Attribution style as a factor in psychosis and symptom resolution

Introduction: Attribution (AT) style theory provides a framework for understanding the causal explanations that individuals give for their own behaviour and the behaviour of others. It has been suggested that patients with persectory delusions excessively attribute hypothetical positive events to internal causes (self) and hypothetical negative events to external personal causes. Despite this, how AT associates with psychotic symptoms (not only persecutory delusions) and how it changes with the resolution of psychosis has never been investigated. We conducted a cross-sectional study to investigate how AT is associated with psychopathology and a longitudinal study to,c of AT during the first 6 weeks of antipsychotic treatment and the relationship with psychopatholoy examine the change improvement. Methods: 86 patients meeting DSM-IV criteria for schizophrenia and related psychotic disorders were included in the cross-sectional study, and 17 patients in the longitudinal study. The longitudinal group were free of antipsychotic drugs at baseline and followed for 6 weeks after being started on antipsychotic medication by their psychiatrist. We Used the Internal. Personal and Situational Attribirtions Questionnaire (IPSAQ) as a measure of AT. Results: Patients that tend to internalize (i.e. less self-serving bias), showed greater overall psychopatholog, as measured by PANSS-Total (F(2,83)-6.59,p = 0.002), with a trend toward significance for PANSS-Positive (F(2,83)= 2.62 p = 0.07). longutudinally, having a low selfserving bias was associated with poorer response to antipsychotic treatment. Further, externalizing bias seems to chan in treatment (F = 9.65 df = 1.15 p = 0.007) and reach ceiling effects thereafter. Conclusions: AT is related to overall symptom severity, with internalizing style linked to higher global psychopathology. Antipsychotic treatment has little effect on AT, at least within 6 weeks of antipsychotic exposure. and only a modest effect is on EB which plateus within 2 weeks. Finally, internalizing style appears associated with poorer response to antipsychotic treatment. (C) 2008 Elsevier B.V. All rights reserved.