The Role of Worry, Rumination and Sleep Disturbance in Psychosis

Abstract

The aim of this thesis was to explore the relationships between worry, rumination, psychotic symptoms and sleep disturbance. The thesis is presented as three papers; a systematic literature review, an empirical study and a critical appraisal. The systematic literature review in paper one gathered findings from clinical studies on the role of worry and rumination in psychosis. Robust evidence was found for a positive association between worry and persecutory delusions but not auditory hallucinations. Little evidence was found for a relationship between rumination and persecutory delusions or auditory hallucinations, yet conclusions remained tentative due to the limited number of studies in this area. The empirical study in paper two used experience sampling methodology (ESM) to investigate the relationship between objective, actigraphy defined, sleep disturbance and next-day worry, rumination and psychotic symptoms in people experiencing psychosis. Sleep disturbance did not predict worry, rumination or psychotic symptoms. Worry and rumination predicted concurrent auditory hallucinations and worry additionally predicted concurrent persecutory delusions. Effect estimates were small, as was the sample size, meaning the findings must be interpreted with caution. The critical appraisal in paper three evaluates and reflects upon the entire research process for both the literature review and empirical study. Strengths and weaknesses of the research are considered as well as implications for theory, clinical practice and future research.

Date of Award	31 Dec 2017
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Gillian Haddock (Supervisor) & Lynsey Gregg (Supervisor)