Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-03T02:56:27.608Z Has data issue: false hasContentIssue false
  • English
  • Français

Core beliefs in healthy youth and youth at ultra high-risk for psychosis: Dimensionality and links to depression, anxiety, and attenuated psychotic symptoms

Published online by Cambridge University Press:  06 March 2018

Henry R. Cowan Open the ORCID record for Henry R. Cowan [Opens in a new window] ,
Dan P. McAdams  and
Vijay A. Mittal
Henry R. Cowan*
Affiliation:
Northwestern University
Dan P. McAdams
Affiliation:
Northwestern University
Vijay A. Mittal
Affiliation:
Northwestern University
*
Address correspondence and reprint requests to: Henry R. Cowan, Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL 60208. E-mail: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Cognitive theory posits that core beliefs play an active role in developing and maintaining symptoms of depression, anxiety, and psychosis. This study sought to comprehensively examine core beliefs, their dimensionality, and their relationships to depression, anxiety, and attenuated psychotic symptoms in two groups of community youth: a group at ultrahigh risk for psychosis (UHR; n = 73, M age = 18.7) and a matched healthy comparison group (HC; n = 73, M age = 18.1). UHR youth reported significantly more negative beliefs about self and others, and significantly less positive beliefs about self and others. HC youth rarely endorsed negative self-beliefs. Exploratory factor analyses found that HC negative self-beliefs did not cohere as a single factor. We hypothesized specific links between core beliefs and symptoms based on cognitive models of each disorder, and tested these links through regression analyses. The results in the HC group were consistent with the proposed models of depression and anxiety. The results in the UHR group were consistent with proposed models of depression and negative psychotic symptoms, somewhat consistent with a proposed model of positive psychotic symptoms, and not at all consistent with a proposed model of anxiety. These findings add to a growing developmental literature on core beliefs and psychopathology, with important clinical implications.

Type
Regular Articles
Information
Development and Psychopathology , Volume 31 , Special Issue 1: The effect of maltreatment experiences on maltreating and dysfunctional parenting: A search for mechanisms , February 2019 , pp. 379 - 392
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

This work was supported in part by the National Institutes of Health Grants RO1MH094650 and R21/R33MH103231 (to V.A.M.) and the Canadian Institutes of Health Research DFS-152268 (to H.R.C.). We thank our many supportive colleagues and the participants without whom this research would not have been possible. Vijay A. Mittal is a consultant for Takeda. No other authors have any disclosures.

References

Adamson, L., Hartman, S. G., & Lyxell, B. (1999). Adolescent identity—A qualitative approach: Self-concept, existential questions and adult contacts. Scandinavian Journal of Psychology, 21. doi:10.1111/1467-9450.00094Google Scholar
Addington, J., Epstein, I., Reynolds, A., Furimsky, I., Rudy, L., Mancini, B., … Zipursky, R. (2008). Early detection of psychosis: Finding those at clinical high risk. Journal of Early Intervention in Psychiatry, 2, 147–153. doi:10.1111/j.1751-7893.2008.00078.xGoogle Scholar
Addington, J., Penn, D., Woods, S. W., Addington, D., & Perkins, D. O. (2008). Social functioning in individuals at clinical high risk for psychosis. Schizophrenia Research, 99, 119–124. doi:10.1016/j.schres.2007.10.001Google Scholar
Addington, J., & Tran, L. (2009). Using the Brief Core Schema Scales with individuals at clinical high risk of psychosis. Behavioral and Cognitive Psychotherapy, 37, 227–231. doi:10.1017/s1352465809005116Google Scholar
Bardhoshi, G., Duncan, K., & Erford, B. T. (2016). Psychometric meta-analysis of the English version of the Beck Anxiety Inventory. Journal of Counseling and Development, 94, 356–373. doi:10.1002/jcad.12090Google Scholar
Bechdolf, A., Wagner, M., Ruhrmann, S., Harrigan, S., Putzfeld, V., Pukrop, R., … Klosterkötter, J. (2012). Preventing progression to first-episode psychosis in early initial prodromal states. British Journal of Psychiatry, 200, 22–29. doi:10.1192/bjp.bp.109.066357Google Scholar
Beck, A. T. (1979). Cognitive therapy and the emotional disorders. New York: Penguin.Google Scholar
Beck, A. T., Emery, G., & Greenberg, R. L. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.Google Scholar
Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory manual. San Antonio, TX: Psychological Corporation.Google Scholar
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory—II. San Antonio, TX: Psychological Corporation.Google Scholar
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond. New York: Guildford Press.Google Scholar
Beesdo, K., Pine, D. S., Lieb, R., & Wittchen, H. U. (2010). Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder. Archives of General Psychiatry, 67, 47–57. doi:10.1001/archgenpsychiatry.2009.177Google Scholar
Berna, F., Göritz, A. S., Schröder, J., Martin, B., Cermolacce, M., Allé, M. C., … Moritz, S. (2016). Self-disorders in individuals with attenuated psychotic symptoms: Contribution of a dysfunction of autobiographical memory. Psychiatry Research, 239, 333–341. doi:10.1016/j.psychres.2016.03.029Google Scholar
Carol, E. E., & Mittal, V. A. (2015). Resting cortisol level, self-concept, and putative familial environment in adolescents at ultra high-risk for psychotic disorders. Psychoneuroendocrinology, 57, 26–36. doi:10.1016/j.psyneuen.2015.03.018Google Scholar
Carragher, N., Teesson, M., Sunderland, M., Newton, N. C., Krueger, R. F., Conrod, P. J., … Slade, T. (2015). The structure of adolescent psychopathology: A symptom-level analysis. Psychological Medicine, 46, 981–994. doi:10.1017/s0033291715002470Google Scholar
Cole, D. A., Maxwell, S. E., Martin, J. M., Peeke, L. G., Seroczynski, A. D., Tram, J. M., … Maschman, T. (2001). The development of multiple domains of child and adolescent self-concept: A cohort sequential longitudinal design. Child Development, 72, 1723–1746. doi:10.1111/1467-8624.00375Google Scholar
DeVylder, J. E., Yang, L. H., Harkavy-Friedman, J. M., Azimov, N., Walder, D. J., & Corcoran, C. M. (2014). Assessing depression in youth at clinical high risk for psychosis: A comparison of three measures. Psychiatry Research, 215, 323–328. doi:10.1016/j.psychres.2013.12.002Google Scholar
Dozois, D. J., Dobson, K., & Ahnberg, J. L. (1998). A psychometric evaluation of the Beck Depression Inventory—II. Psychological Assessment, 10, 83–89. doi:10.1037/1040-3590.10.2.83Google Scholar
Dozois, D. J., & Rnic, K. (2015). Core beliefs and self-schematic structure in depression. Current Opinion in Psychology, 4, 98–103. doi:10.1016/j.copsyc.2014.12.008Google Scholar
First, M., Spitzer, R. L., Gibbon, M., & Williams, J. B. (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. (SCID-I/P) Biometrics Research, New York State Psychiatric Institute, New York.Google Scholar
Fowler, D., Freeman, D., Smith, B., Kuipers, E., Bebbington, P., Bashforth, H., … Garety, P. (2006). The Brief Core Schema Scales (BCSS): Psychometric properties and associations with paranoia and grandiosity in non-clinical and psychosis samples. Psychological Medicine, 36, 749–759. doi:10.1017/s0033291706007355Google Scholar
Freeman, D., Garety, P., Fowler, D., Kuipers, E., Dunn, G., Bebbington, P., & Hadley, C. (1998). The London-East Anglia randomised controlled trial of cognitive behaviour therapy for psychosis IV: Self-esteem and persecutory delusions. British Journal of Clinical Psychology, 37, 415–430. doi:10.1111/j.2044-8260.1998.tb01399.xGoogle Scholar
Fusar-Poli, P., Borgwardt, S., Bechdolf, A., Addington, J., Riecher-Rössler, A., Schultze-Lutter, F., … Yung, A. (2013). The psychosis high-risk state: A comprehensive state-of-the-art review. JAMA Psychiatry, 70, 107–120. doi:10.1001/jamapsychiatry.2013.269Google Scholar
Fusar-Poli, P., Deste, G., Smieskova, R., Barlati, S., Yung, A. R., Howes, O., … Borgwardt, S. (2012). Cognitive functioning in prodromal psychosis: A meta-analysis. Archives of General Psychiatry, 69, 562–571. doi:10.1001/archgenpsychiatry.2011.1592Google Scholar
Fusar-Poli, P., Howes, O. D., Allen, P., Broome, M., Valli, I., Asselin, M., … McGuire, P. K. (2010). Abnormal frontostriatal interactions in people with prodromal signs of psychosis: A multimodal imaging study. Archives of General Psychiatry, 67, 683–691. doi:10.1001/archgenpsychiatry.2010.77Google Scholar
Fusar-Poli, P., Howes, O. D., Allen, P., Broome, M., Valli, I., Asselin, M. C., … McGuire, P. (2011). Abnormal prefrontal activation directly related to pre-synaptic striatal dopamine dysfunction in people at clinical high risk for psychosis. Molecular Psychiatry, 16, 67–75. doi:10.1038/mp.2009.108Google Scholar
Fusar-Poli, P., Nelson, B., Valmaggia, L., Yung, A. R., & McGuire, P. K. (2014). Comorbid depressive and anxiety disorders in 509 individuals with an at-risk mental state: Impact on psychopathology and transition to psychosis. Schizophrenia Bulletin, 40, 120–131. doi:10.1093/schbul/sbs136Google Scholar
Garety, P. A., Kuipers, E., Fowler, D., Freeman, D., & Bebbington, P. E. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31, 189–195. doi:10.1017/s0033291701003312Google Scholar
Graber, J. A. (2013). Internalizing problems during adolescence. In Lerner, R. M. & Steinberg, L. (Eds.), Handbook of adolescent psychology (2nd ed., pp. 587–626). Hoboken, NJ: Wiley.Google Scholar
Häfner, H., Maurer, R., Löffler, W., Bustamante, S., an der Heiden, W., Reicher-Rössler, & Nowotny, B. (1995). Onset and early course of schizophrenia. In Häfner, H. & Gattaz, W. F. (Eds.), Search for the causes of schizophrenia (Vol. 3, pp. 43–66). Berlin: Springer-Verlag.Google Scholar
Häfner, H., Maurer, K., Trendler, G., an der Heiden, W., Schmidt, M., & Könnecke, R. (2005). Schizophrenia and depression: Challenging the paradigm of two separate diseases—A controlled study of schizophrenia, depression and healthy controls. Schizophrenia Research, 77, 11–24. doi:10.1016/j.schres.2005.01.004Google Scholar
Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6, 65–70.Google Scholar
Horn, J. L. (1965). A rationale and test for the number of factors in factor analysis. Psychometrika, 30(2), 179–185.Google Scholar
Howes, O., Bose, S., Turkheimer, F., Valli, I., Egerton, A., Stahl, D., … McGuire, P. (2011). Progressive increase in striatal dopamine synthesis capacity as patients develop psychosis: A PET study. Molecular Psychiatry, 16, 885–886. doi:10.1038/mp.2011.20Google Scholar
Howes, O. D., Montgomery, A. J., Asselin, M.-C., Murray, R. M., Valli, I., Tabraham, P., … McGuire, P. K. (2009). Elevated striatal dopamine function linked to prodromal signs of schizophrenia. Archives of General Psychiatry, 66, 13–20. doi:10.1001/archgenpsychiatry.2008.514Google Scholar
Hui, C., Morcillo, C. R., Stochi, J., Shelley, G. F., Painter, M., Jones, P. B., & Perez, J. (2013). Psychiatric morbidity, functioning and quality of life in young people at clinical high risk for psychosis. Schizophrenia Research, 148, 175–180. doi:10.1016/j.schres.2013.05.026Google Scholar
Kaslow, N. J., Adamson, L. B., & Collins, M. H. (2000). A Developmental Psychopathology Perspective on the Cognitive Components of Child and Adolescent Depression. In Sameroff, A.J., Lewis, M., Miller, S.M. (Eds.), Handbook of Developmental Psychopathology. Springer, Boston, MA. 491–510.Google Scholar
Koreen, A. R., Siris, S. G., Chakos, M., & Alvir, J. (1993). Depression in first-episode schizophrenia. American Journal of Psychiatry, 150, 1643–1648. doi:10.1176/ajp.150.11.1643Google Scholar
Kreuger, R. F., Caspi, A. C., Moffitt, T. E., & Silva, P. A. (1998). The structure and stability of common mental disorders (DSM-III-R): A longitudinal-epidemiological study. Journal of Abnormal Psychology, 107, 216–227. doi:10.1037/0021-843x.107.2.216Google Scholar
Leary, M. R., & Baumeister, R. F. (2000). The nature and function of self-esteem: Sociometer theory. Advances in Experimental Social Psychology, 32, 1–62. doi:10.1016/s0065-2601(00)80003-9Google Scholar
McAdams, D. P. (2013). The psychological self as actor, agent, and author. Perspectives on Psychological Science, 8, 272–295. doi:10.1177/1745691612464657Google Scholar
McDonald, R. P. (1999). Test theory: A unified treatment. Mahwah, NJ: Erlbaum.Google Scholar
Miller, T., McGlashan, T., Woods, S., Stein, K., Driesen, N., Corcoran, C., … Davidson, L. (1999). Symptom assessment in schizophrenia prodromal states. Psychiatric Quarterly, 70, 273–287. doi:10.1023/A:1022034115078Google Scholar
Modinos, G., Renken, R., Ormel, J., & Aleman, A. (2011). Self-reflection and the psychosis-prone brain: An fMRI study. Neuropsychology, 25, 295–305. doi:10.1037/a0021747Google Scholar
Nelson, B., Fornito, A., Harrison, B. J., Yücel, M., Sass, L. A., Yung, A. R., … McGorry, P. D. (2009). A disturbed sense of self in the psychosis prodrome: Linking phenomenology and neurobiology. Neuroscience & Biobehavioral Reviews, 33, 807–817. doi:10.1016/j.neubiorev.2009.01.002Google Scholar
Niendam, T. A., Jalbrzikowski, M., & Bearden, C. E. (2009). Exploring predictors of outcome in the psychosis prodrome: Implications for early identification and intervention. Neuropsychology Review, 19, 280–293. doi:10.1007/s11065-009-9108-zGoogle Scholar
Peterson, A. C., Compas, B. E., Brooks-Gunn, J., Stemmler, M., Ey, S., & Grant, K. E. (1993). Depression in Adolescence. American Psychologist, 48(2), 155–68.Google Scholar
Perivoliotis, D., Morrison, A. P., Grant, P. M., French, P., & Beck, A. T. (2009). Negative performance beliefs and negative symptoms in individuals at ultra-high risk of psychosis: A preliminary study. Psychopathology, 42, 375–379. doi:10.1159/000236909Google Scholar
Piskulic, D., Addington, J., Cadenhead, K. S., Cannon, T. D., Comblatt, B. A., Heinssen, R., … McGlashan, T. H. (2012). Negative symptoms in individuals at clinical high risk of psychosis. Psychiatry Research, 196, 220–224. doi:10.1016/j.psychres.2012.02.018Google Scholar
R Core Team. (2016). R: A language and environment for statistical computing [Computer software]. Vienna: R Foundation for Statistical Computing. Retrieved from https://www.R-project.orgGoogle Scholar
Rector, N. A., Beck, A. T., & Stolar, N. (2005). The negative symptoms of schizophrenia: A cognitive perspective. Canadian Journal of Psychiatry, 50, 247–257. doi:10.1177/070674370505000503Google Scholar
Revelle, W. (2016). psych: Procedures for personality and psychological research (Version 1.6.9) [Computer software]. Evanston, IL: Northwestern University.Google Scholar
Richter, P., Werner, J., Heerlein, A., Kraus, A., & Sauer, H. (1998). On the validity of the Beck Depression Inventory: A review. Psychopathology, 31, 160–168. doi:10.1159/000066239Google Scholar
Rogers, A. H. (1958). The self concept in paranoid schizophrenia. Journal of Clinical Psychology, 14, 365–366. doi:10.1002/1097-4679Google Scholar
Rosenberg, M. (1979). Conceiving the self. New York: Basic Books.Google Scholar
SAS Institute Inc. (1989–2013). JMP® Pro, Version 13.0.0 [Computer software]. Cary, NC: Author.Google Scholar
Schwartz, G. (1978). Estimating the dimension of a model. Annals of Statistics, 6, 461–464. doi:10.1214/aos/1176344136Google Scholar
Sebastian, C., Burnett, S., & Blakemore, S.-J. (2008). Development of the self-concept during adolescence. Trends in Cognitive Science, 12, 441–446. doi:10.1016/j.tics.2008.07.008Google Scholar
Shah, R., & Waller, G. (2000). Parental style and vulnerability to depression: The role of core beliefs. Journal of Nervous and Mental Disease, 188, 19–25. doi:10.1097/00005053-200001000-00004Google Scholar
Smith, B., Fowler, D. G., Freeman, D., Bebbington, P., Bashforth, H., Garety, P., … Kuipers, E. (2006). Emotion and psychosis: Links between depression, self-esteem, negative schematic beliefs and delusions and hallucinations. Schizophrenia Research, 86, 181–188. doi:10.1016/j.schres.2006.06.018Google Scholar
Stowkowy, J., Liu, L., Cadenhead, K. S., Cannon, T. D., Cornblatt, B. A., Perkins, D. O., … Addington, J. (2016). Core schemas in youth at high risk for psychosis. Behavioural and Cognitive Psychotherapy, 44, 203–213. doi:10.1111/j.1751-7893.2011.00297.xGoogle Scholar
Tackett, J. L., Quilty, L. C., Sellbom, M., Rector, N. A., & Bagby, R. M. (2008). Additional evidence for a quantitative hierarchical model of mood and anxiety disorders for DSM-V: The context of personality structure. Journal of Abnormal Psychology, 117, 815–825. doi:10.1037/a0013795Google Scholar
Taylor, H. E., Stewart, S. L., Dunn, G., Parker, S., Fowler, D., & Morrison, A. P. (2014). Core schemas across the continuum of psychosis: A comparison of clinical and non-clinical groups. Behavioural and Cognitive Psychotherapy, 42, 718–730. doi:10.1017/s1352465813000593Google Scholar
Tiernan, B., Tracey, R., & Shannon, C. (2014). Paranoia and self-concepts in psychosis: A systematic review of the literature. Psychiatry Research, 216, 303–313. doi:10.1016/j.psychres.2014.02.003Google Scholar
Van Vlierberghe, L., Braet, C., Bosmans, G., Rosseel, Y., & Bögels, S. (2010). Maladaptive schemas and psychopathology in adolescence: On the utility of Young's schema theory in youth. Cognitive Therapy and Research, 34, 316–332. doi:10.1007/s10608-009-9283-5Google Scholar
Velicer, W. F. (1976). Determining the number of components from the matrix of partial correlations. Psychometrika, 41(3), 321–327. https://doi.org/10.1007/BF02293557Google Scholar
Vorontsova, N., & Garety, P. (2013). Cognitive factors maintaining persecutory delusions in psychosis: The contribution of depression. Journal of Abnormal Psychology, 122, 1121–1131. doi:10.1037/a0034952Google Scholar
Young, J. E. (1994). Cognitive therapy for personality disorders: A schema-focused approach. Sarasota, FL: Professional Resource Press.Google Scholar
Zavos, H. M., Eley, T. C., McGuire, P., Plomin, R., Cardno, A. G., Freeman, D., & Angelica, R. (2016). Shared etiology of psychotic experiences and depressive symptoms in adolescence: A longitudinal twin study. Schizophrenia Bulletin, 42, 1197–1206. doi:10.1093/schbul/sbw021Google Scholar
Zinbarg, R. E., Revelle, W., Yovel, I., & Li, W. (2005). Cronbach's α, Revelle's β, and McDonald's ω: Their relations with each other and two alternative conceptualizations of reliability. Psychometrika, 70, 123–133. doi:10.1007/s11336-003-0974-7Google Scholar