Aggressive behavior has been repeatedly observed in patients with schizophrenia and related psychotic disorders. However, there is little known about the underlying psychological mechanisms, especially the role of social cognition, in contributing to the exhibition of aggression. The aim of this study was to investigate whether aggression was associated with theory of mind (ToM) deficiency and the presence of hostility bias. Thirty individuals with a DSM-IV-TR diagnosis of schizophrenia or other psychotic disorders were asked to complete the Faux Pas Recognition Test, the Ambiguous Intentions Hostility Questionnaire, and the Conflict Tactic Scale. Results suggested that psychotic patients with predominately referential or persecutory delusions were more susceptible to theory of mind anomalies and hostility bias, and had a higher frequency of the demonstration of aggressive behavior relative to patients with auditory hallucination and remitted patients. Correlational analysis revealed significant associations among ToM, hostility bias, and aggression. Multiple regression analyses showed that hostility bias was neither a mediator nor a moderator in the relationship between ToM and aggression. The present study provided preliminary evidence that social cognition and social-cognitive attributional styles are related to the demonstration of aggressive behavior. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Background: Researchers have addressed the extraordinarily high rate of unemployment in patients with psychotic disorders for many years, but few have focused on these patients’ subjective experience of employment in the recovery process. Method: A thematic analysis was performed by conducting six semistructured interviews with young patients diagnosed with psychotic disorders. Results: The interviewees agreed on the importance and benefits of employment in their recovery. Acceptance, financial support, and a meaningful life can be secured throughout the working process. However, the interviewees mentioned certain barriers to seeking and sustaining employment. Stigma and low motivation were common problems in searching for a job. Cognitive deficit, the side effects of medication, and interpersonal challenges in the workplace increased the difficulty of sustaining a job. Most of the interviewees participated in vocational rehabilitation programmes, and they expressed the belief that these programmes can help them enter the labour market at a certain level, but the programme design can be improved further to meet individual needs. Conclusion: Consistent with previous findings, the patients faced various difficulties in open employment. Employability training, psychoeducation at the corporate level, and self-efficacy development can be considered interventions for improving patients’ vocational outcomes. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

54 local secondary school teachers from two different secondary schools at same district were invited to participate in the study. A 67-item self-reported Chinese questionnaire was filled in by the 54 participants in order to test their knowledge about early psychosis, attitude towards students with early psychosis and also the school re-entry of young patients. It was found that there was no statistical significance correlation between the years of teaching experience of teachers and their attitude towards students with early psychosis and school re-entry of young patients. There was no significance gender difference in the attitude towards young patients and their school re-entry. Plus, a one-way ANOVA was used to further examined the significant difference across teachers had no religion, Christian teachers, Buddhist teachers and also Catholic teachers, F (3, 50) =4.628, p= .009, n^2=.042. Tukey’s post hoc procedure indicated that Christian teachers (M=95.7, SD=18.26) hold significance less negative attitude towards young patients than those who were Buddhist (M=92.6, SD=18.60), Catholic (M=80.25, SD=5.80) and those teachers who had no religion (M=74.71, SD=18.76). The feelings and attitude of participants towards psychosis was quite negative such as unpredictable (21%), violence and dangerous (16.7%), abnormal (13.6%), uncontrollable (14.2%) and madness (11.1%). Participants also were found that they were lack of enough basic knowledge on the average age of onset as most of them chose middle age is the age of onset of psychosis in Hong Kong. It was suggested that more structured mental health trainings session should be provided to educational professionals including teaching assistants. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

By re-examining the epistemological foundations upon which the ego-centric clinical construct of insight in psychosis rests, research conducted with the narratives of patients who participated in the clinical project, Psychosis and Culture: The Role of Spaces of Negotiation (Between Patients, Families, and Practitioners) During Consultation was aimed to explore and formulate a socio-centric model of insight construction more sensitive to patients' intersubjective and cultural milieus. Collected interviews---conducted with recently diagnosed psychotic patients using the Turning Point Interview (TPI) grid---were approached from a phenomenological and hermeneutical perspective in order to illustrate the processual manner in which patients' insight (into the cause and reason of illness) was the cognitive and epistemic derivative of dialogical relations with other persons set within a socio-cultural matrix. The results of this research indicate that the production of patients' insight in psychosis is an inherently intersubjective and dialogic phenomenon which, in the clinical context, occurs at two points of juncture: (1) a synchronic juncture where the patient is interpellated by the clinician and hence positioned as a speaking subject, and (2) a diachronic juncture where the patient, as a result of having been called into a speaking position, constructs and authors a narrative account of significant events related to his/her illness experience based on biographical memory. Insight was shown to consist of 3 stages: (1) Detection of alteration of lived experience, (2) Causal attribution, and (3) Global construction of meaning . Each stage was shown to form the intersubjective and dialogic basis for the production of a subjectively meaningful account of insight, using the lifeworid of the patients and the patients' entourage as subjective frames of reference.

No description available.

Introduction: The connection between self and psychosis has been qualitatively noted for centuries, but left relatively neglected in the field of quantitative psychology research. Some targeted studies have shown that self-concept is different in patients with psychosis than healthy volunteers. Studies of individuals have established a specific relationship between distortions of self and the content of delusions. Recent studies have begun to collect evidence of changes of self in the early stages of psychosis. Research suggests that delusions and self-concept have various shared cognitive mechanisms and neuroanatomy, particularly with respect to persecutory delusions. Changes in self-concept are apparent in persons at ultra high risk for developing psychosis, suggesting that it precedes specific symptomatology and could be at the root of delusion formation. Therefore, we identify where the two domains intersect while overcoming the limitations of past studies such as considering only persecutory delusions, minimally defining self, and including patients with a wide range of diagnoses. Methods: We consider delusions and self-concept in a patient group, consisting of 22 persons with first-episode schizophrenia spectrum disorders, and a group of 22 healthy volunteers. Delusional ideation is measured through the Peters et al Delusion Inventory (PDI) which derives a total, three subscores- Distress, Preoccupation, Conviction- and seven factor scores based on delusion content. Self-concept is quantified using hierarchical classification (HICLAS) analysis which generates numeric and visual outputs. It is important to specify that self is a deceivingly broad topic of which we will focus on the trait level- that is, which adjectives individuals use to describe their selves and others who are close to them. In addition to PDI and HICLAS evaluations, patients undergo clinical diagnoses and symptom ratings. Results: While there was no diagnostic group difference in the PDI total or subscores, patients had more delusional ideation with respect to three types of content, as determined by the factor scores. HICLAS did not show group differences. However, patients and controls had different relationships between PDI and HICLAS measures, with patients showing a greater overall connection between the two domains. The specific results are discussed, including two qualitative case studies. Conclusion: We conclude that the relationship between self-concept and schizophrenia is specific to delusions rather than general symptomatology. Relationships are drawn between the cognitive theories underlying each domain. The findings are important to theoretical understandings of self and delusions. Furthermore, it is hoped that advanced understanding of these topics can likely lead to new, targeted psychotherapeutic treatment approaches. / published_or_final_version / Psychiatry / Master / Master of Philosophy

published_or_final_version / abstract / toc / Psychiatry / Master / Master of Philosophy

published_or_final_version / Public Health / Master / Master of Public Health

Objective: The current study aimed to examine the psychological distress of family caregivers of patients with psychosis following a stress-coping model as well as a self-regulation model. Methods: A cross-sectional correlational study was conducted in a psychiatric out-patient clinic of a local hospital. 26 caregivers were recruited. Associations among their psychological distress, appraisal of caregiving experience, illness perception, coping style and care burden were explored. Results: Psychological distress was found to be significantly correlated to negative appraisal of caregiving, perceived consequences on patient, perceived consequences on relative, perceived control by relative and care burden. Preliminary analysis showed that a combination of four factors, including negative appraisal of caregiving, perceived consequences on relative, perceived control by relative and care burden, significantly predicted psychological distress (〖R 〗^2= 0.36, F(4,21) = 2.97, p < 0.05). Among the predictors, negative appraisal of caregiving was the single strongest predictor of distress (〖R 〗^2 = 0.28, F(1,24) = 9.18, p < 0.01). Conclusion: The psychological wellbeing of family caregivers were influenced by both factors suggested by the stress-coping model and the self-regulation model. Findings from the present study provided preliminary evidence for developing caregiver-centered intervention that focused on appraisal of caregiving experience and illness perception in order to reduce the distress of caregivers. Further studies would be recommended to explore and differentiate the impact of appraisal of caregiving, coping style and illness perception on psychological distress in the caregiving experience for patients with psychosis. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

published_or_final_version / Mental Health / Master / Master of Social Sciences