The social environment and psychosis: search for symptom specificity

Wickham, Sophie
(2014) The social environment and psychosis: search for symptom specificity. PhD thesis, University of Liverpool.

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Research with clinical and nonclinical samples has linked multiple psycho-social risk factors with psychosis. There has since been an emphasis on the importance of investigating specific symptoms experienced within the psychosis spectrum to better understand the psychological processes involved. The studies included in this doctoral thesis used cross sectional methods to explore relationships between specific social adversities and specific symptoms within the psychotic domain and also depression, using a number of different samples (students, client groups and general population). This thesis also explores mediating mechanisms between adversities and specific symptoms, paying particular attention to the role of specific adversities in paranoid ideation. I found that perceived childhood inequality, neglect and adulthood social deprivation and insecure attachment styles predicted paranoid thoughts in student, epidemiological and clinical samples. In my student study I further developed and validated a tool to measure perceived relative deprivation. I then used this tool and found that personal perceptions of injustice and low social rank mediated the relationship between perceived relative deprivation and paranoia. In my epidemiological study I found that experiences of discrimination, lack of trust and stress partially explained the relationship between current social disadvantage and paranoia. In my two clinical studies I found that negative self-esteem explained the association between insecure attachment dimensions and paranoia, and strong perceptions of injustice and an over perception of justice in the world explained the association between childhood emotional neglect and paranoia. Considering hallucinations, I found specific associations between perceived childhood deprivation and hallucinations in my student sample and between sexual abuse and hallucinations in my patient sample, although none of the mediating variables tested in this thesis accounted for these associations, suggesting other mechanisms may be important. The findings of the current studies suggest that it is possible to identify specific associations between adversity and psychotic symptoms in general, and highlight the need to develop a science of public mental health, which at present barely exists as a discipline. In the future, more complex and imaginative designs examining specific environments, specific outcomes, and specific mediating mechanisms will be required if this is to be achieved.

Item Type: Thesis (PhD)
Additional Information: Date: 2014-07 (completed)
Depositing User: Symplectic Admin
Date Deposited: 27 Aug 2015 15:18
Last Modified: 17 Dec 2022 01:07
DOI: 10.17638/02007509