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Schizophr Res. 2006 Sep;86(1-3):181-8. Epub 2006 Jul 20.

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

Author information

  • 1UCL, Department of Mental Health Sciences, Archway Campus, Holborn Union Building, Highgate Hill, London, UK. ben.smith@ucl.ac.uk

Abstract

BACKGROUND:

The role of emotion in psychosis is being increasingly recognised. Cognitive conceptualisations of psychosis (e.g. [Garety, P.A., Kuipers, E.K., Fowler, D., Freeman, D., Bebbington, P.E., 2001. A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31, 189-195]) emphasise a central, normal, direct and non-defensive role for negative emotion in the development and maintenance of psychosis. This study tests specific predictions made by Garety et al. [Garety, P.A., Kuipers, E.K., Fowler, D., Freeman, D., Bebbington, P.E., 2001. A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31, 189-195] about the role of emotion and negative evaluative beliefs in psychosis.

METHODS:

100 participants who had suffered a recent relapse in psychosis were recruited at baseline for the Prevention of Relapse in Psychosis (PRP) trial. In a cross-sectional analysis, we examined the role of depression, self-esteem and negative evaluative beliefs in relation to specific positive symptoms (persecutory delusions, auditory hallucinations and grandiose delusions) and symptom dimensions (e.g. distress, negative content, pre-occupation and conviction).

RESULTS:

Analysis indicated that individuals with more depression and lower self-esteem had auditory hallucinations of greater severity and more intensely negative content, and were more distressed by them. In addition, individuals with more depression, lower self-esteem and more negative evaluations about themselves and others had persecutory delusions of greater severity and were more pre-occupied and distressed by them. The severity of grandiose delusions was related inversely to depression scores and negative evaluations about self, and directly to higher self-esteem.

CONCLUSIONS:

This study provides evidence for the role of emotion in schizophrenia spectrum-disorders. Mood, self-esteem and negative evaluative beliefs should be considered when conceptualising psychosis and designing interventions.

PMID:
16857346
[PubMed - indexed for MEDLINE]
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