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2. Metacognitive Therapy Versus Prolonged Exposure in Adults with Chronic Post-traumatic Stress Disorder: A Parallel Randomized Controlled Trial

Author

Karina Lovell, Adrian Wells, Dawn Proctor, and Deborah Walton

Subjects
medicine.medical_specialty, Traumatic stress, Experimental and Cognitive Psychology, law.invention, Prolonged exposure, Clinical trial, Clinical Psychology, Metacognitive therapy, Randomized controlled trial, law, Internal medicine, medicine, Group effect, Anxiety, medicine.symptom, Psychology, Depression (differential diagnoses), Clinical psychology
Abstract

A parallel randomized controlled trial compared metacognitive therapy (MCT) with prolonged exposure (PE) in 32 patients with PTSD of ≥3 months duration. Participants were assigned to; eight sessions of therapy (MCT or PE) or an 8-week wait period (WL). There was only one drop-out from each treatment. Both active treatments were effective, resulting in significantly lower symptoms of PTSD, anxiety and depression compared with the WL. At post-treatment MCT was superior to PE on self-report symptoms of PTSD and superior to WL on objective measures of hyper-arousal (heart-rate). Recovery rates and reliable improvement in both MCT and PE were high. MCT exerted effects more rapidly and within group effect sizes in MCT were much larger than those in PE at the end of treatment. Clinical gains remained evident at follow-up by which time the treated groups did not differ. In conclusion; both treatments were effective but MCT had a clear advantage. The clinical implications and suggestions for future research are discussed.

Published
2014
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3. Metacognition in Substance Misuse

Author

Marcantonio M. Spada, Esben Strodl, Dawn Proctor, and Gabriele Caselli

Subjects
Coping (psychology), Psychotherapist, Conceptual framework, Maladaptive coping, Substance misuse, Metacognition, Psychology, Psychopathology, Arousal, Developmental psychology
Abstract

Metacognitive theory provides a novel conceptual framework to understand the development and maintenance of psychopathology. It emphasizes the importance of stored knowledge guiding the individual’s plan for coping with heightened cognitive-affective arousal. According to the metacognitive model individuals experience strong affective responses and engage in a process of metacognitive appraisal and initiation of coping responses in the pursuit of cognitive-affective self-regulation. This chapter outlines the details of this theoretical approach as applied to substance misuse and the metacognitive treatment components aimed at interrupting the selection of maladaptive coping responses.

Published
2013
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4. List of Contributors

Author

Jeremy Adams, Christina Aivadyan, Jackie Andrade, Cecilie Schou Andreassen, Angela Attwood, Paul Aveyard, Amanda Baker, Kimberly F. Balsam, John Bancroft, Kelly S. Barth, Linda Bauld, Marta Beranuy, Arthur W. Blume, James M. Bolton, Marcel O. Bonn-Miller, Brian Borsari, Kathleen T. Brady, Ashley R. Braun, John Britton, Brian P. Brown, Justine Campbell, Xavier Carbonell, Félix Carvalho, Gabriele Caselli, Natalie Castellanos-Ryan, Grace Chan, Karen Grube Chartier, Chuan-Yu Chen, Wei J. Chen, Tammy Chung, Kelly J. Clemens, Anahi Collado-Rodriguez, Megan Conrad, Patricia J. Conrod, Jan Copeland, Christopher J. Correia, Baine B. Craft, Ann Crosland, Teresa Cunha-Oliveira, Kelly C. Davis, Mark Deady, Louisa Degenhardt, Paul H. Delfabbro, Ashley A. Dennhardt, Paul Dillon, David J. Drobes, Jessica L. Eaddy, Enrique Echeburúa, Vivian B. Faden, Miriam C. Fenton, Stuart G. Ferguson, M.J. Fernandez-Serrano, Matt Field, Nicole Fossos, Dawn W. Foster, Ingmar H.A. Franken, Irene M. Geisner, William H. George, Lilian A. Ghandour, Virginia Gil-Rivas, Amanda K. Gilmore, Meyer D. Glantz, Mark S. Gold, Vivian M. Gonzalez, Mark D. Griffiths, Christian Grov, Kristin W. Grover, Catherine A. Haighton, Peter Hajek, Wayne Hall, David J. Hanson, Paul Harrell, Deborah Hasin, Penelope Anne Hasking, Gerard Hastings, Jennifer A. Heaton, Adrienne J. Heinz, Shai Hendricks, Daniel Hermens, Michie N. Hesselbrock, Victor M. Hesselbrock, Elizabeth M. Hill, Ralph W. Hingson, Julianna Hogan, Keith J. Horvath, Sharon Hsin Hsu, Xiuqin Huang, Dorian Hunter-Reel, Qiaolei Jiang, Thomas J. Johnson, Gen Kanayama, Eileen F.S. Kaner, Jon D. Kassel, Frances Kay-Lambkin, Sharlene S. Kaye, Debra Kaysen, Eva Kemps, Jason R. Kilmer, Daniel L. King, Axel Klein, Jesse Kosiba, Jean L. Kristeller, Grace P. Lee, Keren Lehavot, Michel Lejoyeux, Carl Lejuez, Kenneth E. Leonard, Melissa A. Lewis, Kristen P. Lindgren, Jonathan Ling, Dana Litt, Andrew K. Littlefield, M. Kathleen B. Lustyk, Laura MacPherson, David A. MacQueen, Jennifer L. Maggs, Robert Malcolm, Christina Marel, G. Alan Marlatt, Matthew P. Martens, Silvia S. Martins, Jon May, Wasim Maziak, Rebecca McKetin, Ann McNeill, Linda McWhorter, Katherine L. Mills, Manish K. Mishra, Yamile Molina, Hamdy Fouad Moselhy, Kim T. Mueser, Marcus Munafò, James G. Murphy, Rachael Murray, Clayton Neighbors, Nora E. Noel, Susan Nolen-Hoeksema, Douglas L. Noordsy, Timothy J. O'Farrell, Ursula Oberst, Michael Odenwald, Catarina R. Oliveira, Jason A. Oliver, Tian P.S. Oei, Jeffrey T. Parsons, Megan E. Patrick, Martin P. Paulus, Harrison G. Pope, Patricia A. Powell, Dawn Proctor, Brian M. Quigley, Danielle E. Ramo, Ana Cristina Rego, Jürgen Rehm, Elizabeth K. Reynolds, Jennifer A. Robinson, Lindsey Rodriguez, John M. Roll, Abigail K. Rose, Harold Rosenberg, Desiree M. Rudisill, Andriy V. Samokhvalov, Zila M. Sanchez, Natalia Santoya, Rebecca L. Schacht, Trevor J. Schraufnagel, John E. Schulenberg, Jeremiah A. Schumm, Lion Shahab, Saul Shiffman, Richard L. Shriner, Rajita Sinha, Monica C. Skewes, Andrew Paul Smith, Karen E. Smith, Marcantonio Spada, Alan W. Stacy, Gillian Steckler, Jennifer L. Stewart, Carla L. Storr, Esben Strodl, Tian Po Sumantri Oei, Ran Tao, Maree Teesson, Jo Thakker, Judy Tidwell, Marika Tiggemann, J. Tirapu-Ustarroz, Tony Toneatto, Lynn M. Veatch, Jennifer C. Veilleux, A. Verdejo-García, Nasir Warfa, Aviv Weinstein, Robert West, Joseph Westermeyer, Aaron M. White, Reinout W. Wiers, Graeme B. Wilson, Rachel P. Winograd, Adam R. Winstock, Katie Witkiewitz, George E. Woody, Laura Wray-Lake, Li-Tzy Wu, Ross Mc.D. Young, Michael J. Zvolensky, and Ivori Zvorsky

Published
2013
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6. Differentiating first episode substance induced and primary psychotic disorders with concurrent substance use in young people

Author

Leanne Hides, Lisa Philips, Dawn Proctor, Dan I. Lubman, and Samantha Fraser

Subjects
Male, medicine.medical_specialty, Psychosis, Adolescent, Cross-sectional study, Substance-Related Disorders, Hostility, Logistic regression, Psychoses, Substance-Induced, Young Adult, Predictive Value of Tests, medicine, Humans, Family history, Young adult, Psychiatry, Biological Psychiatry, First episode, Psychiatric Status Rating Scales, medicine.disease, Comorbidity, Psychiatry and Mental health, Cross-Sectional Studies, Logistic Models, Psychotic Disorders, Female, medicine.symptom, Psychology, Clinical psychology
Abstract

Objective Substance use is common in first-episode psychosis, and complicates the accurate diagnosis and treatment of the disorder. The differentiation of substance-induced psychotic disorders (SIPD) from primary psychotic disorders (PPD) is particularly challenging. This cross-sectional study compares the clinical, substance use and functional characteristics of substance using first episode psychosis patients diagnosed with a SIPD and PPD. Method Participants were 61 young people (15–24 years) admitted to a psychiatric inpatient service with first episode psychosis, reporting substance use in the past month. Diagnosis was determined using the Psychiatric Research Interview for DSM-IV Substance and Mental disorders (PRISM-IV). Measures of clinical (severity of psychotic symptoms, level of insight, history of trauma), substance use (frequency/quantity, severity) and social and occupational functioning were also administered. Results The PRISM-IV differentially diagnosed 56% of first episode patients with a SIPD and 44% with a PPD. Those with a SIPD had higher rates of substance use and disorders, higher levels of insight, were more likely to have a forensic and trauma history and had more severe hostility and anxious symptoms than those with a PPD. Logistic regression analysis indicated a family history of psychosis, trauma history and current cannabis dependence were the strongest predictors of a SIPD. Almost 80% of diagnostic predictions of a SIPD were accurate using this model. Conclusions This clinical profile of SIPD could help to facilitate the accurate diagnosis and treatment of SIPD versus PPD in young people with first episode psychosis admitted to an inpatient psychiatric service.

Published
2011

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