Mental Disorders (General)https://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/542024-03-29T12:25:56Z2024-03-29T12:25:56ZA Compassion-Focused Therapy group for young people who live in foster, adoptive or kinship care: Initial development, reflections, and ways forwardLau-Zhu, Alexhttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/13412024-01-09T17:01:54Z2023-11-01T00:00:00ZA Compassion-Focused Therapy group for young people who live in foster, adoptive or kinship care: Initial development, reflections, and ways forward
Lau-Zhu, Alex
Care-experienced youth are more likely than their peers to present with earlier, more severe and more chronic mental health difficulties. This case study presents the development of a Compassion-Focused Therapy (CFT) group for young people who do not live with their birth families due to an early history of abuse and neglect, delivered by psychologists in a social care service. Eight adolescent girls (aged 12–16), who lived in foster, adoptive or kinship care, attended eight face-to-face weekly sessions of a ‘Building Your Self-Confidence’ group. Most of them attended all sessions, found the group ‘enjoyable’ and ‘interesting’, and reported finding it helpful to improve their self-confidence at least to some extent (‘a little’ or ‘yes’). On standardised measures, half of the caregivers reported improvements in their child’s mental health but none of the adolescents did themselves. These initial data pave the way to further optimise the application of group CFT for care-experienced youth and inform psychological treatment innovation in youth more generally.
Open Access
2023-11-01T00:00:00ZCaregiver Mentalizing and Child Emotional Regulation: A Novel Approach to Examining Bidirectional ImpactKerr-Davis, Asahttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/13362024-01-03T17:24:38Z2023-11-01T00:00:00ZCaregiver Mentalizing and Child Emotional Regulation: A Novel Approach to Examining Bidirectional Impact
Kerr-Davis, Asa
Mentalization theory suggest bidirectional links between a caregiver’s capacity to mentalize their child and emotional regulation in their children. However, there has been little empirical investigation to verify this theory. The bidirectional relationship between caregiver mentalizing and child emotional regulation may be especially important to understand in caregiving contexts where there is greater risk of relationship breakdown or child emotional dysregulation, such as in fostering relationships. This study used a novel time-sequence analysis approach to explore the putative bidirectional relationship between caregiver mentalizing and child emotional regulation in the context of long-term foster care. Existing theories about caregiver mentalizing and child emotional regulation were evaluated and developed by looking at moment-by-moment interactions between a foster carer and a child in her care. The findings of this study gave mixed support for bidirectional relationships between foster carer mentalizing, and child emotional regulation predicted by existing theoretical models. These findings have implications for refining and applying mentalization theory broadly and more specifically in the context of foster care. Furthermore, this study provides a useful example of how time-sequence analysis may be useful for exploring the links between phenomena, such as caregiver mentalizing and child emotional dysregulation, occurring over time in observational data.
Open access
2023-11-01T00:00:00ZUltradian hydrocortisone replacement alters neuronal processing, emotional ambiguity, affect and fatigue in adrenal insufficiency: The PULSES trialHarmer, Catherine Jhttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/13262023-12-22T10:47:00Z2023-10-01T00:00:00ZUltradian hydrocortisone replacement alters neuronal processing, emotional ambiguity, affect and fatigue in adrenal insufficiency: The PULSES trial
Harmer, Catherine J
Background: Primary adrenal insufficiency (PAI) mortality and morbidity remain unacceptably high, possibly arising as glucocorticoid replacement does not replicate natural physiology. A pulsatile subcutaneous pump can closely replicate cortisol's circadian and ultradian rhythm.
Objectives: To assess the effect of pump therapy on quality of life, mood, functional neuroimaging, behavioural/cognitive responses, sleep and metabolism.
Methods: A 6-week randomised, crossover, double-blinded and placebo-controlled feasibility study of usual dose hydrocortisone in PAI administered as either pulsed subcutaneous or standard care in Bristol, United Kingdom (ISRCTN67193733). Participants were stratified by adrenal insufficiency type. All participants who received study drugs are included in the analysis. The primary outcome, the facial expression recognition task (FERT), occurred at week 6.
Results: Between December 2014 and 2017, 22 participants were recruited - 20 completed both arms, and 21 were analysed. The pump was well-tolerated. No change was seen in the FERT primary outcome; however, there were subjective improvements in fatigue and mood. Additionally, functional magnetic resonance imaging revealed differential neural processing to emotional cues and visual stimulation. Region of interest analysis identified the left amygdala and insula, key glucocorticoid-sensitive regions involved in emotional ambiguity. FERT post hoc analysis confirmed this response. There were four serious adverse events (AE): three intercurrent illnesses requiring hospitalisation (1/3, 33.3% pump) and a planned procedure (1/1, 100% pump). There was a small number of expected AEs: infusion site bruising/itching (3/5, 60% pump), intercurrent illness requiring extra (3/7, 42% pump) and no extra (4/6, 66% pump) steroid.
Conclusions: These findings support the administration of hormone therapy that mimics physiology.
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2023-10-01T00:00:00ZImpaired subjective organisation of memory in psychogenic amnesiaMalhotra, Tinahttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/13182023-12-20T16:11:50Z2023-08-01T00:00:00ZImpaired subjective organisation of memory in psychogenic amnesia
Malhotra, Tina
Objectives: Psychogenic or dissociative amnesia is a rare condition which involves primarily impairment in episodic
autobiographical memory. Why such impairment occurs in such patients has always perplexed researchers and multiple
theories have been proposed. Tis paper proposes a novel hypothesis to explain psychogenic amnesia through a mechanism associated with impairment in the ability to subjectively organise and bring memory to conscious awareness.
Methods: Te present paper presents a case study through careful investigation of a patient with psychogenic amnesia
using extensive neuropsychological evaluation encompassing intellectual functioning, executive functions, and memory.
Results: Te neuropsychological fndings established that the patient sufered an autobiographical memory impairment
which was more pronounced for events of the previous 5 years. On tests of episodic memory, the patient showed impairment in subjective organisation in recall of the memory. Te patient’s intellectual functioning and new learning were
intact. Recognition memory for faces and words were also not impaired.
Conclusion: We propose that patients with psychogenic amnesia may have selective difculty in bringing materials for
retrieval into their subjective awareness. Such an impairment is observed in the subjective organisation of materials for
memory retrieval. Tis case study will add to the understanding, assessment, and management of patients with psychogenic amnesia.
Open Access
2023-08-01T00:00:00Z