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Heriot-Maitland C, Wykes T, Peters E. Social influences on the relationship between dissociation and psychotic-like experiences. Psychol Med 2024:1-9. [PMID: 38825863 DOI: 10.1017/s0033291724001405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
BACKGROUND Shame is experienced as a threat to social self, and so activates threat-protective responses. There is evidence that shame has trauma-like characteristics, suggesting it can be understood within the same conceptual framework as trauma and dissociation. Evidence for causal links among trauma, dissociation, and psychosis thus warrant the investigation of how shame may influence causal mechanisms for psychosis symptoms. METHODS This study tested the interaction between dissociation and shame, specifically external shame (feeling shamed by others), in predicting psychotic-like experiences (PLEs) six months later in a general population sample (N = 314). It also tested if social safeness moderates these effects. A longitudinal, online questionnaire design tested a moderation model (dissociation-shame) and a moderated moderation model (adding social safeness), using multiple regressions with bootstrap procedures. RESULTS Although there was no direct effect of dissociation on PLEs six months later, there was a significant interaction effect with shame, controlling for PLEs at baseline. There were complex patterns in the directions of effects: For high-shame-scorers, higher dissociation predicted higher PLE scores, but for low-shame-scorers, higher dissociation predicted lower PLE scores. Social safeness was found to significantly moderate these interaction effects, which were unexpectedly more pronounced in the context of higher social safeness. CONCLUSIONS The results demonstrate evidence for an interaction between dissociation and shame on its impact on PLEs, which manifests particularly for those experiencing higher social safeness. This suggests a potential role of social mechanisms in both the etiology and treatment of psychosis, which warrants further testing in clinical populations.
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Affiliation(s)
- Charles Heriot-Maitland
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Til Wykes
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Emmanuelle Peters
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Ford CG, Kiken LG, Haliwa I, Shook NJ. Negatively biased cognition as a mechanism of mindfulness: a review of the literature. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02147-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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LoPilato AM, Zhang Y, Pike M, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Mathalon DH, McGlashan TH, Seidman L, Perkins DO, Tsuang MT, Woods SW, Walker EF. Associations between childhood adversity, cognitive schemas and attenuated psychotic symptoms. Early Interv Psychiatry 2021; 15:818-827. [PMID: 32770658 DOI: 10.1111/eip.13017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/29/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022]
Abstract
AIM Childhood Adversity (CA) is strongly linked to psychotic-like symptoms across the clinical spectrum, though the mechanisms underlying these associations remain poorly understood. Negative cognitive schemas are associated with both CA exposure and psychotic symptoms, highlighting the possibility that cognitive schemas may be a key risk pathway. The purpose of this study was to determine whether negative cognitive schemas mediate the association between CA and specific attenuated psychotic symptoms in a large sample of clinical-high risk youth. Given the variability in experiences that encompass CA (eg, abuse, neglect and poverty) and attenuated psychotic symptoms (eg, suspiciousness and perceptual abnormalities), we also tested whether these associations differ by CA type (threat vs deprivation) and attenuated positive psychotic symptom domain. METHODS Data were collected from 531 clinical-high risk youth between 12 and 35 years of age (mean = 18.80, SD = 4.21) who completed a clinical assessment that included the Structured Interview of Prodromal Syndromes (SIPS), Childhood Trauma and Abuse scale and questionnaires on cognitive schemas and depressive symptoms. RESULTS No direct effects of threat or deprivation exposure on any of the psychotic symptom domains were found. However, there was a unique indirect effect of threat, but not deprivation, on delusional thinking and suspiciousness through negative cognitive schemas about others. CONCLUSION Cognitive vulnerability in the form of negative schemas about others may be one mechanism linking childhood threat experiences and attenuated psychotic symptoms. The results underscore the importance of targeting negative schemas in interventions to mitigate psychosis risk.
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Affiliation(s)
- Allison M LoPilato
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA
| | - Yinghao Zhang
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA
| | - Madeline Pike
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Department of Psychology, Semel Institute for Neuroscience and Human Behaviour, UCLA, Los Angeles, California, USA
| | | | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA.,Department of Psychology, Yale University, New Haven, Connecticut, USA
| | | | | | | | - Larry Seidman
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Diana O Perkins
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, La Jolla, California, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA
| | - Elaine F Walker
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA.,Department of Psychology, Emory University, Atlanta, Georgia, USA
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Janovsky T, Clark GI, Rock AJ. Trait mindfulness mediates the relationship between early maladaptive schema and interpersonal problems. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12390] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Thomas Janovsky
- School of Psychology and Behavioural Sciences, University of New England, Armidale, New South Wales, Australia
| | - Gavin I. Clark
- School of Psychology and Behavioural Sciences, University of New England, Armidale, New South Wales, Australia
| | - Adam J. Rock
- School of Psychology and Behavioural Sciences, University of New England, Armidale, New South Wales, Australia
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Petrocchi N, Ottaviani C. Mindfulness facets distinctively predict depressive symptoms after two years: The mediating role of rumination. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2015.08.017] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Variation in psychosocial influences according to the dimensions and content of children's unusual experiences: potential routes for the development of targeted interventions. Eur Child Adolesc Psychiatry 2016; 25:311-9. [PMID: 26149604 DOI: 10.1007/s00787-015-0739-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022]
Abstract
The psychosocial processes implicated in the development and maintenance of psychosis differ according to both the dimensional attributes (conviction, frequency, associated distress, adverse life impact) and the content or type (e.g. grandiosity, hallucinations, paranoia) of the psychotic symptoms experienced. This has informed the development of 'targeted' cognitive behavioural therapy for psychosis (CBTp): interventions focusing on specific psychological processes in the context of particular symptom presentations. In adults, larger effect sizes for change in primary outcomes are typically reported in trials of targeted interventions, compared to those for trials of generic CBTp approaches with multiple therapeutic foci. We set out to test the theoretical basis for developing targeted CBTp interventions for young people with distressing psychotic-like, or unusual, experiences (UEs). We investigated variations in the psychosocial processes previously associated with self-reported UE severity (reasoning, negative life events, emotional problems) according to UE dimensional attributes and content/type (using an established five-factor model) in a clinically referred sample of 72 young people aged 8-14 years. Regression analyses revealed associations of conviction and grandiosity with reasoning; of frequency, and hallucinations and paranoia, with negative life events; and of distress/adverse life impact, and paranoia and hallucinations, with emotional problems. We conclude that psychological targets for intervention differ according to particular characteristics of childhood UEs in much the same way as for psychotic symptoms in adults. The development of targeted interventions is therefore indicated, and tailoring therapy according to presentation should further improve clinical outcomes for these young people.
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Randal C, Bucci S, Morera T, Barrett M, Pratt D. Mindfulness-Based Cognitive Therapy for Psychosis: Measuring Psychological Change Using Repertory Grids. Clin Psychol Psychother 2015; 23:496-508. [DOI: 10.1002/cpp.1966] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 03/09/2015] [Accepted: 05/18/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Chloe Randal
- School of Psychological Sciences; University of Manchester; UK
| | - Sandra Bucci
- School of Psychological Sciences; University of Manchester; UK
| | - Tirma Morera
- School of Psychological Sciences; University of Manchester; UK
| | | | - Daniel Pratt
- School of Psychological Sciences; University of Manchester; UK
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Morris EMJ, Garety P, Peters E. Psychological flexibility and nonjudgemental acceptance in voice hearers: relationships with omnipotence and distress. Aust N Z J Psychiatry 2014; 48:1150-62. [PMID: 24835207 DOI: 10.1177/0004867414535671] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The psychological flexibility model has been hypothesized as a transdiagnostic, process-oriented approach to understanding various clinical disorders and problems, including chronic pain, anxiety, and substance misuse. In this study we investigated the model's applicability to the experience of hearing distressing voices. METHODS Fifty people experiencing persisting auditory hallucinations were administered the Kentucky Inventory of Mindfulness Skills, Acceptance and Action Questionnaire, Beliefs about Voices Questionnaire-Revised, Thought Control Questionnaire, and the Beck Anxiety and Depression Inventories. We predicted that psychological flexibility, mindful action, and nonjudgemental acceptance would be negatively associated with distress, disability, and behavioural responses to voice hearing and would have additional explanatory power when included with appraisals of voices and thought-control strategies (as predicted by cognitive models of auditory hallucinations). RESULTS The results showed differential contributions between measures of psychological flexibility and nonjudgemental acceptance. Psychological flexibility accounted for a significant proportion of the variance in regression-based models of depression and anxiety, while nonjudgemental acceptance contributed to the prediction of emotional and behavioural resistance to voices, in addition to appraisals of voices and use of thought-control strategies. However, this was not found for distress associated with voice hearing, life disruption, and engagement with voices, which were explained solely by cognitive variables. CONCLUSIONS The study results suggest that psychological flexibility and nonjudgemental acceptance are related to general emotional well being and resistance response styles to voices, but not to specific dimensions of voice hearing.
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Affiliation(s)
- Eric M J Morris
- Institute of Psychiatry, King's College London, Department of Psychology, London, UK NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
| | - Philippa Garety
- Institute of Psychiatry, King's College London, Department of Psychology, London, UK NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
| | - Emmanuelle Peters
- Institute of Psychiatry, King's College London, Department of Psychology, London, UK NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
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Udachina A, Varese F, Myin-Germeys I, Bentall RP. The role of experiential avoidance in paranoid delusions: An experience sampling study. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2014; 53:422-32. [DOI: 10.1111/bjc.12054] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 03/19/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Alisa Udachina
- Clinical Psychology Unit; Department of Psychology; University of Sheffield; UK
| | - Filippo Varese
- Division of Clinical Psychology; School of Psychological Sciences; University of Manchester; UK
| | - Inez Myin-Germeys
- Department of Psychiatry and Neuropsychology; South Limburg; Mental Health Research and Teaching Network; EURON; Maastricht University; Maastricht The Netherlands
| | - Richard P. Bentall
- Institute of Psychology, Health and Society; University of Liverpool; UK
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Service use for mental health problems in people with delusional-like experiences: a nationwide population based survey. PLoS One 2013; 8:e71951. [PMID: 23991012 PMCID: PMC3749219 DOI: 10.1371/journal.pone.0071951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 07/04/2013] [Indexed: 11/22/2022] Open
Abstract
Objective Previous population-based studies have found that delusional-like experiences (DLEs) are prevalent in the community, and are associated with a wide range of mental health disorders. The aim of the study was to investigate mental health service use by people with DLEs. Methods Subjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007 of 8 841community residents aged between 16 and 85 years. The Composite International Diagnostic Interview (CIDI) was used to identify DLEs. Service utilization was assessed using a module that elicited information about hospital admissions, consultations with various health professionals, and prescription medication use. This study focussed on service use for mental health problems. We used logistic regression to examine the association, adjusting for potential confounding factors. Results Of 8 773 included participants, 8.4% (n = 776) positively endorsed one or more DLEs. With respect to consultations for mental health needs, individuals who endorsed DLEs were more likely to consult health professionals compared with those who did not endorse DLEs. Individuals with DLEs were also more likely to use prescription medicine. When we repeated the main analysis in a subgroup excluding any CIDI diagnosis of mental health disorders the results remained largely unchanged. Conclusions DLEs are common in the general population, and individuals with DLEs have an increased rate of accessing services for their mental health needs. Individuals endorsing both DLEs and increased help-seeking may identify a group of vulnerable people who have increased risk of developing psychotic illnesses later in life. This needs closer scrutiny in longitudinal prospective studies.
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Affiliation(s)
- Sally Bloy
- South London and Maudsley NHS Foundation, London, England
| | | | - Eric Morris
- South London and Maudsley NHS Foundation, London, England
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