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Appraisals, psychotic symptoms and affect in daily life

Published online by Cambridge University Press:  13 September 2011

E. Peters ,
T. Lataster ,
K. Greenwood ,
E. Kuipers ,
J. Scott ,
S. Williams ,
P. Garety  and
I. Myin-Germeys
E. Peters*
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychology, London, UK
T. Lataster
Affiliation:
University of Maastricht, Maastricht, The Netherlands
K. Greenwood
Affiliation:
Sussex University, Department of Psychology, Brighton, UK
E. Kuipers
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychology, London, UK
J. Scott
Affiliation:
Newcastle University, Institute of Neuroscience, Academic Psychiatry, UK
S. Williams
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychology, London, UK
P. Garety
Affiliation:
King's College London, Institute of Psychiatry, Department of Psychology, London, UK
I. Myin-Germeys
Affiliation:
University of Maastricht, Maastricht, The Netherlands
*
*Address for correspondence: Dr E. Peters, PO77, Psychology Department, King's College London, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. (Email: [email protected])
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Abstract

Background

Psychological models of psychosis were examined using Experience Sampling Methods (ESM) to explore relationships between dimensions and appraisals of key symptoms and affect.

Method

Individuals were signalled to complete ESM booklets 10 times per day for six consecutive days; 534 data points were obtained from 12 out-patients with psychosis.

Results

Although only 3.6% of spontaneous thoughts were psychosis related, these predicted more negative and less positive affect. Delusions and hallucinations, when present, were rated at a moderate level of intensity, and intensity was associated with distress, interference and preoccupation. Symptom dimensions were related to each other, with weaker associations with delusional conviction, which, it is hypothesized, may represent a separate factor. Conviction and appraisals relating to insight and decentring (‘my problems are something to do with the way my mind works’) were highly variable. Decentring appraisals of delusions, but not insight, were associated with less distress. Appraisals about the power of voices were strong predictors of negative affect and symptom distress.

Conclusions

This study demonstrates that ESM is a useful methodology to capture ‘online’ variability in psychotic phenomenology and provides evidence supporting cognitive models, which posit that psychotic symptoms are multi-dimensional phenomena, shaped by appraisals that, in turn, predict their emotional and behavioural sequelae.

Keywords

Cognitive modelsdelusionsExperience Sampling Methodhallucinationsinsight psychosis
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 5 , May 2012 , pp. 1013 - 1023
Copyright
Copyright © Cambridge University Press 2011

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