Suchergebnisse

Background: The study examines effects of social difficulties such as invalidating and stressful relationships and lack of social support on cognitive processes in psychosis.Methods: Biographical and ethnographic methods deriving insights from personal experience of psychosis; interactions with patients in hospital and hostel care and from group work.Conclusions: Social stresses can damage the self, resulting in disarray to executive control, serial ordering, organizational and retrieval processes. Negative social experiences also skew probability judgements of the likelihood of threat/ betrayal which may be confirmed by coincidences – resulting in the adoption of a risky decisional style. This maximizes perceptions confirming of a delusional belief.

Congruent with recent demands for greater attention to be given to patients' actual experiences at a fine-grained level in the understanding of psychosis (e.g. Thomas 1997) the present paper first describes one day in an actual psychotic episode suffered by the author in 1979 and then subjects this narrative to analytic and normalisation interpretations. It is suggested that acute psychotic thinking of paranoid form is critically mediated by real social events and by intrapsychic deficits in attentional capacity; metacognition; thought regulation and signal discriminative ability. Cognitive processes in delusion however, are suggested to be influenced by the presence of a threatening external locus of control. This reflects the strong social and political quality to delusional suffering. The effects therefore of victimisation on cognitive processes is suggested to be an important issue in social cognitive psychology and psychiatry.