The present study aimed to assess whether there is an association of Early Maladaptive Schemas (EMS) in acute Axis I disorders in a mixed clinical population of 21 women and 10 men, aged between 18 and 57 years. For this purpose, two evaluation instruments were used: the Young Schema Questionnaire - Short version (YSQ-S3) and the MINI diagnostic interview Plus Version 5.0.0. For this method, cross-sectional descriptive study with a quantitative approach was performed. The sample allowed us to evaluate the association of EMS with the diagnostic category of anxiety, mood, bipolar disorder, generalized anxiety disorder (GAD) and comorbid panic disorder with agoraphobia and GAD. After collecting data, the data were subjected to statistical analyzes, performed by Fisher's exact test procedures. The results were the significance p 043 Subjugation of the EID for the group of anxiety disorders and a significance p 048 second schematic Domain - Autonomy and impaired performance for comorbid panic disorder with agoraphobia and GAD, compared to other diagnostic found in studies of anxiety. No associations of EMS for bipolarity GAD and mood disorders were found. The current literature indicates that the Schema Theory has been applied most often to personality disorders, however the stability of Early Maladaptive Schemas combine as a vulnerability factor for mood disorders and anxiety. Therefore, Schema Therapy has shown relevance for acute disorders, especially among the more chronic cases of mood and anxiety disorders, which have high levels of EMS. Research is needed to strengthen this assertion and better identify cases that may benefit most. / O presente estudo teve como objetivo principal averiguar a existência de associação de Esquemas Iniciais Desadaptativos (EIDs) em transtornos agudos de Eixo I numa amostra clínica mista de 21 mulheres e 10 homens, com idades compreendidas entre os 18 e 57 anos. Foram utilizados dois instrumentos de avaliação: o Questionário de Esquemas de Young - versão breve (YSQ-S3) e a entrevista diagnóstica M.I.N.I. Plus Version 5.0.0. Para tal, foi realizado como método um estudo transversal, descritivo, com abordagem quantitativa. A amostra possibilitou avaliar associação de EIDs com a categoria diagnóstica de ansiedade, de humor, de bipolaridade, de transtorno de ansiedade generalizada (TAG) e da comorbidade de transtorno de pânico com agorafobia e TAG. Após a coleta, os dados foram submetidos a procedimentos estatísticos e análises realizadas através do Teste Exato de Fisher. Os resultados encontrados foram uma significância p 0,043 do EID de Subjugação para o grupo de transtornos de ansiedade e uma significância p 0,048 do segundo Domínio esquemático Autonomia e desempenho prejudicados para a comorbidade de pânico com agorafobia e TAG, em comparação aos outros diagnósticos de ansiedade encontrados nos estudos. Não foram encontradas significâncias de EIDs para bipolaridade, TAG e em transtornos de humor. A literatura atual aponta que a Teoria do Esquema tem sido aplicada mais frequentemente a perturbações da personalidade, entretanto a estabilidade dos Esquemas Iniciais Desadaptativos combinam como um fator de vulnerabilidade para transtornos de humor e ansiedade. Assim sendo, a Terapia do Esquema vem apresentando relevância para os transtornos agudos, especialmente entre os casos mais crônicos de humor e ansiedade, que apresentam níveis elevados de EIDs. Pesquisas ainda são necessárias para reforçar tal afirmação e identificar melhor os casos que podem se beneficiar mais.

Critical Review of the LiteratureCan Borderline Personality Disorder be treated effectively in forensic settings? A systematic reviewBorderline Personality Disorder (BPD) is a common diagnosis in forensic settings. Certain features of BPD, such as impulsivity and emotional dysregulation, can create a vulnerability to impulsive acts. The condition is also associated with poor mental and physical health, making the treatment of BPD and its clinical features an important goal in forensic settings. This paper reviews evidence for the effectiveness of treating BPD and its symptoms using psychological approaches in forensic settings. A systematic search found 2913 papers, of which 13 met the inclusion criteria. The papers reported nine separate studies (six controlled) that implemented four distinct interventions, often adapted for particular forensic settings. Improvements in overall BPD symptomatology and specific BPD symptoms were reported for all types of intervention, although few differences in outcome between intervention and control groups were found. There were also reported improvements in BPD-related behaviours, but data on offending behaviour were absent. Heterogeneity in study quality and design makes it challenging to draw any firm conclusions about the effectiveness of any one form of treatment over another, nor about which treatment may best suit a particular setting. Further randomised controlled trials are needed to answer these questions. Service Improvement ProjectEvaluation of a brief educational intervention for clinical staff aimed at promoting trauma-informed approaches to careThere is growing evidence that trauma plays an important role in the aetiology of severe and enduring mental health problems. Yet staff can be reluctant to ask patients about trauma for reasons such as anxiety about harming patients and limited access to training. Where services have adopted trauma-informed approaches (TIAs) to mental health care (i.e., considering the ways in which trauma affects individuals when planning and delivering services), improved clinical outcomes have been observed. With this in mind, a new educational video was developed for mental health staff at an NHS trust. The video was intended to be (a) brief (10 minutes); (b) contemporary and engaging; and (c) accessible using computers, smartphones and tablets. Forty-one multidisciplinary staff viewed the video. Quantitative and qualitative evaluation indicated improvements in self-reported knowledge and confidence with regard to trauma, and a decrease in worries with regard to asking patients about such experiences. Participants found the video to be enjoyable, understandable and informative. Importantly, many indicated that it spurred them to further action, such as further training and asking patients about possible trauma. These findings indicate that a video of this type can offer an important ‘taster’ of trauma-related learning, constituting an important step towards embedding trauma-informed ways of working at a service. Main Research ProjectThe Role of Intrusive Imagery in Hoarding DisorderThe cardinal feature of Hoarding Disorder (HD) is persistent difficulty discarding possessions, with the resulting clutter compromising the intended use of living areas. Within the dominant cognitive-behavioural model of hoarding (Frost & Hartl, 1996), hoarding behaviours are positively and negatively reinforced in the context of certain object-related beliefs. Available treatments for HD have so far yielded modest outcomes, indicating a need for new approaches. Intrusive imagery has so far been neglected in HD research, despite the frequency of trauma in the histories of people with the condition. To address this, 27 individuals who met the DSM-5 criteria for HD and 28 community controls (CCs) were interviewed about their everyday experiences of mental imagery. Participants were also asked about the images they experienced during two recent real-life examples of actual or attempted discard of (1) an object of low subjective value; and (2) an object of high subjective value. Everyday imagery in the HD group commonly reflected themes of illness, death and reminiscence. Imagery in HD participants tended to carry negative emotional valence in comparison with CCs, and was associated with greater interference in everyday life and attempts to avoid the imagery. HD participants reported more negative experiences of intrusive imagery in comparison with CCs during recent episodes of discarding objects of low subjective value. However, HD participants experienced positive imagery when discarding, or trying to discard, high value objects. These findings indicate that although people with HD frequently report traumatic histories, this is not reflected in the everyday imagery that they experience. There is some evidence to suggest that the negative and positive memories experienced in relation to low and high value objects may aid our understanding of discarding and saving behaviour in HD. The theoretical and clinical implications of these findings are further discussed.