Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-26T22:33:43.694Z Has data issue: false hasContentIssue false

14 - Theories of cognition, emotion and the social world: missing links in psychosis

from Part IV - Models and conclusions

Published online by Cambridge University Press:  07 December 2009

By
Paul Bebbington ,
David Fowler ,
Philippa Garety ,
Daniel Freeman  and
Elizabeth Kuipers
Edited by
Craig Morgan ,
Kwame McKenzie  and
Paul Fearon
Paul Bebbington
Affiliation:
Department of Mental Health Sciences, University College, London (Bloomsbury Campus), Wolfson Building 48, Riding House Street, London, UK
David Fowler
Affiliation:
School of Medicine, Health Policy and Practice University of East Anglia, Norwich, UK
Philippa Garety
Affiliation:
Department of Psychology Box 77 Institute of Psychiatry De Crespigny Park, London, UK
Daniel Freeman
Affiliation:
Department of Psychology Box 77 Institute of Psychiatry De Crespigny Park, London, UK
Elizabeth Kuipers
Affiliation:
Department of Psychology Box 77 Institute of Psychiatry De Crespigny Park, London, UK
Craig Morgan
Affiliation:
Institute of Psychiatry, King's College London
Kwame McKenzie
Affiliation:
University College London
Paul Fearon
Affiliation:
Trinity College, Dublin
Get access

Summary

Introduction

Throughout the twentieth century, clinicians and researchers struggled to establish a convincing account of psychosis and the processes and mechanisms underlying its manifestations. This effort depended on refinements of classification and case definition over the whole course of the century. However, despite the huge investment of intellectual energy and monetary resources, results have been slow in coming and disappointingly piecemeal. It has become clear that psychosis is a phenomenon of great complexity. Recent social and cognitive models of psychosis are attempts to deal with some aspects of this complexity. We will argue for the appositeness of such models, and place them within the broader research effort in psychosis. Before doing this, we need to revisit some of the consequences of the formulation of the concept of schizophrenia, the disorder that represents the core of psychotic phenomena.

A failed category?

The idea that schizophrenia is a failed category emerges regularly in the psychiatric and psychological literature, the most prominent current advocate being Bentall (2003). This is essentially a criticism of approaching schizophrenia as a medical entity. The medical strategy of investigation involves the identification of syndromes, which, in turn, form the basis of theories. These include those relating to aetiology, pathology, outcome and treatment (Wing, 1978). Syndromes are essentially theoretical constructs: while they can be regarded as disease entities, they are never really more than tentative. Nevertheless, there is a tendency in psychiatry to regard psychiatric syndromes as having more virtue than they actually possess.

Keywords

aetiological processescognitive modelsemotionpsychosisstressful eventstraumaschizophreniasocial world
Type
Chapter
Information
Society and Psychosis , pp. 219 - 237
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barch, D., Mitropoulou, V., Harvey, P. D.et al. (2004). Context-processing deficits in schizotypal personality disorder. Journal of Abnormal Psychology, 113, 556–68.Google Scholar
Barrowclough, C., Tarrier, N., Humphreys, L.et al. (2003). Self-esteem in schizophrenia: relationships between self-evaluation, family attitudes, and symptomatology. Journal of Abnormal Psychology, 112, 92–9.Google Scholar
Bebbington, P. E. and Broome, M. (2004). Exploiting the interface between philosophy and psychiatry. International Review of Psychiatry, 16, 179–83.Google Scholar
Bebbington, P. E., Bowen, J., Hirsch, S. R. and Kuipers, E. (1995). Schizophrenia and psychosocial stressors. In Schizophrenia, ed. Hirsch, S. R. and Weinberger, D.. Oxford: Blackwell Science, pp. 587–604.
Bebbington, P. E., Bhugra, D., Brugha, T.et al. (2004). Psychosis, victimisation and childhood disadvantage: evidence from the second British National Survey of Psychiatric Morbidity. British Journal of Psychiatry, 185, 220–6.Google Scholar
Bentall, R. P. (2003). Madness Explained: Psychosis and Human Nature. London: Penguin.
Bentall, R. P. and Kinderman, P. (1999). Self-regulation, effect and psychosis: the role of social cognition in paranoia and mania. In Handbook of Cognition and Emotion, 2nd edn, ed. Dalgleish, T. and Power, M.. Chichester: Wiley, pp 353–81.
Bentall, R. P., Corcoran, R., Howard, R.et al. (2001). Persecutory delusions: a review and theoretical integration. Clinical Psychology Review, 21, 1143–92.Google Scholar
Berman, I., Kalinowski, A., Berman, S. M.et al. (1995). Obsessive and compulsive symptoms in chronic schizophrenia. Comprehensive Psychiatry, 36, 6–10.Google Scholar
Birchwood, M. (2003). Pathways to emotional dysfunction in first-episode psychosis. British Journal of Psychiatry, 182, 373–5.Google Scholar
Blakemore, S. J., Oakley, D. A. and Frith, C. D. (2003). Delusions of alien control in the normal brain. Neuropsychologia, 41, 1058–67.Google Scholar
Brentano, F. (1874). Psychologie vom empirischen Standpunkt. Leipzig: Duncker and Humblot.
Broome, M. R., Wooley, J. B., Tabraham, P.et al. (2005). What causes the onset of psychosis?Schizophrenia Research, 79, 23–34.Google Scholar
Callicott, J. H., Straub, R. E., Pezawas, L.et al. (2005). Variation in DISC1 affects hippocampal structure and function and increases risk of schizophrenia. Proceedings of the National Academy of Sciences of the USA, 102, 8627–32.Google Scholar
Cantor-Graae, E. and Selten, J. P. (2005). Schizophrenia and migration: a meta-analysis and review. American Journal of Psychiatry, 162, 12–24.Google Scholar
Caspi, A., Moffitt, T. E., Cannon, M.et al. (2005). Moderation of the effect of adolescent-onset cannabis use on adult psychosis by a functional polymorphism in the catechol-O-methyltransferase gene: longitudinal evidence of a gene X environment interaction. Biological Psychiatry, 57, 1117–27.Google Scholar
Craddock, N. and Owen, M. J. (2005). The beginning of the end for the Kraepelinian dichotomy. British Journal of Psychiatry, 186, 364–6.Google Scholar
Craddock, N., O'Donovan, M. C. and Owen, M. J. (2005). The genetics of schizophrenia and bipolar disorder: dissecting psychosis. Journal of Medical Genetics, 42, 193–204.Google Scholar
Craddock, N., O'Donovan, M. C. and Owen, M. J. (2006). Genes for schizophrenia and bipolar disorder? Implications for psychiatric nosology. Schizophrenia Bulletin, 32, 9–16.Google Scholar
Day, R., Neilsen, J. A., Korten, A.et al. (1987). Stressful life events preceding the acute onset of schizophrenia: a cross national study from the World Health Organization. Culture, Medicine and Psychiatry, 11, 123–206.Google Scholar
Fearon, P., Kirkbride, J. B., Morgan, C.et al. (2006). Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC ÆSOP study. Psychological Medicine, 36, 1541–50.Google Scholar
Fialko, L., Freeman, D., Bebbington, P. E.et al. (2006). Understanding suicidal ideation in psychosis: findings from the Psychological Prevention of Relapse in Psychosis (PRP) Trial. Acta Psychiatrica Scandinavica, 114, 177–86.Google Scholar
Fish, E. W., Shahrokh, D., Bagot, R.et al. (2004). Epigenetic programming of stress responses through variations in maternal care. Annals of the New York Academy of Sciences, 1036, 167–80.Google Scholar
Fowler, D. (2000). Cognitive behaviour therapy for psychosis: from understanding to treatment. Psychiatric Rehabilitation Skills, 4, 199–215.Google Scholar
Fowler, D., Freeman, D., Steel, C. et al. (2006). The catastrophic interaction hypothesis: how do stress, trauma emotion and information processing abnormalities lead to psychosis? In Trauma and Psychosis, ed. Larkin, W. and Morrison, A.. London: Routledge, pp. 101–24.
Freeman, D., Garety, P., Kuipers, E.et al. (2002). A cognitive model of persecutory delusions. British Journal of Clinical Psychology, 41, 331–47.Google Scholar
Freeman, D., Slater, M., Bebbington, P. E.et al. (2003). Can virtual reality be used to investigate persecutory ideation?Journal of Nervous and Mental Disease, 191, 509–14.Google Scholar
Freeman, D., Garety, P. A., Fowler, D.et al. (2004). Why do people with delusions fail to choose more realistic explanations for their experiences? An empirical investigation. Journal of Consulting and Clinical Psychology, 72, 671–80.Google Scholar
Freeman, D., Garety, P. A., Bebbington, P.et al. (2005a). The psychology of persecutory ideation II: a virtual reality experimental study. Journal of Nervous and Mental Disease, 193, 309–15.Google Scholar
Freeman, D., Garety, P. A., Bebbington, P. E.et al. (2005b). Psychological investigation of the structure of paranoia in a non-clinical population. British Journal of Psychiatry, 186, 427–35.Google Scholar
Freeman, D., Garety, P., Kuipers, E.et al. (2007). Acting on persecutory delusions: the importance of safety-seeking. Behaviour Research and Therapy, 45, 89–99.Google Scholar
Frith, C. D. (1992). The Cognitive Neuropsychology of Schizophrenia. Hove: Lawrence Erlbaum Associates.
Frith, C. (2005). The neural basis of hallucinations and delusions. Comptes Rendus Biologies, 328, 169–75.Google Scholar
Garety, P. A. and Hemsley, D. R. (1994). Delusions: Investigations into the Psychology of Delusional Reasoning. Oxford: Oxford University Press.
Garety, P. A., Kuipers, E. A., Fowler, D.et al. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31, 189–95.Google Scholar
Garety, P., Freeman, D., Jolley, S.et al. (2005). Reasoning, emotions and delusional conviction in psychosis. Journal of Abnormal Psychology, 114, 373–84.Google Scholar
Glaser, B., Moskvina, V., Kirov, G.et al. (2006). Analysis of ProDH, COMT and ZHHHC8 risk variants does not support individual or interactive effects on schizophrenia susceptibility. Schizophrenia Research, 87, 21–7.Google Scholar
Gray, J., Feldon, J. and Rawlins, J. (1991). The neuropsychology of schizophrenia. Behavioral and Brain Sciences, 14, 1–84.Google Scholar
Green, C. E. L., Garety, P. A., Freeman, D.et al. (2006). Content and affect in persecutory delusions. British Journal of Clinical Psychology, 45, 561–77.Google Scholar
Hanssen, M., Peeters, F., Krabbendam, L.et al. (2003). How psychotic are individuals with non-psychotic disorders?Social Psychiatry and Psychiatric Epidemiology, 38, 149–54.Google Scholar
Hanssen, M., Krabbendam, L., Graaf, R.et al. (2005). Role of distress in delusion formation. British Journal of Psychiatry, 48 (suppl.), s55–s58.Google Scholar
Hardy, A., Fowler, D., Freeman, D.et al. (2005). Trauma and hallucinatory experience in psychosis. Journal of Nervous and Mental Disease, 193, 503–7.Google Scholar
Hariri, A. R., Goldberg, T. E., Mattay, V. S.et al. (2003). Brain-derived neurotrophic factor val66met polymorphism affects human memory-related hippocampal activity and predicts memory performance. Journal of Neuroscience, 23, 6690–4.Google Scholar
Harris, T. (1987). Recent developments in the study of life events in relation to psychiatric and physical disorders. In Psychiatric Epidemiology, ed. Cooper, B.. London: Croom-Helm, pp. 81–103.
Harrison, P. J. and Weinberger, D. R. (2005). Schizophrenia genes, gene expression, and neuropathology: on the matter of their convergence. Molecular Psychiatry, 10, 40–68.Google Scholar
Hemsley, D. R. (1993). A simple (or simplistic?) cognitive model for schizophrenia. Behaviour Research and Therapy, 31, 633–45.Google Scholar
Hemsley, D. R. (1998). The disruption of the ‘sense of self’ in schizophrenia: potential links with disturbances of information processing. British Journal of Medical Psychology, 71, 115–24.Google Scholar
Hemsley, D. R. (2005). The schizophrenic experience: taken out of context?Schizophrenia Bulletin, 31, 43–53.Google Scholar
Janssen, I., Krabbendam, L., Bak, M.et al. (2004). Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatrica Scandinavica, 109, 38–45.Google Scholar
Jaspers, K. (1913). General Psychopathology. Translated (1963) by J. Hoenig and M. W. Hamilton. Manchester, UK: Manchester University Press.
Johns, L. C., Rossell, S., Ahmad, F.et al. (2001). Verbal self-monitoring and auditory verbal hallucinations in patients with schizophrenia. Psychological Medicine, 31, 705–15.Google Scholar
Johns, L. C., Cannon, M., Singleton, N.et al. (2004). The prevalence and correlates of self-reported psychotic symptoms in the British population. British Journal of Psychiatry, 185, 298–305.Google Scholar
Jolley, S., Garety, P., Bebbington, P.et al. (2006). Attributional style in psychosis: the role of affect and belief type. Behaviour Research and Therapy, 44, 1597–607.Google Scholar
Joyce, E. (2005). Origins of cognitive dysfunction in schizophrenia: clues from age at onset. British Journal of Psychiatry, 186, 93–5.Google Scholar
Kapur, S. (2003). Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. American Journal of Psychiatry, 160, 13–23.Google Scholar
Krabbendam, L. and Os, J. (2005). Affective processes in the onset and persistence of psychosis. European Archives of Psychiatry and Clinical Neuroscience, 255, 185–9.Google Scholar
Krabbendam, L., Myin-Germeys, I., Graaf, R.et al. (2004). Dimensions of depression, mania and psychosis in the general population. Psychological Medicine, 34, 1177–86.Google Scholar
Krabbendam, L., Myin-Germeys, I., Hanssen, M.et al. (2005). Development of depressed mood predicts onset of psychotic disorder in individuals who report hallucinatory experiences. British Journal of Clinical Psychology, 44, 113–25.Google Scholar
Kuipers, E., Bebbington, P., Dunn, G.et al. (2006). The influence of carer expressed emotion and affect on relapse in non-affective psychosis. British Journal of Psychiatry, 188, 173–9.Google Scholar
Kuipers, E., Watson, P., Onwumere, J.et al. (2007). Discrepant illness perceptions, expressed emotion and affect, in people with psychosis and their carers. Social Psychiatry and Psychiatric Epidemiology, 35, 242–7.Google Scholar
Law, A. J., Lipska, B. K., Weickert, C. S.et al. (2006). Neuregulin 1 transcripts are differentially expressed in schizophrenia and regulated by 5 SNPs associated with the disease. Proceedings of the National Academy of Sciences of the USA, 103, 6747–52.Google Scholar
Linney, Y. M., Murray, R. M., Peters, E. R.et al. (2003). A quantitative genetic analysis of schizotypal personality traits. Psychological Medicine, 33, 803–16.Google Scholar
Lipska, B. K., Peters, T., Hyde, T. M.et al. (2006). Expression of DISC1 binding partners is reduced in schizophrenia and associated with DISC1 SNPs. Human Molecular Genetics, 15, 1245–58.Google Scholar
Lobban, F., Barrowclough, C. and Jones, S. (2004). The impact of beliefs about mental health problems and coping on outcome in schizophrenia. Psychological Medicine, 37, 1165–74.Google Scholar
McGrath, J. J. (2006). Variations in the incidence of schizophrenia: data versus dogma. Schizophrenia Bulletin, 32, 195–7.Google Scholar
Meaney, M. J. (2001). Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations. Annual Review of Neuroscience, 24, 1161–92.Google Scholar
Melzer, D., Tom, B. D. M., Brugha, T. S.et al. (2002). Common mental disorder symptom counts in populations: are there distinct case groups above epidemiological cut-offs?Psychological Medicine, 32, 1195–201.Google Scholar
Meyer-Lindenberg, A., Kohn, P. D., Kolachana, B.et al. (2005). Midbrain dopamine and prefrontal function in humans: interaction and modulation by COMT genotype. Nature Neuroscience, 8, 594–6.Google Scholar
Morrison, A. P. (2001). The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy, 29, 257–76.Google Scholar
Mueser, K. T., Goodman, L. B., Trumbetta, S. L.et al. (1998). Trauma and posttraumatic stress disorder in severe mental illness. Journal of Consulting and Clinical Psychology, 66, 493–9.Google Scholar
Myin-Germeys, I., Os, J., Schwartz, J.et al. (2001). Emotional reactivity to daily life stress in psychosis. Archives of General Psychiatry, 58, 1137–44.Google Scholar
Norton, N., Williams, H. J. and Owen, M. J. (2006). An update on the genetics of schizophrenia. Current Opinion in Psychiatry, 19, 158–64.Google Scholar
Nuechterlein, K. H., Dawson, M. E., Ventura, J.et al. (1994). The vulnerability/stress model of schizophrenic relapse – a longitudinal study. Acta Psychiatrica Scandinavica, 89 (suppl. 382), 58–64.Google Scholar
Owen, M. J., Craddock, N. and Donovan, M. C. (2005). Schizophrenia: genes at last?Trends in Genetics, 21, 518–25.Google Scholar
Peters, E. and Garety, P. (2005). Cognitive functioning in delusions: a longitudinal analysis. Behaviour Research and Therapy, 44, 481–514.Google Scholar
Pinkham, A. E., Penn, D. L., Perkins, D. O.et al. (2003). Implications of the neural basis of social cognition for the study of schizophrenia. American Journal of Psychiatry, 160, 815–24.Google Scholar
Pinkham, A., Penn, D., Wangelin, B.et al. (2005). Facial emotion perception and fusiform gyrus volume in first episode schizophrenia. Schizophrenia Research, 79, 341–3.Google Scholar
Plomin, R., Owen, M. J. and McGuffin, P. (1994). The genetic basis of complex human behaviors. Science, 264, 1733–9.Google Scholar
Raune, D., Bebbington, P., Dunn, G.et al. (2006). Event attributes and the content of psychotic experiences in first-episode psychosis. Psychological Medicine, 36, 221–30.Google Scholar
Read, J., Os, J., Morrison, A. P.et al. (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica, 112 (5), 330–50.Google Scholar
Rechtman, R. (2004). The rebirth of PTSD: the rise of a new paradigm in psychiatry. Social Psychiatry and Psychiatric Epidemiology, 39, 913–15.Google Scholar
Sands, J. R. and Harrow, M. (1999). Depression during the longitudinal course of schizophrenia. Schizophrenia Bulletin, 25, 157–71.Google Scholar
Smith, B., Fowler, D. G., Freeman, D.et al. (2006). Emotion and psychosis: links between depression, self-esteem, negative schematic beliefs and delusions and hallucinations. Schizophrenia Research, 86, 181–8.Google Scholar
Sturt, E. (1981). Hierarchical patterns in the incidence of psychiatric symptoms. Psychological Medicine, 11, 783–94.Google Scholar
Turnbull, G. and Bebbington, P. (2001). Anxiety and the schizophrenic process: clinical and epidemiological evidence. Social Psychiatry and Psychiatric Epidemiology, 36, 235–43.Google Scholar
Os, J., Verdoux, H., Maurice-Tison, S.et al. (1999). Self-reported psychosis-like symptoms and the continuum of psychosis. Social Psychiatry and Psychiatric Epidemiology, 34, 459–63.Google Scholar
Watson, P. W. B., Garety, P. A., Weinman, J.et al. (2006). Emotional dysfunction in schizophrenia spectrum psychosis: the role of illness perceptions. Psychological Medicine, 36, 761–70.Google Scholar
Weaver, I. C., Carvoni, N., Champagne, F. A.et al. (2004). Epigenetic programming by maternal behaviour. Nature Neuroscience, 7, 847–54.Google Scholar
Wiles, N. J., Zammit, S., Bebbington, P.et al. (2006). Self-reported psychotic symptoms in the general population. British Journal of Psychiatry, 188, 519–26.Google Scholar
Wing, J. (1978). Reasoning about Madness. Oxford: Oxford University Press.

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×