The Role of Unhelpful Appraisals and Behaviours in Vulnerability to Psychotic-like Phenomena

Abstract

Numerous research studies have found evidence of psychotic-like experiences in the general population which are unrelated to psychopathology. Recent cognitive models of psychosis have considered these findings and have taken a normalizing approach to psychosis. It is suggested that hallucinations and delusions are essentially “normal” but are interpreted and responded to in an unhelpful way by individuals who come into contact with services. A web-based cross-sectional survey was conducted in which 544 students completed measures of predisposition to psychotic phenomena, appraisals of hallucinations and delusions, the use of safety behaviours and thought control strategies and a measure of general health. Positive appraisals of psychotic-like phenomena were found to be associated with the frequency of such phenomena but no more so than negative beliefs. Negative appraisals were more strongly associated with distress than positive appraisals but when the frequency of psychotic-like phenomena was controlled for negative appraisals made only a small contribution to distress. Avoidant safety behaviours and punishment-based thought control strategies were found to be associated with both distress and the frequency of psychotic-like phenomena. These findings provide some support for recent cognitive conceptualizations of psychosis, but essentially they emphasize the multi-faceted nature of vulnerability to psychosis.