What is psychosis? A meta-synthesis of inductive qualitative studies exploring the experience of psychosis

Qualitative studies have played an important role in elucidating the lived experience of psychosis and there has recently been an increase in the number of such studies. There is now an urgent need to draw together the findings of these studies. This paper performed a meta-synthesis of inductive qualitative peer-reviewed research into psychosis. Ninety-eight articles were identified for systematic appraisal. Four themes, ‘Losing’, ‘Identifying a need for, and seeking, help’, ‘Rebuilding and reforging’, and ‘Better than new: gifts from psychosis’, were identified. The important implications these themes for clinicians and future research are examined upon. These findings also highlight that the experience of psychosis is much more than simply just hallucinations and/or delusions

Autistic women’s experiences of self-compassion and receiving their diagnosis in adulthood.

Knowledge of autistic individuals’ experiences of self-compassion is very limited. This study investigated autistic women’s experiences of self-compassion after receiving their diagnosis in adulthood. Eleven autistic women completed semi-structured interviews analysed using interpretative phenomenological analysis. Three super-ordinate themes were identified: ‘Disconnect between the autistic self and experience of societal expectations’ (the burden of conformity; autism is misunderstood; social challenges; mental health impact); ‘Unmasking: the process of self-understanding’ (autonomy and self-compassion; validation and grief) and ‘Impact on relationships’ (diagnosis disclosure dilemmas; connection and understanding). Frustration with society’s misconceptions of autism and unhelpful thinking styles were presented as barriers to self-compassion. Most participants reported that their diagnosis had led to the development of a greater sense of self-understanding, which facilitated self-compassion. Some participants suggested their own increased understanding of autism facilitated their compassion towards others. Findings from this study have clinical implications for increasing understanding about autistic women’s experiences of self-compassion and possibly ways to facilitate its development, to enhance well-being

Relationships between paranoid thinking, self-esteem and the menstrual cycle.

This study aimed to investigate whether paranoid experiences and levels of self-esteem fluctuate over the menstrual cycle and whether levels of self-esteem are lower when perceived persecution is felt to be deserved. Measures of anxiety, depression, persecution, deservedness and self-esteem were completed on-line by 278 women over their menstrual cycle. Responses were compared at the paramenstrual (3 days before and after menses onset) and mid-cycle phase. At the paramenstrual phase persecution, negative self-esteem, anxiety and depression were higher and positive self-esteem was lower than at mid-cycle. A greater proportion of women experienced persecution as deserved at the paramenstrual phase. This was associated with higher depression and negative self-esteem scores. Increased levels of deservedness significantly strengthened the relationship between persecution and negative, but not positive, self-esteem. These findings suggest that the paramenstrual phase is a time of vulnerability to increased paranoid experiences, an increased likelihood that feelings of persecution will feel deserved and lowered self-esteem. The findings support the view that interpersonal sensitivities may be key to menstrual cycle symptoms and have an impact on relationships. Further, the study illustrated that ideas developed for psychosis could make a valuable contribution to understanding and managing this aspect of menstruation-related distress

A psychological autopsy study of non-deliberate fatal opiate-related overdose.

The study adapted and described the psychological autopsy methodology to identify psychological and social risk factors associated with fatal opiate overdose. A case-control study was also conducted, in which living heroin users were compared to those who died from opiate overdose, in order to identify the psychological and social risks associated with fatal opiate overdose

Grandiose delusions : a review and theoretical integration of cognitive and affective perspectives

Grandiose delusions (GDs) are found across a wide range of psychiatric conditions, including in around two-thirds of patients diagnosed with bipolar disorder, half of patients diagnosed with schizophrenia, as well as in a substantial proportion of patients with substance abuse disorders. In addition, over 10% of the healthy general population experience grandiose thoughts that do not meet full delusional criteria. Yet in contrast to other psychotic phenomena, such as auditory hallucinations and persecutory delusions, GDs have received little attention from researchers. This paper offers a comprehensive examination of the existing cognitive and affective literature on GDs, including consideration of the evidence in support of 'delusion-as-defence' and emotion-consistent' models. We then propose a tentative model of GDs informed by a synthesis of the available evidence designed to be a stimulus to future research in this area. As GDs are considered to be relatively resistant to traditional cognitive behavioural techniques, we then discuss the implications of our model for how CBT may be modified to address these beliefs. Directions for future research are also highlighted.13 page(s

More than words? Hypomanic personality traits, visual imagery and verbal thought in young adults

The use of visual mental imagery has been proposed to be a risk factor for the development of bipolar disorder, due to its potential to amplify affective states. This study examined the relation between visual imagery (both trait usage and intrusive experiences of such imagery), intrusive verbal thought, and hypomania, as assessed by self-report questionnaires, in a sample of young adults (N= 219). Regression analyses found (after controlling for anxiety, depression, and positive and negative affect) that levels of intrusive visual imagery predicted levels of hypomania, but that neither trait use of visual imagery nor intrusive verbal thought did. These results were consistent with the proposal that being a 'visualiser', as opposed to a 'verbaliser', is a risk factor for bipolar disorder, with the caveat that it is specifically intrusive experiences of imagery, rather than the tendency to utilize imagery per se, that acts as a risk factor.7 page(s

A structural equation model of the relationship between insomnia, negative affect, and paranoid thinking

A growing body of evidence points to relationships between insomnia, negative affect, and paranoid thinking. However, studies are needed to examine (i) whether negative affect mediates the relation between insomnia and paranoid thinking, (ii) whether different types of insomnia exert different effects on paranoia, and (iii) to compare the impact of objective and self-reported sleeping difficulties

The Journey through cannabis use : a qualitative study of the experiences of young adults with psychosis

The present study explored the personal experiences of cannabis and psychosis among young adults, including the reasons and meanings of cannabis use and the perceived relationship between cannabis and mental health. Interviews with seven young adults with psychosis who described regular current or past cannabis use were conducted and analyzed using Interpretative Phenomenological Analysis. Four master themes emerged: The Journey Through Cannabis Use, The Social and Cultural World, The Struggle to Make Sense, and The Depths and Beyond. Respondent validation supported these themes, particularly the idea of cannabis use as a journey that changed in time. Social and cultural factors clearly influenced the initiation of and decision whether to continue using cannabis. Individuals could simultaneously hold positive and negative views on using cannabis. Implications for clinical interventions are explored, and the relevance of motivational interviewing and the stages of change models of behavior change are noted.6 page(s