Delusional belief flexibility and informal caregiving relationships in psychosis: a potential cognitive route for the protective effect of social support.

Aims. For people with psychosis, contact with informal caregivers is an important source of social support, associated with recovery, and with better outcomes following individual cognitive therapy (CBTp). In this study, we tested whether increased flexibility in delusional thinking, an established...

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Main Authors: Jolley, S, Ferner, H, Bebbington, P, Garety, P, Dunn, G, Freeman, D, Fowler, D, Kuipers, E
Format: Journal article
Language:English
Published: Cambridge University Press 2014
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author Jolley, S
Ferner, H
Bebbington, P
Garety, P
Dunn, G
Freeman, D
Fowler, D
Kuipers, E
author_facet Jolley, S
Ferner, H
Bebbington, P
Garety, P
Dunn, G
Freeman, D
Fowler, D
Kuipers, E
author_sort Jolley, S
collection OXFORD
description Aims. For people with psychosis, contact with informal caregivers is an important source of social support, associated with recovery, and with better outcomes following individual cognitive therapy (CBTp). In this study, we tested whether increased flexibility in delusional thinking, an established predictor of positive outcome following CBTp, was a possible mechanism underlying this effect. Methods. 219 participants with delusions (mean age 38 years; 71% male; 75% White) were grouped according to the presence of a caregiver (37% with a caregiver) and caregiver level of expressed emotion (High/Low EE, 64% Low). Delusional belief flexibility was compared between groups, controlling for interpersonal functioning, severity of psychotic symptoms, and other hypothesised outcome predictors. Results. Participants with caregivers were nearly three times more likely than those without to show flexibility (OR = 2.7, 95% CI 1.5 to 5.0, p = 0.001), and five times more likely if the caregiving relationship was Low EE (OR = 5.0, 95% CI 2.0-13.0, p = 0.001). ORs remained consistent irrespective of controlling for interpersonal functioning and other predictors of outcome. Conclusions. This is the first evidence that having supportive caregiving relationships is associated with a specific cognitive attribute in people with psychosis, suggesting a potential cognitive mechanism by which outcomes following CBTp, and perhaps more generally, are improved by social support.
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spelling oxford-uuid:50d3e407-9022-4ee7-b4fa-af2cbef2b31e2022-03-26T16:15:54ZDelusional belief flexibility and informal caregiving relationships in psychosis: a potential cognitive route for the protective effect of social support.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:50d3e407-9022-4ee7-b4fa-af2cbef2b31eEnglishSymplectic Elements at OxfordCambridge University Press2014Jolley, SFerner, HBebbington, PGarety, PDunn, GFreeman, DFowler, DKuipers, EAims. For people with psychosis, contact with informal caregivers is an important source of social support, associated with recovery, and with better outcomes following individual cognitive therapy (CBTp). In this study, we tested whether increased flexibility in delusional thinking, an established predictor of positive outcome following CBTp, was a possible mechanism underlying this effect. Methods. 219 participants with delusions (mean age 38 years; 71% male; 75% White) were grouped according to the presence of a caregiver (37% with a caregiver) and caregiver level of expressed emotion (High/Low EE, 64% Low). Delusional belief flexibility was compared between groups, controlling for interpersonal functioning, severity of psychotic symptoms, and other hypothesised outcome predictors. Results. Participants with caregivers were nearly three times more likely than those without to show flexibility (OR = 2.7, 95% CI 1.5 to 5.0, p = 0.001), and five times more likely if the caregiving relationship was Low EE (OR = 5.0, 95% CI 2.0-13.0, p = 0.001). ORs remained consistent irrespective of controlling for interpersonal functioning and other predictors of outcome. Conclusions. This is the first evidence that having supportive caregiving relationships is associated with a specific cognitive attribute in people with psychosis, suggesting a potential cognitive mechanism by which outcomes following CBTp, and perhaps more generally, are improved by social support.
spellingShingle Jolley, S
Ferner, H
Bebbington, P
Garety, P
Dunn, G
Freeman, D
Fowler, D
Kuipers, E
Delusional belief flexibility and informal caregiving relationships in psychosis: a potential cognitive route for the protective effect of social support.
title Delusional belief flexibility and informal caregiving relationships in psychosis: a potential cognitive route for the protective effect of social support.
title_full Delusional belief flexibility and informal caregiving relationships in psychosis: a potential cognitive route for the protective effect of social support.
title_fullStr Delusional belief flexibility and informal caregiving relationships in psychosis: a potential cognitive route for the protective effect of social support.
title_full_unstemmed Delusional belief flexibility and informal caregiving relationships in psychosis: a potential cognitive route for the protective effect of social support.
title_short Delusional belief flexibility and informal caregiving relationships in psychosis: a potential cognitive route for the protective effect of social support.
title_sort delusional belief flexibility and informal caregiving relationships in psychosis a potential cognitive route for the protective effect of social support
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