Información básica sobre Finlandia 53

Inclusion and exclusion criteria

Participant recruitment is based on the procedure outlined by O’Neill and McMillan (2012).

Inclusion criteria

Participants will be aged 18 to 65 years old, with a history of serious head injury (defined as post traumatic amnesia > 1 day; Russell, 1935) that occurred at least three months prior to testing. They will also have capacity to consent, as defined by professional staff members responsible for their care.

Exclusion criteria

Individuals with a learning disability, deteriorating neurological condition; ongoing alcohol and/or drug abuse; visual, hearing or communication difficulties that might affect ability to consent or understand/comply with test procedures, or severe mental illness that would prevent effective participation in the study will be excluded from the study.

Participant recruitment

Participants for an initial focus group will be approached through Headway, a registered brain injury charity. Subsequently, participants for the preparation/ information study will be identified and approached through inpatient brain injury rehabilitation services in the West of Scotland, primarily Graham Anderson House and the Murdostoun Unit, and also community groups such as Headway and West Dunbartonshire Brain Injury Project

Measures

The following assessments will be conducted prior to preparatory information. A

description of each measure, including psychometric properties where appropriate, can be found in Appendix A.

113 • Balanced Emotional Empathy Scale (BEES) (Mehrabian, 2000). A baseline measure of empathy, to examine this as a covariate.

• Test of Premorbid Functioning (Wechsler, 2011). A measure to estimate pre-injury IQ and memory abilities, to examine this as a co-variate.

• The Symbol-Digit Modalities Test. (Smith, 2010). To detect cognitive impairment, to examine this as a covariate.

• The Self Compassion Scale (Neff, 2003). A measure of compassion towards self, this will be an outcome variable within the linked study, to measure changes in this before and after CFI/relaxation intervention.

Pre and post-preparatory information assessments will include:

• Positive and negative affect schedule (PANAS) (Watson, Clark, & Tellegen, 1988). This will be a measure of outcome, measuring change in positive and negative affect before and after preparatory information.

• Fears of Compassion Scales (Gilbert, McEwan, Matos & Rivis, 2011). This will be repeated and will measure change in fears of compassion before and after preparatory information. It will measure fears of expressing compassion towards others, responding to compassion from others and expressing compassion towards oneself.

• Motivation for intervention scale. This will be adapted from the Intrinsic Motivation Inventory (IMI) (Ryan, 1982). This will measure change in motivation for the CFI or relaxation intervention before and after preparatory information.

• State-Trait- Anxiety Inventory, Short form (STAI, six item version) (Marteau & Bekker, 1992). The key measure from this will be change in state anxiety before and after preparatory information.

• Measure of attentional bias to threat. This will be an adaptation of the Imbedded Work Task (Wenzlaff et al., 2001), which involves identification of words embedded in a letter grid or ‘word search’ to measure attentional bias of depression-prone individuals to positively/negatively valenced words. This will measure change in attentional bias towards threat words before and after preparatory information.

Post- preparatory information assessment:

•Measure of knowledge of imagery interventions (constructed by researcher, can be found in Appendix B).

DESIGN

A repeated measures design will be used with the pre-post intervention difference on measure of fears of compassion, PANAS and motivation for intervention as the main outcome variables.

Research procedures

The present study will form the ‘preparatory phase’ which will then lead on to a linked study containing the ‘intervention phase,’ meaning that two researchers are involved in the study as a whole. Within both parts of the study, one researcher will complete all assessments and the other researcher will complete the preparatory information and CFI/relaxation information. The researcher responsible for intervention will randomly allocate participants to treatment, thus blinding the researcher involved in assessment to treatment type.

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Preparatory Phase

Part one of the present study will involve a focus group, where qualitative information will be sought to inform the construction of preparatory information and the delivery of CFI intervention.

Preparatory Information Production. The short preparatory DVD will be produced and

shown to all participants. In order to reduce expectation bias relating to the specific intervention, the DVD will inform patients about procedures involved in a general ‘imagery exercise’ which aims to help individuals with ‘management of the threat response,’ and it will contain information on themes central to compassion focussed theory. An outline for this has been based on Gilbert (2009), and the final information will be altered by the results of the focus group (see Appendix C).

Part two of the present study will constitute the main data collection phase. Within an inpatient unit, each participant will be asked to complete all baseline measures with the support of the researcher. They will then be asked to watch the preparatory DVD within a quiet room, with a Trainee Psychologist present. There will be a break for a five-minute discussion in the middle of this DVD in order to reduce the likelihood of fatigue and to maintain attention. Following the DVD presentation, the participant will again be asked to complete the specified post- preparatory information measures.

Intervention Phase This phase will be conducted as part of another study, and will involve

participants being randomly assigned to a CFI or relaxation intervention. Full details of this study can be found in Iain Campbell’s MRP Proposal. Figure 1 shows the overall procedure of the two studies.

Settings and Equipment

Participants will be asked to take part in the study within the inpatient unit or community group from which they had been recruited. Necessary equipment will be neuropsychological assessments, psychometric measures, attentional measures, and an encrypted laptop.

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Figure 1. Procedure for preparatory phase (present study, in black) and intervention phase (linked study, in red)