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Design and Implementation of an fMRI Study Examining Thought Suppression in Young Women with, and At-risk, for Depression

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Negative cognition, depressed mood, and paranoia: a longitudinal pathway analysis using structural equation modeling.

David Fowler¹, Joanne Hodgekins, Philippa Garety

¹Department of Psychological Sciences, Norwich Medical School, University of East Anglia, Norwich, United Kingdom. d.fowler@uea.ac.uk

Schizophrenia Bulletin

|April 9, 2011

Summary

Negative cognition and depressed mood directly contribute to paranoia in psychosis. Depressed mood

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Area of Science:

Psychiatry and Psychology
Clinical Psychology

Background:

The role of negative cognition and affect in maintaining psychotic symptoms is recognized but lacks longitudinal substantiation.
Negative cognition and depressed mood are hypothesized to maintain paranoia in psychosis.

Purpose of the Study:

To investigate the causal role of negative cognition and depressed mood in maintaining paranoia.
To examine if the effect of mood on paranoia is mediated by negative cognition.

Main Methods:

Longitudinal cohort design with 301 patients from the Prevention of Relapse in Psychosis Trial.
Data collected at baseline, 3 months, and 12 months.
Structural equation modeling used to analyze relationships between negative cognition, depressed mood, and paranoia.

Main Results:

Models supporting a direct causal pathway from negative cognition and depressed mood to paranoia were most plausible.
No evidence for reverse causality was found.
The link between depressed mood and paranoia was mediated by negative cognition, corroborating hypotheses.

Conclusions:

Negative cognition plays a central role in the maintenance of paranoia in psychosis.
Findings support the integration of negative cognition into psychological interventions for psychosis.
The study contributes to conceptualizations of psychosis, highlighting cognitive and affective factors.