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The cognitive process of worry, which keeps negative thoughts in mind and elaborates the content, contributes to the occurrence of many mental health disorders. Our principal aim was to develop a straightforward measure of general problematic worry suitable for research and clinical treatment. Our secondary aim was to develop a measure of problematic worry specifically concerning paranoid fears.
An item pool concerning worry in the past month was evaluated in 250 non-clinical individuals and 50 patients with psychosis in a worry treatment trial. Exploratory factor analysis and item response theory (IRT) informed the selection of scale items. IRT analyses were repeated with the scales administered to 273 non-clinical individuals, 79 patients with psychosis and 93 patients with social anxiety disorder. Other clinical measures were administered to assess concurrent validity. Test-retest reliability was assessed with 75 participants. Sensitivity to change was assessed with 43 patients with psychosis.
A 10-item general worry scale (Dunn Worry Questionnaire; DWQ) and a five-item paranoia worry scale (Paranoia Worries Questionnaire; PWQ) were developed. All items were highly discriminative (DWQ a = 1.98–5.03; PWQ a = 4.10–10.7), indicating small increases in latent worry lead to a high probability of item endorsement. The DWQ was highly informative across a wide range of the worry distribution, whilst the PWQ had greatest precision at clinical levels of paranoia worry. The scales demonstrated excellent internal reliability, test-retest reliability, concurrent validity and sensitivity to change.
The new measures of general problematic worry and worry about paranoid fears have excellent psychometric properties.
We compare the results of using a Random Forest Classifier with the results of using Nonparametric Discriminant Analysis to classify whether a filament channel (in the case of a filament eruption) or an active region (in the case of a flare) is about to produce an event. A large number of descriptors are considered in each case, but it is found that only a small number are needed in order to get most of the improvement in performance over always predicting the majority class. There is little difference in performance between the two classifiers, and neither results in substantial improvements over simply predicting the majority class.
Persecutory delusions may be unfounded threat beliefs maintained by
safety-seeking behaviours that prevent disconfirmatory evidence being
successfully processed. Use of virtual reality could facilitate new
To test the hypothesis that enabling patients to test the threat
predictions of persecutory delusions in virtual reality social
environments with the dropping of safety-seeking behaviours (virtual
reality cognitive therapy) would lead to greater delusion reduction than
exposure alone (virtual reality exposure).
Conviction in delusions and distress in a real-world situation were
assessed in 30 patients with persecutory delusions. Patients were then
randomised to virtual reality cognitive therapy or virtual reality
exposure, both with 30 min in graded virtual reality social environments.
Delusion conviction and real-world distress were then reassessed.
In comparison with exposure, virtual reality cognitive therapy led to
large reductions in delusional conviction (reduction 22.0%,
P = 0.024, Cohen's d = 1.3) and
real-world distress (reduction 19.6%, P = 0.020, Cohen's
d = 0.8).
Cognitive therapy using virtual reality could prove highly effective in
Background: Many patients do not respond adequately to current pharmacological or psychological treatments for psychosis. Persistent persecutory delusions are common in clinical services, and cause considerable patient distress and impairment. Our aim has been to build a new translational personalized treatment, with the potential for wide use, that leads to high rates of recovery in persistent persecutory delusions. We have been developing, and evaluating individually, brief modular interventions, each targeting a key causal factor identified from our cognitive model. These modules are now combined in “The Feeling Safe Programme”. Aims: To test the feasibility of a new translational modular treatment for persistent persecutory delusions and provide initial efficacy data. Method: 12 patients with persistent persecutory delusions in the context of non-affective psychosis were offered the 6-month Feeling Safe Programme. After assessment, patients chose from a personalized menu of treatment options. Four weekly baseline assessments were carried out, followed by monthly assessments. Recovery in the delusion was defined as conviction falling below 50% (greater doubt than certainty). Results: 11 patients completed the intervention. One patient withdrew before the first monthly assessment due to physical health problems. An average of 20 sessions (SD = 4.4) were received. Posttreatment, 7 out of 11 (64%) patients had recovery in their persistent delusions. Satisfaction ratings were high. Conclusions: The Feeling Safe Programme is feasible to use and was associated with large clinical benefits. To our knowledge this is the first treatment report focused on delusion recovery. The treatment will be tested in a randomized controlled trial.
Background: Ruminative negative thinking has typically been considered as a factor maintaining common emotional disorders and has recently been shown to maintain persecutory delusions in psychosis. The Perseverative Thinking Questionnaire (PTQ) (Ehring et al., 2011) is a transdiagnostic measure of ruminative negative thinking that shows promise as a “content-free” measure of ruminative negative thinking. Aims: The PTQ has not previously been studied in a psychosis patient group. In this study we report for the first time on the psychometric properties of Ehring et al.'s PTQ in such a group. Method: The PTQ was completed by 142 patients with current persecutory delusions and 273 non-clinical participants. Participants also completed measures of worry and paranoia. A confirmatory factor analysis was performed on the clinical group's PTQ responses to assess the factor structure of the measure. Differences between groups were used to assess criterion reliability. Results: A three lower-order factor structure of the PTQ (core characteristics of ruminative negative thinking, perceived unproductiveness, and capturing mental capacity) was replicated in the clinical sample. Patients with persecutory delusions were shown to experience significantly higher levels of ruminative negative thinking on the PTQ than the general population sample. The PTQ demonstrated high internal reliability. Conclusions: This study did not include test-retest data, and did not compare the PTQ against a measure of depressive rumination but, nevertheless, lends support for the validity of the PTQ as a measure of negative ruminative thinking in patients with psychosis.
The United Nations' draft Sustainable Development Goals (SDGs) only briefly mention mental health. In the context of a growing burden of disease due to mental disorders and psychosocial disabilities, the inclusion of a clear mental health target and indicators in the SDGs will acknowledge the needs and rights of hundreds of millions of people. It will mobilise international funding and policy development, and support other SDGs; it will also strengthen mental health structures, governance and services in low- and middle-income countries. We argue that for a just, sustainable and inclusive post-2015 development agenda, it is vital that the United Nations includes a clear mental health target and indicators in the SDGs.
Background: Paranoia may build directly upon negative thoughts about the self. There have been few direct experimental tests of this hypothesis. Aims: The aim of the study was to test the immediate effects of manipulating self-esteem in individuals vulnerable to paranoia. Method: A two condition cross-over experimental test was conducted. The participants were 26 males reporting paranoid ideation in the past month. Each participant experienced a neutral immersive virtual reality (VR) social environment twice. Before VR participants received a low self-confidence manipulation or a high self-confidence manipulation. The order of manipulation type was randomized. Paranoia about the VR avatars was assessed. Results: The low self-confidence manipulation, relative to the high self-confidence manipulation, led to significantly more negative social comparison in virtual reality and higher levels of paranoia. Conclusions: Level of self-confidence affects the occurrence of paranoia in vulnerable individuals. The clinical implication is that interventions designed to improve self-confidence may reduce persecutory ideation.
This paper presents a holistic, contextualised case study of reintegration and trust repair at a UK utilities firm in the wake of its fraud and data manipulation scandal. Drawing upon conceptual frameworks of reintegration and organizational trust repair, we analyze the decisions and actions taken by the company in its efforts to restore trust with its stakeholders. The analysis reveals seven themes on the merits of proposed approaches for reintegration after an integrity violation (including open investigations, accurate explanations, apologies, penance, and systemic reforms), and novel insights on the role of organizational identity, “changing of the guard” and cultural reforms alongside procedural modifications. The case further supports the dynamic nature of stakeholder salience across the reintegration process. The study both supports propositions from existing frameworks and suggests novel theoretical extensions for future research.
In the Western and Central Pacific Ocean (WCPO), which accounts for over half of world
tuna production, purse seine effort and catch on floating objects have increased
significantly due to a rapid increase in the use of fixed and free-floating fish
aggregation devices (FADs). FAD fishing has had an impact on the current status of the
stocks of the three main target tunas in the equatorial WCPO, skipjack (Katsuwonus
pelamis), yellowfin (Thunnus albacares) and bigeye (T.
obesus). FADs have been shown to influence the behaviour and movement patterns
of the three tuna species with the juveniles of each species occupying shallower habitats
when associated with FADs. Aggregation of tunas around drifting objects increases their
vulnerability to purse seine gear, particularly for juvenile and small size classes.
Further to the impacts on the target stocks, the use of FADs has increased the
vulnerability of other fishes to the purse seine method, including some shark and billfish
species. Given the concern over FAD-related fishing effort on target and bycatch species,
there is a need to understand how FAD use affects target and bycatch stocks. Science needs
to better support management decisions are highlighted including the need to identify the
magnitude of broader community-level affects.
The globalized nature of modern organizations presents new and intimidating challenges for effective relationship building. Organizations and their employees are increasingly being asked to manage unfamiliar relationships with unfamiliar parties. These relationships not only involve working across different national cultures, but also dealing with different organizational cultures, different professional cultures and even different internal constituencies. Managing such differences demands trust. This book brings together research findings on organizational trust-building across cultures. Established trust scholars from around the world consider the development and maintenance of trust between, for example, management consultants and their clients, senior international managers from different nationalities, different internal organizational groupings during times of change, international joint ventures, and service suppliers and the local communities they serve. These studies, set in a wide variety of national settings, are an important resource for academics, students and practitioners who wish to know more about the nature of cross-cultural trust-building in organizations.