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Editorial Unexplored issues and future directions in social phobia research. 2004
Bögels SM, Tarrier N. · No affiliation provided · Clin Psychol Rev. · Pubmed #15501554 No free full text.
Abstract: There have been significant advances in recent years in the understanding and treatment of social phobia, which are summarised in this Special Issue. This paper outlines and describes some further priority areas for future research. It is suggested that social phobia should be investigated as a developmental condition, with special attention to the first two years of life; and subtypes of social phobia be further explored and their implication for treatment. Social phobia is often comorbid with other disorders and its relationship with these disorders warrants further investigation with respect to causality and treatment implications. Lastly, the investigation of social phobia within a health services research context is highlighted with the necessity of refining the design of clinical trials to establish the efficacy and effectiveness of current treatments.
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Review Virtual reality in mental health : a review of the literature. 2007
Gregg L, Tarrier N. · Academic Division of Clinical Psychology, University of Manchester, Manchester, UK. · Soc Psychiatry Psychiatr Epidemiol. · Pubmed #17431528 No free full text.
Abstract: BACKGROUND: Several virtual reality (VR) applications for the understanding, assessment and treatment of mental health problems have been developed in the last 10 years. The purpose of this review is to outline the current state of virtual reality research in the treatment of mental health problems. METHODS: PubMed and PsycINFO were searched for all articles containing the words "virtual reality". In addition a manual search of the references contained in the papers resulting from this search was conducted and relevant periodicals were searched. Studies reporting the results of treatment utilizing VR in the mental health field and involving at least one patient were identified. RESULTS: More than 50 studies using VR were identified, the majority of which were case studies. Seventeen employed a between groups design: 4 involved patients with fear of flying; 3 involved patients with fear of heights; 3 involved patients with social phobia/public speaking anxiety; 2 involved people with spider phobia; 2 involved patients with agoraphobia; 2 involved patients with body image disturbance and 1 involved obese patients. There are both advantages in terms of delivery and disadvantages in terms of side effects to using VR. Although virtual reality based therapy appears to be superior to no treatment the effectiveness of VR therapy over traditional therapeutic approaches is not supported by the research currently available. CONCLUSIONS: There is a lack of good quality research on the effectiveness of VR therapy. Before clinicians will be able to make effective use of this emerging technology greater emphasis must be placed on controlled trials with clinically identified populations.
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Review Cognitive behaviour therapy for posttraumatic stress disorder. 2003
Harvey AG, Bryant RA, Tarrier N. · Department of Experimental Psychology, University of Oxford, Oxford, UK. · Clin Psychol Rev. · Pubmed #12729682 No free full text.
Abstract: Following considerable empirical scrutiny, cognitive behaviour therapy (CBT) has proven to be a safe and effective treatment for posttraumatic stress disorder (PTSD). This article overviews the general principles of treatment and describes the components that comprise CBT for PTSD. We then move on to review the efficacy of CBT for the treatment of PTSD caused by various traumas, including assault, road traffic accident (RTA), combat, and terrorism. Recent advances in early intervention and in the treatment of disorders that are comorbid with PTSD are reviewed. Finally, future directions are discussed. In particular, it is proposed that randomised controlled trials (RCT) of CBT for PTSD must be conducted with enhanced methodological rigour and public health relevance.
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Review Posttraumatic stress disorder following medical illness and treatment. 2003
Tedstone JE, Tarrier N. · Clinical Psychology Services, Nottinghamshire Healthcare NHS Trust, Nottinghamshire, Mansfield, UK. · Clin Psychol Rev. · Pubmed #12729679 No free full text.
Abstract: Studies describing posttraumatic stress disorder (PTSD) as a result of physical illness and its treatment were reviewed. PTSD was described in studies investigating myocardial infarction (MI), cardiac surgery, haemorrhage and stroke, childbirth, miscarriage, abortion and gynaecological procedures, intensive care treatment, human immunodeficiency virus (HIV) infection, awareness under anaesthesia, and in a group of miscellaneous conditions. Cancer medicine was not included as it had been the subject of a recent review in this journal. Studies were reviewed in terms of the prevalence rates for PTSD, intrusive and avoidance symptoms, predictive and associated factors and the consequences of PTSD on healthcare utilization and outcome. There was considerable variability both in the study methodology and design and in the results. The highest prevalence rates were identified in patients treated in intensive care units (ICUs) and those with HIV infection. Irrespective of the physical illness, posttraumatic symptomatology is more common than PTSD caseness. Existing characteristics of the patient may well predispose individuals to the development of PTSD as do other factors such as poor social support and negative interactions with healthcare staff. Generally, the severity of the illness itself is not predictive of PTSD. Issues relating to sampling, attrition, diagnosis, the course of symptoms, aetiological pathways, and the consequences of the disorder are discussed. The presence of PTSD most probably influences the patient's use of healthcare resources and may affect their clinical outcome.
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Clinical Conference Suicide risk in civilian PTSD patients--predictors of suicidal ideation, planning and attempts. 2004
Tarrier N, Gregg L. · Academic Division of Clinical Psychology, Education and Research Building (2nd Floor), University of Manchester, Wythenshawe Hospital, Manchester M23 9LT, UK. · Soc Psychiatry Psychiatr Epidemiol. · Pubmed #15300376 No free full text.
Abstract: BACKGROUND: There appears to be a strong connection between suicidality and the experience of trauma. The study investigated suicidality in chronic civilian post-traumatic stress disorder (PTSD). METHOD: Ninety-four participants suffering from chronic PTSD were assessed for suicidal ideation, plans and attempts since the index trauma as part of a comprehensive assessment. The prevalence of these was assessed and characteristics of those reporting suicide-related thoughts and behaviour were investigated through logistic and multinominal regression analyses. RESULTS: Over half of the sample (56.4%) reported some aspect of suicidality with 38.3% reporting ideation, 8.5% reporting suicide plans and 9.6% having made suicide attempts since the trauma. Of the nine participants who reported suicide attempts, six had made more than one attempt. The proportions of participants who reported suicidality in this sample were significantly greater than reported within the general population, when comparisons were made with an epidemiological study. Logistic regression analysis indicated that a unit increase in life impairment (OR = 3.1) and depression (OR = 1.14) scores were independently and significantly associated with suicidality. Multinominal regression indicated that life impairment (OR = 2.71) and depression (OR = 1.13) scores were associated with the presence of suicidal ideation compared to no ideation, and life impairment (OR = 5.75), depression (OR = 1.2) scores and receiving psychotropic medication (OR = 10.6) were associated with the presence of plans and attempts compared to no suicidal behaviour. CONCLUSIONS: Suicide risk is elevated in those suffering from chronic PTSD and is associated with impaired functioning in combination with depression.
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Clinical Conference A randomized trial of the effectiveness of cognitive-behavioral therapy and supportive counseling for anxiety symptoms in older adults. 2001
Barrowclough C, King P, Colville J, Russell E, Burns A, Tarrier N. · Academic Division of Clinical Psychology, School of Psychiatry and Behavioural Sciences, University of Manchester, England. · J Consult Clin Psychol. · Pubmed #11680552 No free full text.
Abstract: The authors used a randomized trial to compare cognitive-behavioral therapy (CBT) and supportive counseling (SC) in the treatment of anxiety symptoms in older adults who met Diagnostic and Statistical Manual of Mental Disorders (4th ed.: American Psychiatric Association, 1994) criteria for anxiety disorders. Both conditions had a 6-week baseline no-treatment phase. Treatment was delivered primarily in patients' own homes and in an individual format. Outcomes were assessed at posttreatment and at 3-, 6-, and 12-month follow-ups. There was no spontaneous improvement during the baseline phase. Both groups showed improvement on anxiety measures following treatment, with a better outcome for the CBT group on self-rating of anxiety and depression. Over the follow-up period, the CBT group maintained improvement and had significantly greater improvement than the SC group on anxiety and 1 depression measure. Treatment response for anxiety was also superior for the CBT group, although there was no difference between groups in endstate functioning.
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Clinical Conference Randomised controlled trial of non-directive counselling, cognitive-behaviour therapy, and usual general practitioner care for patients with depression. I: clinical effectiveness. free! 2000
Ward E, King M, Lloyd M, Bower P, Sibbald B, Farrelly S, Gabbay M, Tarrier N, Addington-Hall J. · Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, University College London, London NW3 2PF, UK. · BMJ. · Pubmed #11099284 links to free full text
Abstract: OBJECTIVE: To compare the clinical effectiveness of general practitioner care and two general practice based psychological therapies for depressed patients. DESIGN: Prospective, controlled trial with randomised and patient preference allocation arms. SETTING: General practices in London and greater Manchester. PARTICIPANTS: 464 of 627 patients presenting with depression or mixed anxiety and depression were suitable for inclusion. INTERVENTIONS: Usual general practitioner care or up to 12 sessions of non-directive counselling or cognitive-behaviour therapy provided by therapists. MAIN OUTCOME MEASURES: Beck depression inventory scores, other psychiatric symptoms, social functioning, and satisfaction with treatment measured at baseline and at 4 and 12 months. RESULTS: 197 patients were randomly assigned to treatment, 137 chose their treatment, and 130 were randomised only between the two psychological therapies. All groups improved significantly over time. At four months, patients randomised to non-directive counselling or cognitive-behaviour therapy improved more in terms of the Beck depression inventory (mean (SD) scores 12.9 (9.3) and 14.3 (10.8) respectively) than those randomised to usual general practitioner care (18.3 (12.4)). However, there was no significant difference between the two therapies. There were no significant differences between the three treatment groups at 12 months (Beck depression scores 11.8 (9.6), 11.4 (10.8), and 12.1 (10.3) for non-directive counselling, cognitive-behaviour therapy, and general practitioner care). CONCLUSIONS: Psychological therapy was a more effective treatment for depression than usual general practitioner care in the short term, but after one year there was no difference in outcome.
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Clinical Conference Cognitive therapy or imaginal exposure in the treatment of post-traumatic stress disorder. Twelve-month follow-up. 1999
Tarrier N, Sommerfield C, Pilgrim H, Humphreys L. · Department of Clinical Psychology, School of Psychiatry and Behavioural Science, University of Manchester. · Br J Psychiatry. · Pubmed #10789356 No free full text.
Abstract: BACKGROUND: Previously reported results have demonstrated the efficacy of exposure and cognitive therapy in the treatment of chronic post-traumatic stress disorder (PTSD), but have not shown one to be superior to the other. AIMS: To investigate whether treatment benefits and equivalence are maintained at 12-month follow-up in patients with chronic PTSD treated with either imaginal exposure or cognitive therapy. METHOD: Twelve-month follow-up of a randomised clinical trial. RESULTS: Fifty-four subjects (87% of the sample) were available to follow-up. They did not significantly differ clinically from drop-outs. There was significant clinical improvement at 12 months compared with pre-treatment. However, 39% of those followed-up still met criteria for PTSD. There were no significant differences between the two treatments. Victims of crime displayed higher levels of symptoms at follow-up than victims of accidents. CONCLUSIONS: Clinical benefits for exposure or cognitive therapy were maintained.
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Clinical Conference Subjective improvement in PTSD patients with treatment by imaginal exposure or cognitive therapy: session by session changes. 2000
Tarrier N, Humphreys L. · Department of Clinical Psychology, School of Psychiatry and Behavioural Science, University of Manchester, UK. · Br J Clin Psychol. · Pubmed #10789026 No free full text.
Abstract: A self-rating scale, the Subjective Symptom Checklist (SSC) was developed to assess PTSD patients' perception of their symptoms between treatment sessions. Reliability and validity of the scale were acceptable. The scale was used in a treatment trial comparing the efficacy of cognitive therapy versus imaginal exposure. Conventional pre-post treatment comparisons using standardized assessments showed no differences between the two treatments. However, when patients who failed to respond to treatment were excluded, group treatment effects became apparent. Patients who received imaginal exposure showed a significantly greater reduction in subjective ratings of their symptoms than did those who received cognitive therapy. It was cautiously concluded that although some PTSD patients could not tolerate exposure, those who could may receive greater subjective benefit than those who received cognitive therapy.
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Clinical Conference Factors associated with outcome of cognitive-behavioural treatment of chronic post-traumatic stress disorder. 2000
Tarrier N, Sommerfield C, Pilgrim H, Faragher B. · Department of Clinical Psychology, School of Psychiatry and Behavioural Science, University of Manchester, UK. · Behav Res Ther. · Pubmed #10661003 No free full text.
Abstract: The study examined factors that were associated with outcome in the treatment of PTSD. A trial of cognitive therapy compared to imaginal exposure of chronic PTSD showed that although clinical improvements were obtained after treatment and at 6 month follow-up one type of treatment was not significantly superior to the other. Characteristics of the patient, the trauma and treatment and of pretreatment clinical measures were investigated as predictors of PTSD outcome. Eleven variables were significantly associated with the pre- to post-treatment change in CAPS severity scores. Of these, three (duration of therapy, gender and suicide risk) were selected into a step-wise multiple regression equation to explain 36.5% of the outcome. Similarly, nine variables were significant associated with the pretreatment to follow-up change with three variables (number of missed therapy sessions, residential status and co-morbid GAD) being selected into the equation and explaining 36.9% of the outcome. The best predictor of outcome was inconsistent attendance at therapy.
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Clinical Conference Relatives' expressed emotion (EE) and PTSD treatment outcome. 1999
Tarrier N, Sommerfield C, Pilgrim H. · Department of Clinical Psychology, School of Psychiatry and Behavioural Sciences, University of Manchester. · Psychol Med. · Pubmed #10473307 No free full text.
Abstract: BACKGROUND: Expressed emotion (EE) is a measure that has been used to assess the quality of the relationship between patient and their key relative. It has been shown to be strongly predictive of clinical outcome in a range of psychiatric and medical disorders. This study investigated the effect of EE on treatment outcome in chronic post-traumatic stress disorder (PTSD). METHODS: A prospective design was adopted. The key relatives of 31 PTSD patients participating in a treatment trial comparing imaginal exposure with cognitive therapy were interviewed and rated on EE prior to treatment allocation. The effect of EE on post-treatment clinical outcomes was assessed. RESULTS: Sixteen patients (52%) had high EE and 15 (48%) low EE relatives. Patients with high EE relatives showed lesser change scores on the main outcome variable of the trial, the total CAPS score, and on all the secondary outcome variables than those with low EE relatives. Using different multiple regression models the EE scales of criticism and hostility predicted just under 20% of the outcome variance. These two scales were highly correlated and criticism marginally predicted the greatest variance (19.7%). CONCLUSIONS: The results highlight the importance of the quality of the patient's social environment in influencing their response to cognitive and behavioural treatments.
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Clinical Conference A randomized trial of cognitive therapy and imaginal exposure in the treatment of chronic posttraumatic stress disorder. 1999
Tarrier N, Pilgrim H, Sommerfield C, Faragher B, Reynolds M, Graham E, Barrowclough C. · Department of Clinical Psychology, Research and Teaching Building, Withington Hospital, University of Manchester, United Kingdom. · J Consult Clin Psychol. · Pubmed #10028204 No free full text.
Abstract: A randomized trial was performed in which imaginal exposure (IE) and cognitive therapy (CT) were compared in the treatment of chronic posttraumatic stress disorder (PTSD). Patients who continued to meet PTSD caseness at the end of a 4-week symptom-monitoring baseline period (n = 72) were randomly allocated to either IE or CT. There was a significant improvement in all measures over treatment and at follow-up, although there were no significant differences between the 2 treatments at any assessment. A significantly greater number of patients who showed worsening over treatment received IE, although this effect was not found at follow-up. Patients who worsened showed a greater tendency to miss treatment sessions, rated therapy as less credible, and were rated as less motivated by the therapist. It was concluded that either exposure or a challenge to cognition can result in symptom reduction, although neither resulted in complete improvement.
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Article A longitudinal investigation of psychological morbidity in patients with ovarian cancer. 2008
Gonçalves V, Jayson G, Tarrier N. · Academic Division of Clinical Psychology, School of Psychological Sciences, University of Manchester, Zochonis Building, Brunswick Street, Manchester M13 9PL, UK. · Br J Cancer. · Pubmed #19002175 No free full text.
Abstract: Ovarian cancer patients may experience psychological disorders due to the aggressive nature of the illness and treatment. We investigated the presence of psychological disorders longitudinally in women with a new diagnosis of ovarian cancer and the factors that predicted development and maintenance of these disorders. Patients were assessed in a prospective longitudinal study at the beginning of chemotherapy treatment, mid-treatment, end of treatment and 3 months follow-up for depression, anxiety, perceived social support, neuroticism and cognitive strategies to control unwanted thoughts. A total of 121 patients were recruited and 85 patients were assessed at all four time points. Three different longitudinal profiles of anxiety and depression caseness were found: non-cases (never cases), occasional cases (cases on at least one but not all four occasions) and stable cases (cases on all four occasions). Most of the women were occasional cases of anxiety (52%, 44), whereas for depression, the majority of women were non-cases (55%, 47). A subset of patients were stable cases of anxiety (22%, 19). Neuroticism and marital status were significant independent predictors of anxiety caseness profile. Neuroticism and use of anti-depressants were independent predictors of depression caseness profile. Social support was not related to psychological morbidity.
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Article Expressed emotion and causal attributions in relatives of post-traumatic stress disorder patients. 2008
Barrowclough C, Gregg L, Tarrier N. · Division of Clinical Psychology, School of Psychological Sciences, University of Manchester, Unit 4, Ground Floor, Rutherford House, Manchester Science Park, Lloyd Street North, Manchester M15 6SZ, UK. · Behav Res Ther. · Pubmed #18177841 No free full text.
Abstract: This study investigates the relationship between expressed emotion (EE) and causal attributions in relatives of post-traumatic stress disorder (PTSD) patients, and examines the contributions of EE and attributions to patient outcomes. Thirty-eight relatives of patients with PTSD participating in a treatment trial were assessed on EE, causal attributions for patient problems and nature of attributions. Patients' PTSD symptoms at 6 and 12 months were assessed. Criticism and hostility in relatives were associated with attributing problems to factors controllable by patients. Relatives with marked emotional over-involvement (EOI) had an attributional profile similar to low EE relatives. Deficits in normal behaviour ("negative symptoms") were perceived as more controllable, internal and stable than were more obvious signs of an illness or mental health problem such as hypervigilance and intrusive thoughts and nightmares ("positive symptoms"). Irritability or anger was perceived as more controllable and personal than any other problem. Hostility was associated with less psychological understanding. EE (hostility) but not attributions was found to predict clinical outcome. The results are consistent with previous studies of relatives of schizophrenia patients. The study suggests a need for interventions, which focus on helping relatives to reappraise the impact of PTSD.
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Article Predictors of incident depression after hip fracture surgery. 2007
Voshaar RC, Banerjee S, Horan M, Baldwin R, Pendleton N, Proctor R, Tarrier N, Woodward Y, Burns A. · Department of Psychiatry, Nijmegen Medical Centre, Radboud University, Nijmegen, the Netherlands. · Am J Geriatr Psychiatry. · Pubmed #17698601 No free full text.
Abstract: OBJECTIVE: Depression after hip fracture surgery is prevalent and associated with increased mortality rates and impaired functional recovery. The incidence of new-onset depressive symptoms in patients initially not depressed after hip fracture surgery and their relationship with functional recovery is unknown. METHODS: A cohort of 139 nondepressed elderly patients (>60 years) hospitalized for hip fracture surgery were followed up for six months. Clinically significant depressive symptoms were defined as a score of 7 or more on the 15-item Geriatric Depression Scale. RESULTS: The authors found a cumulative incidence rate of 20.5% adjusted for dropouts. Multiple Cox-regression analyses yielded the presence of subthreshold symptoms of depression, anxiety, pain, and cognitive impairment at baseline, the premorbid level of mobility, and a history of (treated) depression as risk factors for incident depression (p <0.05). A forward, conditional procedure identified postoperative pain (hazard ratio [HR] = 1.32, 95% confidence interval [CI]: 1.14-1.53, Wald chi(2) = 13.57, df = 1, p <0.001) and baseline anxiety (HR = 1.25, 95% CI: 1.08-1.44, Wald chi(2) = 8.86, df = 1, p = 0.003) as the strongest independent risk factors. Incident depression was associated with a less favorable outcome at 3 months follow-up. CONCLUSION: This exploratory study identified two treatable baseline characteristics that predicted incident depression in nondepressed patients after hip-fracture surgery.
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Article Where to start? Attempting to meet the psychological needs of burned patients. 2007
Wisely JA, Hoyle E, Tarrier N, Edwards J. · Academic Division of Clinical Psychology, School of Psychological Sciences, University of Manchester, 2nd Floor ERC Building, Wythenshawe Hospital, Manchester M23 9LT, United Kingdom. · Burns. · Pubmed #17499929 No free full text.
Abstract: The National Burn Care Review Committee [National Burn Care Review Committee. National Burns Care Review. Standards and Strategy for Burn Care; 2001] recommend routine psychosocial screening for all burned in-patients, as well as access to different levels of psychological input. This paper aims to report on: (1) a system which integrates routine clinical practice, psychological screening and a system of data collection to identify level of need; (2) an audit of the range of levels of psychological input required to meet this need. All consecutive admissions (n=72) to a regional burns unit were screened within a week of admission using the Hospital Anxiety and Depression Scale (HADS), the Impact of Event Scale (IES) and a screening tool developed in the unit. Clinical input was provided as required and recorded. Thirty-five percent reported a previous mental health problem. Forty percent fell into 'borderline' or 'caseness' on the HADS. Fifteen percent met a level of clinical 'caseness' on both the intrusions and avoidance subscales of the IES. Sixty-three percent required some level of psychological input during their in-patient stay. Given the high level of need identified and the range of levels of psychological intervention identified, a system of routine screening and a tiered model of psychological care is proposed to best utilise psychological resources.
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Article The subjective consequences of suffering a first episode psychosis: trauma and suicide behaviour. 2007
Tarrier N, Khan S, Cater J, Picken A. · Division of Clinical Psychology, School of Psychological Sciences, 2nd Floor, Zochonis Building, University of Manchester, Brunswick Street, Manchester, M13 9PL, UK. · Soc Psychiatry Psychiatr Epidemiol. · Pubmed #17082897 No free full text.
Abstract: BACKGROUND: The subjective impact of a psychotic breakdown can be profound, potentially resulting in loss of social roles, hopes and aspirations and leading to stigmatisation, trauma and elevated suicide risk. This study aimed to assess the subjective effect and consequences of suffering a first episode of psychosis. It was hypothesised that suicide behaviour would be associated with the negative consequences of psychosis and co-morbid symptomatic-PTSD. METHODS: Patients were assessed by means of a semi-structured interview on their reactions and experience of their psychotic episode and its treatment and by means of standardised methods for psychotic (PANSS) and trauma-related (CAPS) symptoms. RESULTS: A total of 35 patients suffering their first episode of psychosis were interviewed. As a result of the onset of their illness, 77% indicated they had suffered loss or disruption to their life, 60% had thwarted future aspirations, 38% had suffered violence or harassment, 53% had suffered stigma and 50% social exclusion. Totally, 80% felt they had been traumatised by their treatment and 38% were cases for symptomatic-PTSD. Symptomatic-PTSD was significantly associated with involuntary hospitalisation but not psychotic symptoms. Positive psychotic symptoms were associated with harassment, stigma and social exclusion. Suicidal ideation was reported by 40% and 31% reported attempting suicide. Suicidal behaviour was greater in those suffering symptomatic-PTSD but this was not significant, suicidal behaviour was significantly associated with the experience of trauma, but not the severity of that trauma, prior to the onset of their psychosis. CONCLUSIONS: The negative consequences of a psychotic episode are significant. The potential iatrogenic effect of psychiatric care needs to be considered. Interventions need to be developed to reduce traumatisation and suicide risk.
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Article Post-traumatic stress disorder and illness perceptions over time following myocardial infarction and subarachnoid haemorrhage. 2006
Sheldrick R, Tarrier N, Berry E, Kincey J. · Department of Behavioural Medicine, Hope Hospital, Salford, UK. · Br J Health Psychol. · Pubmed #16870051 No free full text.
Abstract: OBJECTIVES: This study investigated post-traumatic stress disorder (PTSD) symptoms and illness perceptions in people who suffered the acute medical trauma of a myocardial infarction (MI) or a subarachnoid haemorrhage (SAH). The study tested hypotheses regarding changes in PTSD symptoms and illness perceptions over time, associations between PTSD and illness perceptions and cognitive predictors of PTSD. DESIGN AND METHOD: The study employed a longitudinal design and measured the illness perceptions and PTSD symptoms of an MI group (N=17) and a SAH group (N=27). Data were collected within 2 weeks of admission (T1), 6 weeks after admission (T2) and 3 months after admission (T3). Statistical analysis was undertaken to examine associations between illness perceptions and PTSD and to examine cognitive predictors of PTSD. RESULTS: The prevalence of PTSD within the total acute medical trauma sample was 16% at 2 weeks, 35% at 6 weeks and 16% at 3 months. Illness perception factors of identity, timeline (acute/chronic), consequences and emotional representation were strongly correlated with PTSD at all three time points. PTSD symptoms and illness perceptions were shown to have changed over time. The results also showed that several illness perception factors are significant predictors of PTSD. CONCLUSIONS: Both PTSD symptoms and illness perceptions changed significantly over time following an MI or SAH. Illness perception factors are significant predictors of PTSD.
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Article The acceptability and preference for the psychological treatment of PTSD. 2006
Tarrier N, Liversidge T, Gregg L. · Academic Division of Clinical Psychology, School of Psychological Sciences, University of Manchester, UK. · Behav Res Ther. · Pubmed #16460671 No free full text.
Abstract: The acceptability and preference of psychological treatments is important in understanding patient treatment seeking, choice, engagement and attrition and possibly treatment response in health care. The acceptability of, and preference for, 14 different types of psychological treatment for posttraumatic stress disorder (PTSD) were investigated in a student population through invitation to participate in a web-based survey. Respondents were asked to rate each treatment on 10 scales and to rank the treatments in order of preference. Respondents were also asked whether they would seek treatment themselves, recommend treatment to friends and family, feel stigmatised by suffering from PTSD, had any prior knowledge of the treatments and if this had been positive or negative and whether they had a history of psychological problems or treatment. A total of 330 respondents completed the survey. A past or current history of psychological problems and treatment was surprisingly high. Almost all respondents indicated that they would seek or recommend treatment in spite of high levels of stigmatisation. Factor analysis of the 10 scales indicated two factors: Endorsement and Discomfort. Rank ordering on preference and Endorsement scores was highly consistent. The highly preferred and endorsed treatments involved cognitive therapy, exposure or psycho-education in spite of high levels of discomfort anticipated with exposure. Treatments involving new technologies, EMDR and psychodynamic psychotherapy received the lowest Endorsement and preference. There was a modest influence of prior knowledge of a treatment.
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Article Personality and peritraumatic dissociation in the prediction of PTSD in victims of road traffic accidents. 2001
Holeva V, Tarrier N. · Academic Division of Clinical Psychology, School of Psychiatry and Behavioural Science, University of Manchester, Withington Hospital, Manchester M20 8LR, UK. · J Psychosom Res. · Pubmed #11728510 No free full text.
Abstract: OBJECTIVES: To investigate the contribution of personality and peritraumatic dissociation in the development of posttraumatic stress disorder (PTSD). METHOD: Victims of road traffic accidents (RTA) were assessed within 2-4 weeks (Time 1) of the accident and again between 4 and 6 months (Time 2). The Eysenck Personality Questionnaire (EPQ) and Peritraumatic Dissociation Experience Questionnaire (PDEQ) were administered at Time 1 and posttraumatic stress symptoms were assessed at Time 2. RESULTS: 265 subjects were assessed at both time points, although neuroticism, psychoticism, and peritraumatic dissociation were significantly correlated with posttraumatic symptoms, only the personality dimensions were independent and significant predictors of subsequent PTSD in a logistic regression. CONCLUSIONS: Consistent with the literature personality measures, especially neuroticism, is associated with the development of PTSD. However, peritraumatic dissociation was not found to be an independent predictor of PTSD.
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