The role of shame, schemas, cognitions, paranoia and memories in social anxiety following psychosis: a comparison with typical social anxiety

Cooke, Sarah (2012) The role of shame, schemas, cognitions, paranoia and memories in social anxiety following psychosis: a comparison with typical social anxiety. Doctoral thesis, University of East Anglia.

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Objectives. This study aimed to investigate the nature of social anxiety in
psychosis through comparison with individuals with social anxiety without
psychosis. Extending the work of Lockett (2011), it explored factors
associated with both cognitive models of social anxiety (Clark & Wells, 1995;
Rapee & Heimberg, 1997) and models of social anxiety in psychosis
(Birchwood et al., 2006; Lockett, 2011).
Methods. The study employed a quantitative cross-sectional design to
compare participants with social anxiety and psychosis (SAp group, n = 30)
with participants with social anxiety and no psychosis (SA group, n = 35) on
measures of shame, socially anxious cognitions, schemas and paranoia. A
semi-structured interview elicited images and memories experienced in
social situations. A self-report measure compared the groups in relation to
trauma symptoms associated with reported memories.
Results. Participants in the SAp group experienced significantly higher
levels of shame, negative self-schemas and PTSD symptoms than
participants in the SA group. There were no significant differences between
the groups on measures of socially anxious cognitions, negative otherschemas
and self/other focus of memories. Participants in both groups
scored highly for paranoia, with the scores for the SAp group being
significantly higher. When the sample was split based on level of paranoia
(regardless of psychosis), paranoid participants had significantly higher
scores for shame, negative self and other schemas, depression and PTSD.
Data suggested paranoid participants are more likely to experience images
associated with memories focused on threatening others.
Conclusions. The findings suggested two possible pathways to the
development of social anxiety. Paranoia may differentiate social anxiety as
part of complex emotional dysfunction from social anxiety as conceptualised
within existing cognitive models (Clark & Wells, 1995; Rapee & Heimberg,
1997). A number of limitations are discussed to enable a balanced
interpretation of the study findings. These included the small sample size;
characteristics of the participants, particularly the number of students in the
SA group; and the violation of parametric assumptions in the data for
depression and negative schemas. Clinical implications are discussed,
including the need for thorough assessment of paranoia, trauma and shame
and the importance of the therapeutic relationship and assertive engagement
of complex clients.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Users 2593 not found.
Date Deposited: 28 May 2013 15:26
Last Modified: 28 May 2013 15:43


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