Biomedical subjects

Fiona Lobban

Publications and source records attributed to Fiona Lobban.

8 recordsLinked to original sources

PubMed2006

The social problem-solving abilities of people with borderline personality disorder.

Interventions for people suffering from borderline personality disorder (BPD), such as dialectical behaviour therapy, often include a problem-solving component. However, there is an absence of published studies examining the problem-solving abilities of this client group. In this study, the social problem-solving (SPS) abilities of three groups of participants were assessed: a BPD group (n=25), a clinical control (CC) group (n=25) procedure and a non-clinical control (NCC) group (n=25). SPS ability was assessed using the means-end problem-solving (MEPS) procedure and the Social Problem-Solving Inventory-Revised (SPSI-R). The BPD group exhibited deficits in their SPS abilities, however the majority of these deficits were not specific to the BPD group but were also found in the CC group, indicating that a common factor between these two groups, such as negative affect, may account for these observed deficits. Specific SPS deficits were identified in the BPD group: they provided less specific solutions on the MEPS and reported higher levels of negative problem orientation and a more impulsive/carelessness style towards solving social problems. The results of this study provide empirical support for the use of problem-solving interventions with people suffering from BPD.

Adult↗

PubMed2006

Illness beliefs in schizophrenia.

Beliefs about health and illness shape emotional responses to illness, health-related behaviour and relationships with health-care providers in physical illness. Researchers are beginning to study the illness beliefs of people with psychosis, primarily using models developed in relation to physical illness. It is likely that modifications to these models will be necessary if they are to apply to mental disorders, and it is probable that some of the assumptions underlying the models will be inappropriate. In particular, different dimensions of understanding may be present in mental illness in comparison to those identified in physical illness. The present study examines the beliefs of 20 patients in the UK diagnosed with schizophrenia, including 10 currently psychotic inpatients and 10 outpatients in remission, about their experiences, using qualitative interviews and thematic analysis. Patients currently experiencing psychosis did not identify their experiences as separable 'illnesses' and did not have 'illness beliefs'. Patients currently in a period of remission appraised their experiences as distinct from their own normal behaviour, but used conceptual frameworks of understanding that deviated significantly from conventional 'health belief' models. Patients' ways of understanding mental illness did not parallel those described in physical illnesses. Methods for assessing beliefs about mental illness should therefore not be transferred directly from studies of beliefs about physical illness, but should be tailored to the nature of patients' beliefs about mental illness.

Adult↗

PubMed2006

Does Expressed Emotion need to be understood within a more systemic framework? An examination of discrepancies in appraisals between patients diagnosed with schizophrenia and their relatives.

BACKGROUND: This study examined the relationship between discrepancies in beliefs about schizophrenia and Expressed Emotion (EE) in family dyads. METHOD: Illness beliefs were assessed in patients with a diagnosis of schizophrenia and their relatives (N=49 dyads). The degree and the direction of discrepancy were calculated, and comparisons were made between dyads in which the relative was rated as high EE and dyads in which the relative was rated as low EE. RESULTS: There was greater discrepancy between illness models of schizophrenia in dyads involving a high-EE relative than in dyads involving a low-EE relative. This difference was not accounted for by the differences in either relatives' or patients' beliefs alone. CONCLUSION: Further research is needed to understand EE in the context of discrepancies in beliefs between patients and relatives rather than focussing on relatives' beliefs alone.

Adult↗

PubMed2006

Group cognitive-behavioural therapy for schizophrenia. Randomised controlled trial.

BACKGROUND: The efficacy of cognitive-behavioural therapy for schizophrenia is established, but there is less evidence for a group format. AIMS: To evaluate the effectiveness of group cognitive-behavioural therapy for schizophrenia. METHOD: 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. RESULTS: 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. CONCLUSIONS: 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.

Adult↗

PubMed2005

Assessing cognitive representations of mental health problems. I. The illness perception questionnaire for schizophrenia.

OBJECTIVE: To design a questionnaire to assess cognitive representations of mental health problems held by people diagnosed with schizophrenia. BACKGROUND: 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). METHOD: 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. RESULTS: 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. CONCLUSIONS: The IPQS is a reliable and valid measure of cognitive representations of mental health problems held by people with a diagnosis of schizophrenia.

Acute Disease↗

PubMed2005

Assessing cognitive representations of mental health problems. II. The illness perception questionnaire for schizophrenia: Relatives' version.

OBJECTIVE: To design a questionnaire to assess cognitive representations of mental health problems held by relatives of people diagnosed with schizophrenia. BACKGROUND: 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). METHOD: 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. RESULTS: 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. CONCLUSIONS: 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.

Adaptation, Psychological↗

PubMed2004

Illness representations in depression.

BACKGROUND AND OBJECTIVES: Illness representations in physical health problems have been studied extensively using the Self-regulation Model (SRM) focusing on five dimensions of illness beliefs (identity, consequences, causes, timeline and control, or cure). Associations have been found between beliefs about illness and a range of health outcomes. This study aimed to examine models of depression, to assess whether the five dimensions of the SRM are relevant, to compare depression models with those for physical illness, and to examine the psychometric properties of the Illness Perception Questionnaire (IPQ) when used with depression. DESIGN AND METHOD: A sample of 101 women either currently depressed or with a history of depression was asked to write about their experiences of physical sickness and depression. Their responses were analysed in terms of the dimensions of beliefs expressed and the two experiences were compared. The IPQ was also administered to assess the women's perceptions of depression. RESULTS: The women used the same five dimensions of illness as identified in the SRM in describing both their experience of depression and physical sickness. There was evidence of some consistency across the models of the two illnesses in terms of their content and structure. The IPQ was a reliable measure for depressed experiences and discriminated between women who were currently depressed or not. Comparing the women's descriptions of their depression with their IPQ scores showed some relationships between their responses on the two different measures, at least for the consequences and cause dimensions. CONCLUSION: The SRM model and associated methodology may provide an appropriate framework to further explore illness representations in depression. Problems inherent in the study of illness models in depression including the influence of mood on the model are described. Applications of this research area to the understanding of treatment preferences and adherence to treatment in mood disorders are discussed.

Adult↗

PubMed2003

A review of the role of illness models in severe mental illness.

The ways in which people think about illness experiences have been associated with a variety of important behaviours and emotional responses in patients, carers, and professionals. Some of these responses have been shown to be related to outcome. Explicit models such as the self-regulation model (SRM) [Leventhal, H., Nerenz, D. R., & Steele, D. F. (1984). Illness representations and coping with health threats. In A. Baum & J. Singer (Eds.), A handbook of psychology and health. Hillsdale, NJ: Erlbaum, 219-252.] have been shown to be useful in highlighting key beliefs across a wide range of different physical illnesses. The specific beliefs about mental illness that have been assessed have been varied and largely without a common theoretical framework. This has resulted in a literature from which it is difficult to draw firm conclusions. The central aim of this paper is to assess the applicability of the SRM to mental illness. To this end, we review studies to date that have examined the beliefs that people with a mental illness have about their experiences. In addition, we review studies that have examined the beliefs of relatives of people with a mental illness and professionals who work with this population. We assess to what extent these studies are consistent with the SRM before suggesting ways in which the model could be further developed and tested. The SRM is presented as a useful framework for more advanced investigations into the function of beliefs about mental illness and how these can be modified in order to effect outcome. Developing psychological theories common to both physical and mental health may eventually result in an integrated approach in which mental illness becomes less stigmatised within the treatment setting.

Attitude to Health↗