How is paranoia experienced in a student population? A qualitative study of students scoring highly on a paranoia measure

Brief imagery based metacognitive intervention for flashforwards in psychosis: a fixed baseline case series

BACKGROUND

Distressing mental images are common in people with psychosis. The central role of metacognitive difficulties in psychosis suggests that metacognitive interventions with imagery properties could play a central role in managing distressing mental imagery. A brief imagery-based metacognitive intervention was developed to target the control mechanism of distressing mental images in psychosis.

AIMS

A fixed baseline case series was designed to investigate whether the intervention was acceptable, feasible and effective.

METHOD

Eight participants who met criteria for a schizophrenia spectrum diagnosis and experienced distressing future-oriented mental images took part in the case series, which consisted of three phases; baseline, intervention, and follow-up. Symptoms of anxiety, depression, persecutory delusions and schemas were assessed pre- and post-intervention, and qualitative feedback was collected at follow-up.

RESULTS

The metacognitive intervention was feasible, acceptable, and rated as highly satisfactory. One participant dropped out at the baseline phase. No adverse events were reported. Positive change scores with a decrease in symptoms were reported for anxiety, depression, persecutory delusions, and schemas. Tau-U analysis showed positive trends and high effect sizes on mental imagery characteristics at follow-up.

CONCLUSION

Our findings suggest that it is acceptable and feasible to engage people with psychosis in a brief imagery-based metacognitive intervention and that positive change can be achieved. Further studies are needed to replicate and clarify the findings of our study and develop the evidence base for this intervention.

Big brother: the effects of surveillance on fundamental aspects of social vision

Despite the dramatic rise of surveillance in our societies, only limited research has examined its effects on humans. While most research has focused on voluntary behaviour, no study has examined the effects of surveillance on more fundamental and automatic aspects of human perceptual awareness and cognition. Here, we show that being watched on CCTV markedly impacts a hardwired and involuntary function of human sensory perception-the ability to consciously detect faces. Using the method of continuous flash suppression (CFS), we show that when people are surveilled (N = 24), they are quicker than controls (N = 30) to detect faces. An independent control experiment (N = 42) ruled out an explanation based on demand characteristics and social desirability biases. These findings show that being watched impacts not only consciously controlled behaviours but also unconscious, involuntary visual processing. Our results have implications concerning the impacts of surveillance on basic human cognition as well as public mental health.

A study in University of Ruhuna for investigating prevalence, risk factors and remedies for psychiatric illnesses among students

There is no comprehensive study on the mental health of Sri Lankan undergraduate in higher education, as most existing studies have been done for medical students only. It is unknown how academic and environmental factors contribute for the prevalence of psychiatric illnesses. Further, there is no sufficient information on the student/university based remedies to reduce the psychological distress of students. This research is carried out to find the overall psychological distress, well-being, prevalence percentages of psychiatric illnesses, associated risk factors, and student/university remedies to overcome them. We use standard questionnaires to screen for psychiatric illnesses, and we analyze the responses for our own questionnaire using Binary logistic regression analysis to identify demographic factors, academic factors, and environmental factors causing each mental disorder. We use Pearson correlation coefficient to identify correlation between prevalence of each psychiatric illnesses. All 13 psychiatric illnesses were found with a moderate correlation among diseases having a mean prevalence percentage of 28 and a standard deviation of 14.36, despite the prevalence of well-being factors among students and only 8% are clinically diagnosed. 89% of the students were suffering from at least one psychiatric illness and 68% were found to be psychologically distressed. Sets of overall and individual demographic, academic, and environmental risk factors contributing for the prevalence of a psychiatric illness in general and in particular were identified respectively after a binary logistic regression analysis. 61% of the students don't receive psychiatric help from the university and are using their own remedies. The universities must consider the environmental and academic risk factors associated with psychiatric illnesses and design curriculum, expand resources, and provide counseling services to reduce the impact of risk factors.

'Thinking about Them is only making me feel worse'. The mediating role of metacognitive factors in the relationship between paranoia-like beliefs and psychopathology symptoms in a community sample

INTRODUCTION

Paranoia in community samples is associated with higher levels of depression, anxiety symptoms and suicidality. The metacognitive model assumes the role of metacognitive factors in these associations. Positive and negative metacognitive beliefs (PMB and NMB, respectively) and cognitive-attentional syndrome (CAS) are to mediate between paranoia-like beliefs and psychopathology symptoms. The current study is an attempt to test this prediction.

METHODS

A cross-sectional community study with n = 840 participants. We used R-GPTS's persecutory subscale to measure paranoia-like beliefs, CAS-1 for CAS and metacognitive beliefs and SCL-27-plus for psychopathology symptoms.

RESULTS

Indirect effects of PMB, CAS and NMB accounted for 22% to 56% (CI 95%) of total effects of relationships between paranoia-like beliefs and vegetative symptoms, symptoms of social phobia, agoraphobia, depression and suicidality screening.

CONCLUSIONS

We demonstrated that PMB, CAS and NMB mediate between paranoia-like beliefs and various psychopathological symptoms, as predicted by the metacognitive model of psychopathology. We also uncovered other indirect effects, including negative mediation effect of PMB on the relationship between paranoia-like beliefs and depressive symptoms and suicidality.

How does attachment imagery for paranoia work? Cognitive fusion and beliefs about self and others mediate the impact on paranoia and anxiety

OBJECTIVES

Paranoia describes unfounded and distressing interpersonal threat beliefs. Secure attachment imagery has been shown to attenuate paranoia and anxiety in non-clinical and clinical groups, but little is known about the differential effects of anxious and avoidant imagery or mechanisms of change. In this study, we tested the impact of secure, anxious, and avoidant attachment imagery on paranoia, anxiety, and help-seeking intentions. We also examined hypothesized mechanisms of change, specifically whether cognitive fusion and negative self- and other-beliefs mediate these relationships.

DESIGN

This study utilized an experimental, cross-sectional design.

METHODS

A large (N = 303), international general population sample with high levels of non-clinical paranoia completed a series of measures before and after engaging in secure, anxious, or avoidant imagery.

RESULTS

Relative to anxious and avoidant attachment imagery, secure attachment imagery reduced paranoia and anxiety and increased help-seeking intentions. Cognitive fusion and negative self- and other-beliefs mediated the impact of attachment imagery on paranoia and anxiety, but not help-seeking.

CONCLUSIONS

In line with attachment and cognitive theory, secure attachment imagery is effective in reducing paranoia and anxiety and works by reducing cognitive fusion and negative self- and other-beliefs. These novel findings suggest that the secure imagery task could be incorporated into cognitive and behavioural therapies to reduce distressing interpersonal threat beliefs and associated negative affect, and increase help-seeking intentions.

PRACTITIONER POINTS

When working with people experiencing paranoia, secure attachment imagery may be effective in reducing state paranoia and anxiety and improving help-seeking intentions. Attachment imagery works by influencing beliefs about self and others, and the degree to which people are fused with their beliefs. In clinical practice, the rationale for the imagery task fits well with psychological models of paranoia and the secure imagery task can be introduced as a way to cope when struggling with distressing beliefs about self and others, and feeling overwhelmed by these fears.

Paranoia, hallucinations and compulsive buying during the early phase of the COVID-19 outbreak in the United Kingdom: A preliminary experimental study

This study examines the impact of COVID-19 (in the early phase of the outbreak) on symptoms of psychosis, namely paranoia and hallucinations. Three hundred and sixty-one people in the United Kingdom participated in a 2 (self-isolation vs. no self-isolation) x 2 (perceived COVID-19 symptomatology vs. no perceived COVID-19 symptomatology) x 2 (exposure to COVID-19 news vs. control) experiment online. Participants completed measures of political trust, social network, fear of COVID-19, current paranoid thoughts, hallucinatory experiences and compulsive buying. Kruskal-Wallis results showed that employed people and students are more prone to paranoia and hallucinatory experiences in response to COVID-19 news. A multigroup model showed a moderation effect of the news conditions - in the COVID-19 news condition, fear of COVID-19 and political trust significantly predict the variance of paranoia, hallucinatory experiences and compulsive buying and these co-vary with each other but not in the control condition. In line with cognitive and social theories of paranoia, results suggest that negative affect and low political trust are linked to the presence of paranoid thoughts and hallucinatory experiences and compulsive buying amid COVID-19. Digitized and Tailored Cognitive and Behavioral Therapy are proposed to address the psychiatric impact of COVID-19.

Demographic and motivational factors affecting the whole-body donation programme in Nanjing, China: a cross-sectional survey

OBJECTIVES

To investigate the demographics and motivations of whole-body donors in China, and help suggest a solution to the problem of low body donation numbers.

DESIGN

A cross-sectional study on body donors in China. Demographic analysis of the donating information of deceased donors and in-depth interviews of potential body donors.

SETTING

Eleven districts in Nanjing, China.

PARTICIPANTS

Deceased whole-body donors who had donated their bodies to the body donation receiving station of Nanjing Medical University between 1 July 2009 and 30 June 2019 (n=835), and living registered whole-body donors (n=68).

RESULTS

Among the whole-body donor population, the numbers of males, people older than 65 years and those working as teachers, government officials, medical staff and farmers were significantly higher than those of the general Nanjing population. Donors with an education level of college or above accounted for nearly half of the deceased donors, and considered donating their bodies earlier in their lives than others. Cancer and heart disease were the major causes of death among donors. Interviews of the 68 living donors revealed the following major motivations for the decision to donate: to support medical education; to reduce their children's funeral burden; no longer holding traditional Chinese views on life and death; influence by role models and annoyance at complex funeral ceremonies.

CONCLUSIONS

Older people, people with an education level of college or above, labourers, teachers, government officials and farmers are the major groups that donate their bodies. Although people's motivations for donation are complex, their desire to support medical education is the most prevalent motivation. By helping focus on target groups for promotional messaging and identifying their prime motivations, this study's findings can provide a reference for promoting body donation in China.