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Early Intervention in Psychiatry Dec 2022Thinking biases are posited to be involved in the genesis and maintenance of delusions. Persecutory delusions are one of the most commonly occurring delusional subtypes... (Review)
Review
AIM
Thinking biases are posited to be involved in the genesis and maintenance of delusions. Persecutory delusions are one of the most commonly occurring delusional subtypes and cause substantial distress and disability to the individuals experiencing them. Their clinical relevance confers a rationale for investigating them. Particularly, this review aims to elucidate which cognitive biases are involved in their development and persistence.
METHODS
MEDLINE, Embase, PsycINFO and Global Health were searched from the year 2000 to June 2020. A formal narrative synthesis was employed to report the findings and a quality assessment of included studies was conducted.
RESULTS
Twenty five studies were included. Overall, 18 thinking biases were identified. Hostility and trustworthiness judgement biases appeared to be specific to persecutory delusions while jumping to conclusions, self-serving attributional biases and belief inflexibility were proposed to be more closely related to other delusional subtypes. While the majority of the biases identified were suggested to be involved in delusion maintenance, hostility biases, need for closure and personalizing attributional biases were believed to also have aetiological influences.
CONCLUSIONS
These findings show that some cognitive biases are specific to paranoid psychosis and appear to be involved in the formation and/or persistence of persecutory delusions.
Topics: Humans; Delusions; Paranoid Disorders; Bias; Psychotic Disorders
PubMed: 35396904
DOI: 10.1111/eip.13292 -
Cureus Feb 2023Child abuse is a global problem for public health as it negatively affects people and society. The US Centers for Disease Control and Prevention (CDC) associates the... (Review)
Review
Child abuse is a global problem for public health as it negatively affects people and society. The US Centers for Disease Control and Prevention (CDC) associates the adverse experience during childhood with a series of long-term impacts on health. The aim of this study is to explore the impact of child abuse on females' health, including physical, mental, and social health. The methodology used in this specific review is to carry out a systematic search in electronic databases (Google Scholar, Scopus, PubMed, and Crossref) in published articles between 2004 and 2021. The exclusion criteria were all review papers, such as literature reviews, systematic reviews, and meta-analyses. We also excluded papers that were not written in the English language. Consequently, the inclusion criteria were written in English, original articles, and prospective, case-control, cross-sectional studies that investigated childhood abuse of girls and the health effects in adulthood. Initially, from a total of 796 papers returned by the search, 415 were rejected due to duplicate articles, systematic reviews, and meta-analyses. In addition, 316 articles were rejected due to nonrelevance to the study's subject. However, from the first 796 papers, 18 met the conditions to be included in the review. We found that females exposed to childhood abuse were more likely to suffer from eating disorders, depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, anxiety, phobias, paranoid ideation and psychoticism, early menarche, sleep disorders, metabolism disorders, cardiovascular diseases, asthma, chronic pain, and early mortality, which are physical and mental conditions in females' adulthood related to child abuse. The conclusions of this work show that it is a primary need to give emphasis on combating child abuse and timely management when this is a fact.
PubMed: 36938260
DOI: 10.7759/cureus.34981 -
The Cochrane Database of Systematic... Dec 2018Amphetamine-type stimulants (ATS) refer to a group of synthetic stimulants including amphetamine, methamphetamine, 3,4-methylenedioxy-methamphetamine (MDMA) and related... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Amphetamine-type stimulants (ATS) refer to a group of synthetic stimulants including amphetamine, methamphetamine, 3,4-methylenedioxy-methamphetamine (MDMA) and related substances. ATS are highly addictive and prolonged use may result in a series of mental and physical symptoms including anxiety, confusion, insomnia, mood disturbances, cognitive impairments, paranoia, hallucinations and delusion.Currently there is no widely accepted treatment for ATS-use disorder. However, cognitive-behavioural treatment (CBT) is the first-choice treatment. The effectiveness of CBT for other substance-use disorders (e.g. alcohol-, opioid- and cocaine-use disorders) has been well documented and as such this basic treatment approach has been applied to the ATS-use disorder.
OBJECTIVES
To investigate the efficacy of cognitive-behavioural treatment for people with ATS-use disorder for reducing ATS use compared to other types of psychotherapy, pharmacotherapy, 12-step facilitation, no intervention or treatment as usual.
SEARCH METHODS
We identified randomised controlled trials (RCT) and quasi-RCTs comparing CBT for ATS-use disorders with other types of psychotherapy, pharmacotherapy, 12 step facilitation or no intervention. We searched the Cochrane Drugs and Alcohol Group Specialised Register, Cochrane Central Register of Controlled Trials, MEDLINE via PubMed, Embase and five other databases up to July 2018. In addition, we examined reference lists of eligible studies and other systematic reviews. We contacted experts in the field.
SELECTION CRITERIA
Eligibility criteria consisted of RCTs and quasi-RCTs comparing CBT versus other types of interventions with adult ATS users (aged 18 years or older) diagnosed by any explicit diagnostic system. Primary outcomes included abstinence rate and other indicators of drug-using behaviours.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by Cochrane.
MAIN RESULTS
Only two studies met the eligibility criteria. Both studies were at low risk of selection bias and reporting bias. In one study, almost half of participants in the intervention group dropped out and this study was at high risk of attrition bias. The studies compared a single session of brief CBT or a web-based CBT to a waiting-list control (total sample size across studies of 129). Results were mixed across the studies. For the single-session brief CBT study, two out of five measures of drug use produced significant results, percentage of abstinent days in 90 days (odds ratio (OR) 0.22, 95% confidence interval (CI) 0.02 to 2.11) and dependence symptoms (standardised mean difference (SMD) -0.59, 95% CI -1.16 to -0.02). Little confidence could be placed in the results from this study give the small sample size (25 participants per group) and corresponding large CIs around the observed effects. For the web-based CBT, there was no significant difference across different outcomes. Neither study reported adverse effects. The meta-analytic mean across these two trials for drug use was not significant (SMD -0.28, 95% CI -0.69 to 0.14). In summary, overall quality of evidence was low and there was insufficient evidence to conclude that CBT is effective, or ineffective, at treating ATS use.
AUTHORS' CONCLUSIONS
Currently, there is not enough evidence to establish the efficacy of CBT for ATS-use disorders because of a paucity of high-quality research in this area.
Topics: Adult; Amphetamine-Related Disorders; Amphetamines; Cognitive Behavioral Therapy; Female; Humans; Male; Patient Dropouts; Randomized Controlled Trials as Topic; Sample Size; Waiting Lists
PubMed: 30577083
DOI: 10.1002/14651858.CD011315.pub2 -
The British Journal of Clinical... Sep 2022The relationship between attachment and paranoia is now well established. There is good theoretical reason and evidence to indicate that attachment style affects...
BACKGROUND
The relationship between attachment and paranoia is now well established. There is good theoretical reason and evidence to indicate that attachment style affects cognitive, affective, and behavioural processes which, in turn, contribute to the maintenance of paranoia, but this research has not been integrated. We critically and systematically review research that examines relevant cognitive, affective, and behavioural processes, which may explain how attachment insecurity leads to paranoia and constitute key targets in psychotherapeutic interventions for people with psychosis.
METHOD
We conducted three systematic searches across six databases (PsycINFO, CINAHL, Medline, Web of Science, Embase, and Google Scholar), from inception to September 2021, to investigate key cognitive, affective, and behavioural processes in the attachment-paranoia association.
RESULTS
We identified a total of 1930 papers and critically reviewed 16. The literature suggests that negative self- and other-beliefs, inability to defuse from unhelpful cognitions, and use of maladaptive emotion regulation strategies mediate the association between attachment insecurity and paranoia in people with psychosis/psychotic experience. Attachment-secure people with psychosis are more likely to seek help and engage with services than attachment-insecure people.
CONCLUSIONS
Attachment styles impact help-seeking behaviours in people with psychosis and are likely to influence paranoia via self- and other-beliefs, cognition fusion, and emotion regulation - these candidate mechanisms may be targeted in psychological therapy to improve clinical outcomes for people with psychosis, characterized by paranoia.
PRACTITIONER POINTS
Insecure attachment is likely to lead to paranoia via negative beliefs about self and others, cognitive fusion, and use of maladaptive emotion regulation strategies. These mechanisms can be targeted in psychotherapeutic interventions for psychosis, such as cognitive behaviour therapy, to improve clinical and recovery outcomes. People with psychosis who are attachment-secure are more likely to seek help and engage with services than those who are attachment-insecure (particularly avoidant). Attachment style can be assessed to predict service engagement and help-seeking behaviours in people with psychosis. Attachment styles are important predictors of key cognitive, affective, and behavioural processes in people with psychosis. These processes can be assessed and incorporated into individualised formulations, and then targeted in therapy to effect psychotherapeutic change.
Topics: Cognition; Emotional Regulation; Humans; Object Attachment; Paranoid Disorders; Psychotic Disorders
PubMed: 35178714
DOI: 10.1111/bjc.12361 -
Iranian Journal of Psychiatry and... Mar 2016Suicide prevention is a health service priority. Some surveys have assessed suicidal behaviors and potential risk factors. (Review)
Review
CONTEXT
Suicide prevention is a health service priority. Some surveys have assessed suicidal behaviors and potential risk factors.
OBJECTIVES
The current paper aimed to gather information about etiology of suicide attempts in Iran.
DATA SOURCES
Pubmed, ISI web of science, PsychInfo, IranPsych, IranMedex, IranDoc as well as gray literature were searched.
STUDY SELECTION
By electronic and gray literature search, 128 articles were enrolled in this paper. Pubmed, ISI web of science, PsychInfo, IranPsych, IranMedex, IranDoc were searched for electronic search. After reading the abstracts, 84 studies were excluded and full texts of 44 articles were reviewed critically.
DATA EXTRACTION
Pubmed, ISI web of science, PsychInfo, IranPsych, IranMedex, IranDoc as well as gray literature were searched to find any study about etiologic factors of suicide attempt in Iran.
RESULTS
Depressive disorder was the most common diagnosis in suicide attempters that is 45% of the evaluated cases had depression. One study that had used Minnesota multiphasic personality inventory (MMPI) found that Histrionics in females and Schizophrenia and Paranoia in males were significantly influential. Family conflicts with 50.7% and conflict with parents with 44% were two effective psychosocial factors in suicidal attempts. In around one fourth (28.7%) of the cases, conflict with spouse was the main etiologic factor.
CONCLUSIONS
According to the methodological limitations, outcomes should be generalized cautiously. Further studies will help to plan preventive strategies for suicidal attempts; therefore, continued researches should be conducted to fill the data gaps.
PubMed: 27284284
DOI: 10.17795/ijpbs-948 -
Revista Brasileira de Psiquiatria (Sao... 2015To identify, by means of a systematic review, the frequency with which comorbid personality disorders (PDs) have been assessed in studies of euthymic bipolar patients. (Review)
Review
OBJECTIVE
To identify, by means of a systematic review, the frequency with which comorbid personality disorders (PDs) have been assessed in studies of euthymic bipolar patients.
METHODS
PubMed, ciELO and PsychINFO databases were searched for eligible articles published between 1997 and 2013. After screening 1,249 empirical papers, two independent reviewers identified three articles evaluating the frequency of PDs in patients with bipolar disorders assessed in a state of euthymia.
RESULTS
The total sample comprised 376 euthymic bipolar patients, of whom 155 (41.2%) had at least one comorbid PD. Among them, we found 87 (23.1%) in cluster B, 55 (14.6%) in cluster C, and 25 (6.6%) in cluster A. The frequencies of PD subtypes were: borderline, 38 (10.1%); histrionic, 29 (7.7%); obsessive-compulsive, 28 (7.4%); dependent, 19 (5%); narcissistic, 17 (4.5%); schizoid, schizotypal, and avoidant, 11 patients each (2.95%); paranoid, five (1.3%); and antisocial, three (0.79%).
CONCLUSION
The frequency of comorbid PD was high across the spectrum of euthymic bipolar patients. In this population, the most common PDs were those in cluster B, and the most frequent PD subtype was borderline, followed by histrionic and obsessive-compulsive.
Topics: Comorbidity; Humans; Obsessive-Compulsive Disorder; Personality Disorders
PubMed: 25946399
DOI: 10.1590/1516-4446-2014-1459 -
Clinical Psychology Review Dec 2015Sleep dysfunction is extremely common in patients with schizophrenia. Recent research indicates that sleep dysfunction may contribute to psychotic experiences such as... (Review)
Review
BACKGROUND
Sleep dysfunction is extremely common in patients with schizophrenia. Recent research indicates that sleep dysfunction may contribute to psychotic experiences such as delusions and hallucinations.
OBJECTIVES
The review aims to evaluate the evidence for a relationship between sleep dysfunction and individual psychotic experiences, make links between the theoretical understanding of each, and highlight areas for future research.
METHOD
A systematic search was conducted to identify studies investigating sleep and psychotic experiences across clinical and non-clinical populations.
RESULTS
66 papers were identified. This literature robustly supports the co-occurrence of sleep dysfunction and psychotic experiences, particularly insomnia with paranoia. Sleep dysfunction predicting subsequent psychotic experiences receives support from epidemiological surveys, research on the transition to psychosis, and relapse studies. There is also evidence that reducing sleep elicits psychotic experiences in non-clinical individuals, and that improving sleep in individuals with psychosis may lessen psychotic experiences. Anxiety and depression consistently arise as (partial) mediators of the sleep and psychosis relationship.
CONCLUSION
Studies are needed that: determine the types of sleep dysfunction linked to individual psychotic experiences; establish a causal connection between sleep and psychotic experiences; and assess treatments for sleep dysfunction in patients with non-affective psychotic disorders such as schizophrenia.
Topics: Delusions; Hallucinations; Humans; Psychotic Disorders; Schizophrenia; Sleep Wake Disorders
PubMed: 26407540
DOI: 10.1016/j.cpr.2015.09.001 -
JMIR Serious Games Nov 2018Although traditional forms of therapy for anxiety-related disorders (eg, cognitive behavioral therapy, CBT) have been effective, there have been long-standing issues... (Review)
Review
BACKGROUND
Although traditional forms of therapy for anxiety-related disorders (eg, cognitive behavioral therapy, CBT) have been effective, there have been long-standing issues with these therapies that largely center around the costs and risks associated with the components comprising the therapeutic process. To treat certain types of specific phobias, sessions may need to be held in public, therefore risking patient confidentiality and the occurrence of uncontrollable circumstances (eg, weather and bystander behavior) or additional expenses such as travel to reach a destination. To address these issues, past studies have implemented virtual reality (VR) technologies for virtual reality exposure therapy (VRET) to provide an immersive, interactive experience that can be conducted privately and inexpensively. The versatility of VR allows various environments and scenarios to be generated while giving therapists control over variables that would otherwise be impossible in a natural setting. Although the outcomes from these studies have been generally positive despite the limitations of legacy VR systems, it is necessary to review these studies to identify how modern VR systems can and should improve to treat disorders in which anxiety is a key symptom, including specific phobias, posttraumatic stress disorder and acute stress disorder, generalized anxiety disorder, and paranoid ideations.
OBJECTIVE
The aim of this review was to establish the efficacy of VR-based treatment for anxiety-related disorders as well as to outline how modern VR systems need to address the shortcomings of legacy VR systems.
METHODS
A systematic search was conducted for any VR-related, peer-reviewed articles focused on the treatment or assessment of anxiety-based disorders published before August 31, 2017, within the ProQuest Central, PsycINFO, and PsycARTICLES databases. References from these articles were also evaluated.
RESULTS
A total of 49 studies met the inclusion criteria from an initial pool of 2419 studies. These studies were a mix of case studies focused solely on VRET, experimental studies comparing the efficacy of VRET with various forms of CBT (eg, in vivo exposure, imaginal exposure, and exposure group therapy), and studies evaluating the usefulness of VR technology as a diagnostic tool for paranoid ideations. The majority of studies reported positive findings in favor of VRET despite the VR technology's limitations.
CONCLUSIONS
Although past studies have demonstrated promising and emerging efficacy for the use of VR as a treatment and diagnostic tool for anxiety-related disorders, it is clear that VR technology as a whole needs to improve to provide a completely immersive and interactive experience that is capable of blurring the lines between the real and virtual world.
PubMed: 30404770
DOI: 10.2196/10965 -
Brain Sciences Mar 2023Virtual reality (VR) has emerged as a safe and non-invasive technology for the assessment of psychotic symptoms, social and cognitive impairments, and psychosocial... (Review)
Review
Virtual reality (VR) has emerged as a safe and non-invasive technology for the assessment of psychotic symptoms, social and cognitive impairments, and psychosocial intervention in improving outcomes in psychosis. This study systematically reviewed the current state of evidence in applying semi- and fully immersive VR for assessing and treating patients with psychosis. A systematic review was conducted adhering to the PRISMA statement and was conducted in Embase, PsycINFO, and PubMed databases for articles published between January 2013 and April 2022, which identified 28 eligible studies, including 12 for assessment and 16 for intervention. In the assessment studies, not all VR tasks could distinguish the differences between patients and healthy controls regarding their physiological responses, paranoid ideation, and certain aspects of cognitive functioning such as memory bias on the object tasks. Comparatively, VR-based interventions are more promising, especially for improving cognitive impairments, social skills, agoraphobic avoidance, negative and positive affective states, auditory verbal hallucination, paranoid ideation and persecutory delusions, and other psychiatric symptoms in patients. We conclude that more rigorous studies are needed to confirm treatment effectiveness and to understand the underlying mechanism of VR-based intervention for psychotic disorders. Future studies should also improve the reliability and validity of VR-based assessments for psychotic disorders.
PubMed: 36979281
DOI: 10.3390/brainsci13030471 -
World Psychiatry : Official Journal of... Feb 2021Experiencing psychological trauma during childhood and/or adolescence is associated with an increased risk of psychosis in adulthood. However, we lack a clear knowledge...
Experiencing psychological trauma during childhood and/or adolescence is associated with an increased risk of psychosis in adulthood. However, we lack a clear knowledge of how developmental trauma induces vulnerability to psychotic symptoms. Understanding the psychological processes involved in this association is crucial to the development of preventive interventions and improved treatments. We sought to systematically review the literature and combine findings using meta-analytic techniques to establish the potential roles of psychological processes in the associations between developmental trauma and specific psychotic experiences (i.e., hallucinations, delusions and paranoia). Twenty-two studies met our inclusion criteria. We found mediating roles of dissociation, emotional dysregulation and post-traumatic stress disorder (PTSD) symptoms (avoidance, numbing and hyperarousal) between developmental trauma and hallucinations. There was also evidence of a mediating role of negative schemata, i.e. mental constructs of meanings, between developmental trauma and delusions as well as paranoia. Many studies to date have been of poor quality, and the field is limited by mostly cross-sectional research. Our findings suggest that there may be distinct psy-chological pathways from developmental trauma to psychotic phenomena in adulthood. Clinicians should carefully ask people with psychosis about their history of developmental trauma, and screen patients with such a history for dissociation, emotional dysregulation and PTSD symptoms. Well conducted research with prospective designs, including neurocognitive assessment, is required in order to fully understand the biopsychosocial mechanisms underlying the association between developmental trauma and psychosis.
PubMed: 33432756
DOI: 10.1002/wps.20841