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PubMed2007

The relationship between bullying, psychotic-like experiences and appraisals in 14-16-year olds.

The psychological consequences of bullying have been the focus of much research over the last 25 years. However, the relationship between bullying and psychotic experiences has been relatively ignored despite the weight of evidence which suggests that traumatic events in childhood are significantly related to psychotic disorders. 373 pupils aged between 14 and 16 years took part in the study. They were asked to complete a number of self-report measures which examined their experience of bullying, predisposition to auditory hallucinations, paranoia and dissociation, and beliefs about both the self and the world and about paranoia. It was found that bullying was significantly associated with predisposition to psychotic experiences. Negative post-trauma cognitions were also associated with predisposition to psychotic phenomena as were positive beliefs about paranoia. Being bullied at school and beliefs about trauma and psychotic symptoms may contribute to the development of psychosis. However, it is also possible that these results indicate that experiencing psychotic-like phenomena increases the likelihood that a pupil's interpersonal context is characterised by peer hostility and rejection. The implications of these results are discussed.

Adolescent↗
PubMed2000

Neuropsychological and conditioned blocking performance in patients with schizophrenia: assessment of the contribution of neuroleptic dose, serum levels and dopamine D2-receptor occupancy.

Patients with schizophrenia show impairments of attention and neuropsychological performance, but the extent to which this is attributable to antipsychotic medication remains largely unexplored. We describe here the putative influence of the dose of antipsychotic medication (chlorpromazine equivalents, CPZ), the antipsychotic serum concentration of dopamine (DA) D2-blocking activity and the approximated central dopamine D2-receptor occupancy (DA D2-occupancy), on conditioned blocking (CB) measures of attention and performance on a neuropsychological battery, in 108 patients with schizophrenia (compared with 62 healthy controls). Antipsychotic serum concentration and D2-occupancy were higher in patients with a paranoid versus non-paranoid diagnosis, and in female versus male patients (independent of symptom severity). Controlling for D2-occupancy removed the difference between high CB in paranoid and impaired low CB in non-paranoid patients. Similar partial correlations for antipsychotic drug dose and serum levels of DA D2-blocking activity with performance of the trail-making and picture completion tests (negative) and the block-design task (positive) showed the functional importance of DA-related activity. High estimates of central DA D2-occupancy were related to impaired verbal fluency but were associated with improved recall of stories, especially in paranoid patients. This, the first study of its kind, tentatively imputes a role for DA D2-related activity in left frontal (e.g. CB, verbal fluency) and temporal lobe functions (verbal recall) as well as in some non-verbal abilities mediated more in the right hemisphere in patients with schizophrenia.

Adult↗
PubMed1993

Acting on delusions. I: Prevalence.

Associations between delusions and abnormal behaviour were retrospectively assessed in a sample of 83 consecutively admitted deluded subjects. All were interviewed about events in the previous month using a new measure of delusional phenomenology and action. For 59 subjects this information was supplemented by informant interviews. Clinical consensus was reached concerning the probability that actions reported by informants were linked to delusions. Half of the sample reported that they had acted at least once in accordance with their delusions. Violent behaviour in response to delusions was uncommon. Information provided by informants suggested that some aspect of the actions of half of the sample was either probably or definitely congruent with the content of their delusions. However, there was no link between self-reports and informants' reports of such action. A latent class analysis of self-reported delusional action suggested three classes of action, namely aggressive to self or other, defensive action, and either none or single action. Self-reported action was associated with delusions of catastrophe. Informant data suggested that persecutory delusions were the most likely to be acted upon, but in contrast delusions of guilt or catastrophe appeared to decrease the chance of delusional behaviour. Actions associated with abnormal beliefs are more common than has been suggested.

Acting Out↗
PubMed1993

Acting on delusions. II: The phenomenological correlates of acting on delusions.

The aim of the study was to identify the phenomenological characteristics of those delusions which are associated with action. The sample consisted of 79 patients admitted to a general psychiatric ward, each of whom described at least one delusional belief. The variables studied included the phenomenology of the delusions, and behaviour. Two behavioural ratings were used, one derived from the subjects' own description of their behaviour and the other from information provided by informants. There was no association between delusional phenomenology and acting on a delusion when the subjects' behaviour was described by informants. When action was described by the subjects themselves, acting was associated with: being aware of evidence which supported the belief and with having actively sought out such evidence; a tendency to reduce the conviction with which a belief was held when that belief was challenged; and with feeling sad, frightened or anxious as a consequence of the delusion.

Acting Out↗
PubMed1999

Cognitive approaches to delusions: a critical review of theories and evidence.

PURPOSE: To review critically the evidence for three contemporary theories of delusions. METHODS: The theoretical approaches to delusions proposed by Frith and colleagues ('theory of mind' deficits), Garety and colleagues (multi-factorial, but involving probabilistic reasoning biases) and Bentall and colleagues (attributional style and self-discrepancies) are summarised. The findings of empirical papers directly relevant to these proposals are critically reviewed. These papers were identified by computerised literature searches (for the years 1987-1997) and a hand search. RESULTS: The evidence does not unequivocally support any of the approaches as proposed. However, strong evidence is found to support modifications of Garety and colleagues' and Bentall and colleagues' theories. Studies have replicated a 'jumping to conclusions' data-gathering bias and an externalising attributional bias in people with delusions. There is preliminary evidence for a 'theory of mind' deficit, as proposed by Frith, although possibly related to a more general reasoning bias. Evidence for an underlying discrepancy between ideal and actual self-representations is weaker. CONCLUSIONS: A multi-factorial model of delusion formation and maintenance incorporating a data-gathering bias and attributional style, together with other factors (e.g. perceptual processing, meta-representation) is consistent with the current evidence. It is recommended that these findings be incorporated into cognitive therapy approaches. However, there are limitations to existing research. Future studies should incorporate longitudinal designs and first episode studies, and should not neglect the co-morbidity of delusions, including affective processes, or the multi-dimensional nature of delusions.

Cognition Disorders↗
PubMed1999

The Piggle: confrontations with non-existence in childhood.

The author interweaves pieces from D. W. Winnicott's 'The Piggle: An Account of the Psychoanalytic Treatment of a Little Girl' with her own experiences and case material, to explore how confrontations with existence/non-existence can become terrifying realities that overwhelm the child's resources. In the pages of 'The Piggle', we can see a young child 'playing' with the unfathomable notions of beginnings and endings in the wake of the birth of a sibling, which also heralds the death of the extant mother/child relationship. In the case material these issues are explored from the perspective of an adult who had been unable to resolve them without great loss of self. In both cases, parental failures impeded the child's ability to integrate his or her experiences. The work of Matte-Blanco provides a useful terminology for understanding condensations and equivalences in the material; as affect intensifies, the rules of conventional logic recede, and sameness threatens to annihilate distinctions between good and bad, or self and other. Containing these dichotomies within the analytic setting facilitates their integration, in a movement from the fragmentation of the paranoid-schizoid position towards the reconciliation and renunciation of the depressive position.

Child↗
PubMedDate not supplied

[Anxiety and self-assurance in elderly patients].

The concept of social competence covers emotional, cognitive and behavioral abilities in the field of interpersonal communication and behavior patterns to cope with practical problems of life. Under the specific conditions of age, aging, and diseases in one part of the elderly, a loss of psycho-social competence may reduce the ability and quality of independent living. To improve social competence in old patients, an age-adapted assertiveness-training, based on the Assertiveness Training Program was proved in a group of psychogeriatric inpatients in a controlled study. In the self-rated activities of daily living and state-anxiety as well as in observer-rated self-confidence and assertiveness, the training group showed significant improvement compared to the controls.

Aged↗
PubMed2005

[Behavioral, stress and immunological evaluation methods of music therapy in elderly patients with senile dementia].

The purpose of this study was to clarify the efficacy of behavioral, stress and immunological evaluation methods in music therapy (MT) with elderly patients with senile dementia. The MT group consisted of 8 elderly patients with dementia and the control group included 8 similarly matched patients. A total of 25 sessions of music therapy were conducted for one hour, twice each week for three months. The Mini-Mental State Exam (MMSE), Gottfries-Brane-Steen Scale (GBS), and Behavioral Pathology in Alzheimer's Disease Rating Scale (Behave-AD) were used to evaluate behavioral changes. Saliva Chromogranin A (Cg A) and Immunoglobulin A (Ig A) were used to assess changes in stress and immunological status, respectively. The results of the study were as follows: 1. In GBS, the mean score of "different symptoms common in dementia" improved significantly after MT. 2. The mean Behave-AD score of "paranoid and delusional ideation" was also significantly improved (p<0.05) after the intervention. 3. In the 25th session, mean saliva Cg A was significantly decreased after MT (p<0.05). IgA was slightly increased prior to intervention. Our results suggest that a combination of behavioral, stress and immunological evaluation methods were valuable for assessing changes that occurred during MT for elderly patients with dementia.

Aged↗
PubMed2006

Associations between physical and psychological problems in a group of patients with stress-related behavior and somatoform disorders.

The research questions in this study were. How do patients with stress-related behavior and somatoform disorders assess symptoms and self-image compared to healthy individuals, and how are these assessments related to bodily resources, assessed with a physiotherapeutic body examination? The test group (n = 31) consisted of consecutive patients referred to a treatment center specializing in psychosomatic problems. Significant differences (p < or = 0.01) were found between the test and comparison group (n = 22) on all but two of the ten subscales of the Resource-Oriented Body Examination (ROBE II). This was also the case for all the subscales of The Symptom Checklist-90(SCL-90; comparison group n = 52), and for all but three of the eight clusters of the Structural Analysis of Social Behavior (SASB) (comparison group n = 52). For the patient group, the ROBE II subscale Increased respiratory control correlated significantly with the SCL-90 subscales that measures Anger-hostility, Phobic anxiety, Paranoid ideation, with the Personality Severity Index (PSI) and with the SASB clusters Daydreaming and self-neglect, Self-indictment and oppression with r's between 0.38 and 0.50. Body examination with ROBE II might provide a useful assessment tool in patients whose stress-related problems appear to contain associations between psychological and physical problems.

Anxiety Disorders↗