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Previous research suggests that measures of dysphoria relate to positive schizophrenic symptoms. These relationships have rarely been studied within the dimensionality of psychopathology framework. The present study examined the relationship between 3 distinct aspects of dysphoria (depression and state and trait anxiety) and delusion and hallucinat...
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... interaction was inferred when the interaction term was a significant predictor, and there was a significant ΔR 2 in the second step. Table 1 presents the mean scores and SDs for each of the questionnaire measures used in the study. Independent samples t tests found no significant differences between men and women for each of the questionnaire measures. ...
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Citations
... It is important to note that this was not a healthy control sample, but rather a non-psychotic general population sample. This was necessary because removing participants with any mental illness may have artificially reduced the number of participants who demonstrate hallucination-proneness, given that there is some evidence of more frequent psychopathology (such as anxious and depressive symptoms) in those with hallucination or delusion-proneness [28][29][30] . 120 participants signed up to complete the task. ...
There is increasing evidence that people with hallucinations overweight perceptual beliefs relative to incoming sensory evidence. Much past work demonstrating prior overweighting has used simple, non-linguistic stimuli. However, auditory hallucinations in psychosis are often complex and linguistic. There may be an interaction between the type of auditory information being processed and its perceived quality in engendering hallucinations. We administered a linguistic version of the Conditioned Hallucinations (CH) task to an online sample of 88 general population participants. Metrics related to hallucination-proneness, recent auditory hallucinations, stimulus thresholds, and stimulus detection were collected; data was used to fit parameters of a Hierarchical Gaussian Filter model of perceptual inference to determine how latent perceptual states influenced task behavior. Replicating past results, higher CH rates were associated with measures of higher hallucination-proneness and recent hallucinatory experiences; CH rates were positively correlated with increased prior weighting; and increased prior weighting was related to recent hallucinatory experiences. Unlike past results, participants with recent hallucinatory experiences as well as those with higher hallucination-proneness had higher stimulus thresholds, lower sensitivity to stimuli presented at the highest threshold, and tended to have lower response confidence, consistent with lower precision of sensory evidence. We show that hallucination-prone individuals in the general population have increased conditioned hallucination rates using a linguistic version of the CH task, and replicated the finding that increased CH rates and recent hallucinations correlate with increased prior weighting. Results support a role for reduced sensory precision in the interplay between prior weighting and hallucination-proneness. *contributed equally
... Research has shown that the experience of hallucinations and delusions are frequently associated with high levels of emotional distress (Buck et al., 2020;Hartley et al., 2013a;Smith et al., 2006) and depression (Hartley et al., 2013b). Specifically, depression, rather than anxiety, has been linked to higher rates of hallucinations and delusional ideation (Cella et al., 2008), and individuals with psychosis with high levels of depression have been observed to have more severe auditory hallucinations with more negative content, as well as more distressing and severe persecutory delusions (Smith et al., 2006). Thus, it has been proposed that there are both affective and cognitive components involved in the mechanisms of psychosis (Garety et al., 2001Smith et al., 2006). ...
Background
Subclinical psychotic symptoms are common in the general population and are often benign. However, those that become distressing or persistent may increase risk for development of a psychotic disorder. Cognitive models have proposed that certain appraisals of hallucinatory experiences can lead to delusional beliefs, particularly if an individual is experiencing negative mood. However, the dynamic relationships among these symptoms in young people are poorly understood. This study examined the longitudinal relationships among hallucinations, delusional ideation, and depression in a sample of young adults.
Methods
677 college students completed baseline questionnaires to assess: delusional ideation (Peters Delusions Inventory), hallucinations (Launay-Slade Hallucinations Scale-Extended), and depression (Beck Depression Inventory). These measures were repeated 7, 13, 19, and 25 months later.
Results
Higher baseline severity of hallucinations was strongly predictive of severity of delusions across all future follow-up timepoints, specifically when baseline depression was high. However, the severity of hallucinations did not change over time, nor were they predicted by baseline delusional ideation.
Conclusions
These findings support the proposal that hallucinations frequently precede more severe delusional ideation, rather than the reverse sequence, and only when depressive symptoms are present. Such longitudinal relationships provide clues to the underlying mechanisms of psychosis, highlighting one pathway for intervention.
... The CDSS total score was not related with momentary negative PLEs in daily life, which seems to suggest that the CDSS, as intended by its developers, overcomes the problematic differentiation between depressive and negative symptoms. In contrast, clear associations between CDSS total score and positive PLEs were found, which is in agreement with other studies describing the relationship between depressive and positive symptoms in clinical (Häfner et al., 2013;Hartley et al., 2013;Peralta & Cuesta, 2009;Salokangas et al., 2016;Zisook et al., 1999) and nonclinical populations (Cella et al., 2008;Debbané et al., 2009;Lewandowski et al., 2006;Moritz et al., 2017), and in ESM studies (Ben-Zeev et al., 2011;Kramer et al., 2014;Thewissen et al., 2011;van der Steen et al., 2017). Similarly, we found a clear association of the general depression factor of the CDSS with positive PLEs, which is also consistent with various studies (Addington et al., 2014;Lançon et al., 1999;Suttajit et al., 2013). ...
This study evaluated the psychometric properties and factor structure of the Calgary Depression Scale for Schizophrenia (CDSS) across different levels of the schizotypy continuum. A combined sample of high-schizotypy, at-risk mental states, and patients with first-episode psychosis was assessed for depression and other clinical and functional outcomes. Additionally, experience sampling methodology was used to assess depressive and psychotic-like experiences in daily life. The CDSS exhibited solid internal consistency, validity, and discrimination between depressed and nondepressed participants. Confirmatory factor analyses and the associations of the resulting factors with clinical and functional measures supported a two-factor structure that included general depression and guilt factors. Furthermore, both factors of the CDSS were differentially related to positive and negative symptoms of psychosis in daily life. The CDSS appears to have two underlying psychopathological dimensions and to be a reliable and valid measure for assessing depression across the schizotypy continuum.
... Also, because previous studies have observed correlations between delusional severity and measures of symptoms of depression, anxiety, and hallucinatory experiences Preti et al., 2007a;Cella et al., 2008;Scott et al., 2008;Varghese et al., 2008), we repeated the analyses while covarying for these symptoms, to determine the specificity of our findings to delusional beliefs. Lastly, we measured the contribution of the participants who endorsed persecutory beliefs (+P) and those who did not (−P), using a regions-of-interest (ROI) approach. ...
... In the full sample (n = 122), levels of symptoms of depression, anxiety, and hallucinatory experiences were found to be significantly correlated with levels of subclinical delusional thinking (r = 0.38, p < 0.001; r = 0.31, p = 0.001; r = 0.64, p < 0.001, respectively), as expected (Cella et al., 2008;Varghese et al., 2008). Given these relationships, we repeated the categorical analyses above with levels of depression, anxiety, and hallucinatory experiences included as covariates; the findings remained significant [ p < 0.05, FDR whole-brain-corrected; MNI coordinates of peak of the H v. L group comparison (x, y, z) = −24, −84, −2, z = 4.69, p = 0.020, 1523 voxels; MNI coordinates of peak of the PH v. PL group comparison (x, y, z) = −28, −78, 2, z = 5.83, p = 0.003, 1756 voxels]. ...
Background
Subclinical delusional ideas, including persecutory beliefs, in otherwise healthy individuals are heritable symptoms associated with increased risk for psychotic illness, possibly representing an expression of one end of a continuum of psychosis severity. The identification of variation in brain function associated with these symptoms may provide insights about the neurobiology of delusions in clinical psychosis.
Methods
A resting-state functional magnetic resonance imaging scan was collected from 131 young adults with a wide range of severity of subclinical delusional beliefs, including persecutory ideas. Because of evidence for a key role of the amygdala in fear and paranoia, resting-state functional connectivity of the amygdala was measured.
Results
Connectivity between the amygdala and early visual cortical areas, including striate cortex (V1), was found to be significantly greater in participants with high ( n = 43) v. low ( n = 44) numbers of delusional beliefs, particularly in those who showed persistence of those beliefs. Similarly, across the full sample, the number of and distress associated with delusional beliefs were positively correlated with the strength of amygdala-visual cortex connectivity. Moreover, further analyses revealed that these effects were driven by those who endorsed persecutory beliefs.
Conclusions
These findings are consistent with the hypothesis that aberrant assignments of threat to sensory stimuli may lead to the downstream development of delusional ideas. Taken together with prior findings of disrupted sensory-limbic coupling in psychosis, these results suggest that altered amygdala-visual cortex connectivity could represent a marker of psychosis-related pathophysiology across a continuum of symptom severity.
... Relapse prevention is therefore a highly desired outcome. Early warning signs of relapse usually comprise dysphoria and the emergence of attenuated but distressing psychotic symptoms (eg, hearing voices), appearing over a period of typically 5 days (Brown, Kim, Mitchell, & Inskip, 2010;Cella, Cooper, Dymond, & Reed, 2008;Gleeson, Rawlings, Jackson, & McGorry, 2005). Evidence using ambulatory methods for tracking symptoms suggests that high levels of symptom related distress and poor coping abilities are amongst the most important factors contributing to relapse (Lardinois et al., 2007). ...
Aims
Psychotic symptoms fluctuate over time and effective and regular monitoring may contribute to relapse prevention and improve long‐term outcomes. In this proof‐of‐concept study we test the feasibility, acceptability and potential usefulness of a novel digital method assessing the association between physiological signals and psychotic symptom distress.
Methods
Fifteen participants with first episode psychosis were asked to use a self‐assessment mobile phone application for psychotic symptom monitoring for 10 days while using a wrist worn device continuously recording heart rate variability (HRV) and electrodermal activity (EDA). We compared physiological activity when participants reported experiencing distressing and non‐distressing psychotic symptoms.
Results
Participants completed on average 76% of the mobile phone symptom assessments. When reporting distressing hallucinations and delusions participants had significantly higher EDA levels and non‐significant lower HRV values compared to when these symptoms were non‐distressing.
Conclusions
This study provides further evidence linking psychotic symptom's distress, as experienced in everyday life, and autonomic deregulation. This proof‐of‐concept study may lead to further longer‐term efforts to identify relapse biosignatures using automated methods based on passive monitoring. This method may allow for earlier interventions, contribute to improve relapse prevention and reduce symptoms interfering with recovery.
... The psychological distress seen in mental disorders usually manifests as a state of emotional suffering marked by negative emotions such as depression (e.g., lost interest, sadness, hopelessness) and anxiety (e.g., restlessness, feeling tense; Mirowsky & Ross, 2002). Some research has indicated that negative emotions (psychological distress) may also accompany psychotic symptoms (Cella, Cooper, Dymond, & Reed, 2008;Freeman & Garety, 2003). ...
... Associations between increased negative emotions, such as anxiety, depression, and stress, and hallucinatory and delusional symptoms (Cella et al., 2008;Freeman & Garety, 2003;Paulik, Badcock, & Maybery, 2006) and schizotypal traits (Armando et al., 2010) have been documented in both clinical and nonclinical samples. On the other hand, a lot of research has shown that some factors are inversely related to several negative mental health outcomes. ...
... These findings may not be totally relevant to the present study, which focused on nonclinical individuals with a proneness to PLEs. Research on nonclinical adults has also provided evidence for dysphoria as a potential risk factor for the development of positive schizophrenic symptoms (Cella et al., 2008;Guillem, Pampoulova, Stip, Lalonde, & Todorov, 2005;Paulik et al., 2006) and the significant effect of stress on the occurrence of hallucinatory experiences (Crowe et al., 2011). In these previous investigations, dysphoria was considered as contributing to the emergence of psychotic like symptoms. ...
... The word "dysphoria" derives from the ancient Greek dysphoros, formed from dis-, "difficult," and phero, "to bear," meaning an oppressive and unbearable emotional condition. In psychiatric and clinical psychological literature, the term appears not only in the context of borderline personality disorder but even in that of mood or anxiety, being used as a synonym for sadness or subthreshold forms of depression and to describe a mixture of negative and unpleasant emotions lacking specificity (Voruganti and Awad 2004;Cella et al. 2008). So, things are not clear and a deeper understanding of dysphoria is needed. ...
This article on dysphoria as a psychopathological organizer in borderline patients
examines the borderline personality disorder (BPD) from a contemporary
psychopathological perspective, focusing on the dimension of lived experience rather
than on the description of psychiatric symptoms. It presents dysphoria as a process which
structures the borderline patient’s experience in multiple, psychopathological pathways
moving from basic lived experience to symptomatic disturbances (and vice versa),
through here-and-now lived experience. It describes the psychopathological features
characterizing the BPD basic lived experience (background dysphoria and negative
interpersonal disposition) as well as the temporary affect related to situational triggers
saturating the BPD here-and-now lived experience (situational dysphoria). It also
discusses two specific pathways of situational dysphoria, one organizing and another
disorganizing, each ending up in different, acute phenomena. A final paragraph of this
article is dedicated to the role of shame in borderline psychopathology.
... Moreover, whereas a five-factor solution was found in the LSHS adaptation of Larøi and van der Linden (2005b), a four-factor structure was proposed by the Italian adaptation of the Belgian version (Vellante et al., 2012). Despite the controversy surrounding this topic, there is substantial evidence that all LSHS versions are especially reliable, having adequate psychometric properties (e.g., Waters et al., 2003;Cella et al., 2008) and temporal stability (e.g., Morrison et al., 2002). Moreover, the LSHS is a versatile instrument that can be used to measure hallucination predisposition in both nonclinical (e.g., Morrison et al., 2000;Waters et al., 2003;Larøi et al., 2004;Larøi and van der Linden, 2005b) and clinical individuals (e.g., Levitan et al., 1996;Serper et al., 2005). ...
The experience of hallucinations is a hallmark of psychotic disorders, but they are also present in other psychiatric and medical conditions, and may be reported in nonclinical individuals. Despite the increased number of studies probing the incidence of nonclinical hallucinations, the underlying phenomenological characteristics are still poorly understood. This study aimed to examine the psychometrics proprieties of the Portuguese adaptation of the 16-item Launay-Slade Hallucinations Scale (LSHS), the phenomenological characteristics of nonclinical hallucinatory experiences in a Portuguese sample, and the relationship between clinical symptoms and hallucination predisposition. Three-hundred-and-fifty-four European Portuguese college students completed the LSHS. Of those, 16 participants with high LSHS scores and 14 with low LSHS scores were further screened for clinical symptoms. A three-factor solution for the LSHS Portuguese version proved to be the most adequate. Intrusive or vivid thoughts and sleep-related hallucinations were the most common. Although, fundamentally perceived as positive experiences, all types of hallucinations were described as uncontrollable and dominating. However, the more pleasant they were perceived, the more controllable they were assessed. In addition, hallucination predisposition was associated with increased clinical symptoms. These results corroborate the lower severity of hallucinations in the general population compared to psychotic individuals. Further, they support an association between clinical symptoms and increased vulnerability to hallucinations. Specifically, increased schizotypal tendencies and negative mood (anxiety and depression) may be related to increased psychotic risk.
... Distress can be triggered by events in an individual's environment or other subjective psychological experiences. The presentation of trait schizotypy with state auditory verbal hallucination (AVH) predisposition is one combination which may lead to the emergence of additional psychological vulnerabilities including psychological distress (Cella et al., 2008), disruptions in metacognitive processes (Barkus et al., 2010), and delusion formation (Krabbendam et al., 2005). The greater the number of additional "hits" an individual encounters, the higher the risk of transition to psychotic disorders, with risk increasing in a dose-dependent fashion (Binbay et al., 2012;Pedersen and Mortensen, 2001). ...
Schizotypy is regarded as a trait vulnerability for psychotic disorders, yet alone is insufficient for development of a diagnosable disorder. Additional symptoms and psychological distress are necessary for help seeking and transition from an at risk mental state to a clinical diagnosis. The present study investigated the interaction between trait schizotypy, state auditory verbal hallucination (AVH) predisposition, distress and handedness for the expression of neurological soft signs (NSS), a neurodevelopmental vulnerability factor for psychosis. Cluster analysis formed schizotypy groups statistically across the dimensions captured by the SPQ. It was hypothesized that schizotypy and AVH predisposition would interact, resulting in significantly greater NSS. Psychological distress and handedness were hypothesized to be significant covariates, accounting for some variance in the expression of NSS between the groups. A sample of University students (n=327) completed the Schizotypal Personality Questionnaire, Launay-Slade Hallucination Scale, General Health Questionnaire and the Neurological Evaluation Scale (NES). Cluster Analysis revealed four schizotypy groups. Distress was not a significant covariate in any analysis. As expected, those with high overall schizotypy and high AVH predisposition expressed significantly greater Motor-Coordination NSS compared to those with high schizotypy and low AVH predisposition. Within the Mixed Interpersonal and Cognitive-Perceptual Schizotypy cluster, those with low AVH predisposition expressed significantly more Motor-Coordination NSS than those with high AVH predisposition. These findings suggest motor coordination NSS are detectable in schizotypy, and AVH predisposition appears to interact with these traits. This study highlights the importance of considering both trait and subclinical state risk factors when investigating risk for psychosis.
... However, on the basis of the present study we could not draw conclusions about the factors underlying the occurrence of delusion-like experiences. The results of the previous study indicate that the cognitive [42,43], emotional [33,39,43] and personality factors (e.g. [17]) play a role in the emergence of delusion-like and hallucination-like experiences. ...
... However, on the basis of the present study we could not draw conclusions about the factors underlying the occurrence of delusion-like experiences. The results of the previous study indicate that the cognitive [42,43], emotional [33,39,43] and personality factors (e.g. [17]) play a role in the emergence of delusion-like and hallucination-like experiences. ...
