The Coping with Unusual Experiences for Children Study (<scp>CUES</scp>): A pilot randomized controlled evaluation of the acceptability and potential clinical utility of a cognitive behavioural intervention package for young people aged 8–14 years with unusual experiences and emotional symptoms

Jolley, Suzanne; Kuipers, Elizabeth; Stewart, Catherine; Browning, Sophie; Bracegirdle, Karen; Basit, Nedah; Gin, Kimberley; Hirsch, Colette R.; Corrigall, Richard; Banerjea, Partha; Turley, Grainne; Ståhl, Daniel; Laurens, Kristin R.

doi:10.1111/bjc.12176

Cited by 17 publications

(18 citation statements)

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“…For the Strong and Hallucinatory classes, Emotional Symptoms were a particularly prominent psychopathological correlate (the confidence intervals separated from those of all other covariates significantly associated with these classes). Psychological distress resulting from PLEs might contribute to depressive/anxious thoughts and feelings, but also, affective disturbances have been implicated in the development and maintenance of hallucinations and delusions (Freeman & Garety, ) and are a central component of cognitive models of psychosis (Garety, Kuipers, Fowler, Freeman, & Bebbington, ) addressed in cognitive behaviour therapies for psychosis (Fowler, Garety, & Kuipers, ) and PLEs in children and adolescents (Jolley et al ., , ). However, medium‐to‐large associations of these PLE classes with the other psychopathologies, and multiple psychopathology, imply that additional treatment needs should be considered.…”

Section: Discussionmentioning

confidence: 99%

Population profiles of child‐reported psychotic‐like experiences and their differential association with other psychopathologies

Laurens

Tzoumakis

Dean

et al. 2019

British J Clinic Psychol

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Objectives. Childhood psychotic-like experiences (PLEs) increase risk for concurrent and future psychiatric disorders but are common in the population. Strategies are needed to identify vulnerable individuals who may benefit from monitoring or targeted intervention. This study aimed to delineate profiles of childhood PLEs that might be differentially associated with other psychopathologies, and multiple psychopathology.Design. Cross-sectional, online self-report survey.Methods. Participants were 27,000 Australian children from a population cohort (13,416 girls; mean age 11.91 years) who completed an online self-report questionnaire assessing PLEs (hallucinations and delusions) and Emotional, Peer Relationship, Conduct, and Hyperactivity-Inattention psychopathology. Latent class analysis differentiated classes of children showing different patterns of PLE responses, and multinomial logistic regression determined the association between the PLE classes and the various psychopathologies, adjusted for demographic covariates and the other psychopathologies.Results. Five latent profiles of PLE responses were characterized as follows: None (27.4% of children), Minor (29.7%), Moderate (11.8%), Hallucinatory (21.0%), and Strong (10.2%). These classes showed distinct associations with other psychopathologies (odds ratios between 1.27 and 4.58), and dose-response relationships indicated increasing likelihood of multiple psychopathology for the Hallucinatory and Strong classes (odds ratio = 21.87 for ≥3 psychopathologies in the Strong class).Children aged 11-12 years who report psychotic-like experiences (PLEs) can be classified into five different PLE profiles based on self-reported questionnaire responses, which may reflect different pathological processes. These PLE profiles show different patterns and magnitudes of increased risk for other types of psychopathology, and multiple psychopathology, suggesting that they present different treatment needs. Cross-sectional investigation of the associations between PLE profiles and other psychopathologies limits any conclusions as to the causal direction of these relationships. Multi-informant reports of psychopathology were unavailable.

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Section: Discussionmentioning

confidence: 99%

Population profiles of child‐reported psychotic‐like experiences and their differential association with other psychopathologies

Laurens

Tzoumakis

Dean

et al. 2019

British J Clinic Psychol

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“…Children and adolescents who present with unusual experiences, such as perceptual a bnormalities and cognitive distortions that resemble delusions and hallucinations but are below the threshold for clinical psychosis (1, 2), are at risk of mental health problems in later life (1, 3, 4). Subclinical psychotic experiences (PE) are associated with psychiatric morbidity (5–7) and may impact global functioning to a larger extent than other mental health problems (8).…”

Section: Introductionmentioning

confidence: 99%

Differences Between Self-Reported Psychotic Experiences, Clinically Relevant Psychotic Experiences, and Attenuated Psychotic Symptoms in the General Population

Moriyama

Gadelha

et al. 2019

Front. Psychiatry

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Purpose: Psychotic experiences in childhood (such as hearing voices or being suspicious) represent an important phenotype for early intervention. However, these experiences can be defined in several ways: self-reported psychotic experiences (SRPE) rely exclusively on the child’s report, clinically validated psychotic experiences (CRPE) are based on clinical assessment, and attenuated psychotic symptoms (APS) represents a categorization to do with clinical relevance in relation to severity. Very few studies have investigated how these distinctions impact clinical and other domains. The present study aims to compare SRPE, CRPE, and APS among children and adolescents.Methods: This study is part of the Brazilian High-Risk Cohort Study for Psychiatric Disorders, in which 2,241 individuals aged 6–14 years provided self-ratings of 20 psychotic experiences using the Community Assessment of Psychic Experiences (CAPE). A trained psychologist conducted an interview to validate or reject reported experiences and to rate the presence of APS and affective flattening. In parallel, parents provided information about child mental health to an independent interviewer. We tested the association of mutually exclusive categories of non-validated SRPE (nSRPE), clinically validated PE below the threshold for APS (nCRPE), and APS (nSRPE = 33%, nCRPE = 11%, APS = 6%), with parents’ information about the child’s positive attributes and levels of psychopathology and psychologist assessment of blunted affect.Results: Most associations were qualitatively similar, and there was a dose–response in the strength of associations across categories, such that APS > nCRPE > nSRPE. Experiences in all three categories were associated with female sex. nSRPE were associated with overall levels of psychopathology, but to a lesser degree than nCRPE and APS. APS and nCRPE were associated with less positive attributes, with APS more so than nCRPE. Only APS was associated with affective flattening.Conclusions: In children and adolescents, SRPE, CRPE, and APS all index liability for psychopathology, but as clinician rated relevance increases, associations get stronger and become evident across more domains.

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“…Although STYV, at this time, seems to be the first youth- and symptom-specific CBT, psychotherapy for youth targeting a broader spectrum of psychotic-like symptoms is currently being developed. In the United Kingdom, the CBT-informed treatment protocols “Coping with Unusual ExperienceS” (CUES and CUES+) for youth are being developed and evaluated (Jolley et al, 2017; Jolley et al, 2018). The CUES also draw on previous pilot work by Maddox and colleagues (2013), also showing positive results in a case series of CBT for children suffering from psychotic like experiences.…”

Section: Discussionmentioning

confidence: 99%

“…The CUES also draw on previous pilot work by Maddox and colleagues (2013), also showing positive results in a case series of CBT for children suffering from psychotic like experiences. While the main approach (both combining psychoeducation and CBT-techniques) and duration (up to 14 sessions) of STYV and CUES(+) (Jolley et al, 2017; Jolley et al, 2018) are comparable, the core difference is that STYV provides a single symptom targeted psychotherapy where CUES(+) is designed for youth with various forms of unusual (or psychotic-like) experiences (UE). Interestingly, the findings of the CUES study pointed out that UE-CBT is most promising to improve UE-specific outcomes rather than psychopathology in general (Jolley et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…While the main approach (both combining psychoeducation and CBT-techniques) and duration (up to 14 sessions) of STYV and CUES(+) (Jolley et al, 2017; Jolley et al, 2018) are comparable, the core difference is that STYV provides a single symptom targeted psychotherapy where CUES(+) is designed for youth with various forms of unusual (or psychotic-like) experiences (UE). Interestingly, the findings of the CUES study pointed out that UE-CBT is most promising to improve UE-specific outcomes rather than psychopathology in general (Jolley et al, 2018). This is in line with the aim and view of STYV to provide an add-on therapy, specifically targeting the impact of AVH, but only after (or next to) interventions primarily focusing on possible causall factors.…”

Section: Discussionmentioning

confidence: 99%

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Stronger than your voices: A cognitive behavioral therapy for youth suffering from auditory verbal hallucinations

Maijer

Staring

Bartels-Velthuis

et al. 2019

Clin Child Psychol Psychiatry

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Objective: Auditory verbal hallucinations (AVHs) are a common feature in youth and mostly transient. Nevertheless, while present, AVH can cause considerable distress. Children and adolescents seeking help for distressing AVH represent a heterogeneous group in terms of underlying factors, yet they consistently suffer from their AVH. Until now, a youth-specific psychotherapeutic intervention for AVH was lacking. Experts in the field of treating AVH in both adults and youngsters collaborated with service users to develop the cognitive behavioral therapy (CBT) “Stronger Than Your Voices” (STYV). We investigated feasibility and clinical outcomes of the STYV therapy. Methods: Patients were derived from children and adolescents seeking help for AVH at the UMC Utrecht outpatient clinic with an indication for STYV therapy. Therapists preferably originated from referring health care facilities and were required to have sufficient general knowledge and experience with CBT. They received a short individual training to apply STYV. After, patients and their therapists could participate this naturalistic pilot study, assessing feasibility, tolerability, and clinical change when applying the STYV therapy. Results: Six participants (10–16 years old), all suffering from comorbid psychopathology, provided pre and post measures, all completing STYV therapy without experiencing an aggravation of symptoms. AVH total impact decreased 40% with Cohen’s d within-group effect size (1.28) also suggesting clinically meaningful change. Therapists were positive about STYV therapy and manual. Conclusion: The STYV therapy is feasible for youth with distressing AVH. First results indicate that STYV may be clinically effective. A trial to further test effectiveness in a larger sample is needed.

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The Coping with Unusual Experiences for Children Study (CUES): A pilot randomized controlled evaluation of the acceptability and potential clinical utility of a cognitive behavioural intervention package for young people aged 8–14 years with unusual experiences and emotional symptoms

Cited by 17 publications

References 34 publications

Population profiles of child‐reported psychotic‐like experiences and their differential association with other psychopathologies

Population profiles of child‐reported psychotic‐like experiences and their differential association with other psychopathologies

Differences Between Self-Reported Psychotic Experiences, Clinically Relevant Psychotic Experiences, and Attenuated Psychotic Symptoms in the General Population

Stronger than your voices: A cognitive behavioral therapy for youth suffering from auditory verbal hallucinations

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