Psychosis
Conditions
Keywords
Negative Symptoms, Autobiographical Memory
Brief summary
People with a diagnosis of psychosis often experience low motivation and pleasure when thinking about doing future activities. This leads, quite understandably, to doing fewer activities they used to enjoy and not taking up opportunities to do new activities. One model suggests that this may be partly due to difficulties using memories of previous events to help boost motivation and anticipation before a future activity. Research shows that people with psychosis may recall previous events in less detail. These memories therefore may not be as helpful as they could be for motivation. This study will investigate this by asking people with experience of psychosis and low motivation who are seen by a care team in South London and Maudsley NHS Trust to attend two research sessions. In the first session the participants will be asked to recall memories of events from their lives and the researcher will assess how detailed the memories are and how much the participant refers to the past and future. Alongside this task the participants will also be asked to complete measures of symptoms such as low pleasure and motivation as well as a measure of depression. These will be used to find out if the detail and specificity of the memories are related to these symptoms in people with psychosis. The second half of the study will then investigate whether additional prompts to support positive memory retrieval can increase the specificity of this and subsequently improve mood, motivation and self-belief. Participants will be randomised to one of two groups. The clinical group will be guided through their memory recall using prompts and a control group will be asked to recall positive memories without prompts. If the investigators show that supporting memory recall is beneficial then memories for past events may be an important target for future therapies.
Interventions
BEHAVIORALGuided Autobiographical Memory Recall
Participants are asked to recall positive autobiographical memories with the assistance of prompts to promote specificity, generalisability and links to the future. The participants will also view a 5min psychoeducation video on the subject of memory specificity and motivation.
Sponsors
King's College London
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* A diagnosis of non-affective psychosis (as determined by medical records). * Above 18yrs old. * A score of at least 18 on the Clinical Assessment Interview for Negative Symptoms. * A sufficient command of the English language to engage with the research materials
Exclusion criteria
* Lack of capacity to provide informed consent. * Primary diagnosis of intellectual disability, head injury, substance misuse or known organic cause of psychosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Post-Intervention Motivation Score | Immediately after completing the intervention | A rating on a visual analogue scale assessing motivation to repeat the same activity recalled in the future. The scale is rated from 0-100 and a higher score indicated better outcome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-Intervention Anticipatory Pleasure | Immediately after completing the intervention | A rating on a visual analogue scale assessing how pleasant that activity is anticipated to be if repeated. The scale is rated from 0-100 and a higher score indicated better outcome. |
Countries
United Kingdom
Participant flow
Recruitment details
A total of 31 people with a diagnosis of non-affective psychosis participated between May 2017-Feb 2018.
Participants by arm
| Arm | Count |
|---|---|
| Intervention Guided autobiographical memory recall to enhance specificity and links to the future. | 21 |
| Control Recall without prompts or psychoeducation video. | 10 |
| Total | 31 |
Baseline characteristics
| Characteristic | Intervention | Control | Total |
|---|---|---|---|
| Age, Continuous | 38.62 Years STANDARD_DEVIATION 10.98 | 41.10 Years STANDARD_DEVIATION 9.09 | 39.55 Years STANDARD_DEVIATION 10.83 |
| Clinical Assessment Interview for Negative Symptoms | 24.1 units on a scale STANDARD_DEVIATION 6.37 | 17.1 units on a scale STANDARD_DEVIATION 6.82 | 21.73 units on a scale STANDARD_DEVIATION 7.04 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants | 1 Participants | 1 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 21 Participants | 9 Participants | 30 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Female | 5 Participants | 2 Participants | 7 Participants |
| Sex: Female, Male Male | 16 Participants | 8 Participants | 24 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 21 | 0 / 10 |
| other Total, other adverse events | 0 / 21 | 0 / 10 |
| serious Total, serious adverse events | 0 / 21 | 0 / 10 |
Outcome results
Primary
Post-Intervention Motivation Score
A rating on a visual analogue scale assessing motivation to repeat the same activity recalled in the future. The scale is rated from 0-100 and a higher score indicated better outcome.
Time frame: Immediately after completing the intervention
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Post-Intervention Motivation Score | 81.01 units on a scale | Standard Error 4.15 |
| Control | Post-Intervention Motivation Score | 72.89 units on a scale | Standard Error 5.79 |
95% CI: [0.21, 0.86]Standardised Effect Size
Secondary
Post-Intervention Anticipatory Pleasure
A rating on a visual analogue scale assessing how pleasant that activity is anticipated to be if repeated. The scale is rated from 0-100 and a higher score indicated better outcome.
Time frame: Immediately after completing the intervention
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Post-Intervention Anticipatory Pleasure | 84.35 units on a scale | Standard Error 3.05 |
| Control | Post-Intervention Anticipatory Pleasure | 86.58 units on a scale | Standard Error 4.76 |
95% CI: [-0.59, 0.48]Standardised Effect Size