-
Behavioral Sciences (Basel, Switzerland) Jul 2023Mental health literacy (MHL) refers to lay people's knowledge and beliefs about the diagnosis and treatment of mental illness. The current study aimed at investigating...
Mental health literacy (MHL) refers to lay people's knowledge and beliefs about the diagnosis and treatment of mental illness. The current study aimed at investigating MHL regarding personality disorders (PDs) multiculturally, comparing Turkish and Italian populations. In total, 262 participants responded to an online vignette identification task that required them to label the PDs of seven hypothetical subjects and rate various dimensions of their disorders. Narcissistic (25%), obsessive-compulsive (13%), and paranoid (12%) PDs were the most correctly labeled, while the average accuracy values for other PDs were below 0.04%. Compared to Turkish participants, Italian participants were more accurate in labeling narcissistic PD. Additionally, of the seven PDs, narcissistic PD was associated with the most happiness and success at work. Subjects with borderline and avoidant PDs were the most recognized as having psychological problems (>90%), yet their PDs were among the least correctly identified. Overall, participants from both cultures were generally successful at recognizing the presence of a mental illness, but they rarely labeled it correctly. Only limited cultural differences emerged. The present findings may inform the design of outreach programs to promote MHL regarding PDs, thereby facilitating early recognition of PDs and help-seeking behaviors for affected individuals.
PubMed: 37504052
DOI: 10.3390/bs13070605 -
Journal of Behavior Therapy and... Dec 2023Cognitive theories assume an imbalance of intuitive and analytical reasoning in paranoid ideation. The argumentative theory of reasoning offers an approach on the...
BACKGROUND AND OBJECTIVES
Cognitive theories assume an imbalance of intuitive and analytical reasoning in paranoid ideation. The argumentative theory of reasoning offers an approach on the primary function of reasoning and its flaws. It assumes social exchange as main purpose of reasoning. We applied this theory to delusion research and tested experimentally whether social exchange in the form of production and evaluation of arguments influences subsequent reflective reasoning. Additionally, we examined whether the social network and the frequency/preference for discussions are associated with distorted reflective reasoning and paranoid ideation.
METHODS
327 participants completed the Social Network Index (SNI), the Paranoia Checklist (PCL), and the Cognitive Reflection Test-2 (CRT2). Moreover, preference and frequency of discussions were assessed. In the discussion group (N = 165), participants produced arguments and evaluated counterarguments on two socially relevant topics. The control group (N = 162) watched a nature video instead.
RESULTS
The discussion group showed lower distorted reflective reasoning than the control group. Discussion preference and/or frequency was associated with frequency and disturbance of paranoid thoughts, as well as overall paranoid ideation.
LIMITATIONS
Due to the online format environmental factors could not be held constant and no intrasubject comparison of the CRT2 could be computed in the trial. Furthermore, the sample mainly consisted of psychology students.
CONCLUSION
The results contribute to the understanding of distorted reflective reasoning and provides preliminary evidence that the argumentative theory of reasoning may offer a promising perspective for delusion research.
Topics: Humans; Pilot Projects; Problem Solving; Paranoid Disorders; Neuropsychological Tests
PubMed: 37307645
DOI: 10.1016/j.jbtep.2023.101884 -
JMIR Human Factors Oct 2023Early intervention in mental health crises can prevent negative outcomes. A promising new direction is remote mental health monitoring using smartphone technology to...
BACKGROUND
Early intervention in mental health crises can prevent negative outcomes. A promising new direction is remote mental health monitoring using smartphone technology to passively collect data from individuals to rapidly detect the worsening of serious mental illness (SMI). This technology may benefit patients with SMI, but little is known about health IT acceptability among this population or their mental health clinicians.
OBJECTIVE
We used the Health Information Technology Acceptability Model to analyze the acceptability and usability of passive mobile monitoring and self-tracking among patients with serious mental illness and their mental health clinicians.
METHODS
Data collection took place between December 2020 and June 2021 in 1 Veterans Administration health care system. Interviews with mental health clinicians (n=16) assessed the acceptability of mobile sensing, its usefulness as a tool to improve clinical assessment and care, and recommendations for program refinements. Focus groups with patients with SMI (n=3 groups) and individual usability tests (n=8) elucidated patient attitudes about engaging in health IT and perceptions of its usefulness as a tool for self-tracking and improving mental health assessments.
RESULTS
Clinicians discussed the utility of web-based data dashboards to monitor patients with SMI health behaviors and receiving alerts about their worsening health. Potential benefits included improving clinical care, capturing behaviors patients do not self-report, watching trends, and receiving alerts. Clinicians' concerns included increased workloads tied to dashboard data review, lack of experience using health IT in clinical care, and how SMI patients' associated paranoia and financial instability would impact patient uptake. Despite concerns, all mental health clinicians stated that they would recommend it. Almost all patients with SMI were receptive to using smartphone dashboards for self-monitoring and having behavioral change alerts sent to their mental health clinicians. They found the mobile app easy to navigate and dashboards easy to find and understand. Patient concerns centered on privacy and "government tracking," and their phone's battery life and data plans. Despite concerns, most reported that they would use it.
CONCLUSIONS
Many people with SMI would like to have mobile informatics tools that can support their illness and recovery. Similar to other populations (eg, older adults, people experiencing homelessness) this population presents challenges to adoption and implementation. Health care organizations will need to provide resources to address these and support successful illness management. Clinicians are supportive of technological approaches, with adapting informatics data into their workflow as the primary challenge. Despite clear challenges, technological developments are increasingly designed to be acceptable to patients. The research development-clinical deployment gap must be addressed by health care systems, similar to computerized cognitive training. It will ensure clinicians operate at the top of their skill set and are not overwhelmed by administrative tasks, data summarization, or reviewing data that do not indicate a need for intervention.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-10.2196/39010.
Topics: United States; Humans; Aged; Mental Disorders; Mental Health; Smartphone; Mobile Applications; United States Department of Veterans Affairs
PubMed: 37874639
DOI: 10.2196/46909 -
BMC Psychiatry Oct 2023There is a notable a gap between promising research findings and implementation of digital health tools. Understanding and addressing barriers to use is key to...
BACKGROUND
There is a notable a gap between promising research findings and implementation of digital health tools. Understanding and addressing barriers to use is key to widespread implementation.
METHODS
A survey was administered to a self-selecting sample in-person (n = 157) or online (n = 58), with questions examining: i) ownership and usage rates of digital devices among people with psychosis; ii) interest in using technology to engage with mental health services; and iii) facilitators of and barriers to using digital tools in a mental healthcare context.
RESULTS
Device ownership: Virtually all participants owned a mobile phone (95%) or smartphone (90%), with Android phones slightly more prevalent than iPhones. Only a minority owned a fitness tracker (15%) or smartwatch (13%). Device ownership was significantly lower in unemployed people and those without secondary education. Device cost and paranoid ideation were barriers to ownership. Technology and mental health services: Most participants (88%) said they would willingly try a mental health app. Symptom monitoring apps were most popular, then appointment reminders and medication reminders. Half the sample would prefer an app alongside face-to-face support; the other half preferred remote support or no other mental health support. Facilitators: Participants thought using a mental health app could increase their understanding of psychosis generally, and of their own symptoms. They valued the flexibility of digital tools in enabling access to support anywhere, anytime. Barriers: Prominent barriers to using mental health apps were forgetting, lack of motivation, security concerns, and concerns it would replace face-to-face care. Overall participants reported no substantial effects of technology on their mental health, although a quarter said using a phone worsened paranoid ideation. A third used technology more when psychotic symptoms were higher, whereas a third used it less. Around half used technology more when experiencing low mood.
CONCLUSIONS
Our findings suggest rapidly increasing device ownership among people with psychosis, mirroring patterns in the general population. Smartphones appear appropriate for delivering internet-enabled support for psychosis. However, for a sub-group of people with psychosis, the sometimes complex interaction between technology and mental health may act as a barrier to engagement, alongside more prosaic factors such as forgetting.
Topics: Humans; Mental Health; Psychotic Disorders; Smartphone; Surveys and Questionnaires; Cell Phone
PubMed: 37803367
DOI: 10.1186/s12888-023-05114-y -
Schizophrenia Bulletin Apr 2024Trauma is a robust risk factor for delusional ideation. However, the specificity and processes underlying this relationship are unclear. Qualitatively, interpersonal...
BACKGROUND AND HYPOTHESIS
Trauma is a robust risk factor for delusional ideation. However, the specificity and processes underlying this relationship are unclear. Qualitatively, interpersonal traumas (i.e., trauma caused by another person) appear to have a specific relationship with delusional ideation, particularly paranoia, given the commonality of social threat. However, this has not been empirically tested and the processes by which interpersonal trauma contributes to delusional ideation remain poorly understood. Given the role of impaired sleep in both trauma and delusional ideation, it may be a critical mediator between these variables. We hypothesized that interpersonal trauma, but not non-interpersonal trauma, would be positively related to subtypes of delusional ideation, especially paranoia, and that impaired sleep would mediate these relationships.
STUDY DESIGN
In a large, transdiagnostic community sample (N = 478), an exploratory factor analysis of the Peter's Delusion Inventory identified three subtypes of delusional ideation, namely magical thinking, grandiosity, and paranoia. Three path models, one for each subtype of delusional ideation, tested whether interpersonal trauma and non-interpersonal trauma were related to subtypes of delusional ideation, and impaired sleep as a mediating variable of interpersonal trauma.
STUDY RESULTS
Paranoia and grandiosity were positively related to interpersonal trauma and unrelated to non-interpersonal trauma. Furthermore, these relationships were significantly mediated by impaired sleep, which appeared strongest for paranoia. In contrast, magical thinking was unrelated to traumatic experiences.
CONCLUSIONS
These findings support a specific relationship between interpersonal trauma and paranoia as well as grandiosity, with impaired sleep appearing as an important process by which interpersonal trauma contributes to both.
Topics: Humans; Male; Adult; Female; Middle Aged; Paranoid Disorders; Delusions; Psychological Trauma; Young Adult; Interpersonal Relations; Aged; Adolescent; Sleep Wake Disorders
PubMed: 37315337
DOI: 10.1093/schbul/sbad081 -
The Apple Doesn't Fall Far from the Tree? Paranoia and Safety Behaviours in Adolescent-Parent-Dyads.Research on Child and Adolescent... Feb 2024Paranoia is a common experience in adolescence that may entail the use of safety behaviours (e.g. avoidance), which are assumed to maintain paranoia in the long run. As...
Paranoia is a common experience in adolescence that may entail the use of safety behaviours (e.g. avoidance), which are assumed to maintain paranoia in the long run. As the development of paranoia and related safety behaviours in youth may be influenced by their caregivers, we aimed to investigate the associations of paranoia and safety behaviours in adolescents and their parents. Adolescents from the general population aged 14-17 and one of their parents (N = 142 dyads) were recruited via Qualtrics to complete online surveys including measures of paranoia, safety behaviour use, anxiety, and demographics. We fitted an Actor-Partner-Interdependence Model (APIM) for testing dyadic parent-child interaction by using structural equation modelling and controlled for adolescents' and parents' anxiety. Results indicated that paranoia positively predicted safety behaviour use in adolescents and in parents. There were significant positive intra-dyad (i.e. parent-adolescent) correlations for both paranoia and safety behaviour use. One partner effect was significant: parental paranoia positively predicted the safety behaviour use of their adolescent child. Conversely, adolescents' paranoia did not predict their parents' safety behaviour use. Our findings corroborate prior research demonstrating an association between paranoia and safety behaviours among adults, and extend this association to adolescents. Children of parents experiencing paranoia are at increased risk of developing paranoia and safety behaviours, which indicates the need for interventions that target paranoia and safety behaviours in family systems.
Topics: Adult; Humans; Adolescent; Paranoid Disorders; Adolescent Behavior; Parents; Health Behavior; Surveys and Questionnaires
PubMed: 37740777
DOI: 10.1007/s10802-023-01128-y -
PloS One 2023It has been shown that ideas of reference in the context of paranoia (IoR-P) and schizophrenia spectrum disorders (IoR-S) are caused by different psychological...
It has been shown that ideas of reference in the context of paranoia (IoR-P) and schizophrenia spectrum disorders (IoR-S) are caused by different psychological constructs. Although it is well known that both IoR-P and IoR-S are frequently evoked during the same period of life, how they interact with each other is unknown. The purpose of the present study was to develop the Japanese version of the Referential Thinking Scale (J-REF) to assess IoR-S, examine its validity and reliability, and explore the predictors of IoR-P and IoR-S. In this study, several subgroups of Japanese individuals in their 20s were included in the analysis. The J-REF had high internal consistency, high test-retest reliability, good convergent, and discriminant validity. Two hierarchical regression analyses showed that public self-consciousness predicted the manifestation of IoR-P, while the dimensions of schizotypy predicted that of IoR-S. Moreover, social anxiety and negative moods could cause IoR-P and IoR-S. This study directly showed the existence of two different types of ideas of reference in terms of their predictors. It is also significant in that it first examined referential thinking using the REF scale in the context of Asia and showed that there may not be much difference in the frequency of ideas of reference from other cultures. Future research directions are also discussed.
Topics: Humans; Cross-Sectional Studies; Emotions; Japan; Psychometrics; Reproducibility of Results; Schizophrenia; Surveys and Questionnaires
PubMed: 37418436
DOI: 10.1371/journal.pone.0283416 -
Frontiers in Psychiatry 2023Although musical hallucinations do not tend to be accompanied by delusions, occasionally patients persistently accuse others of being responsible for causing the music...
INTRODUCTION
Although musical hallucinations do not tend to be accompanied by delusions, occasionally patients persistently accuse others of being responsible for causing the music they perceive, sometimes with severe social consequences such as frequently calling the police or moving house. In this study we seek to broaden our understanding of this rare type of musical hallucination that comes with secondary delusions and lack of insight, and to explore associations, underlying mechanisms, and treatment possibilities.
METHODS
The present study is part of a cohort study on musical hallucinations carried out in the Netherlands from 2010 through 2023. Participants underwent testing with the aid of the , (LSHS), (SPQ), (HDRS), and (MMSE). Additionally, they underwent a brain MRI, electroencephalogram, and audiological testing.
RESULTS
Five patients out of a group of = 81 (6%) lacked insight and presented with secondary delusions regarding the perceived music. They were all female, of advanced age, and hearing-impaired, and were diagnosed with cognitive impairment. In three patients (60%), risperidone was started. This had a positive effect on the hallucinations secondary delusions.
CONCLUSION
The pathophysiological process underlying musical hallucinations is multifactorial in nature. We consider cognitive impairment the most likely contributing factor of the secondary delusions and lack of insight encountered in our patients, and antipsychotics the most beneficial treatment. On the basis of these small numbers, no definite conclusions can be drawn, so further research is needed to elucidate the underlying mechanisms and to develop evidence-based treatment methods for people experiencing this rare and debilitating combination of symptoms. Since the black box warning of risperidone cautions against the use of this drug in elderly persons with dementia, a proper comparison with the efficacy and safety of other antipsychotics for this group is paramount.
PubMed: 37840806
DOI: 10.3389/fpsyt.2023.1253625 -
Schizophrenia Bulletin Jul 2023Paranoia is higher in minority group individuals, especially those reporting intersecting aspects of difference. High negative and low positive self and other beliefs,...
BACKGROUND
Paranoia is higher in minority group individuals, especially those reporting intersecting aspects of difference. High negative and low positive self and other beliefs, and low social rank, are predictive of paranoia overtime; however, data are typically from majority group participants. This study examined whether social defeat or healthy cultural mistrust best characterizes paranoia in minority groups.
STUDY DESIGN
Using cross-sectional, survey design, with a large (n = 2510) international sample, moderation analyses (PROCESS) examined whether self and other beliefs, and perceived social rank, operate similarly or differently in minority vs majority group participants. Specifically, we tested whether beliefs moderated the influence of minority group, and intersecting aspects of difference, on paranoia.
STUDY RESULTS
Paranoia was consistently higher in participants from minority vs majority groups and level of paranoid thinking was significantly higher at each level of the intersectionality index. Negative self/other beliefs were associated with elevated paranoia in all participants. However, in support of the notion of healthy cultural mistrust, low social rank, and low positive self/other beliefs were significantly associated with paranoia in majority group participants but unrelated to paranoia in respective minority group members.
CONCLUSIONS
Although mixed, our findings signal the need to consider healthy cultural mistrust when examining paranoia in minority groups and bring into question whether "paranoia" accurately describes the experiences of marginalized individuals, at least at low levels of severity. Further research on paranoia in minority groups is crucial to developing culturally appropriate ways of understanding people's experiences in the context of victimization, discrimination, and difference.
Topics: Humans; Minority Groups; Cross-Sectional Studies; Intersectional Framework; Paranoid Disorders; Crime Victims
PubMed: 36940411
DOI: 10.1093/schbul/sbad027 -
Psychological Medicine Dec 2023Sexual abuse and bullying are associated with poor mental health in adulthood. We previously established a clear relationship between bullying and symptoms of psychosis....
BACKGROUND
Sexual abuse and bullying are associated with poor mental health in adulthood. We previously established a clear relationship between bullying and symptoms of psychosis. Similarly, we would expect sexual abuse to be linked to the emergence of psychotic symptoms, through effects on negative affect.
METHOD
We analysed English data from the Adult Psychiatric Morbidity Surveys, carried out in 2007 ( = 5954) and 2014 ( = 5946), based on representative national samples living in private households. We used probabilistic graphical models represented by directed acyclic graphs (DAGs). We obtained measures of persecutory ideation and auditory hallucinosis from the Psychosis Screening Questionnaire, and identified affective symptoms using the Clinical Interview Schedule. We included cannabis consumption and sex as they may determine the relationship between symptoms. We constrained incoming edges to sexual abuse and bullying to respect temporality.
RESULTS
In the DAG analyses, contrary to our expectations, paranoia appeared early in the cascade of relationships, close to the abuse variables, and generally lying upstream of affective symptoms. Paranoia was consistently directly antecedent to hallucinations, but also indirectly so, via non-psychotic symptoms. Hallucinosis was also the endpoint of pathways involving non-psychotic symptoms.
CONCLUSIONS
Via worry, sexual abuse and bullying appear to drive a range of affective symptoms, and in some people, these may encourage the emergence of hallucinations. The link between adverse experiences and paranoia is much more direct. These findings have implications for managing distressing outcomes. In particular, worry may be a salient target for intervention in psychosis.
Topics: Adult; Humans; Affective Symptoms; Psychotic Disorders; Hallucinations; Paranoid Disorders; Sex Offenses
PubMed: 37485689
DOI: 10.1017/S003329172300185X