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C Barrowclough

Publications and source records attributed to C Barrowclough.

18 recordsLinked to original sources
PubMed1992

Training community psychiatric nurses for psychosocial intervention. Report of a pilot study.

Community psychiatric nurses were trained to deliver psychosocial intervention to clients with a diagnosis of schizophrenia living at home with relatives. The training package consisted of family assessment, health education, and family stress management strategies. In a 'quasi-experimental' design, a sample of families (n = 54) were recruited to either a control or experimental condition and followed up for 12 months. A number of favourable outcomes were observed in the experimental group, including improvements in the client's target symptoms, personal functioning, and social adjustment. Relatives' satisfaction with services increased and reports of their own minor psychiatric morbidity improved.

Adolescent↗
PubMed1991

Prodromal signs of relapse in schizophrenia.

Fifty-six patients who were hospitalised for a schizophrenic episode were followed up for nine months after discharge. The Psychiatric Assessment Scale (PAS, Krawiecka et al., 1977) was administered at monthly intervals during this period. Twenty-three patients relapsed of which data were available for sixteen. In these sixteen patients who relapsed comparisons were made of the PAS symptoms between the month prior to relapse and the month preceding this. Sixteen patients who did not relapse were randomly matched with the relapsing patients and an index point comparable in time to relapse onset in the matched relapsed patient was identified. Comparisons were made on the PAS symptoms using a repeated measures ANOVA to compare relapsers and non relapsers on the month prior to relapse and the month which preceded this. Discriminant function analysis was used to predict relapse by analysis of those PAS symptoms which showed an increase in the month before relapse. This suggested that the measures of depression and hallucinations significantly increased in the month prior to relapse compared to the preceding month in relapsers but not non-relapsers. The results of this study closely agree with previous published results even though there were some differences between studies in the patient samples.

Adolescent↗
PubMed1991

Some aspects of family interventions in schizophrenia. II: Financial considerations.

The direct costs to the mental health services for patients who participated in a trial of a behavioural family intervention to reduce schizophrenic relapse were estimated. Comparisons were made between two patient groups from households of high expressed emotion (HEE): one group received a nine-month family intervention (HEE Intervention) and the other group routine treatment (HEE Control). A third group consisted of patients from low-EE households (LEE Control). The significant decrease in relapse rates in the HEE Intervention group compared with the HEE Control group has previously been reported; the analysis of costs indicates that any increase in costs due to the family intervention is outweighed by a decrease in usage of the established mental health services. The intervention resulted in a decrease of 27% in mean cost per patient.

Adult↗
PubMed1990

Social functioning in schizophrenic patients. I. The effects of expressed emotion and family intervention.

The relationship between the social functioning of schizophrenic patients and the EE levels of their relatives is examined. Patients living with a high EE relative function significantly worse than those living with low EE relatives. This appeared to be due to a poorer social functioning in patients who lived with hostile relatives. Patients who participated in a nine month behavioural family intervention showed greater improvements in social functioning than control groups. The improvements could not be explained as being due to medication since high neuroleptic dosage over nine months was associated with poorer social functioning.

Adult↗
PubMed1990

Social functioning in schizophrenia. II. The effects of autonomic arousal.

The association between electrodermal arousal and social functioning was investigated. It was predicted that poor social functioning would be associated with higher levels of arousal. Patients were tested for a 15 minute period without their relative and for 15 minutes with their relative present. The prediction received some support from the results in that three subscales of the Social Adjustment Scale (SAS) showed a significant association between lower social functioning and higher arousal. This association showed a trend towards significance in the SAS Overall Score. When patients with high EE and low EE relatives were analysed separately, significant associations were only found for the high EE group. These results were interpreted as giving some support to the hypothesis that patients who are functioning poorly have relatively stable high levels of arousal.

Adult↗
PubMed1990

Family interventions for schizophrenia.

Studies that have attempted to reduce schizophrenic relapse by the use of family interventions are described. Results from studies that implemented behavioral family interventions with patients who were identified as high risk because of the expressed emotion status of their relatives have demonstrated that relapse rates can be significantly reduced over a 2-year postdischarge follow-up period. A number of ongoing studies, especially those that are investigating the interaction of family interventions and different medication regimes, are also discussed. Areas for further investigation are identified, for example: the use of multiple outcome measures, the use of single-case studies and the development of ideographic assessment measures, the interaction of biological and environmental influences, the alleviation of the burden of care, the involvement of the consumer in services, the development of behavioral formulations and analysis of family engagement and compliance, staff training in intervention methods, and the translation of research results into clinical practice.

Behavior Therapy↗
PubMed1989

Electrodermal activity as a predictor of schizophrenic relapse.

Electrodermal activity and self-report of affect were recorded from schizophrenic patients with their relative absent and present, at index admission and on two subsequent occasions after discharge. It was hypothesised that it would be possible to discriminate at index admission patients who relapsed in the subsequent 2-year period from those who remained well, and that these differences would be stable over time and independent of illness episode. The former hypothesis was supported in part, but not the second. The results did not support electrodermal hyperactivity as a stable, enduring vulnerability marker.

Adolescent↗
PubMed1989

Community management of schizophrenia. A two-year follow-up of a behavioural intervention with families.

The relapse and readmission rates of schizophrenic patients who participated in a controlled trial of a nine-month behavioural family intervention trial based on the EE status of their relatives are presented at two years. The patients who received the behavioural family intervention had lower rates of relapse and readmission than patients from high-EE homes who had received a short educational programme or routine treatment. The relapse rate of the behavioural family intervention group (33%) was the same as that of the low-EE group (33%), and significantly lower than that of the non-intervention high-EE group (59%).

Behavior Therapy↗
PubMed1988

The assessment of psychophysiological reactivity to the expressed emotion of relatives of schizophrenic patients.

The measure of expressed emotion (EE) of the relative has been found to be an important predictor of schizophrenic relapse. Electrodermal measures were recorded when the schizophrenic patient was talking to an experimenter, and when the patient was talking to a relative. Although there were no differences during the relative-absent period, patients with a high-EE relative present exhibited significantly higher frequencies of non-specific skin-conductance responses (NS-SCRs) than patients with a low-EE relative present. Patients show a significant decrease in NS-SCRs on the entry of low-EE, but not high-EE relatives. Patients with high-EE relatives show overall higher levels of skin-conductance levels (SCLs) than patients with low-EE relatives. Although patients with high-EE relatives rate themselves significantly more tense and anxious on self-rating scales, there are no significant correlations between self-ratings and electrodermal measures. The use of electrodermal reactivity as an assessment measure of relapse risk is discussed.

Adolescent↗
PubMed1988

The community management of schizophrenia. A controlled trial of a behavioural intervention with families to reduce relapse.

Schizophrenic patients were recruited into a trial of a prophylactic behavioural intervention with families. Families with at least one high Expressed Emotion (EE) relative were randomly allocated to one of four intervention groups: Behavioural Intervention Enactive; Behavioural Intervention Symbolic; Education Only; Routine Treatment. Patients from low-EE families were randomly allocated to two groups: Education Only or Routine Treatment. Relapse rates over nine months after discharge were significantly lower for patients in the two Behavioural Intervention, compared with Education Only and Routine Treatment groups. There was little difference between the two low-EE groups. Patients returning to high-EE relatives showed significantly higher relapse rates than those returning to low-EE relatives, in groups not receiving active intervention. Changes from high to low EE occurred in the Behavioural Intervention groups, and similar although less extensive changes occurred in the Education Only and Routine Treatment groups. Changes in criticism and marked emotional over-involvement (EOI) occurred generally in high-EE groups but were larger in magnitude in the Enactive and Symbolic groups. Reduction of hostility only occurred in the Behavioural Intervention groups. These results give partial support for the causal role of EE in relapse. There were no significant differences between the groups with respect to contact with the psychiatric services or medication.

Adult↗
PubMed1987

Assessing the functional value of relatives' knowledge about schizophrenia: a preliminary report.

An instrument for assessing and evaluating what relatives know about schizophrenia was evaluated as both a pre- and a post-test for an educational programme. The Knowledge About Schizophrenia Interview (KASI) places emphasis on the functional value of the reported knowledge rather than on the recall of information; it is quick, easy to administer, can be rated reliably, and has face-validity for the relative. The educational programme increased scores from pre-test to a post-test one week after the programme. Relatives with high criticism ratings on the Camberwell Family Interview had lower scores at both tests. Relatives of less chronic patients showed lower scores at pre-test and acquired significantly more information from the programme, while relatives of more chronic patients were less influenced by the information sessions.

Adolescent↗
PubMed1986

Providing information to relatives about schizophrenia: some comments.

There has recently been an increased interest in providing relatives of schizophrenic patients with information about the illness and how to manage the patient at home, due partly to the development of psychosocial intervention programmes (which frequently include an educational component) and a consumer demand for such information in an era of community care. Studies which describe the effects of such educational programmes are reviewed, and two different models of information acquisition are contrasted. These models have different implications, in terms of outcome measures, on how educational programmes should be evaluated. Guidelines are offered for practitioners wishing to give information to relatives.

Attitude to Health↗
PubMed1984

'Psychosocial' interventions with families and their effects on the course of schizophrenia: a review.

Recent interest in the way social factors influence the course of schizophrenia has led to attempts to monitor and manipulate these factors. The work on the Expressed Emotion of the relative has been especially influential in this area. A number of studies have now been conducted in which a psychosocial intervention has been employed in an attempt to prevent relapse after discharge from hospital. These studies are reviewed with an emphasis on their methodological adequacy and on the nature of the intervention used. Recent studies have demonstrated a positive result for psychosocial interventions used in combination with neuroleptic medication. However, analysis of these studies does not allow us to conclude that we can identify the 'active ingredients' in these psychosocial treatment regimes. Although there is cause for optimism, further investigation is required.

Adaptation, Psychological↗
PubMed1984

Psychophysiological assessment of expressed emotion in schizophrenia. A case example.

Previous research has demonstrated a different psychophysiological response of schizophrenic patients depending on whether their key relative was rated high or low on Expressed Emotion (EE). A case assessment is described in which a young man suffering from schizophrenia, who lived with both a high EE and a low EE parent, was tested psychophysiologically in their presence using an ABAC design. The patient demonstrated a significantly higher amount of spontaneous activity in skin conductance level when the high EE parent was present. The high EE parent also demonstrated a greater perceived inability to cope, and a higher level of personal distress.

Adult↗
PubMedDate not supplied

Noisy neighbours.

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Aged↗