Tavistock and Portman NHS Foundation Trust
Recent publications
The exploration of negative feelings is one of the core principles of psychoanalytic psychotherapy, yet anger experienced towards the therapist may lead to increased risk, ruptures in the therapeutic relationship and dropout. This study explored the psychotherapists’ immediate responses to patients’ anger in Short Term Psychoanalytic Psychotherapy (STPP). Data came from a randomised controlled trial investigating the efficacy of three types of therapy in the treatment of adolescent depression, in which therapy sessions were audio-recorded. Purposive sampling was used to select ten extracts from four different patient-therapist couples where patients expressed anger towards their therapist. Those extracts were transcribed and analysed using conversation analysis (CA). The analysis showed that following patients’ anger expression, psychotherapists were inclined to create distance either by moving aside from the topic of conversation, or by referring to ‘other times’, past or future. In only one out of the ten extracts did the psychotherapist name the young person’s anger towards them in the moment. In all other cases, psychotherapists commented on patients’ latent feelings of anger, but were inclined to create distance from explicit and direct anger-expressions. Possible reasons for this are explored, along with both clinical and research implications.
Background: Children with neurodevelopmental conditions have high levels of school absence. During the COVID-19 pandemic, schools closed for many students. The relationship between home learning during school closures and subsequent school attendance requires attention to better understand the impact of pandemic education policy decisions on this population. This study aims to investigate the association between home learning, hybrid learning and school learning during school closures (in January - March 2021) with subsequent school attendance (in May 2021) in children with neurodevelopmental conditions. Methods: An online survey was completed by 809 parents/carers of 5-15-year-old autistic children and/or children with intellectual disability. Regression models examined the association of learning location during school closures with subsequent school absence (i.e., total days missed, persistent absence, school refusal). Results: Children who were learning from home during school closures later missed 4.6 days of a possible 19. Children in hybrid and school learning missed 2.4 and 1.6 school days, respectively. The rates of school absence and persistent absence were significantly higher in the home learning group even after adjusting for confounders. Learning location was not associated with subsequent school refusal. Conclusions: Policies for school closures and learning from home during public health emergencies may exacerbate school attendance problems in this group of vulnerable children.
This chapter focuses on our third stream of research, which examines a total of 20 journals published in the year 2020, including five American criminology journals, five American criminal justice journals, five international criminology journals, and five international criminal justice journals. We begin by presenting key 2020 statistics for the 20 journals individually, as well as for each group of five journals, and then we present the five most-cited scholars in each journal. We explain how we created a combined measure of influence based on all journals that gives each journal equal weight. This allows us to merge groups of journals to identify the most-cited scholars in groups of five journals and in groups of ten journals (ten criminology journals, ten criminal justice journals, ten American journals, and ten international journals). Finally, we present a list of the most-cited scholars in all 20 journals combined and identify the most-cited works of the ten most-cited scholars. For all groups of journals, the comparative rankings of these scholars in the six previous years that we studied (at five-year intervals from 1990) are also included, so that citations are documented over a 30-year period. We also compare the most-cited scholars in these 20 journals over one year with the results from nine journals over five years and identify similarities and differences. Finally, we use concepts developed in criminal career research, examining the prevalence, frequency, specialization and versatility of the ten most-cited scholars in 2020.
This chapter provides an introduction to the book. In this chapter, we review the advantages of citation analysis as a measure of scholarly impact and prestige, as well as briefly discussing productivity analysis, a subsidiary form of citation analysis. We also give a brief overview of the main sources of citation data and explain why we chose to use the more labor-intensive method of examining journal reference lists. In this chapter, we also review our prior research from 1986 to 2015, which falls into three main areas. Our first stream of research examines the major criminology and criminal justice journals in the United States as well as in the major English-speaking countries around the world (Australia and New Zealand, Canada, and the United Kingdom). Our second research stream focuses specifically on American journals, looking at three major criminology journals and three major criminal justice journals. Finally, our third stream of research examines 20 American and international journals. Chapter 1 also includes a discussion of how concepts developed in criminal career research may be used in citation analysis. Finally, we conclude with an overview of some of the limitations of citation analysis.
Background: Gender-diverse young people navigate a cisnormative world and are subject to unique minority stressors, which have been found to contribute to adverse mental health. This research aimed to understand the experiences of clinically referred gender-diverse young people prior to commencing clinical support in gender services. Methods: The baseline measure of a newly developed questionnaire, the GIDS Gender Questionnaire (GIDS-GQ), was sent to all young people (or caregivers for those aged under 12) attending the Gender Identity Development Service (GIDS). Eighty-four young people and caregivers completed the questionnaire, with eighty-one included in the final sample (M = 15.77 years, SD = 1.83, range = 9-17; assigned female at birth = 72, assigned male at birth = 9). Questionnaires were emailed to participants via an online survey between one and three appointments with the Service. Data were collected between April 2021 and February 2022. Results: All young people had initiated a social transition, with 75.3% categorised as fully socially transitioned. More young people reported experiencing transphobic bullying (64.2%) and a lack of acceptance of their gender identity (85.1%) in the past than in the time just prior to attending the service (transphobic bullying: 12.3%; non-acceptance: 49.4%). 94.5% of the sample reported disliked body parts, most commonly breasts (80.8%), genitals (37%), and hips (31.5%). Participants most commonly reported a decrease in their mood (61.25%) and most areas of social connectedness. Conclusions: The majority of this sample had socially transitioned, were supported in their identification, and had experienced less transphobic bullying and non-acceptance prior to commencing services. However, young people continued to dislike their bodies, and experience low mood and social connectedness. Prospective research is required to understand the role of clinical support in distress management.
Background Relationship quality between a parent and a child typically differs between families with a child with intellectual disability (ID) and families with other children. Parent-child relationship quality matters in ID as it has been linked with child outcomes. However, there are few research studies examining factors that are related to parent-child relationship quality in ID. Aims The aim of the present study was to investigate factors associated with parent-child relationship quality in families of children with ID. In particular, we aimed to examine the association between the amount of time parents and children spend together in leisure activities and parent-child relationship quality. Methods and procedures The sample was drawn from the 1000 Families Study, a survey including parent-reported data from families of children with ID aged 4–16 years. Measures of parent-child relationship quality and shared parent-child time were available. Outcomes Regression analyses showed that parental investment in shared leisure time was significantly associated with parent-child closeness and conflict, even after controlling for a number of factors related to relationship quality. Parental psychological distress was also associated with parent-child relationship quality. Conclusions and implications Interventions that aim to improve parent-child relationship quality may want to investigate the role of shared parent-child time in leisure activities as one of the mechanisms of change.
This chapter focuses on our first stream of research, which examines a major criminology and criminal justice journal in the United States as well as one from each of the major English-speaking countries around the world (Australia and New Zealand, Canada, and the United Kingdom). The four journals are the Australian and New Zealand Journal of Criminology, the British Journal of Criminology, the Canadian Journal of Criminology and Criminal Justice, and Criminology, which is the house journal of the American Society of Criminology. For each journal, we discuss the results we obtained, including presenting a list of the most-cited scholars in each journal in 2016–2020 (those ranked up to 50). The comparable rankings of these scholars in the six previous five-year time periods that we studied (from 1986–1990) are also included, so that citations are documented over a 35-year period. We then explain how we created a combined measure of influence based on all four journals that gives each journal equal weight, and we present a table of the 50 most-cited scholars on this combined measure. The most-cited works of the ten most-cited scholars are also identified. This chapter concludes with a discussion of continuity and changes in citations over time.
This chapter focuses on our second stream of research, which examines six major American journals. The study includes three criminology journals (Criminology; the Journal of Quantitative Criminology; and the Journal of Research in Crime and Delinquency) as well as three criminal justice journals (Justice Quarterly, the Journal of Criminal Justice, and Criminal Justice and Behavior). For each journal, we discuss the results we obtained, including presenting a list of the most-cited scholars in each journal in 2016–2020 (those ranked up to 50). The comparable rankings of these scholars in the six previous five-year time periods (from 1986–1990) are also included, so that citations are documented over a 35-year period. We then explain how we created a combined measure of influence based on all six journals that gives each journal equal weight, and we present a table of the 50 most-cited scholars on this combined measure. The most-cited works of the ten most-cited scholars are also identified. The chapter concludes with a discussion of continuity and changes in citations over time.
This chapter describes the methodology that we have used in our citation analysis research. We go into detail regarding the main sources of citation data, including the Web of Science, Scopus, and Google Scholar, and review the limitations of each, before emphasizing our decision to examine reference lists of journal articles. The selection of the specific journals that we studied is the first step in our research process and we explain how we selected first the four English language journals and later the six American journals. We also explain why some prestigious journals had to be excluded from our research. Because of our concern that the limited number of journals studied might create a bias against scholars who do not publish in these specific journals, we later decided to investigate the most-cited scholars in a much larger number of journals, and this chapter includes a description of how we selected these additional journals. The chapter then proceeds to explain how we obtained the citation data, the process of editing and cross-checking the data, and how the citations were counted, excluding self-citations. A detailed description of the many attempts to ensure accuracy is also included. We conclude by reviewing some of the strengths and limitations of our methodology.
Importance Limited prior research suggests that transgender and gender diverse (TGD) people may have higher mortality rates than cisgender people. Objective To estimate overall and cause-specific mortality among TGD persons compared with cisgender persons. Design, Setting, and Participants This population-based cohort study used data from general practices in England contributing to the UK’s Clinical Practice Research Datalink GOLD and Aurum databases. Transfeminine (assigned male at birth) and transmasculine (assigned female at birth) individuals were identified using diagnosis codes for gender incongruence, between 1988 and 2019, and were matched to cisgender men and women according to birth year, practice, and practice registration date and linked to the Office of National Statistics death registration. Data analysis was performed from February to June 2022. Main Outcomes and Measures Cause-specific mortality counts were calculated for categories of disease as defined by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision chapters. Overall and cause-specific mortality rate ratios (MRRs) were estimated using Poisson models, adjusted for index age, index year, race and ethnicity, Index of Multiple Deprivation, smoking status, alcohol use, and body mass index. Results A total of 1951 transfeminine (mean [SE] age, 36.90 [0.34] years; 1801 White [92.3%]) and 1364 transmasculine (mean [SE] age, 29.20 [0.36] years; 1235 White [90.4%]) individuals were matched with 68 165 cisgender men (mean [SE] age, 33.60 [0.05] years; 59 136 White [86.8%]) and 68 004 cisgender women (mean [SE] age, 33.50 [0.05] years; 57 762 White [84.9%]). The mortality rate was 528.11 deaths per 100 000 person-years (102 deaths) for transfeminine persons, 325.86 deaths per 100 000 person-years (34 deaths) for transmasculine persons, 315.32 deaths per 100 000 person-years (1951 deaths) for cisgender men, and 260.61 deaths per 100 000 person-years (1608 deaths) for cisgender women. Transfeminine persons had a higher overall mortality risk compared with cisgender men (MRR, 1.34; 95% CI, 1.06-1.68) and cisgender women (MRR, 1.60; 95% CI, 1.27-2.01). For transmasculine persons, the overall MMR was 1.43 (95% CI, 0.87-2.33) compared with cisgender men and was 1.75 (95% CI, 1.08-2.83) compared with cisgender women. Transfeminine individuals had lower cancer mortality than cisgender women (MRR, 0.52; 95% CI, 0.32-0.83) but an increased risk of external causes of death (MRR, 1.92; 95% CI, 1.05-3.50). Transmasculine persons had higher mortality from external causes of death than cisgender women (MRR, 2.77; 95% CI, 1.15-6.65). Compared with cisgender men, neither transfeminine nor transmasculine adults had a significantly increased risk of deaths due to external causes. Conclusions and Relevance In this cohort study of primary care data, TGD persons had elevated mortality rates compared with cisgender persons, particularly for deaths due to external causes. Further research is needed to examine how minority stress may be contributing to deaths among TGD individuals to reduce mortality.
This paper draws on the author’s own experience of becoming a parent during the Covid-19 pandemic as a starting point from which to explore, and consider, how the experience of new parenthood was profoundly affected by the unusual and challenging circumstances created by the pandemic. Using a psychoanalytic lens, the author considers the legacy effects of Covid-19 restrictions and the atmosphere of heightened anxiety and danger, on the families who welcomed their first child in 2020 or 2021. The paper brings into focus the simultaneous experience of increased isolation and the withdrawal of support that would ordinarily be offered to new parents, along with the increased opportunities for closeness and early bonding this might bring, and considers how these factors might interrelate. It considers the changes to fatherhood that the pandemic created, and examines the benefits as well as pitfalls of the unusual circumstances brought about by successive lockdowns in the UK. The paper also explores the role that child psychotherapy has, as a profession, to examine and understand this experience for new parents and children born in the pandemic.
Menu energy labelling has been implemented as a public health policy to promote healthier dietary choices and reduce obesity. However, it is unclear whether the influence energy labelling has on consumer behaviour differs based on individuals’ demographics or characteristics and may therefore produce inequalities in diet. Data were analysed from 12 randomized control trials (N = 8508) evaluating the effect of food and drink energy labelling (vs. labelling absent) on total energy content of food and drink selections (predominantly hypothetical) in European and US adults. Analyses examined the moderating effects of participant age, sex, ethnicity/race, education, household income, body mass index, dieting status, food choice motives and current hunger on total energy content of selections. Energy labelling was associated with a small reduction (f² = 0.004, −50 kcal, p < 0.001) in total energy selected compared to the absence of energy labelling. Participants who were female, younger, white, university educated, of a higher income status, dieting, motivated by health and weight control when making food choices, and less hungry, tended to select menu items of lower energy content. However, there was no evidence that the effect of energy labelling on the amount of energy selected was moderated by any of the participants' demographics or characteristics. Energy labelling was associated with a small reduction in energy content of food selections and this effect was similar across a range of participants’ demographics and characteristics. These preliminary findings suggest that energy labelling policies may not widen existing inequalities in diet.
Introduction An increasing number of studies have demonstrated that acupuncture can influence Autonomic Nervous System functions. Heart Rate variability (HRV) is one widely used marker of autonomic activity. The main objective of this systematic review is to critically assess the evidence from randomized clinical trials (RCTs) regarding the effect of acupuncture on HRV as compared to placebo methods. Method EMBASE, Pubmed, The Cochrane Library, Web of Science, Scopus electronic databases were searched until 9 September 2020 for RCTs in which human subjects were treated with needle acupuncture using acupoints of the body without electric stimulation. Results The searches identified 1698 potentially relevant articles, 9 RCTs were included. The statistical analysis of the available data showed that the changes between pre and post treatment HF (high frequency) and LF/HF (high frequency/low frequency) values in Verum group were significant, while there were no significant changes in these parameters in Sham groups. Conclusion the results of this meta-analysis suggest that real acupuncture has superior effect over placebo acupuncture in increasing parasympathetic tone and in this way may improve physical well-being. Due to the quality of primary studies and degree of heterogeneity the results should be interpreted cautiously.
Plain english summary Organisations and researchers need to collaborate to produce new knowledge of health interventions. The literature identifies that there is a substantial evidence gap between producing knowledge and improving health outcomes. Here we reflect, via a case study methodology, on ways to co-create new knowledge by following a four-step collaborative process. The case study reviews the evaluation of an Australian-based psychoeducational program for people who attempt suicide by analysing multiple qualitative data sources to explore the perspectives of researchers and stakeholders. We discovered the need for a shared language of co-creation that focuses on experiences of collaboration while seeking out new value-creation opportunities and dismantling barriers. We learnt that implementing co-creation requires trust and good fortune within collaborative relationships alongside good management. Using the alternative collaboration framework of best practice for public health interventions in third sector organisations may eliminate gaps between research evidence and translation into practice, assisting health providers, clients, policymakers, universities, and funders.
Caring responsibilities for children and family members with complex health care needs often go unnoticed among health care staff. Statistically, a significant portion of these responsibilities are met by women, widening the gender pay gap. This article highlights the impact of caring responsibilities on physicians and the need for more inclusive work and leave policies to support recruitment and retention of this workforce, valuing both professional and lived experience in care giving.
An up-to-date and accurate picture of the evidence on the impact of poverty is a necessary element of the debate about the future direction of children’s social care services internationally. The purpose of this paper is to update evidence about the relationship between poverty and child abuse and neglect (CAN) published since a previous report in 2016 (Bywaters et al., 2016). A systematic search was conducted, identifying seven reviews. Poverty was found to be consistently and strongly associated with maltreatment, be that in terms of familial or community-level poverty, or in terms of economic security. Findings demonstrated that both the type and the quantity of economic insecurities impacted child maltreatment. Certain economic insecurities – income losses, cumulative material hardship and housing hardship – reliably predicted future child maltreatment. Likewise, as families experienced more material hardship, the risk for maltreatment intensified. In some studies, the relationship between poverty and maltreatment differed by abuse type. Future reviews need to investigate individual papers and their findings across different CAN measures, definitions, samples, abuse types and conceptualisations of poverty to provide a comprehensive understanding of the current research base and the directions which need to be taken to further understand and prevent CAN.
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Jocelyn Catty
  • Department of Education and Training
Stephen Blumenthal
  • Portman Clinic
Sarah Helps
  • Lifespan
Maria Rhode
  • Children & Families
London, United Kingdom