Core beliefs and adjustment in adolescent and adult onset psychosis

Abstract

INTRODUCTION: Historically, psychosis, or schizophrenia, has been regarded as a biologically explained illness of an enduring deteriorating course. The absence of conclusive evidence regarding its biological nature, however, has led to the proposals of psychological models of psychosis, most recently, psychosis as a disorder of blocked adolescent development (Harrop & Trower, 2001). It was hypothesised that the roles of adult versus adolescent onset; depressive and anxious core beliefs; current emotional dysfunction; and traumatic symptomatology, would be predictive of beliefs about illness and recovery style in psychosis.METHOD: A total of 26 adolescents with psychosis and 17 individuals whose first episode of psychosis was after the age of 25 completed the questionnaires used to test the research hypotheses. A single case study illustrates both the theory of psychosis as a disorder of adolescent development, and the proposed, quantitatively tested model of the role of core beliefs in illness beliefs and recovery style.RESULTS: Independent /-tests indicated there were no significant differences between adult and adolescent onset psychosis regarding each of these factors. Multiple regressions analyses indicated that current anxiety is the only significant predictor of beliefs about illness. Excluding the contribution of current anxiety, a further model with anxious and depressive core beliefs as predictors of illness beliefs approached significance. None of the proposed factors were correlated with or, therefore, predictive of recovery style.DISCUSSION: Findings require cautious interpretation given limited sample size and difficulties recruiting to the adult onset group. Although the quantitative findings do not indicate differences between groups, the case study illustrates the complexity of adolescent psychosis and demonstrates the utility of a developmental psychopathological framework in studying these phenomena.Conclusion: Further research of the role of core beliefs in adjustment to psychosis is warranted. It might be appropriate to review the concepts of recovery and illness beliefs, perhaps using qualitative research methodologies, to broaden the understanding of individuals' experiences of psychosis and thus promote recover

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