Counselling psychologists in eight countries (Australia, Canada, New Zealand, South Africa, South... more Counselling psychologists in eight countries (Australia, Canada, New Zealand, South Africa, South Korea, Taiwan, the United Kingdom, and the United States) responded to survey questions that focused on their demographics as well as their professional identities, roles, settings and activities. As well, they were asked about satisfaction with the specialty and the extent to which they endorsed 10 core counselling psychology values. This article reports those results, focusing both on areas in which there were between-country similarities as well as on those for which there were differences. These data provide is a snapshot of counselling psychology globally and establish a foundation for the other articles in this special issue of the journal.
Counselling psychology within the UK has grown over the last three decades, adapting to many chan... more Counselling psychology within the UK has grown over the last three decades, adapting to many changes in the field of applied psychology, whilst remaining true to its core values and humanistic origins. The identity of counselling psychology is strongly rooted in a relational stance and applied psychology, where attention to psychological formulation is given to improve psychological functioning and well-being. This article outlines a brief history of counseling psychology in the UK, the training process, credentialing and looks at some important challenges and future directions for counselling psychology in the UK. A proportion of the members from the British Psychological Society’s division of counselling psychology (DCoP, N = 148) took part in the study. Participants provided demographic, training, employment, workplace and career pathway information obtained through an online questionnaire distributed to all DCoP members. On the whole, DCoP members are working in a variety of areas within the UK and the findings of this article contribute to the international study comparing counselling psychology across the globe.
There may be important public health implications of increasing our knowledge of factors associat... more There may be important public health implications of increasing our knowledge of factors associated with age of dementia onset. The pre-morbid personality domain of Neuroticism constituted an interesting and theoretically plausible, yet uninvestigated, candidate for such an association. We aimed to examine whether midlife Neuroticism was associated with earlier age of onset of Alzheimer's disease (AD). This was a case-comparison study of 213 patients with probable AD. Detailed clinical information was collected for all patients including age of onset of dementia symptoms. One or two knowledgeable informants rated each patient's midlife personality retrospectively using the Neuroticism, Extraversion, Openness Five-Factor Inventory (NEO-FFI) questionnaire. The relationship between midlife Neuroticism and age of dementia onset was evaluated using both correlational analysis and backward linear regression analysis. Midlife Neuroticism predicted younger age of dementia onset in females but not in males. The association found in females was independent of pre-morbid history of affective disorder. This finding and its potential mechanism warrant further investigation.
Whilst business travel is deemed important for organisational success and economic outcomes, litt... more Whilst business travel is deemed important for organisational success and economic outcomes, little is known about the actual process of business travelling from the perspective of individuals who undertake such travel on a regular basis. Thus the current qualitative study examined how business travellers (three women and eight men) attempt to find a balance between work and family, by focusing
and to assess the influence of other variables such as gender, age, education, manual activities ... more and to assess the influence of other variables such as gender, age, education, manual activities and reading habits in this sample. Methods: The sample consisted of 520 individuals of both sexes from three different health care institutions (School Hospital, Center for Living and Unit-Family Health). All participants received a questionnaire and the standard Mini Mental State Examination (MMSE), which is an auxiliary method of treatment of possible cognitive deficits in individuals at risk, such as the elderly. The cutoff used was 13 points for illiterates, 18 for primary and secondary education and 26 for high school graduates (Bertolucci, 1994). Results: The mean age was 66.3 years. The mean score of MMSE in the total sample was 24.8 points.19.6% of the total sample had scores suggestive of dementia, with similar distribution between the sexes. Frequency of manual activity and reading are inversely related to the frequency of cognitive impairment. Conclusions: It was observed that the prevalence rates suggesting dementia were lower in the Center for Living, which may be correlated with the frequent practice of physical and social activities, and possibly greater interpersonal contact. Individuals from the primary unit and tertiary care displayed similar prevalence.
International Journal of Geriatric Psychiatry, 2010
Objective: To examine the association between premorbid personality traits, social networks and A... more Objective: To examine the association between premorbid personality traits, social networks and AD, using a case-control design, and two informant-based retrospective assessments of premorbid personality. Methods: Cases consisted of 217 Subjects diagnosed with probable late onset Alzheimer's disease (160 females and 57 males). Recruitment was from both community and nursing home settings. Controls consisted of 76 unaffected siblings (44 females and 32 males) of patients with AD. Both cases and controls received informant ratings of premorbid personality. Results: A selection of abnormal personality traits were over represented in the AD group. AD was particularly associated with Cluster A personality disorder traits (Paranoid, Schizoid, Schizotypal). AD cases had correspondingly sparser social networks. Conclusions: There is an association between abnormal personality traits and AD. Individuals with AD also appear to have had lower levels of social interactivity.
Alzheimer's & Dementia: The Journal of the Alzheimer's Association, Vol... more Alzheimer's & Dementia: The Journal of the Alzheimer's Association, Volume 6, Issue 4, Pages S451, July 2010, Authors:Mohammed O. Husain; Helen Nicholas; Paul Moran; Catherine Foy; Richard Brown; Simon Lovestone; Stephanie Bryant; Harry Boothby.
BackgroundPrescribed drugs in patients with Alzheimer's disease may affect the symptomatic progre... more BackgroundPrescribed drugs in patients with Alzheimer's disease may affect the symptomatic progression of their disease, both positively and negatively.AimTo examine the effects of drugs on the progression of disease in a representative group of patients with Alzheimer's disease.MethodsPatients with the diagnosis of probable Alzheimer's disease were recruited from the community. The prescribed drugs taken by 224 patients (mean age 82.3 years) were recorded at initial assessment and then correlated in logistic regression analysis with progression of the disease, defined as an increase of one point or more in the Global Deterioration Scale over the next 12‐month period.ResultsPatients who were taking antipsychotic drugs and sedatives had a significantly higher risk of deterioration than those who were taking none (odds ratios (ORs) 2.74 (95% confidence interval (CI) 1.17 to 6.41) and 2.77 (95% CI 1.14 to 6.73), respectively). Higher risk of deterioration was observed in those who were taking both antipsychotic and sedative drugs together (OR 3.86 (95% CI 1.28 to 11.7). Patients taking drugs licensed for dementia, drugs affecting the renin–angiotensin system and statins had a significantly lower risk of deterioration than those who were not taking any of these drugs (ORs 0.49 (95% CI 0.25 to 0.97), 0.31 (95% CI 0.11 to 0.85) and 0.12 (95% CI 0.03 to 0.52), respectively).ConclusionOur findings have implications for both clinicians and trialists. Most importantly, clinicians should carefully weigh any potential benefits of antipsychotics and benzodiazepines, especially in combination, against the risk of increased decline. Researchers need to be aware of the potential of not only licensed drugs for dementia but also drugs affecting the renin–angiotensin system and statins in reducing progression in clinical trials.
Objective: To examine the association between premorbid personality traits, social networks and A... more Objective: To examine the association between premorbid personality traits, social networks and AD, using a case-control design, and two informant-based retrospective assessments of premorbid personality. Methods: Cases consisted of 217 Subjects diagnosed with probable late onset Alzheimer's disease (160 females and 57 males). Recruitment was from both community and nursing home settings. Controls consisted of 76 unaffected siblings (44 females and 32 males) of patients with AD. Both cases and controls received informant ratings of premorbid personality. Results: A selection of abnormal personality traits were over represented in the AD group. AD was particularly associated with Cluster A personality disorder traits (Paranoid, Schizoid, Schizotypal). AD cases had correspondingly sparser social networks. Conclusions: There is an association between abnormal personality traits and AD. Individuals with AD also appear to have had lower levels of social interactivity.
Background An accurate diagnosis of Alzheimer's disease and an exclusion of other dementias is im... more Background An accurate diagnosis of Alzheimer's disease and an exclusion of other dementias is important in many clinical studies. Obtaining such a clinical diagnosis in epidemiological studies and clinical trials that recruit large numbers of patients is time consuming. Objectives To construct an algorithm using a limited number of data points to generate a diagnosis of the commonest forms of dementia using information collected by non clinicians. Methods We constructed a computer algorithm to generate a diagnosis of Alzheimer's disease (AD), Dementia with Lewy Bodies (DLB), frontotemporal dementia (FTD), vascular dementia or to flag the case as needing a clinical review based on a limited number of data points taken from a largely structured interview using widely used scales. The diagnosis generated in life by the algorithm in a prospective, longitudinal study was compared to definitive diagnosis at post mortem. Results Post mortem diagnosis was available for 43 cases. The positive predictive value of the algorithm was greater than 95%. AD was diagnosed by the algorithm and at post mortem in 36 of the cases.Two cases with FTD were wrongly diagnosed as having AD by the algorithm, five cases were flagged as needing a clinical review due to concomitant medical conditions of whom four had AD and one, who had been diagnosed clinically as having AD, was diagnosed on post mortem with corticobasal degeneration. Conclusions A combination of non-clinical researchers, a structured interview and a computerised algorithm is as effective at identifying AD as highly trained and skilled clinicians.
Aim To assess the inter-informant reliability, intra-informant reliability and internal consisten... more Aim To assess the inter-informant reliability, intra-informant reliability and internal consistency of the NEO-FFI as a measure of premorbid personality in patients with Alzheimer's Disease (AD). Subjects One hundred and five persons with NINCDS-ADRDA probable AD for the assessment of inter-informant reliability and internal consistency, and 30 for the assessment of intra-informant reliability. Methods Premorbid personality was rated retrospectively by close relatives remembering the patient as he/she had been when aged in his/her forties. One hundred and five AD patients were rated by two separate informants. Thirty AD patients were rated by the same informant on separate occasions one year apart. Results Inter-informant reliability for the five domain scores of the NEO-FFI was shown to range from fair to good when measured using the single measure Intraclass Correlation Co-efficient (ICC) (0.52-0.64), and to range from good to excellent when measured using the average ICC (0.68-0.78). Intra-informant reliability for four out of the five domains was shown to be excellent when measured using the single ICC (0.81-0.92), and good for the remaining domain (0.72). Intra-informant reliability was found to be excellent for all five domains when measured using the average ICC (0.84-0.96). Internal consistency of the five domains was good. Conclusions The NEO-FFI can be used reliably to measure premorbid personality in patients with probable AD. It may be useful to maximise reliability by using a mean domain score based on questionnaires completed by two or more informants who knew the patient well earlier in life.
Previous research investigating the influence of premorbid personality on behavioral and psycholo... more Previous research investigating the influence of premorbid personality on behavioral and psychological symptoms in dementia (BPSD) has produced mixed findings. Addressing some limitations of previous studies, the authors aimed to investigate whether some of the common individual symptoms of BPSD (depression, anxiety, irritability, and aggression) were associated with key aspects of previous personality (neuroticism and agreeableness); and also to perform an exploratory investigation into the broader influence of personality factors on behavioral and psychological syndromes. Two hundred eight patients with a diagnosis of probable Alzheimer disease were assessed for the presence of BPSD over the disease course using the caregiver-rated Neuropsychiatric Inventory (NPI). One or two knowledgeable informants rated patients' midlife personalities using a retrospective version of the NEO-FFI questionnaire. Premorbid neuroticism was correlated with anxiety and total NPI score, although not with depression. Premorbid agreeableness was negatively correlated with agitation and irritability. Principal components analysis of the 10 NPI behavioral domains identified three syndromes: "agitation/apathy,"…
Counselling psychologists in eight countries (Australia, Canada, New Zealand, South Africa, South... more Counselling psychologists in eight countries (Australia, Canada, New Zealand, South Africa, South Korea, Taiwan, the United Kingdom, and the United States) responded to survey questions that focused on their demographics as well as their professional identities, roles, settings and activities. As well, they were asked about satisfaction with the specialty and the extent to which they endorsed 10 core counselling psychology values. This article reports those results, focusing both on areas in which there were between-country similarities as well as on those for which there were differences. These data provide is a snapshot of counselling psychology globally and establish a foundation for the other articles in this special issue of the journal.
Counselling psychology within the UK has grown over the last three decades, adapting to many chan... more Counselling psychology within the UK has grown over the last three decades, adapting to many changes in the field of applied psychology, whilst remaining true to its core values and humanistic origins. The identity of counselling psychology is strongly rooted in a relational stance and applied psychology, where attention to psychological formulation is given to improve psychological functioning and well-being. This article outlines a brief history of counseling psychology in the UK, the training process, credentialing and looks at some important challenges and future directions for counselling psychology in the UK. A proportion of the members from the British Psychological Society’s division of counselling psychology (DCoP, N = 148) took part in the study. Participants provided demographic, training, employment, workplace and career pathway information obtained through an online questionnaire distributed to all DCoP members. On the whole, DCoP members are working in a variety of areas within the UK and the findings of this article contribute to the international study comparing counselling psychology across the globe.
There may be important public health implications of increasing our knowledge of factors associat... more There may be important public health implications of increasing our knowledge of factors associated with age of dementia onset. The pre-morbid personality domain of Neuroticism constituted an interesting and theoretically plausible, yet uninvestigated, candidate for such an association. We aimed to examine whether midlife Neuroticism was associated with earlier age of onset of Alzheimer's disease (AD). This was a case-comparison study of 213 patients with probable AD. Detailed clinical information was collected for all patients including age of onset of dementia symptoms. One or two knowledgeable informants rated each patient's midlife personality retrospectively using the Neuroticism, Extraversion, Openness Five-Factor Inventory (NEO-FFI) questionnaire. The relationship between midlife Neuroticism and age of dementia onset was evaluated using both correlational analysis and backward linear regression analysis. Midlife Neuroticism predicted younger age of dementia onset in females but not in males. The association found in females was independent of pre-morbid history of affective disorder. This finding and its potential mechanism warrant further investigation.
Whilst business travel is deemed important for organisational success and economic outcomes, litt... more Whilst business travel is deemed important for organisational success and economic outcomes, little is known about the actual process of business travelling from the perspective of individuals who undertake such travel on a regular basis. Thus the current qualitative study examined how business travellers (three women and eight men) attempt to find a balance between work and family, by focusing
and to assess the influence of other variables such as gender, age, education, manual activities ... more and to assess the influence of other variables such as gender, age, education, manual activities and reading habits in this sample. Methods: The sample consisted of 520 individuals of both sexes from three different health care institutions (School Hospital, Center for Living and Unit-Family Health). All participants received a questionnaire and the standard Mini Mental State Examination (MMSE), which is an auxiliary method of treatment of possible cognitive deficits in individuals at risk, such as the elderly. The cutoff used was 13 points for illiterates, 18 for primary and secondary education and 26 for high school graduates (Bertolucci, 1994). Results: The mean age was 66.3 years. The mean score of MMSE in the total sample was 24.8 points.19.6% of the total sample had scores suggestive of dementia, with similar distribution between the sexes. Frequency of manual activity and reading are inversely related to the frequency of cognitive impairment. Conclusions: It was observed that the prevalence rates suggesting dementia were lower in the Center for Living, which may be correlated with the frequent practice of physical and social activities, and possibly greater interpersonal contact. Individuals from the primary unit and tertiary care displayed similar prevalence.
International Journal of Geriatric Psychiatry, 2010
Objective: To examine the association between premorbid personality traits, social networks and A... more Objective: To examine the association between premorbid personality traits, social networks and AD, using a case-control design, and two informant-based retrospective assessments of premorbid personality. Methods: Cases consisted of 217 Subjects diagnosed with probable late onset Alzheimer's disease (160 females and 57 males). Recruitment was from both community and nursing home settings. Controls consisted of 76 unaffected siblings (44 females and 32 males) of patients with AD. Both cases and controls received informant ratings of premorbid personality. Results: A selection of abnormal personality traits were over represented in the AD group. AD was particularly associated with Cluster A personality disorder traits (Paranoid, Schizoid, Schizotypal). AD cases had correspondingly sparser social networks. Conclusions: There is an association between abnormal personality traits and AD. Individuals with AD also appear to have had lower levels of social interactivity.
Alzheimer's & Dementia: The Journal of the Alzheimer's Association, Vol... more Alzheimer's & Dementia: The Journal of the Alzheimer's Association, Volume 6, Issue 4, Pages S451, July 2010, Authors:Mohammed O. Husain; Helen Nicholas; Paul Moran; Catherine Foy; Richard Brown; Simon Lovestone; Stephanie Bryant; Harry Boothby.
BackgroundPrescribed drugs in patients with Alzheimer's disease may affect the symptomatic progre... more BackgroundPrescribed drugs in patients with Alzheimer's disease may affect the symptomatic progression of their disease, both positively and negatively.AimTo examine the effects of drugs on the progression of disease in a representative group of patients with Alzheimer's disease.MethodsPatients with the diagnosis of probable Alzheimer's disease were recruited from the community. The prescribed drugs taken by 224 patients (mean age 82.3 years) were recorded at initial assessment and then correlated in logistic regression analysis with progression of the disease, defined as an increase of one point or more in the Global Deterioration Scale over the next 12‐month period.ResultsPatients who were taking antipsychotic drugs and sedatives had a significantly higher risk of deterioration than those who were taking none (odds ratios (ORs) 2.74 (95% confidence interval (CI) 1.17 to 6.41) and 2.77 (95% CI 1.14 to 6.73), respectively). Higher risk of deterioration was observed in those who were taking both antipsychotic and sedative drugs together (OR 3.86 (95% CI 1.28 to 11.7). Patients taking drugs licensed for dementia, drugs affecting the renin–angiotensin system and statins had a significantly lower risk of deterioration than those who were not taking any of these drugs (ORs 0.49 (95% CI 0.25 to 0.97), 0.31 (95% CI 0.11 to 0.85) and 0.12 (95% CI 0.03 to 0.52), respectively).ConclusionOur findings have implications for both clinicians and trialists. Most importantly, clinicians should carefully weigh any potential benefits of antipsychotics and benzodiazepines, especially in combination, against the risk of increased decline. Researchers need to be aware of the potential of not only licensed drugs for dementia but also drugs affecting the renin–angiotensin system and statins in reducing progression in clinical trials.
Objective: To examine the association between premorbid personality traits, social networks and A... more Objective: To examine the association between premorbid personality traits, social networks and AD, using a case-control design, and two informant-based retrospective assessments of premorbid personality. Methods: Cases consisted of 217 Subjects diagnosed with probable late onset Alzheimer's disease (160 females and 57 males). Recruitment was from both community and nursing home settings. Controls consisted of 76 unaffected siblings (44 females and 32 males) of patients with AD. Both cases and controls received informant ratings of premorbid personality. Results: A selection of abnormal personality traits were over represented in the AD group. AD was particularly associated with Cluster A personality disorder traits (Paranoid, Schizoid, Schizotypal). AD cases had correspondingly sparser social networks. Conclusions: There is an association between abnormal personality traits and AD. Individuals with AD also appear to have had lower levels of social interactivity.
Background An accurate diagnosis of Alzheimer's disease and an exclusion of other dementias is im... more Background An accurate diagnosis of Alzheimer's disease and an exclusion of other dementias is important in many clinical studies. Obtaining such a clinical diagnosis in epidemiological studies and clinical trials that recruit large numbers of patients is time consuming. Objectives To construct an algorithm using a limited number of data points to generate a diagnosis of the commonest forms of dementia using information collected by non clinicians. Methods We constructed a computer algorithm to generate a diagnosis of Alzheimer's disease (AD), Dementia with Lewy Bodies (DLB), frontotemporal dementia (FTD), vascular dementia or to flag the case as needing a clinical review based on a limited number of data points taken from a largely structured interview using widely used scales. The diagnosis generated in life by the algorithm in a prospective, longitudinal study was compared to definitive diagnosis at post mortem. Results Post mortem diagnosis was available for 43 cases. The positive predictive value of the algorithm was greater than 95%. AD was diagnosed by the algorithm and at post mortem in 36 of the cases.Two cases with FTD were wrongly diagnosed as having AD by the algorithm, five cases were flagged as needing a clinical review due to concomitant medical conditions of whom four had AD and one, who had been diagnosed clinically as having AD, was diagnosed on post mortem with corticobasal degeneration. Conclusions A combination of non-clinical researchers, a structured interview and a computerised algorithm is as effective at identifying AD as highly trained and skilled clinicians.
Aim To assess the inter-informant reliability, intra-informant reliability and internal consisten... more Aim To assess the inter-informant reliability, intra-informant reliability and internal consistency of the NEO-FFI as a measure of premorbid personality in patients with Alzheimer's Disease (AD). Subjects One hundred and five persons with NINCDS-ADRDA probable AD for the assessment of inter-informant reliability and internal consistency, and 30 for the assessment of intra-informant reliability. Methods Premorbid personality was rated retrospectively by close relatives remembering the patient as he/she had been when aged in his/her forties. One hundred and five AD patients were rated by two separate informants. Thirty AD patients were rated by the same informant on separate occasions one year apart. Results Inter-informant reliability for the five domain scores of the NEO-FFI was shown to range from fair to good when measured using the single measure Intraclass Correlation Co-efficient (ICC) (0.52-0.64), and to range from good to excellent when measured using the average ICC (0.68-0.78). Intra-informant reliability for four out of the five domains was shown to be excellent when measured using the single ICC (0.81-0.92), and good for the remaining domain (0.72). Intra-informant reliability was found to be excellent for all five domains when measured using the average ICC (0.84-0.96). Internal consistency of the five domains was good. Conclusions The NEO-FFI can be used reliably to measure premorbid personality in patients with probable AD. It may be useful to maximise reliability by using a mean domain score based on questionnaires completed by two or more informants who knew the patient well earlier in life.
Previous research investigating the influence of premorbid personality on behavioral and psycholo... more Previous research investigating the influence of premorbid personality on behavioral and psychological symptoms in dementia (BPSD) has produced mixed findings. Addressing some limitations of previous studies, the authors aimed to investigate whether some of the common individual symptoms of BPSD (depression, anxiety, irritability, and aggression) were associated with key aspects of previous personality (neuroticism and agreeableness); and also to perform an exploratory investigation into the broader influence of personality factors on behavioral and psychological syndromes. Two hundred eight patients with a diagnosis of probable Alzheimer disease were assessed for the presence of BPSD over the disease course using the caregiver-rated Neuropsychiatric Inventory (NPI). One or two knowledgeable informants rated patients' midlife personalities using a retrospective version of the NEO-FFI questionnaire. Premorbid neuroticism was correlated with anxiety and total NPI score, although not with depression. Premorbid agreeableness was negatively correlated with agitation and irritability. Principal components analysis of the 10 NPI behavioral domains identified three syndromes: "agitation/apathy,"…
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that focused on their demographics as well as their professional identities, roles, settings and activities. As well, they were asked about satisfaction with the specialty and the extent to which they endorsed 10 core counselling psychology values. This article reports those results, focusing both on areas in which there were between-country similarities as well as on those for which there were differences. These data provide is a snapshot of counselling psychology globally and
establish a foundation for the other articles in this special issue of the journal.
is strongly rooted in a relational stance and applied psychology,
where attention to psychological formulation is given to improve psychological functioning and well-being. This article outlines a brief history of counseling psychology in the UK, the training process, credentialing and looks at some important challenges and future directions for counselling psychology in
the UK. A proportion of the members from the British Psychological Society’s division of counselling psychology (DCoP, N = 148) took part in the study. Participants provided demographic, training, employment, workplace and career pathway information obtained through an online questionnaire distributed to all DCoP members. On the whole, DCoP members are working in a variety of areas within the UK and the findings of this article contribute to the international study comparing counselling psychology across the globe.
that focused on their demographics as well as their professional identities, roles, settings and activities. As well, they were asked about satisfaction with the specialty and the extent to which they endorsed 10 core counselling psychology values. This article reports those results, focusing both on areas in which there were between-country similarities as well as on those for which there were differences. These data provide is a snapshot of counselling psychology globally and
establish a foundation for the other articles in this special issue of the journal.
is strongly rooted in a relational stance and applied psychology,
where attention to psychological formulation is given to improve psychological functioning and well-being. This article outlines a brief history of counseling psychology in the UK, the training process, credentialing and looks at some important challenges and future directions for counselling psychology in
the UK. A proportion of the members from the British Psychological Society’s division of counselling psychology (DCoP, N = 148) took part in the study. Participants provided demographic, training, employment, workplace and career pathway information obtained through an online questionnaire distributed to all DCoP members. On the whole, DCoP members are working in a variety of areas within the UK and the findings of this article contribute to the international study comparing counselling psychology across the globe.