Social recovery following first-episode psychosis: the role of negative symptoms and motivation

Background Impairment in social functioning following psychosis is associated with negative symptoms, particularly reduced motivation (Foussias & Remington, 2010). Cognitive models of negative symptoms propose that expectancy appraisals are involved in the expression and maintenance of negative symptoms (Rector, Beck, & Stolar, 2005; Staring & Van der Gaag, 2010). Theories of motivation (e.g. expectancy-value theory; Eccles and Wigfield 2002) describe how self-efficacy beliefs, appraisals of task value, and self-schema may influence behaviour, but minimal research has applied these models to the understanding of negative symptoms and functional outcomes in first-episode psychosis. This was the aim of the current study. Method A cross-sectional, correlational study was conducted to explore relationships between negative symptoms and appraisals of self-efficacy, task value and self-schema in a clinical sample of individuals with first-episode psychosis. Fifty-one participants completed measures examining psychotic symptoms, functioning, and appraisals. Results Relationships between negative symptoms and appraisals of self-efficacy, task value and self-schema were found, however these relationships were not significant when controlling for depression and anxiety symptoms. Contrary to expectations, there was no difference in the strength of relationships between self-efficacy, subjective task value and self-schema and the negative symptoms associated with motivation compared with other negative symptoms. Self-efficacy and self-schema were not significantly correlated with social functioning, but negative symptoms significantly mediated the relationship between subjective task value and social functioning. Discussion Although some hypotheses were partially supported, depressive symptoms accounted for the most variance in negative symptoms in this sample. The findings support a psychological approach for treatment to assist functional recovery of individuals with first-episode psychosis. This study addresses some methodological limitations of previous research, though was itself limited by small sample size. Theoretical implications for the applicability of cognitive models of negative symptoms and theories of motivation in first-episode psychosis are also discussed

Young people's views on psychological therapy within an outpatient paediatric diabetes service

The evidence base for the efficacy of psychological intervention in paediatric diabetes is substantial, yet little research exists exploring young people’s opinions of the psychological support offered within their diabetes service. The current study investigated the experiences of adolescents with type 1 diabetes who received psychological therapy, and asked what they thought was helpful in bringing about change. Qualitative semi-structured interviews were conducted with eight adolescents. Thematic analysis was employed to identify common themes. The results suggest an overall positive and helpful impression of psychological therapy. Consistent with previous research investigating therapeutic change, factors such as psychologist characteristics, therapeutic activities and external factors were identified as facilitating change. Additional important themes were identified by adolescents with diabetes such as: the impact of feelings of isolation; potential anxieties about engaging with psychology; and young people’s personal willingness to change. The implications for clinical practice are discussed