Cognitive Mechanisms of Change in Delusions: An Experimental Investigation Targeting Reasoning to Effect Change in Paranoia. by Garety, P, Waller, H, Emsley, R, Jolley, S, Kuipers, E, Bebbington, P, Dunn, G, Fowler, D, Hardy, A, Freeman, D

“…The primary hypotheses tested were that the reasoning training intervention, would improve (1) data gathering and belief flexibility and (2) delusional thinking, specifically paranoia. We then tested whether the changes in paranoia were mediated by changes in data gathering and flexibility, and whether working memory and negative symptoms moderated any intervention effects. …”

The Stress of the Street for Patients With Persecutory Delusions: A Test of the Symptomatic and Psychological Effects of Going Outside Into a Busy Urban Area. by Freeman, D, Emsley, R, Dunn, G, Fowler, D, Bebbington, P, Kuipers, E, Jolley, S, Waller, H, Hardy, A, Garety, P

“…There were indications that the increase in paranoia was partially mediated by increases in anxiety (45%), depression (38%), and negative beliefs about others (45%). …”

The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis. by Freeman, D, Sheaves, B, Goodwin, G, Yu, L, Nickless, A, Harrison, P, Emsley, R, Luik, A, Foster, R, Wadekar, V, Hinds, C, Gumley, A, Jones, R, Lightman, S, Jones, S, Bentall, R, Kinderman, P, Rowse, G, Brugha, T, Blagrove, M, Gregory, A, Fleming, L, Walklet, E, Glazebrook, C, Davies, E, Hollis, C, Haddock, G, John, B, Coulson, M, Fowler, D, Pugh, K, Cape, J, Moseley, P, Brown, G, Hughes, C, Obonsawin, M, Coker, S, Watkins, E, Schwannauer, M, MacMahon, K, Siriwardena, A, Espie, C

“…Insomnia was a mediator of change in paranoia and hallucinations. No adverse events were reported. …”

The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis by Freeman, D, Sheaves, B, Goodwin, G, Yu, L, Nickless, A, Harrison, P, Emsley, R, Luik, A, Fosterk, R, Wadekar, V, Hinds, C, Gumley, A, Jones, R, Lightman, S, Jones, S, Bentall, R, Kinderman, P, Rowse, G, Brugha, T, Blagrove, M, Gregory, A, Fleming, L, Walklet, E, Glazebrook, C, Davies, E, Hollis, C, Haddock, G, John, B, Coulson, M, Fowler, D, Pugh, K, Cape, J, Moseley, P, Brown, G, Hughes, C, Obonsawin, M, Coker, S, Watkins, E, Schwannauer, M, Macmahon, K, Siriwardena, A, Espie, C

“…Insomnia was a mediator of change in paranoia and hallucinations. No adverse events were reported. …”

Disrupting Sleep: The Effects of Sleep Loss on Psychotic Experiences Tested in an Experimental Study With Mediation Analysis by Reeve, S, Emsley, R, Sheaves, B, Freeman, D

“…Our view is that insomnia may be a causal factor in the occurrence of psychotic experiences such as paranoia and hallucinations. However, the causal relationship is not established. …”

Current paranoid thinking in patients with delusions: the presence of cognitive-affective biases. by Freeman, D, Dunn, G, Fowler, D, Bebbington, P, Kuipers, E, Emsley, R, Jolley, S, Garety, P

“…Psychological research on persecutory delusions ascribes a prominent role to cognitive processes related to negative affect: anxiety leads to the anticipation of threat within paranoia; depressive negative ideas about the self create a sense of vulnerability in which paranoid thoughts flourish; and self-consciousness enhances feelings of the self as a target. …”

Urbanicity, persecutory delusions, and clinical intervention: the development of a brief CBT module for helping patients with persecutory delusions enter social urban environments. by Freeman, D, Waller, H, Harpur-Lewis, R, Moore, R, Garety, P, Bebbington, P, Kuipers, E, Emsley, R, Dunn, G, Fowler, D, Jolley, S

“…There was evidence that going outside after the intervention led to less paranoid responses than the initial exposure, but this was only statistically significant for levels of distress.Initial evidence was obtained that a brief CBT module specifically focused on helping patients with paranoia go outside is feasible, acceptable, and may have clinical benefits. …”

High-resolution examination of the relationship between sleep disturbance, functioning and psychotic symptoms in schizophrenia: a novel experience sampling study. by Mulligan, L, Haddock, G, Emsley, R, Neil, S, Kyle, S

“…Increased sleep fragmentation and reduced subjective and objective sleep efficiency predicted greater next-day auditory hallucinations, whereas increased objective sleep fragmentation and reduced subjective sleep quality predicted greater paranoia and delusions of control. Negative affect on awakening mediated a proportion of these relationships (range: 17.9% - 57.3%). …”