One method that has recently shown promise in modifying appraisals of intrusive memories is computerised cognitive bias modification (CBM).
FIs generally focus on cognitive and behavioural techniques to modify appraisals that relatives hold about the behaviour of the person with psychosis and develop coping strategies.
This study was the first to demonstrate that CBM techniques can successfully modify appraisals of intrusions, leading to reductions in important intrusive memory variables.
Hamdan and Defever's [ 21] analysis of HRH in Palestine between 1994 and 2001 noted how inappropriate performance appraisal systems had negatively affected the efficiency and effectiveness of public health services – although modified performance appraisal systems had been piloted in some health districts.
Thus, we would support a previous conclusion [ 41], i.e. that a modified critical appraisal tool should be created for evaluating studies with two separate educational interventions.
Quality of studies was assessed by two reviewers using a modified CASP appraisal tool for cohort and case control studies as appropriate for all the included studies.
We therefore modified an appraisal checklist for prognosis study developed by the Centre for Evidence Based Medicine, Oxford, to assess the quality of the studies [ 11].
This modified critical appraisal tool has not been subjected to peer review or tested for validity under the conditions of the current review.
This was in agreement with conclusions from previous studies that efforts to establish and maintain a sense of control over one's life and environment might serve to modify the appraisal of stressful circumstances and to build a certain degree of resistance to depressive symptoms [ 17, 44].
This is, in our opinion, a large improvement of the previous quality assessments in reviews on this topic, which have omitted a large number of studies from the quality assessment and have only used a subjectively determined evidence level cut-off, a modified generic quality appraisal tool or a seven-point bias-risk assessment.
7 All study designs were eligible for inclusion, but only five studies were included and assessed with a modified generic quality appraisal tool.
