Search

Objectives: Dimensional approaches suggest psychotic symptoms exist along a continuum, with psychotic‐like experiences (PLEs) being an expression of a non‐clinical psychosis phenotype. Existing research indicates self‐criticism may contribute to symptom maintenance, frequency and distress, whereas self‐compassion may act protectively. Associations between self‐criticism, self‐compassion and PLEs in the general population have received less attention. The present study sought to investigate these associations. It was hypothesised that PLE endorsement would be associated positively with self‐criticism and negatively with self‐compassion. Design: Quantitative cross‐sectional study. Data collected via an online questionnaire. Methods: Five hundred thirty‐one participants completed the Self‐Compassion Scale (Short Form), the Forms of Self‐Criticising/Attacking and Self‐Reassuring Scale and the Transpersonal Experiences Questionnaire. Individuals with a psychosis‐related diagnosis were excluded. The data were analysed using linear regression, accounting for the effects of demographic variables. Results: Self‐criticism subtype self‐hatred was associated with PLEs. Subtype self‐inadequacy was not. No association was found between self‐compassion and PLEs. Educational attainment was negatively associated with PLE endorsement. Conclusions: Self‐criticism, but not self‐compassion, is associated with PLE endorsement, suggesting they are separate factors with different relationships to PLEs. Further research is needed to confirm the direction of the interaction. Either way, psychological interventions (where needed) could target self‐criticism and may be important in assessing psychosis risk. [ABSTRACT FROM AUTHOR]

Background: Cognitive Bias Modification for paranoia (CBM-pa) is a novel, theory-driven psychological intervention targeting the biased interpretation of emotional ambiguity associated with paranoia. Study objectives were (i) test the intervention's feasibility, (ii) provide effect size estimates, (iii) assess dose–response and (iv) select primary outcomes for future trials. Methods: In a double-blind randomised controlled trial, sixty-three outpatients with clinically significant paranoia were randomised to either CBM-pa or an active control (text reading) between April 2016 and September 2017. Patients received one 40 min session per week for 6 weeks. Assessments were given at baseline, after each interim session, post-treatment, and at 1- and 3-months post-treatment. Results: A total of 122 patients were screened and 63 were randomised. The recruitment rate was 51.2%, with few dropouts (four out of 63) and follow-up rates were 90.5% (1-month) and 93.7% (3-months). Each session took 30–40 min to complete. There was no statistical evidence of harmful effects of the intervention. Preliminary data were consistent with efficacy of CBM-pa over text-reading control: patients randomised to the intervention, compared to control patients, reported reduced interpretation bias (d = −0.48 to −0.76), improved symptoms of paranoia (d = −0.19 to −0.38), and lower depressed and anxious mood (d = −0.03 to −0.29). The intervention effect was evident after the third session. Conclusions: CBM-pa is feasible for patients with paranoia. A fully powered randomised control trial is warranted. [ABSTRACT FROM AUTHOR]

There are communities in which hearing voices frequently is common and expected, and in which participants are not expected to have a need for care. This paper compares the ideas and practices of these communities. We observe that these communities utilize cultural models to identify and to explain voice-like events—and that there are some common features to these models across communities. All communities teach participants to "discern," or identify accurately, the legitimate voice of the spirit or being who speaks. We also observe that there are roughly two methods taught to participants to enable them to experience spirits (or other invisible beings): trained attention to inner experience, and repeated speech to the invisible other. We also observe that all of these communities model a learning process in which the ability to hear spirit (or invisible others) becomes more skilled with practice, and in which what they hear becomes clearer over time. Practice—including the practice of discernment—is presumed to change experience. We also note that despite these shared cultural ideas and practices, there is considerable individual variation in experience—some of which may reflect psychotic process, and some perhaps not. We suggest that voice-like events in this context may be shaped by cognitive expectation and trained practice as well as an experiential pathway. We also suggest that researchers could explore these common features both as a way to help those struggling with psychosis, and to consider the possibility that expectations and practice may affect the voice-hearing experience. [ABSTRACT FROM AUTHOR]

Remote therapy promises a cost-effective way of increasing delivery of psychological-therapy in underserved populations. However, research shows a "digital divide", with some groups experiencing digital exclusion. To assess whether technology, accessibility, and demographic factors influence remote therapy uptake among individuals with psychosis, and whether demographic factors are associated with digital exclusion. Remote therapy uptake and demographics were assessed in people (n = 51) within a psychology-led service for psychosis, using a survey of access to digital hardware, data and private space. The majority of individuals had access to digital devices, but 29% did not meet minimum requirements for remote therapy. Nineteen (37%) individuals declined remote therapy. Those who accepted were significantly younger and more likely to have access to technology than those who declined. The mean age of those with access to smartphones and large screen devices was younger than those without access. A subgroup of people with psychosis face barriers to remote therapy and a significant minority are digitally excluded. Older age is a key factor influencing remote therapy uptake, potentially related to less access to digital devices. Services must minimize exclusion through provision of training, hardware and data, whilst promoting individual choice. [ABSTRACT FROM AUTHOR]