Expressed emotion, attributions, utility beliefs, and distress in parents of young people with first episode psychosis

2007 ◽  
Vol 151 (1-2) ◽  
pp. 97-106 ◽  
Author(s):  
Catharine McNab ◽  
Nick Haslam ◽  
Peter Burnett
Keyword(s):  
Young People ◽  
Expressed Emotion ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis

Longitudinal relationship between expressed emotion and cannabis misuse in young people with first-episode psychosis

2015 ◽  
Vol 30 (1) ◽  
pp. 20-25 ◽  
Author(s):  
C. González-Blanch ◽  
J.F. Gleeson ◽  
S.M. Cotton ◽  
K. Crisp ◽  
P.D. McGorry ◽  
...  
Keyword(s):  
Young People ◽  
Family Environment ◽  
Temporal Relationship ◽  
Expressed Emotion ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Substance Involvement ◽  
Over Time

AbstractCarers’ expressed emotion (EE) and patients’ cannabis misuse are two of the most robust predictors of psychotic relapse. We aimed to examine the temporal relationship between EE and cannabis misuse. Sixty-three key carers of young people with first-episode psychosis (FEP) were assessed at baseline and 7-month follow-up. EE was measured in carers using the Family Questionnaire (FQ) and cannabis misuse in patients using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Correlational and hierarchical logistic regression analyses were conducted to examine the temporal relationship between EE components (i.e. criticism and emotional over involvement) and cannabis misuse. Carers’ criticism at baseline significantly predicted cannabis misuse according to the ASSIST at 7-month follow-up. The association remained significant after controlling for baseline symptom severity and social functioning (B = 0.15, P = .02). Conversely, baseline cannabis misuse was not associated with carers’ criticism at 7-month follow-up. Patients in families with high criticism showed a tendency to increase cannabis misuse over time whereas the opposite trend was observed in those with carers with low criticism. A family environment characterized by high criticism may become a key risk factor for worsening cannabis misuse over time in young people with FEP. Further studies should investigate the potential mechanisms (e.g., patient's anxiety or perceived stress) through which criticism increases cannabis misuse in FEP.

A comparison of experiences of care and expressed emotion among caregivers of young people with first-episode psychosis or borderline personality disorder features

2021 ◽  
pp. 000486742110502
Author(s):  
Sue M Cotton ◽  
Jennifer K Betts ◽  
Dina Eleftheriadis ◽  
Kate Filia ◽  
Mirra Seigerman ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Young People ◽  
Expressed Emotion ◽  
First Episode Psychosis ◽  
Borderline Personality ◽  
First Episode ◽  
Negative Experiences ◽  
Episode Psychosis ◽  
Caregiver Experiences

Objective: Caregivers of individuals with severe mental illness often experience significant negative experiences of care, which can be associated with higher levels of expressed emotion. Expressed emotion is potentially a modifiable target early in the course of illness, which might improve outcomes for caregivers and patients. However, expressed emotion and caregiver experiences in the early stages of disorders might be moderated by the type of severe mental illness. The aim was to determine whether experiences of the caregiver role and expressed emotion differ in caregivers of young people with first-episode psychosis versus young people with ‘first-presentation’ borderline personality disorder features. Method: Secondary analysis of baseline (pre-treatment) data from three clinical trials focused on improving caregiver outcomes for young people with first-episode psychosis and young people with borderline personality disorder features was conducted (ACTRN12616000968471, ACTRN12616000304437, ACTRN12618000616279). Caregivers completed self-report measures of experiences of the caregiver role and expressed emotion. Multivariate generalised linear models and moderation analyses were used to determine group differences. Results: Data were available for 265 caregivers. Higher levels of negative experiences and expressed emotion, and stronger correlations between negative experiences and expressed emotion domains, were found in caregivers of young people with borderline personality disorder than first-episode psychosis. Caregiver group (borderline personality disorder, first-episode psychosis) moderated the relationship between expressed emotion and caregiver experiences in the domains of need to provide backup and positive personal experiences. Conclusion: Caregivers of young people with borderline personality disorder experience higher levels of negative experiences related to their role and expressed emotion compared with caregivers of young people with first-episode psychosis. The mechanisms underpinning associations between caregiver experiences and expressed emotion differ between these two caregiver groups, indicating that different supports are needed. For borderline personality disorder caregivers, emotional over-involvement is associated with both negative and positive experiences, so a more detailed understanding of the nature of emotional over-involvement for each relationship is required to guide action.

Views of Young People in Early Intervention Services for First-Episode Psychosis in England

2011 ◽  
Vol 62 (8) ◽  
pp. 882-887 ◽  
Author(s):  
Helen Lester ◽  
Max Marshall ◽  
Peter Jones ◽  
David Fowler ◽  
Tim Amos ◽  
...  
Keyword(s):  
Early Intervention ◽  
Young People ◽  
First Episode Psychosis ◽  
First Episode ◽  
Early Intervention Services ◽  
Episode Psychosis ◽  
Intervention Services

Suicide Prevention in First Episode Psychosis: The Development of a Randomised Controlled Trial of Cognitive Therapy for Acutely Suicidal Patients With Early Psychosis

2003 ◽  
Vol 37 (4) ◽  
pp. 414-420 ◽  
Author(s):  
P.J.R. Power ◽  
R.J. Bell ◽  
R. Mills ◽  
T. Herrman-Doig ◽  
M. Davern ◽  
...  
Keyword(s):  
Early Intervention ◽  
Treatment Group ◽  
Young People ◽  
Controlled Trial ◽  
First Episode Psychosis ◽  
Early Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Randomised Controlled ◽  
Suicidal Patients

Background: Young people with early psychosis are at particularly high risk of suicide. However, there is evidence that early intervention can reduce this risk. Despite these advances, first episode psychosis patients attending these new services still remain at risk. To address this concern, a program called LifeSPAN was established within the Early Psychosis Prevention and Intervention Centre (EPPIC). The program developed and evaluated a number of suicide prevention strategies within EPPIC and included a cognitively oriented therapy (LifeSPAN therapy) for acutely suicidal patients with psychosis. We describe the development of these interventions in this paper. Method: Clinical audit and surveys provided an indication of the prevalence of suicidality among first episode psychosis patients attending EPPIC. Second, staff focus groups and surveys identified gaps in service provision for suicidal young people attending the service. Third, a suicide risk monitoring system was introduced to identify those at highest risk. Finally, patients so identified were referred to and offered LifeSPAN therapy whose effectiveness was evaluated in a randomised controlled trial. Results: Fifty-six suicidal patients with first episode psychosis were randomly assigned to standard clinical care or standard care plus LifeSPAN therapy. Forty-two patients completed the intervention. Clinical ratings and measures of suicidality and risk were assessed before, immediately after the intervention, and 6 months later. Benefits were noted in the treatment group on indirect measures of suicidality, e.g., hopelessness. The treatment group showed a greater average improvement (though not significant) on a measure of suicide ideation. Conclusions: Early intervention in psychosis for young people reduces the risk of suicide. Augmenting early intervention with a suicide preventative therapy may further reduce this risk.

Characterising Usage of a Multicomponent Digital Intervention to Predict Treatment Outcomes in First-Episode Psychosis: A Cluster Analysis (Preprint)

2021 ◽  
Author(s):  
Shaunagh O'Sullivan ◽  
Lianne Schmaal ◽  
Simon D'Alfonso ◽  
Yara J Toenders ◽  
Lee Valentine ◽  
...  
Keyword(s):  
Young People ◽  
Treatment Outcomes ◽  
Social Functioning ◽  
Negative Symptoms ◽  
User Profile ◽  
First Episode Psychosis ◽  
First Episode ◽  
User Profiles ◽  
Episode Psychosis ◽  
Social Components

BACKGROUND Multicomponent digital interventions offer the potential for tailored and flexible interventions that aim to address high attrition rates and increase engagement, an area of concern in digital mental health. However, increased flexibility in usage makes it difficult to determine which components lead to improved treatment outcomes. OBJECTIVE This study aimed to identify user profiles on Horyzons, an 18-month digital relapse prevention intervention that incorporates therapeutic content and social networking, along with clinical, vocational and peer support, and to examine the predictive value of these user profiles for treatment outcomes. A secondary objective was to compare each user profile with young people receiving treatment as usual (TAU). METHODS Participants comprised 82 young people (16-27 years of age) with access to Horyzons and 84 receiving TAU, recovering from first-episode psychosis. Six-month usage data from the therapy and social networking components of Horyzons were used as features for K-means clustering for joint trajectories to identify user profiles. Social functioning, psychotic symptoms, depression and anxiety were assessed at baseline and six-month follow-up. General linear mixed models were used to examine the predictive value of user profiles for treatment outcomes, and between each user profile with TAU. RESULTS Three user profiles were identified based on system usage metrics including: (a) low usage; (b) maintained usage of social components; and (c) maintained usage of both therapy and social components. The maintained therapy and social group showed improvements in social functioning (F (2, 51) = 3.58; P = .04), negative symptoms (F (2, 51) = 4.45; P = .02) and overall psychiatric symptom severity (F (2, 50) = 3.23; P = .048) compared to the other user profiles. This group also showed improvements in social functioning (F (1, 62) = 4.68; P = .03), negative symptoms (F (1, 62) = 14.61; P = <.001) and overall psychiatric symptom severity (F (1, 63) = 5.66; P = .02) compared to TAU. Conversely, the maintained social group showed increases in anxiety compared to TAU (F (1, 57) = 7.65; P = .01). No differences were found between the low usage group and TAU on treatment outcomes. CONCLUSIONS Continued engagement with both therapy and social components might be key in achieving long-term recovery. Maintained social usage and low usage outcomes were broadly comparable to TAU, emphasizing the importance of maintaining engagement for improved treatment outcomes. Although the social network may be a key ingredient to increase sustained engagement, as users engaged with this more consistently, it should be leveraged as a tool to engage young people with therapeutic content to bring about social and clinical benefits.

What Is Psychosis?

2021 ◽  
pp. 3-16
Author(s):  
Beth Broussard ◽  
Michael T. Compton
Keyword(s):  
Mental Illness ◽  
Young People ◽  
First Episode Psychosis ◽  
Initial Evaluation ◽  
Treatment Programs ◽  
First Episode ◽  
Her Family ◽  
Episode Psychosis ◽  
The Individual ◽  
Work Goals

This first chapter explains what psychosis is. Psychosis is a treatable mental illness. For many people with first-episode psychosis, symptoms begin to clear up partially or completely within weeks of starting treatment. Although the symptoms of psychosis may be frightening to the individual and his or her family, there are treatments for these symptoms. First-episode psychosis is the period of time when a person first begins to experience psychosis. It is during this time that young people and their families need detailed information about the initial evaluation and treatment. People who get into treatment earlier often do better. In many places, specialty treatment programs now exist that specifically focus on first-episode psychosis. Those programs often provide treatments designed to help young people get back on track in terms of school and work goals.

scholarly journals F129. FAMILY PHYSICIAN ACCESS AMONG YOUNG PEOPLE WITH FIRST-EPISODE PSYCHOSIS

2019 ◽  
Vol 45 (Supplement_2) ◽  
pp. S303-S303 ◽  
Author(s):  
Kelly Anderson ◽  
Suzanne Archie ◽  
Richard Booth ◽  
Chiachen Cheng ◽  
Arlene MacDougall ◽  
...  
Keyword(s):  
Young People ◽  
Family Physician ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis
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