Cargando…
Unravelling psychosis: psychosocial epidemiology, mechanism, and meaning
This paper reviews a revolution in our understanding of psychosis over the last 20 years. To a major extent, this has resulted from a process of cross-fertilization between psychosocial epidemiology and cognitive behavior therapy for psychosis (CBT-p). This encouraged complementary strategies for th...
Autor principal: | |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Shanghai Municipal Bureau of Publishing
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4466846/ https://www.ncbi.nlm.nih.gov/pubmed/26120255 http://dx.doi.org/10.11919/j.issn.1002-0829.215027 |
_version_ | 1782376292975378432 |
---|---|
author | BEBBINGTON, Paul |
author_facet | BEBBINGTON, Paul |
author_sort | BEBBINGTON, Paul |
collection | PubMed |
description | This paper reviews a revolution in our understanding of psychosis over the last 20 years. To a major extent, this has resulted from a process of cross-fertilization between psychosocial epidemiology and cognitive behavior therapy for psychosis (CBT-p). This encouraged complementary strategies for the acquisition and analysis of data. These include the use of a range of dependent variables related to psychosis, and the exploitation of data from cross-sectional and longitudinal epidemiological surveys, virtual reality experiments, experience sampling methodology, and treatment trials. The key element is to investigate social and psychological measures in relation to each other. This research has confirmed the role of the external social world in the development and persistence of psychotic disorder. In addition, several psychological drivers of psychotic experiences have been identified. There is now persuasive evidence that the influence of social factors in psychosis is significantly mediated by non-psychotic symptoms, particularly mood symptoms and other attributes of affect such as insomnia. Psychotic symptoms are also driven by reasoning biases such as jumping to conclusions and belief inflexibility, though little is known about social influences on such biases. It is now clear that there are many routes to psychosis and that it takes many forms. Treatment of all kinds should take account of this: the dependence of CBT-p on a detailed initial formulation in terms of psychological processes and social influences is an example of the required flexibility. Individual mediators are now being targeted in specific forms of CBT-p, with good effect. This in turn corroborates the hypothesized role of non-psychotic symptoms in mediation, and attests to the power of the approaches described. |
format | Online Article Text |
id | pubmed-4466846 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Shanghai Municipal Bureau of Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-44668462015-06-26 Unravelling psychosis: psychosocial epidemiology, mechanism, and meaning BEBBINGTON, Paul Shanghai Arch Psychiatry Special Article This paper reviews a revolution in our understanding of psychosis over the last 20 years. To a major extent, this has resulted from a process of cross-fertilization between psychosocial epidemiology and cognitive behavior therapy for psychosis (CBT-p). This encouraged complementary strategies for the acquisition and analysis of data. These include the use of a range of dependent variables related to psychosis, and the exploitation of data from cross-sectional and longitudinal epidemiological surveys, virtual reality experiments, experience sampling methodology, and treatment trials. The key element is to investigate social and psychological measures in relation to each other. This research has confirmed the role of the external social world in the development and persistence of psychotic disorder. In addition, several psychological drivers of psychotic experiences have been identified. There is now persuasive evidence that the influence of social factors in psychosis is significantly mediated by non-psychotic symptoms, particularly mood symptoms and other attributes of affect such as insomnia. Psychotic symptoms are also driven by reasoning biases such as jumping to conclusions and belief inflexibility, though little is known about social influences on such biases. It is now clear that there are many routes to psychosis and that it takes many forms. Treatment of all kinds should take account of this: the dependence of CBT-p on a detailed initial formulation in terms of psychological processes and social influences is an example of the required flexibility. Individual mediators are now being targeted in specific forms of CBT-p, with good effect. This in turn corroborates the hypothesized role of non-psychotic symptoms in mediation, and attests to the power of the approaches described. Shanghai Municipal Bureau of Publishing 2015-04-25 /pmc/articles/PMC4466846/ /pubmed/26120255 http://dx.doi.org/10.11919/j.issn.1002-0829.215027 Text en Copyright © 2015 by Shanghai Municipal Bureau of Publishing http://creativecommons.org/licenses/by-nc-sa/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/ |
spellingShingle | Special Article BEBBINGTON, Paul Unravelling psychosis: psychosocial epidemiology, mechanism, and meaning |
title | Unravelling psychosis: psychosocial epidemiology, mechanism, and meaning |
title_full | Unravelling psychosis: psychosocial epidemiology, mechanism, and meaning |
title_fullStr | Unravelling psychosis: psychosocial epidemiology, mechanism, and meaning |
title_full_unstemmed | Unravelling psychosis: psychosocial epidemiology, mechanism, and meaning |
title_short | Unravelling psychosis: psychosocial epidemiology, mechanism, and meaning |
title_sort | unravelling psychosis: psychosocial epidemiology, mechanism, and meaning |
topic | Special Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4466846/ https://www.ncbi.nlm.nih.gov/pubmed/26120255 http://dx.doi.org/10.11919/j.issn.1002-0829.215027 |
work_keys_str_mv | AT bebbingtonpaul unravellingpsychosispsychosocialepidemiologymechanismandmeaning |