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1
Felber, Werner, i Thomas Reuster. "The Fading of Psychosis". Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-134488.
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Felber, Werner, i Thomas Reuster. "The Fading of Psychosis". Karger, 2001. https://tud.qucosa.de/id/qucosa%3A27570.
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Hides, Leanne, i n/a. "An Examination of the Influence of Cannabis Use on Psychotic Symptom Exacerbation and Relapse in Early Psychosis". Griffith University. School of Applied Psychology, 2003. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030922.130049.
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There has been concern about the impact of cannabis use on the onset, course and relapse of psychosis. Evidence from retrospective and a small number of prospective studies has suggested that cannabis use may precipitate a latent psychosis, exacerbate psychotic symptoms and increase the likelihood of psychotic relapse. The purpose of the current study was to examine the influence of cannabis use on psychotic symptom exacerbation and relapse within the stress vulnerability-coping model of psychosis. Two studies were conducted. The influence of cannabis use on the onset and course of psychosis was retrospectively examined in the first study. The second study prospectively examined the influence of cannabis use on psychotic symptom exacerbation and relapse over a 6-month period. The influence of the severity of psychotic symptoms on a relapse in cannabis use was also explored. Eighty-four participants were assessed at admission, 81 of whom were followed up for a 6-month period. Measures consisted of structured diagnostic interviews and self-report measures of stress, medication compliance, family functioning, premorbid adjustment, quality of life, substance use and psychotic symptoms. The onset of cannabis use clearly preceded the onset of psychosis. Cannabis use was predictive of the severity of psychotic and general psychopathology symptoms at admission. Both the frequency and quantity of cannabis use was predictive of time to psychotic relapse over the 6-month follow up period. Psychotic symptom severity was predictive of a substantial increase in the quantity but not the frequency of cannabis use. Cannabis use was related to the onset, course and relapse of psychosis.
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Hides, Leanne. "An Examination of the Influence of Cannabis Use on Psychotic Symptom Exacerbation and Relapse in Early Psychosis". Thesis, Griffith University, 2003. http://hdl.handle.net/10072/366456.
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There has been concern about the impact of cannabis use on the onset, course and relapse of psychosis. Evidence from retrospective and a small number of prospective studies has suggested that cannabis use may precipitate a latent psychosis, exacerbate psychotic symptoms and increase the likelihood of psychotic relapse. The purpose of the current study was to examine the influence of cannabis use on psychotic symptom exacerbation and relapse within the stress vulnerability-coping model of psychosis. Two studies were conducted. The influence of cannabis use on the onset and course of psychosis was retrospectively examined in the first study. The second study prospectively examined the influence of cannabis use on psychotic symptom exacerbation and relapse over a 6-month period. The influence of the severity of psychotic symptoms on a relapse in cannabis use was also explored. Eighty-four participants were assessed at admission, 81 of whom were followed up for a 6-month period. Measures consisted of structured diagnostic interviews and self-report measures of stress, medication compliance, family functioning, premorbid adjustment, quality of life, substance use and psychotic symptoms. The onset of cannabis use clearly preceded the onset of psychosis. Cannabis use was predictive of the severity of psychotic and general psychopathology symptoms at admission. Both the frequency and quantity of cannabis use was predictive of time to psychotic relapse over the 6-month follow up period. Psychotic symptom severity was predictive of a substantial increase in the quantity but not the frequency of cannabis use. Cannabis use was related to the onset, course and relapse of psychosis.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Applied Psychology
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Robertson, Denise L. "Making Sense of Psychosis: Parental Attributions for Problem Behaviour in Recent Onset Psychosis". Thesis, Griffith University, 2008. http://hdl.handle.net/10072/365597.
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The onset of a psychotic disorder causes much distress, and has negative health consequences, for the affected individuals and their families. As the highest risk time for initial onset of psychoses is in late adolescence and early adulthood, most people developing psychoses live with their parents. Often the sufferer has little insight into their deteriorating mental health, and is reliant on parents to identify that there is a problem and to seek treatment for the sufferer. However, during the onset of psychoses behaviour often gradually deteriorates, and the family members are often confused about what might be causing the changes in the young person. This confusion about what to attribute the problem behaviours to has at least two potentially important effects. First, family members seem unlikely to seek treatment for the young person until they recognize psychiatric disorder is at least contributing to the young persons’ behaviour. Consistent with this possibility, it is known that there is usually a substantial delay (of two or more years) between the initial onset of psychiatric symptoms and young people accessing treatment. Second, relatives often suffer considerable distress and care giver burden as a psychosis develops in their offspring. The attributions they make for the emerging abnormal behaviours of their offspring might well mediate the extent of that suffering. Two studies were conducted. The first examined the attribution of parents of young people with and without a recent onset psychoses for abnormal behaviour in young people. The second study examined whether parent attributions predicted distress and care giver burden in parents of young people with recent onset psychoses...Thesis (PhD Doctorate)
Doctor of Philosophy in Clinical Psychology (PhD)
School of Psychology
Griffith Health
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Gómez, de Regil Lizzette M. de Gpe. "Schizophrenia and related psychoses: studies of the early stages of psychosis". Doctoral thesis, Universitat Autònoma de Barcelona, 2010. http://hdl.handle.net/10803/32078.
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Actualmente se reconoce que la psicosis no implica un deterioro inevitable, y que un primer episodio puede seguir varios cursos, entre la recuperación completa y el curso crónico. Una perspectiva actual ve las características de la psicosis en un continuo (desde una variación de la personalidad normal hasta la esquizofrenia) que incluye manifestaciones atenuadas que pueden o no evolucionar en psicosis. De ahí el creciente interés por predecir el resultado a lo largo de las diferentes etapas del continuum, estudiando aquellos factores que pudieran señalar el inicio del trastorno y/o predecir las consecuencias de un primer episodio. Más aún, con el desarrollo de nuevos antipsicóticos, el concepto de resultado se ha extendido más allá de la prevención de recaídas y remisión de los síntomas, adoptando medidas más positivas y amplias como la calidad de vida. Se discuten tres cambios importantes en la perspectiva que ha guiado el estudio de la esquizofrenia y las psicosis relacionadas y se aporta evidencia con cinco estudios empíricos. En primer lugar, la idea de que la esquizofrenia es el punto final en un continuum de psicosis se trata en el estudio “Psychotic-like symptoms and positive schizotypy are associated with mixed and ambiguous handedness in an adolescent community sample” (Anexo 1). Su principal hallazgo es que las medidas de dimensión positiva de la predisposición a la psicosis tanto a nivel rasgo como de síntoma subclínico están asociadas con patrones de preferencia manual atípica (como en pacientes con esquizofrenia), particularmente con la ambigüedad manual en la ejecución de acciones primarias. En segundo lugar, el concepto de que el curso de la psicosis es heterogéneo y se puede predecir de manera fiable e influenciar en su fase temprana es el tema de dos estudios: “Predictors of outcome in the early course of first-episode psychosis” (Capítulo 2) y “Predictors of short-term course in Mexican first-episode psychosis patients” (Capítulo 3). Ambos estudios aportan evidencia de la heterogeneidad en el curso de la psicosis, con algunos pacientes mostrando incluso una recuperación total. El principal hallazgo es que factores de línea base predicen el resultado a corto plazo en pacientes con un primer episodio psicótico. Sin embargo, la predicción varía según el criterio seleccionado (diagnóstico, síntomas residuales o recaídas) y el origen de los participantes (España o México), destacando la necesidad de tomar en consideración tales diferencias y el hecho de que pudieran explicar las inconsistencias de resultados reportados en la literatura. En tercer lugar, la idea de que las medidas de resultado en la psicosis se han extendido más allá de la remisión de los síntomas incluyendo la calidad de vida de los pacientes e incluso la de sus familiares se trata en dos estudios: “Quality of life: relation to illness course, illness perception and functioning in short-term course psychosis patients” (Anexo 2) y “Predictors of expressed emotion, burden and quality of life in relatives of short-term course psychosis patients” (Anexo 3). El principal hallazgo en la muestra de pacientes es que los síntomas residuales, más que las recaídas o el diagnóstico en sí mismo, tienen un efecto negativo en la calidad de vida; efecto totalmente mediado por la representación emocional de la enfermedad y el nivel de funcionamiento. El principal hallazgo en las díadas paciente-familiar es que la percepción de la enfermedad de los familiares y el estrés psicológico, predijeron significativamente sus niveles de emoción expresada, sobrecarga y calida de vida, por encima del estatus clínico y funcional del paciente. Las principales contribuciones de los estudios en apoyo a las nuevas perspectivas en el estudio de la psicosis son discutidas junto con sus limitaciones y algunas propuestas de futura investigación.Nowadays there is a general agreement that schizophrenia no longer means an inescapable pathway to deterioration, and that a first episode of psychosis might follow various courses, from a full recovery to a chronic course. Also, there is a current perspective that sees psychosis features on a continuum (from a normal personality variation to schizophrenia) involving attenuated manifestations which may or not evolve into psychosis. Therefore, interest has grown to predict the outcome at different stages of the psychosis continuum, studying factors that might signal the onset of illness and/or predict outcome after the first episode of psychosis. Moreover, with the development of novel antipsychotics with fewer side-effects the concept of outcome criteria has extended beyond relapse prevention and symptom remission, adopting more positive and wide-reaching measures such as quality of life. Three important changes in the perspective that have guided the study of schizophrenia and related psychosis are discussed and supporting evidence is provided through five empirical studies. Firstly, the idea that schizophrenia is the endpoint of a psychosis continuum is addressed in the study “Psychotic-like symptoms and positive schizotypy are associated with mixed and ambiguous handedness in an adolescent community sample” (Appendix 1). The main finding of the study is that both trait and symptom-like measures of positive psychosis proneness are associated with patterns of atypical handedness (resembling the pattern observed in schizophrenia patients), particularly with ambiguous handedness across primary actions. Secondly, the concept that the course of psychosis is heterogeneous and can be fairly predicted and influenced in its early phase is addressed in two studies: “Predictors of outcome in the early course of first-episode psychosis” (Chapter 2) and “Predictors of short-term course in Mexican first-episode psychosis patients” (Chapter 3). Both studies provide evidence of the heterogeneity in the early course of psychosis, with a number of patients even showing a complete recovery. The main finding is that baseline factors can reliably predict the short-term outcome of first-episode psychosis patients. Nevertheless, their predictive value varies with the selected outcome criteria (diagnosis, residual symptomatology and relapse course) and origin of participants (Spain or Mexico), which indicates the need to take such differences into account and the fact that they might explain some of the inconsistent findings reported in the literature. Thirdly, the idea that the outcome measures in psychosis have expanded beyond symptom remission in order to embrace patients' quality of life and even that of their relatives is addressed in two studies: “Quality of life: relation to illness course, illness perception and functioning in short-term course psychosis patients” (Appendix 2) and “Predictors of expressed emotion, burden and quality of life in relatives of short-term course psychosis patients” (Appendix 3). The main finding from the sample of patients is that residual symptoms, rather than subsequent relapses or diagnosis per se, have a deteriorating effect on their quality of life, and this effect is fully mediated by their emotional representation of illness and level of functioning. The main finding from the patient-relative dyads is that relatives' levels of expressed emotion, burden and quality of life were significantly predicted by their perception of illness and psychological distress above patients' clinical and functional status. The studies' main contributions in support to the new perspectives in the study of psychosis are discussed, along with their limitations and some directions for further research.
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Dixon, James Eoin Luke. "The centrality of psychotic experiences and emotional dysfunction following psychosis". Thesis, University of Birmingham, 2013. http://etheses.bham.ac.uk//id/eprint/4474/.
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Objective: The first objective of the thesis was to carry out a literature review to critically review the literature on emotion regulation within psychosis populations. The second objective of the thesis was to empirically investigate the concept of centrality in psychosis. Method: For the literature review a systematic search of five databases was carried out with the final selection of quantitative studies evaluated for methodological and theoretical quality. For the empirical part a cross-sectional methodology was employed which used a qualitative analysis of the data collected from fifty participants diagnosed with first-episode psychosis attending an early intervention service. Results: Twenty-one papers met inclusion criteria, with the review identifying emotion regulation strategies that were adaptive and maladaptive to a psychosis population. Results for the empirical research found centrality to be associated with increased post-psychotic depression. Discussion: Methodological and theoretical challenges within the field of emotion regulation were discussed following the literature review. The concept of centrality as applied to a psychosis populations. Clinical implications were drawn out from both parts of the thesis.
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Mannion, Aisling. "Psychosis and psychotic-like experiences in pregnant and postpartum women". Thesis, University of Sheffield, 2013. http://etheses.whiterose.ac.uk/4586/.
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Waite, Felicity Ann. "Exploring psychosis". Thesis, University of Oxford, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.599905.
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Psychosis is a term used to describe a range of experiences often associated with significant distress. Interpretative Phenomenological Analysis (IPA) is a qualitative method which focuses on the first person perspective to understand lived experience and how an individual makes sense of that experience. There has been a growth in the use of IPA to explore psychosis. The first paper is a systematic review assessing the quality of IPA studies which explore the subjective experience of psychosis from a range of different perspectives, including service user, family and professional. This review identified examples of high quality research which adhered to the principles of IPA. However, the field is currently limited by a lack of reflexive practice, thus improvements in reflexivity are encouraged. The exploration of different perspectives, for example sibling or friend, to further understand the systemic experience and impact of psychosis is recommended for future research. This review concluded that JP A is a useful tool to explore psychosis. The second paper presents an IPA st1.ldy that explored the internal processes in recovery in psychosis, with particular consideration of the potential roles of self-criticism and self-compass ion. The results indicate that the process of self-.acceptance following experiences of psychosis was central to recovery. The internal process of self-to-self relating contributed to two maintenance cycles. Self-criticism was identified as maintaining distressing experiences of psychosis. In contrast, compassionate self-acceptance and empowered action resulted in progress in recovery and for some participants' growth. Thus it is proposed that therapeutic approaches which promote compassionate self-acceptance may facilitate recovery and potentially growth. The novel finding of growth following enduring experiences of psychosis indicates a fruitful area for future research and demands active engagement from services to promote not only recovery but also psychological growth following psychosis
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Crutchfield, Audra. "Negative affect and positive symptoms of psychosis". Thesis, University of North Texas, 2009. https://digital.library.unt.edu/ark:/67531/metadc12109/.
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The current study utilized structural equation modeling (SEM) to examine the factor-to-factor relations and temporal associations between disturbances in negative affect (NA) and positive symptoms of psychosis (PP). Data were drawn from a large, public-domain data set (MacArthur Violence Risk Assessment Study). A dimensional approach was used to conceptualize and identify latent variables of NA (depression, anxiety, and guilt) and PP (hallucinations, delusions, and thought disorder) among individuals with a diagnosis of primary psychotic disorder. Results showed that anxiety, guilt, and depressed mood modeled an NA latent variable, and that hallucinations and unusual thought content modeled a PP latent variable. As predicted, results revealed strong, significant cross-sectional (synchronous) associations between NA and PP at each measured time-frame, suggesting that NA and PP occurred concurrently within the sample. Contrary to predictions, no significant cross-lagged effect between NA and PP was identified (10 weeks and 20 weeks respectively).
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Watkin, Lalage. "Racism and psychosis". Thesis, Open University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.390557.
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Applegate, E. "Psychosis and savouring". Thesis, University of Liverpool, 2018. http://livrepository.liverpool.ac.uk/3019485/.
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Harrop, Christopher Edward. "Schizophrenia : adolescent development and self-construction". Thesis, University of Birmingham, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.364491.
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Marehin, Marie-Stella. "Le rôle de l'alexithymie dans l'étiopathogénie de la psychose non décompensée". Thesis, Montpellier 3, 2016. http://www.theses.fr/2016MON30066.
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Cette étude démontre que l’alexithymie primaire nous oriente vers la présence de troubles schizophréniques. Comme hypothèse, nous formulons que : «l’alexithymie est un trait de personnalité dans la schizophrénie responsable de la toxicomanie et du recours aux traitements méthadone. La méthadone est une suppléance dans la psychose». L’intérêt de cette recherche est double : sur le plan clinique, elle souligne l’importance du repérage des troubles émotionnels et de la personnalité en addictologie. Elle précise que la TAS-20 et MMPI-2 sont des outils d’aide au diagnostic de la schizophrénie ; sur le plan thérapeutique, le repérage de ces affections permettra de traiter simultanément les comorbidités associées et de guider la prise en charge. L’approche de la schizophrénie à partir du concept d’alexithymie nous inscrits dans une approche intégrative(neuropsychatrique et psychodynamique). Dans un premier volet, nous avons réalisé une étude longitudinale avec suivi de 6 mois chez des toxicomanes sous TSO, admis au CSAPA de Montpellier. Le groupe contrôle est composé 28 toxicomanes sans trouble avéré. Six mois après, 15 usagers ont mené l’étude à son terme (âge=35ans ; ET=6,43). 11 toxicomanes atteints de troubles(âge= 39 ans ; ET= 6,9) constituent le groupe expérimental. La procédure consistait à diagnostiquer les troubles de la personnalité dans le groupe contrôle ; à évaluer la dépendance aux drogues et le niveau d’alexithymie au sein des groupes. Nous avons eu recours à : le MMPI-2 pour le diagnostic des troubles ; la DAST-20 pour le repérage de la dépendance (DSM-IV) et la TAS-20 pour la mesure de l’alexithymie. La TAS-20 a été administrée pendant le traitement et six mois après. Les résultats au MMPI-2 décrivent une prévalence de troubles schizophréniques 33% et de protocoles invalides 20%. La DAST-20 présente un faible niveau de dépendance dans le groupe contrôle 1.93 et expérimental 1.49. Dans le groupe contrôle, les scores d’alexithymie et ses sous-dimensions augmentent six mois après le traitement. L’alexithymie est un trait (z=.21 ; p=.834) et un état de la personnalité (r=.621*; p=.013). Dans le groupe expérimental, la TAS-TOT confirme une diminution des scores, mais l’analyse des sous-dimensions admet que cette baisse est non significative. L’alexithymie est un trait de la personnalité (z=.4 ; p=.689).Des hauts scores d’alexithymie sont observés chez les toxicomanes diagnostiqués schizophrènes des deux groupes. L’alexithymie est un trait (z=1.21 ; p=.225) et un état (r=.90* ; p=.015) de la personnalité chez les schizophrènes du groupe contrôle. En ce qui concerne les schizophrènes du groupe expérimental, la diminution des scores TASTOT 63% et 57% invalide sa dimension primaire. Dans le second volet, l’analyse du discours a permis de déceler des unités signifiantes spécifiques à l’alexithymie et à la psychose. La méthodologie est centrée sur des cas cliniques. Des entretiens semi-directifs avec pour support un guide d’entretien ont été réalisés chez des toxicomanes sans trouble de la personnalité (groupe contrôle). Ils ont été retranscrits sur papier selon la méthode analytique. Nous avons recours aux paradigmes psychanalytique, phénoménologique et psychosomatique. La description narrative s’est élaborée sur quatre temps : le contexte anamnestique, l’expression des sentiments, l’entrée dans la toxicomanie et au Programme Méthadone. L’analyse des récits atteste un ensemble de signes cliniques qui résultent de la non extraction de l’objet a, prototype de la psychose. L’alexithymie se traduit sur le plan clinique par relation la blanche. En définitive, les résultats de l’analyse mixte admettent que l’alexithymie est présente dans la toxicomanie et dans la schizophrénie. Chez le toxicomane, le score élevé d’alexithymie est un indice diagnostic de schizophrénie, indépendamment de sa nature primaire ou secondaire.Mots clés: schizophrénie-alexithymie-toxicomanie-méthadone-buprénorphine-suppléanceAs hypothesis, we propose that alexithymie is a personality trait of schizophrenia responsible of the drug addiction and the use of methadone treatment. Methadone is an antipsychotic. Clinically, this study stresses the importance of the diagnosis of emotional disorders and personality. It demonstrates that TAS-20 and MMPI-2 are disposal tools for diagnosis of schizophrenia. Therapeutically, the importance of diagnosis is to treat comorbidities and to orientate the care. The approach of schizophrenia from the concept of alexithymia enrolled us in an integrative approach, which takes into consideration the neuropsychiatric and psychodynamic concepts.In the first part, we conducted a longitudinal study with follow-up 6 months with drug addict on methadone or buprenorphine, admitted to CSAPA-UTTD Montpellier. The control group includes 28 addicts out without disorder. Six months later, 15 users conducted the study to completion (age = 35 years, SD = 6.43). 11 addicts with schizophrenia, depression and anxiety (age = 39 years, SD = 6.9) constitute the experimental group. The procedure was to diagnose personality disorders in the control group; to evaluate drug dependence and the level of alexithymia in the groups. We used : the MMPI-2 for the diagnosis of personality disorders; DAST-20 for evaluate dependence according to DSM-IV and the TAS-20 to measure alexithymia. The TAS-20 was administered during treatment and six months after. The results MMPI-2 describe a prevalence of schizophrenic 33% and 20% invalid protocols. The DAST-20 has a low level of dependence in the control group and 1.93 1.49 experimental. In the control group, the scores of alexithymia and its sub-dimensions increase six months after treatment TAS-TOT 52.88% and 55.2%; DIF 19.54 et19.9; DDF 14.87% and 15.57%; EOT 18.47% and 19.73%. Alexithymia is a trait (z = .21, p = .834) and a state of personality (r = .621 *; p = .013). In the experimental group, the TAS-TOT confirms lower scores, but the analysis of sub-dimensions admits that this decrease is not significant TAS-TOT 56% and 54.36%; DDF 17% and 16.36%; DIF 18.45% and 18.18%; EOT 20.55% and 19.82%. Alexithymia is a personality trait (z = .4, p = .689). High alexithymia scores were observed among addicts diagnosed with schizophrenia in both groups. In the TAS-TOT control group 59% and 65.2%; DIF 19.53% and 19.9%; DDF 14.87% and 15.57%; EOT 18.47% and 19.73%. In the10experimental group TAS-TOT 63% and 57%; DIF 21% and 18%; DDF 24% and 21%; EOT 18% and 18%. Alexithymia is a trait (z = 1.21, p = .225) and a state (r = .90 * P = .015) personality in schizophrenics control group. Regarding schizophrenia in the experimental group, lower TASTOT scores 63% and 57% alexithymia is a state.In the second part, discourse analysis detected specific signifying units of alexithymia and psychosis. The methodology focuses on clinical cases. We use semi-structured interview with addicts without personality disorder. They were transcribed on paper according to the analytical method. We use psychoanalytic paradigms, phenomenological and psychosomatic. The narrative description shall include four stages: the anamnesis, the expression of feelings, entry into drug addiction and Methadone Program. The analysis of stories attests a set of clinical signs resulting from the non-extraction of the object, prototype of psychosis. Alexithymia translates clinically by white relationship.Ultimately, the results of the joint analysis recognize that alexithymia is present in drug addiction and schizophrenia. Among drug users, high alexithymia scores are diagnoses of schizophrenia indications, regardless of primary or secondary in nature. Alexithymia is a polydrug factor.Keywords : schizophrenia-alexithymia-drug addiction-methadone-buprenorphine-
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Flemal, Simon. "D’une étude métapsychologique de la fonction délirante dans les processus psychiques de la schizophrénie". Thesis, Lyon 2, 2011. http://www.theses.fr/2011LYO20050.
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En nous étayant des théories issues de l’épistémologie psychanalytique, nous concevons la schizophrénie comme résultant d’une expérience traumatique primaire n’ayant pu être intégrée au sein de la subjectivité. Ce traumatisme, nous le rattachons moins à un évènement en tant que tel qu’à la position impensable qu’il désigne pour le sujet. Ainsi, en nous inspirant de la pensée de P. Aulagnier et de R. Roussillon, nous suggérons que le noyau traumatique conditionnant le développement d’une problématique schizophrénique se rapporte à la position d’objet pulsionnel, ou de non-désir, à laquelle se trouve identifié le sujet au sein des premiers échanges avec son environnement. Face à l’impensable de cette position identificatoire, le sujet se voit contraint de s’extraire de la scène relationnelle avec ses objets primaires, se clivant par la même opération du capital représentatif qui lui est associé. Dans ces conditions, nous pensons que le délire, moins d’apparaître comme une production pathologique dépourvue de sens, correspond à un mode de réponse face au retour hallucinatoire de l’impensé traumatique. Aussi, à partir d’une méthodologie qualitative basée sur l’analyse d’une douzaine de cas cliniques, nous mettons en évidence trois principales fonctions du délire dans la schizophrénie. La première, conceptualisée sous le terme de « fonction contenante », procède à la mise en forme et à la transformation signifiante de ce qui ne put être symbolisé de l’expérience traumatique. La seconde, nommée « fonction localisante », tente de situer en dehors du sujet le débordement pulsionnel inhérent au traumatisme primaire. La troisième, appelée « fonction identifiante », permet à la personne délirante de s’attribuer un énoncé identificatoire qui, de manière auto-créée, supplée à l’énigme de son histoire insensée.Enfin, l’analyse de nos données cliniques souligne que ces trois fonctions de l’activité délirante ne se réalisent pas de façon aléatoire mais qu’elles s’articulent selon une logique particulière. Ainsi, nous suggérons qu’à partir de sa triple opération le délire schizophrénique tend à se déployer en un « processus délirant », par lequel le sujet peut rendre pensable et supportable la position traumatique à laquelle il a été identifié au cours de son histoireBy following theories from the psychoanalytical epistemology, we consider schizophrenia as the result of a primary trauma that has not been assimilated within the subjectivity. We connect less this traumatism with an event than with the unthinkable position the subject is identified to. Therefore, being inspired by the thought of P. Aulagnier and R. Roussillon, we suggest that the traumatic nucleus which conditions the development of schizophrenia is related to the position of instinctual object, or of non-desire, to which the subject is identified within the first exchanges with his environment. In view of this unthinkable position, the subject is forced to remove himself from the relationship with his primary objects, splitting off from the representative capital that is associated with it. In these conditions, we think that the delusion appears less as a meaningless pathological production than as a way of answering to the hallucinatory return of the traumatic unthought. From a qualitative methodology based on the analysis of a dozen clinical cases, we highlight three main functions of the delusion in schizophrenia. The first, conceptualized under the term «containing function», carries out the shaping and the significant transformation of what could have not been symbolized of the traumatic experience. The second, called «localizing function», tries to locate outside of the subject the instinctual overflow inherent to the primary trauma. The third, named «identifying function», enables the delusional person to assume an identificatory principle which, in a self-created way, compensates for the enigma of his senseless history.Finally, the analysis of our clinical data underlines that these three functions of the delusional activity are not randomly accomplished but are organized according to a particular logic. Thus from its triple operation, we suggest that the schizophrenic delusion tends to develop into a «delusional process», by which the subject can make thinkable and bearable the traumatic position to which he was identified during his history
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Cougnard, Audrey, Machteld Marcelis, Inez Myin-Germeys, Graaf Ron De, Wilma A. M. Vollebergh, Lydia Krabbendam, Roselind Lieb i in. "Does normal developmental expression of psychosis combine with environmental risk to cause persistence of psychosis? A psychosis proneness-persistence model". Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-103679.
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Background. Research suggests that low-grade psychotic experiences in the general population are a common but transitory developmental phenomenon. Using two independent general population samples, the hypothesis was examined that common, non-clinical developmental expression of psychosis may become abnormally persistent when synergistically combined with developmental exposures that may impact on behavioural and neurotransmitter sensitization such as cannabis, trauma and urbanicity.
Method. The amount of synergism was estimated from the additive statistical interaction between baseline cannabis use, childhood trauma and urbanicity on the one hand, and baseline psychotic experiences on the other, in predicting 3-year follow-up psychotic experiences, using data from two large, longitudinal, random population samples from the Netherlands [The Netherlands Mental Health Survey and Incidence Study (NEMESIS)] and Germany [The Early Developmental Stages of Psychopathology (EDSP) study].
Results. The 3-year persistence rates of psychotic experiences were low at 26% in NEMESIS and 31% in EDSP. However, persistence rates were progressively higher with greater baseline number of environmental exposures in predicting follow-up psychotic experiences (χ2=6·9, df=1, p=0·009 in NEMESIS and χ2=4·2, df=1, p=0·04 in EDSP). Between 21% and 83% (NEMESIS) and 29% and 51% (EDSP) of the subjects exposed to both environmental exposures and psychotic experiences at baseline had persistence of psychotic experiences at follow-up because of the synergistic action of the two factors.
Conclusion. The findings suggest that environmental risks for psychosis act additively, and that the level of environmental risk combines synergistically with non-clinical developmental expression of psychosis to cause abnormal persistence and, eventually, need for care.
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Cougnard, Audrey, Machteld Marcelis, Inez Myin-Germeys, Graaf Ron De, Wilma A. M. Vollebergh, Lydia Krabbendam, Roselind Lieb i in. "Does normal developmental expression of psychosis combine with environmental risk to cause persistence of psychosis? A psychosis proneness-persistence model". Cambridge University Press, 2007. https://tud.qucosa.de/id/qucosa%3A26462.
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Background. Research suggests that low-grade psychotic experiences in the general population are a common but transitory developmental phenomenon. Using two independent general population samples, the hypothesis was examined that common, non-clinical developmental expression of psychosis may become abnormally persistent when synergistically combined with developmental exposures that may impact on behavioural and neurotransmitter sensitization such as cannabis, trauma and urbanicity.
Method. The amount of synergism was estimated from the additive statistical interaction between baseline cannabis use, childhood trauma and urbanicity on the one hand, and baseline psychotic experiences on the other, in predicting 3-year follow-up psychotic experiences, using data from two large, longitudinal, random population samples from the Netherlands [The Netherlands Mental Health Survey and Incidence Study (NEMESIS)] and Germany [The Early Developmental Stages of Psychopathology (EDSP) study].
Results. The 3-year persistence rates of psychotic experiences were low at 26% in NEMESIS and 31% in EDSP. However, persistence rates were progressively higher with greater baseline number of environmental exposures in predicting follow-up psychotic experiences (χ2=6·9, df=1, p=0·009 in NEMESIS and χ2=4·2, df=1, p=0·04 in EDSP). Between 21% and 83% (NEMESIS) and 29% and 51% (EDSP) of the subjects exposed to both environmental exposures and psychotic experiences at baseline had persistence of psychotic experiences at follow-up because of the synergistic action of the two factors.
Conclusion. The findings suggest that environmental risks for psychosis act additively, and that the level of environmental risk combines synergistically with non-clinical developmental expression of psychosis to cause abnormal persistence and, eventually, need for care.
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Chotai, Shivani. "Postpartum psychosis and beyond : exploring mothers' experiences of postpartum psychosis and recovery". Thesis, Staffordshire University, 2016. http://eprints.staffs.ac.uk/2649/.
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The aim of this thesis is to provide an understanding of motherhood and the mother-infant relationship within the context of postnatal distress. To facilitate this, it is necessary to understand universal experiences of motherhood as well as mental health difficulties following childbirth. Part of this understanding includes mothers’ experiences and management of distressing, repetitive thoughts of infant harm. Therefore, paper one consists of a literature review in which 10 empirical studies regarding thoughts of intentional infant harm (TIIHs) were critically appraised and synthesised. These thoughts were experienced in clinical and non-clinical samples. Common themes were found in terms of cognitive, emotional and behavioural responses to TIIHs and understood within the context of the parenting role. This review differentiated TIIHs between psychotic and non-psychotic difficulties and identified the need to understand such thoughts within mothers’ experiences of postpartum psychosis (PP). Paper two is a qualitative study exploring mothers’ experiences of PP and recovery. Purposive sampling was used to interview eight women across the United Kingdom. Transcripts were analysed using Interpretative Phenomenological Analysis (Smith, Flowers, & Larkin, 2009) and four super-ordinate themes were identified: ‘becoming unrecognisable’, ‘mourning losses’, ‘recovery as an ongoing process’ and ‘post-traumatic growth’. These themes demonstrated the need for physical and psychological space to facilitate recovery following childbirth. Paper three provides a personal reflective account of completing this thesis. The dynamic process of transitioning to a qualified psychologist is likened to the transformative process of motherhood. Ethical issues and the recent surge in perinatal mental health awareness are presented.
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Gomar, Gallardo Juan Antonio. "Rythme et psychose infantile". Thesis, Sorbonne Paris Cité, 2016. http://www.theses.fr/2016USPCD059.
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Cette thèse a pour objectif de montrer l’importance du rythme comme socle thérapeutique dans la prise en charge de la psychose infantile. Le rythme sera abordé selon deux points de vue :D’une part, comme élément communicationnel originaire entre l’enfant et la mère, il permet les premières associations de sens et par là, des mises en forme initiales (représentation de chose) du contact avec l’altérité. Les continuités et discontinuités dans le contact avec l’extérieur peuvent devenir, grâce à la régularité et la répétition qui constituent le rythme, des présences et des absences.D’autre part, l’articulation interne du rythme nous révèle une structure ternaire codifiée par les chiffres (1-0-1). Le chiffre Un est entendu comme une présence et le chiffre Zéro comme une presentia in absentia. Cette structure permettrait la négativation de la présentation pulsionnelle et l’introduction de l’enfant dans les préambules de la figuration moïque et la triangulation oedipienneThe aim of this study is to demonstrate the importance of rhythm in the treatment of infantile psychosis. This rhythm is studied from two perspectives.First, as the first means of communication between mother and child, rhythm enables children to experience their first sensory associations and thus to structure their first representations of contact with otherness. Continuity and discontinuity with otherness could become presences and absences, thanks to the regularity and repetition inherent in the rhythm.Secondly, the inner speech of this rhythm reveals a ternary structure codified by the digital sequence (1-0-1). 1 is understood as a presence, 0 as a presentia in absentia.This structure would allow the negativation of the inner drive representation and would introduce the child to the preambles of Ego and Oedipus triangulation
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Plaistow, James. "Exploratory study of psychological risk factors for post-psychotic depression in early psychosis". Thesis, University of East Anglia, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.393305.
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Georgiades, Anna. "Resilience in early psychosis". Thesis, Royal Holloway, University of London, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.604568.
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Stress has been implicated in the onset and exacerbation of psychotic symptoms. Some authors have thus suggested that interventions should target reducing stress levels and improving resilience in patients with early psychosis. However, no study to date has investigated resilience in early psychosis or how resilience influences the relationship between stress and positive symptoms of psychosis. Some authors have also suggested that using a measure of coping with the illness (recovery style), rather than coping with stress per se, may aid in understanding the relationship between stress and symptoms. The present study employed the Brief Resilience Scale and the Can nor-Davidson Resilience Scale to measure two different conceptualisations of resilience. This study also measured stress, recovery style, the severity of positive symptoms of psychosis, and the dimensions of delusions, and auditory hallucinations. The total sample comprised of 44 patients with early psychosis recruited from three Early Intervention in Psychosis Services in London. The main findings were that lower levels of brief resilience and a sealing over recovery style were associated with a greater severity of delusions, when levels of stress were controlled for. Neither resilience nor recovery style moderated the relationship between stress and the dimension of delusions. However, stress, brief resilience, and recovery style significantly accounted for 28% of the variance in delusional severity. Moreover, stress, brief resilience, and recovery style were all found to be significant independent predictors of delusional severity. These findings indicate that high levels of stress, low levels of brief resilience, and a sealing over recovery style were associated with higher levels of delusional severity. Overall, the findings suggest that enhancing stress coping strategies, building resilience in terms of bouncing back from stress, and developing a more integrative recovery style may be helpful in reducing the severity of delusions in patients with early psychosis.
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Livingstone, Karen. "Emotion regulation in psychosis". Thesis, University of Edinburgh, 2006. http://hdl.handle.net/1842/29225.
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The relatively new field of emotion regulation may provide insight into emotional dysfunction in psychosis and therefore the aim of this thesis is to better understand emotional experience and regulation in psychosis in comparison with other mental health problems and healthy volunteers. This study used a between-groups design and was based on an opportunity sample of patients attending clinical psychology departments. Three groups of participants were recruited for this study comprising of 21 individuals who had experienced psychosis, 21 individuals with an anxiety/mood disorder and 21 healthy volunteers. The participants completed 2 measures of emotion regulation: the Emotion Regulation Questionnaire (ERQ) and the Emotion Regulation Questionnaire-2 (ERQ-2); a measure of emotional experience: the Basic Emotions Scale and a measure of coping strategies: the Brief COPE. The clinical groups were found to utilise similar emotion regulation strategies and in comparison to healthy volunteers they used significantly more dysfunctional and less functional strategies. The clinical groups were found to experience similar levels of emotions and in comparison to healthy volunteers they experienced greater levels of negatively valenced emotions and lower levels of happiness. The clinical groups were also found to use greater amounts of maladaptive coping strategies and lesser amounts of problem-focussed coping strategies than the healthy volunteers. Overall it appears that emotional experience and regulation in psychosis may be more similar to neuroses than originally was believed to be the case. This would suggest therefore that theories of psychosis should take into consideration emotional dysfunction. Difficulties with emotion regulation should be considered as potential contributory factors in the development, maintenance and course of psychosis.
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Palaniyappan, Lena. "Salience network in psychosis". Thesis, University of Nottingham, 2013. http://eprints.nottingham.ac.uk/13746/.
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This thesis explores the role of a large-scale brain network comprising of the insula and anterior cingulate cortex in the pathophysiology of psychosis using structural and functional neuroimaging. Primarily, anatomical changes affecting the grey matter structure and patterns of dysconnectivity involving the insula are investigated. Various meta-analytic studies have reported consistent reduction in insular grey matter across various psychotic disorders. Despite these robust observations, the role played by this brain region in the generation of psychotic symptoms remains unexplored. In this thesis, using a meta-analytic approach, the relevance of insula for the clinical expression of psychosis is highlighted. Further, significant reduction in the cortical folding of the insula was noted in patients with schizophrenia. Reduced gyrification is accompanied by reduced functional connectivity between the insula and the rest of the brain. Using an effective connectivity approach (Granger Causal Analysis), the primacy of insula in driving the dorsolateral prefrontal cortex is demonstrated in healthy controls; this relationship is significantly affected in schizophrenia amounting to aberrant connectivity within a putative salience-execution loop. Reduced primacy of the salience-execution loop relates to illness severity. It is argued that the insula, as a key region of the salience network, plays a crucial role in the generation of symptoms of psychosis. The evidence in support of this theory is discussed, together with its implications for clinical practice aimed at reducing the burden of psychosis.
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Simmonite, Molly. "Cerebral connectivity in psychosis". Thesis, University of Nottingham, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.606849.
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The central pathological process underlying schizophrenia remains unknown. During recent decades evidence from MRI studies investigating the integrity of distributed networks and EEG studies examining the recruitment of diverse brain regions has converged to support impaired coordination of brain regions as the pathological process of schizophrenia. This impaired coordination is often described as a disturbance of cerebral connectivity. However, a number of issues remain unresolved, regarding the heritability, mechanism and specificity of impaired coordination. This work uses both EEG techniques and fMRI to address these questions. In particular, EEG features previously reported in established illness were examined in tmaffected first-degree relatives, with the goal of assessing the extent to which coordination disturbances are present in those with genetic vulnerability for the ilh1ess. The main findings are reduced error related negativity (ERN) amplitudes and attenuated event-related low-frequency oscillations in unaffected siblings of patients with schizophrenia, indicating these abnormalities are not purely an expression of illness. The examination of cross frequency coupling in schizophrenia provides evidence for an abnormal hierarchy of oscillations, including reduced low frequency phase modulation of high frequency amplitude. This supports the hypothesis that the mechanism of impaired recruitment of distributed brain networks in schizophrenia is an attenuation of cross frequency coupling. The reported fMRI investigations demonstrated that, disturbances of the salience network, thought to govern the switch between states of brain connectivity, occur in both schizophrenia and bipolar disorder. The presence of abnormalities in patients with bipolar disorder that are similar in nature, yet less severe in comparison with those found in patients with schizophrenia supports the idea of a continuum of psychotic illness. Additionally relationships are present between functional connectivity measures of brain networks and the dimension of impairment, which is a cardinal feature of Kraepelin's concept of schizophrenia but is also found to a lesser degree in bipolar disorder.
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Cater, Joanne Jerstad. "Self-Esteem in Psychosis". Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.504720.
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Research suggests that self-esteem is influential in many aspects of schizophrenia, including symptomatology, experience ofillness, quality of life, and recovery (Barrowclough, et aI, 2003; Freeman, et aI, 1998). However, this field of study has been limited by a number of factors including a lack of longitudinal research, difficulties in interpreting the construct, and problematic measurement techniques (Andrews & Brown 19903). Barrowclough et al. (2003) used an interview-based method ofself-esteem assessment (SESS-sv), which was found to be superior to past measures ofthe construct. Using this measure, Barrowclough and colleagues (2003) found a relationship between negative self-evaluation and positive symptom severity and an inverse relationship between positive self-evaluation and negative symptoms. The general aim ofthe current research is to investigate the relationship of self-esteem to aspects ofpsychopathology in a clinical and a non-clinical sample, using new measures that address past inconsistencies in the self-esteem literature. Method The relationship between self-esteem and psychopathology was assessed in three ways: (1) A follow-up investigation ofBarrowclough and colleagues (2003) study was conducted to address the stability ofself-esteem and its effect on outcomes over time; (2) A new self-report measure of self-evaluation was developed based on an established interview to see if the benefits of the SESS-sv are due to its interview format or to its specific conceptualization ofthe construct; (3) The psychometric properties ofthe measure and its relation~hip to positive and negative symptoms of psychosis were tested in a clinical and a non clinical sample. Results Self-evaluation appeared to be relatively stable at follow-up. Time to relapse was associated with High negative self-evaluation and inversely with High positive selfevaluation. The Questionnaire for Evaluation of Self (QES) was found to be a reliable and valid self-report assessment of self-evaluation. As predicted, negative selfevaluation was strongly associated with positive symptoms ofpsychosis, specifically feelings ofparanoia and persecution. Participants in the clinical sample had greater levels ofnegative self-evaluation than a university sample, but their levels ofpositive self-evaluation were comparable. Discussion/Conclusions This research emphasizes the importance ofrecognising the multi-dimensional nature of self-esteem and its potential long-term impact on outcomes. The QES is a useful new measure of self-evaluation that will be appropriate for use in both research and practice settings, as it provides a more comprehensive assessment of self-evaiuation than traditional self-report measures.
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Harvey, Aimee Marie. "Adolescent egocentrism and psychosis". Thesis, University of Birmingham, 2013. http://etheses.bham.ac.uk//id/eprint/3931/.
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Research has noted the onset of psychosis during adolescence and the influence of childhood adversity on the risk for psychosis. Prior social and self-construction difficulties contributory to psychosis and theorised to impinge upon adolescent development have also been highlighted. However, despite these links little empirical research has investigated this. This thesis aims to investigate the contributions of disruptions and exaggerations to adolescent egocentrism suggested by Harrop and Trower (2001). This thesis investigated the relationship between psychosis and adolescent egocentrism in healthy adolescents, young people at high risk of psychosis and those with a first episode of psychosis. These relationships were tracked across the adolescent period and finally examined in clinical samples. It was found that a rise in psychotic-like experiences in mid-adolescence was linked to a rise in egocentric thinking suggesting that adolescent egocentrism contributes to psychotic-like experiences in healthy adolescents. At the clinical psychosis level, adolescent egocentrism was not contributory; however findings suggested that early emotional trauma and insecure attachment were moderated by adolescent egocentrism difficulties influencing the persistence of psychotic-like experiences into psychosis. These findings support the critical importance of adolescent development and developmental risk factors within the genesis of psychosis.
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Steele, Ann. "Let's talk about psychosis". Thesis, King's College London (University of London), 2014. http://kclpure.kcl.ac.uk/portal/en/theses/lets-talk-about-psychosis(ecbf77f9-57e9-4c31-b454-abe84c01ea96).html.
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Background: Recent advances in the psychological understanding of psychosis are supplementing the traditional medical model approach to schizophrenia. Furthermore, a patient-centred model of care is being introduced throughout healthcare promoting collaborative care inline with patients’ values and preferences. Research suggests that patients with schizophrenia wish to talk about their psychotic symptoms. In contrast psychiatrists may be reluctant to engage in discussion of psychotic symptoms leading to potential difficulties in delivering truly collaborative care. Aims: The current study aims to explore the aspects of psychotic experiences patients wish to discuss in psychiatric consultations, as well as the features on which psychiatrists focus by applying thematic analysis to extracts of naturally occurring, routine outpatient psychiatric consultations between patients with psychosis and their psychiatrists. Results: Sixty-five consultations from a total of 143 contained at least one discussion about a present positive psychotic symptom. Patients with higher clinical levels of positive psychotic symptoms were more likely to discuss psychotic symptoms during the consultation. Both psychiatrists and patients initiated discussions of symptoms, but psychiatrists were more likely to end the discussion. Conclusions: The focus of psychiatrists during discussion of positive psychotic symptoms in consultations does not correspond to the features of psychosis most salient to patients. In order to be more patient-centred the focus and aims of the psychiatric consultation may need to be adjusted to more closely target the concerns of patients.
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Bloomfield, Michael. "Dopaminergic mechanisms underlying psychosis". Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/44332.
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Schizophrenia is a potentially devastating mental illness with a complex aetiology, in which the odds ratios for environmental risk factors for the disorder are greater than the odds ratios of any single gene hitherto identified. Within schizophrenia, striatal dopamine dysfunction has been proposed to underlie the development of psychosis. The Aberrant Salience hypothesis provides an explanatory model based on empirical findings to explain how psychotic symptoms may arise from striatal hyperdopaminergia, whereby multiple risk factors converge to elevate striatal dopamine synthesis capacity as the Final Common Pathway to psychosis. Two important epidemiological risk factors for the disorder are chronic cannabis use and longterm psychosocial stress, both of which have evidence supporting effects on the dopamine system. Environmental risk factors are by their very nature modifiable, and so this thesis examined whether these environmental risk factors were associated with the same dopaminergic abnormalities that have been observed in schizophrenia with 3,4-dihydroxy-6- [18F]-fluoro-l-phenylalanine Positron Emission Tomography. This thesis also examined whether cannabis users exhibit aberrant salience processing using a behavioural task, the Salience Attribution Task. This thesis found that long-term cannabis use was associated with reduced dopamine synthesis capacity and no relationship was found between striatal dopamine synthesis capacity and cannabis-induced psychotic-like symptoms. Whilst cannabis use was not associated with increased aberrant salience processing, there was a relationship between cannabis-induced psychotic-like symptoms and aberrant salience processing. This thesis found that long-term psychosocial stress is associated with reduced dopamine synthesis capacity, although this finding may be due confounding factors. However, a positive relationship was observed between childhood and recent adult stressors and dopamine synthesis capacity. These findings call into question the hypothesis that cannabis increases the risk of psychosis by inducing the same changes observed in schizophrenia, although there some evidence to support the hypothesis that psychosocial stressors do increase risk via this mechanism.
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Seghers, James P. "Psychosis and Psychological Stress". Kent State University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=kent1310692265.
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Law, Heather Louise. "Understanding recovery in psychosis". Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/understanding-recovery-in-psychosis(8c6ef0e7-0ede-47d9-af46-302926d68b0b).html.
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This thesis explored conceptualisations of recovery, associated psychological factors and predictors, measurement of subjective recovery, and attitudes towards recovery. A multi-method approach was utilised, including reviewing evidence from the existing literature, cross-sectional, survey and longitudinal designs, and a computer based implicit association task. Chapter 1 provided a review of the literature, followed by an overview of the methodology employed throughout this thesis in chapter 2. Chapter 3 (study 1) included a user informed review of existing recovery measures. The Recovery Assessment Scale appeared to be the most valid and acceptable measure currently in use, although the Questionnaire about the Process of Recovery (QPR) received particularly positive feedback from service users, but lacked further psychometric validation. Consequently, chapter 4 (study 2, N=335) went on to explore the psychometric properties of the QPR. Exploratory factor analysis suggested a one factor model with high internal consistency, test re-test reliability and convergent validity. Recommendations for the use of the QPR in routine clinical practice was discussed. Chapter 5 (study 3, N=381) utilised the Delphi method to consult a large sample of service users about their views on recovery. A high level of consensus (>80%) was reached for a number of items on defining recovery, factors which help and hinder recovery and factors which show recovery. Implications for clinical practice and future research are discussed. Chapter 6 (study 4, N=110) examined longitudinal predictors of recovery. Negative emotion, positive self-esteem, hopelessness, and to a lesser extent symptoms and functioning predicted subjective recovery. Psychosocial factors and negative emotion appear to be the strongest longitudinal predictors of subjective recovery. Chapter 7 (study 5, N=146) used an online survey and computer task to explore attitudes towards recovery in health professionals and the general public. Explicit attitudes towards recovery were generally positive, with health professionals having significantly more positive attitudes than the general public group. Positive attitudes towards recovery were predicted by greater knowledge of recovery and a preference for psychosocial causal models of psychosis. Implications for focussing on psychosocial causal explanations in recovery training and awareness programmes for health professionals and the general public are discussed. This thesis has advanced our understanding of recovery by reaching consensus about what recovery means to individuals with experiences of psychosis, evaluating tools for measuring recovery and determining some of the key psychological processes and predictors of recovery, including causal beliefs, locus of control and negative emotion. These findings appear to fall into four main themes: conceptualising and defining recovery, measurement of recovery, relationships between psychological processes and recovery, and facilitating recovery. Further research is needed to explore recovery across the continuum of psychosis and investigate recovery focussed interventions which target the key psychological processes identified throughout this thesis.
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Spauwen, Janneke, Lydia Krabbendam, Roselind Lieb, Hans-Ulrich Wittchen i Os Jim van. "Impact of psychological trauma on the development of psychotic symptoms: relationship with psychosis proneness". Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-108608.
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Background. The reported link between psychological trauma and onset of psychosis remains controversial.
Aims. To examine associations between self-reported psychological trauma and psychotic symptoms as a function of prior evidence of vulnerability to psychosis (psychosis proneness).
Method. At baseline, 2524 adolescents aged 14-24 years provided self-reports on psychological trauma and psychosis proneness, and at follow-up (on average 42 months later) participants were interviewed for presence of psychotic symptoms.
Results. Self-reported trauma was associated with psychotic symptoms, in particular at more severe levels (adjusted OR1.89,95% CI1.16-3.08) and following trauma associated with intense fear, helplessness or horror. The risk difference between those with and without self-reported trauma at baseline was 7% in the group with baseline psychosis proneness, but only 1.8% in those without (adjusted test for difference between these two effect sizes: χ2=4.6, P=0.032).
Conclusions. Exposure to psychological trauma may increase the risk of psychotic symptoms in people vulnerable to psychosis.
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Tortelli, Andrea. "Incidence, prévalence et facteurs de risque sociaux de psychose chez la population migrante en France L’importance de la recherche épidémiologique psychiatrique sur les populations migrantes en France Capital social, santé mentale et immigration". Thesis, Paris Est, 2018. http://www.theses.fr/2018PESC0031.
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L’association entre psychose et migration a largement été établie dans plusieurs études en Europe. Ce risque est en lien avec le processus d’immigration en tant que tel, mais il découle aussi de la qualité de l’interaction entre les groupes migrants et la population du pays d’accueil, et plus largement ses institutions et son contexte social. En France, un français sur quatre a des origines immigrées sur deux générations. Malgré ce fait, les études épidémiologiques psychiatriques de la population migrante en France sont récentes et peu nombreuses, et l’existence des groupes migrants ayant un risque accru de troubles psychiatriques ainsi que les facteurs de risque associés sont encore mal connus.Ma thèse consiste a à l’étude de l'incidence et de la prévalence de psychose dans la population migrante (et descendants) en France, l’identification des groupes les plus vulnérables et les facteurs de risque environnementaux associésMigrant status and ethnic minority position have been associated to an increased risk of psychosis in many European countries in the last decades. A variation of this risk is observed in migrants and their descendants, across countries and different ethnic groups. Findings suggest a modulation of this risk by cumulative individual and environmental psycho-social adversity experienced during the migration process and in the host country, such as trauma, discrimination, isolation, inequalities in the access to the welfare and health system, employment, housing and regular status. France is the European country where migration is the most important (11% of general population) and the most ancient, as the result of many waves of migration from different countries since the 19th century. However, epidemiological studies on mental health problems in migrant populations are very recent in comparison to other European countries, and data are still lacking.This work will focus on the study of the incidence and the prevalence of psychosis among migrants and their descendants in France, and associated environmental risk factors
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Ermakova, Anna. "Rewarding learning, salience and jumping to conclusions in psychosis and risk for psychosis". Thesis, University of Cambridge, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708603.
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Dar, S. K. "Journey into psychosis : personal experiences of the time period leading up to psychosis". Thesis, University of East London, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.532679.
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This study aimed to explore the subjective experiences of people leading up to their first experiences of psychosis. It was conceptualised in response to the increased interest in mainstream psychiatry in this period (often termed the 'prodrome') within the paradigm of early intervention, for the purposes of identifying and intervening with people at risk of developing psychosis. Eight individuals were interviewed about their experiences and transcripts of these interviews were analysed using the qualitative research methodology of Interpretative Phenomenological Analysis. A number of themes were identified concerning issues of transition, identity, relationship, existence and withdrawal. For example, all participants described going through a major transition in their lives, which placed greater personal demands than they had the capacity and resources to manage. Conflicts in constructing a desirable identity in the face of an invalidating social context were also found to be pertinent in the participants' accounts. Themes concerning their relatedness to others highlighted experiences of extreme loneliness and isolation in the context of a desire for connection with others. These findings are discussed in relation to existing theories and their implications for understanding the development of psychosis. The implications of these findings for the concept of the 'prodrome' are also considered.
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Peoc'h, Mickaël. "Solutions élégantes à la psychose : aspects historiques, enjeux épistémologiques et clinique des constructions supplétives". Thesis, Rennes 2, 2018. http://www.theses.fr/2018REN20023.
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À travers une recherche historique, nous explorerons les modèles qui ont orientés successivement les cliniciens confrontés à la psychose, tant leurs conceptions à propos du traitement qu’à propos de l’évolution et de la terminaison de la pathologie mentale. Deux paradigmes actuels seront plus précisément questionnés : celui de la psychiatrie contemporaine qui redécouvre depuis peu les possibilités de rémission de la psychose ; et celui de la psychanalyse, qui propose une autre définition, tant de la psychose que de la guérison, particulièrement avec Lacan. Puis, en nous plaçant dans ce deuxième paradigme, nous nous appuierons sur la clinique pour montrer comment s’élaborent de façon dynamique les solutions élégantes à la psychose. Les notions lacaniennes de compensation, suppléance, sinthome seront explorées. Nous proposerons de lire les symptômes à partir de leur fonction dans l’économie subjective pour en dresser une cartographie clinique nécessaire pour sortir d’une vision déficitaire de la psychose. Puis, en nous appuyant sur les témoignages de deux sujets psychotiques, l’un ayant rédigé ses mémoires, l’autre rencontré durant plusieurs années, nous proposeront de montrer en quoi l’élaboration d’une solution élégante singulière peut être le résultat d’un processus subjectif. Il s’agit de défendre l’existence de possibilités de suppléances à la psychose clinique, d’en proposer une lecture qui ne cède pas sur la singularité, mais qui tienne compte de quelques balises propre à la structure et aux conditions du lien socialThrough a historical research, we will explore the models that guided the clinicians confronted to psychosis; their conception of the treatment as much as evolution and outcome of mental pathology. Two current paradigms will be discussed: the contemporary psychiatry, which is newly rediscovering the possibilities of a remission in psychosis; and psychoanalysis, that offers another definition of psychosis as much as another definition of recovery/healing, especially with Lacan teaching.Then, following this second paradigm, and helped with clinical cases studies, we will show the dynamic development of the elegant solutions to psychosis. We will explore the lacanian concepts of compensation, supplementation, and sinthome. We will suggest to read the symptoms from their role in subjective economy in order to draw a clinical map, which is an essential key to stop considering psychosis as a deficit. Finally, with the help of two psychotic subjects; one who wrote his memories, and one met during several years; we will suggest that elaboration of a singular elegant solution can be resulting from a subjective process. We will defend that supplementations to clinical psychosis exist. We will offer a reading that does not only consider singularity, but that also consider some specific markers of the psychotic structure regarding some social link conditions
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Spauwen, Janneke, Lydia Krabbendam, Roselind Lieb, Hans-Ulrich Wittchen i Os Jim van. "Impact of psychological trauma on the development of psychotic symptoms: relationship with psychosis proneness". Technische Universität Dresden, 2006. https://tud.qucosa.de/id/qucosa%3A26761.
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Background. The reported link between psychological trauma and onset of psychosis remains controversial.
Aims. To examine associations between self-reported psychological trauma and psychotic symptoms as a function of prior evidence of vulnerability to psychosis (psychosis proneness).
Method. At baseline, 2524 adolescents aged 14-24 years provided self-reports on psychological trauma and psychosis proneness, and at follow-up (on average 42 months later) participants were interviewed for presence of psychotic symptoms.
Results. Self-reported trauma was associated with psychotic symptoms, in particular at more severe levels (adjusted OR1.89,95% CI1.16-3.08) and following trauma associated with intense fear, helplessness or horror. The risk difference between those with and without self-reported trauma at baseline was 7% in the group with baseline psychosis proneness, but only 1.8% in those without (adjusted test for difference between these two effect sizes: χ2=4.6, P=0.032).
Conclusions. Exposure to psychological trauma may increase the risk of psychotic symptoms in people vulnerable to psychosis.
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Hultsjö, Sally. "Caring for foreign-born persons with psychosis and their families : Perceptions of psychosis care". Doctoral thesis, Linköpings Universitet, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-24291.
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The aim of this thesis was to describe and analyse perceptions of psychosis care among those involved in care, foreign‐born persons with psychoses, their families and health care staff, and further to reach agreement about core components in psychosis care. This was in order to find out whether current psychosis care in Sweden is suitable for foreign‐born persons and theirfamilies. The study design was explorative and descriptive. Health care staff (n=35), persons with psychosis (n=22) and families (n=26) of persons with psychosis were chosen from different regions in Southern Sweden. To capture health care staff’s experiences and to explore whether specific needs occurred within psychiatric care, nine focus group interviews were held. The perspectives of psychosis care among persons with psychoses and their families were captured through individual interviews. Finally, a study was accomplished all over Sweden in which staff, foreign‐born persons with psychosis and foreign-born families of persons with psychoses answered a questionnaire to identifycore components in psychosis care of foreign‐born persons and their families. There was agreement that the core components in psychosis care concern general psychiatric caring, even though varying perceptions were identified. Asking about foreign‐born persons’ religious and ethnic background or having the possibility to decide whether care should be provided by male or female staff were agreed to be less important. No agreement could be reached concerning the importance of considering different perceptions of psychosis care, treatments and different ways of managing the psychosis. Nor could agreement be reached as to whether staff should have specific cultural knowledge and whether interpreters should be unknown to the family but speak the right dialect. Perceptions among staff in somatic and psychiatric care as well as perceptions among foreign‐and Swedish‐born persons with psychosis and their families were more similar than different. General psychiatric care is important for Swedish‐born as well as foreign‐born persons with psychosis and their families, indicating the importance of not letting culturally determined perceptions dictate the care and take away energy from health care staff and make them lose their focus on the basic elements in general psychiatric care. However, within the general care there were individual perceptions on whose importance those involved in care did not agree. Further development suggested is to illuminate the importance of identifying individual perceptions which may differ between different persons and could be related to cultural background. Staff need to acquire strategies so they can easily manage to encounter and offer general care to foreign‐born persons. Development must be achieved on both an organizational level and an individual level.Disseration
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Carmona, Jessica Abigail. "Towards Dimensionality in Psychosis: A Conceptual Analysis of the Dimensions of Psychosis Symptom Severity". BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/6203.
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Given the heterogeneity of symptoms allowed in the diagnosis of psychotic disorders, as well as other challenges of categorical diagnosis (e.g., First et al., 2002; Krueger, 1999), the increased specificity brought by dimensional ratings of underlying features is often important. Models using the factorial structure of psychotic symptoms perform as good as or better than traditional categorical models (Allardyce, Suppes, & Van Os, 2007). DSM-5 has provided such a system of ratings to aid clinicians, the Clinician Rated Dimensions of Psychosis Symptom Severity Scale (PSS; APA, 2013). In this approach, the clinician rates symptom severity in eight domains which emphasize traditional psychotic symptomatology, cognition, and mood. Given its accessibility and the support of the DSM-5, it is possible that the measure could achieve wide use. However, little is known about the measure and the challenges of applying it in clinical settings. This study is a conceptual analysis of the conceptual foundation of the PSS, including its psychometric properties, applications, and demonstrated validity. It is also compared to the widely used Brief Psychiatric Rating Scale – Revised (BPRS-R). The PSS is more concise that other measures, and five of the PSS domains parallel the DSM-5's "Key Features That Define the Psychotic Disorders" (p. 87-88) (although the brief instructions of the PSS differ at times from DSM-5 definitions, and little in the way of definition is offered in the PSS itself). In contrast, no rationale is given for adding the remaining three domains. The dimensional model of the PSS has similarities to the factor structure typically found for symptomatology in psychotic disorder, but a number of important differences are noted. The data required for making ratings is never defined, although the only mention of data that might be helpful for rating one of the domains depends upon extensive testing. Although anchors for the ratings might, at first glance, appear to be given in the PSS, in fact, they offer almost nothing beyond the adjectives of "equivocal," "mild," "moderate," and "severe." Finally, we found that very little research exists on the PSS, no field trial was done, psychometric properties are largely unknown, and normative data is unavailable. The PSS is brief and provides a quick way to rate the severity of the five key features of psychosis required by DSM-5 diagnoses. Thus, it can work as a quick quantification of these features. Beyond this its utility is unknown, and it appears to lack the specificity of other rating scales, such as the BPRS-R.
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Arslanturk, Pinar. "Amour et transfert dans les psychoses". Thesis, Aix-Marseille, 2016. http://www.theses.fr/2016AIXM3016.
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Freud s'était intéressé à la question de l'étiologie et les spécificités de la relation d'objet dans les psychoses dès le fondement de sa théorie. Il avait buté sur la possibilité du traitement des sujets psychotiques par la psychanalyse puisqu'ils lui paraissaient inaptes au transfert à cause d'une part de l'état anobjectal primitif de leur narcissisme et d'autre part de leur régression au stade autoérotique. Lacan, dans son retour à Freud, revient sur les spécificités de la structure et cerne la question. Il étoffe ainsi son hypothèse selon laquelle la forclusion du Nom-du-Père et la réapparition dans le réel de ce qui est forclos seraient la cause de la psychose. Ce travail de recherche est une mise en tension entre la rencontre avec trois femmes dont le diagnostic de psychose est avéré et l'approche de Freud et de Lacan des psychoses pour cerner notre question de recherche. De là, notre hypothèse sera la suivante : l'amour et le transfert ont des dimensions bien particuliers dans les névroses et dans les psychoses. Néanmoins ils restent des organisateurs de la vie du sujet pour toutes les structures psychiques. À travers l'amour, le sujet psychotique essaie de suppléer : au défaut dans la symbolisation dû à la forclusion du Nom-du-Père ; au défaut de la signification phallique ; et au défaut dans la localisation de la jouissance de l'Autre. L'amour fait symptôme dans les psychoses. Il est une des seules défenses que le sujet a contre le Réel et, constitue une tentative de guérisonFreud has focused his research on the etiology of psychosis and the specificities of object relations in psychosis since the foundation of his theory. He has confronted with the impossibility of the treatment of the psychotic patient by his methods because they seem to be incapable of transference due to their narcissism and their regression to the autoerotic stage of the development. After Freud, Lacan questions the specificities of the psychotic structure and identifies the foreclosure of the Name of the Father, a primordial signifier, as the etiologic source of the psychosis.This thesis is a tension between case studies of three psychotic women and the approach of Freud and Lacan. Our hypothesis is: love and transference have unique dimensions in neurosis and psychosis. However they still organize the life of the subject in all the structures psyches.Through love, the psychotic subject tries to compensate structural fault. It is one of the only defenses against the Real and it is an attempt to cure. The psychotic subject can form an ego by identifying with the love object. In this case, love is articulated in three registers defined by Lacan: the real, the imaginary and the symbolic. If the psychotic slides purely to the narcissistic side, if the love is based solely on the imaginary register, the deadly side of love, Thanatos, can take over
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Koehler, Gregory C. (Gregory Charles). "Distorted Time Perception as an Underlying Factor of Psychosis Proneness and Dissociation". Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc279102/.
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Distortions in the perception of time historically have been associated with dissociation and psychosis in clinical populations. However, the relations among dissociation, psychosis, and time perception in sub-clinical populations have not been investigated. In the present study, college undergraduates scoring either normally or deviantly high on the Per-Mag were given a Dissociative Experiences Scale (DES) and a computerized time-estimation/production task. Participants scoring high on the Per-Mag obtained higher scores on the DES than participants scoring low on the Per- Mag. Per-Mag scores also correlated positively with DES scores across 608 total participants screened. The relation between dissociative and psychotic symptomatology is discussed considering dichotomous versus continuous conceptualizations of psychopathology. The effects of intelligence, social desirability, malingering, gender, and post-traumatic stress on the measures used are also discussed.
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McConville, Pauline Mary. "Obstetric complications and functional psychosis". Thesis, University of Edinburgh, 2007. http://hdl.handle.net/1842/24928.
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The main body of the work is a study of the rates of obstetric complications in 492 patients meeting ICD-9 criteria for schizophrenia, affective disorder and other functional psychosis, compared to their 797 non-psychotic siblings and to 2,460 normal controls. The main results, for each of the three diagnostic groups, indicate significant confounding between obstetric complications, maternal marital status and social class. No single obstetric complication remained associated with schizophrenia once these factors had been controlled for. Bleeding in pregnancy was associated with an increased risk of affective disorder compared to controls. A low Apgar score at 5 minutes was associated with an increased risk of affective disorder compared to controls. Low social class and maternal marital status were also associated with the risk of affective disorder. Induction of labour or elective caesarean section was associated with an increased risk of other functional psychosis compared to their non-psychotic siblings. Secondary analyses of the effect of season of birth, age of onset of illness and family history are presented. Schizophrenic patients were more likely to have been born in winter than their siblings but winter-born schizophrenics had similar rates of OCs to those born at other times. An induced labour or elective caesarean section was associated with an increased risk of affective disorder of early onset and of non-familial affective disorder. Bleeding in pregnancy was also associated with an increased risk of non-familial affective disorder. The findings are compared to those of other studies and conclusions are drawn about the importance of obstetric complications in the aetiology of psychotic disorders, with particular emphasis on schizophrenia, and suggestions are made for further research.
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Bloomfield, Peter S. "Neuroinflammation and psychosis : antipsychotic medication". Thesis, Imperial College London, 2015. http://hdl.handle.net/10044/1/39588.
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Neuroinflammation is an early feature of a number of nervous system disorders. Inflammation in the brain is primarily mediated via microglial cells, which are active components of circuit development in the central nervous system. Schizophrenia is a psychiatric illness with deficits in perceptual, cognitive and emotional function. Prior to the onset of psychosis, there is a period of attenuated psychotic symptoms, where individuals experience sub threshold features of psychosis. This 'ultra high risk' period can provide unique opportunities to investigate the development of psychosis. It has been demonstrated through translocator protein (TSPO) positron emission tomographic (PET) imaging that microglial activity is elevated in chronic schizophrenia, however it is unknown whether this elevation is present prior to the onset of psychosis. It is also uncertain what effect antipsychotic medication has on microglia in vivo. This thesis is divided between clinical and animal investigation, the results can be split into four findings; Firstly we demonstrate that there is a higher binding of [11C]PBR28 (a novel TSPO PET ligand) in ultra high risk subjects and patients with schizophrenia compared to healthy controls. Symptoms in the ultra high risk subjects also correlate with the level of ligand binding. Secondly, brain volumes are not correlated with [11C]PBR28 binding or inflammatory cytokine levels in peripheral blood samples. The third finding of this thesis is that antipsychotic drug administration does not appear to alter cortical microglial cells in naïve and systemically inflamed animals. The final finding is that brain volume is reduced by antipsychotic medication. Together these findings demonstrate that inflammation is present in subjects experiencing subthreshold psychotic symptoms. The animal experiments suggest medicated patients would not be expected to have higher levels of microglial activity than their un-medicated counterparts. Further investigation is needed to determine the mechanism of cortical volume changes after medication and how this relates to TSPO.
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Gardner-Sood, Poonam. "Health risk perceptions in psychosis". Thesis, King's College London (University of London), 2016. https://kclpure.kcl.ac.uk/portal/en/theses/health-risk-perceptions-in-psychosis(5be7e966-f32b-4f00-b5de-67eef1d92523).html.
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People with severe mental illness are at increased risk of heart disease and diabetes. First episode psychosis (FEP) patients tend to engage in health-risk behaviours, typically consuming an unhealthy diet and engaging in low levels of physical activity. Protection Motivation Theory proposes that risk perceptions are the most proximal determinants of such behaviour. Understanding the risk perceptions of FEP patients may therefore have the potential to inform health behaviour change interventions. This thesis reports findings from a prospective cohort study, in which FEP patients completed a battery of assessments (including a theory-derived risk perception questionnaire) at baseline, and health behaviour was measured twelve months later. Three preliminary studies were undertaken to identify a parsimonious health risk questionnaire. The Health Risk Appraisal Study (Study 1) modelled the relationship between risk perceptions, diet and physical activity. Risk perceptions remained stable between baseline and follow-up, despite increases in BMI, which suggest a declining health state. Although risk perceptions did not predict health behaviour at either time point, findings demonstrated that patients underestimated their health risks. The Cognitive Deficits Study (Study 2) showed that cognitive deficits account for a small but significant proportion of the variance in risk perceptions, though risk perceptions did not mediate relationships between baseline cognitive deficits and 12-month health behaviour. The Insight Study (Study 3) showed that insight into mental health status was associated with greater perceived health risks. The Interview Study (Study 4) used qualitative methods to explore reflections on health-related experiences. While patients valued their physical and mental health and wellbeing, and had some knowledge of their health risks, during the acute phase of illness, physical health was a lesser concern than mental wellbeing, housing, employment and education. Risk perception models may have limited utility for understanding health among FEP patients. Physical health promotion campaigns must recognise and contextualise health concerns within the broader goals and priorities of FEP patients.
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Butler, Lucy. "Caregiver wellbeing in psychosis services". Thesis, Canterbury Christ Church University, 2016. http://create.canterbury.ac.uk/15029/.
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The study aimed to examine the relationship between wellbeing, burden, distress and third-wave factors, including self-compassion and psychological flexibility, in caregivers of people with psychosis. The study secondly aimed to trial a new brief group intervention, combining Acceptance and Commitment Therapy (ACT) and Compassion-focused Therapy (CFT) for this population. Twenty-nine participants were assessed at baseline on primary measures of wellbeing, distress, psychological flexibility and self-compassion. Secondary factors including burden and mindfulness were also collected. Correlation analyses were used. Fourteen participants completed the group in intervention and follow-up measures, and pre-post investigations were employed. Lower levels of psychological flexibility and self-compassion were related to lower levels of wellbeing and higher levels of burden and distress. There was a potential mediating effect of psychological flexibility on the relationship between self-compassion and wellbeing. The group intervention was acceptable to caregivers, and there were significant positive changes in self-compassion, distress, burden and mindfulness. The study adds to the existing data regarding wellbeing and burden in caregivers of people with psychosis. This study provides new insights into the factors of self-compassion and psychological flexibility within this population. The ACT with Compassion intervention is a promising, brief intervention which would benefit from further application and evaluation.
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Tarsia, Massimo. "Trauma and dissociation in psychosis". Thesis, University of Edinburgh, 2004. http://hdl.handle.net/1842/29392.
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In this thesis we have attempted to address the complex issue of the relationship between trauma, dissociation, and psychosis. It is hypothesised that dissociation, occurred as a result of trauma, plays a key role in the formation and maintenance of psychotic symptoms, chiefly hallucinations and delusions. We have used methods from experimental psychopathology to investigate the potential role played by dissociative processes in the disruption of the cognitive processes of attention and memory for trauma-related, positive and neutral information in two groups of participants: 30 individuals with psychosis and 30 matched controls. In particular, we used self-report measures of symptomatology, recovery style, trauma, and dissociation, and employed two experimental tasks. The first was specifically devised to assess attentional processes: a Directed Forgetting Stroop Task (DFST) performed under conditions of divided attention. The second task was a Word-Stem Completion Task (WSCT) on which we applied the process dissociation procedure (PDP; Jacoby, 1991) in order to estimate the relative contribution to dissociation of implicit and explicit memory. As expected, our findings revealed that the experimental group processed information preferentially in an implicit manner. Generally, the psychosis group exhibited a better memory performance for trauma-related information, better conscious retrieval inhibition for the same material, and more difficulty in forgetting it. We also found that our self-report measure of trauma predicted levels of dissociation, which, in turn predicted individuals’ recovery style. Additionally, both dissociation and recovery style predicted levels of positive symptoms. However, we did not find a standard directed forgetting effect on our memory task or an advantage (less interference due to dissociation) on our task of divided attention. Results are discussed in the light of the theoretical background, previous experimental literature, and current models of trauma and dissociation.
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Sansom, Gareth D. "Judging Schreber : psychoanalysis and psychosis". Thesis, McGill University, 1985. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=65981.
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Bell, Victoria. "Advancing cognitive therapy for psychosis". Thesis, University of Oxford, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.606409.
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There is an increasing awareness of the limitations of Cognitive Behavioural Therapy for psychosis (CBTp) and researchers are attempting to advance its efficacy. The first part of this thesis was a systematic review of the new CBT approaches for positive symptoms. The evidence for their efficacy was summarised and then examined from a methodological perspective. A search of the literature since 2003 produced sixteen studies, falling into two main strands: an interventionist causal model approach, with studies indicating the potential for greater effect sizes for both persecutory delusions and auditory hallucinations; and 'third wave' CBT, with mindfulness and acceptance-based approaches demonstrating limited benefits for auditory hallucinations. The new developments are potentially a step forward from standard CBTp and implications for future research are discussed. Multiple factors have been identified in the development of persecutory thinking. The second part of this thesis specifically focused on interpersonal sensitivity as a hypothesised causal factor of persecutory delusions, in line with the interventionist causal model approach referred to above. The study evaluated the impact of a newly-devised cognitive behavioural intervention for interpersonal sensitivity (CBT-IPS) for patients with persecutory delusions. The therapy was tested in an uncontrolled pilot study, which included a 2-week baseline period and I-month follow-up. CBT-IPS did not depend on disputing the validity of delusional beliefs• but on reducing concerns regarding criticism or rejection. Eleven participants with persecutory delusions and a psychosis diagnosis completed the 6-session CBT-IPS intervention. Results indicated statistically significant reductions with large effect sizes for both interpersonal sensitivity and persecutory delusions, consistent with the hypothesised causal role. Participants also reported a significant decline in negative beliefs about others. All gains were maintained at follow-up. This was the first test of CBT-IPS and it shows promise as a therapeutic intervention. The next step is to conduct a randomised controlled trial.
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Cheong, Po-man, i 張寶文. "Media professionals' perspective of psychosis". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206554.
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Background / Objectives:
Mental diseases are perceived as one of the highest stigmatised conditions in our society. Public knowledge of mental illness does not come from professional journals or medical authorities, but largely from mass media as it is a major and most convenient source of information. Media tends to portray mental illness with negative attitude, focusing on bizarre and unexplainable behaviours of patients with mental illness, and exaggerating the linkage between mental illness and aggressive behaviours. However, few studies have been conducted in Hong Kong focusing on media perspective on this. This study focuses on the research of media’s role on psychosis from the perspective and experience of media professionals, and to identify media’s functional role of whether it is fostering public awareness and reducing stereotypes towards psychosis or on the contrary intensifying stigma conditions in the community of Hong Kong.
Methodology:
This is a qualitative study that purposive sampling method was used to recruit 22 media professionals from various media background including news media, entertainment and creative media, as well as public service broadcasting. All participants had up to one hour’s face-to-face in-depth interview based on pre-set theme of area of discussion.
Results:
Majority of subjects is able to recognise psychosis symptoms such as hallucination and (mainly persecutory) delusions, but unknown factors and myths about psychosis are still existed among the subjects. Confusion between psychosis, multiple personality disorders and even psychopath is commonly observed. Suggesting that media portrayal on psychosis and other mental illnesses is instilled with negative and stigmatised attitude is not prevalent. Most subjects believe that local news media can still perform with a neutral attitude when reporting the issues related to psychosis and mental illness. However, insufficient exposure of discussion about the topic across media platforms may affect public accessibility on the knowledge of psychosis and mental illness. Anti-stigma programs can contribute mostly positive messages and images about psychosis, but quality and quantity of those programs and promotions have to be designed and planned in delicate and persistent manners so as to maximise the effectiveness.
Conclusion:
Media plays a constructive role in educating the public about mental illness, and can also perpetuate stereotype and undermine the efforts of public campaigns. Suggesting that media practitioners are recommended to learn more about the well-round knowledge of psychosis and mental illness issue. Indeed, increased communication between media and mental health agencies can benefit the mutual understanding and lead to cooperative approach to tackle social stigma against psychosis. Though media professionals agree that media has its own limitation in terms of highly competitive broadcasting time and editorial space, most suggested that envisioned educational plan is an essential and influential method in removing public stigma and stereotype about psychosis.published_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
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Chen, Chih-Ken. "Predisposing factors to methamphetamine psychosis". Thesis, King's College London (University of London), 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274936.
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Upthegrove, Rachel. "Depression in first episode psychosis". Thesis, University of Birmingham, 2011. http://etheses.bham.ac.uk//id/eprint/1650/.
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There has been renewed interest into affective symptoms and psychological approaches to schizophrenia and other psychosis, yet no in-depth investigation as to the course, consequences or indeed psychological causes of depression in a phase specific manner in the important first episode. Our understanding of risk and aetiological processes in psychotic illness will only advance once we accurately identify the “end phenotype” of psychotic illness. This series of studies investigates the course of depression in first episode psychosis, its significance in terms of suicidal thinking, and relation to both diagnosis and other symptom domains. Depression in the acute and post psychotic phases is explored, through the importance of the awareness and appraisal of positive symptoms, and diagnosis itself. Significant findings include a pervasive nature of depression throughout the course of first episode psychosis, the predictive nature of prodromal depression and the high prevalence of suicidal acts. Appeasement and engagement with voices, subordination to persecutors and the (ineffective) use of safety behaviours drive a position of entrapment, demoralization and a lack of control. In addition negative illness appraisals are stable and may vary between cultural groups. Implications are explored, in terms of clinical practice, aetiological pathways, potential treatments and intervention strategies