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J Godley

Publications and source records attributed to J Godley.

3 recordsLinked to original sources

Randomized controlled trial of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm: the POPMACT study.

BACKGROUND: We carried out a large randomized trial of a brief form of cognitive therapy, manual-assisted cognitive behaviour therapy (MACT) versus treatment as usual (TAU) for deliberate self-harm. METHOD: Patients presenting with recurrent deliberate self-harm in five centres were randomized to either MACT or (TAU) and followed up over 1 year. MACT patients received a booklet based on cognitive behaviour therapy (CBT) principles and were offered up to five plus two booster sessions of CBT from a therapist in the first 3 months of the study. Ratings of parasuicide risk, anxiety, depression, social functioning and global function, positive and negative thinking, and quality of life were measured at baseline and after 6 and 12 months. RESULTS: Four hundred and eighty patients were randomized. Sixty per cent of the MACT group had both the booklet and CBT sessions. There were seven suicides, five in the TAU group. The main outcome measure, the proportion of those repeating deliberate self-harm in the 12 months of the study, showed no significant difference between those treated with MACT (39%) and treatment as usual (46%) (OR 0.78, 95% CI 0.53 to 1.14, P=0.20). CONCLUSION: Brief cognitive behaviour therapy is of limited efficacy in reducing self-harm repetition, but the findings taken in conjunctin with the economic evaluation (Byford et al. 2003) indicate superiority of MACT over TAU in terms of cost and effectiveness combined.

Adult↗

Future-directed thinking in eating disorders.

OBJECTIVES: The aim of the study was to examine future-directed thinking in individuals with eating disorders, given the possible role of such cognitions in the maintenance of anorexia nervosa and bulimia nervosa. METHOD: Twenty-six anorexics, 18 bulimics and 34 female controls were interviewed using the 'Future Thinking Task', assessing quantitative and qualitative aspects of positive and negative anticipated events. RESULTS: Patients with anorexia nervosa had similar levels of positive future-oriented cognitions and significantly more negative future-oriented cognitions than controls. The most common positive themes in this group concerned the social/interpersonal and leisure/pleasure domains. The negative theme most commonly mentioned by anorexics was that of their own health, followed by the social/interpersonal domain, whereas controls were most preoccupied with achievement/failure and a broad range of other issues. Bulimics had significantly fewer positive future-oriented cognitions and significantly more negative future-oriented cognitions than controls, most commonly concerning the patient's own health. CONCLUSION: In anorexia nervosa, anticipated positive future outcomes may to some extent help to maintain the disorder; however, these patients are also highly preoccupied with the possibility of negative future outcomes, i.e. a failure of recovery. Bulimia nervosa sufferers are relatively hopeless about their future. The clinical implications of these findings are discussed.

Adult↗

Pseudomonas cepacia peritonitis associated with contamination of automatic peritoneal dialysis machines.

During a 3-month period, Pseudomonas cepacia was recovered from the peritoneal fluid of 10 patients having chronic dialysis therapy at a peritoneal dialysis center. Six patients developed clinical evidence of peritonitis; one patient developed septicemia. Epidemiologic studies showed that dialysis on specific peritoneal dialysis machines was associated with an increased risk of infection. Laboratory investigation showed contamination of two machines with P. cepacia. Inadequacies in the cleaning and disinfection practices of the automatic peritoneal dialysis machines were identified. Cross-contamination between machines probably occurred through the peritoneal fluid discharge from infected patients during dialysis. Also, the intermittent 2-hour exposure of the machine to 2% formaldehyde may have been inadequate. P. cepacia has not been isolated from the peritoneal fluid of any peritoneal dialysis patient after machine cleaning and disinfection practices were altered.

Adult↗