Moment-to-moment Associations Between Emotional Disturbances, Aberrant Salience, and Persecutory Delusions

2017 ◽  
Author(s):  
Suzanne H. So
Keyword(s):  
Emotional Disturbances ◽  
Persecutory Delusions ◽  
Aberrant Salience

scholarly journals Moment-to-moment associations between emotional disturbances, aberrant salience and persecutory delusions

2017 ◽  
Vol 41 (S1) ◽  
pp. s838-s838 ◽  
Author(s):  
S.H. So ◽  
A.K.C. Chau ◽  
E. Peters ◽  
J. Swendsen ◽  
P. Garety ◽  
...  
Keyword(s):  
Rating Scales ◽  
Negative Emotions ◽  
Experience Sampling ◽  
Emotional Disturbances ◽  
Multilevel Regression ◽  
Persecutory Delusions ◽  
Final Sample ◽  
Aberrant Salience ◽  
Time Lagged ◽  
Competing Interest

IntroductionExperiences of depression and anxiety are common among patients with persecutory delusions. It has been theorized that emotional disturbances affect the formation and appraisal of persecutory delusions directly and possibly via increasing the sense of aberrant salience.ObjectivesUsing a time-lagged analysis of experience sampling data, this study modelled the role of momentary levels of negative emotions and aberrant salience in maintaining persecutory delusions in patients with active delusions.MethodsClinically acute participants with at least a mild level of persecutory delusions were assessed using experience sampling method (ESM; 7 entries per day for 14 days) and clinical rating scales. ESM data of participants who completed at least 30 ESM entries were analysed by using multilevel regression modelling.ResultsThe final sample consisted of 14 participants, with a total of 1161 momentary observations. Time-lagged analysis revealed that both negative emotions (B = 0.125, P = .009) and aberrant salience (B = 0.267, P< .001) predicted an increase in persecutory delusions in the next moment. Conversely, persecutory delusions did not predict change in negative emotions or change in aberrant salience in the next moment (ps> .05). Negative emotions also predicted an increase in aberrant salience in the next moment (B = 0.087, P = .009).ConclusionsOur results supported the hypothesis that both negative emotions and aberrant salience exacerbate persecutory delusions, rather than being merely the sequelae of the symptoms. Our results suggested both direct and indirect (via aberrant salience) pathways from negative emotions to persecutory delusions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The weeks before 100 persecutory delusions: the presence of many potential contributory causal factors

BJPsych Open ◽  
2019 ◽  
Vol 5 (5) ◽  
Author(s):  
Daniel Freeman ◽  
Anthony Morrison ◽  
Jessica C. Bird ◽  
Eleanor Chadwick ◽  
Emily Bold ◽  
...  
Keyword(s):  
Sleep Problems ◽  
Cognitive Model ◽  
Self Report ◽  
Poor Sleep ◽  
Subjective Experiences ◽  
Persecutory Delusions ◽  
Causal Factors ◽  
Self Confidence ◽  
Different Types ◽  
Aberrant Salience

Background The period before the formation of a persecutory delusion may provide causal insights. Patient accounts are invaluable in informing this understanding. Aims To inform the understanding of delusion formation, we asked patients about the occurrence of potential causal factors – identified from a cognitive model – before delusion onset. Method A total of 100 patients with persecutory delusions completed a checklist about their subjective experiences in the weeks before belief onset. The checklist included items concerning worry, images, low self-esteem, poor sleep, mood dysregulation, dissociation, manic-type symptoms, aberrant salience, hallucinations, substance use and stressors. Time to reach certainty in the delusion was also assessed. Results Most commonly it took patients several months to reach delusion certainty (n = 30), although other patients took a few weeks (n = 24), years (n = 21), knew instantly (n = 17) or took a few days (n = 6). The most frequent experiences occurring before delusion onset were: low self-confidence (n = 84); excessive worry (n = 80); not feeling like normal self (n = 77); difficulties concentrating (n = 77); going over problems again and again (n = 75); being very negative about the self (n = 75); images of bad things happening (n = 75); and sleep problems (n = 75). The average number of experiences occurring was high (mean 23.5, s.d. = 8.7). The experiences clustered into six main types, with patients reporting an average of 5.4 (s.d. = 1.0) different types. Conclusions Patients report numerous different experiences in the period before full persecutory delusion onset that could be contributory causal factors, consistent with a complex multifactorial view of delusion occurrence. This study, however, relied on retrospective self-report and could not determine causality. Declaration of interest None.

KECEMASAN PASIEN PENYAKIT GINJAL KRONIS YANG MENJALANI HEMODIALISA

2019 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Devi Novita Damanik
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Rating Scale ◽  
Femoral Vein ◽  
Univariate Analysis ◽  
Sampling Technique ◽  
Emotional Disturbances ◽  
Hamilton Anxiety Rating Scale ◽  
One Year ◽  
Severe Anxiety

Background: Anxiety is a condition of psychological and physiological disorders characterized by cognitive, somatic, emotional disturbances and components of behavioral sequences. Purpose: This study aims to describe the anxiety of chronic kidney disease patients undergoing hemodialysis. Methods: This study uses univariate analysis which will describe the anxiety level of chronic kidney disease patients undergoing hemodialysis. The anxiety variable was measured using the HARS (Hamilton Anxiety Rating Scale) anxiety instrument with a validity value of 0.68 dd 0.93 and a reliability value of 0.93. The population in this study were all chronic kidney disease patients who underwent hemodialysis and experienced anxiety. The sampling technique used in this study was purposive sampling technique. The sample in this study were patients with chronic kidney disease who met the requirements of the study patients, namely: Patients who underwent hemodialysis for less than one year, patients undergoing hemodialysis with femoral vein puncture, patients undergoing hemodialysis twice a week. Results: The results showed that the study respondents had a mild anxiety rate of 9 patients (56.25%), moderate anxiety as many as 8 patients (21.875%) and severe anxiety as many as 8 patients (21.875%). Conclusion: conclusions and implications for nursing practice. The results showed a high incidence of anxiety in patients undergoing hemodialysis and distributed evenly on mild, moderate and severe anxiety.

LSD, madness and healing: Mystical experiences as possible link between psychosis model and therapy model

2021 ◽  
pp. 1-15
Author(s):  
Isabel Wießner ◽  
Marcelo Falchi ◽  
Fernanda Palhano-Fontes ◽  
Amanda Feilding ◽  
Sidarta Ribeiro ◽  
...  
Keyword(s):  
Therapeutic Potential ◽  
Five Facet Mindfulness Questionnaire ◽  
Psychotic Experience ◽  
Creative Imagination ◽  
Double Blind ◽  
Alteration Of Consciousness ◽  
Therapy Model ◽  
Aberrant Salience ◽  
Mystical Experiences ◽  
Meaning Attribution

Abstract Background For a century, psychedelics have been investigated as models of psychosis for demonstrating phenomenological similarities with psychotic experiences and as therapeutic models for treating depression, anxiety, and substance use disorders. This study sought to explore this paradoxical relationship connecting key parameters of the psychotic experience, psychotherapy, and psychedelic experience. Methods In a randomized, double-blind, placebo-controlled, crossover design, 24 healthy volunteers received 50 μg d-lysergic acid diethylamide (LSD) or inactive placebo. Psychotic experience was assessed by aberrant salience (Aberrant Salience Inventory, ASI), therapeutic potential by suggestibility (Creative Imagination Scale, CIS) and mindfulness (Five Facet Mindfulness Questionnaire, FFMQ; Mindful Attention Awareness Scale, MAAS; Experiences Questionnaire, EQ), and psychedelic experience by four questionnaires (Altered State of Consciousness Questionnaire, ASC; Mystical Experiences Questionnaire, MEQ; Challenging Experiences Questionnaire, CEQ; Ego-Dissolution Inventory, EDI). Relationships between LSD-induced effects were examined. Results LSD induced psychedelic experiences, including alteration of consciousness, mystical experiences, ego-dissolution, and mildly challenging experiences, increased aberrant salience and suggestibility, but not mindfulness. LSD-induced aberrant salience correlated highly with complex imagery, mystical experiences, and ego-dissolution. LSD-induced suggestibility correlated with no other effects. Individual mindfulness changes correlated with aspects of aberrant salience and psychedelic experience. Conclusions The LSD state resembles a psychotic experience and offers a tool for healing. The link between psychosis model and therapeutic model seems to lie in mystical experiences. The results point to the importance of meaning attribution for the LSD psychosis model and indicate that psychedelic-assisted therapy might benefit from therapeutic suggestions fostering mystical experiences.

scholarly journals Peripandemic psychiatric emergencies: impact of the COVID-19 pandemic on patients according to diagnostic subgroup

2021 ◽  
Vol 271 (2) ◽  
pp. 259-270
Author(s):  
Johanna Seifert ◽  
Catharina Meissner ◽  
Anna Birkenstock ◽  
Stefan Bleich ◽  
Sermin Toto ◽  
...  
Keyword(s):  
Psychiatric Treatment ◽  
Somatoform Disorders ◽  
Presentation Rate ◽  
Well Being ◽  
Control Group ◽  
Medical Care System ◽  
Persecutory Delusions ◽  
Vulnerable Patients ◽  
Group A ◽  
Repeat Visits

AbstractOn March 11th, 2020, the outbreak of coronavirus disease 2019 (COVID-19) was declared a pandemic. Governments took drastic measures in an effort to reduce transmission rates and virus-associated morbidity. This study aims to present the immediate effects of the pandemic on patients presenting in the psychiatric emergency department (PED) of Hannover Medical School. Patients presenting during the same timeframe in 2019 served as a control group. A decrease in PED visits was observed during the COVID-19 pandemic with an increase in repeat visits within 1 month (30.2 vs. 20.4%, pBA = 0.001). Fewer patients with affective disorders utilized the PED (15.2 vs. 22.2%, pBA = 0.010). Suicidal ideation was stated more frequently among patients suffering from substance use disorders (47.4 vs. 26.8%, pBA = 0.004), while patients with schizophrenia more commonly had persecutory delusions (68.7 vs. 43.5%, pBA = 0.023) and visual hallucinations (18.6 vs. 3.3%, pBA = 0.011). Presentation rate of patients with neurotic, stress-related, and somatoform disorders increased. These patients were more likely to be male (48.6 vs. 28.9%, pBA = 0.060) and without previous psychiatric treatment (55.7 vs. 36.8%, pBA = 0.089). Patients with personality/behavioral disorders were more often inhabitants of psychiatric residencies (43.5 vs. 10.8%, pBA = 0.008). 20.1% of patients stated an association between psychological well-being and COVID-19. Most often patients suffered from the consequences pertaining to social measures or changes within the medical care system. By understanding how patients react to such a crisis situation, we can consider how to improve care for patients in the future and which measures need to be taken to protect these particularly vulnerable patients.

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