The role of metacognitive beliefs in determining the impact of anomalous experiences: a comparison of help-seeking and non-help-seeking groups of people experiencing psychotic-like anomalies

Unusual but sound minds: mental health indicators in spiritual individuals

Previous research has linked certain types of modern spirituality, including New Age and Pagan, with either benign schizotypy or insecure attachment. While the first view emphasizes a positive aspect of spiritual believers' mental health (benign schizotypy), the second view emphasizes a negative aspect, namely the unhealthy emotional compensation associated with an insecure attachment style. This study addresses these two conflicting views by comparing a sample of modern spiritual individuals (N = 114) with a contrast group of traditional religious believers (N = 86). Measures of schizotypy and attachment style were combined with mental health scales of anxiety and depression. We further assessed death anxiety to determine whether modern spiritual beliefs fulfilled a similar function as traditional religious beliefs in the reduction of existential threat. Our results support a psychological contiguity between traditional and modern spiritual believers and reinforce the need to de-stigmatize spiritual ideas and experiences. Using hierarchical regression, we showed that unusual experiences and ideas are the major predictor of engagement in modern spiritual practices. Anxiety, depression variables, and insecure attachment were not significant predictors of spirituality or correlated with them; on the other hand, the results show that spiritual believers report high social support satisfaction and this variable predicts involvement in modern spirituality. Further, spiritual practices were negatively correlated with and negatively predicted by death anxiety scores. Overall, the results strengthen the association between modern spirituality, good mental health, and general well-being.

Effects of Appraisals of Anomalous Experience on Distress in People at Risk of Psychosis

Background: A cognitive model of psychosis suggests that appraisals of psychotic-like experiences (PLEs), and the subsequent responses adopted, are responsible for the maintenance of distress and disability associated with psychosis. Aims: This study aimed to investigate whether it is possible to manipulate appraisals of an anomalous experience in people at risk of psychosis and whether this affects levels of distress. Method: Participants who had experienced an “at risk mental state” (ARMS) within the past year, were randomized to one of two groups and received either negative or neutral information pertaining to an anomalous experience (a card trick). Participants completed a questionnaire measuring PLEs, then completed pre and post measures of distress and anxiety in relation to the card trick. Participants were also asked to rate a series of psychotic or non-psychotic appraisals regarding how they thought the card trick worked. Results: Data analysis revealed that distress and anxiety were not related to the information group assigned (our experimental manipulation was unsuccessful). However, when analyzed as one group, higher conviction in non-psychotic appraisals was found to be related to lower levels of distress and state anxiety. Conclusions: The findings provide some validation for a relationship between appraisals and distress. Clinical implications, methodological limitations and possible future research directions are discussed.

Phenotypically continuous with clinical psychosis, discontinuous in need for care: evidence for an extended psychosis phenotype

BACKGROUND

Rates of self-reported psychotic experiences (SRPEs) in general population samples are high; however the reliability against interview-based assessments and the clinical significance of false-positive (FP) ratings remain unclear.

DESIGN

The second Netherlands Mental Health Survey and Incidence Study-2, a general population study.

METHODS

Trained lay interviewers administered a structured interview assessing psychopathology and psychosocial characteristics in 6646 participants. Participants with at least one SRPE (N = 1084) were reassessed by clinical telephone interview.

RESULTS

Thirty-six percent of participants with SRPEs were confirmed by clinical interview as true positive (TP). SPREs not confirmed by clinical interview (FP group) generated less help-seeking behavior and occurred less frequently compared with TP experiences (TP group). However, compared with controls without psychotic experiences, the FP group more often displayed mood disorder (relative risk [RR] 1.7, 1.4-2.2), substance use disorder (RR 2.0, 1.6-2.6), cannabis use (RR 1.5, 1.2-1.9), higher levels of neuroticism (RR 1.8, 1.5-2.2), affective dysregulation, and social dysfunction. The FP group also experienced more sexual (RR 2.0, 1.5-2.8) and psychological childhood trauma (RR 2.1, 1.7-2.6) as well as peer victimization (RR 1.5, 1.2-2.0) and recent life events (RR 2.0, 1.6-2.4) than controls without psychotic experiences. Differences between the FP group and the TP group across these domains were much smaller and less conclusive.

DISCUSSION

SRPEs not confirmed by clinical interview may represent the softest expression of an extended psychosis phenotype that is phenotypically continuous with clinical psychosis but discontinuous in need for care.

Associations among perceptual anomalies, social anxiety, and paranoia in a college student sample

Recent evidence suggests that normal-range paranoid ideation may be particularly likely to develop in individuals disposed to both social anxiety and perceptual anomalies. This study was designed to test the hypothesis that among college students in an unselected sample, social anxiety and experience of perceptual anomalies would not only each independently predict the experience of self-reported paranoid ideation, but would also interact to predict paranoid patterns of thought. A diverse sample of 644 students completed a large battery of self-report measures, as well as the five-factor Paranoia/Suspiciousness Questionnaire (PSQ). We conducted hierarchical multiple regression analyses predicting scores on each PSQ factor from responses on measures of social anxiety, perceptual aberration, and the interaction between the two constructs. Current general negative affect was covaried in all analyses. We found that both social anxiety and perceptual aberrations, along with negative affect, predicted multiple dimensions of paranoia as measured by the PSQ; the two constructs did not, however, interact significantly to predict any dimensions. Our findings suggest that perceptual aberration and anxiety may contribute to normal-range paranoid ideation in an additive rather than an interactive manner.

WITHDRAWN: The psychometric properties of the Taiwanese version of the Cardiff Anomalous Perceptions Scale

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The metacognitive beliefs account of hallucinatory experiences: a literature review and meta-analysis

An influential model of hallucinations proposed by Morrison et al. (1995. Behavioural and Cognitive Psychotherapy, 23(3), 265-280) assumes that dysfunctional metacognitive beliefs lead to the misattribution of intrusive thoughts to external sources, therefore generating hallucinatory experiences. Following a comprehensive review of the literature, a series of meta-analyses was carried out to summarize the empirical findings on the association between hallucination-proneness and different metacognitive beliefs. The results of this research synthesis found little support for the existence of specific associations between hallucinations and dysfunctional metacognitive beliefs. While metacognitive beliefs are robustly associated with hallucination-proneness in non-clinical studies, they were only moderately associated with hallucinations in clinical samples. Additional analyses revealed that, after controlling for the effect of comorbid symptoms, hallucination-proneness was only weakly associated with metacognitive beliefs, suggesting that the large associations observed in previous research might stem from the failure to consider the covariation between different symptoms. These findings have important implications in relation to the role of metacognitive factors in psychopathological symptoms, as well as for the implementation of metacognitive-focused cognitive behavioural techniques for the treatment of psychosis.

Distress and metacognition in psychosis prone individuals: comparing high schizotypy to the at-risk mental state

Both schizotypy and at-risk mental states (ARMS: prodromal states) define individuals at risk for psychotic symptoms. However, the relationship between the 2 is unclear. ARMS individuals are, by definition, help-seeking and therefore at greater risk. We tested whether high schizotypes and ARMS exist along the same continuum by examining maladaptive metacognitions and distress. About 95 healthy volunteers (39% male; mean age, 22.8 years) completed the Schizotypal Personality Questionnaire, the Launay-Slade Hallucinations Scale, Metacognitions Questionnaire (MCQ), and the General Health Questionnaire, and 58 help seeking individuals with ARMS status (41% male; mean age, 22.2 years) completed the Metacognitions Questionnaire and General Health Questionnaire. With increasing expression of schizotypy and hallucinatory proneness healthy volunteers became difficult to differentiate from ARMS patients and showed similarities in distress and metacognitive abnormalities. Results suggest healthy volunteers who express both schizotypal trait and proneness to hallucinations have cognitive processes in common with ARMS patients.