Sleep problems and worrying precede psychotic symptoms during an online intervention for psychosis

Abstract

Objective. Experience sampling assessments (multiple assessments per day for approximately one week) indicate that positive symptoms fluctuate over time in psychosis. Precursors, such as sleep problems or worrying, predict these fluctuations. To date, it remains unclear whether the same precursors predict symptom variability also during treatment in an online intervention for psychosis, using assessments lying temporally further apart. Methods. Participants completed brief intermediate online self-report assessments on their computers (up to every 7 days during a 2-month waiting period and up to twice every 6 days during a 2-month intervention period) within a randomized controlled trial. We monitored the course of paranoia, auditory verbal hallucinations, and their theorydriven precursors worrying, negative affect, self-esteem, self-reported cognitive biases, and quality of sleep in n = 124 participants (M = 10.32 assessments per participant; SD = 6.07). We tested group differences regarding the course of the composite of precursors, group differences regarding the effect of the composite on subsequent momentary psychotic symptoms, and the effect of each individual precursor on subsequent psychotic symptoms, using (lagged) linear mixed models. Results. The course composite precursors over time and their lagged effect on subsequent momentary psychotic symptoms did not differ between groups. During the intervention, increased worrying and decreased quality of sleep preceded heightened momentary psychotic symptoms. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Identifying Resilience Factors of Distress and Paranoia During the COVID-19 Outbreak in Five Countries

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“…We used a newly created Thriving Scale based on research into optimal human functioning and positive psychology (Maslow, 1965 ; Antonovsky, 1979 ; Ryff and Singer, 1996 ; Ryan and Deci, 2000 ; Keyes, 2005 ; Diener et al, 2009 ; Seligman, 2011 ). The scale was adapted to assess important factors for thriving in the situation of a large scale crisis, and items were created similar to our ESM studies (Lüdtke et al, 2021 ). It has eight items on a 5-point Likert scale ranging from 0 (don't agree) to 4 (strongly agree).…”

Association between Sleep and Suicidal Ideation in Chinese Undergraduate Students

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Perspective of patients with first‐episode psychosis, their relatives, and mental health professionals on the design and usability of an app in clinical practice

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