Evidence of mediation of anxiety and depression between abuse and positive symptoms of psychosis

SynopsisThe problem of a possible lack of motivation to perform cognitive tasks, which is often encountered in psychotic patients, has been approached from the perspective of the ‘energetics’ of cognition (Hockey et al. 1986) and from the broader clinical context of psychosis as an ‘amotivational syndrome’ and its related negative symptoms.The presence of motivational deficits was investigated in a group of psychotic in-patients (N = 73, and 40 had schizophrenia) compared with a control group of non-psychotic psychiatric in-patients (N = 23). The motivational deficit was operationalized in terms of Sanders's (1983) cognitive–energetic model as a large effect of ‘time-on-task’ during a simple, monotonous reaction test. Significantly more psychotic patients than control patients showed evidence of this type of motivational deficit. The deficit appeared to be related with negative but not with positive symptoms of psychosis. Furthermore, the deficit was shown to be related to the cognitive disorders of psychosis, which have been amply documented in the literature, i.e. disorders of vigilance, verbal memory and distractibility. These results suggest that the cognitive disorders of psychosis are not of a ‘computational’ but of an ‘energetical’, i.e. motivational nature.

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When it's the Time to Switch the Therapeutic Approach on Electroconvulsive Therapy for Residual Positive Symptoms in Schizophrenia?

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.975 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S613-S613

Author(s):

I. Nechifor ◽

N. Nita ◽

M. Buzut

Keyword(s):

Electroconvulsive Therapy ◽

Social Life ◽

Negative Impact ◽

Paranoid Schizophrenia ◽

Anxiety And Depression ◽

Positive Symptoms ◽

Treatment Resistant ◽

The Past ◽

Competing Interest ◽

Depot Antipsychotics

IntroductionSchizophrenia is clearly one of the most debilitating diseases. Luckily, in the past 20 years, there has been a wide and good change in symptomatology due to the new atypical antipsychotics. Still, there are patients who are treatment resistant after different adjustments like switching or adding antipsychotics. Most of the clinicians consider Clozapine the “last resort”. But what if it doesn’t work so well on some patients?ObjectiveTo determine the point when it's time to try electroconvulsive therapy in schizophrenia treatment-resistant patients or remain on conventional approach.AimsThe aim of this work is to determine whether it's better for those patients who have residual positive symptoms to use oral/depot antipsychotics or to switch on electroconvulsive therapy.MethodsThis work presents the case of the patient C.D., 35 years, diagnosed with paranoid schizophrenia since 2008. Risperidone, Olanzapine, Aripiprazole were introduced during time, with some improvement on the positive symptomatology, but the patient developed several side-effects. At his last admission in our hospital, he came after a suicidal attempt caused by high anxiety and depression due to his false beliefs. Clozapine was introduced, but after one month of treatment, the patient still had the belief that his neighbours want to harm him somehow.ResultsThe patient and his mother definitively refused electroconvulsive therapy because of their personal beliefs. He affirmed that he can live with this “low-dose” of suspiciousness which, unfortunately, had a negative impact on his social life.ConclusionsWe still recommend electroconvulsive therapy in these situations, even though, there are many misconceptions regarding this approach.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Positive symptoms of psychosis in posttraumatic stress disorder

Biological Psychiatry ◽

10.1016/0006-3223(95)00314-2 ◽

1996 ◽

Vol 39 (10) ◽

pp. 839-844 ◽

Cited By ~ 85

Author(s):

Robert W. Butler ◽

Kim T. Mueser ◽

Joyce Sprock ◽

David L. Braff

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Positive Symptoms ◽

Positive Symptoms Of Psychosis

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Positive symptoms of psychosis correlate with expression of ubiquitin proteasome genes in peripheral blood

American Journal of Medical Genetics Part B Neuropsychiatric Genetics ◽

10.1002/ajmg.b.31106 ◽

2010 ◽

Vol 153B (7) ◽

pp. 1336-1341 ◽

Cited By ~ 30

Author(s):

Chad A. Bousman ◽

Gursharan Chana ◽

Stephen J. Glatt ◽

Sharon D. Chandler ◽

Todd May ◽

...

Keyword(s):

Peripheral Blood ◽

Positive Symptoms ◽

Ubiquitin Proteasome ◽

Positive Symptoms Of Psychosis

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Rethinking Social Cognition in Light of Psychosis: Reciprocal Implications for Cognition and Psychopathology

Clinical Psychological Science ◽

10.1177/2167702616677079 ◽

2017 ◽

Vol 5 (3) ◽

pp. 537-550 ◽

Cited By ~ 13

Author(s):

Vaughan Bell ◽

Kathryn L. Mills ◽

Gemma Modinos ◽

Sam Wilkinson

Keyword(s):

Social Cognition ◽

Comparative Psychology ◽

Mental States ◽

Social Reasoning ◽

Positive Symptoms ◽

Cognitive Anthropology ◽

Social Agent ◽

Social Actors ◽

Social Nature ◽

Positive Symptoms Of Psychosis

The positive symptoms of psychosis largely involve the experience of illusory social actors, and yet our current measures of social cognition, at best, only weakly predict their presence. We review evidence to suggest that the range of current approaches in social cognition is not sufficient to explain the fundamentally social nature of these experiences. We argue that social agent representation is an important organizing principle for understanding social cognition and that alterations in social agent representation may be a factor in the formation of delusions and hallucination in psychosis. We evaluate the feasibility of this approach in light of clinical and nonclinical studies, developmental research, cognitive anthropology, and comparative psychology. We conclude with recommendations for empirical testing of specific hypotheses and how studies of social cognition could more fully capture the extent of social reasoning and experience in both psychosis and more prosaic mental states.

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Exploring the Associations between Social Rank and External Shame with Experiences of Psychosis

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465815000570 ◽

2015 ◽

Vol 44 (5) ◽

pp. 527-538 ◽

Cited By ~ 11

Author(s):

Lisa Wood ◽

Chris Irons

Keyword(s):

Social Rank ◽

Positive Symptoms ◽

Personal Recovery ◽

Cross Sectional ◽

External Shame ◽

Correlational Design ◽

Study Participants ◽

Relationship Of ◽

Positive Symptoms Of Psychosis ◽

The Relationship

Background:Low social rank and external shame have been found to be significantly associated with anxiety and depression. However, their relevance to experiences of psychosis has rarely been explored.Aims:This study aims to examine the relationship of social rank and external shame to personal recovery, depression and positive symptoms in psychosis.Method:A cross sectional correlational design was adopted to examine the relationship between all variables. Fifty-two service users, aged between 18 to 65 years, with experiences of psychosis were recruited for the study. Participants were administered outcome measures examining social rank, external shame, positive symptoms of psychosis, depression and personal recovery. Multiple regression analyses were conducted on the data.Results:Significant correlations were found between all variables. Low social rank was significantly associated with lower reported personal recovery, and higher levels of external shame and depression symptomology. The relationship between external shame and positive symptoms of psychosis and personal recovery was found to be mediated by participants’ level of depression.Conclusion:Findings suggest that social rank and external shame are relevant to those who experience psychosis. Therapeutic approaches may need to focus on perceptions of social rank and external shame in working with experiences of psychosis.

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The impact of family environment on self-esteem and symptoms in early psychosis

PLoS ONE ◽

10.1371/journal.pone.0249721 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249721

Author(s):

Lídia Hinojosa-Marqués ◽

Manel Monsonet ◽

Thomas R. Kwapil ◽

Neus Barrantes-Vidal

Keyword(s):

Family Environment ◽

Expressed Emotion ◽

Mental States ◽

Self Esteem ◽

Early Psychosis ◽

First Episode ◽

Positive Symptoms ◽

Patients At Risk ◽

Positive Symptoms Of Psychosis ◽

The Impact

Expressed emotion (EE) and self-esteem (SE) have been implicated in the onset and development of paranoia and positive symptoms of psychosis. However, the impact of EE on patients’ SE and ultimately on symptoms in the early stages of psychosis is still not fully understood. The main objectives of this study were to examine whether: (1) patients’ SE mediated the effect of relatives’ EE on patients’ positive symptoms and paranoia; (2) patients’ perceived EE mediated the effect of relatives’ EE on patients’ SE; (3) patients’ SE mediated between patients’ perceived EE and patients’ symptomatology; and (4) patients’ perceived EE and patients’ SE serially mediated the effect of relatives’ EE on patients’ positive symptoms and paranoia. Incipient psychosis patients (at-risk mental states and first-episode of psychosis) and their respective relatives completed measures of EE, SE, and symptoms. Findings indicated that: (1) patients’ perceived EE mediated the link between relatives’ EE and patients’ negative, but not positive, SE; (2) patients’ negative SE mediated the effect of patients’ perceived EE on positive symptoms and paranoia; (3) the association of relatives’ EE with positive symptoms and paranoia was serially mediated by an increased level of patients’ perceived EE leading to increases in negative SE; (4) high levels of patients’ distress moderated the effect of relatives’ EE on symptoms through patients’ perceived EE and negative SE. Findings emphasize that patients’ SE is relevant for understanding how microsocial environmental factors impact formation and expression of positive symptoms and paranoia in early psychosis. They suggest that broader interventions for patients and their relatives aiming at improving family dynamics might also improve patients’ negative SE and symptoms.

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Cognitive behaviour therapy for psychosis

Epidemiology and Psychiatric Sciences ◽

10.1017/s1121189x00002153 ◽

2006 ◽

Vol 15 (4) ◽

pp. 267-275 ◽

Cited By ~ 6

Author(s):

Elizabeth Kuipers ◽

Paul Bebbington

Keyword(s):

Empirical Studies ◽

Cognitive Model ◽

Positive Symptoms ◽

Behaviour Therapy ◽

Cognitive Behavioural ◽

Social Adversity ◽

Cognitive Behaviour ◽

Positive Symptoms Of Psychosis ◽

Reasoning Biases

SummaryAims – It used to be thought that the problems of psychosis were qualitatively difference from those of other disorders and therefore unamenable to psychological interventions. However more recent evidence will be summarised which suggests otherwise. Methods – A cognitive model of the positive symptoms of psychosis (Garety et al, 2001; Kuipers et al.,2006) is described which builds on work on the dimensions of symptoms of psychosis, the continuum between non-clinical and clinical populations, and the contribution of emotional processes, cognitive reasoning biases and social factors. Results – Evidence from both epidemiological and empirical studies from our research group and others, support some of the pathways of symptom formation and maintenance proposed by the model. Specifically there is evidence for the role of trauma, social adversity and stress. These may trigger emotional responses and unusual experiences and together with reasoning biases lead to appraisals that can be defined as positive symptoms such as delusions and hallucinations. Similar processes interact to maintain symptoms. Conclusions – Cognitive models of psychosis have led to the development of cognitive behavioural treatments for delusions and hallucinations, which show some evidence of efficacy. Such treatments need to be refined in the light of recent research.Declaration of Interest: none

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