Momentary social and psychological predictors of positive psychotic symptoms

Abstract

The current thesis titled 'Momentary social and psychological predictors of positive psychotic symptoms' has been prepared by Kate Lawrence in the year 2019. The thesis has been submitted to The University of Manchester for the degree of Doctor of Clinical Psychology in the Faculty of Biology, Medicine and Health. The thesis has been prepared in paper-based format and comprises three papers. The overall theme of the thesis is the investigation of momentary social and psychological predictors of positive psychotic symptoms, specifically hallucinations and delusions. Firstly, a systematic literature review to elucidate associations between momentary psychological and social predictors and positive psychotic symptomatology is presented. Paper 1 provides a comprehensive review of 34 studies investigating psychological and social predictors of positive psychotic symptoms. The review critically synthesises and evaluates the research that has been carried out and published to date. The most consistent psychosocial predictors were negative affect, cognitive processes and stress sensitivity. There was a lack of recurring support for other psychosocial predictors namely, the social and familial environment, self-esteem, attachment insecurity, self-stigma and social media use. The results are considered in relation to methodological limitations, clinical implications and recommendations for future research. Secondly, an experience sampling methodology study was conducted to explore associations between proximity seeking, stress and paranoia in the context of daily life, and whether these relationships are moderated by trait attachment styles. Paper 2 presents an investigation involving 60 nonclinical participants. Participants completed state measures of stress, proximity seeking and paranoia six-times per day for 14-days. The results of multilevel regression analyses indicated that greater stress leads to shifts or disturbance in proximity seeking, but these alone are not associated with momentary paranoia. However, for individuals with an avoidant attachment style, greater shifts in proximity seeking were associated with greater reports of paranoia at subsequent timepoints, highlighting the need to consider the contribution of attachment representations to paranoid thinking. The findings are considered in relation to limitations of the study, recommendations for future research, and possible clinical and theoretical implications. Thirdly, a critical evaluation and reflection of the two papers mentioned above was conducted. Strengths and weaknesses regarding the chosen methodology, directions for theory, clinical implications and future research were considered. Finally, the overall research process was reflected upon.

Date of Award	1 Aug 2020
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Richard Brown (Supervisor)