Helping patients with paranoid and suspicious thoughts: a cognitive–behavioural approach

Freeman, Daniel; Garety, Philippa

doi:10.1192/apt.12.6.404

Cited by 55 publications

(36 citation statements)

References 45 publications

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“…The intervention itself is evolving, becoming more theoretically driven, targeted and problem focused (e.g. Trower et al 2004; Freeman et al 2008; Foster et al 2010; Freeman, 2011; Hepworth et al 2011; Myers et al 2011; Ross et al 2011). These findings indicate further that it is likely that techniques for encouraging more adaptive illness beliefs should be incorporated into therapy (e.g.…”

Section: Discussionmentioning

confidence: 99%

Patients' beliefs about the causes, persistence and control of psychotic experiences predict take-up of effective cognitive behaviour therapy for psychosis

et al. 2012

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BackgroundThere is evidence that patients with schizophrenia benefit from standard cognitive behaviour therapy (CBT) only if active techniques are used (‘full therapy’). By contrast, attending sessions but not proceeding beyond engagement and assessment strategies (‘partial therapy’), or simply not attending sessions (‘no therapy’), is not associated with better outcomes. The factors leading to full therapy are unknown. We hypothesized that patients' initial ideas about the nature and extent of their problems would predict use of CBT. A match between patients' views of their problems and the principles underlying treatment would lead to better outcomes.MethodNinety-two patients with a recent relapse of psychosis completed the Illness Perception Questionnaire (IPQ) before receiving CBT. We examined whether their illness perceptions predicted the take-up of therapy.ResultsPatients who did not attend sessions believed their problems would not last as long as those who attended them. Those who attended sessions but did not proceed to full therapy had a lower sense of control over their problems and a more biological view of their causes. Patients who took up full therapy were more likely to attribute the cause of their problems to their personality and state of mind. The take-up of therapy was predicted neither by levels of psychiatric symptoms nor by insight.ConclusionsPeople with psychosis who have psychologically orientated views of their problems, including the potential to gain control over them, may be more likely to engage fully and do well with standard CBT for psychosis, irrespective of the severity of their problems.

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Section: Discussionmentioning

confidence: 99%

Patients' beliefs about the causes, persistence and control of psychotic experiences predict take-up of effective cognitive behaviour therapy for psychosis

et al. 2012

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“…Paranoia can be conceptualized as a type of anxious fear. The clinical implication is that approaches used to treat anxiety disorders, suitably modified, will also be of benefit to people with paranoia (Freeman et al 2006). This is an emerging research strategy that focuses on experiences such as paranoid thoughts, not on diagnoses such as schizophrenia, and treats problems as on a continuum of severity in the population.…”

Section: Discussionmentioning

confidence: 99%

What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation

et al. 2008

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BackgroundIn recent years a close association between anxiety and persecutory ideation has been established, contrary to the traditional division of neurosis and psychosis. Nonetheless, the two experiences are distinct. The aim of this study was to identify factors that distinguish the occurrence of social anxiety and paranoid thoughts in an experimental situation.MethodTwo hundred non-clinical individuals broadly representative of the UK general population were assessed on a range of psychological factors, experienced a neutral virtual reality social environment, and then completed state measures of paranoia and social anxiety. Clustered bivariate logistic regressions were carried out, testing interactions between potential predictors and the type of reaction in virtual reality.ResultsThe strongest finding was that the presence of perceptual anomalies increased the risk of paranoid reactions but decreased the risk of social anxiety. Anxiety, depression, worry and interpersonal sensitivity all had similar associations with paranoia and social anxiety.ConclusionsThe study shows that social anxiety and persecutory ideation share many of the same predictive factors. Non-clinical paranoia may be a type of anxious fear. However, perceptual anomalies are a distinct predictor of paranoia. In the context of an individual feeling anxious, the occurrence of odd internal feelings in social situations may lead to delusional ideas through a sense of ‘things not seeming right’. The study illustrates the approach of focusing on experiences such as paranoid thinking rather than diagnoses such as schizophrenia.

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“…Their impact on patient behaviour and social cognition are well documented (Martin & Penn , Freeman et al . , Freeman & Garety ). To date, most authors have focused on the theoretical frameworks (e.g.…”

Section: Introductionmentioning

confidence: 97%

Caring for a relative with delusional beliefs: a qualitative exploration

Onwumere

Learmonth

Kuipers

2016

Psychiatric Ment Health Nurs

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Background In recent years, there has been a gradual shift towards the study of individual symptom presentations in psychosis, this is particularly found in studies of delusional beliefs. However, the literature remains sparse on informal caregiver experiences of individual symptoms. Aim The study sought to investigate carer experiences of supporting a relative with delusional beliefs, which involve family members. Methods Semi-structured interviews were undertaken with five caregivers and subject to interpretative phenomenological analysis. Results Interviews yielded six superordinate themes highlighting issues concerning a carer's exposure to symptoms of illness; lack of understanding about their relatives' delusional beliefs; concerns over coming to harm from their relative: efforts made by the carer to conceal their relative's delusional beliefs and their consequences; fractured relationships, and a long process of learning how to best cope. Conclusion Caring for a relative with psychosis who experiences delusional beliefs about the carer and family members can be challenging. The results underscore the importance of providing a programme of support to meet the varied needs of informal carers with an explicit aim of assisting carers in their day-to-day problem solving. It should also help to address issues carers may have about causality, including beliefs about self-blame, and identifying effective coping strategies.

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Helping patients with paranoid and suspicious thoughts: a cognitive–behavioural approach

Cited by 55 publications

References 45 publications

Patients' beliefs about the causes, persistence and control of psychotic experiences predict take-up of effective cognitive behaviour therapy for psychosis

Patients' beliefs about the causes, persistence and control of psychotic experiences predict take-up of effective cognitive behaviour therapy for psychosis

What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation

Caring for a relative with delusional beliefs: a qualitative exploration

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