Academic literature on the topic 'Paranoia : Psychosis : Anxiety cognitive models'
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Journal articles on the topic "Paranoia : Psychosis : Anxiety cognitive models"
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Mankiewicz, Pawel D. "Cognitive Restructuring and Graded Behavioral Exposure for Persecutory Paranoia and Agoraphobic Anxiety in Complex Psychosis." Clinical Case Studies 18, no. 2 (2019): 143–58. http://dx.doi.org/10.1177/1534650119826713.
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Cognitive behavioral models of psychosis assert the notion of cognitive mediation, in which threat-oriented subjective misinterpretations of anomalous experiences lead to increased levels of emotional distress. Thus, paranoid appraisals of auditory hallucinations often result in hypervigilance and associated anxiety. The prevalence of diagnostic comorbidity between psychosis and anxiety disorders has been shown to be considerable. Among the evidence-based psychological treatments for complex mental ill-health, Cognitive Behavioral Therapy for psychosis (CBTp) has been supported with particularly promising research outcomes. Yet, despite such encouraging empirical data, the treatment provision often remains insufficient, predominantly among individuals with more acute presentations. Likewise, literature demonstrating the actual utilization of CBTp with complex psychoses appears above all relevant to the daily clinical practice in the specialism of severe mental ill-health. This methodologically rigorous case study describes a successful implementation of CBTp undertaken with a socially withdrawn individual diagnosed with paranoid schizophrenia and comorbid agoraphobic anxiety disorder. The intervention focused on cognitive restructuring of paranoid appraisals of voices and graded behavioral exposure to anxiety-inducing stimuli. Standardized measurement, behavior frequency sampling, and subjective data were utilized to evaluate the outcomes, indicating a considerable reduction in both paranoia and associated anxiety, and an overall improvement in the client’s behavioral and interpersonal functioning. The article highlights the importance of direct intellectual engagement with the content of paranoia, alongside methodically facilitated graded behavioral exposure and response prevention in the treatment of severe, socially debilitating psychoses with comorbid mood disorders.
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Flower, Laura, Katherine Newman-Taylor, and Lusia Stopa. "Cognitive Control Processes in Paranoia: The Impact of Threat Induction on Strategic Cognition and Self-Focused Attention." Behavioural and Cognitive Psychotherapy 43, no. 1 (2013): 108–18. http://dx.doi.org/10.1017/s1352465813000891.
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Background:Current clinical models emphasize certain cognitive processes in the maintenance of distressing paranoia. While a number of these processes have been examined in detail, the role of strategic cognition and self-focused attention remain under-researched.Aims:This study examined the deployment of cognitive strategies and self-focused attention in people with non-clinical paranoia.Method:An experimental design was used to examine the impact of a threat activation task on these processes, in participants with high and low non-clinical paranoia. Twenty-eight people were recruited to each group, and completed measures of anxiety, paranoid cognition, strategic cognition and self-focused attention.Results:The threat activation task was effective in increasing anxiety in people with high and low non-clinical paranoia. The high paranoia group experienced more paranoid cognitions following threat activation. This group also reported greater use of thought suppression, punishment and worry, and less use of social control strategies when under threat. No differences were found between the groups on measures of self-focused attention.Conclusions:This study shows that the threat activation task increased anxiety in people with high non-clinical paranoia, leading to increased paranoid thinking. The use of strategic cognition following threat activation varied dependent on level of non-clinical paranoia. If these differences are replicated in clinical groups, the strategies may be implicated in the maintenance of distressing psychosis, and may therefore be a valuable target for therapeutic intervention.
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Mankiewicz, Pawel D., and Colin Turner. "Cognitive Restructuring and Graded Behavioural Exposure for Delusional Appraisals of Auditory Hallucinations and Comorbid Anxiety in Paranoid Schizophrenia." Case Reports in Psychiatry 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/124564.
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The prevalence of diagnostic comorbidity between psychosis and anxiety disorders has been found to be considerable. Cognitive models of psychosis suggest that anxiety does not arise directly from positive symptoms of schizophrenia but rather from an individual interpretation of such experiences. In the United Kingdom, cognitive-behavioural therapy for psychosis (CBTp) has been recommended within clinical guidelines as a psychological treatment of choice for those diagnosed with schizophrenia. However, despite empirical evidence supporting CBTp, the treatment provision remains infrequent and not routinely available. This case describes a successful implementation of CBTp. Sixteen sessions were delivered to a 40-year-old male with diagnoses of paranoid schizophrenia and comorbid anxiety, focusing primarily on cognitive restructuring of paranoid appraisals of auditory hallucinations and behavioural experiments employed progressively via graded exposure to anxiety-inducing stimuli. Standardised measurements, behavioural frequency sampling, and subjective data indicated a considerable reduction in both paranoia and anxiety. Also, the client’s psychosocial functioning improved substantially. This report indicates that the treatment may help those with experiences of psychosis and comorbid anxiety reach a significant improvement in their quality of life and offers an encouraging and innovative perspective on direct engagement with the content of paranoia and voices at the onset of therapy.
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Cowles, Megan, and Lorna Hogg. "An Experimental Investigation into the Effect of State-Anxiety on State-Paranoia in People Experiencing Psychosis." Behavioural and Cognitive Psychotherapy 47, no. 1 (2018): 52–66. http://dx.doi.org/10.1017/s1352465818000401.
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Background:There is strong evidence to suggest that anxiety is associated with paranoia in clinical and non-clinical samples. However, no research to date has directly manipulated anxiety to investigate if state-anxiety has a causal role in state-paranoia in clinical populations.Aims:To investigate whether an anxious-mood induction leads to greater paranoia than a neutral-mood induction in people experiencing psychosis and paranoia and, if so, whether this is predicted by anxiety over and above other variables.Method:22 participants with a psychosis-spectrum diagnosis took part in a two condition cross-over experimental design. Participants underwent a neutral-mood and an anxious-mood induction with levels of state-anxiety, state-affect and state-paranoia being measured before and after each condition.Results:State-paranoia was significantly higher after the anxious condition compared with the neutral condition. State-anxiety and negative-affect were significant predictors of levels of state-paranoia after the anxious condition. When both predictors were included in a regression model, only negative-affect was a significant predictor of state-paranoia after the anxious condition. There were a number of methodological limitations.Conclusions:State-anxiety and negative-affect may both be involved in the maintenance of paranoia in clinical populations, as predicted by cognitive models. Negative-affect may be the strongest predictor of state-paranoia in clinical populations. Reasons for this are discussed, as well as the implications. Interventions that seek to reduce negative state-affect may be beneficial in managing state-paranoia. Further research is warranted to explore the suggested clinical and theoretical implications of these findings.
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Strand, Jennifer, and Lisa Rudolfsson. "Mental Health Professionals’ Perceptions of Parenting by Service Users with Psychosis." Community Mental Health Journal 56, no. 6 (2020): 1014–22. http://dx.doi.org/10.1007/s10597-020-00548-0.
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Despite extensive needs, interventions for parents with psychosis are rarely offered, poorly described, and vary between offering instrumental and emotional support. To improve the design of interventions offered to families with parental psychosis, more knowledge is needed. The aim of this study was to gain knowledge about mental health professionals’ perceptions of parenting by patients with psychosis. Eleven mental health professionals educated in family interventions were interviewed using a semi-structured interview guide and the material underwent inductive thematic analysis. Results showed that the professionals described the patients parenting as characterized by difficulties in providing security and predictability, taking part in and organizing family life, and to focus on the child’s needs. The difficulties were described as related to specific symptoms such as voice hearing, cognitive impairments, anxiety, and paranoia. As a vast amount of research stresses the psychosocial basis of psychosis and the interpersonal causes of its symptoms, parenting difficulties in people with psychosis could benefit from being addressed from a relational perspective. Accordingly, parents with psychosis should be offered interventions that enable them to create positive parental role models, develop reflective functioning, and identify situations in which their symptoms might hinder positive parenting. Many of these needs are unmet by interventions offered in adult psychosis services today.
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Valmaggia, Lucia R., Daniel Freeman, Catherine Green, et al. "Virtual reality and paranoid ideations in people with an ‘at-risk mental state’ for psychosis." British Journal of Psychiatry 191, S51 (2007): s63—s68. http://dx.doi.org/10.1192/bjp.191.51.s63.
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BackgroundVirtual reality provides a means of studying paranoid thinking in controlled laboratory conditions. However, this method has not been used with a clinical groupAimsTo establish the feasibility and safety of using virtual reality methodology in people with an at-risk mental state and to investigate the applicability of a cognitive model of paranoia to this groupMethodTwenty-one participants with an at-risk mental state were assessed before and after entering a virtual reality environment depicting the inside of an underground trainResultsVirtual reality did not raise levels of distress at the time of testing or cause adverse experiences over the subsequent week. Individuals attributed mental states to virtual reality characters including hostile intent. Persecutory ideation in virtual reality was predicted by higher levels of trait paranoia, anxiety, stress, immersion in virtual reality, perseveration and interpersonal sensitivityConclusionsVirtual reality is an acceptable experimental technique for use with individuals with at-risk mental states. Paranoia in virtual reality was understandable in terms of the cognitive model of persecutory delusions
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Morrison, A. P., N. Shryane, D. Fowler, et al. "Negative cognition, affect, metacognition and dimensions of paranoia in people at ultra-high risk of psychosis: a multi-level modelling analysis." Psychological Medicine 45, no. 12 (2015): 2675–84. http://dx.doi.org/10.1017/s0033291715000689.
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BackgroundParanoia is one of the commonest symptoms of psychosis but has rarely been studied in a population at risk of developing psychosis. Based on existing theoretical models, including the proposed distinction between ‘poor me’ and ‘bad me’ paranoia, we aimed to test specific predictions about associations between negative cognition, metacognitive beliefs and negative emotions and paranoid ideation and the belief that persecution is deserved (deservedness).MethodWe used data from 117 participants from the Early Detection and Intervention Evaluation for people at risk of psychosis (EDIE-2) trial of cognitive–behaviour therapy, comparing them with samples of psychiatric in-patients and healthy students from a previous study. Multi-level modelling was utilized to examine predictors of both paranoia and deservedness, withpost-hocplanned comparisons conducted to test whether person-level predictor variables were associated differentially with paranoia or with deservedness.ResultsOur sample of at-risk mental state participants was not as paranoid, but reported higher levels of ‘bad-me’ deservedness, compared with psychiatric in-patients. We found several predictors of paranoia and deservedness. Negative beliefs about self were related to deservedness but not paranoia, whereas negative beliefs about others were positively related to paranoia but negatively with deservedness. Both depression and negative metacognitive beliefs about paranoid thinking were specifically related to paranoia but not deservedness.ConclusionsThis study provides evidence for the role of negative cognition, metacognition and negative affect in the development of paranoid beliefs, which has implications for psychological interventions and our understanding of psychosis.
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Corcoran, R. "The allusive cognitive deficit in paranoia: the case for mental time travel or cognitive self-projection." Psychological Medicine 40, no. 8 (2010): 1233–37. http://dx.doi.org/10.1017/s003329170999211x.
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Delusional beliefs are characteristic of psychosis and, of the delusions, the paranoid delusion is the single most common type associated with psychosis. The many years of research focused on neurocognition in schizophrenia, using standardized neurocognitive tests, have failed to find conclusive cognitive deficits in relation to positive symptoms. However, UK-based psychological research has identified sociocognitive anomalies in relation to paranoid thinking in the form of theory of mind (ToM), causal reasoning and threat-related processing anomalies. Drawing from recent neuroscientific research on the default mode network, this paper asserts that the common theme running through the psychological tests that are sensitive to the cognitive impairment of paranoia is the need to cognitively project the self through time, referred to as mental time travel. Such an understanding of the cognitive roots of paranoid ideation provides a synthesis between psychological and biological accounts of psychosis while also retaining the powerful argument that understanding abnormal thinking must start with models of normal cognition. This is the core theme running through the cognitive psychological literature of psychiatric disorders that enables research from this area to inform psychological therapy.
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Huppert, Jonathan D., and Thomas E. Smith. "Anxiety and Schizophrenia: The Interaction of Subtypes of Anxiety and Psychotic Symptoms." CNS Spectrums 10, no. 9 (2005): 721–31. http://dx.doi.org/10.1017/s1092852900019714.
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AbstractObjectiveTo examine the interaction of specific anxiety subtypes and psychosis.IntroductionAccumulating evidence suggests that anxiety and its disorders play a significant role in patients with schizophrenia, but few studies have examined multiple types of anxiety and how they interact with different symptoms of schizophrenia.MethodsThirty-two patients diagnosed with schizophrenia or schizoaffective disorder were assessed through self-report measures and interviewer rating scales to examine symptoms of psychosis and anxiety.ResultsA majority of patients (62%) were diagnosed with at least one comorbid anxiety disorder. Obsessive-compulsive symptoms and social anxiety symptoms were related to positive symptoms, bizarre behavior, and quality of life (QOL). Furthermore, panic and social anxiety were related to suspiciousness/paranoia. No consistent relationship was found with negative symptoms. Finally, severity of anxiety disorders was negatively correlated with the severity of formal thought disorder.DiscussionThis is one of the first studies to simultaneously examine the interrelationships of different types of anxiety symptoms and psychotic symptoms. The present findings are consistent with the studies that have suggested relationships between panic and paranoia and comorbid anxiety disorders and impaired QOL. These data suggest that further research into anxiety in schizophrenia, including the cognitive and neurobiological correlates, may help elucidate the mechanisms involved in the manifestation of these psychopathologiesConclusionAnxiety disorders are common in patients with schizophrenia. The presence of such symptoms may influence the presence of core psychotic symptoms and QOL. More information is needed in terms of the relationship between treatment of these symptoms and changes in psychotic symptoms and/or relapse prevention.
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FOWLER, DAVID, DANIEL FREEMAN, BEN SMITH, et al. "The Brief Core Schema Scales (BCSS): psychometric properties and associations with paranoia and grandiosity in non-clinical and psychosis samples." Psychological Medicine 36, no. 6 (2006): 749–59. http://dx.doi.org/10.1017/s0033291706007355.
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Background. Traditional instruments that measure self-esteem may not relate directly to the schema construct as outlined in recent cognitive models. The Brief Core Schema Scales (BCSS) aim to provide a theoretically coherent self-report assessment of schemata concerning self and others in psychosis. The scales assess four dimensions of self and other evaluation: negative-self, positive-self, negative-other, positive-other.Method. We analysed the psychometric properties of the BCSS using a sample of 754 students recruited by email and 252 people with psychosis recruited as part of a trial of cognitive therapy. We report the internal consistency, stability and the factor structure of the scale, and the association of the BCSS with measures of self-esteem and with symptoms of paranoia and grandiosity.Results. The BCSS have good psychometric properties and have more independence from mood than the Rosenberg Self-Esteem Schedule. People with chronic psychosis reported extreme negative evaluations of both self and others on these scales, but their levels of self-esteem and positive evaluations of self and others were similar to the student sample.Conclusions. Extreme negative evaluations of self and others appear to be characteristic of the appraisals of people with chronic psychosis, and are associated with symptoms of grandiosity and paranoia in the non-clinical population. The BCSS may provide a more useful measure of schemata about self and others than traditional measures of self-esteem.
Dissertations / Theses on the topic "Paranoia : Psychosis : Anxiety cognitive models"
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Camino, Ordonez Gustavo. "A comparison of paranoid ideation in clients with psychosis or anxiety disorders during an interactive video task." Thesis, University of Hertfordshire, 2009. http://hdl.handle.net/2299/2807.
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Background. Previous studies have shown that the use of simulated social environments permits paranoid thinking to be studied. These studies have used a cognitive model of paranoia and suggest that anxiety is an important part of the paranoid experience. Additionally, research addressing the relationship of childhood trauma to psychosis indicates that psychotic symptoms are related to childhood abuse and neglect. The aim of the study was to explore the role of anxiety and childhood trauma in psychotic and anxious participants using a simulated social encounter task. Method. 15 individuals with paranoid delusions (diagnosed with a psychotic disorder), 11 with anxiety disorders and 14 non-clinical controls experienced a simulated social encounter task populated by four filmed characters instructed to behave neutrally (n=40). After the task, the participants completed questionnaires to describe their experience of the situation. 5 questionnaires were used to study paranoid thoughts. The first two were the Details of Threat questionnaire and the VR questionnaire. The other 3 were designed specifically for the study (faces, trust and power questionnaires). Additionally, the Beck Anxiety and Depression Inventories and also a childhood trauma questionnaire were used as indicators of emotional distress. Results. Appraisals from the clinical participants but not from the non-clinical ones were persecutory. The psychological variables from the cognitive model that predicted persecutory ideation were anxiety and neglect. Further, over-sensitivity towards the neutral faces of the characters distinguished again, clinical and non-clinical participants. Conclusions. Paranoid thinking was elicited in clinical participants (anxious and psychotic) by a simulation of a social situation but not in normal controls. Anxiety and two forms of childhood trauma (physical and emotional neglect) were closely associated to persecutory thoughts. The results provide support for the cognitive model of paranoid delusions suggesting that anxiety and neglect underlay paranoid thinking. The study also shows the usefulness of simulations in clinical research.
Book chapters on the topic "Paranoia : Psychosis : Anxiety cognitive models"
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Lecomte, Tania, Claude Leclerc, and Til Wykes. "Basic Cognitive Behavioral Model Used in Group CBT for Psychosis." In Group CBT for Psychosis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med:psych/9780199391523.003.0002.
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This chapter reviews the essential CBT model, such as the ABC’s of CBT model, as well as the specifics linked to psychosis in terms of cognitive biases (attributional, reasoning, etc) and different core beliefs, either specific to psychosis or shared by other disorders, such as depression or personality disorders. Cognitive and behavioral theories, linking biases as well as cognitive and metacognitive deficits, to positive symptoms such as paranoia, grandiosity, and negative symptoms are also presented. Other models used in group CBT for psychosis, such as the recovery model, which focuses on hope in the future, taking personal responsibility for oneself, and getting on with life, or the vulnerability-stress-competence model—empowering the person in developing protective factors to avoid relapse, are explained. The chapter also presents the single-session model, enabling participants to gain from each group session, and Bandura’s social learning theory, as useful for group CBT for psychosis.