Attachment, Schemas and Psychosis

Abstract

The aim of this thesis was to understand more about how attachment and schemas are involved in the experience of psychosis. The thesis is presented in the form of three individual papers. Paper One presents a systematic literature review and meta-analysis of current evidence for schema change through Cognitive Behavioural Therapy (CBT) interventions for psychosis. Database searches identified 19 studies delivering a CBT informed intervention to a sample of people with experiences of psychosis. Ten studies included a control group and were subsequently included within the meta-analysis. The findings highlighted that participants receiving a CBT intervention were more likely to experience a significant reduction in their negative self-schemas at the end of the study period compared to those who were in a control group. Clinical and research implications are discussed, and the results emphasise the importance of considering schema as a process measure within future research. Paper Two is an empirical investigation of the relationship between styles of parenting from caregivers during childhood, and adult experiences of psychosis. The role of insecure attachment styles and negative self and other schemas were considered as mediating factors within this relationship. One hundred and thirty-two adults with self-reported experiences of psychosis were recruited to an online cross-sectional questionnaire study. Serial mediation analyses revealed that the relationship between parenting styles experienced during childhood and adult experiences of psychosis was mediated by insecure attachment and negative schemas. Differences were seen in the mediation analyses depending on parenting styles. Abusive and overcontrolling parenting were associated with anxious and disorganised attachment. In contrast, indifferent parenting was linked to avoidant attachment. Clinical implications of the study include recommendations for attachment-based parenting interventions and a focus on attachment and schemas within psychological interventions for psychosis. Paper Three is a critical reflection of the process of carrying out the thesis as a whole. Methodological decisions are explained alongside personal reflections of carrying out the thesis project.

Date of Award	19 Sept 2024
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Katherine Berry (Main Supervisor) & Christopher Taylor (Co Supervisor)