Abstract
Main Research ProjectOBJECTIVE: This study aimed to replicate previous findings regarding the influence of recovery style and attachment on engagement and help seeking in first episode psychosis (FEP). It also aimed to explore self-compassion and shame as new potential moderators of engagement, and in terms of their relationship with attachment and recovery style.
DESIGN: A cross-sectional between groups design was used to compare ‘high’ and ‘low’ engagers on key variables. Whole sample correlational analysis was also undertaken to further explore associations with self-compassion and shame in FEP.
METHODS: Twenty-two individuals with psychosis under the care of Early Intervention (EI) Services completed four questionnaires. Care Coordinators were subsequently sent a questionnaire on engagement to complete.
RESULTS: No significant group differences on the predicted variables were found, with only time in service reaching significance. Although non-significant, avoidant attachment did result in a small to medium effect size whereby ‘low’ engagers scored higher on avoidant attachment, and a trend towards more non-white individuals in the ‘low’ engagers group was nearing significance. In the secondary analysis, avoidant attachment was associated with shame and problems help seeking, even when positive symptoms were controlled for. Anxious attachment was associated with lower self-compassion and higher shame. None of the variables were significantly correlated with recovery style.
CONCLUSIONS: The small sample size limits the conclusions which can be made, however it is of interest that no significant differences were found between the two groups on the expected variables. Although self-compassion and shame did not appear to effect engagement in this sample, strong and distinct associations were found between these variables and insecure attachment dimensions, indicating a possible area for further exploration.
Service Improvement Project
This paper outlines the development and evaluation of a professionals training day focussing on understanding and treatment of Obsessive Compulsive Disorder (OCD). The training included talks from experts in OCD, and was organised by OCD-UK (a national service-user led OCD charity) with consultation and input from the researcher. The training day was developed in an attempt to target common unhelpful therapist beliefs about OCD. An evaluation of the day found that attendees’ confidence in understanding and treating OCD increased significantly from pre to post training. The training was also found to significantly increase attendees’ optimism about the treatment of OCD, and significantly decrease beliefs of OCD being a biological (rather than psychological) problem. Implications and links to relevant literature are considered.
Literature Review
BACKGROUND: Anxiety in Parkinson’s Disease (PD) is highly prevalent yet frequently underdiagnosed, undertreated, and historically overshadowed in research by a focus on depression. More recently there has been increasing interest in anxiety as its significant impact on quality of life in PD is increasingly recognised. However anxiety is frequently conceptualised purely as one of many ‘non-motor’ manifestations of neurological change, with minimal consideration of potentially useful psychosocial factors.
OBJECTIVE: This review aimed to identify and synthesise the available evidence for psychosocial risk factors for anxiety, and to provide an alternative conceptualisation through development of a hypothetical cognitive behavioural model of anxiety in PD.
METHODS: This is a narrative review utilising a systematic search strategy to identify relevant papers relating to psychosocial factors and anxiety in PD.
RESULTS: Thirty relevant papers were located and reviewed, and demographic, disease/pharmacological and psychosocial risk factors for anxiety in PD were identified. A prominent finding was that individuals with motor fluctuation appeared to be more vulnerable to anxiety. A hypothetical cognitive behavioural model of anxiety in PD is offered.
CONCLUSIONS: Research focusing on anxiety in PD beyond just the biomedical perspective has only recently started to increase, and a number of methodological considerations have been highlighted by this review. The current shift in perspective on anxiety in PD from one of diagnostic overshadowing to a more psychologically informed one, has the potential to address the current problems with under- recognition and lack of treatment, which would potentially benefit a wide range of PD patients.
| Date of Award | 2 Sept 2016 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Lorna Hogg (Supervisor), James Gregory (Supervisor), Josie Millar (Supervisor) & Paul Salkovskis (Supervisor) |
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