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This study investigated if the association between childhood maltreatment and cognition among psychosis patients and community controls was partially accounted for by genetic liability for psychosis. Patients with first-episode psychosis (N = 755) and unaffected controls (N = 1219) from the EU-GEI study were assessed for childhood maltreatment, intelligence quotient (IQ), family history of psychosis (FH), and polygenic risk score for schizophrenia (SZ-PRS). Controlling for FH and SZ-PRS did not attenuate the association between childhood maltreatment and IQ in cases or controls. Findings suggest that these expressions of genetic liability cannot account for the lower levels of cognition found among adults maltreated in childhood.

The editorial article if part of the special issue: Data Monitoring and Triage Practices during COVID-19: Shaping the future of Public Mental Health

Since its conceptual origins, borderline personality has been deeply intertwined with psychosis. Although initially thought to be on the ‘borderline’ to psychosis (hence its label) (Knight, 1953; Stern, 1938), afflicted individuals were eventually recognized to be suffering from a distinct syndrome of primarily neurotic features. This ‘borderline’ (to psychosis) syndrome was formally recognized in 1980, when it was included in DSM-III, and has since been defined in terms of affective instability and extreme interpersonal sensitivity (see Gunderson, 2009). Psychosis, on the other hand, has been defined as a constellation of positive (i.e., delusions or hallucinations), negative (e.g., flat affect and anhedonia), and disorganized (e.g., thought disorder) symptoms (American Psychiatric Association, 2013). Despite their historical affiliation, the two syndromes are now considered distinct, with almost no research existing on their relation. As a consequence, little is understood about how the modern conceptions of the ‘psychotic’ and ‘borderline’ constructs relate to each other. In this study, we aim to address this gap in the literature, by applying state-of-the-art machine-learning and network psychometric methods on three large, representative samples of the UK population (N > 20,000) to reveal ‘phenomenological’ similarities, as well as key differences, across the two psychiatric conditions.

This project aims to formalize the psychological theory of ''attribution'', which dates back to the work of Fritz Heider in the 1980s (e.g., Heider, 1983). Since its conceptual origins, attribution theory has been highly influential, having been fruitfully applied to various scientific disciplines (beyond psychology), including sports science, marketing, law, and education (please see attached research proposal for a thorough literature and historical overview of attribution theory). Despite its widespread success, though, several limitations persist. The most notable limitation of this theory (which extends to similar psychological theories, as well) includes its constraint to the verbal level of explanation. As we argue in the attached research proposal, theories that are specified at the verbal level are limited, both in terms of their explanatory depth and predictive power. In this project, we aim to address this limitation of attribution theory, by re-specifying it using the formal language of mathematics. Following recent trends in theoretical psychology (e.g., Robinaugh, Haslbeck et al., 2021), as well as more traditional approaches from mathematical psychology (e.g., Coombs, Dawes, and Tversky, 1970), we aim to employ differential equations so as to specify how various kinds of attribution processes ‘generate’ various emotional responses. By building a computational model of attribution processes, we hope to demonstrate how attributional ‘styles’ (that is, persistent ways of attributing putative ‘causes’ to particular life experiences) could lead to various emotional ''attractor states'' (from ‘depression,’ to ‘paranoid ideation,’ and beyond). More generally, by demonstrating how to ‘translate’ a verbal theory into a mathematical one, we hope to inspire other psychological researchers to transform their ways of thinking and theorizing, from more verbal to computational ones.

The COVID-19 Psychological Research Consortium Study (C19PRC Study) aims to assess and monitor the psychological and social impact of the coronavirus (COVID-19) pandemic in the general population, using longitudinal surveys and mixed-methods studies in multiple countries. This pre-registration document outlines a set of research questions, and expected results, for data collected on mental health difficulties (clinically relevant anxiety-depression and COVID-19 related traumatic stress) across eight C19PRC-UK study waves.

The COVID-19 Psychological Research Consortium Study (C19PRC Study) aims to assess and monitor the psychological and social impact of the coronavirus (COVID-19) pandemic in the general population, using longitudinal surveys and mixed-methods studies in multiple countries.

When the first UK national lockdown was announced, large numbers of the population began purchasing non-perishable foods and hygiene items in quantities that exceeded their usual weekly shop. This so called ‘over-purchasing’ was featured in news outlets and led to total stockouts of items including canned food and toilet paper in several UK supermarkets. To understand the psychological characteristics that were associated with the tendency to panic buy, several studies have considered the psychological and demographic predictors of this behaviour (e.g., Bentall et al., 2021; Garbe et al., 2020). The former of these studies found that participants who reported having a higher income were more likely to engage in panic buying, as these individuals had greater means of stockpiling resources relative to members of the population with a lower income. Far from being an irrational strategy, for those with access to the means to hoard, this may be a rational behaviour to avoid resource scarcity and is observed in several animal species during periods of uncertainty (Anselme & Güntürkün, 2020; Dickins & Schalz, 2020). As the response of the virus has become increasingly protracted, the economic impacts of the pandemic have grown. Current estimates of the cost of the pandemic to the UK Government have been estimated at 317 billion pounds as of September 2020. In the private sector, this has led to the closing of a number of businesses either temporarily or permanently. As such, some members of the population have experienced a fall in income due to job loss or being placed on the Government’s furlough scheme. However, other groups in the population have experienced the opposite effect: with fewer leisure activities to spend their disposable income on, some individuals have reported increases in wealth due to the pandemic (Institute for Fiscal Studies, 2020). As income predicted over purchasing during the first wave of the pandemic, the current study will examine how changes to income during the COVID-19 pandemic affect this behaviour. Specifically, we will examine whether those who experience a reduction to their income report a decline in over-purchasing, and whether those who experience an increase in their income report an increase in over purchasing behaviour. We also examine whether psychological variables contribute to longitudinal changes in over purchasing behaviour.

Established in March 2020, the COVID-19 Psychological Research Consortium (C19PRC) Study is a dynamic, longitudinal, multi-country study which aims to monitor and evaluate the psychological, socio-economic, and political impacts of the COVID-19 pandemic on the lives of adults living in the UK, Republic of Ireland, Spain, and Italy (McBride et al., 2020). The UK-strand of the C19PRC Study (C19PRC-UK) is the ‘parent’ strand of the Consortium upon which other countries model their survey design, content, and fieldwork procedures. Methodological reports for the C19PRC Study in the UK and other countries are available elsewhere (Bruno et al., 2021; McBride et al., 2021a; McBride et al., 2021b; McBride et al., 2020; Spikol et al., 2021; Valiente et al., 2020; Valiente et al., 2021). This pre-registration document outlines a set of research questions, and expected results, for data collected on mental health during the first year of the COVID-19 pandemic in Europe. This pre-registration has been submitted prior to conducting any network analyses on the combined C19PRC data from the UK, Republic of Ireland, Spain and Italy.

The authoritarian personality (Adorno et al., 1950) has been a subject of great interest for social and political psychologists alike; however, research has traditionally focused on studying the psychopathology and behavioural consequences of far-right ideology and right-wing authoritarianism (RWA). Since its inception, the literature has largely ignored the left end of this spectrum, with some scholars suggesting left-wing authoritarianism (LWA) is an extremely rare phenomena, or dismissing its existence entirely (Stone, 1980; Stone & Smith, 1993; Altemeyer, 1996). More recently, however, exploration into the conceptualisation of LWA has emerged, building a more precise framework of psychological, ideological, and behavioural factors integral to LWA. Costello and colleagues’ (2020-in pres), for example, have developed an in-depth conceptualisation of this so-called “Loch Ness Monster” (Conway, 2018), outlining both the independent beliefs and worldviews, cognitive, behavioural, and personality traits of LWA, and those it shares with its right-wing counterpart. Scholars have long theorised that authoritarianism exists as a predisposition triggered by a threat to the homogeneity of the in-group, and therefore society (Stenner, 2005; Feldman, 2003). Namely, that authoritarian behaviours "rise and fall" in response to changing social conditions perceived as threatening to the individual's societal norms, acting as a defence serving the needs of the individual (Duckitt, 1989; Stenner, 2005; Kehrberg, 2017; Van Assche et al., 2019a, b). Furthermore, this authoritarian continuum is concerned with maintaining an equilibrium between group authority and uniformity on one extreme, with a priority of individual autonomy and diversity on the extreme libertarian end of the scale (Duckitt, 1989). We therefore have three aims: 1) To support Stenner's (2005) hypothesis of authoritarianism as a psychological predisposition for group homogeneity. 2) To support the validation of left-wing economic authoritarianism as a measurable psychological construct. 3) To focus on analysing core psychological elements of authoritarianism, and further predict its outcomes. In order to meet out aims, our objectives are as follows: 1) To develop a self-report measure based on theoretical ground assessing an individual's extent of authoritarian predisposition regarding right- and left-wing economic values, sexuality, child rearing views, attitudes on public health during the COVID-19 pandemic, and finally, justice-seeking behaviour. 2) To pilot this survey on a convenience sample of a minimum 200 participants. 3) To run appropriate statistical measures to amend the scale items where necessary, ensuring strong validity and reliability with the measure, with the intent on conducting empirical research on a larger, representative sample. 4) To redistribute the final survey to a more representative sample (N 500). 5) To conduct an exploratory factor analysis (EFA), one-factor confirmatory factor analysis (CFA), two-factor CFA, and bifactor model to explore shared factors between authoritarian values. 6) To use the results of the final bifactor model to predict the outcomes of authoritarian predisposition.

This project aims to validate a short version of the Monotheist and Atheist Belief Scales using a large cross-cultural secondary dataset collected as part of the COVID-19 psychological research consortium (C19PRC). It then aims to examine the relationship between religious beliefs and psycho-pathological variables using Structural Equation Modelling (SEM) techniques.

The authoritarian personality (Adorno et al., 1950) has been a subject of great interest for social and political psychologists alike; however, research has traditionally focused on studying the psychopathology and behavioural consequences of far right ideology and right-wing authoritarianism (RWA). Since its inception, the literature has largely ignored the left end of this spectrum, with some scholars suggesting left-wing authoritarianism (LWA) is an extremely rare phenomena, or dismissing its existence entirely (Stone, 1980; Stone & Smith, 1993; Altemeyer, 1996). More recently; however, exploration into the conceptualization of LWA has emerged, building a more precise framework of psychological, ideological, and behavioural factors integral to LWA. Costello and colleagues’ (2020-in pres), for example, have developed an in-depth conceptualization of this so-called “Loch Ness Monster” (Conway, 2018), outlining both the independent beliefs and worldviews, cognitive, behavioural, and personality traits of LWA, and those it shares with its right-wing counterpart. Our study aims to further explore the relationship between authoritarian personalities on both the Right and Left of the political spectrum using bifactor analysis to observe whether a shared latent construct emerges, and further, whether this underlying dimension could be the defining factor in predicting a general authoritarian personality. Using longitudinal secondary data collected by the COVID-19 Psychological Research Consortium Study (Wave 5), we first assess whether LWA can be observed in a nationally representative UK sample. We then test whether a shared underlying general factor can be observed in authoritarians on both ends of the political spectrum. Finally, we investigate the attitudinal and behavioural social psychological consequences of this underlying general trait.

The project aims to understand the mental health burden on healthcare workers. A part of this consists of understanding factors that play a role in the development of greater severity, or probable diagnosis of certain mental health outcomes.

This review aims to provide a systematic narrative review of all literature that considers poor me, bad me paranoia. This study falls under the domain of paranoia. It considers studies that research individuals who have received a Diagnostic and Statistical Manual of Mental Disorders [DSM] diagnosis e.g., Schizophrenia, bipolar disorder, paranoid personality disorder where paranoia is prevalent. It will also consider studies that research sub-clinical experiences of paranoia in the general population.

Additional file 1: Table S1. Standardised Factor Loadings for PHQ-GAD Confirmatory Factor Analysis for Each Country.

Additional file 1: Table S1. Baseline characteristics of original RCT sample (n = 253). Table S2. Median time to recovery from index depressive episode (Kaplan Meier). Table S3. Cox regression analysis showing predictors of time to recovery from index depressive episode. Figure S1. Cumulative time to any recurrence in individuals with no or suboptimal mood stabilizer treatment. Figure S2. Cumulative time to depressive recurrence in individuals with no or suboptimal mood stabilizer treatment.

Additional file 2: Table S2. Shapiro-Wilk Normality Tests for PHQ and GAD-7 Scores for each Country

Objectives: The COVID-19 Psychological Research Consortium (C19PRC) Study aims to assess the impact of the COVID-19 pandemic in the adult population in multiple countries. This paper describes the third wave of the UK survey (the ‘parent’ strand of the Consortium) during July-August 2020. Methods: Adults (N=2025) who participated in the baseline and/or first follow-up surveys were reinvited to participate in this survey, which assessed: (1) COVID-19 related knowledge, attitudes, and behaviours; (2) the occurrence of common mental disorders; as well as the role of (3) psychological factors and (4) social and political attitudes, in influencing the public’s response to the pandemic. Weights were calculated using a survey raking algorithm to ensure that the cross-sectional sample is nationally representative in terms of gender, age, and household income, and representative of the baseline sample characteristics for household composition, ethnicity, urbanicity and born/raised in UK. Results: 1166 adults (57.6% of baseline participants) provided full interviews at Wave 3. The raking procedure successfully re-balanced the cross-sectional sample to within 1% of population estimates across selected socio-demographic characteristics. Conclusion: This paper demonstrates the strength of the C19PRC Study data to facilitate and stimulate interdisciplinary research addressing important public health questions relating to the COVID-19 pandemic.

Objectives: Psychological models of voice‐hearing propose that auditory‐verbal hallucinations occur when inner speech is attributed to a source external to the self. Approximately half of the world's population is multilingual, and the extent to which they use a second language for inner speech depends on their experience and competency in it. Bilingualism therefore provides a natural window into the processes operating in auditory‐verbal hallucinations, but no systematic study of voice‐hearing in bilinguals has hitherto been conducted. Design: A mixed‐methods observational study of psychiatric service users who hear voices and who are Welsh–English bilingual. Methods: Thirty‐seven participants were interviewed about their history and use of Welsh and English and divided into three groups: those who learnt Welsh first (L1 Welsh), those who learnt English first (L1 English), and those who learnt the two languages simultaneously. Detailed phenomenological data were collected using The Mental Health Research Institute Unusual Perceptions Schedule. Results: Both qualitative and quantitative data indicated very considerable variation in the extent to which voices were in Welsh, English, or both, with some voice‐hearers reporting that the predominant language of their voices had changed with time. There were modest but statistically significant associations between the predominant language of voices and age of language acquisition (late Welsh learners did not hear voices in Welsh), frequency of language use (more frequent use of Welsh was associated with more Welsh voices), and subjective language proficiency (proficiency in English was associated with a tendency to hear English voices). Conclusions: Although this was a small study, it was the first of its kind. There is a need for more research on the implications of bilingualism for psychosis in particular and mental illness more generally. The results are broadly consistent with the hypothesis that hallucinated voices are misattributed inner speech. Practitioner points: Assessments of people with mental health difficulties should routinely inquire whether they are multilingual and, if so, which language they prefer to use. People with mental health difficulties may have difficulty expressing complex issues and emotions in a second language, despite apparent fluency. When working with bilingual people who hear voices, mental health professionals should consider the language used by the voices when conducting assessments and proposing formulations.

The over-purchasing and hoarding of necessities is a common response to crises, especially in developed economies where there is normally an expectation of plentiful supply. This behaviour was observed internationally during the early stages of the Covid-19 pandemic. In the absence of actual scarcity, this behaviour can be described as ‘panic buying’ and can lead to temporary shortages. However, there have been few psychological studies of this phenomenon. Here we propose a psychological model of over-purchasing informed by animal foraging theory and make predictions about variables that predict over-purchasing by either exacerbating or mitigating the anticipation of future scarcity. These variables include additional scarcity cues (e.g. loss of income), distress (e.g. depression), psychological factors that draw attention to these cues (e.g. neuroticism) or to reassuring messages (eg. analytical reasoning) or which facilitate over-purchasing (e.g. income). We tested our model in parallel nationally representative internet surveys of the adult general population conducted in the United Kingdom (UK: N = 2025) and the Republic of Ireland (RoI: N = 1041) 52 and 31 days after the first confirmed cases of COVID-19 were detected in the UK and RoI, respectively. About three quarters of participants reported minimal over-purchasing. There was more over-purchasing in RoI vs UK and in urban vs rural areas. When over-purchasing occurred, in both countries it was observed across a wide range of product categories and was accounted for by a single latent factor. It was positively predicted by household income, the presence of children at home, psychological distress (depression, death anxiety), threat sensitivity (right wing authoritarianism) and mistrust of others (paranoia). Analytic reasoning ability had an inhibitory effect. Predictor variables accounted for 36% and 34% of the variance in over-purchasing in the UK and RoI respectively. With some caveats, the data supported our model and points to strategies to mitigate over-purchasing in future crises.

COVID-19 continues to pose a threat to global public health. Multiple safe and effective vaccines against COVID-19 are available with one-third of the global population now vaccinated. Achieving a sufficient level of vaccine coverage to suppress COVID-19 requires, in part, sufficient acceptance among the public. However, relatively high rates of hesitance and resistance to COVID-19 vaccination persists, threating public health efforts to achieve vaccine-induced population protection. In this study, we examined longitudinal changes in COVID-19 vaccine acceptance, hesitance, and resistance in two nations (the United Kingdom and the Republic of Ireland) during the first nine months of the pandemic, and identified individual and psychological factors associated with consistent non-acceptance of COVID-19 vaccination. Using nationally representative, longitudinal data from the United Kingdom (UK; N = 2025) and Ireland (N = 1041), we found that (1) COVID-19 vaccine acceptance declined in the UK and remained unchanged in Ireland following the emergence of approved vaccines; (2) multiple subgroups existed reflecting people who were consistently willing to be vaccinated (‘Accepters’: 68% in the UK and 61% in Ireland), consistently unwilling to be vaccinated (‘Deniers’: 12% in the UK and 16% in Ireland), and who fluctuated over time (‘Moveable Middle’: 20% in the UK and 23% in Ireland); and (3) the ‘deniers’ and ‘moveable middle’ were distinguishable from the ‘accepters’ on a range of individual (e.g., younger, low income, living alone) and psychological (e.g., distrust of scientists and doctors, conspiracy mindedness) factors. The use of two high-income, Western European nations limits the generalizability of these findings. Nevertheless, understanding how receptibility to COVID-19 vaccination changes as the pandemic unfolds, and the factors that distinguish and characterise those that are hesitant and resistant to vaccination is helpful for public health efforts to achieve vaccine-induced population protection against COVID-19.

Supplemental Material, Supplemental_material for The Authoritarian Dynamic During the COVID-19 Pandemic: Effects on Nationalism and Anti-Immigrant Sentiment by Todd K. Hartman, Thomas V. A. Stocks, Ryan McKay, Jilly Gibson-Miller, Liat Levita, Anton P. Martinez, Liam Mason, Orla McBride, Jamie Murphy, Mark Shevlin, Kate M. Bennett, Philip Hyland, Thanos Karatzias, Frédérique Vallières and Richard P. Bentall in Social Psychological and Personality Science

Supplemental Material, Hartman_Authorship-change-request-form--fillable-PDF_SIGNED for The Authoritarian Dynamic During the COVID-19 Pandemic: Effects on Nationalism and Anti-Immigrant Sentiment by Todd K. Hartman, Thomas V. A. Stocks, Ryan McKay, Jilly Gibson-Miller, Liat Levita, Anton P. Martinez, Liam Mason, Orla McBride, Jamie Murphy, Mark Shevlin, Kate M. Bennett, Philip Hyland, Thanos Karatzias, Frédérique Vallières and Richard P. Bentall in Social Psychological and Personality Science

The prevalence of posttraumatic stress disorder (PTSD) as it relates to people’s experiences of the COVID-19 pandemic has yet to determined. This study was conducted to determine rates of COVID-19 related PTSD in the Irish general population, the level of comorbidity with depression and anxiety, and sociodemographic risk factors associated with COVID-19 related PTSD. A nationally representative sample of adults from the general population of the Republic of Ireland (N = 1,041) completed self-report measures of all study variables. The rate of COVID-19 related PTSD was 17.7% (95% CI = 15.35 - 19.99%: n=184), and comorbidity with generalized anxiety (49.5%) and depression (53.8%) was high. Meeting the diagnostic requirement for COVID-19 related PTSD was associated with younger age, male sex, living in a city, living with children, moderate and high perceived risk of COVID-19 infection, and screening positive for anxiety or depression. Traumatic stress problems related to the COVID-19 pandemic are common in the general population. Our results show that health professionals responsible for responding to the COVID-19 pandemic should expect to routinely encounter traumatic stress problems.

Objectives\udPsychological models of voice-hearing propose that auditory-verbal hallucinations occur when inner speech is attributed to a source external to the self. Approximately half of the world's population is multilingual, and the extent to which they use a second language for inner speech depends on their experience and competency in it. Bilingualism therefore provides a natural window into the processes operating in auditory-verbal hallucinations, but no systematic study of voice-hearing in bilinguals has hitherto been conducted.\ud\udDesign\udA mixed-methods observational study of psychiatric service users who hear voices and who are Welsh–English bilingual.\ud\udMethods\udThirty-seven participants were interviewed about their history and use of Welsh and English and divided into three groups: those who learnt Welsh first (L1 Welsh), those who learnt English first (L1 English), and those who learnt the two languages simultaneously. Detailed phenomenological data were collected using The Mental Health Research Institute Unusual Perceptions Schedule.\ud\udResults\udBoth qualitative and quantitative data indicated very considerable variation in the extent to which voices were in Welsh, English, or both, with some voice-hearers reporting that the predominant language of their voices had changed with time. There were modest but statistically significant associations between the predominant language of voices and age of language acquisition (late Welsh learners did not hear voices in Welsh), frequency of language use (more frequent use of Welsh was associated with more Welsh voices), and subjective language proficiency (proficiency in English was associated with a tendency to hear English voices).\ud\udConclusions\udAlthough this was a small study, it was the first of its kind. There is a need for more research on the implications of bilingualism for psychosis in particular and mental illness more generally. The results are broadly consistent with the hypothesis that hallucinated voices are misattributed inner speech.

Additional file 1. The CLAHRC NWC Household Health Survey. Public health survey.

The conditions in which we are born, grow, live, work and age are key drivers of health and inequalities in life chances. To maximise health and wellbeing across the whole population, we need well-coordinated action across government sectors, in areas including economic, education, welfare, labour market and housing policy. Current research struggles to offer effective decision support on the cross-sector strategic alignment of policies, and to generate evidence that gives budget holders the confidence to change the way major investment decisions are made. This open letter introduces a new research initiative in this space. The SIPHER (Systems Science in Public Health and Health Economics Research) Consortium brings together a multi-disciplinary group of scientists from across six universities, three government partners at local, regional and national level, and ten practice partner organisations. The Consortium’s vision is a shift from health policy to healthy public policy, where the wellbeing impacts of policies are a core consideration across government sectors. Researchers and policy makers will jointly tackle fundamental questions about: a) the complex causal relationships between upstream policies and wellbeing, economic and equality outcomes; b) the multi-sectoral appraisal of costs and benefits of alternative investment options; c) public values and preferences for different outcomes, and how necessary trade-offs can be negotiated; and d) creating the conditions for intelligence-led adaptive policy design that maximises progress against economic, social and health goals. Whilst our methods will be adaptable across policy topics and jurisdictions, we will initially focus on four policy areas: Inclusive Economic Growth, Adverse Childhood Experiences, Mental Wellbeing and Housing.

Communication deviance (CD) reflects features of the content or manner of a person's speech that may confuse the listener and inhibit the establishment of a shared focus of attention. The construct was developed in the context of the study of familial risks for psychosis based on hypotheses regarding its effects during childhood. It is not known whether parental CD is associated with nonverbal parental behaviors that may be important in early development. This study explored the association between CD in a cohort of mothers (n = 287) at 32 weeks gestation and maternal sensitivity with infants at 29 weeks in a standard play procedure. Maternal CD predicted lower overall maternal sensitivity (B = -.385; p < .001), and the effect was somewhat greater for sensitivity to infant distress (B = -.514; p < .001) than for sensitivity to nondistress (B = -.311; p < .01). After controlling for maternal age, IQ and depression, and for socioeconomic deprivation, the associations with overall sensitivity and sensitivity to distress remained significant. The findings provide new pointers to intergenerational transmission of vulnerability involving processes implicated in both verbal and nonverbal parental behaviors.

Supplemental material, McElroy_Supplemental_Materials for Mental Health, Deprivation, and the Neighborhood Social Environment: A Network Analysis by Eoin McElroy, Jason C. McIntyre, Richard P. Bentall, Tim Wilson, Keith Holt, Cecil Kullu, Rajan Nathan, Andrew Kerr, Katerina Panagaki, Mick McKeown, Pooja Saini, Mark Gabbay and Rhiannon Corcoran in Clinical Psychological Science

Supplemental material, Supplementary_table_1 for Coping Strategies and self-esteem in the high-risk offspring of bipolar parents by Sarah M Goodday, Richard Bentall, Steven Jones, Arielle Weir and Anne Duffy in Australian & New Zealand Journal of Psychiatry

Background: Sleep difficulties might be a contributory causal factor in the occurrence of mental health problems. If this is true, improving sleep should benefit psychological health. We aimed to determine whether treating insomnia leads to a reduction in paranoia and hallucinations.Methods: We did this single-blind, randomised controlled trial (OASIS) at 26 UK universities. University students with insomnia were randomly assigned (1:1) with simple randomisation to receive digital cognitive behavioural therapy (CBT) for insomnia or usual care, and the research team were masked to the treatment. Online assessments took place at weeks 0, 3, 10 (end of therapy), and 22. The primary outcome measures were for insomnia, paranoia, and hallucinatory experiences. We did intention-to-treat analyses. The trial is registered with the ISRCTN registry, number ISRCTN61272251. Findings: Between March 5, 2015, and Feb 17, 2016, we randomly assigned 3755 participants to receive digital CBT for insomnia (n=1891) or usual practice (n=1864). Compared with usual practice, the sleep intervention at 10 weeks reduced insomnia (adjusted difference 4·78, 95% CI 4·29 to 5·26, Cohen’s d=1·11; pInterpretation: To our knowledge, this is the largest randomised controlled trial of a psychological intervention for a mental health problem. It provides strong evidence that insomnia is a causal factor in the occurrence of psychotic experiences and other mental health problems. Whether the results generalise beyond a student population requires testing. The treatment of disrupted sleep might require a higher priority in mental health provision.Funding: Wellcome Trust

Thought disorder (TD) has been shown to vary in relation to negative affect. Here we examine the role internal source monitoring (iSM, i.e. ability to discriminate between inner speech and verbalized speech) in TD and whether changes in iSM performance are implicated in the affective reactivity effect (deterioration of TD when participants are asked to talk about emotionally-laden topics). Eighty patients diagnosed with schizophrenia-spectrum disorder and thirty healthy controls received interviews that promoted personal disclosure (emotionally salient) and interviews on everyday topics (non-salient) on separate days. During the interviews, participants were tested on iSM, self-reported affect and immediate auditory recall. Patients had more TD, poorer ability to discriminate between inner and verbalized speech, poorer immediate auditory recall and reported more negative affect than controls. Both groups displayed more TD and negative affect in salient interviews but only patients showed poorer performance on iSM. Immediate auditory recall did not change significantly across affective conditions. In patients, the relationship between self-reported negative affect and TD was mediated by deterioration in the ability to discriminate between inner speech and speech that was directed to others and socially shared (performance on the iSM) in both interviews. Furthermore, deterioration in patients' performance on iSM across conditions significantly predicted deterioration in TD across the interviews (affective reactivity of speech). Poor iSM is significantly associated with TD. Negative affect, leading to further impaired iSM, leads to increased TD in patients with psychosis. Avenues for future research as well as clinical implications of these findings are discussed.

Algunas teorías psicológicas sobre los delirios persecutorios enfatizan la importancia del concepto de self y otros (Bentall, Corcoran, Howard, Blackwood y Kinderman, 2001). Sin embargo, los resultados son inconsistentes, en parte por el uso casi exclusivo de medidas explícitas centradas en la autoestima. Freeman (2007) propone que las creencias evaluativas sobre el self y los otros son el indicador más estable y mejor predictor que la autoestima, por lo que este estudio exploró las diferencias en el concepto explícito e implícito del self y de los otros entre pacientes con paranoia (n = 79), con depresión (n = 38) y un grupo control sano (n = 52). Los resultados mostraron que a nivel explícito los grupos clínicos tenían más creencias negativas del self que los controles, pero no hubo diferencias entre los grupos en las creencias negativas sobre los otros. Sólo el grupo con depresión mostró un self significativamente más negativo que el de los otros. A nivel implícito, aunque los pacientes presentaban un self más negativo que los controles, estas diferencias no fueron significativas. Tampoco se observaron diferencias entre grupos en las asociaciones negativas implícitas sobre los otros. Sin embargo, el grupo control presentó un patrón implícito opuesto al explícito en el que el índice de los otros fue significativamente más negativo que el del self. Este estudio señala la importancia de explorar el self en comparación con el concepto de los otros en diferentes dimensiones del procesamiento cognitivo. Some psychological theories about persecutory delusions emphasize the importance of the concepts of self and others (Bentall, Corcoran, Howard, Blackwood, & Kinderman, 2001). However, results are inconsistent, in part due to an almost exclusive usage of explicit measures focusing on self-esteem. Freeman (2007) has proposed that evaluative beliefs about self and others are a more stable indicator and a better predictor than self-esteem. Then, this study explored the differences in the explicit and implicit conception of self and others between patients with paranoia (n = 79), depression (n = 38), and a healthy control group (n = 52). The results showed that at the explicit level clinical groups had more negative evaluative beliefs about the self than controls, but there were no differences in evaluative beliefs about others between groups. Only the depression group showed a significantly more negative self than others. At implicit level, although patients had a more negative self than controls, these differences were not significant. There were no differences between groups in implicit indexes of others either. However, the control group presented an implicit pattern opposite to the explicit one, in which the index of others was significantly more negative than the index self. This study highlights the importance of exploring self together with the concept of others at different dimensions of processing.

OBJECTIVES. The evidence to date for a causal role of emotions in the generation of paranoid symptoms is scarce, mainly because of a lack of studies investigating the longitudinal association between emotional processes and paranoia. The primary aim of this study was to investigate whether momentary emotional experiences (anxiety, depression, anger/irritability) and self-esteem predicted the onset and duration of a paranoid episode. We also studied whether levels of emotional experiences and self-esteem were respectively higher and lower during a paranoid episode. DESIGN. A 1-week, prospective momentary assessment study. METHODS. Data were collected using the experience sampling method, a structured self-assessment diary technique. The sample consisted of 158 individuals who ranged across the paranoia continuum. Participants with a psychotic disorder were recruited from in-patient and out-patient mental health services. Participants without psychotic disorder were sampled from the general population. RESULTS. Specific aspects of emotional experience were implicated in the onset and persistence of paranoid episodes. Both an increase in anxiety and a decrease in self-esteem predicted the onset of paranoid episodes. Cross-sectionally, paranoid episodes were associated with high levels of all negative emotions and low level of self-esteem. Initial intensity of paranoia and depression was associated with longer, and anger/irritability with shorter duration of paranoid episodes. CONCLUSIONS. Paranoid delusionality is driven by negative emotions and reductions in self-esteem, rather than serving an immediate defensive function against these emotions and low self-esteem. Clinicians need to be aware of the central role of emotion-related processes and especially self-esteem in paranoid thinking.

Objectives: This paper aims to study dysfunctional self-schematic processes, abnormal coping styles, over-responsiveness to reward stimuli (indicative of an over-sensitive behavioural activation system) and stability of self-esteem in relation to subclinical hypomania. Design: Three cross-sectional studies were conducted on selected students on the basis of their scores on the Hypomanic Personality Scale (HPS) (study 1) and on elevated HPS and Dysfunctional Attitude Scale scores (studies 2 and 3). Methods: In studies 1 and 2, participants completed questionnaires and kept a self-esteem diary for 6 days. In study 3, the experience sampling method was used to assess momentary self-esteem, emotion and use of different coping styles over a 6-day period. Results: Study 1 demonstrated that hypomanic traits are associated with high fluctuations in self-esteem. In study 2, high scores on both the HPS and the Dysfunctional Attitude Scale, but not the HPS alone, were associated with bipolar spectrum symptoms. These participants showed more evidence of alcohol and substance abuse, greater self-esteem fluctuation and dysfunctional coping styles (rumination and risk-taking) compared with controls. Changes in self-esteem were related to the use of these strategies. Conclusions: Vulnerability to bipolar disorder is associated with a combination of depression-related and reward-related processes.

Introduction High risk of mental health problems is associated with loneliness resulting from social distancing measures and ‘lockdowns’ that have been imposed globally due to the COVID-19 pandemic. This study explores the interconnectedness of loneliness, anxiety and depression on a symptom level using network analysis. Methods A representative sample of participants (N = 1,041), who were of at least 18 years of age, was recruited from the Republic of Ireland (ROI). Loneliness, anxiety and depression were assessed using validated instruments. Network analysis was used to identify the network structure of loneliness, anxiety and depression. Results Loneliness was found to be largely isolated from anxiety and depression nodes in the network. Anxiety and depression were largely interconnected. ‘Trouble relaxing’, ‘feeling bad about oneself’ and ‘not being able to stop or control worrying’ were suggested as the most influential nodes of the network. Discussion Despite the expectation that loneliness would be implicated more robustly in the anxiety and depression network of symptoms, the results suggest loneliness as a distinct construct that is not interwoven with anxiety and depression.

This abstract summarises the thesis entitled Defensive Avoidance in Paranoid Delusions: Experimental and Computational Approaches, submitted by Michael Moutoussis to The University of Manchester for the degree of Doctor of Philosophy (PhD) in the faculty of Medical and Human Sciences, in 2011.The possible aetiological role of defensive avoidance in paranoia was investigated in this work. First the psychological significance of the Conditioned Avoidance Response (CAR) was reappraised. The CAR activates normal threat-processing mechanisms that may be pathologically over-activated in the anticipation of threats in paranoia. This may apply both to external threats and also to threats to the self-esteem.A temporal-difference computational model of the CAR suggested that a dopamine-independent process may signal that a particular state has led to a worse-than-expected outcome. On the contrary, learning about actions is likely to involve dopamine in signalling both worse-than-expected and better-than-expected outcomes. The psychological mode of action of dopamine blocking drugs may involve dampening (1) the vigour of the avoidance response and (2) the prediction-error signals that drive action learning.Excessive anticipation of negative events might lead to inappropriately perceived high costs of delaying decisions. Efforts to avoid such costs might explain the Jumping-to-Conclusions (JTC) bias found in paranoid patients. Two decision-theoretical models were used to analyse data from the ‘beads-in-a-jar’ task. One model employed an ideal-observer Bayesian approach; a control model made decisions by weighing evidence against a fixed threshold of certainty. We found no support for our ‘high cost’ hypothesis. According to both models the JTC bias was better explained by higher levels of ‘cognitive noise’ (relative to motivation) in paranoid patients. This ‘noise’ appears to limit the ability of paranoid patients to be influenced by cognitively distant possibilities.It was further hypothesised that excessive avoidance of negative aspects of the self may fuel paranoia. This was investigated empirically. Important self-attributes were elicited in paranoid patients and controls. Conscious and non-conscious avoidance were assessed while negative thoughts about the self were presented. Both ‘deserved’ and ‘undeserved’ persecutory beliefs were associated with high avoidance/control strategies in general, but not with increased of avoidance of negative thoughts about the self. On the basis of the present studies the former is therefore considerably more likely than the latter to play an aetiological role in paranoia.This work has introduced novel computational methods, especially useful in the study of ‘hidden’ psychological variables. It supported and deepened some key hypotheses about paranoia and provided consistent evidence against other important aetiological hypotheses. These contributions have substantial implications for research and for some aspects of clinical practice.

Background Many kinds of beliefs can be held both strongly and emotionally, which means that they can prove difficult to change. Such beliefs can be either pathological (e.g. delusions) or non-pathological (e.g. religious, political and supernatural beliefs as well as belief in conspiracy theories). The difficulty associated with distinguishing between delusions and other types of strong beliefs has given rise to the term ‘master explanatory systems’ (MES), which include paranoid beliefs, belief in conspiracies, political beliefs, religious beliefs and paranormal beliefs. The present study sought to investigate the commonalities between pathological and non-pathological beliefs, in addition to their correlation with other psychological constructs. Methods This study comprised three large-scale online surveys and one online experiment. The first survey involved over 500 participants from three different universities (Liverpool, Ulster and Oxford) in the United Kingdom (UK). The second survey involved a representative sample of 1508 participants from the UK, while the third survey involved a smaller representative sample (about 630 participants) of the UK population. Finally, the online experiment involved 245 participants, who were divided into two groups. The data derived from the three surveys and the online experiment were analysed by means of different statistical approaches. First, confirmatory factor analysis was performed to study the relationship between paranoia and belief in conspiracy theories, while a multivariate regression was run between the two types of beliefs and certain other psychological constructs. Second, the same statistical approach as used in the first study was also used to investigate the relationship between religious (monotheistic) belief and atheism. Third, a bifactor analysis was performed to determine whether there was a common latent factor (or 'S') underlying all the MES. Finally, a mortality salience intervention was conducted to examine the effect of the fear of death on the strong belief latent factor S. Results The first study revealed that paranoia and belief in conspiracy theories are better explained as two separate yet related factors. Moreover, they are both related positively to loneliness and factors relevant to the external locus of control (i.e., powerful others and chance). However, belief in conspiracy theories but not paranoia was related positively with poor analytical reasoning. The second study indicated that religious belief and atheism are also can better explained as two distinct yet related factors. The scale that was designed for the two factors (monotheism and atheism) was found to exhibit high reliability. In terms of the third study, a bifactor model incorporating strong beliefs of paranoia, beliefs in conspiracies, religiosity, and nationalism as well as the three factors associated with paranormal beliefs was found to have a better fit indices when compared with the confirmatory factor analysis of those beliefs, while the latent strong belief factor S was found to underlie all the MES. Finally, the online experiment revealed that the mortality salience manipulation increased the participants’ death anxiety, worsened their analytical reasoning, and enhanced the S. Conclusions Taken together, the findings of this study support the existence of the strong belief latent factor S. The surveys showed S to exhibit consistent correlation with the other psychological constructs of interest. However, further studies involving clinical samples are recommended to replicate and extend the present findings.

Theory and research in the field of persecutory beliefs have identified a number of important psychological processes involved in clinical and non-clinical paranoia. This dissertation set out to investigate some of these processes. Firstly, the empirical evidence for the distinction of 'Poor Me' and 'Bad Me' paranoia (Trower & Chadwick, 1995) was reviewed systematically. Secondly, an empirical study with two phases aimed to investigate the contribution of key processes to paranoia in clinical and non-clinical samples. Investigated factors were: anxiety, depression, anger, attachment anxiety, attachment avoidance, deservedness, submissiveness, self-attacking, self-compassion and experiential avoidance. The review found the distinction of 'Poor Me' and 'Bad Me' paranoia to have some validity and clinical usefulness; however, as yet not all of the theoretical predictions have been borne out in the empirical literature. The importance of the role of deservedness and its measurement was discussed. A series of one-way ANCOVAs found levels of a number of processes to distinguish clinical and non-clinical paranoid groups. Hierarchical regression revealed experiential avoidance to be a significant predictor of paranoia in the final model. A concluding section synthesised these findings and consideration was given to future directions.

The experience of hallucinations is one of the symptoms used in the diagnosis of a psychiatric disorders such as schizophrenia. Functional and structural neuroimaging studies consistently link hallucinatory experience with abnormalities in brain areas supporting normal processing such language areas in auditory verbal hallucinations (AVH) and visual sensory areas in visual hallucinations (VH). Hallucinations are not confined to clinical populations, but are also relatively frequent in the general population. Finding that healthy individuals experience hallucinations without distress has led to models proposing that hallucinatory experiences lie on a continuum, which spans healthy and clinical populations. Continuum models (e.g., Baumeister et al., 2017) provide a theoretical framework with testable hypotheses, that predict brain functional activation, morphometrics or microstructural alterations in the healthy hallucinator group from existing data in the clinical group. Healthy hallucinators therefore may be a key resource in informing transdiagnostic research into the neurological cause of hallucinations. The aim of the current study is to test whether hallucination proneness predict a wide range of multi-modal neuroimaging measures in a large, healthy population. The Launay-Slade Hallucination Scale modified by Morrison’s et al. (2000) LSHS(M) scale as well as auditory (LSHS(A)) and visual (LSHS(V)) subscales were used as a regressors in structural (VBM and FreeSurfer based morphometrics), functional (fMRI) and microstructural (DTI diffusivity and tractography) neuroimaging experiments to test whether alterations seen in patients translate into the healthy population. The morphometric analysis of structural data showed a significant positive correlation between brain thickness in the temporal cortex (bilateral transverse temporal gyrus) (TTG) and LSHS(M) scores. Functional activation data shows a significant positive correlation between LSHS(A) scores and activation in irrelevant task activation (audio/visual) in right (inferior frontal gyrus, superior temporal gyrus and middle temporal gyrus). DTI diffusivity analysis showed that reduced mean diffusivity (MD) in the right inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus (SLF) and occipital lobe (OL), also reduced axial diffusivity (AD) in the bilateral (SLF) and (OL) were linked to higher LSHS(M) scores. The arcuate fasciculus (AF) analysis showed that reduced diffusivity in the left (MD) and left (AD) were linked to high LSHS(M) scores. It is striking that, for this healthy population, the effects observed are the opposite of what might have been expected (continuum theory) for brain pathology and contrasts with previously published data for schizophrenia patients suffering from hallucinations. Finding consistent results using multiple imaging modalities in overlapping brain areas and for a relatively large population makes methodological differences or sampling effects an unlikely explanation for the results. The continuum hypothesis of hallucination assumes that psychotic symptoms, such as AVH and VH, which are experienced in clinical and non-clinical populations, have a common cause. In neuroimaging terms this means that similar functional, structural, and microstructural parameters would be expected for clinical and non-clinical populations show the same direction of differences. Our data does not fit well with this model. However, the results failed to prove that. Studying hallucinatory experiences in a healthy population is attractive because it avoids confounding effects, ranging from childhood trauma, medication or hospitalization. Our data suggests that studies in healthy individuals may not provide data that easily extrapolates to the causes underlying schizophrenic hallucinations.

Individuals experience psychosis when their thoughts and emotions are so impaired that they lose touch with reality. Psychosis consists of many symptoms, of which paranoia is the most common. It is important to assess the structure of paranoia as, should paranoia exist on a continuum, examining paranoia in general population samples may inform interventions and preventative strategies for individuals who experience clinical levels of paranoia. Research has consistently shown that elevated rates of paranoia, and psychosis in general, are apparent in ethnic minority populations in Britain. Here, paranoia will be assessed in various community samples using the Social Identity Approach (SIA). The SIA was developed to explain intergroup relations and consists of the Self-Categorisation Theory (SCT) and the Social Identity Theory (SIT). The SIT was recently posited to explain the higher rates of psychotic symptoms, such as paranoia, in immigrant and ethnic minority populations. It suggests that the elevated rates of mental illnesses in these groups are a result of social identity processes. As detailed in Chapter 1, many other explanations have been made to explain the high rates of psychotic symptoms in majority and minority populations. These will be discussed but the focus of Chapter 1 will be the SIA, in particular the SIT. The four empirical studies in my thesis examined the latent structure of paranoia and the relationship between social stressors, social identities and paranoia in majority and minority populations. In Chapter 2, I synthesised research on the structure of paranoia and critiqued the methodology used in previous studies. In Chapter 3, using data from the general population, individuals with an at-risk mental state (ARMS) and individuals who had been clinically diagnosed, I assessed the latent structure of paranoia using up-to-date taxometric methods. My findings strongly supported previous research that paranoia is best represented by a continuum rather than a taxon. In Chapter 4, I discussed the application of the SIA to explain levels of paranoia in the community. Specifically, I proposed that identifying with social groups can buffer people against paranoia that is associated with social stress. In Chapter 5, I examined this suggestion in a general population sample. I investigated whether the relationship between financial stress and paranoia was mediated by self-esteem and whether neighbourhood identification moderated this relationship. I assessed the same relationship in students who moved away from home to attend university, specifically testing the protective value of their current host town identity and their previous hometown identity. My results suggested that strong neighbourhood identification protected people in the general population from paranoia associated with financial stress by furnishing them with self-esteem. The same effect was observed for students when they identified with their new host town but not their previous hometown. Thus, highlighting the importance of identifying with one���s local community in order to mitigate the effects of stress on paranoia. In Chapter 6, I applied the SIA to ethnic minority populations and discussed the role of negative social interactions (negative contact) in contributing to elevated rates of paranoia. Chapter 7 examined the relationship between negative contact with White British people and paranoia in an African-Caribbean sample and whether this relationship was moderated by British identification. Further, I examined whether the relationship was mediated by self-esteem and/or powerful others locus of control (LoC). The interactive relationship between negative contact and British identification on paranoia was mediated by LoC, but not self-esteem. Specifically, I found that increased negative contact predicted higher levels of paranoia through a stronger powerful others LoC, but only when British identification was strong. In Chapter 8, the importance of perceived discrimination as a risk factor for paranoia and the use of implicit identity measures was outlined. Students who were born in England, and of Pakistani heritage, were recruited in Chapter 9. Their explicit and implicit Pakistani and English identities were tested as moderators of the effect of perceived discrimination on paranoia. Participants��� implicit Pakistani identification moderated the relationship between perceived discrimination and paranoia, such that, high levels of perceived discrimination were associated with high levels of paranoia when implicit Pakistani identification was low. Interestingly, these results fit with the results from Chapter 7 where it was found that identifying with the group that was a source of negative contact (British identity) was associated with high levels of paranoia and in Chapter 9, it appears that identifying with the group that was not the source of perceived discrimination (implicit Pakistani identity) protected against paranoia. In Chapter 10, I integrated and summarised the findings of my studies and examined how they build on previous research. Limitations of the studies were detailed, and clinical and policy implications were discussed. I suggested potential avenues for future research examining stressor-identity-paranoia relationships. Overall, my studies suggest that paranoia exists on a continuum, therefore, assessing paranoia in general population samples may inform interventions and preventative treatments for clinical paranoia. The studies highlight the importance of maintaining strong identification with groups that are meaningful and are a source of positivity, particularly identities associated with one���s local community. However, identifying with the majority culture may be harmful when combined with adverse social experiences within that culture. The findings also emphasise the importance of positive majority-minority intergroup relationships in improving community mental health.