Investigating the psychological factors associated with distress in psychosis

  • Rebecca Wilson

Student thesis: Doctor of Clinical Psychology


This thesis investigated the psychological factors associated with distress in the early stages of psychosis. The first chapter is a systematic review and meta-analysis of the literature assessing the comorbidity rates of both depression and anxiety in first-episode psychosis (FEP). Prevalence rates were shown be similar between depression and anxiety for included studies, suggesting that both anxiety and depression should be targeted for intervention, together with the psychotic symptoms. The second chapter is a secondary analysis of clinical trial data investigating the relationship between distress, severity and frequency of attenuated psychotic symptoms in individuals meeting ultra-high risk criteria for psychosis (UHR), both cross-sectionally and over time. A confirmatory factor analysis (CFA) and latent growth curve (LGC) models were applied to assess the study aims. The impact of cognitive behavioural therapy (CBT) on distress reduction over time by symptom was also assessed which did not significantly reduce distress compared with monitoring. Overall distress reduced over time, particularly in the first three months after presentation, although this was dependent on the type of psychotic symptom. The final chapter provides a critical appraisal of the previous chapters and overall research process. In conclusion, this thesis recommends that distress should be used as an outcome in future clinical research and as a clinical indicator to guide professional involvement.
Date of Award31 Dec 2019
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorAnthony Morrison (Supervisor) & Alison Yung (Supervisor)

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