Self-help And Guided Self-help For Bulimia Nervosa In Primary Care: A Randomised Control Trial.
Funder
National Health and Medical Research Council
Funding Amount
$206,113.00
Summary
Bulimia nervosa (BN) is a major health problem in Australian women with an estimated prevalence of 1.5%. It is frequently invisible, however as women with BN are often self-blaming, ashamed and reluctant to seek specialist help. Therapist led cognitive behavioural therapy (CBT) for BN, while effective, is expensive and frequently difficult to access. This research aims to evaluate the effectiveness of two accessible and promising treatments: CBT self-help alone and guided CBT self-help treatment ....Bulimia nervosa (BN) is a major health problem in Australian women with an estimated prevalence of 1.5%. It is frequently invisible, however as women with BN are often self-blaming, ashamed and reluctant to seek specialist help. Therapist led cognitive behavioural therapy (CBT) for BN, while effective, is expensive and frequently difficult to access. This research aims to evaluate the effectiveness of two accessible and promising treatments: CBT self-help alone and guided CBT self-help treatment conducted in primary care in which the patient receives regular guidance from a general practitioner (GP). Women with BN from the community will be randomly assigned to one of 3 conditions: self-help alone, guided self-help or delayed treatment control and symptoms assessed before and after treatment. Patient characteristics associated with improvement will be examined. We anticipate patients in guided self-help will show greatest improvement, then those in the self-help alone treatment. This information will be extremely valuable in both Australia and internationally for a number of reasons. It is ethically inappropriate to recommend any treatment before it has been shown to be effective and a careful design such as the one proposed is the best way to determine treatment effectiveness. In addition, a treatment delivered in primary care is likely to be one of the most accessible within Australia?s health care system in which specialist services tend to be centralised. Further, it is essential to know which patients are likely to benefit from less resource intensive interventions. Finally, if GPs have at their disposal an effective, evidence based treatment for BN, they would be in an ideal position for secondary prevention. They are likely under these circumstances to be more alert to the symptoms of eating disorders and confident in their ability to manage them. If successful, this research will result in more widespread treatment of this disturbing disorder.Read moreRead less
Risk Factors For Compliance With Command Hallucinations In Psychotic Disorders
Funder
National Health and Medical Research Council
Funding Amount
$180,290.00
Summary
There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the community. Whilst a number of violence risk factors such as being male, exhibiting hostility, and having a prior history of violence are well established, they are of limited use to clinicians in making management decisions. Our study will investigate a different approach to identify individuals and occasions when a sufferer might require more intensive care or ob ....There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the community. Whilst a number of violence risk factors such as being male, exhibiting hostility, and having a prior history of violence are well established, they are of limited use to clinicians in making management decisions. Our study will investigate a different approach to identify individuals and occasions when a sufferer might require more intensive care or observation. Most individuals with schizophrenia experience auditory hallucinations. Amongst these hallucinations, voices that command the individual to undertake a particular action are common; many of these involve significant potential harm to the hallucinator or to other persons. We will attempt to identify those factors that are associated with an individual obeying command hallucinations. Variables to be examined include the characteristics of the hallucinated voices, and the beliefs of the subject about the power of the voices. Subjects will be interviewed to find out whether they have delusions that are consistent with their hallucinations, whether they suffer from Antisocial Personality Disorder, or are dependent on alcohol or drugs. We will also determine whether subjects who report being raised by authoritarian parents, who are dependent on the approval of others, or who see external factors as determining the occurrence of major events in their lives, are more likely to act on their hallucinations. Two groups of 100 patients will be studied. One group will be representative of people living in the community with schizophrenia. The other group will be people with schizophrenia who have been treated by the State Forensic Psychiatric Services. Statistical models will be developed in order to determine the accuracy with which compliance with command hallucinations can be predicted. These models with also reveal which risk factors are the most important.Read moreRead less