title: Variation in psychosocial influences according to the dimensions and content of children's unusual experiences: potential routes for the development of targeted interventions.
abstract: The psychosocial processes implicated in the development and maintenance of psychosis differ according to both the dimensional attributes (conviction, frequency, associated distress, adverse life impact) and the content or type (e.g. grandiosity, hallucinations, paranoia) of the psychotic symptoms experienced. This has informed the development of 'targeted' cognitive behavioural therapy for psychosis (CBTp): interventions focusing on specific psychological processes in the context of particular symptom presentations. In adults, larger effect sizes for change in primary outcomes are typically reported in trials of targeted interventions, compared to those for trials of generic CBTp approaches with multiple therapeutic foci. We set out to test the theoretical basis for developing targeted CBTp interventions for young people with distressing psychotic-like, or unusual, experiences (UEs). We investigated variations in the psychosocial processes previously associated with self-reported UE severity (reasoning, negative life events, emotional problems) according to UE dimensional attributes and content/type (using an established five-factor model) in a clinically referred sample of 72 young people aged 8-14 years. Regression analyses revealed associations of conviction and grandiosity with reasoning; of frequency, and hallucinations and paranoia, with negative life events; and of distress/adverse life impact, and paranoia and hallucinations, with emotional problems. We conclude that psychological targets for intervention differ according to particular characteristics of childhood UEs in much the same way as for psychotic symptoms in adults. The development of targeted interventions is therefore indicated, and tailoring therapy according to presentation should further improve clinical outcomes for these young people.
authors.affiliation: King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK.
authors.forename: Tamatha
authors.initials: T
authors.lastname: Ruffell
authors.affiliation: King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK.
authors.forename: Matilda
authors.initials: M
authors.lastname: Azis
authors.affiliation: King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK.
authors.forename: Nedah
authors.initials: N
authors.lastname: Hassanali
authors.affiliation: King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Ames
authors.affiliation: South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Sophie
authors.initials: S
authors.lastname: Browning
authors.affiliation: South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Bracegirdle
authors.affiliation: South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Corrigall
authors.affiliation: National Institute for Health Research Mental Health Biomedical Research Centre and Dementia Unit (BRC/U) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, UK.|King's College London, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, London, UK.|Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia.|Schizophrenia Research Institute, Sydney, Australia.
authors.forename: Kristin R
authors.initials: KR
authors.lastname: Laurens
authors.affiliation: King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK.|National Institute for Health Research Mental Health Biomedical Research Centre and Dementia Unit (BRC/U) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, UK.|University of Western Australia, Crawley, Australia.
authors.forename: Colette
authors.initials: C
authors.lastname: Hirsch
authors.affiliation: King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK.|National Institute for Health Research Mental Health Biomedical Research Centre and Dementia Unit (BRC/U) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuipers
authors.affiliation: South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Maddox
authors.affiliation: King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK. suzanne.jolley@kcl.ac.uk.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Jolley
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000523:psychology / Q000628:therapy*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003702:Delusions / Q000523:psychology / Q000628:therapy*; D005260:Female; D006212:Hallucinations / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D011613:Psychotherapy / Q000379:methods; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*
keywords: CBT; Cognitive model; Cognitive therapy; Psychosis; Psychotic-like experience (PLE)