Anneli Goulding

Attachment styles and symptoms in individuals with psychosis

Abstract Background: The capacity to manage affects is rooted in early interactions with caregivers, which in adulthood are internalized as different attachment styles. Few studies have explored associations between all four attachment styles and symptoms. Aim: Our aim was to investigate the relations between the four attachment styles and psychological distress in a group of people with psychosis. Method: In a cross-sectional study, associations between self-reported attachment style and symptoms in a psychosis group were explored. Attachment styles were measured with the Relationship Questionnaire (RQ) and symptoms were assessed with the revised version of the Symptom Checklist (SCL-90R) Results: The analyses showed a significant positive association between preoccupied attachment and the severity of symptoms. Furthermore, the analyses indicated significant positive associations between preoccupied attachment and the subscales measuring depression, anxiety, interpersonal sensitivity, paranoia and psychoticism. We also found significant positive associations between fearful attachment and both interpersonal sensitivity and psychoticism. Conclusion: The associations between attachment styles and symptoms found here are consistent with those of previous studies. It could be important for clinicians to identify patients’ attachment styles. Such knowledge would help mental health professionals to understand better the patients’ capacity to handle distress and help professionals to address interventions aiming to target each patients specific needs.

A Swedish sample of 45 adolescent males who have sexually offended

This study describes the background, individual characteristics, and offending behavior of 45 adolescent males who have sexually offended. This group was also compared to adolescents from the general population. The data sources were intake assessment information and questionnaires. Family problems and neglect were common. Having separated parents and growing up in large families or foster-homes discriminated the group from the general population of Swedish adolescent males. The group scored higher than norm data regarding anger, depression, and disruptive behavior. They showed a wish to present themselves in a positive way and they were less open concerning sexuality than a comparison group. There were overall few significant differences between the target group and the comparison groups. Future studies need to explore offender sub-groups; specifically how and why problematic backgrounds affect children differently.

S253. PERSON-CENTERED PSYCHOSIS CARE (PCPC) IN AN INPATIENT SETTING: PATIENT OUTCOMES

Abstract Background The person-centered care approach has been little tested in inpatient settings for persons with schizophrenia and similar psychoses. We developed a staff educational intervention, Person-Centered Psychosis Care (PCPC) tailored to our care setting (4 hospital wards for persons with psychoses, 43 beds). The intervention was co-created by professionals, patients, and researchers using a participatory approach. There was a focus on the patient’s narrative, the creation of partnership between staff and patient, an agreement between staff and patient concerning care, and a bridging of inpatient and outpatient care and support. The present study aims to describe patient outcomes associated with PCPC. Methods The study had a before and after design. Before the PCPC intervention started, questionnaire data was collected from 50 inpatients shortly before discharge. Post intervention data are currently under collection (anticipated n=50). The primary outcome measure is self-reported empowerment (Empowerment Scale, Range 0–112) and the secondary measure is consumer satisfaction (UKU-ConSat Rating Scale, converted to range between 11 and 77). Participants also complete questionnaires related to possible confounding variables such as overall health (EQ-5D), symptom burden (PANSS), and functional ability (GAF). Results The participants (46% women) included in the pre-intervention sample had a mean age of 47.5 years (SD=14.5). The total mean empowerment score for the pre-intervention sample was 82.6 (SD=8.1) whereas the mean consumer satisfaction score was 51.5 (SD=12.9). There were no statistically significant gender differences regarding empowerment or consumer satisfaction. There were no significant correlations between age, any of the confounding variables, and empowerment and consumer satisfaction. We will present results from comparisons between the pre- and post-intervention groups regarding empowerment and consumer satisfaction. Discussion The before and after design has its limitations, but if the PCPC intervention proves beneficial, such a model could be tested with a cluster randomized study design.

Schizotypy and mental health in women and men from the general population

Abstract Schizotypy is a construct that has been connected both to psychosis disorders and to variation in general behavior. There is a dispute whether schizotypy should be viewed as something connected to mental ill-health, or can be viewed as personality traits not automatically connected to mental ill-health. Therefore, the present study investigated the relations between schizotypy factors and mental health in a randomized sample from the general population (n = 764, 58% women). A simultaneous multiple regression analysis of the total sample showed that negative and disorganized schizotypy predicted mental health, whereas positive schizotypy and impulsive nonconformity did not. Higher levels of negative and disorganized schizotypy were associated with worse mental health. Separate regression analyses for women and men showed that the pattern for women was the same as for the total sample, whereas only disorganized schizotypy predicted mental health (negative relation) for men. The main gender difference was that the regression model for women explained a larger amount of variance than that for men. The fact that positive schizotypy did not predict worse mental health supports the notion of “healthy” schizotypy.

Study protocol design and evaluation of a hospital-based multi-professional educational intervention: Person-Centred Psychosis Care (PCPC)

BackgroundWhile patient involvement in mental health care is repeatedly stressed in policy documents, there are actually few studies that evaluate person-centred care interventions within psychiatric services. We present here the design and planned evaluation of an educational intervention for inpatient staff involved in the care of persons with schizophrenia and similar psychoses.Methods/designThe care intervention will be assessed using a non-randomised trial with a before and after approach. The intervention involves an educational and experimental learning phase for hospital staff, followed by an implementation phase. The intervention is multi-professional; psychiatrists, psychiatric nurses, psychiatric carers, social workers, occupational therapists, and a medical secretary will be engaged in a participatory approach where they practice how to create a partnership and explore recovery-related goals together with patients. Patient-related outcomes include empowerment and satisfaction with care. Ward-level outcomes include daily ward burden, length of inpatient stay, and number of days with involuntary care. In addition, qualitative methods will be applied to capture patient, next-of-kin, and staff perspectives.DiscussionThe care intervention is expected to contribute to the improvement of inpatient care for persons with severe and complex mental health issues.Trial registrationThe trial was retrospectively registered at ClinicalTrials.gov June 9, 2017, identifier: NCT03182283.

Experiences of intimate relationships in young men who sexually offended during adolescence: interviews 10 years later

ABSTRACT Intimate relationships and sexuality are important, but often complicated, aspects of life. In this study we examined experiences of intimate relationships and sexuality in 20 young men, aged 22–31 years, who had sexually offended during adolescence. The participants were interviewed and the transcripts were thematically analysed. The main picture observed was that of young men with unfulfilled needs and a low capacity to meet those needs. Additionally, the men’s experiences of intimate relationships and sexuality seemed to be affected by their experience of having sexually offended. Some men longed for closeness with a partner but were afraid of getting too close. Others distanced themselves from relationships, claiming that they did not need others. These findings may demonstrate the men’s self-protective strategies for handling their identification as sexual offenders. These 20 men could also have been struggling with universal questions about closeness and sexuality while bearing other burdens, such as mistrust in others and feelings of shame, that interfered with this struggle.