Search results for ‘Author:"barrowclough christine"’ Sort:
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Integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and comorbid substance misuse: randomised controlled trial
- Authors:
- BARROWCLOUGH Christine, et al
- Journal article citation:
- British Medical Journal, 4.12.10, 2010, p.1204.
- Publisher:
- British Medical Association
This study aimed to evaluate the effectiveness of integrated motivational interviewing and cognitive behavioural therapy in addition to standard care for patients with psychosis and a comorbid substance use problem. 327 participants were randomly allocated to either the intervention or treatment as usual. Phase one of the intervention, motivation building, concerns engaging the patient, then exploring and resolving ambivalence for change in substance use. Phase two, action, supports and facilitates change using cognitive behavioural approaches. At 24 months, 326 (99.7%) were assessed on the primary outcome and 246 (75.2%) on the main secondary outcomes. The results found that integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and substance misuse did not improve outcome in terms of hospitalisation, symptom outcomes, or functioning. However, it did reduce the amount of substance used for at least one year after completion of therapy.
Group cognitive–behavioural therapy for schizophrenia: randomised controlled trial
- Authors:
- BARROWCLOUGH Christine, et al
- Journal article citation:
- British Journal of Psychiatry, 189(6), December 2006, pp.527-532.
- Publisher:
- Cambridge University Press
The efficacy of cognitive–behavioural therapy for schizophrenia is established, but there is less evidence for a group format. The aim was to evaluate the effectiveness of group cognitive–behavioural therapy for schizophrenia. In all, 113 people with persistent positive symptoms of schizophrenia were assigned to receive group cognitive–behavioural therapy or treatment as usual. The primary outcome was positive symptom improvement on the Positive and Negative Syndrome Scales. Secondary outcome measures included symptoms, functioning, relapses, hopelessness and self-esteem. There were no significant differences between the cognitive–behavioural therapy and treatment as usual on measures of symptoms or functioning or relapse, but group cognitive–behavioural therapy treatment resulted in reductions in feelings of hopelessness and in low self-esteem. Although group cognitive–behavioural therapy may not be the optimum treatment method for reducing hallucinations and delusions, it may have important benefits, including feeling less negative about oneself and less hopeless for the future.
Treatment development for psychosis and co-occurring substance misuse: a descriptive review
- Authors:
- BARROWCLOUGH Christine, et al
- Journal article citation:
- Journal of Mental Health, 15(6), December 2006, pp.619-632.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
It is common for people with psychosis to have co-occurring drug or alcohol problems. This combination of problems is associated with poor outcomes for clients and presents many challenges for services. This review aims to discuss contextual issues underlying treatment difficulties, to briefly review the treatment literature to date and to describe a randomized controlled treatment trial (RCT) currently being conducted in the UK. Consensus agreement emphasizes the need for integrated treatment strategies that match the client's current level of motivation. There have been encouraging results from recent studies evaluating motivational strategies, either alone or in combination with CBT. Whilst for many clients with established illness and substance using histories, brief therapy does not seem to be adequate, longer term interventions show promise. A current RCT evaluating motivational interviewing with CBT is described. The evidence base for treatment recommendations is still quite small. The MIDAS trial will hopefully make a significant contribution to the literature on treatment options for this high risk group.
Attributional style, defensive functioning and persecutory delusions: symptom-specific or general coping strategy?
- Authors:
- HUMPHREYS Lloyd, BARROWCLOUGH Christine
- Journal article citation:
- British Journal of Clinical Psychology, 45(2), June 2006, pp.231-246.
- Publisher:
- Wiley
Previous research has suggested that individuals with persecutory delusions use an exaggerated self-serving bias to protect themselves from real or delusional threats to their underlying self-concept. However, the research to date has been inconsistent thereby limiting the conclusion that can be inferred. A possible explanation for these discrepant findings may be due to the use of measures with questionable validity and reliability such as the Attributional Style Questionnaire and the Rosenberg Self-Esteem Inventory. The present study aims to re-examine this theory using an improved methodology to determine whether defensive functioning is a defining feature of persecutory delusions. Thirty-five participants suffering from recent onset psychosis were assessed in a cross-sectional design. Three tests of attributional style were used, two overt measures (Attributional Style Questionnaire, ASQ; and the Internal Personal and Situational Attributions Questionnaire, IPSAQ) and one covert measure (Pragmatic Inference Test). Self-esteem was measured using the Rosenberg Self-Esteem Inventory (SEI) and a semi-structured interview (Self-Evaluation and Social Support interview – schizophrenia version). A self-serving bias (SSB) was found in the total sample using the ASQ but not specifically in participants with persecutory delusions. In addition, the SSB was unrelated to levels of paranoia on any measure of attributional style. An underlying depressive attributional style was found in both subjects with and without persecutory delusions, but was not associated with levels of paranoia. Lower positive and higher negative self-esteem was associated with increased paranoia and was associated with a SSB. The results indicate that the attributional biases observed in individuals with persecutory delusions are not symptom-specific as previously suggested. The presence of an attributional, SSB was associated with lower psychotic experiences. The theoretical implications of the results will be discussed.
Accident and emergency staff's perceptions of deliberate self-harm: attributions, emotions and willingness to help
- Authors:
- MACKAY Nadine, BARROWCLOUGH Christine
- Journal article citation:
- British Journal of Clinical Psychology, 44(2), June 2005, pp.255-267.
- Publisher:
- Wiley
The study applied Weiner's (1980, 1986) attributional model of helping behaviour to Accident and Emergency (A&E) staff's care of patients presenting with deliberate self-harm. It was hypothesized that where staff attributed precipitants of the act of deliberate self-harm to controllable, internal, and stable patient factors, then staff would display greater negative affect, less optimism, and less willingness to help the patient. Four hypothetical scenarios in a two-factor between-subjects design, contextual factors describing a self-harm patient were manipulated. Participants were 89 A&E medical and nursing staff. They were asked to rate attributions for the cause of the deliberate self-harm and their emotional responses, optimism for change, and willingness to help change the behaviour. Their general attitudes towards deliberate self-harm patients and perceived needs for training in the care of these patients were also assessed. The findings were consistent with Weiner's attributional model of helping. The greater attributions of controllability, the greater the negative affect of staff towards the person, and the less the propensity to help. The higher the ratings of stability of outcome, the less staff optimism for the success of their input. Male staff and medical staff had more negative attitudes, and medical staff saw less need for further training.
An investigation of models of illness in carers of schizophrenia patients using the Illness Perception Questionnaire
- Authors:
- BARROWCLOUGH Christine, et al
- Journal article citation:
- British Journal of Clinical Psychology, 40(4), November 2001, pp.371-385.
- Publisher:
- Wiley
Although carers' reactions to schizophrenic illness in a close family member may have important implications for the patient and for themselves, little is known of factors that influence the way carers respond. This study examines the use of a modified form of the Illness Perception Questionnaire (IPQ) to investigate illness models in a sample of carers of schizophrenia patients. The psychometric properties of the modified IPQ were examined, and a number of carers and patient outcomes were investigated in relation to carer scores on the illness identity, consequences, control-cure and timeline subscales of the modified IPQ. These outcomes included measures of care distress and burden, expressed emotion dimensions, and patient functioning. Results found the modified IPQ was found to be a reliable measure of carers' perceptions of schizophrenia. Carer functioning, the patient-carer relationship and patient illness characteristics were associated with different dimensions of illness perceptions.
Goal planning with elderly people: making plans to meet individual needs
- Authors:
- BARROWCLOUGH Christine, FLEMING Ian
- Publisher:
- Manchester University Press
- Publication year:
- 1985
- Pagination:
- 92p.
- Place of publication:
- Manchester
Assessing cognitive representations of mental health problems. II. The illness perception questionnaire for schizophrenia: relatives' version
- Authors:
- LOBBAN Fiona, BARROWCLOUGH Christine, JONES Steven
- Journal article citation:
- British Journal of Clinical Psychology, 44(2), June 2005, pp.163-179.
- Publisher:
- Wiley
The ways in which relatives respond to patients with a diagnosis of schizophrenia has been shown to impact on outcome. Understanding variation in relatives' responses is essential if successful interventions are to be developed. This study builds on previous research exploring attributions that relatives make about symptoms. The development of a new measure to assess beliefs that relatives have about schizophrenia is reported; The Illness Perception Questionnaire for Schizophrenia – Relatives version (IPQS–Relatives). Sixty-two relatives completed the IPQS–Relatives, along with measures of general psychopathology, burden, appraisal of coping, and expressed emotion. The psychometric properties of the IPQS–Relatives were analysed, including internal consistency, test–retest reliability, and discriminant and concurrent validity. IPQS–Relatives subscales were shown to be internally consistent and stable over time. Correlations with measures of general psychopathology, distress, burden, coping, and criticism indicate that the subscales have good concurrent validity. The study concludes the IPQS–Relatives can be used to assess relatives' beliefs about schizophrenia. This measure may aid family interventions that target beliefs associated with negative outcome for patients and their relatives.
Assessing cognitive representations of mental health problems. I. The illness perception questionnaire for schizophrenia
- Authors:
- LOBBAN Fiona, BARROWCLOUGH Christine, JONES Steven
- Journal article citation:
- British Journal of Clinical Psychology, 44(2), June 2005, pp.147-162.
- Publisher:
- Wiley
Personal beliefs about health problems have been reliably associated with emotional and behavioural responses to those health problems and health outcomes. This area has been extensively explored in relation to physical health, but somewhat neglected in mental health. In this study, a questionnaire designed to assess key beliefs about physical illness (the Illness Perception Questionnaire – Revised) was modified for use in exploring beliefs about schizophrenia. The new measure was termed the Illness Perception Questionnaire for Schizophrenia (IPQS). Participants were 124 people with a diagnosis of schizophrenia who completed the IPQS and additional measures to assess symptom severity, emotional state, and attitudes towards medication. The psychometric properties of the IPQS were analysed, including internal consistency, test–retest reliability, and discriminant and concurrent validity.The IPQS subscales were shown to be internally reliable, and reliable over time. Correlations with measures of symptom severity, emotional state, and attitudes towards adherence to medication showed that the subscales were measuring the constructs that they were designed to measure. The study concludes that the IPQS is a reliable and valid measure of cognitive representations of mental health problems held by people with a diagnosis of schizophrenia.