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Radez J, Johns L, Waite F. Understanding unusual sensory experiences: a randomised experimental study of a school-based intervention for adolescents. Child Adolesc Ment Health 2024; 29:14-21. [PMID: 36959519 PMCID: PMC10877969 DOI: 10.1111/camh.12651] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND One in ten young people experience unusual sensory experiences (USE), such as hallucinations. From a cognitive perspective, the appraisal of USE determines the impact of these experiences. Negative appraisal, as well as other psychological processes (e.g. thinking flexibility, maladaptive schemas, anxiety/depression), is associated with more distress. Our aim was to (a) develop a universal single-session school-based intervention on USE for adolescents and (b) evaluate the effect of the intervention on appraisals of and help seeking intentions for USE. METHODS A randomised controlled experimental design with a one-month follow-up was used to test the effectiveness of the intervention in one school. Students (n = 223) aged 12-13 were randomised by class to a single-session intervention on USE or a control intervention (generic mental wellbeing). Participants completed measures of appraisals of and help-seeking intentions for USE at pre- and postintervention and at one-month follow-up. They also completed measures of schemas, thinking flexibility and anxiety/depression at preintervention. RESULTS Overall, 190 adolescents completed the main outcome measures at all three points. The intervention on USE led to a significant (p < .05) increase of positive appraisals of USE compared with the control, with effects sustained at one-month follow-up. The intervention on USE did not lead to significantly greater help-seeking intentions for USE (p = .26). Adolescents' schemas were associated with appraisals and slow thinking and anxiety/depressive symptoms with help-seeking behaviour for USE. CONCLUSIONS A single-session universal school-based intervention shows promise by improving appraisals of USE. Further research is required across different school populations.
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Affiliation(s)
- Jerica Radez
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences DivisionUniversity of OxfordOxfordUK
- Oxford Health NHS Foundation TrustOxfordUK
| | - Louise Johns
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences DivisionUniversity of OxfordOxfordUK
- Oxford Health NHS Foundation TrustOxfordUK
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - Felicity Waite
- Oxford Health NHS Foundation TrustOxfordUK
- Department of PsychiatryUniversity of OxfordOxfordUK
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Maraldi EO, Taves A, Moll J, Hartle L, Moreira-de-Oliveira ME, Bortolini T, Fischer R. Nonordinary Experiences, Well-being and Mental Health: A Systematic Review of the Evidence and Recommendations for Future Research. JOURNAL OF RELIGION AND HEALTH 2024; 63:410-444. [PMID: 37507577 DOI: 10.1007/s10943-023-01875-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
Throughout history, people have reported nonordinary experiences (NOEs) such as feelings of oneness with the universe and hearing voices. Although these experiences form the basis of several spiritual and religious traditions, experiencing NOEs may create stress and uncertainty among those who experience such events. To provide a more systematic overview of the research linking NOEs with mental health, we present a systematic review of studies focusing on NOEs, well-being and mental health indicators. In a search of ProQuest and PsycInfo, we identified 725 references, of which 157 reported empirical data and were included in our review. Overall, the studies reviewed suggest that the relationship between NOEs and mental health is complex, varying according to a series of psychological and social factors. In particular, they suggest that appraisal processes play a fundamental role in the mental health outcomes of these experiences. However, we also highlight important methodological challenges such as the conceptual overlap between NOEs and well-being or psychopathological constructs, the conflation between experiences and appraisal processes in the assessment procedure, and the need for clearer assessment of the duration, controllability, impact on daily functioning and general context of the experiences. We provide a qualitative summary of empirical evidence and main themes of research and make recommendations for future investigation.
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Affiliation(s)
- Everton O Maraldi
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro, 30, Botafogo, Rio de Janeiro, 22281-100, Brazil.
- Department of Religious Studies, Pontifical Catholic University of São Paulo, São Paulo, Brazil.
| | - Ann Taves
- Department of Religious Studies, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Jorge Moll
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro, 30, Botafogo, Rio de Janeiro, 22281-100, Brazil
| | - Larissa Hartle
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro, 30, Botafogo, Rio de Janeiro, 22281-100, Brazil
| | - Maria E Moreira-de-Oliveira
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro, 30, Botafogo, Rio de Janeiro, 22281-100, Brazil
| | - Tiago Bortolini
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro, 30, Botafogo, Rio de Janeiro, 22281-100, Brazil
| | - Ronald Fischer
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro, 30, Botafogo, Rio de Janeiro, 22281-100, Brazil
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
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3
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Sun X, Zhong J. The dimensionality of perceptual anomalies and their relationships with bullying victimization among Chinese adolescents: From a network perspective. Schizophr Res 2023; 262:42-50. [PMID: 37922843 DOI: 10.1016/j.schres.2023.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 10/13/2023] [Accepted: 10/28/2023] [Indexed: 11/07/2023]
Abstract
Anomalous perceptual experiences in adolescents are common and may predict future psychotic disorders and other psychopathologies. However, the underlying structure and their specific relationships with bullying victimizations, a typical stressor for adolescents, remain unclear. Therefore, the current study aimed to clarify the structure of perceptual anomalies as assessed by the Cardiff Anomalous Perceptions Scale (CAPS) using exploratory graph analysis (EGA), a new factor retention method based on network psychometrics. The second aim was to explore whether specific dimensions of perceptual anomalies are particularly associated with certain forms of bullying victimization. Data from a validated sample of 1199 Chinese adolescents (56.0 % females, age range: 14-20) on perceptual anomalies and bullying victimizations were analyzed using network approaches, including EGA and mixed graphical modeling (mgm). Results showed that each anomalous perception was experienced by 13.8-50.3 % of the participants. EGA identified four dimensions: aberrant bodily perceptions, altered daily experiences, chemosensation (i.e., abnormal gustatory and olfactory experiences), and clinical psychosis (i.e., visual and auditory hallucinatory experiences). Among them, the altered daily experiences dimension possessed the highest centrality. Physical bullying and cyberbullying were directly and positively linked to two of the aberrant bodily experiences. Bootstrap analyses suggest that the results are reliable. The current findings support the existence of multiple contributive factors to perceptual anomalies and underscore the importance of bullying prevention in reducing mental health risks for adolescents, particularly the risk of psychosis.
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Affiliation(s)
- Xiaoqi Sun
- Department of Psychology, Faculty of Educational Sciences, Hunan Normal University, Changsha, Hunan, China; Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, Hunan, China; The Center for Mind and Brain Science, Hunan Normal University, Changsha, Hunan, China.
| | - Jingyi Zhong
- Department of Psychology, Faculty of Educational Sciences, Hunan Normal University, Changsha, Hunan, China
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4
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Gin K, Stewart C, Abbott C, Banerjea P, Bracegirdle K, Browning S, Byrne M, Emsley R, Ginestet C, Hirsch C, Kuipers E, Laurens KR, Onwumere J, Plant D, Valmaggia L, Jolley S. Psychosocial predictors of distressing unusual experiences in adolescence: Testing the fit of an adult cognitive model of psychosis. Schizophr Res 2021; 237:1-8. [PMID: 34461373 DOI: 10.1016/j.schres.2021.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 08/09/2021] [Accepted: 08/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND For adults with psychosis, international guidelines recommend individual and family based cognitive behavioural therapy interventions. Recommendations are extended to children and adolescents, based on adult research. It is also recommended that psychological interventions are offered for childhood presentations of psychotic-like or Unusual Experiences (UE), in the absence of a formal diagnosis, when these are Distressing (UEDs). Cognitive models underpinning these interventions require testing in adolescent populations, to further refine therapies. We address this need, by testing for the first time, the application of the adult cognitive model of psychosis to adolescent UEDs. METHODS We used baseline data from the Coping with Unusual ExperienceS (CUES+) randomised controlled trial for 122 clinically referred adolescents (12-18 years) with self-reported UEDs. Known psychological mechanisms of adult cognitive models of psychosis; negative life events, affect (anxiety and depression), reasoning (jumping to conclusions bias), and schemas were investigated using multiple linear regression models, alongside variables particularly associated with the development and severity of adolescent UEDs and UE type (dissociation, externalising/behavioural problems, managing emotions). RESULTS The psychological mechanisms of adult cognitive models of psychosis explained 89% of the total variance of adolescent UED severity, F (10, 106) = 99.34, p < .0005, r2 = 0.89, with schemas as the principal significant contributor. Variance explained 40 - 72% across each of the UE types (paranoia, hallucinations, delusions, paranormal thinking and grandiosity). CONCLUSIONS Findings suggest that the psychological components of adult cognitive models of psychosis, particularly schemas, are also implicated in adolescent UEDs.
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Affiliation(s)
- Kimberley Gin
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
| | | | - Chris Abbott
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Partha Banerjea
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | | | - Sophie Browning
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Majella Byrne
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Richard Emsley
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Cedric Ginestet
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Colette Hirsch
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK; King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Elizabeth Kuipers
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Kristin R Laurens
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK; Queensland University of Technology (QUT), School of Psychology and Counselling, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Juliana Onwumere
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Deborah Plant
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Lucia Valmaggia
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Suzanne Jolley
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
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Allen L, Ashford PA, Beeson E, Byford S, Chow J, Dalgleish T, Danese A, Finn J, Goodall B, Grainger L, Hammond M, Humphrey A, Mahoney-Davies G, Morant N, Shepstone L, Sims E, Smith P, Stallard P, Swanepoel A, Trickey D, Trigg K, Wilson J, Meiser-Stedman R. DECRYPT trial: study protocol for a phase II randomised controlled trial of cognitive therapy for post-traumatic stress disorder (PTSD) in youth exposed to multiple traumatic stressors. BMJ Open 2021; 11:e047600. [PMID: 34210731 PMCID: PMC8252885 DOI: 10.1136/bmjopen-2020-047600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a distressing and disabling condition that affects significant numbers of children and adolescents. Youth exposed to multiple traumas (eg, abuse, domestic violence) are at particular risk of developing PTSD. Cognitive therapy for PTSD (CT-PTSD), derived from adult work, is a theoretically informed, disorder-specific form of trauma-focused cognitive-behavioural therapy. While efficacious for child and adolescent single-event trauma samples, its effectiveness in routine settings with more complex, multiple trauma-exposed youth has not been established. The Delivery of Cognitive Therapy for Young People after Trauma randomised controlled trial (RCT) examines the effectiveness of CT-PTSD for treating PTSD following multiple trauma exposure in children and young people in comparison with treatment as usual (TAU). METHODS/DESIGN This protocol describes a two-arm, patient-level, single blind, superiority RCT comparing CT-PTSD (n=60) with TAU (n=60) in children and young people aged 8-17 years with a diagnosis of PTSD following multiple trauma exposure. The primary outcome is PTSD severity assessed using the Children's Revised Impact of Event Scale (8-item version) at post-treatment (ie, approximately 5 months post-randomisation). Secondary outcomes include structured interview assessment for PTSD, complex PTSD symptoms, depression and anxiety, overall functioning and parent-rated mental health. Mid-treatment and 11-month and 29-month post-randomisation assessments will also be completed. Process-outcome evaluation will consider which mechanisms underpin or moderate recovery. Qualitative interviews with the young people, their families and their therapists will be undertaken. Cost-effectiveness of CT-PTSD relative to TAU will be also be assessed. ETHICS AND DISSEMINATION This trial protocol has been approved by a UK Health Research Authority Research Ethics Committee (East of England-Cambridge South, 16/EE/0233). Findings will be disseminated broadly via peer-reviewed empirical journal articles, conference presentations and clinical workshops. TRIAL REGISTRATION ISRCTN12077707. Registered 24 October 2016 (http://www.isrctn.com/ISRCTN12077707). Trial recruitment commenced on 1 February 2017. It is anticipated that recruitment will continue until June 2021, with 11-month assessments being concluded in May 2022.
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Affiliation(s)
- Leila Allen
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Polly-Anna Ashford
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Ella Beeson
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, UK
| | - Sarah Byford
- King's Health Economics, King's College London, London, UK
| | - Jessica Chow
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Tim Dalgleish
- MRC Cognition and Brain Sciences Unit, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Andrea Danese
- Department of Child and Adolescent Psychiatry, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Jack Finn
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Ben Goodall
- North East London NHS Foundation Trust, Rainham, UK
| | - Lauren Grainger
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Matthew Hammond
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Ayla Humphrey
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | | | - Nicola Morant
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Lee Shepstone
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Erika Sims
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Patrick Smith
- Department of Psychology, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | | | - Annie Swanepoel
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, UK
| | - David Trickey
- Specialist Trauma and Maltreatment Service, Anna Freud National Centre for Children and Families, London, UK
| | - Katie Trigg
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jon Wilson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK
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6
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Catone G, Marwaha S, Lennox B, Broome MR. Bullying victimisation and psychosis: The interdependence and independence of risk trajectories. BJPSYCH ADVANCES 2018. [DOI: 10.1192/apt.bp.116.016584] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SummaryA number of studies have noted an association between being the victim of bullying and psychotic symptoms. We offer an overview of the topic, focusing especially on a developmental perspective. We highlight the results of the latest studies on psychosis across the continuum and its relationship with bullying. Then we summarise the three main explanatory models investigated: developmental, biological and cognitive. We recommend that bullying in psychosis requires careful study of the developmental trajectories involved, and that research should now focus on how personal, social and biological factors interact.LEARNING OBJECTIVES•Consider a spectrum of psychosis rather than a dichotomous concept of the disease (present/absent)•Understand that, by preventing bullying, it may also be possible to prevent the development of psychotic symptoms•Reflect that psychotherapy helps to integrate past stressful experiences with current symptoms, providing an alternative interpretation of them
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Jolley S, Browning S, Corrigall R, Laurens KR, Hirsch C, Bracegirdle K, Gin K, Muccio F, Stewart C, Banerjea P, Kuipers E, Garety P, Byrne M, Onwumere J, Achilla E, McCrone P, Emsley R. Coping with Unusual ExperienceS for 12-18 year olds (CUES+): a transdiagnostic randomised controlled trial of the effectiveness of cognitive therapy in reducing distress associated with unusual experiences in adolescent mental health services: study protocol for a randomised controlled trial. Trials 2017; 18:586. [PMID: 29202862 PMCID: PMC5716372 DOI: 10.1186/s13063-017-2326-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 11/13/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Childhood 'unusual experiences' (such as hearing voices that others cannot, or suspicions of being followed) are common, but can become more distressing during adolescence, especially for young people in contact with Child and Adolescent Mental Health Services (CAMHS). Unusual experiences that are distressing or have adverse life impact (UEDs) are associated with a range of current and future emotional, behavioural and mental health difficulties. Recommendations for psychological intervention are based on evidence from adult studies, with some support from small, pilot, child-specific evaluations. Research is needed to ensure that the recommendations suit children as well as adults. The CUES+ study (Coping with Unusual ExperienceS for 12-18 year olds) aims to find out whether cognitive behaviour therapy for UEDs (CBT-UED) is a helpful and cost-effective addition to usual community care for 12-18 year olds presenting to United Kingdom National Health Service Child and Adolescent Mental Health Services in four London boroughs. METHODS The CUES+ study is a randomised controlled trial comparing CBT-UED plus routine care to routine care alone. CBT-UED comprises up to 16 sessions, including up to 12 individual and up to four family support meetings, each lasting around 45-60 min, delivered weekly. The primary outcome is emotional distress. Secondary outcomes are change in UEDs, risk events (self-harm, attendance at emergency services, other adverse events) and health economic outcomes. Participants will be randomised in a 1:1 ratio after baseline assessment. Randomisation will be stratified by borough and by severity of mental health presentation: 'severe' (an identified psychotic or bipolar disorder) or any 'other' condition. Outcomes will be assessed by a trained assessor blind to treatment condition at 0, 16 and 24 weeks. Recruitment began in February, 2015 and is ongoing until the end of March, 2017. DISCUSSION The CUES+ study will contribute to the currently limited child-specific evidence base for psychological interventions for UEDs occurring in the context of psychosis or any other mental health presentation. TRIAL REGISTRATION International Standard Randomised Controlled Trials, ID: ISRCTN21802136 . Prospectively registered on 12 January 2015. Protocol V3 31 August 2015 with screening amended.
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Affiliation(s)
- Suzanne Jolley
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Sophie Browning
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ UK
| | | | - Kristin R. Laurens
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Banyo, QLD 4014 Australia
- Department of Forensic and Neurodevelopmental Sciences, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF UK
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, NSW 2052 Australia
- Neuroscience Research Australia, Randwick, NSW 2031 Australia
| | - Colette Hirsch
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- National Institute for Health Research Mental Health Biomedical Research Centre and Dementia Unit (BRC/U) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AZ UK
| | | | - Kimberley Gin
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ UK
| | - Francesca Muccio
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ UK
| | - Catherine Stewart
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ UK
| | - Partha Banerjea
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ UK
| | - Elizabeth Kuipers
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- National Institute for Health Research Mental Health Biomedical Research Centre and Dementia Unit (BRC/U) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AZ UK
| | - Philippa Garety
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- National Institute for Health Research Mental Health Biomedical Research Centre and Dementia Unit (BRC/U) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AZ UK
| | - Majella Byrne
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ UK
| | - Juliana Onwumere
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Evanthia Achilla
- Department of Health Service and Population Research, King’s Health Economics, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF UK
| | - Paul McCrone
- Department of Health Service and Population Research, King’s Health Economics, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF UK
| | - Richard Emsley
- Centre for Biostatistics, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL UK
- Manchester Academic Health Science Centre Clinical Trials Unit, Manchester, M13 9PL UK
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Abstract
Experiences of bullying predict the development of paranoia in school-age adolescents. While many instances of psychotic phenomena are transitory, maintained victimization can lead to increasingly distressing paranoid thinking. Furthermore, paranoid thinkers perceive threat in neutral social stimuli and are vigilant for environmental risk. The present paper investigated the association between different forms of bullying and paranoid thinking, and the extent to which school-age paranoid thinkers overestimate threat in interpersonal situations. Two hundred and thirty participants, aged between eleven and fourteen, were recruited from one secondary school in the UK. Participants completed a series of questionnaires hosted on the Bristol Online Survey tool. All data were collected in a classroom setting in quiet and standardized conditions. A significant and positive relationship was found between experiences of bullying and paranoid thinking: greater severity of bullying predicted more distressing paranoid thinking. Further, paranoid thinking mediated the relationship between bullying and overestimation of threat in neutral social stimuli. Exposure to bullying is associated with distressing paranoid thinking and subsequent misappraisal of threat. As paranoid thinkers experience real and overestimated threat, the phenomena may persist.
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9
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Laurens KR, Cullen AE. Toward earlier identification and preventative intervention in schizophrenia: evidence from the London Child Health and Development Study. Soc Psychiatry Psychiatr Epidemiol 2016; 51:475-91. [PMID: 26670311 PMCID: PMC4823320 DOI: 10.1007/s00127-015-1151-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/08/2015] [Indexed: 11/02/2022]
Abstract
PURPOSE The London Child Health and Development Study (CHADS) is a prospective, longitudinal investigation of children, sampled from the general community aged 9-11 years and assessed biennially, who present premorbid risk markers for schizophrenia. The study aims to characterise developmental trajectories of psychological, cognitive, and biological functioning in at-risk children and identify potential targets for early preventative intervention. This review summarises CHADS findings, discusses these in the context of recent theory regarding aetiology and prevention of schizophrenia, and highlights challenges to be addressed with future research. METHODS We review (1) epidemiological information on the prevalence and correlates of developmental antecedents of schizophrenia in the general child population, (2) evidence of psychosocial, cognitive, and biological dysfunctions in at-risk children presenting multiple antecedents of schizophrenia and at-risk children with a family history of schizophrenia, and (3) related findings from an associated sample of help-seeking children receiving intervention. RESULTS Community-based screening of 9-11-year olds identified ~9 % with a triad of antecedents of schizophrenia [including psychotic-like experiences (PLEs)] who are putatively at-risk of psychosis; these children reported greater exposure and responsivity to stressors, impairments in general intelligence and specific cognitive functions, brain structure and function abnormalities, and neuromotor dysfunction. Preliminary evidence suggests distressing PLEs are a viable target for cognitive-behavioural intervention in at-risk children. CONCLUSIONS Intervention in early, premorbid phases of illness might alleviate current difficulties and avert future schizophrenia using benign treatments. The CHADS programme has identified several markers that may index early pathophysiology and constitute potential targets for preventative intervention.
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Affiliation(s)
- Kristin R Laurens
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia.
- Schizophrenia Research Institute, Sydney, Australia.
| | - Alexis E Cullen
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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