Negative cognition, affect, metacognition and dimensions of paranoia in people at ultra-high risk of psychosis: a multi-level modelling analysis

Morrison, A.P. et al. (2015) Negative cognition, affect, metacognition and dimensions of paranoia in people at ultra-high risk of psychosis: a multi-level modelling analysis. Psychological Medicine, 45(12), pp. 2675-2684. (doi: 10.1017/s0033291715000689) (PMID:26165380)

109839.pdf - Accepted Version



Background: Paranoia is one of the commonest symptoms of psychosis but has rarely been studied in a population at risk of developing psychosis. Based on existing theoretical models, including the proposed distinction between ‘poor me’ and ‘bad me’ paranoia, we aimed to test specific predictions about associations between negative cognition, metacognitive beliefs and negative emotions and paranoid ideation and the belief that persecution is deserved (deservedness). Method: We used data from 117 participants from the Early Detection and Intervention Evaluation for people at risk of psychosis (EDIE-2) trial of cognitive–behaviour therapy, comparing them with samples of psychiatric in-patients and healthy students from a previous study. Multi-level modelling was utilized to examine predictors of both paranoia and deservedness, with post-hoc planned comparisons conducted to test whether person-level predictor variables were associated differentially with paranoia or with deservedness. Results: Our sample of at-risk mental state participants was not as paranoid, but reported higher levels of ‘bad-me’ deservedness, compared with psychiatric in-patients. We found several predictors of paranoia and deservedness. Negative beliefs about self were related to deservedness but not paranoia, whereas negative beliefs about others were positively related to paranoia but negatively with deservedness. Both depression and negative metacognitive beliefs about paranoid thinking were specifically related to paranoia but not deservedness. Conclusions: This study provides evidence for the role of negative cognition, metacognition and negative affect in the development of paranoid beliefs, which has implications for psychological interventions and our understanding of psychosis.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Gumley, Professor Andrew
Authors: Morrison, A.P., Shryane, N., Fowler, D., Birchwood, M., Gumley, A.I., Taylor, H.E., French, P., Stewart, S.L.K., Jones, P.B., Lewis, S.W., and Bentall, R.P.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
Journal Name:Psychological Medicine
Publisher:Cambridge University Press
ISSN (Online):1469-8978
Copyright Holders:Copyright © 2015 Cambridge University Press
First Published:First published in Psychological Medicine 45(12):2675-2684
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
423761Early detection and psychological intervention for individuals at high risk of psychosisAndrew GumleyMedical Research Council (MRC)G0500264/73571IHW - MENTAL HEALTH & WELLBEING