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Psychosocial predictors of distressing unusual experiences in adolescence: Testing the fit of an adult cognitive model of psychosis

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Kimberley Gin, Catherine S Stewart, Christopher Abbott, Partha Banerjea, Karen Bracegirdle, Sophie Browning, Majella Byrne, Richard Emsley, Cedric Ginestet, Colette Hirsch, Elizabeth Kuipers, Kristin R. Laurens, Juliana Onwumere, Deborah Plant, Lucia Valmaggia, Suzanne Jolley

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalSchizophrenia Research
Volume237
Early online date27 Aug 2021
DOIs
E-pub ahead of print27 Aug 2021
PublishedNov 2021

Bibliographical note

Funding Information: EK, CH and JO are partly supported by and/or affiliated with the National Institute for Health Research (NIHR) Biomedical Research Centre at the South London and Maudsley National Health Service (NHS) Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NIHR, NHS or the Department of Health and Social Care. Funding Information: This publication presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. KRL is supported by an Australian Research Council Future Fellowship ( FT170100294 ). We thank all participating children, parents, and community CAMHS staff. Publisher Copyright: © 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

Background: For adults with psychosis, international guidelines recommend individual and family based cognitive behavioural therapy interventions. Recommendations are extended to children and adolescents, based on adult research. It is also recommended that psychological interventions are offered for childhood presentations of psychotic-like or Unusual Experiences (UE), in the absence of a formal diagnosis, when these are Distressing (UEDs). Cognitive models underpinning these interventions require testing in adolescent populations, to further refine therapies. We address this need, by testing for the first time, the application of the adult cognitive model of psychosis to adolescent UEDs. Methods: We used baseline data from the Coping with Unusual ExperienceS (CUES+) randomised controlled trial for 122 clinically referred adolescents (12–18 years) with self-reported UEDs. Known psychological mechanisms of adult cognitive models of psychosis; negative life events, affect (anxiety and depression), reasoning (jumping to conclusions bias), and schemas were investigated using multiple linear regression models, alongside variables particularly associated with the development and severity of adolescent UEDs and UE type (dissociation, externalising/behavioural problems, managing emotions). Results: The psychological mechanisms of adult cognitive models of psychosis explained 89% of the total variance of adolescent UED severity, F (10, 106) = 99.34, p < .0005, r 2 = 0.89, with schemas as the principal significant contributor. Variance explained 40 - 72% across each of the UE types (paranoia, hallucinations, delusions, paranormal thinking and grandiosity). Conclusions: Findings suggest that the psychological components of adult cognitive models of psychosis, particularly schemas, are also implicated in adolescent UEDs.

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