The relationship between acceptance and commitment therapy processes and psychotic symptoms

Abstract

Psychosis describes a range of experiences including delusional beliefs, hallucinations, disorganised thinking, and negative symptoms. These experiences have been documented to exist on a continuum in the general population. Worry and insomnia are two predictors which have been found to be associated with paranoia and persecutory delusions. Traditionally, Cognitive Behavioural Therapy for Psychosis has been considered the gold standard psychological treatment for psychosis, however, there is preliminary evidence of the use of Acceptance and Commitment Therapy as an intervention for psychosis which targets psychological inflexibility (PI) processes. It is therefore important to understand how PI contributes to the risk, and maintenance, of these experiences. Chapter 1 is a systematic review and meta-analysis which investigates the relationship between PI and other ACT processes with psychosis or psychosis-like symptoms. 32 studies report a relationship between PI or ACT processes and psychosis symptoms and were included in the review. A series of meta-analyses revealed significant associations between PI and paranoia, delusions, and auditory hallucinations. Significant group differences (psychosis vs controls) in PI were found and Cognitive fusion (CF) (a specific component of PI) was significantly associated with paranoia. Additional studies not included in the meta-analyses are reported. Chapter 2 reports a three-wave longitudinal questionnaire-based study to examine whether CF, experiential avoidance (EA) and metacognitive beliefs mediated the relationship between worry and paranoia and worry and insomnia. Case-control analysis identified that a clinical sample (n = 130) were higher in all study variables than a non-clinical sample (n = 24). CF independently mediated the relationship between worry and paranoia and serially in combination with EA. Metacognitive beliefs did not a significantly mediate this relationship and none of the variables mediated the relationship between worry and insomnia. This study adds to the literature on the risk factors associated with psychosis or psychosis-like symptoms. Keywords: Acceptance and Commitment Therapy; Psychological Inflexibility; Psychosis; Paranoia

More information

Identifiers

ORCID for James Andrew Pittman: orcid.org/0009-0008-3195-1649

ORCID for Thomas Richardson: orcid.org/0000-0002-5357-4281

ORCID for Emma Palmer-Cooper: orcid.org/0000-0002-5416-1518

Catalogue record

Export record