2: Psychosis

Question 1

Define: psychosis

Answer 1

loss of contact with reality

Question 2

What are 2 positive symptoms of psychosis?

Answer 2

hallucinations/delusions

Question 3

What are 3 negative symptoms of psychosis?

Answer 3

flat affect, avolution, lack of interest in social interactions

Question 4

define: flat effect

Answer 4

is when you feel emotions but show practically nothing visually

Question 5

define: avolution

Answer 5

a significant or severe lack of motivation or a pronounced inability to complete purposeful tasks

Question 6

Why were psychological therapies not widely investigated for psychosis until the 1990s?

Answer 6

• Psychosis was seen as fundamentally different from neurosis.
• Symptoms not seen as understandable in psychological terms (e.g., Jaspers).
• Lack of therapeutic optimism in the treatment of “schizophrenia”.
• Poor results from early trials of psychotherapy.
• Neuroleptics were seen as the only viable treatment option.

Question 7

What are the 5 types of therapy for psychosis?

Answer 7

Rogerian/person-centred therapy.
Psychoanalytic therapies.
Cognitive Behaviour Therapy (CBT).
Family therapy.
Interventions to reduce substance misuse.

Question 8

How does CBTp (Cognitive Behavioural Therapy for psychosis) work?

Answer 8

Establish links between, thoughts and current or past symptoms and/or functioning.
Re-evaluate their beliefs, perceptions and reasoning relating to target symptoms.
Development of alternative ways of coping, reduction of distress, and/or improvement of functioning.

Question 9

What does formulating in CBTp mean?

Answer 9

Therapist identifies thoughts, feelings, behaviours that are linked to the problem/symptom targeted.
Help the client to see how these interact to maintain the problem in the present.
Create a shared understanding of how the problem developed and what could be done to resolve it.

Question 10

What does normalising psychosis in CBTp involve? (4)

Answer 10

Challenging the stigma of psychosis.
Correcting common misconceptions about psychosis, its causes and its consequences.
Provision of more accurate information.
Promotion of accurate views about psychosis.

Question 11

How do negative beliefs about psychosis correlate to impairment from psychosis?

Answer 11

Evidence suggesting that negative beliefs about psychosis (e.g., that these experiences are dangerous, uncontrollable or lead to catastrophic consequences) strongly predict distress and impairment

Question 12

What are the 5 myths of psychosis?

Answer 12

1. People with psychosis are dangerous
2. Psychosis is a diagnosis for life and there is no recovery.
3. People with psychosis are unable to work.
4. Psychosis always causes distress and people always need treatment
5. Psychosis is always a consequence of brain disease

Question 13

What proportion of people only ever have 1 psychotic episode?

Answer 13

30%

Question 14

What proportion of people experience more than one episode even after long periods of being symptom-free?

Answer 14

30%

Question 15

What proportion of people have persistent ongoing psychosis symptoms

Answer 15

<25%

Question 16

What factors can contribute to psychosis?

Answer 16

Lack of sleep.
Sensory deprivation.
Substances or activities creating altered states of consciousness.
Stressful events (hostage situations, combat stress and other life- threatening situations).
Bereavement.
Trauma (bullying, abuse, violence, etc.).

Question 17

Can CBTp be effective in the absence of anti-psychotic medication?

Answer 17

yes