Lack of Insight in Psychosis: Theoretical Concepts and Clinical Aspects

2013 ◽  
Vol 42 (3) ◽  
pp. 327-338 ◽  
Author(s):  
Moninne McCormack ◽  
Kevin Tierney ◽  
Daria Brennan ◽  
Elizabeth Lawlor ◽  
Mary Clarke
Keyword(s):  
English Language ◽  
Behavioural Therapy ◽  
Clinical Aspects ◽  
Measurement Scales ◽  
Theoretical Concepts ◽  
Cognitive Behavioural ◽  
Assessment Measure ◽  
Research Findings ◽  
Comprehensive Search ◽  
The Impact

Background: Different theories concerning pathways to insight have been proposed which underpin the numerous assessment measures. Cognitive behavioural therapy (CBT) is one treatment approach that has been used to improve insight. Aims: The aim of this review was to promote a greater focus on developing effective CBT strategies to ameliorate insight in psychosis through the exploration of the concept of insight in psychosis and evaluation of research in the area. Method: A comprehensive search and review of published studies examining the impact of CBT on insight in psychosis was conducted. We searched the databases PubMed, Medline, PsychInfo, the Psychology and Behavioral Sciences Database, and CINAHL with limits set to 10 years, humans, and English language. We hand-searched reference lists of major studies on insight, and theoretical review papers. We filtered our results according to relevance and chose 50 papers for final consideration. Results: The multidimensionality of insight is reflected in the variety of different insight measures in clinical use. Research findings on the impact of CBT on insight are conflicting. Cognitive insight and clinical insight appear to be different concepts that are not fully captured by existing measurement scales. Conclusions: The conflicting results found in research examining the impact of CBT on insight may be partially explained by the different theories underpinning insight in psychosis communicated through psychoeducation in CBT. Furthermore, the use of more than one insight assessment measure may capture the complexity of insight more effectively. Qualitative research with service users would enrich the knowledge in this area.

The Efficacy of Traditional Cognitive Behavioural Therapy for Depressed Adults with Anhedonia: A Systematic Review

2021 ◽  
Vol 7 (5) ◽  
pp. 520-544
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioural Therapy ◽  
Primary Outcome ◽  
Behavioural Therapy ◽  
Major Depressive ◽  
Eligibility Criteria ◽  
Cognitive Behavioural ◽  
System Therapy ◽  
Randomised Controlled ◽  
The Impact

To date, the impact of traditional cognitive behavioural therapy (CBT) on anhedonia in major depressive disorder (MDD) has yet been systematically evaluated. This systematic review aims to examine the efficacy of traditional CBT for depressed adults with anhedonia. A literature search for randomised controlled trials of traditional CBT in adults with MDD from inception to July 2020 was conducted in 8 databases. The primary outcome was the levels of anhedonia. Ten studies with adults with MDD met the eligibility criteria. Our results indicate that traditional CBT is as effective as euthymic therapy, positive psychology therapy, self-system therapy,and medications for anhedonia in depression. Besides, our data provide further support for the development of augmented CBT to optimise treatment outcome for depressed adults with anhedonia. Received 11th June 2021; Revised 2nd September 2021; Accepted 20th September 2021

scholarly journals ‘Felt security’ as a means of facilitating imagery rescripting in psychosis: a clinical protocol and illustrative case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Katherine Newman-Taylor
Keyword(s):  
Behavioural Therapy ◽  
Illustrative Case ◽  
Imagery Task ◽  
List Type ◽  
Short Term ◽  
Cognitive Behavioural ◽  
Imagery Rescripting ◽  
Illustrative Case Study ◽  
The Impact

Abstract People with psychosis do not have routine access to trauma-focused cognitive behavioural therapy (CBT) interventions such as imagery rescripting (IR), partly due to clinical caution. This case study describes the use of a simple imagery task designed to engender ‘felt security’, as a means of facilitating IR with a woman struggling with distressing memory intrusions, linked to her voices and paranoia. We assessed the impact of the felt security task, which was used before IR to enable Kip to engage in reprocessing of her trauma memories, and again after IR so that she would leave sessions feeling safe. The brief imagery task was effective in improving felt security before IR sessions. Felt security then reduced during IR, when distressing material was recalled and reprocessed, and increased again when the task was repeated. It is not yet clear whether trauma-focused interventions such as IR need to be routinely adapted for people with psychosis. In the event that individuals express concerns about IR, if the person’s formulation indicates that high levels of arousal may trigger an exacerbation of voices, paranoia or risk, or where clinicians are otherwise concerned about interventions likely to increase emotional arousal in the short term, the felt security task may facilitate safe and effective reprocessing of trauma memories. This in turn may increase access to trauma-focused CBT for people with psychosis. Key learning aims (1) To understand that people with psychosis need access to trauma-focused CBT. (2) To be familiar with a simple attachment-based imagery task designed to foster ‘felt security’. (3) To learn that this task may facilitate imagery rescripting in people with psychosis.

scholarly journals Adapted CBT to Stabilize Sleep on Psychiatric Wards: a Transdiagnostic Treatment Approach

2018 ◽  
Vol 46 (6) ◽  
pp. 661-675 ◽  
Author(s):  
Bryony Sheaves ◽  
Louise Isham ◽  
Jonathan Bradley ◽  
Colin Espie ◽  
Alvaro Barrera ◽  
...  
Keyword(s):  
Behavioural Therapy ◽  
Psychiatric Ward ◽  
Night Time ◽  
Sleep Monitoring ◽  
Transdiagnostic Treatment ◽  
Cognitive Behavioural ◽  
Clinically Significant ◽  
Almost All ◽  
The Impact ◽  
Acute Crisis

Background: Almost all patients admitted at acute crisis to a psychiatric ward experience clinically significant symptoms of insomnia. Ward environments pose challenges to both sleep and the delivery of therapy. Despite this, there is no description of how to adapt cognitive behavioural therapy (CBT) for insomnia to overcome these challenges. Aims: (i) To describe the key insomnia presentations observed in the Oxford Ward Sleep Solution (OWLS) trial and (ii) outline key adaptations aimed to increase accessibility and hence effectiveness of CBT for insomnia for a ward setting. Methods: Trial therapists collaboratively agreed the key insomnia presentations and therapy adaptations based on their individual reflective logs used during the trial. Results: Three key insomnia presentations are outlined. These are used to illustrate the application of 10 CBT for insomnia therapy adaptations. These include use of sleep monitoring watches to engage patients in treatment, stabilizing circadian rhythms, reducing the impact of night-time observations and managing discharge as a sleep challenge. Conclusions: Whilst inpatient wards bring challenges for sleep and therapy delivery, creative adaptations can increase the accessibility of evidence based CBT for insomnia techniques. This therapy has proven popular with patients.

scholarly journals Effect of psychiatric disorders on outcome of cognitive-behavioural therapy for chronic fatigue syndrome

2005 ◽  
Vol 187 (2) ◽  
pp. 184-185 ◽  
Author(s):  
Judith Prins ◽  
Gijs Bleijenberg ◽  
Eufride Klein Rouweler ◽  
Jos Van Der Meer
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Psychiatric Disorders ◽  
Cognitive Behavioural Therapy ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Psychiatric Diagnoses ◽  
Psychiatric Interview ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
The Impact

SummaryPsychiatric disorders have been associated with poor outcome in individuals with chronic fatigue syndrome (CFS). This study examines the impact of psychiatric disorders on outcome of cognitive-behavioural therapy (CBT). Psychiatric diagnoses were assessed with a structured psychiatric interview in a CBT trial of 270 people with CFS. Lifetime and current psychiatric disorders were found in 50 and 32% respectively. No significant differences in fatigue severity and functional impairment following treatment were found between participants with and without psychiatric diagnoses.

scholarly journals The success of e-commerce startups: an empirical study in Vietnam

2021 ◽  
Vol 9 (3) ◽  
pp. 622-645
Author(s):  
Quoc Trung Pham ◽  
Dinh Khang Pham
Keyword(s):  
Empirical Study ◽  
Risk Taking ◽  
High Rate ◽  
Business Failure ◽  
Impact Factors ◽  
Measurement Scales ◽  
Achievement Orientation ◽  
Managerial Implications ◽  
Research Findings ◽  
The Impact

Objective of the study: Although many e-commerce startups have been established in recent years, there is a high rate of business failure in start-up community. In addition, e-commerce in Vietnam is still at a beginning stage with many potentials and risks. The research aims to find impact factors which lead to the success of e-commerce startups in Vietnam.Methodology/approach: The qualitative method was applied to identify appropriate measurement scales. Then, the quantitative questionnaire survey was leveraged to test the research framework based on data from local e-commerce startups.Originality/Relevance: This research focuses on evaluating the impact of founder factors, e-service factors, and external factors on the success of startups in Vietnam.Main results: Research findings show that four factors have significant contribution to e-commerce startups’ success including risk-taking propensity, achievement orientation, reliability of e-service quality, and e-networking. Among the four, risk-taking propensity is the most contributed factor in e-commerce startups’ success.Theoretical/methodological contributions: The study helps to test the measurement scales and contributes an empirical study regarding to the success of startups in a developing country like Vietnam.Social/management contributions: Managerial implications for e-commerce incubators, entrepreneurs, and government are also recommended to improve the success rate of e-commerce startups in Vietnam.

scholarly journals A qualitative study of patients’ experiences and acceptance of computerised cognitive behavioural therapy in primary care, Scotland

2021 ◽  
Vol 14 ◽  
Author(s):  
Eliane Du ◽  
Ethel Quayle ◽  
Hamish Macleod
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Information Dissemination ◽  
Behavioural Therapy ◽  
Routine Care ◽  
Computer Assisted ◽  
List Type ◽  
Access To Treatment ◽  
Cognitive Behavioural ◽  
Qualitative Exploration ◽  
The Impact

Abstract Computerised cognitive behavioural therapy (CCBT) has been made available within the National Health Service (NHS) across Scotland as an alternative treatment for mild to moderate anxiety and depression. However, the provision of CCBT services is still limited in the NHS, possibly affecting delivery of this computer-aided therapy to patients and inhibiting acceptance and uptake of this intervention. This paper reports on the qualitative exploration of patients’ experiences and acceptance of one CCBT programme delivering computer-assisted therapy (Beating the Blues: BTB), examining particularly the point of referral, access to treatment, and support. Thematic analysis was conducted on semi-structured face-to-face and email interviews with 33 patients at different NHS organisations across Scotland. Data analysis generated six key themes which illustrated patients’ experiences relating to referral and access to the treatment, and the challenges they faced: (1) information dissemination; (2) expectations and the impact of waiting for BTB; (3) impact of locations on experience of BTB; (4) preference for home access; (5) desire for better human support; and (6) desire for additional application support features. The findings highlighted that better methods of implementing and delivering such CCBT services together with the design of the technological interventions are vital to the success of these services. Key learning aims (1) To understand the service models and methods of implementing and delivering one CCBT programme (BTB) in routine care; (2) To learn about user experiences of accessing and using BTB; and (3) To learn about the implications and factors that might have influenced uptake and understand the implications.

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