Emily Eisner,
PhD Researcher, School of Psychological Sciences, University of Manchester
Contact Details
emily.eisner@manchester.ac.uk
Clinical Psychology Department, Zochonis Building (2nd Floor), University of Manchester, M13
9PL
Biography
Having graduated with a joint honours degree in
Psychology and Philosophy (2:1) from the University of Oxford, I worked as a
volunteer Research Assistant and as a support worker on an acute psychiatric
ward. This led to an interest in clinical research, particularly in the
area of relapse prevention in psychosis. In 2009 I completed a Master’s degree (with
Distinction) at the University of Manchester, which included a research
dissertation entitled Measuring
beliefs about weight gain in young people with early episodes of psychosis: an
adaptation of the Revised Illness Perceptions Questionnaire. I
subsequently worked as a Research Associate at the University of Manchester,
initially on the MIDAS trial (an RCT comparing integrated Motivational
Interviewing and Cognitive Behavioural Therapy to treatment as usual in those
with co-morbid substance misuse and psychosis) and later in a short term
position in the Clinical Psychology Department, supporting applications for
external grant funding. In 2011, I was awarded an MRC Doctoral
Training Grant PhD Studentship entitled Identifying
relapse risk in psychosis using subjectively experienced “basic
symptoms”: assessment and predictive validity, supervised by
Professor Christine Barrowclough, Dr Richard Drake, Dr Richard Emsley and, more
recently, Dr Sandra Bucci. Having taken two maternity leaves during the course
of the PhD, I am now working on the PhD part-time and am due to submit in
November 2019.
Qualifications
MRes, Research Methods
in Psychology, Distinction, University of Manchester (2009)
BA (Hons), Psychology and Philosophy, Oriel College,
2:1, University of Oxford (2006)
Research Interests
My PhD research examines the value of 'basic symptoms' as predictors of
psychosis relapse in the context of early signs interventions for relapse
prevention. I began by publishing a review examining the predictive validity of
early signs of relapse, the effect of early signs interventions on relapse
outcomes and evidence in the literature to date regarding basic symptoms
(Eisner et al, 2013). Subsequently I conducted a qualitative study exploring
facilitators and barriers of early signs interventions (Eisner et al, 2014) and
describing service users’ experiences of basic
symptoms and conventional early signs prior to a recent relapse of psychosis
(Eisner et al,2017). In the final PhD study I will examine the feasibility and
acceptability of using a smartphone application (‘app’) to assess early signs, basic
symptoms and relapse outcomes on a long term basis.
Early Signs Interventions
Early signs interventions work on the premise that timely prediction of
relapses will allow preventative action to be taken, minimizing the chance of
full relapse occurring (Birchwood, Spencer, & McGovern, 2000). The patient
is assisted in identifying and monitoring early signs of relapse, and in
developing concrete action plans for dealing with them. Early signs commonly
reported to emerge in the weeks before a relapse include: anxiety, dysphoria,
insomnia, poor concentration and attenuated psychotic symptoms (Birchwood et
al., 1989). A variety of techniques may be included in the preventative action
plan, such as short term increases in medication, intensive psychological
support or a combination of relapse prevention techniques.
Early signs interventions show promise but could be further developed
(Eisner et al, 2013). My recent review of prospective studies (Eisner et al,
2013) indicated moderate predictive validity (median sensitivity 61%, median
specificity 81%) of checklists of conventional early signs such as the Early
Signs Scale (Birchwood et al., 1989). This could be improved by the addition of
other hypothesised predictors such as basic symptoms (Eisner et al, 2013; Gumley et al, 2014).
Basic symptoms
Basic symptoms are subtle, sub-clinical disturbances in one’s experience
of oneself and the world, which are predictive of first episode psychosis (Schultze-Lutter et al, 2007; Fusar-Poli
et al, 2012). Typical basic symptoms include: changes in perceptions, such as
increased vividness of colour vision; mild subjective cognitive problems;
impaired tolerance to certain stressors. There is preliminary evidence that
basic symptoms occur prior to relapse (Bechdolf et
al, 2002; Gaebel & Riesbeck,
2014; Eisner et al, 2017).
Methodological Knowledge
I have authored or co-authored peer-reviewed papers which included the
following methods:
·
Data collection using a smartphone app
·
Questionnaire design and psychometric evaluation
·
Systematic review, narrative review
·
A randomised controlled trial of a psychological intervention
·
Multiple regression, logistic regression
·
Multilevel models (mixed effects models)
·
Generalised estimating equation (GEE) models
·
Inter-rater reliability
·
Qualitative interviews
·
Thematic analysis
·
Framework analysis
·
Directed content analysis
·
Case note audit
I am also trained in the following clinical interviews:
·
Positive and Negative Syndrome Scale (PANSS)
·
Psychotic Symptoms Rating Scales (PSYRATS)
·
Schizophrenia Proneness Instrument, Adult Version (SPI-A)
Supervisors and Collaborators
·
Dr Sandra Bucci (Lecturer in Clinical
Psychology, University of Manchester)
·
Dr Richard Drake (Senior Lecturer in Adult
Psychiatry, University of Manchester)
·
Prof Richard Emsley (Lecturer in Biostatistics,
University of Manchester)
·
Professor Christine Barrowclough (Professor of
Clinical Psychology, University of Manchester)
·
Professor Fiona Lobban
(Professor of Clinical Psychology, University of Lancaster)
Awards and public engagement
2019 Janice Sinson
Award, Mental Health Foundation
Schizophrenia International Research Society Travel Award
British Federation of
Women Graduates, North West Division, Travel Award
2018 Finalist for the
Postgraduate Summer Research Showcase Research Image Award
‘What Psych Scientists
Do’ schools outreach event, University of Manchester
2015 BBC News article: A 'smart' way to spot
schizophrenia signs http://www.bbc.co.uk/news/health-34656921
2015 Winner, Max Perutz Science
Writing award, Medical Research Council, UK
Best Poster,
Postgraduate Conference, University of Manchester
Publications
Eisner, E., Drake, R., Berry, N., Barrowclough, C., Emsley, R., Machin,
M. & Bucci, S.
Development,
usability and long-term acceptability of ExPRESS, a smartphone app to monitor
basic symptoms and early signs of psychosis relapse. JMIR Mhealth
Uhealth (forthcoming). doi:10.2196/11568
http://dx.doi.org/10.2196/11568
Eisner, E., Bucci,
S., Emsley, R., Barrowclough, C., Drake, R., (2018). Longitudinal
feasibility and acceptability of the ExPRESS smartphone app: recruitment,
retention and preliminary findings. Schizophrenia Bulletin,
44(Suppl. 1), S197-S198. http://doi.org/10.1093/schbul/sby016.484
Eisner, E., Drake,
R., Lobban, F., Bucci , S.,
Emsley, R., Barrowclough, S. (2017). Comparing early signs
and basic symptoms as methods for predicting psychotic relapse in clinical
practice. Schizophrenia Research, doi:
10.1016/j.schres.2017.04.050. [Epub ahead of print]
Eisner, E. (2015). A
'smart' way to spot schizophrenia signs (2015, October 31), BBC News. Retrived from: http://www.bbc.co.uk/news/health-34656921
[Max Perutz Prize, winning article]
Eisner, E., Barrowclough,
C., Lobban, F., Drake, R. (2014). Qualitative
investigation of targets for and barriers to interventions to prevent psychosis
relapse. BMC Psychiatry, 14, 201. DOI:
10.1186/1471-244X-14-201.
Barrowclough, C.,
Eisner, E., Bucci, S., Emsley, R., Wykes, T. (2014). The impact of
alcohol on clinical outcomes in established psychosis: a longitudinal study. Addiction, doi:10.1111/add.12599.
Haddock, G., Eisner,
E., Boone, C., Davies, G., Coogan, C., Barrowclough,
C. (2014). An investigation of the implementation of NICE
recommended CBT and FI interventions for people with schizophrenia. Journal of Mental Health, doi:10.3109/09638237.2013.869571.
Eisner, E., Drake,
R., Barrowclough, C. (2013). Assessing early signs of relapse
in psychosis: review and future directions. Clinical Psychology Review,
33, 637-653.
Haddock, G., Eisner,
E., Davies, G., Coupe, N., Barrowclough, C. (2013). Psychotic symptoms,
self-harm and violence in individuals with schizophrenia and substance misuse
problems. Schizophrenia Research, 151, 215-220.
Haddock, G.,
Beardmore, R., Earnshaw, P., Fitzsimmons, M., Nothard,
S., Butler, R., Eisner, E., Barrowclough, C. (2012). Assessing fidelity
to integrated motivational interviewing and CBT therapy for psychosis and
substance use: the MI-CBT fidelity scale (MI-CTS). Journal of Mental Health,
21(1), 38-48.
Barrowclough, C.,
Emsley, R., Eisner, E., Beardmore, R., Wykes, T.
(2011). Does Change in Cannabis Use in Established Psychosis Affect Clinical
Outcome? Schizophrenia Bulletin, doi:10.1093/schbul/sbr152
Barrowclough C.,
Haddock, G., Wykes, T., Beardmore, R., Conrod, P., Craig, T., Davies, L., Dunn, G., Eisner, E.,
Lewis, S., Moring, J., Steel, C., Tarrier, N. (2010).
Integrated motivational interviewing and cognitive behavioural therapy for
people with psychosis and comorbid substance misuse: randomised controlled
trial. British Medical Journal, 341, c6325
Smart K., Pimm J., Eisner E., Atkinson S., Davis S. (2008).
Development of a questionnaire to measure cognitions associated with fatigue in
adults with Rheumatoid Arthritis, including an evaluation of its psychometric
properties and its utility in predicting Rheumatoid Arthritis fatigue.
Rheumatology, 47(Suppl. 2), ii181