleraine, Northern Ireland UK
| | - Cherie Armour
- School of Psychology, Queen’s University Belfast, Belfast, Northern Ireland UK
| | - Ciaran Shannon
- IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, UK
| |
Collapse
|
10
|
Dong K, Chen V, Shannon C, Tebbutt S, Ng R, Quon B. 533: Whole-blood transcriptome biomarkers of pulmonary exacerbations in cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01957-3] [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: 10/20/2022]
|
11
|
Mitchell S, Shannon C, Mulholland C, Hanna D. Reaching consensus on the principles of trauma-informed care in early intervention psychosis services: A Delphi study. Early Interv Psychiatry 2021; 15:1369-1375. [PMID: 33169532 PMCID: PMC8451918 DOI: 10.1111/eip.13068] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 05/09/2020] [Revised: 10/07/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022]
Abstract
AIM The current study sought to conceptualize and reach consensus on the principles of trauma-informed care in early intervention psychosis services. METHODS A three-phase Delphi method was employed in this study. Experts included researchers, service providers and Experts by Experience in the area of early intervention in psychosis. In the initial qualitative phase, an expert panel (n = 57) shared their views on the constituents of trauma-informed care in early intervention psychosis services. Thematic analysis led to the generation of statement items. The expert panel was asked to rate the extent to which each statement item was an essential principle of trauma-informed care, leading to consensus of endorsed principles. RESULTS Qualitative analysis of the first phase data led to the identification of 185 distinct statements which were compiled into an online questionnaire for the panel to rate in Phase 2. The Phase 2 questionnaire was completed by 42 experts, with the endorsement of seven principles. In Phase 3, the panel were invited to re-rate 24 statements. This phase was completed by 39 panel members, with the acceptance of a further nine principles. Consensus was achieved resulting in the endorsement of 16 essential principles of trauma-informed care. CONCLUSIONS The study offers novel understanding of the conceptualisation of trauma-informed care in early intervention services and suggests principles which are widely agreed by experts in the field. The recommendations may inform the adoption of consistently delivered trauma-informed care in early interventions in psychosis and facilitate the evaluation and development of services.
Collapse
Affiliation(s)
- Sinéad Mitchell
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - Ciaran Shannon
- STEP Team, Northern Health and Social Care Trust, Antrim, Northern Ireland
| | - Ciaran Mulholland
- STEP Team, Northern Health and Social Care Trust, Antrim, Northern Ireland.,School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Donncha Hanna
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| |
Collapse
|
12
|
Jordan JA, Shannon C, Browne D, Carroll E, Maguire J, Kerrigan K, Hannan S, McCarthy T, Tully MA, Mulholland C, Dyer KFW. COVID-19 Staff Wellbeing Survey: longitudinal survey of psychological well-being among health and social care staff in Northern Ireland during the COVID-19 pandemic. BJPsych Open 2021; 7:e159. [PMID: 34493960 PMCID: PMC8410744 DOI: 10.1192/bjo.2021.988] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 05/04/2021] [Revised: 06/21/2021] [Accepted: 08/03/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Throughout the coronavirus disease 2019 (COVID-19) pandemic, health and social care workers have faced unprecedented professional demands, all of which are likely to have placed considerable strain on their psychological well-being. AIMS To measure the national prevalence of mental health symptoms within healthcare staff, and identify individual and organisational predictors of well-being. METHOD The COVID-19 Staff Wellbeing Survey is a longitudinal online survey of psychological well-being among health and social care staff in Northern Ireland. The survey included four time points separated by 3-month intervals; time 1 (November 2020; n = 3834) and time 2 (February 2021; n = 2898) results are presented here. At time 2, 84% of respondents had received at least one dose of a COVID-19 vaccine. The survey included four validated psychological well-being questionnaires (depression, anxiety, post-traumatic stress and insomnia), as well as demographic and organisational measures. RESULTS At time 1 and 2, a high proportion of staff reported moderate-to-severe symptoms of depression (30-36%), anxiety (26-27%), post-traumatic stress (30-32%) and insomnia (27-28%); overall, significance tests and effect size data suggested psychological well-being was generally stable between November 2020 and February 2021 for health and social care staff. Multiple linear regression models indicated that perceptions of less effective communication within their organisation predicted greater levels of anxiety, depression, post-traumatic stress and insomnia. CONCLUSIONS This study highlights the need to offer psychological support to all health and social care staff, and to communicate with staff regularly, frequently and clearly regarding COVID-19 to help protect staff psychological well-being.
Collapse
Affiliation(s)
- Julie-Ann Jordan
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland
| | - Ciaran Shannon
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland
| | - Dympna Browne
- Belfast Health and Social Care Trust, Northern Ireland
| | - Emma Carroll
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland
| | | | - Keith Kerrigan
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland
| | - Sinead Hannan
- Southern Health and Social Care Trust, Northern Ireland
| | | | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Northern Ireland
| | - Ciaran Mulholland
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland
| | - Kevin F W Dyer
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland
| |
Collapse
|
13
|
Bouchard DR, Olthuis JV, Bouffard-Levasseur V, Shannon C, McDonald T, Sénéchal M. Peer-led exercise program for ageing adults to improve physical functions - a randomized trial. Eur Rev Aging Phys Act 2021; 18:2. [PMID: 33573594 PMCID: PMC7879524 DOI: 10.1186/s11556-021-00257-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/31/2021] [Indexed: 12/24/2022] Open
Abstract
Background A peer-led exercise program is one way to empower people sharing similar characteristics to encourage others to be active, but there is a lack of evidence that these programs have physical function and other benefits when delivered to ageing adults. Methods This randomized controlled trial lasting 12 weeks proposed an exercise peer-led program offered to 31 adults aged 50 and above, twice a week, by a trained leader of the same age from March to May 2019. The program was offered for free with limited space and equipment. Valid tests of physical function (e.g., 30-s chair stand, 6-min walk test) were used to assess the functional benefits. Psychosocial outcomes were assessed using self-reported questionnaires and metabolic outcomes via a fasted blood draw. Results A significant difference was found between pre-and post-values in most physical function tests in the intervention group (all p < 0.05). When adjusted for potential confounders, the intervention group was significantly associated with a more significant improvement on the chair stand test (ß = .26; p < 0.001; r2 = 0.26), the arm curl (ß = .29; p < 0.001; r2 = 0.49), as well as the 6-min walk test (ß = -.14; p < 0.001; r2 = 0.62) compared with the control group. Using repetitive measures generalized linear model, the interaction between the changes and the group was significant for all three tests. Benefits were also observed for participants’ stress level and perceived health in the intervention group compared to the control. Finally, no significant difference was observed between groups for metabolic health. Conclusions The current work suggests that a 12-week peer-led exercise program can improve physical function for adults age 50 and above. Trial registration NCT03799952(ClinicalTrials.gov) 12/20/2018. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-021-00257-x.
Collapse
Affiliation(s)
- D R Bouchard
- Cardiometabolic Exercise & Lifestyle Laboratory, Fredericton, NB, Canada. .,Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 4J9, Canada.
| | - J V Olthuis
- Department of Psychology, University of New Brunswick, Fredericton, NB, Canada
| | - V Bouffard-Levasseur
- Secteur Éducation et kinésiologie, Université de Moncton, Fredericton, NB, Canada
| | - C Shannon
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 4J9, Canada
| | - T McDonald
- Faculty of Law, University of New Brunswick, Fredericton, NB, Canada
| | - M Sénéchal
- Cardiometabolic Exercise & Lifestyle Laboratory, Fredericton, NB, Canada.,Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 4J9, Canada
| |
Collapse
|
14
|
Howie C, Potter C, Shannon C, Davidson G, Mulholland C. Screening for the at-risk mental state in educational settings: A systematic review. Early Interv Psychiatry 2020; 14:643-654. [PMID: 31883215 DOI: 10.1111/eip.12926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/10/2019] [Accepted: 12/14/2019] [Indexed: 12/20/2022]
Abstract
AIM The at-risk mental state (ARMS) allows clinicians to identify individuals who have an increased risk of developing psychosis. At present, most screening for psychosis-risk is carried out within help-seeking populations; however, screening within educational settings may allow clinicians to identify individuals at-risk earlier and to increase the rate of detection. This review aimed to examine screening for the ARMS in educational settings, with the key questions: what screening tools have been used in educational settings, can screening in educational settings detect individuals with ARMS, what threshold scores in screening tools indicate a positive screen in educational settings, are there comorbid mental health conditions associated with the ARMS in educational settings? METHODS Searches were carried out in PsycINFO, MEDLINE, EMBASE, Scopus and Web of Science and reference lists of included articles searched. Results were summarized using narrative synthesis. RESULTS Nine papers were included for narrative synthesis. A variety of screening tools have been used when screening for the ARMS in educational settings. The majority of studies have been conducted in schools. The prevalence of the ARMS reported in ranges from 1% to 8%. CONCLUSIONS The ARMS indicates the presence of distressing symptoms for which intervention may be beneficial. Screening programmes within educational settings may allow outreach for prodromal symptoms at an earlier stage than clinical settings currently provided for.
Collapse
Affiliation(s)
- Clare Howie
- School of Medicine, Queen's University Belfast, Belfast, UK
| | - Claire Potter
- School of Medicine, Queen's University Belfast, Belfast, UK
| | - Ciaran Shannon
- Holywell Hospital, Northern Health and Social Care Trust, Antrim, UK
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
| | - Ciaran Mulholland
- School of Medicine, Queen's University Belfast, Belfast, UK.,Holywell Hospital, Northern Health and Social Care Trust, Antrim, UK
| |
Collapse
|
15
|
Mongan D, Lynch J, Hanna D, Shannon C, Hamilton S, Potter C, Gorman C, McCambridge O, Morrow R, Mulholland C. Prevalence of self-reported mental disorders in pregnancy and associations with adverse neonatal outcomes: a population-based cross-sectional study. BMC Pregnancy Childbirth 2019; 19:412. [PMID: 31703644 PMCID: PMC6842147 DOI: 10.1186/s12884-019-2572-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/25/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Mental disorders in pregnancy are common causes of morbidity and mortality with associated risks of adverse neonatal outcomes. Our aims were to evaluate the prevalence of self-reported mental disorders in women presenting to maternity services and to determine the association between history of self-reported maternal mental disorder and adverse neonatal outcomes. METHODS Data on all singleton pregnancies known to maternity services in Northern Ireland over the period 2010 to 2015 were extracted from the Northern Ireland Maternity System (NIMATS), including frequency data for number of pregnancies where the mother reported a history of mental disorder. Odds ratios were derived from logistic regression analyses to determine the associations between self-reported maternal mental disorder and preterm birth, low infant birth weight and APGAR scores. RESULTS In total, 140,569 singleton pregnancies were registered using NIMATS over this period. In 18.9% of these pregnancies, the mother reported a history of at least one mental disorder. After adjustment for potential confounding factors, significant associations were demonstrated between self-reported maternal mental disorder and preterm birth (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.25-1.37), low infant birth weight (OR 1.29, 95% CI 1.21-1.38) and APGAR score < 7 at 1 min (OR 1.14, 95% CI 1.10-1.19) and 5 min (OR 1.23, 95% CI 1.12 to 1.34). CONCLUSIONS These findings emphasise the critical importance of routine enquiry regarding psychiatric history when women present to maternity services and the impact of maternal mental illnesses upon outcomes for their infants.
Collapse
Affiliation(s)
- David Mongan
- School of Medicine, Queen’s University Belfast, University Road, Belfast, BT7 1NN Northern Ireland
- RCSI Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Janine Lynch
- Belfast Health and Social Care Trust, Trust Headquarters, A Floor, Belfast City Hospital, Lisburn Road, Belfast, County Antrim BT9 7AB Northern Ireland
| | - Donncha Hanna
- School of Psychology, Queen’s University Belfast, University Road, Belfast, BT7 1NN Northern Ireland
| | - Ciaran Shannon
- Northern Health and Social Care Trust, Trust Headquarters, Bretten Hall, Bush Road, Antrim, County Antrim BT41 2RL Northern Ireland
| | - Shona Hamilton
- Northern Health and Social Care Trust, Trust Headquarters, Bretten Hall, Bush Road, Antrim, County Antrim BT41 2RL Northern Ireland
| | - Claire Potter
- Southern Health and Social Care Trust, Trust Headquarters, Bretten Hall, Bush Road, Antrim, County Antrim BT41 2RL Northern Ireland
| | - Colin Gorman
- Belfast Health and Social Care Trust, Trust Headquarters, A Floor, Belfast City Hospital, Lisburn Road, Belfast, County Antrim BT9 7AB Northern Ireland
| | - Orlagh McCambridge
- Southern Health and Social Care Trust, Trust Headquarters, Bretten Hall, Bush Road, Antrim, County Antrim BT41 2RL Northern Ireland
| | - Rachel Morrow
- Belfast Health and Social Care Trust, Trust Headquarters, A Floor, Belfast City Hospital, Lisburn Road, Belfast, County Antrim BT9 7AB Northern Ireland
| | - Ciaran Mulholland
- School of Medicine, Queen’s University Belfast, University Road, Belfast, BT7 1NN Northern Ireland
- Northern Health and Social Care Trust, Trust Headquarters, Bretten Hall, Bush Road, Antrim, County Antrim BT41 2RL Northern Ireland
| |
Collapse
|
16
|
Dalsklev M, Cunningham T, Travers Á, McDonagh T, Shannon C, Downes C, Hanna D. Childhood trauma as a predictor of reoffending in a Northern Irish probation sample. Child Abuse Negl 2019; 97:104168. [PMID: 31494351 DOI: 10.1016/j.chiabu.2019.104168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/05/2019] [Accepted: 08/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND It is well-documented that there is a high prevalence rate of childhood trauma experiences among the prison population, and studies have found a link between childhood trauma and later acts of violence. OBJECTIVE The aim of the current study was to investigate whether childhood trauma (i.e., physical, sexual, emotional abuse and physical neglect) among offenders who have served a life sentence in Northern Ireland was associated with general and violent reoffending patterns. The study also explored the relationship between childhood trauma resulting from the sectarian conflict "The Troubles" in the region and its impact on reoffending. METHOD The casefiles of 100 offenders were coded for trauma experiences and official reoffending data was extracted. Logistic regression analysis was performed to explore the relationship between trauma and reoffending. RESULTS The most common form of childhood trauma were emotional abuse and/or emotional neglect (n = 43), conflict-related trauma (n = 43) and physical abuse (n = 40). Only age (OR .91) and conflict-related trauma (OR 5.57) emerged as significant predictors (p < .05) of general reoffending at any time post release. Similarly, only age (OR .92) and conflict-related trauma (OR 4.57) emerged as significant predictors (p < .05) of violent reoffending. Although it did not reach significance (p = .09), childhood physical abuse was related to an increase in the odds of violently reoffending, of a large magnitude (OR 4.09). CONCLUSIONS Conflict-related trauma significantly predicted general and violent reoffending among offenders with previous violent convictions.
Collapse
Affiliation(s)
- Madeleine Dalsklev
- Queens University Belfast, School of Psychology, David Keir Building BT7 1NN, Northern Ireland.
| | - Twylla Cunningham
- Probation Board for Northern Ireland, 1D Monaghan St., Newry, BT35 6BB, Northern Ireland.
| | - Áine Travers
- University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
| | - Tracey McDonagh
- University of Southern Denmark, Department of Psychology, University of Southern Denmark, Campusvej 55, Odense M - DK-523, Denmark.
| | - Ciaran Shannon
- IMPACT Research Centre, Northern Health and Social Care Trust, Gurteen House, Antrim, BT41 2RJ, Northern Ireland.
| | - Ciara Downes
- Scaffold Service, Southern Health and Social Care Trust, Bocombra Lodge, Portadown BT635SG, Northern Ireland.
| | - Donncha Hanna
- Queens University Belfast, School of Psychology, David Keir Building BT7 1NN, Northern Ireland; School of Psychology, Queens University Belfast, and Centre for Evidence and Social Innovation, Queens University Belfast, Northern Ireland.
| |
Collapse
|
17
|
Antill Y, Kok P, Stockler M, Robledo K, Yip S, Parry M, Smith D, Spurdle A, Barnes E, Friedlander M, Baron-Hay S, Shannon C, Coward J, Beale P, Goss G, Meniawy T, Andrews J, Kelly M, Mileshkin L. Updated results of activity of durvalumab in advanced endometrial cancer (AEC) according to mismatch repair (MMR) status: The phase II PHAEDRA trial (ANZGOG1601). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz446.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
18
|
Clarke S, Hanna D, Mulholland C, Shannon C, Urquhart C. A systematic review and meta-analysis of digital health technologies effects on psychotic symptoms in adults with psychosis. Psychosis 2019. [DOI: 10.1080/17522439.2019.1632376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Stephen Clarke
- School of Psychology, Queens University of Belfast, Northern Ireland
| | - Donncha Hanna
- School of Psychology, Queens University of Belfast, Northern Ireland
- Centre for Evidence and Social Innovation, Queens University of Belfast, Northern Ireland
| | - Ciaran Mulholland
- Northern Health and Social Care Trust, Antrim, Northern Ireland
- School of Medicine, Queens University of Belfast, Northern Ireland
| | - Ciaran Shannon
- Northern Health and Social Care Trust, Antrim, Northern Ireland
| | - Callum Urquhart
- School of Psychology, Queens University of Belfast, Northern Ireland
| |
Collapse
|
19
|
Mongan D, Shannon C, Hanna D, Boyd A, Mulholland C. The association between specific types of childhood adversity and attenuated psychotic symptoms in a community sample. Early Interv Psychiatry 2019; 13:281-289. [PMID: 28941143 DOI: 10.1111/eip.12478] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 06/13/2017] [Accepted: 07/11/2017] [Indexed: 12/31/2022]
Abstract
AIM This study aimed to examine the relationship between types of childhood adversity and attenuated psychotic symptoms in a general population sample, and to determine the predictive role of other psychosocial factors such as resilience, coping style and social support. METHODS An online survey was conducted with a US-based general population sample of 748 participants (aged 18 to 35 years) using Amazon's Mechanical Turk (an online crowd-sourcing service). Participants completed the Adverse Childhood Experiences Questionnaire (ACE-Q), the Prodromal Questionnaire (PQ-16), the Brief COPE Scale, the Brief Resilience Scale (BRS), the Multidimensional Scale of Perceived Social Support and the Neighbourhood Cohesion Scale. A series of backwards stepwise hierarchical regression analyses was employed to determine the predictors of PQ-16 score. RESULTS Participants reported an average of 2.99 attenuated psychotic symptoms (from a total of 16), and an average of 2.77 childhood adversities (from a total of 10). In the final model, the specific types of childhood adversity which significantly predicted PQ-16 score were verbal abuse, sexual abuse and physical neglect. Resilience, as well as the coping styles of self-distraction, denial, substance use, emotional support, venting, religion and self-blame, were significant predictors; perceived social support and neighbourhood cohesion were not. This model predicted 33% of the variance in PQ-16 score. CONCLUSIONS The results of this study support the association between childhood adversity and attenuated psychotic symptoms in the general population. Resilience and coping styles were also important predictive factors. These data suggest potential strategies on which to focus for early intervention and prevention.
Collapse
Affiliation(s)
- David Mongan
- Clinical Psychology, Queen's University Belfast, Belfast, UK.,Holywell Hospital, Northern Health and Social Care Trust, Antrim, UK
| | - Ciaran Shannon
- Clinical Psychology, Queen's University Belfast, Belfast, UK.,Holywell Hospital, Northern Health and Social Care Trust, Antrim, UK
| | - Donncha Hanna
- Clinical Psychology, Queen's University Belfast, Belfast, UK
| | - Adrian Boyd
- Holywell Hospital, Northern Health and Social Care Trust, Antrim, UK
| | - Ciaran Mulholland
- Clinical Psychology, Queen's University Belfast, Belfast, UK.,Holywell Hospital, Northern Health and Social Care Trust, Antrim, UK
| |
Collapse
|
20
|
Coyle L, Hanna D, Dyer KFW, Read J, Curran D, Shannon C. Does trauma-related training have a relationship with, or impact on, mental health professionals' frequency of asking about, or detection of, trauma history? A systematic literature review. Psychol Trauma 2019; 11:802-809. [PMID: 30714791 DOI: 10.1037/tra0000434] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Exposure to traumatic events is prevalent, with the impact of trauma and its relationship with other conditions widely documented. Research suggests that clinicians do not routinely ask about trauma history in clinical settings. Trauma-related training has been recommended as a means of addressing this. Neither the impact of training on clinician behavior (i.e., frequency of asking about or detection of trauma history) nor the relationship between training and these variables have been formally reviewed. METHOD A systematic literature review was conducted using PsycINFO, Scopus, and Web of Science. The grey literature and reference lists of included articles were consulted. Nine articles met the eligibility criteria for inclusion. RESULTS Two-thirds of studies reported statistically significant evidence to suggest that trauma-related training is related to (1) increased frequency of asking about trauma history and (2) greater detection of trauma history. CONCLUSIONS While acknowledging the limited number and variable quality of studies, as well as the failure to detect statistical significance in all studies, this review provides some evidence that trauma-related training is related to clinician inquiry and detection of trauma history. Further high-quality research is needed. Training should address barriers to inquiry, acknowledge the potential variation in inquiry behavior across trauma subtypes, and encompass a skill and educational approach to both inquiry and response to trauma. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | - Kevin F W Dyer
- Department of Clinical Psychology, Northern Health and Social Care Trust Northern Ireland
| | - John Read
- School of Psychology, University of East London
| | - David Curran
- School of Psychology, Queen's University Belfast
| | - Ciaran Shannon
- Department of Clinical Psychology, Northern Health and Social Care Trust Northern Ireland
| |
Collapse
|
21
|
Pfisterer J, Dean A, Baumann K, Rau J, Harter P, Joly F, Sehouli J, Canzler U, Schmalfeldt B, Shannon C, Hein A, Reimer D, Hanker L, Petit T, Marmé F, El-Balat A, Glasspool R, de Gregorio N, Mahner S, Kurtz JE. Carboplatin/pegylated liposomal doxorubicin/bevacizumab (CD-BEV) vs. carboplatin/gemcitabine/bevacizumab (CG-BEV) in patients with recurrent ovarian cancer: A prospective randomized phase III ENGOT/GCIG-Intergroup study (AGO study group, AGO-Austria, ANZGOG, GINECO, SGCTG). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.142] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
22
|
Brew B, Doris M, Shannon C, Mulholland C. What impact does trauma have on the at-risk mental state? A systematic literature review. Early Interv Psychiatry 2018; 12:115-124. [PMID: 28560861 DOI: 10.1111/eip.12453] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 02/05/2017] [Accepted: 03/18/2017] [Indexed: 11/27/2022]
Abstract
Identification of individuals with an at-risk mental state (ARMS) who are at a heightened risk of developing psychosis allows researchers and clinicians to identify what factors are associated with poorer outcomes and transitions to psychosis. A number of socioenvironmental factors are linked to an increase risk of developing psychosis, of which childhood trauma is widely acknowledged. The current review aims to examine what impact trauma has on the ARMS by reviewing reported relationships between trauma variables and transition to psychosis, ARMS severity, adaptive functioning and comorbid symptomology from both cross sectional and prospective design studies. A literature search was conducted for all relevant original research articles published in the English language up to December 2015 using 3 electronic databases: PsycINFO, Web of Science and PubMed. A total of 6 papers met the inclusion criteria and were included in the current review. Trauma was found to have a significant impact on the ARMS observed through reported relationships between trauma variables and transition to psychosis, ARMS severity, adaptive functioning and comorbid symptomology. Sexual trauma demonstrated the most consistent trauma variable to impact the ARMS. Individuals with an ARMS who have experienced sexual trauma are at a heightened risk of poorer outcomes and transitions to psychosis. Further prospective design studies are required to examine this observation further.
Collapse
Affiliation(s)
- Benjamin Brew
- Department of Clinical Psychology, Queens University Belfast, Belfast, UK
| | - Michael Doris
- Department of Clinical Psychology, Queens University Belfast, Belfast, UK
| | - Ciaran Shannon
- Department of Clinical Psychology, Queens University Belfast, Belfast, UK
| | - Ciaran Mulholland
- Department of Clinical Psychology, Queens University Belfast, Belfast, UK
| |
Collapse
|
23
|
Bosqui TJ, Marshoud B, Shannon C. Attachment insecurity, posttraumatic stress, and hostility in adolescents exposed to armed conflict. Peace and Conflict: Journal of Peace Psychology 2017. [DOI: 10.1037/pac0000260] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
24
|
King E, Steenson C, Shannon C, Mulholland C. Prevalence rates of childhood trauma in medical students: a systematic review. BMC Med Educ 2017; 17:159. [PMID: 28899378 PMCID: PMC5594709 DOI: 10.1186/s12909-017-0992-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 08/28/2017] [Indexed: 05/17/2023]
Abstract
BACKGROUND It is known that medical students suffer from high rates of mental health difficulties. In recent years there has been an increasing focus on the need to improve support and treatment services for those in difficulty. In order to meet these needs it is important to clarify the relevant aetiological factors. There is robust evidence from general population studies that a history of childhood trauma (including physical and sexual abuse and emotional neglect) predisposes to the subsequent development of mental health difficulties in adult life. It has previously been speculated that students with a history of such trauma might preferentially apply to study medicine. METHODS This systematic review seeks to examine the existing evidence base with regard to rates of childhood trauma in medical student populations. Articles were identified through a literature search of psychINFO, web of science, Embase and medline. RESULTS This search generated 11 articles which were deemed to meet criteria for inclusion in this review. There is a wide range of results given for rates of childhood trauma in these studies. CONCLUSIONS The published research which examines rates of childhood trauma affecting medical students is limited and difficult to generalise from, or to use to draw firm conclusions. Given the possible negative outcomes of a history of childhood trauma in medical students, including that such a history may be associated with difficulties in a student progressing in their undergraduate and postgraduate examinations, well-organised prospective studies are required.
Collapse
Affiliation(s)
- Eimear King
- Centre for Medical Education, Department of Psychiatry, Queen’s University of Belfast, 97 Lisburn Road, Belfast, Northern Ireland BT9 7BL UK
| | - Claire Steenson
- Centre for Medical Education, Department of Psychiatry, Queen’s University of Belfast, 97 Lisburn Road, Belfast, Northern Ireland BT9 7BL UK
| | - Ciaran Shannon
- School of Psychology, Queen’s University of Belfast, Belfast, Northern Ireland UK
| | - Ciaran Mulholland
- Centre for Medical Education, Department of Psychiatry, Queen’s University of Belfast, 97 Lisburn Road, Belfast, Northern Ireland BT9 7BL UK
| |
Collapse
|
25
|
Sutcliffe C, Quinn CH, Shannon C, Glover A, Dunn AM. Exploring the attitudes to and uptake of biosecurity practices for invasive non-native species: views amongst stakeholder organisations working in UK natural environments. Biol Invasions 2017. [DOI: 10.1007/s10530-017-1541-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
26
|
Brew B, Shannon C, Storey L, Boyd A, Mulholland C. A qualitative phenomenological analysis of the subjective experience and understanding of the at risk mental state. Int J Qual Stud Health Well-being 2017; 12:1342504. [PMID: 28689474 PMCID: PMC5510197 DOI: 10.1080/17482631.2017.1342504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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] [Indexed: 11/20/2022] Open
Abstract
Over recent years there has been a growing interest in identifying the early stages of psychosis. The At Risk Mental State (ARMS) is characteristic of the prodromal stages of psychosis and its identification gives rise to a number of clinical and research opportunities including early intervention and prevention of psychosis. This study employs interpretative phenomenological analysis to gain insights into the subjective experience and individuals understanding of the development of their ARMS. Five participants took part and provided information on the experience of symptoms, life prior to onset of their ARMS and their understanding of symptoms and their development through a semi structured interview. From the analysis of transcripts eight themes emerged which were common across participants accounts. Three themes of experience (disturbed world/disturbed self, disconnection with the world, thunderstruck) and five themes of understanding (absence of understanding, use of others, identity, forming links, fragmented understanding) were identified. Themes are explored in detail and discussed in relation to existing literature and theory. Clinical implications, directions for future research, and limitations are discussed within.
Collapse
Affiliation(s)
- Benjamin Brew
- a School of Psychology , Queens University Belfast , Belfast , Northern Ireland
| | - Ciaran Shannon
- a School of Psychology , Queens University Belfast , Belfast , Northern Ireland.,b STEP Team , Northern Health and Social Care Trust , Antrim , Northern Ireland
| | - Lesley Storey
- a School of Psychology , Queens University Belfast , Belfast , Northern Ireland
| | - Adrian Boyd
- b STEP Team , Northern Health and Social Care Trust , Antrim , Northern Ireland
| | - Ciaran Mulholland
- b STEP Team , Northern Health and Social Care Trust , Antrim , Northern Ireland.,c School of Medicine, Dentistry and Biomedical Sciences , Queens University Belfast , Northern Ireland
| |
Collapse
|
27
|
Mulholland C, Mongan D, Boyd A, Shannon C. CAN WE PREVENT PSYCHOSIS? INNOVATIVE SERVICE OFFERS NEW HOPE. Ulster Med J 2017. [PMID: 29535494 PMCID: PMC5846005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- C Mulholland
- Holywell Hospital, Steeple Road, Antrim, BT41 2RJ
| | - D Mongan
- Holywell Hospital, Steeple Road, Antrim, BT41 2RJ
| | - A Boyd
- Holywell Hospital, Steeple Road, Antrim, BT41 2RJ
| | - C Shannon
- Holywell Hospital, Steeple Road, Antrim, BT41 2RJ
| |
Collapse
|
28
|
Fiore LD, Brophy MT, Ferguson RE, Shannon C, Turek SJ, Pierce‐Murray K, Ajjarapu S, Huang GD, Lee CSE, Lavori PW. Data Sharing, Clinical Trials, and Biomarkers in Precision Oncology: Challenges, Opportunities, and Programs at the Department of Veterans Affairs. Clin Pharmacol Ther 2017; 101:586-589. [PMID: 28182272 PMCID: PMC5414893 DOI: 10.1002/cpt.660] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 02/07/2017] [Accepted: 02/07/2017] [Indexed: 01/05/2023]
Abstract
Cancer genomic research reveals that a similar cancer clinical phenotype (e.g., non-small cell lung cancer) can arise from various mutations in tumor DNA. Thus, organ of origin is not a definitive classification. Further, targeted therapy for cancer patients (precision oncology) capitalizes on knowledge of individual patient mutational status to deliver treatment directed against the protein products of these mutations with the goal of reducing toxicity and enhancing efficacy relative to traditional nontargeted chemotherapy.
Collapse
Affiliation(s)
- LD Fiore
- VA Boston Healthcare SystemBostonMassachusettsUSA
| | - MT Brophy
- VA Boston Healthcare SystemBostonMassachusettsUSA
| | - RE Ferguson
- VA Boston Healthcare SystemBostonMassachusettsUSA
| | - C Shannon
- VA Boston Healthcare SystemBostonMassachusettsUSA
| | - SJ Turek
- VA Boston Healthcare SystemBostonMassachusettsUSA
| | | | - S Ajjarapu
- VA Boston Healthcare SystemBostonMassachusettsUSA
| | - GD Huang
- VA Boston Healthcare SystemBostonMassachusettsUSA
| | - CSE Lee
- VA Boston Healthcare SystemBostonMassachusettsUSA
| | - PW Lavori
- VA Boston Healthcare SystemBostonMassachusettsUSA
| |
Collapse
|
29
|
Shannon C, Garmyn A, Miller M. Trends in Consumer Demographics and Willingness to Pay for Perceived Eating Quality Levels of Lamb. Meat and Muscle Biology 2017. [DOI: 10.22175/rmc2017.011] [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: 11/03/2022] Open
|
30
|
Shannon C, Hanna D, Tumelty L, Waldron D, Maguire C, Mowlds W, Meenagh C, Mulholland C. Reliability of reports of childhood trauma in bipolar disorder: A test-retest study over 18 months. J Trauma Dissociation 2016; 17:511-9. [PMID: 26835747 DOI: 10.1080/15299732.2016.1141147] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to explore the reliability of self-reported trauma histories in a population with a diagnosis of bipolar disorder using the Childhood Trauma Questionnaire. Previous studies in other populations suggest high reliability of trauma histories over time, and it was postulated that a similar high reliability would be demonstrated in this population. A total of 39 patients with a confirmed diagnosis (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, criteria) were followed up and readministered the Childhood Trauma Questionnaire after 18 months. Cohen's kappa scores and intraclass correlations suggested reasonable test-retest reliability over the 18-month time period of the study for all types of childhood abuse, namely, emotional, physical, and sexual abuse and physical and emotional neglect. Intraclass correlations ranged from r = .50 (sexual abuse) to r = .96 (physical abuse). Cohen's kappas ranged from .44 (sexual abuse) to .76 (physical abuse). Retrospective reports of childhood trauma can be seen as reliable and are in keeping with results found with other mental health populations.
Collapse
Affiliation(s)
- Ciaran Shannon
- a School of Psychology , Queen's University Belfast , Belfast , Northern Ireland
| | - Donncha Hanna
- a School of Psychology , Queen's University Belfast , Belfast , Northern Ireland
| | - Leo Tumelty
- b Department of Psychiatry , Western Health and Social Care Trust , Derry , Northern Ireland
| | - Daniel Waldron
- a School of Psychology , Queen's University Belfast , Belfast , Northern Ireland
| | - Chrissie Maguire
- a School of Psychology , Queen's University Belfast , Belfast , Northern Ireland
| | - William Mowlds
- a School of Psychology , Queen's University Belfast , Belfast , Northern Ireland
| | - Ciaran Meenagh
- c Department of Psychiatry , Northern Health and Social Care Trust , Newtownabbey , Northern Ireland
| | - Ciaran Mulholland
- d School of Medicine , Queen's University Belfast , Belfast , Northern Ireland
| |
Collapse
|
31
|
Cunningham T, Shannon C, Crothers I, Hoy K, Fitzsimmons C, McCann R, O’Hare J, Mulholland C. The perspectives of people with psychosis about participating in trauma-related research. Psychosis 2016. [DOI: 10.1080/17522439.2016.1145729] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Twylla Cunningham
- School of Psychology, Queens University of Belfast, Belfast, Northern Ireland
| | - Ciaran Shannon
- School of Psychology, Queens University of Belfast, Belfast, Northern Ireland
| | - Ivor Crothers
- Department of Clinical Psychology, Southern Health & Social Care Trust, Craigavon Area Hospital, Portadown, Northern Ireland
| | - Katrina Hoy
- Department of Clinical Psychology, South Eastern Health & Social Care Trust, Downshire Hospital, Downpatrick, Northern Ireland
| | - Carly Fitzsimmons
- Department of Clinical Psychology, Southern Health & Social Care Trust, Craigavon Area Hospital, Portadown, Northern Ireland
| | - Riona McCann
- Department of Psychiatry, Southern Health & Social Care Trust, Craigavon Area Hospital, Portadown, Northern Ireland
| | - John O’Hare
- Department of Psychiatry, Southern Health & Social Care Trust, Craigavon Area Hospital, Portadown, Northern Ireland
| | - Ciaran Mulholland
- School of Medicine, Queens University of Belfast, Belfast, Northern Ireland
| |
Collapse
|
32
|
Cunningham T, Shannon C, Crothers I, Hoy K, Fitzsimmons C, McCann R, O’Hare J, Mulholland C. Enquiring about traumatic experiences in psychosis: A comparison of case notes and self-report questionnaires. Psychosis 2016. [DOI: 10.1080/17522439.2015.1115542] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
33
|
Cunningham T, Hoy K, Shannon C. Does childhood bullying lead to the development of psychotic symptoms? A meta-analysis and review of prospective studies. Psychosis 2015. [DOI: 10.1080/17522439.2015.1053969] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
34
|
Hollander Z, Lam K, Wilson-McManus J, Assadian S, Dai D, Shannon C, Chen V, Tebbutt S, Balshaw R, Borchers C, Davies R, Delgado D, Haddad H, Ignaszewski A, Isaac D, Kim D, Mui A, Rajda M, Ross H, West L, White M, Zieroth S, McMaster R, Keown P, Ng R, McManus B. Blood Test to Monitor for the Absence of Acute Cardiac Rejection: From Discovery to Clinical Implementation. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.099] [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: 11/28/2022] Open
|
35
|
McMullen J, O'Callaghan P, Shannon C, Black A, Eakin J. Group trauma-focused cognitive-behavioural therapy with former child soldiers and other war-affected boys in the DR Congo: a randomised controlled trial. J Child Psychol Psychiatry 2013; 54:1231-41. [PMID: 23738530 DOI: 10.1111/jcpp.12094] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Democratic Republic of Congo (DRC) has been home to the world's deadliest conflict since World War II and is reported to have the largest number of child soldiers in the world. Despite evidence of the debilitating impact of war, no group-based mental health or psychosocial intervention has been evaluated in a randomised controlled trial for psychologically distressed former child soldiers. METHOD A randomised controlled trial involving 50 boys, aged 13-17, including former child soldiers (n = 39) and other war-affected boys (n = 11). They were randomly assigned to an intervention group, or wait-list control group. The intervention group received a 15-session, group-based, culturally adapted Trauma-Focused Cognitive-Behavioural Therapy (TF-CBT) intervention. Assessment interviews were completed at baseline, postintervention and 3-month follow-up (intervention group). RESULTS Analysis of Covariance (ANCOVA) demonstrated that, in comparison to the wait-list control group, the TF-CBT intervention group had highly significant reductions in posttraumatic stress symptoms, overall psychosocial distress, depression or anxiety-like symptoms, conduct problems and a significant increase in prosocial behaviour (p < .001 for all). Effect sizes were higher when former child soldier scores were separated for sub-analysis. Three-month follow-up of the intervention group found that treatment gains were maintained. CONCLUSIONS A culturally modified, group-based TF-CBT intervention was effective in reducing posttraumatic stress and psychosocial distress in former child soldiers and other war-affected boys.
Collapse
Affiliation(s)
- John McMullen
- Doctorate in Educational, Child and Adolescent Psychology, Queens University, Belfast, UK
| | | | | | | | | |
Collapse
|
36
|
Campbell C, Barrett S, Shannon C, Hoy K, Rushe T, Cooper S, Mulholland C. The relationship between childhood trauma and neuropsychological functioning in first episode psychosis. Psychosis 2013. [DOI: 10.1080/17522439.2012.660982] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
37
|
Hoy K, Barrett S, Shannon C, Campbell C, Watson D, Rushe T, Shevlin M, Bai F, Cooper S, Mulholland C. Childhood trauma and hippocampal and amygdalar volumes in first-episode psychosis. Schizophr Bull 2012; 38:1162-9. [PMID: 21799213 PMCID: PMC3494041 DOI: 10.1093/schbul/sbr085] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE A history of childhood trauma is common in individuals who later develop psychosis. Similar neuroanatomical abnormalities are observed in people who have been exposed to childhood trauma and people with psychosis. However, the relationship between childhood trauma and such abnormalities in psychosis has not been investigated. This study aimed to explore the association between the experience of childhood trauma and hippocampal and amygdalar volumes in a first-episode psychosis (FEP) population. METHODS The study employed an observational retrospective design. Twenty-one individuals, who had previously undergone magnetic resonance imaging procedures as part of the longitudinal Northern Ireland First-Episode Psychosis Study, completed measures assessing traumatic experiences and were included in the analysis. Data were subject to correlation analyses (r and r (pb)). Potential confounding variables (age at FEP and delay to scan from recruitment) were selected a priori for inclusion in multiple regression analyses. RESULTS There was a high prevalence of lifetime (95%) and childhood (76%) trauma in the sample. The experience of childhood trauma was a significant predictor of left hippocampal volume, although age at FEP also significantly contributed to this model. There was no significant association between predictor variables and right hippocampal volume. The experience of childhood trauma was a significant predictor of right and total amygdalar volumes and the hippocampal/amygdalar complex volume as a whole. CONCLUSIONS The findings indicate that childhood trauma is associated with neuroanatomical measures in FEP. Future research controlling for childhood traumatic experiences may contribute to explaining brain morphology in people with psychosis.
Collapse
Affiliation(s)
- Katrina Hoy
- School of Psychology, Queen’s University Belfast, Belfast, N. Ireland
| | - Suzanne Barrett
- School of Psychology, Queen’s University Belfast, Belfast, N. Ireland
| | - Ciaran Shannon
- School of Psychology, Queen’s University Belfast, Belfast, N. Ireland,To whom correspondence should be addressed; tel: +44-28- 90975447, fax: +44-28-90974222, e-mail:
| | - Clodagh Campbell
- School of Psychology, Queen’s University Belfast, Belfast, N. Ireland
| | - David Watson
- School of Psychology, Queen’s University Belfast, Belfast, N. Ireland
| | - Teresa Rushe
- School of Psychology, Queen’s University Belfast, Belfast, N. Ireland
| | - Mark Shevlin
- School of Psychology, Queen’s University Belfast, Belfast, N. Ireland
| | - Feng Bai
- School of Psychology, Queen’s University Belfast, Belfast, N. Ireland
| | - Stephen Cooper
- School of Psychology, Queen’s University Belfast, Belfast, N. Ireland
| | | |
Collapse
|
38
|
Curran D, Mclaughlin E, Shannon C. The impact of trauma on therapeutic engagement within an addictions population. Appetite 2011. [DOI: 10.1016/j.appet.2011.05.064] [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: 11/28/2022]
|
39
|
Shannon C, Maguire C, Anderson J, Meenagh C, Mulholland C. Enquiring about traumatic experiences in bipolar disorder: a case note and self- report comparison. J Affect Disord 2011; 133:352-5. [PMID: 21596441 DOI: 10.1016/j.jad.2011.04.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [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] [Received: 12/03/2010] [Revised: 04/22/2011] [Accepted: 04/23/2011] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study examined: (i) the prevalence of lifetime trauma, childhood trauma and trauma related to civil unrest in a Bipolar Disorder sample, and (ii) the agreement between rates of disclosure of trauma in case notes and self-report questionnaires. METHODS The case notes of sixty participants, recruited from a geographically well-defined mental health service in Northern Ireland, were examined for reports of experiences of lifetime, childhood and traumatic events related to civil conflict. The participants also completed self-report measures of trauma. RESULTS Considerable differences were found between the prevalence of trauma as measured by self-report questionnaires and case notes reports. The prevalence of lifetime trauma as measured by the Trauma History Questionnaire was 61.7% (compared to case notes prevalence of 33.3%). The prevalence of moderate and severe levels of childhood trauma as measured by the Childhood Trauma Questionnaire was 65% (case notes 21.7%). Rates of trauma related to civil unrest were 35% (case notes 3.3%). Poor levels of agreement were found between all self-report trauma measures and case notes reports. Agreement on two categories of trauma (childhood emotional neglect and childhood physical neglect) reached statistical significance but kappa scores suggest this agreement was poor (κ=.14, p<.05; κ=.127, p<.05). CONCLUSIONS It is probable that the increased rate of trauma disclosed in the self-report questionnaire arises because clinicians during initial assessment and subsequent treatment do not consistently enquire about trauma. The need for staff training is discussed.
Collapse
Affiliation(s)
- Ciaran Shannon
- School of Psychology, The Queens University of Belfast, Belfast, Northern Ireland, UK.
| | | | | | | | | |
Collapse
|
40
|
Hanna D, White R, Lyons K, McParland MJ, Shannon C, Mulholland C. The structure of the Beck Hopelessness Scale: A confirmatory factor analysis in UK students. Personality and Individual Differences 2011. [DOI: 10.1016/j.paid.2011.03.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
41
|
Abstract
OBJECTIVE Both neurocognitive impairments and a history of childhood abuse are highly prevalent in patients with schizophrenia. Childhood trauma has been associated with memory impairment as well as hippocampal volume reduction in adult survivors. The aim of the following study was to examine the contribution of childhood adversity to verbal memory functioning in people with schizophrenia. METHODS Eighty-five outpatients with a Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnosis of chronic schizophrenia were separated into 2 groups on the basis of self-reports of childhood trauma. Performance on measures of episodic narrative memory, list learning, and working memory was then compared using multivariate analysis of covariance. RESULTS Thirty-eight (45%) participants reported moderate to severe levels of childhood adversity, while 47 (55%) reported no or low levels of childhood adversity. After controlling for premorbid IQ and current depressive symptoms, the childhood trauma group had significantly poorer working memory and episodic narrative memory. However, list learning was similar between groups. CONCLUSION Childhood trauma is an important variable that can contribute to specific ongoing memory impairments in schizophrenia.
Collapse
Affiliation(s)
- Ciaran Shannon
- School of Psychology, Queen’s University Belfast, Belfast, N. Ireland.
| | - Kate Douse
- Department of Clinical Psychology, Belfast Health and Social Care Trust, Belfast, N. Ireland
| | - Chris McCusker
- School of Psychology, Queen's University Belfast, Belfast, N. Ireland
| | - Lorraine Feeney
- Department of Clinical Psychology, Northern Health and Social Care Trust, Antrim, N. Ireland
| | - Suzanne Barrett
- Department of Psychiatry, Queen's University Belfast, Belfast, N. Ireland
| | - Ciaran Mulholland
- Department of Psychiatry, Queen's University Belfast, Belfast, N. Ireland
| |
Collapse
|
42
|
Abstract
OBJECTIVES This study investigates whether cognitive biases related to trauma (physical and sexual trauma) are present in a sample of participants with a diagnosis of schizophrenia. METHOD Fifty-three participants, with a DSM-IV diagnosis of schizophrenia, completed tasks of attentional and memory bias, followed by several trauma report questionnaires. Those who reported a history of sexual and/or physical trauma were compared with a 'non-specific/no-trauma' subgroup. The reliability of trauma reports was determined by comparing current data on the Trauma History Questionnaire to that gathered one year previously, for a subsample of participants. Concordance rates and kappa coefficients suggested moderate to high reliability for reports of sexual and physical trauma. Attentional bias was assessed by comparing colour-naming times on modified Stroops, of either a sexual or physical nature, with control Stroops with negative, positive and neutral emotionally valenced stimuli. A subsequent incidental recall memory task was then employed. RESULTS High rates of sexual and/or physical trauma were found. Those who reported a history of sexual trauma evidenced a statistically significant increase in colour-naming times for sexual trauma stimuli, compared to both the 'physical trauma only' and the 'non-specific/no trauma' control groups. They also showed greater incidental recall of sexual trauma words in comparison to the other groups. Such a pattern was not, however, discerned for those reporting histories of physical trauma. CONCLUSIONS Findings suggest cognitive schemata related to sexual trauma remains 'active' in those people with schizophrenia who report a related history.
Collapse
Affiliation(s)
- Elaine M Klewchuk
- Department of Clinical Psychology, School of Psychology, Queens University, Belfast, Northern Ireland
| | | | | | | |
Collapse
|
43
|
Mowlds W, Shannon C, McCusker CG, Meenagh C, Robinson D, Wilson A, Mulholland C. Autobiographical memory specificity, depression, and trauma in bipolar disorder. British Journal of Clinical Psychology 2010; 49:217-33. [DOI: 10.1348/014466509x454868] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
44
|
Shannon C, Veatch M, Chong E, Agnew K, Nucatola D, Newhall E, Sheehan K, Winikoff B. Vaginal and rectal clostridial colonization among women of reproductive age in the United States. Contraception 2010. [DOI: 10.1016/j.contraception.2010.04.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
45
|
Swica Y, Bracken H, Shannon C, Chong E, Dzube I, Tsereteli T, Maistruk G, Winikoff B. The extended gestational age medical abortion study: the effectiveness of medical abortion with mifepristone and misoprostol at 57–63 days versus 64–70 days gestation. Contraception 2010. [DOI: 10.1016/j.contraception.2010.04.122] [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: 12/01/2022]
|
46
|
Davidson G, Shannon C, Mulholland C, Campbell J. A longitudinal study of the effects of childhood trauma on symptoms and functioning of people with severe mental health problems. J Trauma Dissociation 2009; 10:57-68. [PMID: 19197712 DOI: 10.1080/15299730802485169] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [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: 10/21/2022]
Abstract
This study examines the relationship between childhood trauma and the psychiatric symptoms and psychosocial functioning of adults with severe mental health problems. Participants (n = 31) were recruited from the caseloads of community mental health services in Northern Ireland and assessed at baseline, 9 months, and 18 months. More than half had a history of childhood trauma (n = 17). There were no differences between the no childhood trauma (n = 14) and childhood trauma groups on psychiatric symptoms, but a significant relationship was found between trauma history and all aspects of social functioning. Those with no history of trauma showed improved psychosocial functioning over time, whereas those with a history of trauma deteriorated. These findings have implications for current service provision.
Collapse
Affiliation(s)
- Gavin Davidson
- Department of Social Work, Northern Health and Social Care Trust, Holywell Hospital, 60 Steeple Road, Antrim, Northern Ireland
| | | | | | | |
Collapse
|
47
|
Maguire C, McCusker CG, Meenagh C, Mulholland C, Shannon C. Effects of trauma on bipolar disorder: the mediational role of interpersonal difficulties and alcohol dependence. Bipolar Disord 2008; 10:293-302. [PMID: 18271909 DOI: 10.1111/j.1399-5618.2007.00504.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [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: 11/27/2022]
Abstract
OBJECTIVES This study examined: (i) the prevalence of trauma in a bipolar disorder (BD) sample, and (ii) how trauma histories mediated by interpersonal difficulties and alcohol dependence impact on the severity of BD. The prevalence of posttraumatic stress disorder (PTSD) and its relationship to outcomes in BD were also examined. METHODS Sixty participants were recruited from a geographically well-defined mental health service in Northern Ireland. Self-reported trauma histories, PTSD, interpersonal difficulties and alcohol dependence and were examined in relation to illness severity. RESULTS A high prevalence of trauma was found. Trauma predicted the frequency of hospital admissions (R(2) = 0.08), quality of life (R(2) = 0.23) and inter-episode depressive symptoms (R(2) = 0.13). Interpersonal difficulties, but not alcohol dependence, appeared to play an important role in mediating these adverse effects. While only 8% of the sample met criteria for active PTSD, this comorbid disorder was associated with BD severity. CONCLUSIONS This study indicates that awareness of trauma is important in understanding individual differences in bipolar presentations. The theoretical and clinical implications of evidence that trauma is related to more adverse outcomes in BD are discussed. The finding that interpersonal difficulties mediate the relationship between trauma and BD severity is novel. The need for adjunctive evidence-based treatments targeting interpersonal difficulties is considered.
Collapse
Affiliation(s)
- Chrissie Maguire
- Department of Psychology, Queens University of Belfast, Belfast, Northern Ireland, UK
| | | | | | | | | |
Collapse
|
48
|
Mainwaring PN, Shannon C. A phase II study of dose-dense chemotherapy (doxorubicin (A), cyclophosphamide (C), paclitaxel (T), gemcitabine (G)) supported by pegfilgrastim (P) and darbepoetin-alfa (D) for patients with high-risk early stage breast cancer (ICANDO). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.11068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11068 Background: The primary objective of this study was to estimate the proportion of chemotherapy dose delays in a dose- dense regimen consisting of A (60mg/m2), C (600 mg/m2) x 4 cycles q2 weeks followed by T (175 mg/m2) G (1g/m2) x 4 cycles q2w with pegfilgrastim (6 mg/m2 sc d2) and darbepoetin-alfa (2.25 microg/kg if Hb < 110g/L) as treatment for patients with high-risk early stage breast cancer. Dose delay was defined by the proportion of subjects experiencing delay = 7 days in any cycle. Entry criteria path stage IIA-IIIA breast adenocarcinoma; node positive patients > 6 axillary lymph nodes removed or sentinel LN biopsy positive for metastasis. Treatment commenced within 8 weeks. Secondary endpoints included proportion of delays by cycle, causes of delay by cycle, causes of dose reduction by cycle, as well as time to haematological engraftment. Patients underwent weekly FBC, electrolytes, LFTs, with a normal baseline echo assessment. Herceptin therapy was approved in Australia 1st October 2006 and was added to TG therapy for FISH/CISH/IHC 3+ positive patients. All patients completed FACT-F QOL forms. The half-width confidence interval to predict for delay based on the AC-T data is 0.17 for n = 20 patients. Results: Twenty (20) women; median age 50 (41–66) met the criteria for treatment. No patients had treatment delays ≥ 2 days for any reason. One (5%) patient underwent a blood transfusion for a rapid decline in haemoglobin (Hb) prior to darbepoetin therapy. One (5%) patient was admitted for uncontrolled vomiting. Seven (35%) patients received darbepoetin therapy without secondary Hb rise above 130 g/L. One (5%) patient had a 20% dose reduction in A dose due to mucositis. For nausea >G1 aprepitant therapy was added. There have been no dose modifications due to hepatic toxicity. Final cycle, QOL and pharmacogenomic data will be presented at the meeting. [Table: see text] No significant financial relationships to disclose.
Collapse
Affiliation(s)
| | - C. Shannon
- Mater Adult Hospital, South Brisbane, Australia
| |
Collapse
|
49
|
Biernaskie J, Sparling J, McKenzie I, Xie R, Liu J, Lam C, Wong A, Sutherland D, Choo A, Shannon C, Miller F, Tetzlaff W. [P41]: Skin‐derived precursors: A neural crest‐like precursor capable of remyelinating the injured spinal cord. Int J Dev Neurosci 2006. [DOI: 10.1016/j.ijdevneu.2006.09.104] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- J. Biernaskie
- Hospital for Sick ChildrenCanada
- University of TorontoCanada
| | - J. Sparling
- University of TorontoCanada
- University of British ColumbiaCanada
| | - I. McKenzie
- Hospital for Sick ChildrenCanada
- University of TorontoCanada
| | - R. Xie
- University of TorontoCanada
- University of British ColumbiaCanada
| | - J. Liu
- University of TorontoCanada
- University of British ColumbiaCanada
| | - C. Lam
- University of TorontoCanada
- University of British ColumbiaCanada
| | - A. Wong
- University of TorontoCanada
- University of British ColumbiaCanada
| | - D. Sutherland
- University of TorontoCanada
- University of British ColumbiaCanada
| | - A. Choo
- University of TorontoCanada
- University of British ColumbiaCanada
| | - C. Shannon
- University of TorontoCanada
- University of British ColumbiaCanada
| | - F. Miller
- Hospital for Sick ChildrenCanada
- University of TorontoCanada
| | - W. Tetzlaff
- University of TorontoCanada
- University of British ColumbiaCanada
| |
Collapse
|
50
|
Abstract
OBJECTIVE To compare the efficacy, adverse effects and acceptability of the three most common misoprostol regimens used with mifepristone for medical abortion. DESIGN Randomised nonblinded trial. SETTING Three clinics associated with major research universities in Canada; two in major urban areas and one in a periurban area. POPULATION Women of reproductive age. METHODS Consenting women presenting for abortion services with gestations less than 56 days and who met inclusion criteria were given 200 mg mifepristone orally and then randomised into three misoprostol study groups: (group I) 400 micrograms of oral misoprostol, (group II) 600 micrograms of oral misoprostol, and (group III) 800 micrograms of vaginal misoprostol. Misoprostol was self-administered at home 24-48 hours following mifepristone, and participants were instructed to take a second similar misoprostol dose at 24 hours after the initial dose if bleeding was less than a normal menstrual period. MAIN OUTCOME MEASURES Successful abortion without surgery was 94.1%, with no significant differences across the three study groups (94.7% in group I, 93.4% in group II, and 94.3% in group III; P= 0.975). RESULTS Efficacy and adverse effects did not differ significantly across the three study groups. Pain increased significantly across the study and the gestational age groups and was associated with lower acceptability. CONCLUSIONS There appears to be a range of safe and effective options for early medical abortion with mifepristone including a choice between oral and vaginal administration of misoprostol.
Collapse
Affiliation(s)
- C Shannon
- Gynuity Health Projects, New York, NY, USA.
| | | | | | | | | | | | | |
Collapse
|