Attachment-focused iMAgery Therapy for PSychosis (A-iMAPS)

NCT05042050 | Completed

• 1 other identifier: NHS001888
• Study Type: interventional
• Target: 12
• Locations: 1 country
• Sites: 1

Brief Summary

The relationships we have in childhood affect how we relate to others across our life, including how safe or secure we feel. If our caregivers do not meet our needs well enough in childhood, this can lead to an 'insecure attachment style'. This means we may push others away or cling to them, but never feel fully safe or secure with them. This style is common in people who have mental health problems. This includes psychosis, when people have unusual experiences such as hearing voices others cannot hear. A lot of people with psychosis have difficult experiences with mental health services. This includes involuntary treatments, traumatic interactions and hospital stays, where they may think staff are trying to harm rather than help them. As a result they may not feel safe working with staff and they might re-experience the negative memories of these events. This is known as psychosis-related Post-Traumatic Stress Disorder (PR-PTSD) and can lead to ongoing problems. Imagery is often defined as mental pictures but it includes imagining our senses (smell, touch, taste) too. It can be a useful therapy tool to help people to work with difficult memories and can help them to feel more safe and secure. Research shows that this is helpful for people with psychosis and people who have been through trauma. Hence, it may be helpful for people with PR-PTSD. The study aims to see if it is viable to do a 6-session therapy using imagery to target PR-PTSD memories. The study will use a case series design where up to 12 people with psychosis will be able to try the therapy. They will be asked to complete questionnaires to understand any potential benefits of the therapy. The findings could inform the research and allow for further development of therapies in this area.

Conditions

Psychosis; Psychosis-Related PTSD

Outcome Measures

Primary Outcomes (4)

• Number of participants approached and recruited to the intervention

  Throughout recruitment phase of the study, an average of 24 weeks

• Number of sessions attended

  Calculated as a percentage

  Throughout the study, attendance recorded for each intervention session, an average of 1 year

• Number of participants who drop out of the intervention

  Including the point at which they drop out

  For the duration of the study, an average of 1 year

• Number of Adverse Events and Serious Adverts Events recorded during the study

  For the duration of the study, an average of 1 year

Secondary Outcomes (6)

• The suitability of outcome measures used, determined by the number completed

  For the duration of the study, an average of 1 year

• Change from baseline in PTSD score

  For duration of intervention, up to 12 weeks

• Change from baseline in paranoia score

  For duration of intervention, up to 12 weeks

• Change from baseline in core schemas

  For duration of intervention, up to 12 weeks

• Change from baseline in attachment style

  For duration of intervention, up to 12 weeks

Study Arms (1)

A-iMAPS Intervention

EXPERIMENTAL

Participants will receive six sessions of Attachment-focused iMAgery therapy for PSychosis. They will be randomised to different baseline lengths (two to five assessment sessions)

Behavioral: A-iMAPS

Interventions

A-iMAPS BEHAVIORAL

Imagery therapy targeting Psychosis-Related PTSD

A-iMAPS Intervention

Eligibility Criteria

• Age: 16 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Is currently receiving care under an NHS Community Mental Health Team, and meets ICD-10 or ICD-11 criteria for a schizophrenia-spectrum diagnosis (schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder or psychotic disorder not otherwise specified) indicated by case notes, or under the care of an Early Intervention in Psychosis Service
• Aged 16 or above
• Medication stable for ≥ one month, as indicated by their Care Coordinator
• Has capacity to give written, informed consent
• Proficient in English to complete study questionnaires
• A score of one or more on the four psychosis-related trauma items (items 15 to 18) on the Trauma and Life Events Checklist (Carr et al., 2018b)

You may not qualify if:

• Has an acquired brain injury
• Has a history of substance misuse that is judged to be the acute cause of the psychotic experiences
• Currently experiencing an acute episode requiring inpatient care
• Currently undertaking psychological therapy

Sponsors & Collaborators

• University of Manchester: lead
• Pennine Care NHS Foundation Trust: collaborator
• Greater Manchester Mental Health NHS Foundation Trust: collaborator

Study Sites (1)

Pennine Care NHS Foundation Trust

Manchester, United Kingdom

Location

Related Publications (9)

• Mikulincer M, Shaver PR. An attachment perspective on psychopathology. World Psychiatry. 2012 Feb;11(1):11-5. doi: 10.1016/j.wpsyc.2012.01.003.

  PMID: 22294997 BACKGROUND

• Carr SC, Hardy A, Fornells-Ambrojo M. Relationship between attachment style and symptom severity across the psychosis spectrum: A meta-analysis. Clin Psychol Rev. 2018 Feb;59:145-158. doi: 10.1016/j.cpr.2017.12.001. Epub 2017 Dec 6.

  PMID: 29229220 BACKGROUND

• Lavin R, Bucci S, Varese F, Berry K. The relationship between insecure attachment and paranoia in psychosis: A systematic literature review. Br J Clin Psychol. 2020 Mar;59(1):39-65. doi: 10.1111/bjc.12231. Epub 2019 Aug 7.

  PMID: 31390076 BACKGROUND

• Bullock G, Newman-Taylor K, Stopa L. The role of mental imagery in non-clinical paranoia. J Behav Ther Exp Psychiatry. 2016 Mar;50:264-8. doi: 10.1016/j.jbtep.2015.10.002. Epub 2015 Oct 8.

  PMID: 26492591 BACKGROUND

• Pitfield C, Maguire T, Newman-Taylor K. Impact of attachment imagery on paranoia and mood: evidence from two single case studies. Behav Cogn Psychother. 2020 Sep;48(5):572-583. doi: 10.1017/S1352465820000351. Epub 2020 Jun 29.

  PMID: 32594948 BACKGROUND

• Morrison AP. The use of imagery in cognitive therapy for psychosis: a case example. Memory. 2004 Jul;12(4):517-24. doi: 10.1080/09658210444000142.

  PMID: 15487547 BACKGROUND

• Holmes EA, Mathews A, Dalgleish T, Mackintosh B. Positive interpretation training: effects of mental imagery versus verbal training on positive mood. Behav Ther. 2006 Sep;37(3):237-47. doi: 10.1016/j.beth.2006.02.002. Epub 2006 May 24.

  PMID: 16942975 BACKGROUND

• Taylor CDJ, Bee PE, Kelly J, Emsley R, Haddock G. iMAgery focused psychological therapy for persecutory delusions in PSychosis (iMAPS): a multiple baseline experimental case series. Behav Cogn Psychother. 2020 Sep;48(5):530-545. doi: 10.1017/S1352465820000168. Epub 2020 Apr 8.

  PMID: 32264985 BACKGROUND

• Buswell G, Haime Z, Lloyd-Evans B, Billings J. A systematic review of PTSD to the experience of psychosis: prevalence and associated factors. BMC Psychiatry. 2021 Jan 7;21(1):9. doi: 10.1186/s12888-020-02999-x.

  PMID: 33413179 BACKGROUND

MeSH Terms

Conditions

Psychotic Disorders

Condition Hierarchy (Ancestors)

Schizophrenia Spectrum and Other Psychotic Disorders; Mental Disorders

Study Officials

• Katherine Berry, PhD

  University of Manchester

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Trainee Clinical Psychologist

Model Details: Proof of Concept Case Series Design

Study Record Dates

• First Submitted: August 31, 2021
• First Posted: September 13, 2021
• Study Start: April 27, 2022
• Primary Completion: November 16, 2022
• Study Completion: November 23, 2022
• Last Updated: November 28, 2022

Record last verified: 2022-11

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)