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Variation in psychosocial influences according to the dimensions and content of children's unusual experiences: potential routes for the development of targeted interventions
Ruffell, Tamatha Azis, Matilda Hassanali, Nedah Ames, Catherine Browning, Sophie Bracegirdle, Karen Corrigall, Richard Laurens, Kristin Hirsch, Colette Kuipers, Elizabeth
Ruffell, Tamatha
Azis, Matilda
Hassanali, Nedah
Ames, Catherine
Browning, Sophie
Bracegirdle, Karen
Corrigall, Richard
Laurens, Kristin
Hirsch, Colette
Kuipers, Elizabeth
Abstract
Abstract The psychosocial processes implicated in the development and maintenance of psychosis differ according to both the dimensional attributes (conviction, frequency, associated distress, adverse life impact) and the content or type (e.g. grandiosity, hallucinations, paranoia) of the psychotic symptoms experienced. This has informed the development of ‘targeted’ cognitive behavioural therapy for psychosis (CBTp): interventions focusing on specific psychological processes in the context of particular symptom presentations. In adults, larger effect sizes for change in primary outcomes are typically reported in trials of targeted interventions, compared to those for trials of generic CBTp approaches with multiple therapeutic foci. We set out to test the theoretical basis for developing targeted CBTp interventions for young people with distressing psychotic-like, or unusual, experiences (UEs). We investigated variations in the psychosocial processes previously associated with self-reported UE severity (reasoning, negative life events, emotional problems) according to UE dimensional attributes and content/type (using an established five-factor model) in a clinically referred sample of 72 young people aged 8–14 years. Regression analyses revealed associations of conviction and grandiosity with reasoning, of frequency, and hallucinations and paranoia, with negative life events, and of distress/adverse life impact, and paranoia and hallucinations, with emotional problems. We conclude that psychological targets for intervention differ according to particular characteristics of childhood UEs in much the same way as for psychotic symptoms in adults. The development of targeted interventions is therefore indicated, and tailoring therapy according to presentation should further improve clinical outcomes for these young people.
Keywords
psychotic-like experience (PLE), cognitive Model, psychosis, cognitive therapy, CBT
Date
2016
Type
Journal article
Journal
European Child and Adolescent Psychiatry
Book
Volume
25
Issue
3
Page Range
311-319
Article Number
ACU Department
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled