Individual response determines psychosis impact
By Eleanor McDermid, Senior medwireNews Reporter
30 July 2013
Schizophr Bull 2013; Advance online publication

medwireNews: People who have persistent psychotic experiences but do not require medical care cope by normalizing their experiences, research suggests.

When exposed to experimental set-ups that mimicked symptoms of psychosis, these people largely attributed the incident to a planned part of the study or to normal human experience, report Emmanuelle Peters (Kings College London, UK) and colleagues.

Although many psychosis patients who required care also had these reactions, they were far more likely than the group not requiring care to endorse maladaptive explanations, such as irrational causes, a conspiracy theory, or believing themselves to be at fault.

The experimental set-ups involved a card trick designed to give the impression that a computer can read the participant’s mind, and the Virtual Acoustic Space Paradigm – an experience in which participants hear a sound originating outside their head, despite it being presented through headphones, ie, mimicking auditory hallucinations.

Thirty-four of the study participants were not receiving care for psychosis, despite having experienced symptoms for at least 2 years, and scoring as highly on the Appraisals of Anomalous Experiences Inventory as the 28 participants who required care.

Participants receiving care found the card trick to be significantly more striking, distressing, and threatening than those not receiving care. One of them had seen the trick before; of the others, none guessed how it was done, whereas 18% of patients not receiving care guessed the trick.

By contrast, participants receiving care did not find the auditory hallucination experience any more distressing or threatening than did those not requiring care, and over a third of both groups realized how it was achieved. Yet participants receiving care were significantly more likely to endorse a maladaptive response to the situation.

The team notes that the group not requiring care had a higher IQ than the other group, “intimating that IQ may be a significant factor in how individuals appraise their experiences.”

All participants were asked to judge how they would respond should the experiences recur in their everyday lives. Those not receiving care were significantly more likely than those requiring care to endorse an adaptive, decentering response style, either attempting to devise a rational explanation for events or letting them pass without involvement. By contrast, participants requiring care endorsed maladaptive responses, such as avoidance or distraction, or rumination.

The findings provide “some support for psychological interventions that target maladaptive appraisals (eg, self-denigrating and conspiratorial appraisals) and unhelpful modes of responding (such as rumination),” write Peters et al in Schizophrenia Bulletin.

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

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