Insight, duration of untreated psychosis and attachment in first-episode psychosis: prospective study of psychiatric recovery over 12-month follow-up.

BACKGROUND: Increasing evidence shows attachment security influences symptom expression and adaptation in people diagnosed with schizophrenia and other psychoses. AIMS: To describe the distribution of secure and insecure attachment in a cohort of individuals with first-episode psychosis, and to explore the relationship between attachment security and recovery from positive and negative symptoms in the first 12 months. METHOD: The study was a prospective 12-month cohort study. The role of attachment, duration of untreated psychosis (DUP), baseline symptoms and insight in predicting and mediating recovery from symptoms was investigated using multiple regression analysis and path analysis. RESULTS: Of the 79 participants, 54 completed the Adult Attachment Interview (AAI): 37 (68.5%) were classified as insecure, of which 26 (48.1%) were insecure/dismissing and 11 (20.4%) insecure preoccupied. Both DUP and insight predicted recovery from positive symptoms at 12 months. Attachment security, DUP and insight predicted recovery from negative symptoms at 12 months. CONCLUSIONS: Attachment is an important construct contributing to understanding and development of interventions promoting recovery following first-episode psychosis.

A systematic review of attachment and psychosis: measurement, construct validity and outcomes.

OBJECTIVE: This review sought to identify, summarise and critically evaluate studies that investigated attachment amongst individuals with psychosis. METHOD: The following computerised databases searched were CINAHL<1980 to December 2012; EMBASE<1980 to December 2012; Ovid MEDLINE (R)<1980 to December 2012; PsychINFO<1980 to December 2012; and Google Scholar<1980 to December 2012. RESULTS: We identified 22 papers describing 21 studies comprising 1453 participants, with a mean age of 35.0 years (range of 12-71 years), of whom 68.4% (n=994) were male. Of our sample, 1112 (76.5%) had a diagnosis of schizophrenia. We found small to moderate associations between greater attachment insecurity (as reflected in anxiety and avoidance) and poorer engagement with services, more interpersonal problems, more avoidant coping strategies, more negative appraisals of parenting experiences and more severe trauma. We also found small to modest associations between attachment insecurity and more positive and negative symptoms and greater affective symptom problems. CONCLUSION: Attachment theory may be useful as a means of understanding the developmental and interpersonal basis of recovery and adaptation in the context of psychosis. However, further research comprising more representative samples in their first episode and using prospective designs is required.

The development and validation of a general measure of well-being: the BBC well-being scale.

PURPOSE: The concept of maximising well-being, as opposed to merely treating mental disorder, is a powerful current theme in the area of mental health. Clearly this emphasises the need for appropriate valid and reliable measures of general well-being. This paper examines the appropriateness of a number of measures in this area and concludes that existing assessment tools fail to address the full range of aspects of personal well-being. This paper therefore presents the psychometric properties, validity and reliability of a new measure of well-being-the BBC Well-being Scale. METHODS: A total of 1,940 participants completed the new measure, the Goldberg scales of anxiety and depression, the 'List of Threatening Experiences' life events scale, a modified version of the Response Styles Questionnaire and a modified version of the Internal, Personal and Situational Attributions Questionnaire presented via the internet. RESULTS: Exploratory factor-analysis suggested a three-factor solution including themes of psychological well-being, physical health and well-being and relationships. The total 24-item scale had good internal consistency (α = .935) and correlated significantly with key demographic variables and measures of concurrent validity. CONCLUSIONS: The new measure--the BBC Well-being Scale-is recommended for research and clinical purposes.

[Confirmatory factor analysis of the French version of the emotional intelligence inventory]. / Analyse confirmatoire de la version française de l'inventaire d'intelligence émotionnelle.

BACKGROUND: In the context of the increasing interest in the study and assessment of emotional abilities in psychology, we translated into French and evaluated the construct validity of the emotional intelligence inventory (EII) designed in English [Psychol Rep; 88 (2001):353-64]. This self-rating scale is modelled along the theoretical constructs of the Mayer, Caruso and Salovey's model [Intelligence; 27 (1999):267-98]; it comprises 41 items tapping the four following factors: (1) empathy; (2) utilization of feelings, (3) handling relationships and; (4) self-control. METHODS: One thousand three hundred and thirty-five students (42.7% men) with a mean age of 19.6 years and affiliated to several school and faculties participated to this Belgian interuniversity study. They were administered the French version of the EII, as well as a series of related questionnaires. Confirmatory factor analyses (CFA) were applied to these data and various fit indices examined in order to assess the factorial adjustment to the data of the four-factor a priori structure. RESULTS: CFA did not support the original 41-item four-factor structure for the scale in French, but a good statistical fit to the data could be obtained with the reduction of the scale to 20 items. The content of the resulting item set, keeping Tapia's four factors, encourages a revision of the domain covered by the subscales. CONCLUSION: Further efforts should be directed at assessing the content validity of the proposed revised scale as a reliable tool in measuring emotional intelligence by self-report.