What Measures are Effective in Trauma Screening for Young Males in Custody? A COSMIN Systematic Review.

Despite the available evidence identifying the high prevalence rates of potentially traumatic experiences in forensic populations, there is still a lack of evidence supporting the use of suitable assessment tools, especially for young males in custody. For services to identify, support, and offer trauma interventions to this cohort, practitioners require reliable and valid assessment tools. This systematic review (Open Science Framework registration: https://osf.io/r6hbk) identifies those tools able to provide valid, reliable, and comparable data for this cohort. Five electronic databases and gray literature were searched to identify relevant measures. Inclusion criteria: studies of tools to assess for trauma with males aged between 12 and 25 years-old in a custodial setting, any year of publication, and available in English. Exclusion criteria: studies that did not measure psychological trauma or include a standalone trauma scale, or report primary data. A three-step quality assessment method was used to evaluate the methodological quality and psychometric properties of the measures. Fourteen studies were selected for review (which included 12 measures). The studies sampled a total of approximately 1,768 male participants and an age range of 12 to 25 years. The studies reported on various types of psychometric evidence and due to the lack of homogeneity, a narrative synthesis was used to discuss, interpret, and evaluate each measure. The overall quality of the psychometric properties of the measures in this review showed that the currently available instruments for the assessment of trauma with young males in custody is limited but promising.

Mediating role for metacognitive processes in the relationship between schizotypy and anxiety and depression symptoms.

Introduction: Depression and anxiety symptoms are highly prevalent in schizophrenia-spectrum disorders and are commonly associated with schizotypy in non-clinical samples. However, it remains unclear what factors could be contributing to the relationships between schizotypy and anxiety and depression symptoms. Using path analysis, we explored the complex interplay between schizotypy, metacognitive beliefs, cognitive insight, and symptoms of emotional distress.Methods: Self-report data of schizotypy, metacognitive beliefs, cognitive insight, depression, and anxiety symptoms were collected from 344 participants from a predominantly student sample.Results: Path analysis confirmed unique associations between schizotypy dimensions, metacognitive beliefs, and cognitive insight. Furthermore, negative beliefs about worry mediated the link between the schizotypy dimensions, unusual experiences, cognitive disorganisation, and introvertive anhedonia and both depression and anxiety symptoms. Lack of cognitive confidence also mediated the relationship between cognitive disorganisation and depression symptoms. Finally, the cognitive insight subcomponent self-reflectiveness mediated the relationship between unusual experiences and cognitive disorganisation and anxiety.Conclusions: This study significantly furthers our understanding of the complex relationship between schizotypy, metacognitive processes, and emotional distress. Our findings also provide support for interventions which modify metacognitive beliefs and self-reflectiveness, which may prove beneficial for treatment in clinical settings.

Service user and eating disorder therapist views on anorexia nervosa recovery criteria.

OBJECTIVES: Recovery from anorexia nervosa (AN) is difficult to define, and efforts to establish recovery criteria have led to several versions being proposed. Using the perspectives of people with histories of AN and therapists working in the field, we sought to explore the face validity of Khalsa et al (2017) as one of the most recent examples of proposed systematic recovery criteria. DESIGN: We interviewed 11 health service users (SUs) with histories of AN who had previously received treatment alongside 8 eating disorder therapists (EDTs), exploring their views on the proposed AN recovery criteria. METHODS: Data from verbal and written interviews were analysed thematically. Separate thematic analyses of SU and EDT interviews highlighted where concerns converged and diverged across participants. RESULTS: Both groups saw some merits of having universally recognized recovery criteria, and the multidimensional approach was welcomed, but EDTs were uncomfortable with considering their use in therapy and SUs felt key components were missing around emotional coping and life quality. SUs disliked the prominence of body mass index (BMI) in the criteria, and all struggled with the proposed duration for recovery. Conceptually, the notion of recovery as an endpoint rather than a journey was contested. CONCLUSIONS: Our findings indicate disparities between academically derived recovery criteria and lived experiences and indicate perceived challenges in using such criteria in therapeutic settings. Including SUs and EDTs in the development of criteria may improve the likelihood of consolidating AN recovery criteria, but conceptual challenges remain. PRACTITIONER POINTS: AN recovery is complex, and the use of research-based AN recovery criteria in therapeutic settings could have a detrimental effect on SUs' outcomes. EDTs should be aware of efforts to define AN recovery criteria. EDTs should engage with debates on defining AN recovery and seek to promote participation in such debates to SUs.

The importance of social identities in the management of and recovery from 'Diabulimia': A qualitative exploration.

INTRODUCTION: A significant barrier to recovery for individuals with co-morbid eating disorders and type 1 diabetes is the way in which group members self-categorise. Nonetheless, identity issues are neglected during the recovery process. The aim of this paper is to explore how group memberships (and the associated identities) both contribute to and hinder recovery in this cohort. METHOD: Transcripts from five online focus groups with 13 members of an online support group for individuals with 'Diabulimia' were thematically analysed. RESULTS: Findings suggested that those with whom one shares a recovery identity can be well placed to provide psychological resources necessary for successful recovery although such connections can be damaging if group norms are not managed. Members recognised that other important relationships (including family and friends and health professionals) are also key to recovery; these other group memberships (and the associated identities) can be facilitated through the recovery identity group membership, which allows for external validation of the recovery identity, provides encouragement to disclose the illness to supportive others, and provides information to facilitate positive service interactions. CONCLUSIONS: While clinical interventions typically focus on eliminating disordered behaviours, we suggest that these should also include strengthening important group memberships that promote recovery.