Psychological processes associated with negative symptoms and quality of life in psychosis

Abstract

The thesis has been prepared in paper-based format and comprises three papers. Paper one provides a systematic review and meta-analysis of 42 studies investigating the relationship between mental health stigma and subjective quality of life in non-affective psychosis. Meta-analyses showed medium to large associations between higher stigma and poorer subjective QoL. High statistical inconsistency across the studies was observed that could not be explained by study quality or sample and methodological characteristics. A narrative summary highlighted emerging literature to suggest that psychological processes related to self-concept and social network may mediate the relationship between stigma and subjective QoL in psychosis. The literature was limited by cross-sectional designs. Future longitudinal research is needed to examine causal pathways and explanatory or mediating mechanisms. Paper two presents cross-sectional research investigating the relationships between childhood interpersonal trauma, attachment pattern, dissociation and negative symptoms in psychosis. A sample of 242 participants with experience of psychosis took part in an online survey and completed several validated self-report questionnaires. Mediation analyses showed that disorganised attachment and dissociative experiences mediated the relationship between childhood interpersonal trauma and negative symptoms. Avoidant attachment and dissociative compartmentalisation were independently associated with negative symptoms but were not associated with childhood trauma. Mediation models adjusted for age, and positive and depressive symptoms. Model of fit indices were poor suggesting more work is needed to examine potential psychological processes underlying the pathway to negative symptoms. Papers one and two discuss the findings in relation to methodological and theoretical considerations, and recommendations for research and clinical practice. Paper three presents a critical evaluation and reflection of the research, including additional theoretical and methodological considerations and the author’s personal reflections relating to the topic area and conducting the research.  

Date of Award	31 Dec 2020
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Katherine Berry (Supervisor) & Sandra Bucci (Supervisor)