Effects of Appraisals of Anomalous Experience on Distress in People at Risk of Psychosis

Background: A cognitive model of psychosis suggests that appraisals of psychotic-like experiences (PLEs), and the subsequent responses adopted, are responsible for the maintenance of distress and disability associated with psychosis. Aims: This study aimed to investigate whether it is possible to manipulate appraisals of an anomalous experience in people at risk of psychosis and whether this affects levels of distress. Method: Participants who had experienced an "at risk mental state" (ARMS) within the past year, were randomized to one of two groups and received either negative or neutral information pertaining to an anomalous experience (a card trick). Participants completed a questionnaire measuring PLEs, then completed pre and post measures of distress and anxiety in relation to the card trick. Participants were also asked to rate a series of psychotic or non-psychotic appraisals regarding how they thought the card trick worked. Results: Data analysis revealed that distress and anxiety were not related to the information group assigned (our experimental manipulation was unsuccessful). However, when analyzed as one group, higher conviction in non-psychotic appraisals was found to be related to lower levels of distress and state anxiety. Conclusions: The findings provide some validation for a relationship between appraisals and distress. Clinical implications, methodological limitations and possible future research directions are discussed.