title: Predictors of distress associated with psychotic-like anomalous experiences in clinical and non-clinical populations.
abstract: OBJECTIVE
  Psychotic-like anomalous experiences are not inherently distressing, nor do they inevitably lead to clinical conditions. However, distress is an important predictor of onset and relapse in psychosis, and a primary indicator of problematic mental health. This study aimed to identify factors that predict distress across three groups with anomalous experiences.
  
  
  METHODS
  This study used a cross-sectional design. Participants in 'Diagnosed' (n = 35), 'At Risk' (n = 20), and 'Undiagnosed' (n = 36) groups completed the Appraisals of Anomalous Experiences Interview (AANEX; Brett et al., 2007, Br. J. Psychiatry, 191, s23), which taps anomalies experienced, appraisals, and other psychological and contextual variables. A series of ordinal logistic regression analyses was conducted to investigate which variables predicted anomaly-related distress.
  
  
  RESULTS
  Predictors of higher distress were anomalous states characterized by changes in awareness and cognitive functioning (rather than more typical positive symptoms), appraisals of experiences as caused by 'other people', and greater attempted control over experiences. Predictors of lower distress were 'spiritual' appraisals, greater perceived social support/understanding, greater perceived controllability, and reacting with a 'neutral response'.
  
  
  CONCLUSIONS
  While psychotic-like experiences themselves are not necessarily distressing, appraisals and responses to anomalies do predict distress, as do factors relating to the social context. This adds support to the cognitive-behavioural models, and continuum models, of positive psychotic symptoms.
authors.affiliation: Sussex Partnership NHS Foundation Trust, Early Intervention in Psychosis Service (EIPS), Brighton & Hove, UK; Department of Psychology (P077), Institute of Psychiatry, King's College London, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Brett
authors.forename: Charles
authors.initials: C
authors.lastname: Heriot-Maitland
authors.forename: Philip
authors.initials: P
authors.lastname: McGuire
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Peters
mesh_terms: D000328:Adult; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology*; D012944:Social Support; D029181:Spirituality; D013315:Stress, Psychological / Q000523:psychology*; D055815:Young Adult
keywords: anomalous experiences; appraisals; cognitive models; positive symptoms; psychosis