The need to provide effective mental health treatments for adolescents has been described as a 'global public health challenge ' [27]. In this paper we discuss the exploratory evaluations of the first adolescent intervention to fully integrate a computer game implementing Cognitive Behavioural Therapy. Three distinct studies are presented: a detailed evaluation in which therapists independent of the design team used the game with 6 adolescents experiencing clinical anxiety disorders; a study in which a member of the design team used the game with 15 adolescents; and finally a study assessing the acceptability of the game and intervention with 216 practicing therapists. Findings are presented within the context of a framework for the design and evaluation of complex health interventions. The paper provides an in-depth insight into the use of therapeutic games to support adolescent interventions and provides stronger evidence than previously available for both their effectiveness and acceptability to stakeholders.

Theory of mind deficits in schizophrenia have been parsed into mental state reasoning and mental state decoding components. We report that mental state decoding as measured by the ‘Eyes task’ better predicted social function than mental state reasoning as measured by the ‘Hinting task’ in 73 out-patients with chronic schizophrenia. Mental state decoding task performance also partly mediated the influence of basic neuropsychological performance on social function. We discuss these findings in terms of the accumulating evidence that mental state decoding has particular relevance for understanding deficits in social function in schizophrenia.

Poor insight is associated with impaired cognitive function in psychosis. Whether poor clinical insight overlaps with other aspects of self-awareness in schizophrenia, such as cognitive self-awareness, is unclear. We investigated whether awareness of clinical state ("clinical insight") and awareness of cognitive deficits ("cognitive insight") overlap in schizophrenia in a sample of 51 stabilized patients with chronic schizophrenia. Cognitive insight was assessed in terms of the agreement between subjective self-report and neuropsychological assessment. Patients who show good cognitive insight did not necessarily show good clinical insight. By contrast, self-report and objective neuropsychological assessment only correlated for patients in the intact clinical insight group and not for those in the impairment clinical insight group. We conclude that while good cognitive insight may not be necessary for good clinical insight, good cognitive awareness is at least partly reliant on the processes involved in clinical insight.

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The EI service for psychosis is well-received among GPs. Information about EI delivered through CME appears to have a greater impact on referral rates and satisfaction levels than mailed information.

Objective: The aim of this study was to investigate the attitudes to medication in relation to insight, purpose in life, symptoms and sociodemographic factors among a cohort of stable patients with a diagnosis of schizophrenia and schizoaffective disorder.Method: We included 70 patients with a diagnosis of schizophrenia and schizoaffective disorder attending a Dublin suburban mental health service. All participants were 18 years or older and were excluded if they had a learning disability, acquired brain injury resulting in unconsciousness, and psychosis secondary to a general medical condition or illicit substance misuse. All participants were given self report questionnaires which included Drug Attitude Inventory (DAI-30), Birchwood Insight Scale, and Purpose in Life test. Symptoms were assessed using the Scale for Assessment of Positive and Negative symptoms. All data was analysed using the Statistical Package for the Social Sciences.Results: We found that 86% (n = 60) of the participants had positive attitudes to medication, and 82% (n = 58) had good insight into their illness. Only 27% (n = 19) were found to have a definite purpose in life. There was a significant negative relationship between attitudes to medication and delusions (r = -0.25, n = 70, p < 0.05) and a significant positive relationship between insight and attitudes to medication (r = 0.0.28, n = 70, p < 0.05).Conclusion: Many factors are involved in the multifaceted issue of attitudes to medication. Researchers must realise that these factors do not remain constant and may change with time and over the course of illness and treatment.

The past decade has witnessed increased interest in the visual search behaviour of athletes. Little is known, however, about the relationship between anxiety and eye movements in sport performers or about the extent to which athletes' planned and actual visual search strategies correspond. To address these issues, we conducted two studies. In Study 1, eight expert female gymnasts were presented with three digital slides of a model performing a skill that is known to be anxiety-provoking in this sport--namely, the 'back flip' on the beam. By varying the height of the beam and the presence or absence of safety mats, the slides differed in the amount of anxiety that they elicited vicariously in the viewer. In the study, the gymnasts were asked to imagine themselves in the position of the depicted model and to describe the anxiety that they felt. As they viewed the slides, their eye movements were recorded. As predicted, anxiety was associated with an increase in the number of fixations to peripheral areas. In addition, the more 'threatening' slides elicited significantly more fixations than the less feared images. In Study 2, the plans of 15 equestrian performers (5 expert, 5 intermediate and 5 novice) were elicited as they engaged in a virtual 'walk' around a computerized show-jumping course. Contrary to expectations, the congruence between intended and actual search behaviour was not significantly greater for expert riders than for the less skilled groups. Also, the fact that the top riders allocated more fixations to slides than the less skilled performers challenged the prediction that expertise would be associated with economy of visual search. Finally, as expected, the expert riders were significantly less dependent on the overall 'course plan' than the intermediate and novice equestrian performers when inspecting the fences.