And here it is! A thread on my thesis: Precision in the understanding and treatment of paranoia. The main aim was to show the benefits of taking an early stage translational approach to treatment development for psychosis 1/9.

thanks to @BecciDow and Kathryn Evans. Full paper (open access) 6/6:

We suggest using ideas from nudge theory to support a sustained approach to change. As for how to measure, ideas welcome! 5/6.

A brief training on cognitive behavioral approaches to delusions was valued by staff. But how can brief trainings compete with more ingrained (but nonetheless outdated) views? And how do we measure true change in this area? 4/6.

additionally, the data on numbers of older adults in the services experiencing paranoia/delusions was not easily available. But from the data we could find, it appears to be very common (over 20%). Yet only a handful of referrals for CBTp were received 3/6.

While a strength of MDT working is the integration of care from multiple perspectives, the question must be asked about whether consistent, reflective, and evidence-based patient care can be achieved in the face of such stark differences in conceptualisation and approach 2/6.

In our audit and evaluation of staff conceptualisation of delusions in two older adult CHMTs, staff held vastly different views. Many still see delusions merely as a symptom of a chronic disease with therapy having limited value beyond helping to ‘challenge’ delusions 1/6

Many thanks to @ParkinsonsUK @PUK_Oxford @drlouisecjohns @BecciDow @ProfDFreeman Bao Shang Loe! 5/5.

Cognitive-affective variables like depression and anxiety were significantly associated with PEs in structural equation models so could play a maintaining role and provide easy avenues of intervention 4/5.

Interestingly, although specific delusional ideas e.g. around spousal betrayal and abandonment were reported by 10-20%, general paranoia (R-GPTS score) was lower than in age-matched controls. We don't know why from this data alone! 3/5.

Psychotic experiences were common, including in those not taking dopaminergic medication. For a subset the experiences were distressing and unresolved. 2/5.

New open access paper: Paranoia and USEs in Parkinson's disease. We aimed to explore if our psychological models of psychosis could inform our understanding psychotic experiences in PD 1/5.

Alongside thesis, two case reports: a worry intervention in an older adult with persecutory delusions ( and use of CBTp with a young adult with grandiose delusions (in prep with @louise_isham and @drlouisecjohns, coming soon!) 5/5.

review: ‘Sleep and paranoia: a systematic review and meta-analysis.’ Paper out in Clin Psych Review, summarised in an earlier thread with thanks to @DrSReeve @MattHotton and Craig Steel 4/5.

Service project: '20 years versus 20 minutes: increasing the understanding of delusions from a cognitive behavioural perspective in two older adult community mental health teams.’ Paper in revision, thanks again to @BecciDow 3/5.

Main project: 'Paranoia and Unusual Sensory Experiences in Parkinson’s.’ Cross-sectional study of 369 people with PD, applying our cognitive models of PEs in context of PD. Paper under review, thanks to @BecciDow @drlouisecjohns @ProfDFreeman @Aidenloe86 and @ParkinsonsUK! 2/5.

Officially qualified as a Clinical Psychologist from @oxipt and @UniofOxford. Huge thanks to @vaughanbell and @lihogg22 for the thoughtful and positive feedback at viva, and to @drlouisecjohns for the wonderful clinical supervision this past year. Thesis thread below! 1/5.

Also lots of room to explore other mediators beyond anxiety/depression (e.g. rumination, alexithymia, fatigue) and a wider range of sleep difficulties including parasomnias 5/5.

Continuing the fantastic work of the @SleepWell_Study to explore early intervention in sleep dysfunction will be valuable. And what about the reverse? Does intervening on paranoia subsequently improve sleep? If not, does it increase the chances of relapse? 4/5.

No surprises here but measurement is important! Effects were larger for studies using more robust, homogenous, and well validated measures of both sleep and paranoia. 3/5.

As expected, the size of the relationship between sleep and paranoia was small to moderate. The relationship was often bi-directional, with negative affect as a mediator. 2/5.