British Journal of Clinical Psychology, 56(3), 2017, pp.310-328.
Publisher:
Wiley
Background: Personal recovery is recognized as an important outcome for individuals with bipolar disorder (BD) and is distinct from symptomatic and functional recovery. Recovery-focused psychological therapies show promise. As with therapies aiming to delay relapse and improve symptoms, research on the psychological mechanisms underlying recovery is crucial to inform effective recovery-focused therapy. However, empirical work is limited. This study investigated whether negative beliefs about mood swings and self-referent appraisals of mood-related experiences were negatively associated with personal recovery.
Design: Cross-sectional online survey.
Method: People with a verified research diagnosis of BD (n = 87), recruited via relevant voluntary sector organizations and social media, completed online measures. Pearson's correlations and multiple regression analysed associations between appraisals, beliefs, and recovery.
Results: Normalizing appraisals of mood changes were positively associated with personal recovery. Depression, negative self-appraisals of depression-relevant experiences, extreme positive and negative appraisals of activated states, and negative beliefs about mood swings had negative relationships with recovery. After controlling for current mood symptoms, negative illness models, being employed and recent experience of depression predicted recovery.
Limitations: Due to the cross-sectional design, causality cannot be determined. Participants were a convenience sample primarily recruited online. Power was limited by the sample size.
Conclusions: Interventions aiming to empower people to feel able to manage mood and catastrophize less about mood swings could facilitate personal recovery in people with BD, which might be achieved in recovery-focused therapy.
(Edited publisher abstract)
Background: Personal recovery is recognized as an important outcome for individuals with bipolar disorder (BD) and is distinct from symptomatic and functional recovery. Recovery-focused psychological therapies show promise. As with therapies aiming to delay relapse and improve symptoms, research on the psychological mechanisms underlying recovery is crucial to inform effective recovery-focused therapy. However, empirical work is limited. This study investigated whether negative beliefs about mood swings and self-referent appraisals of mood-related experiences were negatively associated with personal recovery.
Design: Cross-sectional online survey.
Method: People with a verified research diagnosis of BD (n = 87), recruited via relevant voluntary sector organizations and social media, completed online measures. Pearson's correlations and multiple regression analysed associations between appraisals, beliefs, and recovery.
Results: Normalizing appraisals of mood changes were positively associated with personal recovery. Depression, negative self-appraisals of depression-relevant experiences, extreme positive and negative appraisals of activated states, and negative beliefs about mood swings had negative relationships with recovery. After controlling for current mood symptoms, negative illness models, being employed and recent experience of depression predicted recovery.
Limitations: Due to the cross-sectional design, causality cannot be determined. Participants were a convenience sample primarily recruited online. Power was limited by the sample size.
Conclusions: Interventions aiming to empower people to feel able to manage mood and catastrophize less about mood swings could facilitate personal recovery in people with BD, which might be achieved in recovery-focused therapy.
(Edited publisher abstract)
Subject terms:
bipolar disorder, depression, recovery, therapy and treatment;
Journal of Mental Health, 29(1), 2020, pp.103-115.
Publisher:
Taylor and Francis
Place of publication:
London
Background: Despite extensive literature examining perceptions of recovery from severe mental illness, literature focusing on recovery from depression in adults is limited. Aim: Systematically review the existing literature investigating patients’ and clinicians’ perceptions of, and factors associated with, recovery from depression. Method: Studies investigating perceptions of, and factors associated with, recovery from depression in adults were identified through database searches. Studies were assessed against inclusion criteria and quality rating checklists. Results: Fourteen studies met the inclusion criteria. Recovery from depression is perceived as a complex, personal journey. The concept of normalised, biomedical definitions of recovery is not supported, with the construction of self and societal gender expectations identified by women as central to recovery.Recovery from depression was associated with higher levels of perceived social support and group memberships. A range of factors are identified as influencing recovery. However, physicians and patients prioritise different factors assessing what is important in being “cured” from depression. Conclusions: Recovery from depression is perceived by patients as a complex, personal process, influenced by a range of factors. However, greater understanding of clinicians’ perceptions of client recovery from depression is essential to inform clinical practice and influence future research.
(Publisher abstract)
Background: Despite extensive literature examining perceptions of recovery from severe mental illness, literature focusing on recovery from depression in adults is limited. Aim: Systematically review the existing literature investigating patients’ and clinicians’ perceptions of, and factors associated with, recovery from depression. Method: Studies investigating perceptions of, and factors associated with, recovery from depression in adults were identified through database searches. Studies were assessed against inclusion criteria and quality rating checklists. Results: Fourteen studies met the inclusion criteria. Recovery from depression is perceived as a complex, personal journey. The concept of normalised, biomedical definitions of recovery is not supported, with the construction of self and societal gender expectations identified by women as central to recovery. Recovery from depression was associated with higher levels of perceived social support and group memberships. A range of factors are identified as influencing recovery. However, physicians and patients prioritise different factors assessing what is important in being “cured” from depression. Conclusions: Recovery from depression is perceived by patients as a complex, personal process, influenced by a range of factors. However, greater understanding of clinicians’ perceptions of client recovery from depression is essential to inform clinical practice and influence future research.
(Publisher abstract)
Subject terms:
depression, mental health, mental health problems, recovery, gender, systematic reviews, user views;
International Journal of Geriatric Psychiatry, 33(7), 2018, pp.875-882.
Publisher:
Wiley
Objective: Depression after hip fracture in older adults is associated with worse physical performance; however, depressive symptoms are dynamic, fluctuating during the recovery period. The study aim was to determine how the persistence of depressive symptoms over time cumulatively affects the recovery of physical performance. Methods: Marginal structural models estimated the cumulative effect of persistence of depressive symptoms on gait speed during hip fracture recovery among older adults (n = 284) enrolled in the Baltimore Hip Studies 7th cohort. Depressive symptoms at baseline and at 2‐month and 6‐month postadmission for hip fracture were evaluated by using the Center for Epidemiological Studies Depression Scale, and persistence of symptoms was assessed as a time‐averaged severity lagged hip fracture has a meaningful impact on functional recovery.
(Edited publisher abstract)
Objective: Depression after hip fracture in older adults is associated with worse physical performance; however, depressive symptoms are dynamic, fluctuating during the recovery period. The study aim was to determine how the persistence of depressive symptoms over time cumulatively affects the recovery of physical performance. Methods: Marginal structural models estimated the cumulative effect of persistence of depressive symptoms on gait speed during hip fracture recovery among older adults (n = 284) enrolled in the Baltimore Hip Studies 7th cohort. Depressive symptoms at baseline and at 2‐month and 6‐month postadmission for hip fracture were evaluated by using the Center for Epidemiological Studies Depression Scale, and persistence of symptoms was assessed as a time‐averaged severity lagged to standardized 3 m gait speed at 2, 6, and 12 months. Results: A 1‐unit increase in time‐averaged Center for Epidemiological Studies Depression score was associated with a mean difference in gait speed of −0.0076 standard deviations (95% confidence interval [CI]: −0.0184, 0.0032; P = .166). The association was largest in magnitude from baseline to 6 months: −0.0144 standard deviations (95% CI: −0.0303, 0.0015; P = 0.076). Associations for the other time intervals were smaller: −0.0028 standard deviations (95% CI: −0.0138, 0.0083; P = .621) at 2 months and −0.0121 standard deviations (95% CI: −0.0324, 0.0082; P = .238) at 12 months. Conclusion: Although not statistically significant, the magnitude of the numerical estimates suggests that expressing more depressive symptoms during the first 6 months after hip fracture has a meaningful impact on functional recovery.
(Edited publisher abstract)
Subject terms:
ageing, depression, very old people, older people, mobility, recovery, physical illness;
Mental Health Review Journal, 20(1), 2015, pp.28-35.
Publisher:
Emerald
Purpose: The NHS Improving Access to Psychological Therapies (IAPT) programme provides access to psychotherapy in England through a stepped care approach for adults with depression and anxiety disorders. This evaluation sought to investigate IAPT recovery and reliable change rates of those who scored severe on depression (PHQ-9), anxiety (GAD-7) or impaired functioning (WASA). per cent (n=14,612) in the GAD-7 severe range; with 14 per cent (n=3,548) in the severe range on all three measures combined. There were significant falls on all three measures and a large effect size. The percentage of patients who recovered to a point below the recovery threshold was 30 per cent for depression, 34 per cent for anxiety, 18 per cent for impaired functioning, and for those presenting severe on all measures: recovery rates were 21 per cent for anxiety, 26 per cent for depression, and 15 per cent for impaired functioning. Reliable change for anxiety was found to be greater than IAPT patients overall.
Originality/value: The results show that IAPT enables approximately a third of people scoring severe to recover, lower than IAPT recovery rates overall. Reliable change may be a more
(Edited publisher abstract)
Purpose: The NHS Improving Access to Psychological Therapies (IAPT) programme provides access to psychotherapy in England through a stepped care approach for adults with depression and anxiety disorders. This evaluation sought to investigate IAPT recovery and reliable change rates of those who scored severe on depression (PHQ-9), anxiety (GAD-7) or impaired functioning (WASA).
Design/methodology/approach: This evaluation employed a within groups design: a single case evaluation follow-up. Routine service data (from services set-up in 2008-2009 to February 2012) from 25,034 patients treated at four IAPT services was analysed.
Findings: The analysis revealed that 29 per cent (n=7,059) of patients were assessed as being in the WASA severe range, 41 per cent (n=10,208) in the PHQ severe range, and 57 per cent (n=14,612) in the GAD-7 severe range; with 14 per cent (n=3,548) in the severe range on all three measures combined. There were significant falls on all three measures and a large effect size. The percentage of patients who recovered to a point below the recovery threshold was 30 per cent for depression, 34 per cent for anxiety, 18 per cent for impaired functioning, and for those presenting severe on all measures: recovery rates were 21 per cent for anxiety, 26 per cent for depression, and 15 per cent for impaired functioning. Reliable change for anxiety was found to be greater than IAPT patients overall.
Originality/value: The results show that IAPT enables approximately a third of people scoring severe to recover, lower than IAPT recovery rates overall. Reliable change may be a more effective measure of patient progress.
(Edited publisher abstract)
Subject terms:
psychotherapy, anxiety, recovery, depression, outcomes, ecotherapy, mental health problems;
Journal of Substance Use, 21(4), 2016, pp.344-348.
Publisher:
Taylor and Francis
Background and objectives: Twelve-step based interventions promote the recovery from alcohol dependence, support relapse prevention and are associated with improved mental status indices (e.g. depression). This treatment model largely relies on spiritual experience. The authors tested three different alcohol treatment settings, which differently involve elements of spirituality in order to reveal
(Edited publisher abstract)
Background and objectives: Twelve-step based interventions promote the recovery from alcohol dependence, support relapse prevention and are associated with improved mental status indices (e.g. depression). This treatment model largely relies on spiritual experience. The authors tested three different alcohol treatment settings, which differently involve elements of spirituality in order to reveal its possible mediator effect on the level of depressive and anxiety symptoms. Methods: Patients were involved from (1) detoxification (n = 34), (2) long-term – 12-step based – therapeutic community treatment (n = 89), (3) and from Alcoholics Anonymous (AA) groups after at least 3 years of attendance (n = 46). Anxiodepressive symptoms and spirituality/transcendence were compared and the potential mediator role of spirituality was assessed in the levels of depressive and anxiety symptoms. Results: Long-term 12-step based rehabilitation and sustained AA attendance was connected to lower levels of anxiodepressive symptoms and to more pronounced spirituality. The spiritual component of the different treatments played a mediator role in the decrease of state anxiety but this mediation was not detected in the case of depressive symptoms and trait anxiety. Conclusions/Importance: The role of spirituality in the decrease of state anxiety indicates acute beneficial effect. Therefore, long term, regular attendance in AA groups is essential
(Edited publisher abstract)
Mental Health Review Journal, 20(4), 2015, pp.242-255.
Publisher:
Emerald
... contribution to the recovery services in mental health.
(Edited publisher abstract)
Purpose: There is growing interest in self-management support for people living with mental health problems. This paper describes the evaluation of a co-designed and co-delivered self-management programme (SMP) for people living with depression delivered as part of large scale National Health Service quality improvement programme, which was grounded in the principles of co-production. The authors investigated whether participants became more activated, were less psychologically distressed enjoyed better health status, and quality of life, and improved their self-management skills after attending the seven-week SMP.
Design/methodology/approach: The authors conducted a longitudinal study of 114 people living with depression who attended the SMP. Participants completed self-reported measures before attending the SMP and at six months follow up.
Findings: Patient activation significantly improved six months after the SMP. Participants’ experience of depression symptoms as measured by the Patient Health Questionnaire-9 significantly reduced. Participants’ anxiety and depression as measured by the Hospital Anxiety Depression Scale also decreased significantly. The authors also observed significant improvement in participants’ health status, and health-related quality of life. About 35 per cent of participant showed substantial improvements of self-management skills.
Originality/value: The co-produced depression SMP is innovative in a UK mental health setting. Improvements in activation, depression, anxiety, quality of life and self-management skills suggest that the SMP could make a useful contribution to the recovery services in mental health.
(Edited publisher abstract)
Subject terms:
self care, depression, co-production, recovery, intervention, evaluation, anxiety, quality of life, service development, service users;
Journal of Aggression Maltreatment and Trauma, 24(8), 2015, pp.876-896.
Publisher:
Taylor and Francis
Social support represents an important recovery factor for individuals with posttraumatic stress disorder (PTSD). Nevertheless, partners, family, and friends who take on the role of caregiver for individuals with PTSD might face multiple difficulties. For example, they are at risk for developing anxiety and depressive symptoms, which could negatively affect their ability to offer support.
(Edited publisher abstract)
Social support represents an important recovery factor for individuals with posttraumatic stress disorder (PTSD). Nevertheless, partners, family, and friends who take on the role of caregiver for individuals with PTSD might face multiple difficulties. For example, they are at risk for developing anxiety and depressive symptoms, which could negatively affect their ability to offer support. This study examined the associations between the difficulties of individuals with PTSD (i.e., symptoms and level of functioning), their caregivers’ (partners, family, and friends) anxiety and depressive symptoms, and social support behaviours according to 2 variables: relationship status and gender. Sixty-five individuals with PTSD and either their partner, family member, or friend filled out questionnaires and participated in a trauma-oriented discussion. Social support behaviours were coded. Results revealed no associations between the difficulties of individuals with PTSD and their caregivers’ symptoms. However, caregivers’ depressive symptoms were negatively associated with the quality of some of their social support behaviours. Moreover, relationship status and gender were significant moderators, indicating stronger negative associations between anxiety and depressive symptoms and some social support behaviours of men and caregiving partners. Male caregivers could have difficulties offering appropriate support and responding to traditional masculine roles (e.g., being strong and self-reliant) when they report symptoms themselves. Partners are particularly involved in the everyday life of individuals with PTSD. Thus, they could have difficulties keeping an optimal emotional distance to offer support when they report symptoms themselves. Future directions as well as clinical implications are discussed.
(Edited publisher abstract)
Subject terms:
post traumatic stress disorder, partners, stress, mental health problems, family members, recovery, carers, informal care, gender, depression;
Social Work in Mental Health, 13(5), 2015, pp.439-458.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
... processes. Four themes emerged from data supporting recovery: the confident working relationship, time and hiatus for finding one’s own authenticity, successful timing of interventions, and a holistic view of life. This article emphasises the importance of taking into account the expertise of clients. Through these subjective experiences of clients, it is possible for social workers as an expert of social
(Edited publisher abstract)
The aim in this article is to discover means to develop social work in mental health services by analysing reflections on encounters between professionals and people recovering from major depression. This is analysed through lived experiences of two service users. The approach lies on expertise by experiences, and as data were blog-texts which are seen as a novel arena to reflect recovering processes. Four themes emerged from data supporting recovery: the confident working relationship, time and hiatus for finding one’s own authenticity, successful timing of interventions, and a holistic view of life. This article emphasises the importance of taking into account the expertise of clients. Through these subjective experiences of clients, it is possible for social workers as an expert of social determinants of health, to develop services.
(Edited publisher abstract)
Subject terms:
mental health problems, social work, mental health services, depression, social worker-service user relationships, social workers, recovery, service users;