• Assessment of metacognitive beliefs in an at risk mental state for psychosis: A validation study of the Metacognitions Questionnaire-30

      Bright, Measha; Parker, Sophie; French, Paul; Morrison, Anthony P.; Tully, Sarah; Stewart, Suzanne L. K.; Wells, Adrian; University of Manchester; Greater Manchester Mental Health NHS Foundation Trust; University of Chester (Wiley, 2018-06-07)
      Aim: The Metacognitions Questionnaire-30 (MCQ-30) has been used to assess metacognitive beliefs in a range of mental health problems. The aim of this study is to assess the validity of the MCQ-30 in people at risk for psychosis. Methods: One hundred and eighty-five participants meeting criteria for an at risk mental state (ARMS) completed the MCQ-30 as part of their involvement in a randomised controlled trial. Confirmatory and exploratory factor analyses were conducted to assess factor structure and construct validity. Results: Confirmatory factor analyses confirmed the original 5-factor structure of the MCQ-30. Examination of principal component analysis and parallel analysis outputs also suggested a 5-factor structure. Correlation analyses including measures of depression, social anxiety and beliefs about paranoia showed evidence of convergent validity. Discriminant validity was supported using the normalising subscale of the beliefs about paranoia tool. Conclusions: The MCQ-30 demonstrated good fit using the original 5-factor model, acceptable to very good internal consistency of items was evident and clinical usefulness in those at risk for psychosis was demonstrated.
    • Core Schemas across the Continuum of Psychosis: A Comparison of Clinical and Non-Clinical Groups

      Taylor, Hannah E.; Stewart, Suzanne L. K.; Dunn, Graham; Parker, Sophie; Fowler, David; Morrison, Anthony P.; University of Manchester; Greater Manchester West Mental Health NHS Foundation; University of East Anglia (Cambridge University Press, 2013-08-07)
      Background: Research suggests that core schemas are important in both the development and maintenance of psychosis. Aims: The aim of the study was to investigate and compare core schemas in four groups along the continuum of psychosis and examine the relationships between schemas and positive psychotic symptomatology. Method: A measure of core schemas was distributed to 20 individuals experiencing first-episode psychosis (FEP), 113 individuals with “at risk mental states” (ARMS), 28 participants forming a help-seeking clinical group (HSC), and 30 non-help-seeking individuals who endorse some psychotic-like experiences (NH). Results: The clinical groups scored significantly higher than the NH group for negative beliefs about self and about others. No significant effects of group on positive beliefs about others were found. For positive beliefs about the self, the NH group scored significantly higher than the clinical groups. Furthermore, negative beliefs about self and others were related to positive psychotic symptomatology and to distress related to those experiences. Conclusions: Negative evaluations of the self and others appear to be characteristic of the appraisals of people seeking help for psychosis and psychosis-like experiences. The results support the literature that suggests that self-esteem should be a target for intervention. Future research would benefit from including comparison groups of people experiencing chronic psychosis and people who do not have any psychotic-like experiences.
    • Metacognitive beliefs as psychological predictors of social functioning: an investigation with young people at risk of psychosis

      Bright, Measha; Parker, Sophie; French, Paul; Fowler, David; Gumley, Andrew I.; Morrison, Anthony P.; Birchwood, Max; Jones, Peter B.; Stewart, Suzanne L. K.; Wells, Adrian; et al. (Elsevier, 2017-09-14)
      Poor social functioning has been found to be present in those at risk for psychosis. This study aimed to examine metacognitive beliefs as potential predictors of structured activity (measure of social functioning) in those with an At Risk Mental State (ARMS). Regression and correlation analyses were conducted. The sample included 109 young people. Age was found to be positively correlated to structured activity. Metacognitive beliefs concerning uncontrollability and danger of worry were found to negatively predict structured activity. This was after controlling for age, gender, treatment allocation, cognitive schemas, positive symptom severity, social anxiety, and depression. Metacognitive danger items were most important. Age was the only control variable found to be an independent predictor of structured activity in the regression model, despite negative bi-variate relationships with structured activity found across three cognitive schema subscales and social anxiety. This is the first study to find that higher negative metacognitive beliefs about uncontrollability and danger predict lower social functioning in an ARMS sample, and that the perception of thoughts being dangerous was of particular importance. Psychological interventions should consider targeting this metacognitive dimension to increase social functioning. Future longitudinal research is required to strengthen findings in this area.
    • Psychopathology and affect dysregulation across the continuum of psychosis: A multiple comparison group study

      Taylor, Hannah E.; Stewart, Suzanne L. K.; Dunn, Graham; Parker, Sophie; Bentall, Richard P.; Birchwood, Max; Morrison, Anthony P.; University of Manchester; Greater Manchester West Mental Health NHS Foundation Trust; Bangor University; University of Birmingham (Wiley, 2013-06-17)
      Aim: There is evidence that psychotic-like phenomena can be detected within the general population and that psychotic experiences lie on a continuum which also spans affective states. We aimed to investigate comparisons of a first episode psychosis group, an ‘at-risk mental state group’ and a help-seeking control group with non-patients to explore whether affective states lie on a continuum of psychosis. Method: Measures of psychotic-like experiences, social anxiety and depression were administered to 20 patients experiencing first episode psychosis (FEP), 113 patients experiencing an ‘at-risk’ mental state (ARMS), 28 patients who were help-seeking but not experiencing a FEP or ARMS (HSC) and 30 non-clinical participants (NC). Results: For distress in relation to psychotic-like experiences, the FEP, ARMS and HSC groups scored significantly higher than the NC group for the perceptual abnormalities and non-bizarre ideas. In terms of severity of psychotic experiences, the FEP scored the highest, followed by the ARMS group, followed by the HSC and NC group. The clinical groups scored significantly higher for depression than the non-clinical group. Interestingly, only the FEP and the ARMS group scored significantly higher than non-patients for social anxiety. Conclusions: These findings suggest that a psychosis continuum exists, however this does not suggest that both psychosis and affective symptoms lie on the same continuum, rather it would appear that the presence of such affective states that may affect help-seeking behavior and clinical status. The implications of these findings for clinical practice are discussed.