Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
5,896
result(s) for
"Delusions"
Sort by:
Where are the snows
Christopher and Alexandra's passion for one another raises eyebrows and invites envy. This beautiful blinkered couple do the unthinkable and run away from home, abandoning their two teenage children.
Book
Individualized Metacognitive Training (MCT+) Reduces Delusional Symptoms in Psychosis: A Randomized Clinical Trial
Abstract
Individualized metacognitive training (MCT+) is a novel psychotherapy that has been designed to specifically target delusional beliefs in people with psychosis. It works by developing an awareness of the implausible content of delusional beliefs, while also targeting the cognitive biases that contribute to their formation and maintenance. It was expected that MCT+ would lead to significantly greater reductions in delusional severity compared to a cognitive remediation (CR) active control condition. A total of 54 patients with a schizophrenia spectrum disorder and active delusions were randomized into four 2-hourly sessions of MCT+ (n = 27) or CR (n = 27). All participants completed posttreatment assessment, and only 2 participants did not complete 6-month follow-up assessment, resulting in MCT+ (n = 26) and CR (n = 26) for final analysis. The primary outcome measures of delusional and positive symptom severity were assessed rater-blind; secondary outcome assessment was non-blinded and included clinical and cognitive insight, the jumping to conclusions (JTC) bias, and cognitive functioning. Participants in the MCT+ condition showed significant reductions in delusional and overall positive symptom severity (large effect) and improved clinical insight (moderate effect) relative to CR controls. In contrast, CR controls showed moderate improvement in problem-solving ability relative to MCT+, but no other cognitive domain. Importantly, these findings were maintained at 6-month follow-up. The study adds further efficacy to the MCT program, and suggests that even brief psychotherapy can help to ameliorate the symptoms of psychosis.
Journal Article
Delusions in context
\"This open access book offers an explanation of delusions--unusual beliefs that can significantly disrupt people's lives. Experts from a range of disciplinary backgrounds, including lived experience, clinical psychiatry, philosophy, clinical psychology, and cognitive neuroscience, discuss how delusions emerge, why it is so difficult to give them up, what their effects are, how they are managed, and what we can do to reduce the stigma associated with them. Taken as a whole, the book proposes that there is continuity between delusions and everyday beliefs. It is essential reading for researchers working on delusions and mental health more generally, and will also appeal to anybody who wants to gain a better understanding of what happens whne the way we experience and interpret the world is different from that of the people around us\"--Back cover.
Book
Automated psychological therapy using virtual reality (VR) for patients with persecutory delusions: study protocol for a single-blind parallel-group randomised controlled trial (THRIVE)
Background
Persecutory delusions are a major psychiatric problem and are associated with a wide range of adverse outcomes. Our theoretical model views these delusions as unfounded threat beliefs which persist due to defence behaviours (e.g. avoidance) that prevent disconfirmatory evidence being processed. The treatment implications are that patients need to (1) go into feared situations and (2) not use defence behaviours. This enables relearning of safety and hence paranoia diminution. However, this is very difficult for patients due to their severe anxiety. A solution is to use virtual reality (VR) social situations, which are graded in difficulty and which patients find much easier to enter. We have now automated the provision of cognitive therapy within VR using an avatar coach, so that a therapist is not required and the treatment is scalable. In the THRIVE trial, the automated VR cognitive treatment will be tested against a VR control condition. It will contribute to our wider programme of work developing VR for patients with psychosis.
Methods
Patients with persistent persecutory delusions in the context of non-affective psychosis will be randomised (1:1) to the automated VR cognitive treatment or VR mental relaxation (control condition). Each VR treatment will comprise approximately four sessions of 30 min. Standard care will remain as usual in both groups. Assessments will be carried out at 0, 2, 4 (post treatment), 8, 16, and 24 weeks by a researcher blind to treatment allocation. The primary outcome is degree of conviction in the persecutory delusion (primary endpoint 4 weeks). Effect sizes will be re-established by an interim analysis of 30 patients. If the interim effect size suggests that the treatment is worth pursuing (
d
> 0.1), then the trial will go on to test 90 patients in total. Secondary outcomes include real world distress, activity levels, suicidal ideation, and quality of life. Mediation will also be tested. All main analyses will follow the intention-to-treat principle. The trial is funded by the Medical Research Council Developmental Pathway Funding Scheme.
Discussion
The trial will provide the first test of automated cognitive therapy within VR for patients with psychosis. The treatment is potentially highly scalable for treatment services.
Trial registration
ISRCTN,
ISRCTN12497310
. Registered on 14 August 2018.
Journal Article
Cognitive Bias Modification for paranoia (CBM-pa): study protocol for a randomised controlled trial
Background
Persecutory delusions are the most common type of delusions in psychosis and present in around 10–15% of the general population. Persecutory delusions are thought to be sustained by biased cognitive and emotional processes. Recent advances favour targeted interventions, focussing on specific symptoms or mechanisms. Our aim is to test the clinical feasibility of a novel psychological intervention, which manipulates biased interpretations toward more adaptive processing, in order to reduce paranoia in patients.
Methods
The ‘Cognitive Bias Modification for paranoia’ (CBM-pa) study is a feasibility, double-blind, randomised controlled trial (RCT) for 60 stabilised outpatients with persistent, distressing paranoid symptoms. Patients will be randomised at a 50:50 ratio, to computerised CBM-pa or a text-reading control intervention, receiving one 40-min session per week, for 6 weeks. CBM-pa involves participants reading stories on a computer screen, completing missing words and answering questions about each story in a way that encourages more helpful beliefs about themselves and others. Treatment as Usual will continue for patients in both groups. Patients will be assessed by a researcher blind to allocation, at baseline, each interim session, post treatment and 1- and 3-month follow-up post treatment. The primary outcome is the feasibility parameters (trial design, recruitment rate and acceptability) of the intervention. The secondary outcomes are clinical symptoms (including severity of paranoia) as assessed by a clinical psychologist, and ‘on-line’ measurement of interpretation bias and stress/distress. The trial is funded by the NHS National Institute for Health Research.
Discussion
This pilot study will test whether CBM-pa has the potential to be a cost-effective, accessible and flexible treatment. If the trial proves feasible and demonstrates preliminary evidence of efficacy, a fully powered RCT will be warranted.
Trial registration
Current Controlled Trials
ISRCTN: 90749868
. Retrospectively registered on 12 May 2016.
Journal Article
The Elizas : a novel
\"When debut novelist Eliza Fontaine is found at the bottom of a hotel pool, her family at first assumes that it's just another failed suicide attempt. But Eliza swears she was pushed, and her rescuer is the only witness. Desperate to find out who attacked her, Eliza takes it upon herself to investigate. But as the publication date for her novel draws closer, Eliza finds more questions than answers. Like why are her editor, agent, and family mixing up events from her novel with events from her life? Her novel is completely fictional, isn't it?\"-- Provided by publisher.
BOOK
Delusional Themes are More Varied Than Previously Assumed: A Comprehensive Systematic Review and Meta-Analysis
Delusions are classified into themes but the range of themes reported in the literature has never been examined and the extent to which they differ in prevalence, or relate to clinical characteristics or cultural variation, remains poorly understood.
We identified studies reporting delusional theme prevalence in adults with psychosis and completed two multivariate, multilevel, random-effects meta-analyses: one including data from structured assessment scales only and another also including data from ad hoc and clinical assessments to include themes from a wider range of countries and contexts. Sensitivity and meta-regression analyses examined the association with clinical and methodological variables. Analysis code and open data are available online. PROSPERO registration (CRD42019151889).
A total of 155 studies from 37 countries met inclusion criteria. The meta-analysis of data from structured assessments included 110 studies and 173 920 patients. A total of 21 themes were identified from \"persecutory/paranoid\" (57.33%, 53.75-60.88) to \"primary\" (5.18%, 1.07-11.55). The meta-analysis of all data included 155 studies and 240 901 patients. Thirty-seven themes were identified, from \"persecutory/paranoid\" (57.39%, 54.38-60.37) to \"made impulse\" (4.90%, 0.87-11.26). Ad hoc theme classifications were more common in non-Western contexts. Including these did not substantially alter heterogeneity but increased interaction with cultural clusters. There was no evidence of publication bias or association with risk of bias rating.
We report the first comprehensive meta-analysis of delusional themes. Many commonly reported themes are not included in standard classifications. Relationship to culture was modest but more present when not relying solely on established scales.
Journal Article
Supermarket
\"Flynn is stuck--depressed, recently dumped, and living at his mom's house. The supermarket was supposed to change all that. An ordinary job, routine hours, a steady check. Work isn't work when it's saving you from yourself. But things aren't quite as they seem in these aisles. Arriving to work one day to a crime scene, Flynn's world begins to crumble as the secrets of his tortured mind are revealed. And Flynn doesn't want to go looking for answers at the supermarket, because something there seems to be looking for him\"-- Provided by publisher.
Book
