Richard Bentall

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Richard Bentall

FBA
Born (1956-09-30) 30 September 1956 (age 67)
Sheffield, United Kingdom
Alma mater University College of North Wales (Bangor), University of Liverpool, University of Wales, Swansea
Known forResearching schizophrenia and bipolar disorder
Awards British Academy Fellow, May Davidson Award
Scientific career
Fields Clinical psychology
Institutions National Health Service, Bangor University, University of Manchester, University of Liverpool

Richard Bentall FBA (born 30 September 1956) is a Professor of Clinical Psychology at the University of Sheffield in the UK.

Contents

Early life

Richard Pendrill Bentall was born in Sheffield in the United Kingdom. After attending Uppingham School in Rutland and then High Storrs School in his home town, he attended the University College of North Wales, Bangor as an undergraduate before registering for a PhD in Experimental Psychology at the same institution.

Career

After being awarded his doctorate, he moved to the University of Liverpool to undertake professional training as a clinical psychologist. He later returned to his alma mater of Liverpool to work as a lecturer, after a brief stint working for the National Health Service as a forensic clinical psychologist. Later, he studied for an MA in Philosophy Applied to Healthcare from the University of Wales, Swansea. He was eventually promoted to Professor of Clinical Psychology at the University of Liverpool. In 1999, he accepted a position at the University of Manchester, collaborating with researchers based there who were working in understanding the treatment of psychotic experiences. [1] After returning in 2007 to a professorial position at Bangor University, where he retains an honorary professorship, he returned to the University of Liverpool in 2011, before moving to the University of Sheffield in 2017. His research continues to focus on the psychological mechanisms of severe mental illness and social factors that affect these mechanisms, [2] which has led to a recent interest in public mental health. In 1989, he received the British Psychological Society's Division of Clinical Psychology 'May Davidson Award', an annual award for outstanding contributions to the field of clinical psychology, in the first ten years after qualifying. [3] In 2014 he was elected a Fellow of the British Academy, the United Kingdom's national academy for the humanities and social sciences. [4]

Research

He has previously published research on differences between human and animal operant conditioning and on the treatment of chronic fatigue syndrome. However, he is best known for his work in psychosis, especially the psychological processes responsible for delusions and hallucinations and has published extensively in these areas. [5] His research on persecutory (paranoid) delusions has explored the idea that these arise from dysfunctional attempts to regulate self-esteem, so that the paranoid patient attributes negative experiences to the deliberate actions of other people. His research on hallucinations has identified a failure of source monitoring (the process by which events are attributed to either the self or external sources) as responsible for hallucinating patients' inability to recognize that their inner speech (verbal thought) belongs to themselves. Along with many other British researchers, he has used these discoveries to inform the development of new psychological interventions for psychosis, based on cognitive behavioral therapy (CBT). This work has included randomized controlled trials of CBT for first episode patients and patients experiencing an at risk mental state for psychosis.

In a 1992 thought experiment, Bentall proposed that happiness might be classified as a psychiatric disorder. [6] The purpose of the paper was to demonstrate the impossibility of defining psychiatric disorder without reference to values. The paper was mentioned on the satirical television program Have I Got News for You and quoted by the novelist Philip Roth in his novel Sabbath's Theater .

He has edited and written several books, most notably Madness Explained , which was a winner of the British Psychological Society Book Award in 2004. In this book, he advocates a psychological approach to the psychoses, rejects the concept of schizophrenia and considers symptoms worthwhile investigating in contrast to the Kraepelinian syndromes. (Refuting Kraepelin's big idea that serious mental illness can be divided into discrete types is the starting chapter of the book.) A review by Paul Broks in The Sunday Times summarised its position as: "Like Szasz, Bentall is firmly opposed to the biomedical model, but he also takes issue with extreme social relativists who would deny the reality of madness." In the book, Bentall also argues that no clear distinction exists between those diagnosed with mental illnesses and the "well". While this notion is more widely accepted in psychiatry when it comes to anxiety and depression, Bentall insists that schizotypal experiences are also common. [7]

In 2009 he published Doctoring The Mind: Is Our Current Treatment Of Mental Illness Really Any Good? A review of this book by neuro-scientist Roy Sugarman argued that it allied itself with the anti-psychiatry movement in its critiques of biological psychiatry. [8] The review in PsycCRITIQUES was more nuanced, pointing out that Bentall did not reject psycho-pharmacology, but that he was concerned over its overuse. [9]

In 2010, Bentall and John Read co-authored a literature review on "The effectiveness of electroconvulsive therapy" (ECT). It examined placebo-controlled studies and concluded ECT had minimal benefits for people with depression and schizophrenia. [10] The authors said "given the strong evidence of persistent and, for some, permanent brain dysfunction, primarily evidenced in the form of retrograde and anterograde amnesia, and the evidence of a slight but significant increased risk of death, the cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified". [11] Psychiatrists [ who? ], however, sharply criticized this paper in passing by calling it an "evidence-poor paper with an anti-ECT agenda". [12]

In 2012, Bentall and collaborators in Maastricht published a meta-analysis of the research literature on childhood trauma and psychosis, considering epidemiological, case-control, and prospective studies. [13] This study found that the evidence that childhood trauma confers a risk of adult psychosis is highly consistent, with children who have experienced trauma (sexual abuse, physical abuse, loss of a parent or bullying) being approximately three times more likely to become psychotic than non-traumatized children; there was a dose-response effect (the most severely traumatized children were even more likely to become psychotic) suggesting that the effect is causal. This finding, and other findings suggesting that there are many social risk factors for severe mental illness, has led to Bentall's current interest in public mental health.

Bibliography

See also

Related Research Articles

Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.

Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety, suspicion, or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concerning a perceived threat towards oneself. Paranoia is distinct from phobias, which also involve irrational fear, but usually no blame.

<span class="mw-page-title-main">Schizophrenia</span> Mental disorder with psychotic symptoms

Schizophrenia is a mental disorder characterized by reoccurring episodes of psychosis that are correlated with a general misperception of reality. Other common signs include hallucinations, delusions, disorganized thinking, social withdrawal, and flat affect. Symptoms develop gradually and typically begin during young adulthood and are never resolved. There is no objective diagnostic test; diagnosis is based on observed behavior, a psychiatric history that includes the person's reported experiences, and reports of others familiar with the person. For a diagnosis of schizophrenia, the described symptoms need to have been present for at least six months or one month. Many people with schizophrenia have other mental disorders, especially substance use disorders, depressive disorders, anxiety disorders, and obsessive–compulsive disorder.

<span class="mw-page-title-main">Hallucination</span> Perception in the absence of external stimulation that has the qualities of real perception

A hallucination is a perception in the absence of an external stimulus that has the qualities of a real perception. Hallucinations are vivid, substantial, and are perceived to be located in external objective space. Hallucination is a combination of two conscious states of brain wakefulness and REM sleep. They are distinguishable from several related phenomena, such as dreaming, which does not involve wakefulness; pseudohallucination, which does not mimic real perception, and is accurately perceived as unreal; illusion, which involves distorted or misinterpreted real perception; and mental imagery, which does not mimic real perception, and is under voluntary control. Hallucinations also differ from "delusional perceptions", in which a correctly sensed and interpreted stimulus is given some additional significance.

Schizoaffective disorder is a mental disorder characterized by abnormal thought processes and an unstable mood. This diagnosis requires symptoms of both schizophrenia and a mood disorder: either bipolar disorder or depression. The main criterion is the presence of psychotic symptoms for at least two weeks without any mood symptoms. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, bipolar I disorder, schizophreniform disorder, or schizophrenia. This is a problem as treatment and prognosis differ greatly for most of these diagnoses.

<span class="mw-page-title-main">Thought disorder</span> Disorder of thought form, content or stream

A thought disorder (TD) is a disturbance in cognition which affects language, thought and communication. Psychiatric and psychological glossaries in 2015 and 2017 identified thought disorders as encompassing poverty of ideas, neologisms, paralogia, word salad, and delusions—all disturbances of thought content and form. Two specific terms have been suggested—content thought disorder (CTD) and formal thought disorder (FTD). CTD has been defined as a thought disturbance characterized by multiple fragmented delusions, and the term thought disorder is often used to refer to an FTD: a disruption of the form of thought. Also known as disorganized thinking, FTD results in disorganized speech and is recognized as a major feature of schizophrenia and other psychoses. Disorganized speech leads to an inference of disorganized thought. Thought disorders include derailment, pressured speech, poverty of speech, tangentiality, verbigeration, and thought blocking. One of the first known cases of thought disorders, or specifically OCD as it is known today, was in 1691. John Moore, who was a bishop, had a speech in front of Queen Mary II, about "religious melancholy."

In psychology, schizotypy is a theoretical concept that posits a continuum of personality characteristics and experiences, ranging from normal dissociative, imaginative states to extreme states of mind related to psychosis, especially schizophrenia. The continuum of personality proposed in schizotypy is in contrast to a categorical view of psychosis, wherein psychosis is considered a particular state of mind, which the person either has or does not have.

The Hearing Voices Movement (HVM) is the name used by organizations and individuals advocating the "hearing voices approach", an alternative way of understanding the experience of those people who "hear voices". In the medical professional literature, ‘voices’ are most often referred to as auditory verbal hallucinations. The movement uses the term ‘hearing voices’, which it feels is a more accurate and 'user-friendly' term.

Hearing Voices Networks, closely related to the Hearing Voices Movement, are peer-focused national organizations for people who hear voices and supporting family members, activists and mental health practitioners. Members may or may not have a psychiatric diagnosis. Networks promote an alternative approach, where voices are not necessarily seen as signs of mental illness and regard hearing voices as a meaningful and understandable, although unusual, human variation. Voices are not seen as the problem, rather it is the relationship the person has with their voices that is regarded as the main issue.

Thought broadcasting is a type of delusional condition in which the affected person believes that others can hear their inner thoughts, despite a clear lack of evidence. The person may believe that either those nearby can perceive their thoughts or that they are being transmitted via mediums such as television, radio or the internet. Different people can experience thought broadcasting in different ways. Thought broadcasting is most commonly found among people who have a psychotic disorder, specifically schizophrenia.

An auditory hallucination, or paracusia, is a form of hallucination that involves perceiving sounds without auditory stimulus. While experiencing an auditory hallucination, the affected person hears a sound or sounds that did not come from the natural environment.

<span class="mw-page-title-main">Grandiose delusions</span> Subtype of delusion

Grandiose delusions (GDs), also known as delusions of grandeur or expansive delusions, are a subtype of delusion characterized by extraordinary belief that one is famous, omnipotent, wealthy, or otherwise very powerful. Grandiose delusions often have a religious, science fictional, or supernatural theme. Examples include the extraordinary belief that one is a deity or celebrity, or that one possesses extraordinary talents, accomplishments, or superpowers.

Early intervention in psychosis is a clinical approach to those experiencing symptoms of psychosis for the first time. It forms part of a new prevention paradigm for psychiatry and is leading to reform of mental health services, especially in the United Kingdom and Australia.

<span class="mw-page-title-main">Persecutory delusion</span> Delusion involving perception of persecution

A persecutory delusion is a type of delusional condition in which the affected person believes that harm is going to occur to oneself by a persecutor, despite a clear lack of evidence. The person may believe that they are being targeted by an individual or a group of people. Persecution delusions are very diverse in terms of content and vary from the possible, although improbable, to the completely bizarre. The delusion can be found in various disorders, being more usual in psychotic disorders.

In psychiatry, catastrophic schizophrenia or schizocaria is an obsolete term for a rare and acute form of schizophrenia leading directly to a severe and unremitting chronic psychosis and deterioration of the personality. Catastrophic schizophrenia was thought to be the most severe subtype of schizophrenia, as it had "an acute onset and rapid decline into a chronic state without remission". Catastrophic schizophrenia was also referred to as schizocaria, which was defined by Gerhard Mauz as a psychosis that caused the absolute destruction of the core of one's being. The term "catastrophic schizophrenia" has fallen out of use due to a number of reasons, including advances in psychiatric treatment, which led to a significant decline in patients that fit the diagnosis as their symptoms did not reach the severity of catastrophic schizophrenia, along with modern refinement of the definition and subtypes of schizophrenia. This term has not been included in any version of the DSM. In modern terms, catastrophic schizophrenia would likely be defined as 'acute-onset chronic schizophrenia with poor prognosis'.

Childhood schizophrenia is similar in characteristics of schizophrenia that develops at a later age, but has an onset before the age of 13 years, and is more difficult to diagnose. Schizophrenia is characterized by positive symptoms that can include hallucinations, delusions, and disorganized speech; negative symptoms, such as blunted affect and avolition and apathy, and a number of cognitive impairments. Differential diagnosis is problematic since several other neurodevelopmental disorders, including autism spectrum disorder, language disorder, and attention deficit hyperactivity disorder, also have signs and symptoms similar to childhood-onset schizophrenia.

The diagnosis of schizophrenia, a psychotic disorder, is based on criteria in either the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or the World Health Organization's International Classification of Diseases (ICD). Clinical assessment of schizophrenia is carried out by a mental health professional based on observed behavior, reported experiences, and reports of others familiar with the person. Diagnosis is usually made by a psychiatrist. Associated symptoms occur along a continuum in the population and must reach a certain severity and level of impairment before a diagnosis is made. Schizophrenia has a prevalence rate of 0.3-0.7% in the United States.

Unitary psychosis (Einheitspsychose) refers to the 19th-century belief prevalent in German psychiatry until the era of Emil Kraepelin that all forms of psychosis were surface variations of a single underlying disease process. According to this model, there were no distinct disease entities in psychiatry but only varieties of a single universal madness and the boundaries between these variants were fluid. The prevalence of the concept in Germany during the mid-19th century can be understood in terms of a general resistance to Cartesian dualism and faculty psychology as expressed in Naturphilosophie and other Romantic doctrines that emphasised the unity of body, mind and spirit.

John Read is a psychologist and mental health researcher from England. He is professor of clinical psychology in the University of East London's School of Psychology.

<i>Doctoring the Mind</i> 2009 book by Richard Bentall

Doctoring the Mind: Why psychiatric treatments fail is a 2009 book by Richard Bentall, his thesis is critical of contemporary Western psychiatry. Bentall, a professor of clinical psychology, argues that recent scientific research shows that the medical approach to mental illness is fatally flawed. According to Bentall, it seems there is no "evidence that psychiatry has made a positive impact on human welfare" and "patients are doing no better today than they did a hundred years ago".

References

  1. ↑ Richard P. Bentall (2013). "Keynote Address: The Psychology of Paranoid Delusions" (PDF). ISPS.
  2. ↑ "Richard Bentall, Prof". University of Liverpool. Institute of Psychology Health and Society. Retrieved 15 August 2014.
  3. ↑ "British Psychologist Society list of May Davidson Award previous winners". Archived from the original on 10 August 2011. Retrieved 8 January 2009.
  4. ↑ "British Academy announces 42 new fellows". Times Higher Education. 18 July 2014. Retrieved 18 July 2014.
  5. ↑ "list of publications from Bangor staff profile". Archived from the original on 7 June 2011. Retrieved 8 January 2009.
  6. ↑ Bentall, RP (1992). "A proposal to classify happiness as a psychiatric disorder". Journal of Medical Ethics. 18 (2): 94–8. doi:10.1136/jme.18.2.94. PMC   1376114 . PMID   1619629.
  7. ↑ Broaks, Paul (27 July 2003). "Review: Psychiatry: Madness Explained by Richard P Bentall". The Sunday Times . Archived from the original on 15 June 2011.
  8. 1 2 Sugarma, Roy (25 August 2009). "Review – Doctoring the Mind Is Our Current Treatment of Mental Illness Really Any Good?". Matapsychology: Online Reviews. 13 (35).
  9. ↑ Bohart, Arthur (17 February 2010). "Understanding and Treating Madness: Biology or Relationships?" (PDF). PsycCRITIQUES . 55 (7). doi:10.1037/a0018702 . Retrieved 3 July 2012.
  10. ↑ Baker, Richard; McKenzie, Nick (6 September 2011). "Mental health care inquiry". The Age.
  11. ↑ Read, J; Bentall, R (October–December 2010). "The effectiveness of electroconvulsive therapy: a literature review" (PDF). Epidemiologia e Psichiatria Sociale. 19 (4): 333–47. doi:10.1017/S1121189X00000671. PMID   21322506. S2CID   15118442.
  12. ↑ McCall WV, Andrade C, Sienaert P (2014). "Searching for the mechanism(s) of ECT's therapeutic effect". The Journal of ECT. 30 (2): 87–9. doi:10.1097/YCT.0000000000000121. PMC   4695970 . PMID   24755719.
  13. ↑ Varese, F; Smeets, F; Drukker, M; Lieverse, R; Lataster, T; Viechtbauer, W; Read, J; van Os, J; Bentall, RP (29 March 2012). "Childhood Adversities Increase the Risk of Psychosis: A Meta-analysis of Patient-Control, Prospective- and Cross-sectional Cohort Studies". Schizophrenia Bulletin . 38 (4): 661–671. doi:10.1093/schbul/sbs050. PMC   3406538 . PMID   22461484.
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