Negative symptoms in first-episode psychosis: a mixed methods investigation

Gee, Brioney (2016) Negative symptoms in first-episode psychosis: a mixed methods investigation. Doctoral thesis, Norwich Medical School.

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Abstract

Negative symptoms – reductions in expression, motivation, pleasure and sociability
– are observed across the spectrum of functional psychoses. They have been
identified as a significant predictor of poor outcomes following first-episode
psychosis and are a treatment priority for individuals with lived-experience of
psychosis. However, the mechanisms underlying negative symptoms remain poorly
understood. This thesis aims to contribute to our understanding of negative
symptoms in the early phase of psychosis using a mixed methods approach.
Participants in the EDEN study (n = 1006) were followed up for 12 months
following acceptance into UK Early Intervention in Psychosis services. Negative
symptom severity data were modelled using latent class growth analysis, allowing
latent classes comprising individuals with similar patterns of change in negative
symptoms severity over time to be identified. Predictors of latent class membership
were ascertained and the relationship between negative symptom trajectories and
concurrent social recovery explored. Subsequently, transcripts of qualitative
interviews conducted with a subsample (n = 24) of the cohort were analysed
thematically. Comparisons were made between the accounts of members of the
identified latent classes. Experiences and personal understandings of negative
symptoms, psychosis, treatment and recovery were explored, providing insights into
potential mechanisms underlying negative symptoms and their relationship with
social recovery.
The quantitative and qualitative findings were integrated and interpreted in relation
to existing research and theory. Together they informed the development of a
conceptual model of negative symptoms and their relationship with poor social
recovery following first-episode psychosis. The model suggests that active
psychological processes may be important to negative symptoms and their
contribution to poor social recovery. It is proposed that offering tailored
psychosocial interventions at the earliest stage of disorder – after the onset of nonspecific
negative symptoms but before the emergence of attenuated positive
symptoms – may be warranted to improve outcomes following psychosis onset.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Katie Miller
Date Deposited: 21 Jul 2017 13:06
Last Modified: 30 Apr 2018 00:38
URI: https://ueaeprints.uea.ac.uk/id/eprint/64222
DOI:

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