Distress, trauma, and recovery: adjustment to first episode psychosis.

OBJECTIVE: To understand the experiences that people with early psychosis are adjusting to and their perceived barriers to recovery. METHOD: Semi-structured interviews were conducted with eight participants. Grounded Theory was applied to the design and analysis. Sampling and coding ceased when saturation of the data was reached. Respondent validation was sought from participants. RESULTS: A theoretical model was developed using Strauss and Corbin's (1998) framework. A core category of distress was elicited, which was evident in all participants' accounts of their recovery. Overall six main categories were identified and it was proposed that individuals were adjusting to the distress of past experiences, uncertainty, a challenged identity, being in a psychiatric system, the reaction of others and social disadvantage. CONCLUSIONS: Recovery from the distress and trauma of early psychosis does not simply involve adjustment to and recovery from a single experience or set of symptoms. The results are discussed in relation to trauma, developmental, and social inequality frameworks. Specific implications for clinical practice include incorporating the findings within formulations, developing interventions that focus on trauma, identity, and uncertainty as well as addressing the social and systemic issues identified.

A prospective study of relationships between propositions about risk and driver speeding.

Risk propositions are specific and modifiable hypotheses that people hold about the outcomes of risk-taking behavior. According to fuzzy trace theory (FTT), risk propositions arise from the subjective and idiosyncratic interpretations that people make about the meaning of risk information, and form the primary basis of decision-making. A community sample of 255 drivers was interviewed at baseline (T1), 6 weeks after baseline (T2) and 14 weeks after baseline (T3). We tested whether propositions about speeding-related risk at time 1 (T1) would predict speeding at time 3 (T3), controlling perceptions of speeding-related danger and other speeding-related variables (the perceived possibility of being caught and the enjoyment and excitement to be gained from speeding) measured at time 2 (T2). We also tested whether relationships between T1 propositions and T3 speeding would be mediated by T2 perceptions of danger. T1 propositions predicted T3 speeding independently of the control variables, and we also found evidence consistent with mediation by T2 danger. In line with FTT, risk propositions were not scaleable as a single dimension, but generally predicted speeding as independent entities. Taken together these findings support the view that drivers perceive speeding risk as a series of potentially modifiable propositions which may have item-specific influences on speeding behavior.

Psychological adjustment to gynaecological cancer: patients' illness representations, coping strategies and mood disturbance.

This study examined associations between illness representation dimensions specified by the self-regulation model, coping and mood in recently diagnosed gynaecological cancer patients. Participants were 61 patients recruited from a specialist outpatient gynaecology clinic. Patients completed a survey measuring their cognitive illness representations (IPQ-R), coping strategies (COPE) and mood (POMS-SF). Consistent with research into other illnesses, the study found theoretically congruent cross-sectional associations between illness representations and mood disturbance. Support was found for a possible path whereby higher denial and avoidant coping might mediate the relationships between cyclical timeline and illness coherence representations and more negative mood. There were no mediational relationships for other coping strategies. Mediation of the relationship between illness representations and mood by avoidant coping has important theoretical and practical implications. These are discussed, as are direct relationships between illness representations and mood.