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1.
Behav Cogn Psychother ; 44(2): 140-55, 2016 Mar.
Article in English | MEDLINE | ID: mdl-25602290

ABSTRACT

BACKGOUND: Limited data suggest that crime may have a devastating impact on older people. Although identification and treatment may be beneficial, no well-designed studies have investigated the prevalence of mental disorder and the potential benefits of individual manualized CBT in older victims of crime. AIMS: To identify mental health problems in older victims of common crime, provide preliminary data on its prevalence, and conduct a feasibility randomized controlled trial (RCT) using mixed methods. METHOD: Older victims, identified through police teams, were screened for symptoms of anxiety, depression or post-traumatic stress disorder (PTSD) one (n = 581) and 3 months (n = 486) after experiencing a crime. Screen positive participants were offered diagnostic interviews. Of these, 26 participants with DSM-IV diagnoses agreed to be randomized to Treatment As Usual (TAU) or TAU plus our manualized CBT informed Victim Improvement Package (VIP). The latter provided feedback on the VIP. RESULTS: Recruitment, assessment and intervention are feasible and acceptable. At 3 months 120/486 screened as cases, 33 had DSM-IV criteria for a psychiatric disorder; 26 agreed to be randomized to a pilot trial. There were trends in favour of the VIP in all measures except PTSD at 6 months post crime. CONCLUSIONS: This feasibility RCT is the first step towards improving the lives of older victims of common crime. Without intervention, distress at 3 and 6 months after a crime remains high. However, the well-received VIP appeared promising for depressive and anxiety symptoms, but possibly not posttraumatic stress disorder.


Subject(s)
Cognitive Behavioral Therapy/methods , Crime Victims/psychology , Mental Disorders/psychology , Mental Disorders/therapy , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy , Age Factors , Aged , Aged, 80 and over , Crime/statistics & numerical data , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Male , Mental Disorders/epidemiology , Mental Disorders/etiology , Middle Aged , Pilot Projects , Psychiatric Status Rating Scales , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , United Kingdom/epidemiology
2.
Behav Cogn Psychother ; 44(2): 255, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26268423

ABSTRACT

The author list previously published for this article was incomplete when received by the journal. It should also have included Gerard Leavey, University College London, UK, as an author, as follows: Marc Serfaty, Anna Ridgewell, Vari Drennan, Chris R. Brewin, Gerard Leavey, Anwen Wright, Gloria Laycock, Martin Blanchard.

3.
Int J Geriatr Psychiatry ; 30(4): 376-83, 2015 Apr.
Article in English | MEDLINE | ID: mdl-24931116

ABSTRACT

OBJECTIVE: Worry is a common and distressing problem in Parkinson's disease (PD). However, little is known about the nature and content of worry in PD and how it might differ to non-PD populations. The study aimed to explore the content and nature of worry in middle-aged and older-aged adults with and without PD. METHOD: Four groups of participants, 20 PD patients (10 high worry and 10 low worry) and 19 middle-aged and older-aged adults (10 high worry and nine low worry), completed the catastrophising interview (CI) for three worry topics. Worriers were classified (high/low) on the basis of Penn State Worry Questionnaire scores. Data were analysed using framework analysis. RESULTS: High worriers showed a greater diversity of worry topics than low worriers. Health worries differentiated high and low worriers in the non-PD sample but were common across all PD participants. The CI revealed that the root concern of worry was often different to that initially described. In particular, PD high worriers were more likely to express underlying concerns about negative self-perception and death/severe incapacity. CONCLUSION: The CI was able to identify the root cause of worry, demonstrating the value of this technique in the exploration and treatment of worry and psychological distress. Exploring worry content may help to distinguish patients with problematic worry, with worries about self-perception and death/severe incapacity characteristic of high worriers. Therapeutic interventions designed to alleviate problematic worry and distress in PD need to take account of the realities of living with PD and the potentially realistic nature of worries that may appear catastrophic in a healthy population.


Subject(s)
Anxiety Disorders/psychology , Parkinson Disease/psychology , Adult , Aged , Case-Control Studies , Female , Humans , Male , Middle Aged , Self Concept , Surveys and Questionnaires
4.
Pain Manag ; 1(4): 311-23, 2011 Jul.
Article in English | MEDLINE | ID: mdl-24645658

ABSTRACT

UNLABELLED: SUMMARY  AIMS: A thinking process central to the etiology of emotional disorders, rumination is commonly observed in chronic pain. However, very little is understood about the characteristics of pain-related rumination and the mechanisms through which rumination impacts on pain perception and disability. This study began investigating this cognitive phenomenon by qualitatively examining chronic pain patients' experience of rumination. METHODS: Semistructured interviews were conducted with 20 chronic pain patients. Themes were extracted from interview transcripts using thematic analysis. RESULTS: Six themes were extracted from interviews with frequent ruminators. These elucidated the pattern of rumination and suggested a reciprocal relationship of rumination with not only pain, but also negative emotions and sleeplessness. Frequent ruminators appeared to hold positive beliefs about rumination and negative beliefs about self in overcoming pain. Two themes were extracted from interviews with infrequent ruminators: implicating negative beliefs about rumination and the flexible use of disengagement strategies in these individuals. CONCLUSION: Rumination occurs frequently and can be easily triggered by pain, negative emotions and sleeplessness in patients who lack alternative coping strategies and believe rumination is a way to problem-solve. A tentative model of pain-related rumination has been proposed, outlining interesting hypotheses for rigorous empirical investigations.

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