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T114. THE CAUSAL DYNAMICS OF PARANOIA IN PATIENTS WITH SCHIZOPHRENIA: A THEORY DRIVEN NETWORK ANALYSIS
BACKGROUND: A cognitive account identifies six key psychological maintenance factors for persecutory delusions. However, a complex system of causation is likely where these factors interact in their influence on paranoid ideas. We set out to evaluate the causal dynamics of paranoia with theory-drive...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234416/ http://dx.doi.org/10.1093/schbul/sbaa029.674 |
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author | Bird, Jessica Evans, Robin Taylor, Kathryn M Molodynski, Andrew Waite, Felicity Freeman, Daniel |
author_facet | Bird, Jessica Evans, Robin Taylor, Kathryn M Molodynski, Andrew Waite, Felicity Freeman, Daniel |
author_sort | Bird, Jessica |
collection | PubMed |
description | BACKGROUND: A cognitive account identifies six key psychological maintenance factors for persecutory delusions. However, a complex system of causation is likely where these factors interact in their influence on paranoid ideas. We set out to evaluate the causal dynamics of paranoia with theory-driven network approaches. METHODS: 1809 patients with non-affective psychosis attending UK mental health services completed assessments of paranoia, hallucinations, insomnia, self-esteem, worry, anxious avoidance, analytic reasoning, and psychological well-being. To assess causal patterns, we estimated, first, an undirected partial correlation network and then, second, adopted a Bayesian approach with Directed Acyclic Graphs to discover the directed causal pathways best supported by the data. RESULTS: The networks showed that with all other variables controlled, paranoia had direct causal interactions with hallucinations, negative self-beliefs, insomnia, worry, and avoidance. Hallucinations and negative self-beliefs were most directly linked to paranoia, whereas indirect paths had prominent influences on the causal effects for insomnia, worry, and avoidance. The direction of these interactions was uncertain, but negative self-beliefs and insomnia were more likely to influence paranoia than vice versa. Self-report reasoning was likely unrelated to paranoia once other factors were controlled. Causal factors were highly interconnected, with insomnia, negative self-beliefs, avoidance, and worry most directly linked to other variables. Most interactions were likely reciprocal, except for hallucinations which were unlikely to influence other variables and significantly caused by insomnia and avoidance. DISCUSSION: The findings are consistent with a complex system of interacting causation in the maintenance of paranoia. The patterns observed support the cognitive model of persecutory delusions, highlighting multiple pathways of causal interaction between paranoia and theoretically important factors. Interventions directly targeting these factors are likely to lead to multiple benefits, alleviating paranoia both directly and indirectly through connections with other causally related symptoms. |
format | Online Article Text |
id | pubmed-7234416 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-72344162020-05-23 T114. THE CAUSAL DYNAMICS OF PARANOIA IN PATIENTS WITH SCHIZOPHRENIA: A THEORY DRIVEN NETWORK ANALYSIS Bird, Jessica Evans, Robin Taylor, Kathryn M Molodynski, Andrew Waite, Felicity Freeman, Daniel Schizophr Bull Poster Session III BACKGROUND: A cognitive account identifies six key psychological maintenance factors for persecutory delusions. However, a complex system of causation is likely where these factors interact in their influence on paranoid ideas. We set out to evaluate the causal dynamics of paranoia with theory-driven network approaches. METHODS: 1809 patients with non-affective psychosis attending UK mental health services completed assessments of paranoia, hallucinations, insomnia, self-esteem, worry, anxious avoidance, analytic reasoning, and psychological well-being. To assess causal patterns, we estimated, first, an undirected partial correlation network and then, second, adopted a Bayesian approach with Directed Acyclic Graphs to discover the directed causal pathways best supported by the data. RESULTS: The networks showed that with all other variables controlled, paranoia had direct causal interactions with hallucinations, negative self-beliefs, insomnia, worry, and avoidance. Hallucinations and negative self-beliefs were most directly linked to paranoia, whereas indirect paths had prominent influences on the causal effects for insomnia, worry, and avoidance. The direction of these interactions was uncertain, but negative self-beliefs and insomnia were more likely to influence paranoia than vice versa. Self-report reasoning was likely unrelated to paranoia once other factors were controlled. Causal factors were highly interconnected, with insomnia, negative self-beliefs, avoidance, and worry most directly linked to other variables. Most interactions were likely reciprocal, except for hallucinations which were unlikely to influence other variables and significantly caused by insomnia and avoidance. DISCUSSION: The findings are consistent with a complex system of interacting causation in the maintenance of paranoia. The patterns observed support the cognitive model of persecutory delusions, highlighting multiple pathways of causal interaction between paranoia and theoretically important factors. Interventions directly targeting these factors are likely to lead to multiple benefits, alleviating paranoia both directly and indirectly through connections with other causally related symptoms. Oxford University Press 2020-05 2020-05-18 /pmc/articles/PMC7234416/ http://dx.doi.org/10.1093/schbul/sbaa029.674 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Poster Session III Bird, Jessica Evans, Robin Taylor, Kathryn M Molodynski, Andrew Waite, Felicity Freeman, Daniel T114. THE CAUSAL DYNAMICS OF PARANOIA IN PATIENTS WITH SCHIZOPHRENIA: A THEORY DRIVEN NETWORK ANALYSIS |
title | T114. THE CAUSAL DYNAMICS OF PARANOIA IN PATIENTS WITH SCHIZOPHRENIA: A THEORY DRIVEN NETWORK ANALYSIS |
title_full | T114. THE CAUSAL DYNAMICS OF PARANOIA IN PATIENTS WITH SCHIZOPHRENIA: A THEORY DRIVEN NETWORK ANALYSIS |
title_fullStr | T114. THE CAUSAL DYNAMICS OF PARANOIA IN PATIENTS WITH SCHIZOPHRENIA: A THEORY DRIVEN NETWORK ANALYSIS |
title_full_unstemmed | T114. THE CAUSAL DYNAMICS OF PARANOIA IN PATIENTS WITH SCHIZOPHRENIA: A THEORY DRIVEN NETWORK ANALYSIS |
title_short | T114. THE CAUSAL DYNAMICS OF PARANOIA IN PATIENTS WITH SCHIZOPHRENIA: A THEORY DRIVEN NETWORK ANALYSIS |
title_sort | t114. the causal dynamics of paranoia in patients with schizophrenia: a theory driven network analysis |
topic | Poster Session III |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234416/ http://dx.doi.org/10.1093/schbul/sbaa029.674 |
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