Abstract
Could a unified theory of cognition and emotion further the transdiagnostic perspective? A critical analysis using Interacting Cognitive Subsystems as a case example.There is evidence that common processes underlie psychological disorders transdiagnostically. A challenge for the transdiagnostic movement is accounting for such processes theoretically. Theories of psychological disorders are traditionally restricted in scope, often explaining specific aspects of a disorder. The alternative to such ‘micro-theories’ is developing frameworks which explain general human cognition, so called ‘macro-theories’, and applying these systematically to clinical phenomena. Interacting Cognitive Subsystems (ICS) [Teasdale, J.D., & Barnard, P.J. (1993). Affect, cognition and change: Remodelling depressive thought, Lawrence Erlbaum Associates, Hove] is a macro theory which aims to explain aspects of information processing. The aim of this review is to examine whether ICS provides a useful platform for understanding common processes which maintain psychological disorders. The core principles of ICS are explained and theoretical papers adopting ICS to explain a particular psychological disorder or symptom are considered. Dysfunctional schematic mental models, reciprocal interactions between emotional and intellectual beliefs, as well as attention and memory processes, are identified as being important to the maintenance of psychological disorders. Concrete examples of how such variables can be translated into novel therapeutic strategies are given. The review concludes that unified theories of cognition and emotion have the potential to drive forward developments in transdiagnostic thinking, research and treatment.
Staff attitudes towards treatment options and offering choice over treatment in an Early Intervention for Psychosis service
Background: For people with psychosis, the duration of untreated illness is operationalized in terms of administering antipsychotic medication which establishes it as the front-line treatment. This may influence staffs’ attitudes towards different treatments which in turn may make it harder to offer service users (SUs) choice.
Aim: To investigate staff attitudes in an early intervention for psychosis (EIP) team towards different treatment options and the factors that influence whether SUs with psychosis should have choice over their treatment.
Method: Nine members of staff from an EIP team completed a survey which measured the direction and strength of attitudes. Qualitative and quantitative analyses were employed.
Results: Staff believed that antipsychotics need not be the first line intervention and that SUs should have choice over their treatment. However, several factors were identified which influenced their views. Six categories emerged from the qualitative analysis: attitudes towards different interventions, decision-making around treatment, provision of services, factors influencing prescribing, process of prescribing and research influencing practice.
Conclusions: There are a number of factors which influence staff’s attitudes towards different treatments. These factors may make offering choice to SUs with psychosis difficult. Future research should investigate SU’s views, how attitudes relate to clinical practice and how staff keep abreast of and integrate research developments into practice.
Parental anxiety, parent-child talk and psychological adjustment following child trauma
Background: Based on existing theory and research from the child anxiety and adult post-traumatic stress disorder (PTSD) fields, this study aimed to examine whether parental anxiety, parental overprotection and degree of elaboration in parent-child conversations shortly after a traumatic event predicted posttraumatic stress (PTS) symptoms three months post-trauma.
Method: Forty two children who had experienced a traumatic event resulting in attendance at an emergency department were recruited along with their parent. Self-report measures of anxiety, depression, PTSD and parental overprotection were completed 2-6 weeks post-trauma and again three months post-trauma. Parent-child dyads also completed a joint narrative task focused on the traumatic event in order to assess parental elaboration.
Results: Regression analysis demonstrated that three months post-trauma, parental anxiety significantly predicted child PTS symptoms, even after controlling for injury severity. Overprotective parenting and parental elaboration did not predict child PTS symptoms or anxiety and depression symptoms.
Conclusions: In line with etiological models of child anxiety, parental anxiety may be one factor relevant to the development of child PTS symptoms following a traumatic event.
| Date of Award | 30 Jul 2015 |
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| Original language | English |
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| Supervisor | Sarah Halligan (Supervisor) & Ailsa Russell (Supervisor) |
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