Posttraumatic stress symptoms (PTSS) in caregivers of people with psychosis and associations with caregiving experiences.

OBJECTIVE: Posttraumatic stress symptoms (PTSS) have been identified in caregivers of people with psychosis, but their clinical correlates are less well known. This study aimed to assess PTSS in a sample of caregivers of people with psychosis and to examine the relationship between PTSS and caregiving experiences. METHOD: A total of 32 caregivers of people with psychosis completed self-report questionnaires and structured interviews assessing PTSS and caregiving processes, including expressed emotion, burden, and coping. RESULTS: In all, 44% of the sample reported PTSS, which were associated with caregiver reports of burden and less adaptive (avoidant) coping. No links were observed with expressed emotion in this sample. CONCLUSION: Almost half of caregivers of people with psychosis reported PTSS related to their caring role, which may have implications for their caregiving experiences and coping efforts. The findings highlight the importance of assessing need in caregivers and optimizing opportunities to offer needs-led therapeutic interventions to caregivers.

Parent experiences of a specialist intervention service for mental health difficulties in children with autistic spectrum disorder.

BACKGROUND: Mental health problems are increasingly being recognised as a significant health need for people with autism spectrum disorder, but few specialist services are available. This study explored parents' experiences of a specialist autism spectrum psychological intervention service located within a broader Neurodevelopmental and Social Communication Disorders Team. METHOD: Forty-nine parents completed a telephone based survey designed to assess experiences of a specialist intervention service. RESULTS: High levels of satisfaction were reported. Parents reported aspects of the service that they found most useful. CONCLUSION: Most parents reported satisfaction with the service and suggested improvements were used to guide service development.

Life hassles and delusional ideation: Scoping the potential role of cognitive and affective mediators.

OBJECTIVES: An intertemporal association between major psychological stress and subsequent delusion formation has been established by others. The current study explores (1) whether the stress from life hassles predicts delusional ideation and (2) if so, do self-criticism, self-reassurance, and positive and negative affectivity (PA and NA, respectively) mediate this link. This paper thus aimed to scope-out viable psychological processes involved in the formation of stress-induced delusions. DESIGN: A cross-sectional survey using a non-clinical community sample. METHODS: Responses (N = 251) to an online community survey were tested via a nonparametric bootstrap sampling approach to examine the effects of multiple mediators. RESULTS: Self-criticism and NA appear to mediate a connection found between life hassles and delusions. A second mediation analysis found that life hassles positively predicts NA directly and indirectly (via self-criticism). NA in turn predicted delusional tendencies. Life events had direct statistical effects on delusions in all models. Neither PA nor self-reassurance mediated the stress-delusion link. CONCLUSIONS: Self-criticism and NA seem to be viable mediators worth contemplating when elaborating upon the connection between life hassles and delusions. Compared to self-criticism, NA appears to be the intervening variable most proximal to delusions and explains more variance. Even if these cross-sectional results were interpreted as causative, life hassles and delusions remained directly interconnected in all mediation models (suggesting much of the association remains unexplained). Although the results are theory-consistent, investigations using longitudinal, known-group, and experimental methods are now warranted to establish causation and possible feedback loops - especially from delusion to life hassles. PRACTITIONER POINTS: Self-criticism and negative affectivity (NA) mediate the link between stressful life events and delusions suggesting they might actively elicit delusional ideation, whereas self-reassurance and PA (although negatively associated with life hassles) have no unique predictive link to delusions. This study offers initial evidence that NA and self-criticism may be viable clinical intervention targets for early psychosis-sufferers under stress - especially for medically non-compliant and marginal (where drug treatment is not clinically indicated) cases. The clinical efficacy of alleviating self-criticism and/or negative emotional processes in those displaying early psychosis or at high risk appear worthy of exploration using both practice-based case studies and formal experimental research methods.