TY - JOUR
T1 - Variation in psychosocial influences according to the dimensions and content of children’s unusual experiences
T2 - potential routes for the development of targeted interventions
AU - Ruffell, Tamatha
AU - Azis, Matilda
AU - Hassanali, Nedah
AU - Ames, Catherine
AU - Browning, Sophie
AU - Bracegirdle, Karen
AU - Corrigall, Richard
AU - Laurens, Kristin R.
AU - Hirsch, Colette
AU - Kuipers, Elizabeth
AU - Maddox, Lucy
AU - Jolley, Suzanne
PY - 2015/7/7
Y1 - 2015/7/7
N2 - 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.
AB - 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.
KW - CBT
KW - Cognitive model
KW - Cognitive therapy
KW - Psychosis
KW - Psychotic-like experience (PLE)
UR - http://www.scopus.com/inward/record.url?scp=84936816835&partnerID=8YFLogxK
U2 - 10.1007/s00787-015-0739-8
DO - 10.1007/s00787-015-0739-8
M3 - Article
SN - 1018-8827
VL - 24
SP - 949
EP - 957
JO - European Child and Adolescent Psychiatry
JF - European Child and Adolescent Psychiatry
ER -