Virtual reality clinical-experimental tests of compassion treatment techniques to reduce paranoia.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
22 05 2020
22 05 2020
Historique:
received:
17
03
2020
accepted:
24
04
2020
entrez:
24
5
2020
pubmed:
24
5
2020
medline:
2
12
2020
Statut:
epublish
Résumé
Paranoia may build on negative beliefs held both about the self and others. Compassionate imagery may be one way of reducing such negative beliefs, and hence paranoia. Two studies tested this idea, one targeting compassion for the self and one targeting compassion for others. Two-hundred individuals from the general population scoring highly for paranoia were recruited. The studies used a randomised controlled experimental design, with embedded tests for mediation. Study one targeted self-compassion via creation of a compassionate coach (CC) image. Study two targeted compassion for others via loving kindness meditation (LKM). Individuals repeatedly entered neutral virtual reality social environments. Changes in compassion and paranoia were assessed. Compared to controls, the CC group increased in self-compassion (group difference = 2.12, C.I. = 1.57;2.67, p = <0.0001, d = 1.4) and decreased in paranoia (group difference = -1.73, C.I. = -2.48; -0.98, p = <0.0001, d = 0.8). Change in self-compassion explained 57% of change in paranoia. Compared to controls, the LKM group increased their compassion for others (group difference = 3.26, C.I. = 2.72;3.80, p = <0.0001, d = 1.7), and decreased in paranoia (group difference = -1.70, C.I. = -2.50; -0.89, p = <0.0001, d = 0.8). Change in compassion for others explained 67% of change in paranoia. Targeting negative beliefs about the self and others using compassionate imagery causes reductions in paranoia. Tests in clinical populations are indicated.
Identifiants
pubmed: 32444619
doi: 10.1038/s41598-020-64957-7
pii: 10.1038/s41598-020-64957-7
pmc: PMC7244556
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
8547Subventions
Organisme : Department of Health
ID : II-C7-0117-20001
Pays : United Kingdom
Organisme : Department of Health
ID : RP-2014-05-003
Pays : United Kingdom
Références
Kendler, K. S. & Campbell, J. Interventionist causal models in psychiatry: repositioning the mind–body problem. Psychol. Med. 39, 881–887 (2009).
doi: 10.1017/S0033291708004467
Dunn, G. et al. Evaluation and validation of social and psychological markers in randomised trials of complex interventions in mental health: a methodological research programme. Health Technol. Assess. 19, 1–115 (2015).
doi: 10.3310/hta19930
Bebbington, P. E. et al. The structure of paranoia in the general population. Br. J. Psychiatry 202, 419–427 (2013).
doi: 10.1192/bjp.bp.112.119032
Wong, K. K., Freeman, D. & Hughes, C. Suspicious young minds: Paranoia and mistrust in 8- To 14-year-olds in the UK and Hong Kong. Br. J. Psychiatry 205, 221–229 (2014).
doi: 10.1192/bjp.bp.113.135467
Freeman, D. et al. Psychological investigation of the structure of paranoia in a non- clinical population. Br. J. Psychiatry 186, 427–435 (2005).
doi: 10.1192/bjp.186.5.427
Bird, J. C., Waite, F., Rowsell, E., Fergusson, E. C. & Freeman, D. Cognitive, affective, and social factors maintaining paranoia in adolescents with mental health problems: A longitudinal study. Psychiatry Res. 257, 34–39 (2017).
doi: 10.1016/j.psychres.2017.07.023
Zavos, H. M. S. et al. Consistent etiology of severe, frequent psychotic experiences and milder, less frequent manifestations: A twin study of specific psychotic experiences in adolescence Objective—Investigate degree of genetic and environmental influences on specific psychoti. JAMA Psychiatry 71, 1049–1057 (2014).
doi: 10.1001/jamapsychiatry.2014.994
Fowler, D. et al. The Brief Core Schema Scales (BCSS): Psychometric properties and associations with paranoia and grandiosity in non-clinical and psychosis samples. Psychol. Med. 36, 749–759 (2006).
doi: 10.1017/S0033291706007355
Freeman, D. Persecutory delusions: a cognitive perspective on understanding and treatment. The Lancet Psychiatry 3, 685–692 (2016).
doi: 10.1016/S2215-0366(16)00066-3
Kirby, J. N., Tellegen, C. L. & Steindl, S. R. A Meta-Analysis of Compassion-Based Interventions: Current State of Knowledge and Future Directions. Behav. Ther. 48, 778–792 (2017).
doi: 10.1016/j.beth.2017.06.003
Hickey, T., Nelson, B. & Meadows, G. Application of a mindfulness and compassion-based approach to the at-risk mental state. Clin. Psychol. 21, 104–115 (2017).
doi: 10.1111/cp.12132
Ascone, L., Sundag, J., Schlier, B. & Lincoln, T. M. Feasibility and Effects of a Brief Compassion-Focused Imagery Intervention in Psychotic Patients with Paranoid Ideation: A Randomized Experimental Pilot Study. Clin. Psychol. Psychother. 24, 348–358 (2017).
doi: 10.1002/cpp.2003
Lincoln, T. M., Felicitas, H. & Hartmann, M. Can Paranoid Thoughts be Reduced by Targeting Negative Emotions and Self-Esteem? An Experimental Investigation of a Brief Compassion-Focused Intervention. Cognit. Ther. Res. 37, 390–402 (2012).
doi: 10.1007/s10608-012-9470-7
Collett, N., Pugh, K., Waite, F. & Freeman, D. Negative cognitions about the self in patients with persecutory delusions: An empirical study of self-compassion, self-stigma, schematic beliefs, self-esteem, fear of madness, and suicidal ideation. Psychiatry Res. 239, 79–84 (2016).
doi: 10.1016/j.psychres.2016.02.043
Eicher, A. C., Davis, L. W. & Lysaker, P. H. Self-Compassion: A Novel Link With Symptoms in Schizophrenia? J. Nerv. Ment. Dis. 201, 289–93 (2013).
doi: 10.1097/NMD.0b013e31828e10fa
Mills, A. et al. Paranoid Beliefs and Self-Criticism in Students. Clin. Psychol. Psychother. Clin. Psychol. Psychother 14, 358–364 (2007).
doi: 10.1002/cpp.537
Hutcherson, C. A., Seppala, E. M. & Gross, J. J. Loving-Kindness Meditation Increases Social Connectedness. Emotion 8, 720–724 (2008).
doi: 10.1037/a0013237
Freeman, D. et al. Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychol. Med. 47, 2393-2400 https://doi.org/10.1017/S003329171700040X (2017).
Pot-Kolder, R. et al. Effects of virtual reality based cognitive behavioural therapy for paranoid ideation and social avoidance in patients with a psychotic disorder: a randomised controlled trial. The Lancet Psychiatry 5, 217–226, https://doi.org/10.1016/S2215-0366(18)30053-1 (2018).
Freeman, D. et al. Virtual reality in the treatment of persecutory delusions: Randomised controlled experimental study testing how to reduce delusional conviction. Br. J. Psychiatry 209, 62–67 (2016).
doi: 10.1192/bjp.bp.115.176438
Freeman, D. et al. Automated virtual reality (VR) cognitive therapy for patients with psychosis: Study protocol for a single-blind parallel group randomised controlled trial (gameChange). BMJ Open 9, 1–8 (2019).
doi: 10.1136/bmjopen-2019-030833
Atherton, S. et al. Self-Confidence and Paranoia: An Experimental Study Using an Immersive Virtual Reality Social Situation. Behav. Cogn. Psychother. 44, 56–64 (2016).
doi: 10.1017/S1352465814000496
Freeman, D. et al. Height, social comparison, and paranoia: An immersive virtual reality experimental study. Psychiatry Res. 218, 348–352 (2014).
doi: 10.1016/j.psychres.2013.12.014
Freeman, D. et al. Can Virtual Reality be Used to Investigate Persecutory Ideation? J. Nerv. Ment. Dis. 191, 509–514 (2003).
doi: 10.1097/01.nmd.0000082212.83842.fe
Green, C. E. L. et al. Measuring ideas of persecution and social reference: the Green et al. Paranoid Thought Scales (GPTS). Psychol. Med. 38, 101–111 https://doi.org/10.1017/S0033291707001638 (2008).
Freeman, D., Lister, R. & Evans, N. The use of intuitive and analytic reasoning styles by patients with persecutory delusions. J. Behav. Ther. Exp. Psychiatry 45, 454–458 (2014).
doi: 10.1016/j.jbtep.2014.06.005
Freeman, D., Evans, N. & Lister, R. Gut feelings, deliberative thought, and paranoid ideation: A study of experiential and rational reasoning. Psychiatry Res. 197, 119–122 (2012).
doi: 10.1016/j.psychres.2011.12.031
Gilbert, P. & Procter, S. Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clin. Psychol. Psychother. 13, 353–379 (2006).
doi: 10.1002/cpp.507
Kolts, R. The compassionate-mind guide to managing your anger: Using compassion-focused therapy to calm your rage and heal your relationships. (New harbinger Publications, 2012).
Welford, M. The Compassionate Mind Approach to Building Self-Confidence. (Constable & Robinson, 2012).
Statham, V., Emerson, L. M. & Rowse, G. A systematic review of self-report measures of paranoia. Psychol. Assess. 31, 139–158 (2019).
doi: 10.1037/pas0000645
Freeman, D. et al. The use of immersive virtual reality (VR) to predict the occurrence 6 months later of paranoid thinking and posttraumatic stress symptoms assessed by self-report and interviewer methods: a study of individuals who have been physically assaulted. Psychol. Assess. 26, 841–7 (2014).
doi: 10.1037/a0036240
Freeman, D., Pugh, K., Vorontsova, N., Antley, A. & Slater, M. Testing the continuum of delusional beliefs: An experimental study using virtual reality. J. Abnorm. Psychol. 119, 83–92 (2010).
doi: 10.1037/a0017514
Freeman, D. et al. The revised Green et al. Paranoid Thoughts Scale (R-GPTS): psychometric properties, severity ranges, and clinical cut-offs. Psychol. Med. 1–10 https://doi.org/10.1017/s0033291719003155 (2019).
Baron, R. M. & Kenny, D. A. The Moderator-Mediator Variable Distinction in Social The Moderator-Mediator Variable Distinction in Social Psychological Research: Conceptual, Strategic, and Statistical Considerations. J. Pers. Soc. Psychol. 51, 1173–1182 (1986).
doi: 10.1037/0022-3514.51.6.1173
Freeman, D. et al. Effects of cognitive behavioural therapy for insomnia on the mental health of university students: study protocol for a randomized controlled trial. Trials 16, 236 (2015).
doi: 10.1186/s13063-015-0756-4
Whittle, R., Mansell, G., Jellema, P. & van der Windt, D. Applying causal mediation methods to clinical trial data: What can we learn about why our interventions (don’t) work? Eur. J. Pain (United Kingdom) 21, 614–622 (2017).
Garety, P. A. et al. SlowMo, a digital therapy targeting reasoning in paranoia, versus treatment as usual in the treatment of people who fear harm from others: study protocol for a randomised controlled trial. Trials 18, 510 (2017).
doi: 10.1186/s13063-017-2242-7
Salzberg, S. Lovingkindness: The revolutionary art of happiness. (Shambala Publications, 1995).
Martins, M. J. et al. Recovery through affiliation: a Compassionate Approach to Schizophrenia and Schizoaffective Disorder (COMPASS). J. Context. Behav. Sci. 9, 97–102 https://doi.org/10.1016/j.jcbs.2018.07.009 (2018).