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This paper introduces a special issue of the Journal of Forensic Psychiatry and Psychology dedicated to violent extremism and mental health. We address three challenges faced by mental health practitioners who work with people whose harm potential may be ideologically motived. First, how can practitioners engage in good practice in risk assessment and management when the evidence base for such practice in the violent extremism field is limited? Second, how can a mental health practitioner establish and understand the role of an extremist ideology in a client in their care and differentiate it from motivational drivers that may result in broadly similar kinds of actual, attempted or threatened violence? Third, how can practitioners and their services respond to the risks posed in ways that recognise and balance the needs of both the client and those multiple other agencies dedicated to public protection? Following the examination of these challenges, and a brief comment about the relevance of coronavirus to risk of violent extremism, each paper in the special issue will be introduced and their contribution to the work of practitioners who carry such responsibility summarised. The paper concludes with key points and recommendations linked to the three challenges addressed. [ABSTRACT FROM AUTHOR]

Objectives: It is increasingly accepted that paranoia lies on a continuum of severity that can be observed in the general population. Several psychological factors have been implicated in the development of more distressing persecutory ideas including negative affect (i.e., anxiety and depression), beliefs about oneself and other people (i.e., schemas), and metacognitive beliefs. This study aimed to explore the combined role of cognition and metacognition in paranoia. Specifically, unhelpful metacognitive beliefs and schematic beliefs were tested as potential moderators of the relationship between non‐clinical paranoid ideation and negative affect. Methods: Measures from 227 people who took part in a cross‐sectional online survey were analysed using structural equation modelling. A series of models grounded in cognitive and metacognitive theory were tested sequentially. Results: The results demonstrated that unhelpful metacognitive beliefs had a positive moderating effect on the relationship between paranoia and negative affect. Negative beliefs about oneself and other people did not moderate negative affect but positive beliefs about other people had a negative moderating effect. In a final model, negative schematic beliefs predicted paranoid ideation whilst metacognitive beliefs predicted and moderated affect. Conclusions: The findings suggest that consideration of metacognitive beliefs, as well as schemas, may be important in understanding non‐clinical paranoia. Practitioner points: Metacognitive beliefs may be an important determinant of negative affect in the context of non‐clinical paranoia. The consideration of both cognitive and metacognitive factors may be helpful when working with people with distressing paranoid ideas. [ABSTRACT FROM AUTHOR]

This review investigated whether unhelpful metacognitive coping strategies, such as attentional biases, worry, rumination, and thought control, are associated with experiences of psychosis. These processes, known collectively as the Cognitive Attentional Syndrome (CAS), form a central tenet of the Self‐Regulatory Executive Function model. Three research questions based on assumptions underlying the CAS were addressed. It was predicted that processes of (a) self‐focused processing, (b) negative perseverative thinking (worry and rumination), and (c) counterproductive thought control would be associated with experiences of psychosis. A comprehensive search of the literature identified 51 eligible studies: 17 investigated self‐focused attention, 25 investigated perseverative processing (worry: n = 18; rumination: n = 10), and 9 investigated thought control strategies. Findings indicated that unhelpful metacognitive coping strategies associated with the CAS are related to experiences of psychosis and appear to share important relationships with distress. Implications for future research and clinical practice are discussed. [ABSTRACT FROM AUTHOR]