The Experts below are selected from a list of 183 Experts worldwide ranked by ideXlab platform
Jose Catalan - One of the best experts on this subject based on the ideXlab platform.
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differential effects of manual assisted cognitive behavior therapy in the treatment of recurrent deliberate self harm and Personality Disturbance the popmact study
Journal of Personality Disorders, 2004Co-Authors: Peter Tyrer, Sarah Byford, Ulrike Schmidt, Vanessa Jones, Kate Davidson, Martin Knapp, Andrew Macleod, Jose CatalanAbstract:Abstract A total of 480 patients were treated in a large, multicenter randomized trial of a brief form of cognitive therapy, manual-assisted cognitive behavior therapy (MACT) versus treatment as usual (TAU) for recurrent deliberate self-harm. Each patient was randomized after a self-harm episode assessed at an accident and emergency center and followed up over 1 year. The main hypothesis tested was that those allocated to MACT would have a lower proportion of self-harm episodes in the succeeding year. A total of 60% of those allocated to MACT had face-to-face treatment and 430 (90%) of all patients had self-harm data recorded after 1 year. Although the results showed no significant difference between those repeating self-harm in the MACT group (39%) compared with the TAU group (46%)(P = 0.20), the treatment was cost effective (10% cheaper than TAU) and the frequency of self-harm episodes was fewer (50%) in the MACT group. A total of nine of 10 patients had some Personality Disturbance (42% of these with d...
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manual assisted cognitive behaviour therapy mact a randomized controlled trial of a brief intervention with bibliotherapy in the treatment of recurrent deliberate self harm
Psychological Medicine, 1999Co-Authors: Kathryn Evans, Peter Tyrer, Ulrike Schmidt, Jose Catalan, Kate M Davidson, Philip Tata, Susan Thornton, J Barber, Simon G ThompsonAbstract:Background. The treatment of deliberate self-harm (parasuicide) remains limited in efficacy. Despite a range of psychosocial, educational and pharmacological interventions only one approach, dialectical behaviour therapy, a form of cognitive-behaviour therapy (CBT), has been shown to reduce repeat episodes, but this is lengthy and intensive and difficult to extrapolate to busy clinical practice. We investigated the effectiveness of a new manual-based treatment varying from bibliotherapy (six self-help booklets) alone to six sessions of cognitive therapy linked to the booklets, which contained elements of dialectical behaviour therapy. Methods. Thirty-four patients, aged between 16 and 50, seen after an episode of deliberate self-harm, with Personality Disturbance within the flamboyant cluster and a previous parasuicide episode within the past 12 months, were randomly assigned to treatment with manual-assisted cognitive-behaviour therapy (MACT N =18) or treatment as usual (TAU N =16). Assessment of clinical symptoms and social function were made at baseline and repeated by an independent assessor masked to treatment allocation at 6 months. The number and rate of all parasuicide attempts, time to next episode and costs of care were also determined. Results. Thirty-two patients (18 MACT; 14 TAU) were seen at follow-up and 10 patients in each group (56% MACT and 71% TAU) had a suicidal act during the 6 months. The rate of suicidal acts per month was lower with MACT (median 0·17/month MACT; 0·37/month TAU; P =0·11) and self-rated depressive symptoms also improved ( P =0·03). The treatment involved a mean of 2·7 sessions and the observed average cost of care was 46% less with MACT ( P =0·22). Conclusions. Although limited by the small sample, the results of this pilot study suggest that this new form of cognitive-behaviour therapy is promising in its efficacy and feasible in clinical practice.
Peter Tyrer - One of the best experts on this subject based on the ideXlab platform.
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Premature mortality of people with Personality disorder in the Nottingham Study of Neurotic Disorder.
Personality and Mental Health, 2019Co-Authors: Peter Tyrer, Helen Tyrer, Min YangAbstract:: It is known that people with Personality disorders die prematurely. This may be connected to high levels of co-morbidity with other psychiatric disorders. To test whether mortality was independent, deaths were examined in a 31-year cohort study of anxious and depressed patients (Nottingham Study of Neurotic Disorder) who also had their Personality status assessed at baseline. The severity of Personality Disturbance was assessed using a method previously used to separate Personality disorders into ICD-11 categories. Over the follow-up period, 71 of the cohort of 201 patients had died. Age at death was 5.1 (M) and 5.2 (F) years younger in those with Personality disorder compared with no Personality disorder, but after adjusting for age at randomization and clinical diagnosis at baseline, these differences reduced to 1.5 (M) and 1.6 (F) years. The longevity of the group was 12 to 18 years less than the general population (p < 0.0001), reinforcing previous findings of premature mortality in common mental illness. Analysis of causes of death showed no meaningful differences in Personality groups. The hypothesis that premature death in Personality Disturbance is independent of mental health status was not supported in this study, despite other evidence from this cohort that general clinical outcome is worse in those with Personality disorder. © 2019 John Wiley & Sons, Ltd.
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field trial of a putative research algorithm for diagnosing icd 11 Personality disorders in psychiatric patients 1 severity of Personality Disturbance
Personality and Mental Health, 2014Co-Authors: Roger K Blashfield, Peter Tyrer, Soontaeg HwangAbstract:This preliminary field trial examines the reliability and validity of a proposed research algorithm for diagnosing International Classification of Diseases (ICD)-11 Personality disorders and its association with other psychiatric assessments for the primary classification of a single dimension of the five severity levels of Personality dysfunction. In total, 137 psychiatric patients (119 with Personality disorders and 18 without Personality disorders) in Korea were assessed. In the first part of the study, inter-rater reliability was evaluated with an independent assessment of Personality (Personality assessment schedule). In the second part of the study, (1) the algorithm that identified any Personality Disturbance was compared with the ICD-10 and DSM-IV Personality disorder diagnostic equivalents, and (ii) the four levels of severity were examined for their associations with clinical pathology and social functioning. The results showed good agreement between the algorithm and the test instruments for identifying a Personality disorder. A graded increase in clinical pathology and social dysfunction was observed with increasing severity of Personality disorder. These findings suggest that a simple algorithm for recording severity of a Personality Disturbance had both construct validity and was useful in practice, which supports severity classification as a valuable concept. These findings need to be confirmed in other cultures and ethnic groups. Copyright © 2013 John Wiley & Sons, Ltd.
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Classifying Personality disorder according to severity.
Journal of Personality Disorders, 2011Co-Authors: Mike J. Crawford, Nestor Koldobsky, Roger T. Mulder, Peter TyrerAbstract:Current systems for classifying Personality disorder according to specific categories are unsatisfactory because they do not take account of wide variations in levels of Personality Disturbance and associated impairment. We review previous attempts to classify Personality disorder according to severity and place these findings in the context of work exploring the severity of other mental disorders. On the basis of these findings, we propose a new system for classifying Personality-related problems based on severity defined by the extent of Personality Disturbance, the level of social dysfunctioning, and the impact of the disorder for individuals and society. We recognize that studies using these definitions will need piloting and testing in field trials, but believe that this simplified approach to classifying Personality disorder would encourage greater use by clinicians and assist those involved in planning services for people with Personality disorder.
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social function clinical symptoms and Personality Disturbance
Irish Journal of Psychological Medicine, 2004Co-Authors: Peter Tyrer, S Merson, Tony JohnsonAbstract:Objectives: To investigate the relationship between psychiatric symptoms, Personality Disturbance, and social function. Method: Longitudinal study of 100 psychiatric patients presenting as emergencies originally entered to a randomised trial of community and hospital-based treatment strategies. Ratings of social function using the Social Functioning Questionnaire, Personality status using the Personality Assessment Schedule, and clinical symptomatology using the Comprehensive Psycho-pathological Rating Scale were recorded at baseline with assessment of social function repeated at two, four and 12 weeks. Correlation, regression, and path analysis were performed to test the hypothesis that Personality status had more influence than clinical symptoms on social function. Results: Path and regression analysis showed, that at baseline both psychopathology and Personality pathology contributed to social dysfunction equally, but from two weeks onwards Personality abnormality contributed to a greater degree than clinical psychopathology. Of the 100, 35 patients had a Personality disorder and in these there was a strong correlation between social function scores at baseline and 12 weeks (48% of variation explained) whereas in those with no Personality disorder the correlation was much weaker (14%); regression analyses confirmed this conclusion. Conclusions: Psychopathology and Personality status contribute to social dysfunction in patients presenting as emergencies but persistent social dysfunction is more likely to reflect Personality pathology than other forms of mental disorder.
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differential effects of manual assisted cognitive behavior therapy in the treatment of recurrent deliberate self harm and Personality Disturbance the popmact study
Journal of Personality Disorders, 2004Co-Authors: Peter Tyrer, Sarah Byford, Ulrike Schmidt, Vanessa Jones, Kate Davidson, Martin Knapp, Andrew Macleod, Jose CatalanAbstract:Abstract A total of 480 patients were treated in a large, multicenter randomized trial of a brief form of cognitive therapy, manual-assisted cognitive behavior therapy (MACT) versus treatment as usual (TAU) for recurrent deliberate self-harm. Each patient was randomized after a self-harm episode assessed at an accident and emergency center and followed up over 1 year. The main hypothesis tested was that those allocated to MACT would have a lower proportion of self-harm episodes in the succeeding year. A total of 60% of those allocated to MACT had face-to-face treatment and 430 (90%) of all patients had self-harm data recorded after 1 year. Although the results showed no significant difference between those repeating self-harm in the MACT group (39%) compared with the TAU group (46%)(P = 0.20), the treatment was cost effective (10% cheaper than TAU) and the frequency of self-harm episodes was fewer (50%) in the MACT group. A total of nine of 10 patients had some Personality Disturbance (42% of these with d...
Ulrike Schmidt - One of the best experts on this subject based on the ideXlab platform.
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differential effects of manual assisted cognitive behavior therapy in the treatment of recurrent deliberate self harm and Personality Disturbance the popmact study
Journal of Personality Disorders, 2004Co-Authors: Peter Tyrer, Sarah Byford, Ulrike Schmidt, Vanessa Jones, Kate Davidson, Martin Knapp, Andrew Macleod, Jose CatalanAbstract:Abstract A total of 480 patients were treated in a large, multicenter randomized trial of a brief form of cognitive therapy, manual-assisted cognitive behavior therapy (MACT) versus treatment as usual (TAU) for recurrent deliberate self-harm. Each patient was randomized after a self-harm episode assessed at an accident and emergency center and followed up over 1 year. The main hypothesis tested was that those allocated to MACT would have a lower proportion of self-harm episodes in the succeeding year. A total of 60% of those allocated to MACT had face-to-face treatment and 430 (90%) of all patients had self-harm data recorded after 1 year. Although the results showed no significant difference between those repeating self-harm in the MACT group (39%) compared with the TAU group (46%)(P = 0.20), the treatment was cost effective (10% cheaper than TAU) and the frequency of self-harm episodes was fewer (50%) in the MACT group. A total of nine of 10 patients had some Personality Disturbance (42% of these with d...
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manual assisted cognitive behaviour therapy mact a randomized controlled trial of a brief intervention with bibliotherapy in the treatment of recurrent deliberate self harm
Psychological Medicine, 1999Co-Authors: Kathryn Evans, Peter Tyrer, Ulrike Schmidt, Jose Catalan, Kate M Davidson, Philip Tata, Susan Thornton, J Barber, Simon G ThompsonAbstract:Background. The treatment of deliberate self-harm (parasuicide) remains limited in efficacy. Despite a range of psychosocial, educational and pharmacological interventions only one approach, dialectical behaviour therapy, a form of cognitive-behaviour therapy (CBT), has been shown to reduce repeat episodes, but this is lengthy and intensive and difficult to extrapolate to busy clinical practice. We investigated the effectiveness of a new manual-based treatment varying from bibliotherapy (six self-help booklets) alone to six sessions of cognitive therapy linked to the booklets, which contained elements of dialectical behaviour therapy. Methods. Thirty-four patients, aged between 16 and 50, seen after an episode of deliberate self-harm, with Personality Disturbance within the flamboyant cluster and a previous parasuicide episode within the past 12 months, were randomly assigned to treatment with manual-assisted cognitive-behaviour therapy (MACT N =18) or treatment as usual (TAU N =16). Assessment of clinical symptoms and social function were made at baseline and repeated by an independent assessor masked to treatment allocation at 6 months. The number and rate of all parasuicide attempts, time to next episode and costs of care were also determined. Results. Thirty-two patients (18 MACT; 14 TAU) were seen at follow-up and 10 patients in each group (56% MACT and 71% TAU) had a suicidal act during the 6 months. The rate of suicidal acts per month was lower with MACT (median 0·17/month MACT; 0·37/month TAU; P =0·11) and self-rated depressive symptoms also improved ( P =0·03). The treatment involved a mean of 2·7 sessions and the observed average cost of care was 46% less with MACT ( P =0·22). Conclusions. Although limited by the small sample, the results of this pilot study suggest that this new form of cognitive-behaviour therapy is promising in its efficacy and feasible in clinical practice.
Simon G Thompson - One of the best experts on this subject based on the ideXlab platform.
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manual assisted cognitive behaviour therapy mact a randomized controlled trial of a brief intervention with bibliotherapy in the treatment of recurrent deliberate self harm
Psychological Medicine, 1999Co-Authors: Kathryn Evans, Peter Tyrer, Ulrike Schmidt, Jose Catalan, Kate M Davidson, Philip Tata, Susan Thornton, J Barber, Simon G ThompsonAbstract:Background. The treatment of deliberate self-harm (parasuicide) remains limited in efficacy. Despite a range of psychosocial, educational and pharmacological interventions only one approach, dialectical behaviour therapy, a form of cognitive-behaviour therapy (CBT), has been shown to reduce repeat episodes, but this is lengthy and intensive and difficult to extrapolate to busy clinical practice. We investigated the effectiveness of a new manual-based treatment varying from bibliotherapy (six self-help booklets) alone to six sessions of cognitive therapy linked to the booklets, which contained elements of dialectical behaviour therapy. Methods. Thirty-four patients, aged between 16 and 50, seen after an episode of deliberate self-harm, with Personality Disturbance within the flamboyant cluster and a previous parasuicide episode within the past 12 months, were randomly assigned to treatment with manual-assisted cognitive-behaviour therapy (MACT N =18) or treatment as usual (TAU N =16). Assessment of clinical symptoms and social function were made at baseline and repeated by an independent assessor masked to treatment allocation at 6 months. The number and rate of all parasuicide attempts, time to next episode and costs of care were also determined. Results. Thirty-two patients (18 MACT; 14 TAU) were seen at follow-up and 10 patients in each group (56% MACT and 71% TAU) had a suicidal act during the 6 months. The rate of suicidal acts per month was lower with MACT (median 0·17/month MACT; 0·37/month TAU; P =0·11) and self-rated depressive symptoms also improved ( P =0·03). The treatment involved a mean of 2·7 sessions and the observed average cost of care was 46% less with MACT ( P =0·22). Conclusions. Although limited by the small sample, the results of this pilot study suggest that this new form of cognitive-behaviour therapy is promising in its efficacy and feasible in clinical practice.
Raymond Corrado - One of the best experts on this subject based on the ideXlab platform.
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A Network Approach to Understanding the Structure of Core Symptoms of Psychopathic Personality Disturbance in Adolescent Offenders
Journal of Abnormal Child Psychology, 2019Co-Authors: Evan C Mccuish, Martin Bouchard, Eric Beauregard, Raymond CorradoAbstract:A central aim of research on psychopathic Personality Disturbance (PPD) involves identifying core features of the construct. This has been addressed primarily through prototypicality studies and research using item-response theory. More recently, the logic of social network analysis was extended to psychopathology research to examine which symptoms were most central to PPD networks. Such studies identified affective symptoms of the disorder as especially central among adult offenders. To build upon this prior research, the current study used data on male offenders from the Incarcerated Serious and Violent Young Offender Study to examine the network structure of the Comprehensive Assessment of Psychopathic Personality – Institutional Rating Scale (CAPP-IRS; n = 224) and Psychopathy Checklist: Youth Version (PCL:YV; n = 445). Using multiple measures of PPD helped avoid equating measures with constructs. In both the CAPP-IRS and PCL:YV networks, in line with prior studies, attachment/affective features of the disorder were most central. Several recommendations are made for future research, including the need to study the longitudinal development of PPD using a network approach.