Tiago C. Zortea - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych)
<p><strong>Systematic Review</strong></p> <p><em>Background:</em> Understanding and managing suicidal behaviour poses significant challenges for healthcare professionals due to its complex nature. Network analysis offers a novel perspective on psychopatholog...
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
2024
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| _version_ | 1811140601520848896 |
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| author | Zortea, TC |
| author2 | Johns, L |
| author_facet | Johns, L Zortea, TC |
| author_sort | Zortea, TC |
| collection | OXFORD |
| description | <p><strong>Systematic Review</strong></p>
<p><em>Background:</em> Understanding and managing suicidal behaviour poses significant challenges for healthcare professionals due to its complex nature. Network analysis offers a novel perspective on psychopathology, suggesting that mental disorders arise from symptom interactions rather than a single underlying cause. This systematic review (PROSPERO CRD42023454185) investigated the application of network analysis to understanding suicide risk in clinical populations. <em>Method:</em> MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, and Web of Science were searched for studies employing network analysis to understand suicide-related outcomes in clinical populations. These studies were examined for insights into suicide-related outcomes, the role of network analysis, and proposed clinical implications. <em>Results:</em> The search yielded 1,979 records, assessed independently by two authors, and 31 publications were selected for narrative review. Findings indicate that network analysis has been used to examine complex relationships between factors linked to suicide-related outcomes, and to test and validate suicide theories. A primary focus across these studies was identifying central variables within networks, under the premise that these should be prioritised in clinical assessment and intervention. The review discusses the implications of these findings in light of recent methodological and theoretical developments in network analysis, offering recommendations for future clinical suicide research.</p>
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<p><strong>Service Improvement Project</strong></p>
<p><em>Objectives:</em> To explore potential factors associated with the observed decline in Suicide Prevented Today (SPT) rates at the Charity for Suicide Prevention (CSP), a UK-based crisis helpline, and to provide recommendations for practice improvement.</p>
<p><em>Design:</em> Mixed-methods design, incorporating quantitative analysis of service data and qualitative data from focus group interviews.</p>
<p><em>Setting:</em> A UK-based helpline charity offering telephone and webchat support.</p>
<p><em>Participants:</em> Quantitative data involved service users' outcomes, while qualitative data were gathered from two focus groups comprising CSP staff members and service users.</p>
<p><em>Primary and secondary outcome measures:</em> Primary outcome measure was the SPT rate, an agreed outcome between caller and helper at the end of a contact.</p>
<p><em>Results:</em> Quantitative analysis showed a statistically significant reduction in SPT rates, starting in July 2020. No specific events reported by CSP could be temporally associated with this decline. The inductive thematic analysis brought forth three main master themes: “Challenges in ascertaining SPT”, “Decline in SPT rates”, and “Ideas to increase SPT in the service”.</p>
<p><em>Conclusions:</em> The study identified a significant reduction in SPT rates from July 2020. While no single event explained this decline, qualitative findings highlighted several contributory factors. Recommendations for practice improvements are provided, with suggestions for further research to better understand and address these trends.</p>
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<p><strong>Theoretically Driven Research Project</strong></p>
<p><em>Background:</em> The prevalence of hoarding difficulties in the homeless population is unclear but can be up to three times higher than in the general population. The relationship between homelessness and hoarding is not understood. <em>Methods:</em> We recruited 47 individuals experiencing both homelessness and hoarding (H&H), 43 individuals with hoarding difficulties (HD), and 39 individuals who have experienced homelessness (HM). Those in the H&H and HM groups were either currently homeless or had been homeless at some time during the last 10 years. Participants completed measures of beliefs and behaviours linked to hoarding, past financial hardship and psychopathology. We hypothesised that the H&H group would score significantly higher on fear of material deprivation as a reason to hoard and report more past housing issues relative to the other groups. <em>Results:</em> Our hypotheses were partially confirmed. Although the H&H group reported higher levels of fear of material deprivation than the HM group they did not differ significantly from the HD group. Both the H&H and HM groups reported a similar number of negative past housing experiences, higher than the HD group. The H&H group reported significantly higher levels of harm avoidance as a reason to hoard and more early experiences of material deprivation. The H&H group reported higher levels of depression and anxiety relative to the other groups. <em>Conclusions:</em> Despite higher exposure to early material and financial hardship, these experiences do not appear to drive fear of material deprivation as the main motivation to hoard in the H&H group. Harm avoidance seems to be a key factor associated with hoarding behaviours in this group.</p> |
| first_indexed | 2024-09-25T04:24:35Z |
| format | Thesis |
| id | oxford-uuid:70d0189e-0252-4f84-8d23-6aff7eacd696 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:24:35Z |
| publishDate | 2024 |
| record_format | dspace |
| spelling | oxford-uuid:70d0189e-0252-4f84-8d23-6aff7eacd6962024-08-22T15:47:26ZTiago C. Zortea - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych)Thesishttp://purl.org/coar/resource_type/c_db06uuid:70d0189e-0252-4f84-8d23-6aff7eacd696Compulsive hoardingSocial sciences--network analysisHelplinesSuicideClinical psychologyHomelessnessEnglishHyrax Deposit2024Zortea, TCJohns, LSteel, CChurchard, ASalkovskis, P<p><strong>Systematic Review</strong></p> <p><em>Background:</em> Understanding and managing suicidal behaviour poses significant challenges for healthcare professionals due to its complex nature. Network analysis offers a novel perspective on psychopathology, suggesting that mental disorders arise from symptom interactions rather than a single underlying cause. This systematic review (PROSPERO CRD42023454185) investigated the application of network analysis to understanding suicide risk in clinical populations. <em>Method:</em> MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, and Web of Science were searched for studies employing network analysis to understand suicide-related outcomes in clinical populations. These studies were examined for insights into suicide-related outcomes, the role of network analysis, and proposed clinical implications. <em>Results:</em> The search yielded 1,979 records, assessed independently by two authors, and 31 publications were selected for narrative review. Findings indicate that network analysis has been used to examine complex relationships between factors linked to suicide-related outcomes, and to test and validate suicide theories. A primary focus across these studies was identifying central variables within networks, under the premise that these should be prioritised in clinical assessment and intervention. The review discusses the implications of these findings in light of recent methodological and theoretical developments in network analysis, offering recommendations for future clinical suicide research.</p> <br> <p><strong>Service Improvement Project</strong></p> <p><em>Objectives:</em> To explore potential factors associated with the observed decline in Suicide Prevented Today (SPT) rates at the Charity for Suicide Prevention (CSP), a UK-based crisis helpline, and to provide recommendations for practice improvement.</p> <p><em>Design:</em> Mixed-methods design, incorporating quantitative analysis of service data and qualitative data from focus group interviews.</p> <p><em>Setting:</em> A UK-based helpline charity offering telephone and webchat support.</p> <p><em>Participants:</em> Quantitative data involved service users' outcomes, while qualitative data were gathered from two focus groups comprising CSP staff members and service users.</p> <p><em>Primary and secondary outcome measures:</em> Primary outcome measure was the SPT rate, an agreed outcome between caller and helper at the end of a contact.</p> <p><em>Results:</em> Quantitative analysis showed a statistically significant reduction in SPT rates, starting in July 2020. No specific events reported by CSP could be temporally associated with this decline. The inductive thematic analysis brought forth three main master themes: “Challenges in ascertaining SPT”, “Decline in SPT rates”, and “Ideas to increase SPT in the service”.</p> <p><em>Conclusions:</em> The study identified a significant reduction in SPT rates from July 2020. While no single event explained this decline, qualitative findings highlighted several contributory factors. Recommendations for practice improvements are provided, with suggestions for further research to better understand and address these trends.</p> <br> <p><strong>Theoretically Driven Research Project</strong></p> <p><em>Background:</em> The prevalence of hoarding difficulties in the homeless population is unclear but can be up to three times higher than in the general population. The relationship between homelessness and hoarding is not understood. <em>Methods:</em> We recruited 47 individuals experiencing both homelessness and hoarding (H&H), 43 individuals with hoarding difficulties (HD), and 39 individuals who have experienced homelessness (HM). Those in the H&H and HM groups were either currently homeless or had been homeless at some time during the last 10 years. Participants completed measures of beliefs and behaviours linked to hoarding, past financial hardship and psychopathology. We hypothesised that the H&H group would score significantly higher on fear of material deprivation as a reason to hoard and report more past housing issues relative to the other groups. <em>Results:</em> Our hypotheses were partially confirmed. Although the H&H group reported higher levels of fear of material deprivation than the HM group they did not differ significantly from the HD group. Both the H&H and HM groups reported a similar number of negative past housing experiences, higher than the HD group. The H&H group reported significantly higher levels of harm avoidance as a reason to hoard and more early experiences of material deprivation. The H&H group reported higher levels of depression and anxiety relative to the other groups. <em>Conclusions:</em> Despite higher exposure to early material and financial hardship, these experiences do not appear to drive fear of material deprivation as the main motivation to hoard in the H&H group. Harm avoidance seems to be a key factor associated with hoarding behaviours in this group.</p> |
| spellingShingle | Compulsive hoarding Social sciences--network analysis Helplines Suicide Clinical psychology Homelessness Zortea, TC Tiago C. Zortea - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych) |
| title | Tiago C. Zortea - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych) |
| title_full | Tiago C. Zortea - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych) |
| title_fullStr | Tiago C. Zortea - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych) |
| title_full_unstemmed | Tiago C. Zortea - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych) |
| title_short | Tiago C. Zortea - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych) |
| title_sort | tiago c zortea thesis submitted in partial fulfilment of the degree of doctor of clinical psychology dclinpsych |
| topic | Compulsive hoarding Social sciences--network analysis Helplines Suicide Clinical psychology Homelessness |
| work_keys_str_mv | AT zorteatc tiagoczorteathesissubmittedinpartialfulfilmentofthedegreeofdoctorofclinicalpsychologydclinpsych |