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Background: Research suggests that core schemas are important in both the development and maintenance of psychosis., Aims: The aim of the study was to investigate and compare core schemas in four groups along the continuum of psychosis and examine the relationships between schemas and positive psychotic symptomatology., Method: A measure of core schemas was distributed to 20 individuals experiencing first-episode psychosis (FEP), 113 individuals with "at risk mental states" (ARMS), 28 participants forming a help-seeking clinical group (HSC), and 30 non-help-seeking individuals who endorse some psychotic-like experiences (NH)., Results: The clinical groups scored significantly higher than the NH group for negative beliefs about self and about others. No significant effects of group on positive beliefs about others were found. For positive beliefs about the self, the NH group scored significantly higher than the clinical groups. Furthermore, negative beliefs about self and others were related to positive psychotic symptomatology and to distress related to those experiences., Conclusions: Negative evaluations of the self and others appear to be characteristic of the appraisals of people seeking help for psychosis and psychosis-like experiences. The results support the literature that suggests that self-esteem should be a target for intervention. Future research would benefit from including comparison groups of people experiencing chronic psychosis and people who do not have any psychotic-like experiences.

Aim: There is evidence that psychotic-like phenomena can be detected within the general population and that psychotic experiences lie on a continuum that also spans affective states. We aimed to investigate comparisons of a first-episode psychosis group, an 'at-risk mental state group' and a help-seeking control group with non-patients to explore whether affective states lie on a continuum of psychosis., Method: Measures of psychotic-like experiences, social anxiety and depression were administered to 20 patients experiencing first-episode psychosis (FEP), 113 patients experiencing an 'at-risk' mental state (ARMS), 28 patients who were help-seeking but not experiencing a FEP or ARMS (HSC) and 30 non-clinical participants (NC)., Results: For distress in relation to psychotic-like experiences, the FEP, ARMS and HSC groups scored significantly higher than the NC group for the perceptual abnormalities and non-bizarre ideas. In terms of severity of psychotic experiences, the FEP scored the highest, followed by the ARMS group, followed by the HSC and NC groups. The clinical groups scored significantly higher for depression than the non-clinical group. Interestingly, only the FEP and the ARMS groups scored significantly higher than non-patients for social anxiety., Conclusions: These findings suggest that a psychosis continuum exists; however, this does not suggest that both psychosis and affective symptoms lie on the same continuum, rather it would appear the presence of such affective states that may affect help-seeking behaviour and clinical status. The implications of these findings for clinical practice are discussed., (© 2013 Wiley Publishing Asia Pty Ltd.)

Background: A cognitive model of psychosis suggests that appraisals of psychotic-like experiences (PLEs), and the subsequent responses adopted, are responsible for the maintenance of distress and disability associated with psychosis., Aims: This study aimed to investigate whether it is possible to manipulate appraisals of an anomalous experience in people at risk of psychosis and whether this affects levels of distress., Method: Participants who had experienced an "at risk mental state" (ARMS) within the past year, were randomized to one of two groups and received either negative or neutral information pertaining to an anomalous experience (a card trick). Participants completed a questionnaire measuring PLEs, then completed pre and post measures of distress and anxiety in relation to the card trick. Participants were also asked to rate a series of psychotic or non-psychotic appraisals regarding how they thought the card trick worked., Results: Data analysis revealed that distress and anxiety were not related to the information group assigned (our experimental manipulation was unsuccessful). However, when analyzed as one group, higher conviction in non-psychotic appraisals was found to be related to lower levels of distress and state anxiety., Conclusions: The findings provide some validation for a relationship between appraisals and distress. Clinical implications, methodological limitations and possible future research directions are discussed.