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
Efficacy Of Treatment For Resistant Command Hallucinations.
Funder
National Health and Medical Research Council
Funding Amount
$343,875.00
Summary
Auditory hallucinations (AHs), often described as voices, are a common symptom of schizophrenia and psychoses. Command hallucinations (CHs) are a type of AH in which the voice heard by the patient commands him or her to perform a particular action. The nature of the directive may vary from inconsequential actions to commands to harm the patient or others. There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the communit ....Auditory hallucinations (AHs), often described as voices, are a common symptom of schizophrenia and psychoses. Command hallucinations (CHs) are a type of AH in which the voice heard by the patient commands him or her to perform a particular action. The nature of the directive may vary from inconsequential actions to commands to harm the patient or others. There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the community. There is firm evidence pointing to the important role that CHs play in propelling psychotic individuals into serious and damaging actions. We have found, however, that most individuals who comply with dangerous CHs do so, not because they are angry, violent, antisocial or wish to cause harm, but because they feel powerless to resist. Though CHs are one of the most disturbing symptoms of psychosis, standard treatment has proved to be of limited benefit. This study will evaluate the effectiveness of Treatment of Resistant Command Hallucinations (TORCH), an innovative treatment for CHs. TORCH is an extension of an existing treatment for psychosis that we previously developed. TORCH aims to reduce the distress, worry and harmful or self-defeating behaviour associated with CHs by arming the patient with effective strategies that will enhance resistance and reduce compliance. The project has clear implications for improved clinical and therapeutic management of CHs with major public health, clinical and forensic repercussions. The consequences of being formally assessed as being at risk of acting violently result in the potential for substantial restrictions on the freedom of the individual. The availability of TORCH may prompt a less restrictive management of individuals at risk of dangerous behaviour and promote a more optimistic attitude amongst clinicians. Relatives and carers also stand to benefit through reduction in perplexing and fear-inducing behaviours.Read moreRead less
Cannabis is the most widely used illicit drug in the world. Delta-9-tetrahydrocannabinol (THC), the main psychoactive constituent of cannabis, is known to be preferentially taken up into fat tissue where it can be stored for weeks, months and possibly years. Boy fat has the capacity to store large quantities of THC and the slow passive release of THC from fat cells into the blood accounts for why THC remains at detectable levels in the blood or urine for weeks after exposure to cannabis. Under n ....Cannabis is the most widely used illicit drug in the world. Delta-9-tetrahydrocannabinol (THC), the main psychoactive constituent of cannabis, is known to be preferentially taken up into fat tissue where it can be stored for weeks, months and possibly years. Boy fat has the capacity to store large quantities of THC and the slow passive release of THC from fat cells into the blood accounts for why THC remains at detectable levels in the blood or urine for weeks after exposure to cannabis. Under normal conditions the slow passive release of THC from fat cells has negligible effects on the user as the amounts involved are so small. However, we have recent preliminary evidence to show that conditions associated with increased fat metabolism (e.g. dieting, exercise or stress) cause a greatly enhanced release of THC from fat stores into the blood supply. Further, we have demonstrated that such levels attained promote significant behavioural and physiological changes The current proposal aims to further characterise this phenomenon. We aim to: (1) determine the length of time that THC can be stored in fat before being released into blood, (2) establish that the release of THC stored in fat tissue may be promoted by fat breakdown associated with food deprivation, stress or exercise, (3) characterise the physiological and behavioural effects of THC released from fat, (4) determine the mechanisms responsible for THC release from fat, and (5) determine if THC released from fat can cross from the bloodstream into saliva. This proposal has far reaching consequences for our understanding of the long-term effects on cannabis use on physical health and behaviour. Further, it may have major implications for the correct interpretation of analytical data from road-side saliva testing and forensic and criminal cases involving cannabis use.Read moreRead less
The Australian Centre For Research Excellence In Offender Health
Funder
National Health and Medical Research Council
Funding Amount
$2,646,826.00
Summary
Offenders are one of the most marginalised groups in society and endure the worst health outcomes in regards to mental health, exposure to bloodborne viruses and sexually transmissible infections, and engagement in health risk behaviours. Incarceration devastates Indigenous communities and we urgently need for solutions to reduce Aboriginal prisoner numbers. The research proposed by this CRE in mental health and infectious diseases will improve health outcomes for offenders and provide treatment ....Offenders are one of the most marginalised groups in society and endure the worst health outcomes in regards to mental health, exposure to bloodborne viruses and sexually transmissible infections, and engagement in health risk behaviours. Incarceration devastates Indigenous communities and we urgently need for solutions to reduce Aboriginal prisoner numbers. The research proposed by this CRE in mental health and infectious diseases will improve health outcomes for offenders and provide treatment solutions rather than incarceration.Read moreRead less
Visualisation of latent DNA. This project aims to deliver a proof-of-concept that allows visualisation of invisible DNA (latent DNA) into a quick, inexpensive and practical DNA collection method that will lead to DNA evidence being available in more cases. It will build upon a proof-of-concept method ready for transferal to forensic casework. This will allow DNA evidence recovery technicians to improve their hit rate in recovering latent DNA from real crime items, leading to more informative DNA ....Visualisation of latent DNA. This project aims to deliver a proof-of-concept that allows visualisation of invisible DNA (latent DNA) into a quick, inexpensive and practical DNA collection method that will lead to DNA evidence being available in more cases. It will build upon a proof-of-concept method ready for transferal to forensic casework. This will allow DNA evidence recovery technicians to improve their hit rate in recovering latent DNA from real crime items, leading to more informative DNA profiles. Crime items that currently yield no genetic information will now be informative, assisting investigations of serious crimes or terrorist incidents.Read moreRead less
Nutritional Psychiatry: Extending The Evidence And Ensuring Translation
Funder
National Health and Medical Research Council
Funding Amount
$2,238,220.00
Summary
While poor diet is the leading contributor to illness and premature death globally, mental disorders account for the leading cause of disability. I have led the field internationally in establishing, for the first time, that diet quality and mental health are linked and have established a new field of research and clinical practice ‘Nutritional Psychiatry’. My program of research will now extend the evidence base and facilitate translation of this new knowledge into policy and practice.