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Emotion and psychosis: Links between depression, self-esteem, negative schematic beliefs and delusions and hallucinations

Smith, B and Fowler, DG and Freeman, D and Bebbington, P and Bashforth, H and Garety, P and Dunn, G and Kuipers, E (2006) Emotion and psychosis: Links between depression, self-esteem, negative schematic beliefs and delusions and hallucinations. SCHIZOPHR RES , 86 (1-3) 181 - 188. 10.1016/j.schres.2006.06.018.

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Abstract

Background: The role of emotion in psychosis is being increasingly recognised. Cognitive conceptualisations of psychosis (e.g. [Garety, P.A., Kuipers, E.K., Fowler, D., Freeman, D., Bebbington, P.E., 2001. A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31, 189-195]) emphasise a central, normal, direct and non-defensive role for negative emotion in the development and maintenance of psychosis. This study tests specific predictions made by Garety et al. [Garety, P.A., Kuipers, E.K., Fowler, D., Freeman, D., Bebbington, P.E., 2001. A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31, 189-195] about the role of emotion and negative evaluative beliefs in psychosis.Methods: 100 participants who had suffered a recent relapse in psychosis were recruited at baseline for the Prevention of Relapse in Psychosis (PRP) trial. In a cross-sectional analysis, we examined the role of depression, self-esteem and negative evaluative beliefs in relation to specific positive symptoms (persecutory delusions, auditory hallucinations and grandiose delusions) and symptom dimensions (e.g. distress, negative content, pre-occupation and conviction).Results: Analysis indicated that individuals with more depression and lower self-esteem had auditory hallucinations of greater severity and more intensely negative content, and were more distressed by them. In addition, individuals with more depression, lower self-esteem and more negative evaluations about themselves and others had persecutory delusions of greater severity and were more pre-occupied and distressed by them. The severity of grandiose delusions was related inversely to depression scores and negative evaluations about self, and directly to higher self-esteem.Conclusions: This study provides evidence for the role of emotion in schizophrenia spectrum-disorders. Mood, self-esteem and negative evaluative beliefs should be considered when conceptualising psychosis and designing interventions. (c) 2006 Elsevier B.V. All rights reserved.

Type:Article
Title:Emotion and psychosis: Links between depression, self-esteem, negative schematic beliefs and delusions and hallucinations
Open access status:An open access version is available from UCL Discovery
DOI:10.1016/j.schres.2006.06.018
Keywords:schematic beliefs, hallucinations, delusions, depression, schizophrenia, COGNITIVE-BEHAVIORAL TREATMENT, PERSECUTORY DELUSIONS, 1ST-EPISODE PSYCHOSIS, POSITIVE SYMPTOMS, SCHIZOPHRENIA, MODEL, EXPERIENCES, PARANOIA, DIMENSIONS, PATHWAYS
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Neurology > RLW Institute of Neurological Sciences
UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Mental Health Sciences Unit

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