Psychotic experiences as a health indicator: A provisional framework

BackgroundEffective interventions, targeting key contributory causal factors, are needed to prevent the emergence of severe mental health problems in young people. Insomnia is a common clinical issue that is problematic in its own right but that also leads to the development and persistence of psychotic experiences. The implication is that treating sleep problems may prevent the onset of psychosis. We collected initial case series data with 12 young people at ultra-high-risk of psychosis. Post-intervention, there were improvements in sleep, depression and psychotic experiences. Now we test the feasibility of a randomised controlled trial, with a clinical aim to treat sleep problems and hence reduce depression, psychotic experiences, and prevent transition to psychosis.Methods and analysisA randomised controlled feasibility trial will be conducted. Forty patients aged 14 to 25 years who are at ultra-high-risk of psychosis and have sleep disturbance will be recruited from National Health Service (NHS) mental health services. Participants will be randomised to receive either a novel, targeted, youth-focussed sleep intervention in addition to usual care or usual care alone. Assessor-blinded assessments will be conducted at baseline, 3 months (post-intervention) and 9 months (follow-up). The eight-session psychological intervention will target the key mechanisms which disrupt sleep: circadian rhythm irregularities, low sleep pressure, and hyperarousal. To gain an in-depth understanding of participants’ views on the acceptability of the intervention and study procedures, 16 participants (n=10 intervention, n=6 control) will take part in qualitative interviews. Analyses will focus on feasibility outcomes (recruitment, retention, and treatment uptake rates) and provide initial CI estimates of intervention effects. Thematic analysis of the qualitative interviews will assess the acceptability of the intervention and trial procedures.Ethics and disseminationThe trial has received ethical approval from the NHS Health Research Authority. Findings will be disseminated through peer-reviewed publications, conference presentations, and lay networks.Trial registration numberISRCTN85601537.

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Health indicator construction by quadratic function-based deep convolutional auto-encoder and its application into bearing RUL prediction

ISA Transactions ◽

10.1016/j.isatra.2020.12.052 ◽

2020 ◽

Author(s):

Dingliang Chen ◽

Yi Qin ◽

Yi Wang ◽

Jianghong Zhou

Keyword(s):

Quadratic Function ◽

Health Indicator

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Cognitive appraisals of dissociation in psychosis: a new brief measure

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465820000958 ◽

2020 ◽

pp. 1-13

Author(s):

Emma Černis ◽

Jessica C. Bird ◽

Andrew Molodynski ◽

Anke Ehlers ◽

Daniel Freeman

Keyword(s):

Factor Analysis ◽

Convergent Validity ◽

Intraclass Correlation ◽

Cognitive Appraisals ◽

Test Reliability ◽

Psychotic Symptoms ◽

Psychotic Experiences ◽

Internal Reliability ◽

Dissociative Experiences ◽

Additional Variance

Abstract Background: Catastrophic cognitive appraisals, similar to those in anxiety disorders, are implicated in depersonalisation, a form of dissociation. No scales exist to measure appraisals of dissociative experiences. Dissociation is common in psychosis. Misinterpretations of dissociative experiences may maintain psychotic symptoms. Therefore, assessing appraisals in this context may be valuable. Aims: The primary aim was to develop a measure of key appraisals of dissociation in psychosis. Secondary aims were to test the relationship between appraisals and psychotic experiences (paranoia and hallucinations), and determine whether appraisals explain additional variance in psychotic symptoms above dissociative symptoms. Method: Fifty items were generated from transcripts of interviews with patients. The measure was developed and psychometrically validated via factor analysis of data from 9902 general population participants and 1026 patients with psychosis. Convergent validity, test–re-test reliability, and internal reliability were assessed. Regression analyses tested relationships with psychotic symptoms. Results: A 13-item single-factor measure was developed. Factor analysis indicated good model fit [χ2(65) = 247.173, comparative fit index (CFI) = 0.960, root mean square error of approximation (RMSEA) = 0.052]. The scale had good convergent validity with a rumination (non-clinical: r = 0.71; clinical: r = 0.73) and dissociation measure (r = 0.81; r = 0.80), high internal consistency (α = 0.93; α = 0.93), and excellent 1-week test–re-test reliability [intraclass correlation (ICC) = 0.90]. It explained variance in psychotic symptoms (paranoia: 36.4%; hallucinations: 35.0%), including additional variance compared with dissociation alone (paranoia: 5.3%; hallucinations: 2.3%). Conclusions: The Cognitive Appraisals of Dissociation in Psychosis (CAD-P) measure is a psychometrically robust scale identifying appraisals of dissociative experiences in psychosis and is associated with the presence of psychotic experiences. It is likely to prove useful for clinical assessment and research.

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Comparing Primary Voice-Hearers with and without Hallucinations in Other Sensory Modalities

Psychopathology ◽

10.1159/000517455 ◽

2021 ◽

pp. 214-220

Author(s):

Wei Lin Toh ◽

Neil Thomas ◽

Susan L. Rossell

Keyword(s):

Functional Impairment ◽

Auditory Hallucination ◽

Sensory Modality ◽

Clinical Information ◽

Auditory Hallucinations ◽

Auditory Modality ◽

Positive Symptoms ◽

Psychotic Experiences ◽

Sensory Modalities ◽

Preliminary Study

There has been burgeoning interest in studying hallucinations in psychosis occurring across multiple sensory modalities. The current study aimed to characterize the auditory hallucination and delusion profiles in patients with auditory hallucinations only versus those with multisensory hallucinations. Participants with psychosis were partitioned into groups with voices only (AVH; <i>n</i> = 50) versus voices plus hallucinations in at least one other sensory modality (AVH+; <i>n</i> = 50), based on their responses on the Scale for the Assessment of Positive Symptoms (SAPS). Basic demographic and clinical information was collected, and the Questionnaire for Psychotic Experiences (QPE) was used to assess psychosis phenomenology. Relative to the AVH group, greater compliance to perceived commands, auditory illusions, and sensed presences was significantly elevated in the AVH+ group. The latter group also had greater levels of delusion-related distress and functional impairment and was more likely to endorse delusions of reference and misidentification. This preliminary study uncovered important phenomenological differences in those with multisensory hallucinations. Future hallucination research extending beyond the auditory modality is needed.

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Autism Spectrum Disorder and Clinical High Risk for Psychosis: A Systematic Review and Meta-analysis

Journal of Autism and Developmental Disorders ◽

10.1007/s10803-021-05046-0 ◽

2021 ◽

Author(s):

Julio Vaquerizo-Serrano ◽

Gonzalo Salazar de Pablo ◽

Jatinder Singh ◽

Paramala Santosh

Keyword(s):

Systematic Review ◽

High Risk ◽

Literature Search ◽

Meta Analysis ◽

Autism Spectrum ◽

Clinical High Risk ◽

Psychotic Experiences ◽

Attenuated Psychosis Syndrome ◽

The Mean ◽

Spectrum Disorders

AbstractPsychotic experiences can occur in autism spectrum disorders (ASD). Some of the ASD individuals with these experiences may fulfil Clinical High-Risk for Psychosis (CHR-P) criteria. A systematic literature search was performed to review the information on ASD and CHR-P. A meta-analysis of the proportion of CHR-P in ASD was conducted. The systematic review included 13 studies. The mean age of ASD individuals across the included studies was 11.09 years. The Attenuated Psychosis Syndrome subgroup was the most frequently reported. Four studies were meta-analysed, showing that 11.6% of CHR-P individuals have an ASD diagnosis. Symptoms of prodromal psychosis may be present in individuals with ASD. The transition from CHR-P to psychosis is not affected by ASD.

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