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Biomedical subjects

J M G Williams

Publications and source records attributed to J M G Williams.

5 recordsLinked to original sources

Treatment-resistant depressed patients show a good response to Mindfulness-based Cognitive Therapy.

Mindfulness-based Cognitive Therapy (MBCT) is a class-based programme designed for use in the prevention of relapse of major depression. Its aim is to teach participants to disengage from those cognitive processes that may render them vulnerable to future episodes. These same cognitive processes are also known to maintain depression once established, hence a clinical audit was conducted to explore the use of MBCT in patients who were currently actively depressed, and who had not responded fully to standard treatments. The study showed that it was acceptable to these patients and resulted in an improvement in depression scores (pre-post Effect Size=1.04), with a significant proportion of patients returning to normal or near-normal levels of mood.

Adaptation, Psychological↗

Recurrence of suicidal ideation across depressive episodes.

BACKGROUND: In recent years it has become clear that depression is a recurrent disorder, with the risk of recurrence in those with two or more episodes being as high as 90%. This has prompted interest in the consistency of individual depressive symptoms across consecutive episodes, an issue that is important for symptoms such as suicidal ideation, where a past history may give important indicators of future behaviour. METHODS: We prospectively examined 69 individuals with a history of Major Depression, over 12 months, 38 of whom experienced a recurrence of major depression during the follow-up period. RESULTS: Spearman's rank order correlations between severity ratings of each symptom of major depression during a previous episode and severity ratings at recurrence showed significant associations for suicidality, guilt or worthlessness and thinking difficulties only. Weighted kappa coefficients indicated relatively low levels of agreement across episodes for most diagnostic symptoms, with suicidality showing the strongest relationship. Using a broad definition of suicidality-- any reporting of thoughts of death or suicide during episode-- a much higher level of agreement (kappa = .64) was found, with 83% of individuals falling into the same category (suicidal/non-suicidal) at both episodes. LIMITATIONS: This study was based on a relatively small sample and examines re-emergence of suicidal ideation in the absence of suicidal behaviour. CONCLUSIONS: This study provides preliminary evidence of cross-episode consistency in the recurrence of suicidal ideation, in line with the differential activation theory of suicidality in depression.

Major Depressive Disorder↗

Problem-solving in suicide attempters.

BACKGROUND: Recent research studies on the psychological processes underlying suicidal behaviour have highlighted deficits in social problem-solving ability, and suggest that suicide attempters may, in addition, be passive problem-solvers. The aim of this study was to examine problem-solving in suicide attempters (including passivity) and to see whether the deficits are mood-dependent. METHOD: Two groups, a suicide attempter group and a non-suicidal psychiatric control group completed measures of depression, hopelessness, suicidal ideation and social problem-solving ability shortly after admission, and again 6 weeks later. In addition, a non-psychiatric control group provided baseline data at a single time point. RESULTS: The suicide attempter group displayed poorer problem-solving ability than matched psychiatric controls and this difference persisted despite change in mood. However, although suicidal patients were more passive in their problem-solving style than non-psychiatric controls, they were not significantly more passive than psychiatric controls. Problem-solving did not change with improving mood. CONCLUSIONS: Although passivity is not unique to suicidal patients, in combination with the smaller number and less effective alternatives generated, it may increase vulnerability.

Adult↗

Mood, eating behaviour and attention.

BACKGROUND: Obesity is a growing health problem, but most people find dieting unsuccessful. Three studies examine possible reasons for the difficulty and the extent to which dieting-related reductions in cognitive function are associated with mood and well-being. METHOD: In Study One, 49 female dieters were compared with a control group of 31 matched non-dieters on measures of well-being, mood, eating behaviour (Dutch Eating Behaviour Questionnaire), and attention. Study Two examined two measures of restraint to examine why previous studies find high restrainers are prone to react to emotion. Study Three experimentally manipulated mood using music and the standard Velten Induction Procedure to examine attention in restrainers and emotional eaters. RESULTS: Dieting was found to be associated with deficits in sustained attention. This finding was further supported by the demonstration of a significant impairment in performance following a negative mood induction in high emotional eaters whereas high restrainers were relatively unaffected by the mood challenge. CONCLUSIONS: We suggest that different aspects of eating behaviour have dissociable effects on cognitive-affective function. Trait tendencies to restrained eating are associated with attentional deficits, but are not further affected by mood disruption. It is the long-term tendency to eat when emotional that combines with current emotional state to trigger cognitive deficits.

Adult↗

Autobiographical memory and emotion in a non-clinical sample of women with and without a reported history of childhood sexual abuse.

OBJECTIVES: This study focused on the relationship between reported CSA history, subsequent autobiographical memory retrieval, intrusive and dysfunctional thoughts, and mood in a non-clinical sample. The main hypothesis was that specificity in autobiographical memory recall would differentiate between women with a reported history of CSA and those without, and that this finding would be independent of current mood. DESIGN: A between-group comparison of women (female undergraduates) with and without a reported history of CSA. Within group correlations were also examined for the reported CSA group. METHOD: Participants were 79 female students, of whom 22 (28%) reported a history of CSA. All participants completed questionnaires requesting information on a history of CSA, a questionnaire version of the autobiographical memory test, the profile of mood states, the dysfunctional attitude scale, and the impact of events scale. RESULTS: The reported CSA group gave significantly fewer specific autobiographical memories, were significantly more anxious, depressed and angry, and held more dysfunctional beliefs than the comparison group. However, specificity of memory was not correlated with the degree of this mood disturbance or with the impact of event scale or extent of dysfunctional beliefs. CONCLUSIONS: Models of the long-term effects of CSA should incorporate the effects CSA may have on subsequent retrieval for memory of non-abuse events. To improve treatment outcome, clinicians may have to directly address these deficits in therapy.

Adolescent↗