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