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AIM: This study investigated the impact of an 8-month daily-guided intensive meditation-based intervention (iMI) on persistent hallucinations/delusions and health-related quality of life (QoL) in male inpatients with schizophrenia with treatment-refractory hallucinations and delusions (TRHDs). METHODS: A randomized controlled trial assigned 64 male inpatients with schizophrenia and TRHD equally to an 8-month iMI plus general rehabilitation program (GRP) or GRP alone. Assessments were conducted at baseline and the third and eighth months using the Positive and Negative Syndrome Scale (PANSS), 36-Item Short Form-36 (SF-36), and Five Facet Mindfulness Questionnaire (FFMQ). Primary outcomes measured PANSS reduction rates for total score, positive symptoms, and hallucinations/delusions items. Secondary outcomes assessed PANSS, SF-36, and FFMQ scores for psychotic symptoms, health-related QoL, and mindfulness skills, respectively. RESULTS: In the primary outcome, iMI significantly improved the reduction rates of PANSS total score, positive symptoms, and hallucination/delusion items compared with GRP at both the third and eighth months. Treatment response rates (≥25% reduction) for these measures significantly increased in the iMI group at the eighth month. Concerning secondary outcomes, iMI significantly reduced PANSS total score and hallucination/delusion items, while increasing scores in physical activity and mindfulness skills at both the third and eighth months compared with GRP. These effects were more pronounced with an 8-month intervention compared with a 3-month intervention. CONCLUSIONS: An iMI benefits patients with TRHDs by reducing persistent hallucinations/delusions and enhancing health-related QoL. Longer iMI duration yields superior treatment outcomes.
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Meditación , Esquizofrenia , Humanos , Masculino , Esquizofrenia/complicaciones , Esquizofrenia/terapia , Deluciones/terapia , Calidad de Vida , Pacientes Internos , Alucinaciones/etiología , Alucinaciones/terapiaRESUMEN
OBJECTIVES: To examine the feasibility and acceptability of a novel telehealth (video-conferencing software and telephone calls) imagery-based therapeutic intervention for people experiencing persecutory delusions. Utilising a multiple baseline case series design and exploring imagery-focused therapy for psychosis (iMAPS). DESIGN: A non-concurrent A-B multiple baseline design was used. METHODS: Participants experiencing persecutory delusions and self-reporting a psychosis or schizophrenia-spectrum diagnosis were recruited through online adverts. On completion of assessments, participants were randomly assigned to multiple baseline assessments, of between three and five sessions. Six therapy sessions followed, consisting of imagery formulation, safe-place imagery creation, compassionate imagery, imagery manipulation and rescripting. Participants completed pre- and post-measures and sessional measures via an online survey software or in semi-structured interviews. Two weeks post-intervention, a final measure was completed exploring any potential adverse effects of psychotherapy. RESULTS: Five female participants completed all baseline and therapeutic sessions, suggesting the therapy was and mode of delivery was feasible and acceptable. Results indicate strong effect sizes across PANSS positive subscale and mood, as well as participants reporting a clinically significant change in at least one measure, for example, PSYRATS. All participants reported a reduction in the realness and compelling nature of distressing imagery. CONCLUSIONS: Results suggest delivering a telehealth imagery-focused therapy is acceptable and feasibly delivered via telehealth. A control group and blinding of assessments would strengthen the methodological limitations present.
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Trastornos Psicóticos , Esquizofrenia , Telemedicina , Humanos , Femenino , Imágenes en Psicoterapia , Trastornos Psicóticos/terapia , Esquizofrenia/terapia , Deluciones/terapiaRESUMEN
Occasionally, a solution or idea arrives as a sudden understanding - an insight. Insight has been considered an "extra" ingredient of creative thinking and problem-solving. Here we propose that insight is central in seemingly distinct areas of research. Drawing on literature from a variety of fields, we show that besides being commonly studied in problem-solving literature, insight is also a core component in psychotherapy and meditation, a key process underlying the emergence of delusions in schizophrenia, and a factor in the therapeutic effects of psychedelics. In each case, we discuss the event of insight and its prerequisites and consequences. We review evidence for the commonalities and differences between the fields and discuss their relevance for capturing the essence of the insight phenomenon. The goal of this integrative review is to bridge the gap between the different views and inspire interdisciplinary research efforts for understanding this central process of human cognition.
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Alucinógenos , Meditación , Humanos , Deluciones/terapia , Solución de Problemas , PsicoterapiaRESUMEN
BACKGROUND: Negative beliefs about the self, including low self-compassion, have been identified as a putative causal factor in the occurrence of paranoia. Therefore, improving self-compassion may be one route to reduce paranoia. AIMS: To assess the feasibility, acceptability, and potential clinical effects of a brief compassionate imagery intervention for patients with persecutory delusions. METHOD: Twelve patients with persecutory delusions received an individual four-session compassionate imagery intervention. Assessments of self-concept and paranoia were completed before treatment, immediately after treatment, and at 1-month follow-up. A qualitative study exploring participants' experiences of the treatment was also completed. RESULTS: Twelve out of 14 eligible patients referred to the study agreed to take part. All participants completed all therapy sessions and assessments. Post-treatment, there were improvements in self-compassion (change score -0.64, 95% CI -1.04, -0.24, d = -1.78), negative beliefs about the self (change score 2.42, 95% CI -0.37, 5.20, d = 0.51), and paranoia (change score 10.08, 95% CI 3.47, 16.69, d = 0.61). There were no serious adverse events. Three themes emerged from the qualitative analysis: 'effortful learning', 'seeing change' and 'taking it forward'. Participants described a process of active and effortful engagement in therapy which was rewarded with positive changes, including feeling calmer, gaining clarity, and developing acceptance. CONCLUSION: This uncontrolled feasibility study indicates that a brief compassionate imagery intervention for patients with persecutory delusions is feasible, acceptable, and may lead to clinical benefits.
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Deluciones , Autocompasión , Deluciones/terapia , Empatía , Humanos , Imágenes en Psicoterapia , Trastornos Paranoides/terapiaAsunto(s)
Atención Plena , Trastornos Psicóticos , Deluciones/terapia , Humanos , Trastornos Paranoides , Proyectos PilotoRESUMEN
BACKGROUND: Many people with psychosis experience persecutory delusions and report negative schematic beliefs and intrusive mental images which may be maintaining factors for psychotic symptoms. AIMS: This study examined the feasibility and acceptability of a new psychological therapy targeting schemas and images (iMAPS therapy). METHOD: The study used a randomised multiple baseline design. Participants with first episode psychosis were randomised using a multiple baseline design with 2-5 assessments. Six sessions of therapy, consisting of a combination of imagery techniques and imagery rescripting techniques, was used. In each session, participants completed a Mental Imagery in Psychosis Questionnaire (MIPQ) and imagery interview. Mood and delusional beliefs (PSYRATS) were also measured at each session. RESULTS: Five participants with first episode psychosis completed the baseline visits and attended all therapy sessions. One participant declined the final assessment. Results demonstrated significant reductions in negative schematic beliefs, delusions, imagery distress and other measures of schema (YSQ, SMI). Although multiple baseline randomisation strengthens the study, it lacked a control arm and blind assessments. CONCLUSIONS: iMAPS appears a feasible and acceptable treatment for psychosis, and further evaluation is indicated.
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Deluciones , Imágenes en Psicoterapia , Trastornos Psicóticos , Deluciones/terapia , Humanos , Trastornos Psicóticos/terapia , Proyectos de InvestigaciónRESUMEN
BACKGROUND: We present the application of cognitive-behavioural therapy in a clinical case diagnosed with delusional dysmorphophobia. METHOD: The psychometric scales used for evaluation were the Positive and Negative Syndrome Scale for Schizophrenia, Beck Anxiety and Depression inventories, the Rosenberg Self-Esteem Scale along with the degree of conviction in the delusional belief and in alternative explanations, and social functioning measured by patient reporting. The therapy included cognitive and behavioural techniques: evidence analysis, search for alternative explanations, logical and functional analysis, reality testing, progressive relaxation techniques, in vivo and imaginal exposure therapy. Evaluations were performed before and after the treatment and then at follow-up after 12 and 24 months. RESULTS: Progressively, the delusional conviction disappeared. There were significant improvements at an emotional level and the patient recovered social and work functioning. CONCLUSIONS: The need to use psychological treatments for people with delusional disorder as first choice treatment must be considered.
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Trastorno Dismórfico Corporal/terapia , Terapia Cognitivo-Conductual/métodos , Deluciones/terapia , Adulto , Anemia Ferropénica/tratamiento farmacológico , Trastorno Dismórfico Corporal/psicología , Cultura , Deluciones/etiología , Depresión/etiología , Edema/inducido químicamente , Femenino , Humanos , Pruebas Psicológicas , Prueba de Realidad , Desempeño de Papel , AutoimagenRESUMEN
BACKGROUND: There is limited research on the applicability and effectiveness of Acceptance and Commitment Therapy (ACT) for people experiencing psychotic disorders. Clinical trials suggest ACT may be efficacious in reducing distress and rehospitalization rates in psychosis. Mindfulness and reduced literal believability of thought content have been associated with reduced distress for this population. AIMS: To better understand ACT for psychosis, this study investigated clients' perspectives of the hypothesized active therapeutic processes of ACT. METHOD: Semistructured interviews, conducted with nine adults diagnosed with schizophrenia or schizoaffective disorder and persistent positive symptoms, were analysed thematically. RESULTS: Four themes emerged: Usefulness of therapy; Changes attributed to ACT; Understanding of therapy; and Non-specific therapy factors. All participants found therapy useful and recommended ACT. Mindfulness, defusion, acceptance and values work were described as the most useful therapy components and contributing to positive changes. Self-rated frequency of symptoms did not change; however a reduction in the intensity and distress associated with symptoms was reported. Non-specific therapy factors were deemed useful by participants but not directly related to outcome. CONCLUSIONS: These findings are consistent with the theoretically defined underlying active processes of ACT and are relevant for this population. The findings also indicate important clinical implications for ACT for this client group: greater attention to the client connecting metaphors and concepts to the intended meaning may be valuable; caution should be used with some mindfulness and defusion techniques for intense experiences; and values work may be particularly useful for this population.
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Terapia de Aceptación y Compromiso/métodos , Aceptación de la Atención de Salud/psicología , Satisfacción del Paciente , Esquizofrenia/terapia , Psicología del Esquizofrénico , Adaptación Psicológica , Adulto , Deluciones/diagnóstico , Deluciones/psicología , Deluciones/terapia , Autoevaluación Diagnóstica , Emociones , Femenino , Alucinaciones/diagnóstico , Alucinaciones/psicología , Alucinaciones/terapia , Humanos , Entrevista Psicológica , Masculino , Escalas de Valoración Psiquiátrica , Procesos Psicoterapéuticos , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Trastornos Psicóticos/terapia , Investigación Cualitativa , PensamientoRESUMEN
With the aim to study neurophysiologic correlates and to search for some possible predictors of therapeutic response correlation analysis has been carried out of links between temporal parameters of components of auditory event-related potentials (AERPs) and dynamics of quantitative clinical assessments of mental state conditions in two groups of patients--with depressive-delusional conditions (group 1) and with manic-delusional conditions (group 2) in the frames of attack-like schizophrenia. Statistically significant correlations have been revealed between values of peak latencies of main AERPs components and severity of psychopathologic symptoms before beginning of treatment course, as well as between initial (before treatment course) AERPs temporal parameters and quantitative clinical assessments at the stage of remission establishment. Larger severity of residual positive, negative and common psychopathologic symptoms of schizophrenia (and also of depression and anxiety in group 1) after course of treatment was associated with smaller initial (before treatment course) values of peak latencies of "early" (P1 and N1) and with larger initial values of "late" (P2, N2 and P3) AERPs components in both groups of patients. The data obtained allow to justify basic views on brain mechanisms of affective-delusional disorders, and to reveal possible neurophysiologic predictors of treatment efficacy in such disorders.
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Trastornos Psicóticos Afectivos/fisiopatología , Trastornos Psicóticos Afectivos/terapia , Trastorno Bipolar/fisiopatología , Trastorno Bipolar/terapia , Deluciones/fisiopatología , Deluciones/terapia , Potenciales Evocados Auditivos , Estimulación Acústica , Adulto , Trastornos Psicóticos Afectivos/psicología , Trastorno Bipolar/psicología , Interpretación Estadística de Datos , Deluciones/psicología , Femenino , Humanos , Persona de Mediana Edad , Pruebas Neuropsicológicas , Estimulación Luminosa , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
Religious beliefs can lead to difficulties in psychiatric diagnosis, when it comes to distinguishing between faith and delusion. Delusion is defined as a false assessment of reality combined with subjective certainty, which is in contrast with the reality of the social environment. The problem with this definition is that reality cannot be examined with scientific methods/criteria and that the assessment of reality itself underlies historical and cultural fluctuations. The current diagnostic manuals for psychiatric disorders DSM 5 and ICD-10 require, that the content of the belief has to be inadequate even in the subculture of the patient (ICD-10) and that the cultural and socioeconomic background of the patient has to be taken into account (DSM 5). On the basis of this case-report and of selected publications on this topic we want to discuss this diagnostic problem. After that we present a diagnostic model for delusion, which is easy to handle in the daily routine of psychiatrists.
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Catolicismo/psicología , Deluciones/diagnóstico , Deluciones/psicología , Religión y Psicología , Religión , Espiritualidad , Adulto , Austria , Internamiento Obligatorio del Enfermo Mental , Características Culturales , Deluciones/terapia , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Clasificación Internacional de Enfermedades , Masculino , Psicoterapia , Prueba de Realidad , Medio Social , Factores Socioeconómicos , Posesión Espiritual , Adulto JovenRESUMEN
Many schizophrenia patients seek hypnosis when they have not improved with psychopharmacological therapy. However, there has been controversy regarding the use and effectiveness of hypnosis in schizophrenia. Hypnotherapeutic methods such as direct and indirect suggestions, psycho-strengthening suggestions and imagery, hypnoprojective restructuring, guidance, and neutralization of affect associated with delusions have been effective in selected highly hypnotizable patients. Details of the hypnotherapeutic structure and strategy used for managing delusions in schizophrenia are presented with representative cases.
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Hipnosis , Trastornos Psicóticos/terapia , Esquizofrenia/terapia , Psicología del Esquizofrénico , Adulto , Afecto , Antipsicóticos/efectos adversos , Antipsicóticos/uso terapéutico , Terapia Combinada , Deluciones/diagnóstico , Deluciones/psicología , Deluciones/terapia , Femenino , Alucinaciones/diagnóstico , Alucinaciones/psicología , Alucinaciones/terapia , Humanos , Imaginación , Masculino , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Esquizofrenia/diagnóstico , Sugestión , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Emerging evidence suggests that mindfulness can be beneficial for people with distressing psychosis. This study examined the hypothesis that for people with persecutory delusions in the absence of voices, mindfulness training would lead to reductions in conviction, distress, preoccupation and impact of paranoid beliefs, as well as anxiety and depression. METHOD: Two case studies are presented. Participants completed measures of mindfulness, anxiety and depression at baseline, end of therapy and 1 month follow-up, and bi-weekly ratings of their paranoid belief on the dimensions of conviction, preoccupation, distress and impact. RESULTS: Ratings of conviction, distress, impact and preoccupation, and measures of anxiety and depression, reduced for both participants from baseline to end of intervention. Improvements in mindfulness of distressing thoughts and images occurred for both participants. These gains were maintained at 1 month follow-up. CONCLUSIONS: Findings suggest that mindfulness training can impact on cognition and affect specifically associated with paranoid beliefs, and is potentially relevant to both Poor Me and Bad Me paranoia.
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Concienciación , Terapia Cognitivo-Conductual/métodos , Cultura , Meditación/psicología , Trastornos Paranoides/terapia , Adulto , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/psicología , Trastornos de Ansiedad/terapia , Deluciones/diagnóstico , Deluciones/psicología , Deluciones/terapia , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Trastorno Depresivo/terapia , Estudios de Seguimiento , Humanos , Masculino , Meditación/métodos , Persona de Mediana Edad , Trastornos Paranoides/diagnóstico , Trastornos Paranoides/psicología , Encuestas y CuestionariosRESUMEN
Although the psychogenetic hypotheses on child autism have been superseded, psychoanalysis can still reflect on the relational exchange and its sensory aspects in concomitance with the mental development of these patients. Without making generalizations as regards the pathogenesis, but considering the specific features of each autistic child, it may be possible to achieve an integration of those islands of competence that make up these patients' limited personal heritage. Such integration may be reached through the analysis of representational, emotional and relational transformations. The first part of this article describes the case of an autistic child in treatment from the age of four on a four-times-weekly basis who, during puberty, developed severe formal thought disorders together with delusional and hallucinatory formations. The second part develops some post-Jungian theoretical contributions, such as the concept of self as nothingness and the idea of the unsaturated archetype, so as to evaluate the function of some a-priori concepts in support of the analyst's position. These concepts are considered in relation to Bion's model of transformation, and to the formulations on dimensional awareness, especially on the shift from a two-dimensionality to three-dimensionality view, as well as to the rhythm of the object's presence and absence.
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Trastorno Autístico/psicología , Deluciones/psicología , Ego , Desarrollo de la Personalidad , Teoría Psicoanalítica , Pubertad/psicología , Adolescente , Arteterapia , Trastorno Autístico/terapia , Niño , Preescolar , Comunicación , Conducta Cooperativa , Deluciones/terapia , Emociones , Alucinaciones/psicología , Alucinaciones/terapia , Humanos , Trastornos del Desarrollo del Lenguaje/psicología , Trastornos del Desarrollo del Lenguaje/terapia , Cuidados a Largo Plazo , Masculino , Apego a Objetos , Responsabilidad Parental/psicología , Grupo de Atención al Paciente , Relaciones Profesional-Familia , Interpretación Psicoanalítica , SimbolismoRESUMEN
INTRODUCTION: Mirrored-self misidentification is the delusional belief that one's reflection in the mirror is a stranger. Current theories suggest that one pathway to the delusion is mirror agnosia (a deficit in which patients are unable to use mirror knowledge when interacting with mirrors). This study examined whether a hypnotic suggestion for mirror agnosia can recreate features of the delusion. METHOD: Ten high hypnotisable participants were given either a suggestion to not understand mirrors or to see the mirror as a window. Participants were asked to look into a mirror and describe what they saw. Participants were tested on their understanding of mirrors and received a series of challenges. Participants then received a detailed postexperimental inquiry. RESULTS: Three of five participants given the suggestion to not understand mirrors reported seeing a stranger and maintained this belief when challenged. These participants also showed signs of mirror agnosia. No participants given the suggestion to see a window reported seeing a stranger. CONCLUSION: Results indicate that a hypnotic suggestion for mirror agnosia can be used to recreate the mirrored-self misidentification delusion. Factors influencing the effectiveness of hypnotic analogues of psychopathology, such as participants' expectations and interpretations, are discussed.
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Agnosia/terapia , Deluciones/terapia , Hipnosis/métodos , Autoimagen , Sugestión , Adolescente , Adulto , Agnosia/psicología , Deluciones/psicología , Femenino , Humanos , Masculino , Resultado del TratamientoRESUMEN
BACKGROUND: There are already several existing studies that show the effectiveness of mindfulness-based approaches in varying types of disorders. Only a few studies, however, have analyzed the effectiveness of this intervention in psychosis, and without finding, up to now, significant differences from the control group. AIMS: The aim of this study is two-fold: to replicate previous studies, and to focus on analyzing the feasibility and effectiveness of applying mindfulness in a group of people with psychosis. METHOD: Eighteen patients with psychosis were randomly assigned to experimental and control groups. The experimental group received eight 1-hour sessions of Mindfulness-Based Cognitive Therapy (MBCT), while the control group was relegated to a waiting list to receive MBCT therapy. RESULTS: The experimental group scored significantly higher than the control group in their ability to respond mindfully to stressful internal events. CONCLUSIONS: Both the usefulness and effectiveness of implementing a mindfulness-based program have been replicated in a controlled manner in patients with psychosis.
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Concienciación , Terapia Cognitivo-Conductual/métodos , Deluciones/terapia , Meditación/métodos , Psicoterapia de Grupo/métodos , Trastornos Psicóticos/terapia , Esquizofrenia/terapia , Psicología del Esquizofrénico , Adaptación Psicológica , Adulto , Mecanismos de Defensa , Deluciones/diagnóstico , Deluciones/psicología , Femenino , Humanos , Control Interno-Externo , Masculino , Meditación/psicología , Escalas de Valoración Psiquiátrica , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Esquizofrenia/diagnósticoRESUMEN
Erotomania is the delusional belief that one is loved from afar by another person (the target). This study used hypnosis as a novel cognitive neuropsychological research tool to model erotomania. The authors developed 2 versions of a hypnotic erotomania suggestion and tested their impact by asking subjects to recall and interpret a story featuring ambiguous scenarios. They also challenged the delusion by asking subjects to justify their beliefs. The hypnotic erotomania suggestions successfully recreated the features of the clinical delusion for many high hypnotizable subjects. They believed that the target loved them, interpreted ambiguous information consistent with this belief and confabulated evidence in service of their delusion. Some also resisted all challenges to their delusion. These features are strikingly similar to clinical cases and highlight the value of using hypnosis to model clinical delusions. The authors also discuss some limitations of this approach.
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Deluciones/terapia , Hipnosis , Deluciones/psicología , Femenino , Humanos , Amor , Masculino , Modelos Psicológicos , Resultado del Tratamiento , Adulto JovenRESUMEN
Persecutory ideation is one of the most commonly reported psychiatric symptoms in individuals with schizophrenia and is associated with significant patient distress and impairment. Therefore, much attention has recently been devoted to theoretical explanations of persecutory ideation that can help inform and guide patient care. A cognitive model of persecutory ideation suggests that individuals with psychosis who experience anxiety along with other stressors are at increased risk for developing intense "threat" or persecutory beliefs. Correlational studies have found evidence for this proposed link between anxiety levels and the persistence, distress levels, and degree of conviction associated with persecutory ideation. Importantly, recent research has found support for a possible prospective/causal role for anxiety in the generation and maintenance of paranoid beliefs. Existing interventions for persecutory ideation consist of pharmacological treatments that have variable efficacy and often entail serious side-effects, and cognitive behavioral treatments (CBT) that target persecutory thoughts, but are often unavailable, require high level of clinician expertise, and may be difficult to conduct with patients who are cognitively impaired or apprehensive about openly exploring their paranoid beliefs. Given the empirical support for a prospective relationship between anxiety and persecutory ideation, it is reasonable to predict that clinicians could impact persecutory ideations indirectly by making good use of existing evidence-based interventions for anxiety. Progressive Muscle Relaxation (PMR) is an effective method for reducing physiological arousal and treating various anxiety disorders, and has been shown to be feasible with patients with psychosis. We offer that exportability and ease of use makes PMR a promising intervention for mental health practitioners to target anxiety precipitating persecutory ideation. We hypothesize that PMR could be used to help ameliorate anxiety in patients who are at risk or already experiencing persecutory ideation, subsequently reducing the frequency, level of conviction, and distress associated with persecutory thoughts. Our hypothesis could be tested through feasibility and randomized control trials of PMR for treatment of persecutory ideation in individuals with schizophrenia. We expect the relationship between PMR and persecutory ideation will be mediated by reduction in anxiety. Potential advantages of examining our hypothesis include identifying a viable, efficacious, cost-effective novel intervention for paranoia in patients with psychosis. In addition, PMR could be easily facilitated by practitioners with varying levels of training and integrated with other existing interventions for persecutory ideation.
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Ansiedad/terapia , Deluciones/terapia , Relajación Muscular/fisiología , Trastornos Paranoides/terapia , Terapia por Relajación/métodos , Esquizofrenia/complicaciones , Deluciones/etiología , Humanos , Trastornos Paranoides/etiologíaRESUMEN
BACKGROUND: This paper provides a systematic review of selected experimental studies of the effectiveness of psychosocial treatments in reducing psychological symptoms in dementia (e.g. anxiety, depression, irritability and social withdrawal). METHOD: English language reports published or in press by February 2008 were identified by means of database searches and checks of previous reviews. Reports were appraised with respect to study design, participants' characteristics and reporting details. Because people with dementia often respond positively to personal contact, studies were included only if control conditions entailed similar levels of social attention or if one treatment was compared with another. RESULTS: Only 12 of 48 relevant papers met every specification. Treatments proved more effective in reducing psychological symptoms than an attention control condition or another treatment in only six of the 12 selected studies. Interventions with moderate effect sizes included music and recreation therapy. CONCLUSIONS: Some psychosocial interventions appear to have specific therapeutic properties, over and above those due to the benefits of participating in a clinical trial. Their effects were generally modest with an unknown duration of action. This limited efficacy suggests that treatments will work best in specific, time-limited situations, tailored to individuals' requirements. There is no preferred method to rate psychological symptoms.
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Enfermedad de Alzheimer/terapia , Ansiedad/terapia , Deluciones/terapia , Depresión/terapia , Alucinaciones/terapia , Genio Irritable , Aislamiento Social , Anciano , Enfermedad de Alzheimer/psicología , Ansiedad/psicología , Terapia Conductista , Cuidadores/educación , Cuidadores/psicología , Deluciones/psicología , Depresión/psicología , Ejercicio Físico/psicología , Alucinaciones/psicología , Hogares para Ancianos , Humanos , Musicoterapia , Casas de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto , Recreación , Terapia por Relajación , Grupos de Autoayuda , Terapia SocioambientalRESUMEN
OBJECTIVE: This is the first study to investigate the relationship between the level of state anxiety and the jumping to conclusions (JTC) reasoning bias in patients with first-episode psychosis using an experimental manipulation procedure. METHOD: Thirty patients with psychotic delusions and 30 non-clinical controls, from Hong Kong, were randomized into an anxiety induction or an anxiety reduction imagery condition. Questionnaires were used to measure trait emotions, psychotic symptoms and delusional thinking at baseline. After the anxiety manipulation, participants completed two versions of an assessment of the JTC reasoning bias, the beads task. RESULTS: Both the patients and the non-clinical controls were responsive to the anxiety reduction imagery, but only the non-clinical controls responded to the anxiety induction imagery. The JTC reasoning bias was, as hypothesized, more common in patients than in controls, but was not significantly different between the anxiety manipulation conditions. Both patients and controls had higher rates of JTC than in previous studies. CONCLUSIONS: Patients with psychotic delusions have a marked JTC cognitive bias. This is the first JTC study in a Chinese sample, and the results suggest that the bias applies cross-culturally. The results indicate that state anxiety does not influence JTC. Limitations of the study include an inadequate anxiety state manipulation effect in psychotic patients using brief imagery, and unusually high rates of JTC in both patients and controls.