The Chinese University of Hong Kong.
Hunan Normal University.
J Psychopathol Clin Sci. 2023 Feb;132(2):209-221. doi: 10.1037/abn0000784.
It has been argued that what differentiates delusional ideation from full-blown delusions (indicating need for care) is not the number of beliefs, but the experiential dimensions such as conviction, distress, and preoccupation. However, how these dimensions evolve over time and affect outcomes is under-researched. While delusional conviction and distress are associated with reasoning biases and worry respectively in clinical samples, how these processes predict trajectories of delusional dimensions in the general population remains unclear.
Young adults (age 18-30) were screened for delusional ideation on the Peters et al. Delusions Inventory. Participants with at least one delusional ideation were randomly selected for a 4-wave assessment (6-month apart). Trajectories of delusional dimensions were separately identified by latent class growth analyses, then compared on baseline levels of jumping-to-conclusions bias, belief inflexibility, worry, and meta-worry.
The longitudinal sample consisted of 356 individuals (drawn from a community sample of 2,187). For each of the three dimensions (conviction, distress, and preoccupation), four-group linear models were identified-high stable, moderate stable, moderate decreasing, and low stable. The high stable group exhibited worse emotional and functional outcomes at 18 months than the other three groups. Worry and meta-worry predicted group differences, and notably differentiated the moderate decreasing groups from the moderate stable groups. Contrary to hypothesis, jumping-to-conclusions bias was milder in the high/moderate stable groups than the low stable group for conviction.
Distinct trajectories of delusional dimensions were predicted by worry and meta-worry. Differences between the decreasing and stable groups carried clinical implications. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
有人认为，将妄想观念与完全妄想（表明需要护理）区分开来的不是信念的数量，而是信念、苦恼和关注等体验维度。然而，这些维度如何随时间演变并影响结果，这方面的研究还不够充分。虽然在临床样本中，妄想的坚定信念和苦恼分别与推理偏差和担忧相关，但这些过程如何预测一般人群中妄想维度的轨迹尚不清楚。
在彼得斯等人的妄想量表上，对年龄在 18-30 岁之间的年轻人进行妄想观念筛查。在至少有一个妄想观念的参与者中，随机选择他们进行 4 次评估（间隔 6 个月）。通过潜在类别增长分析分别确定妄想维度的轨迹，然后比较结论跳跃偏差、信念灵活性、担忧和元担忧的基线水平。
纵向样本由 356 人组成（从 2187 名社区样本中抽取）。对于信念、苦恼和关注三个维度中的每一个，都确定了四组线性模型-高稳定、中稳定、中降低和低稳定。高稳定组在 18 个月时的情绪和功能结果比其他三组差。担忧和元担忧预测了组间差异，并显著区分了中降低组和中稳定组。与假设相反，在坚定信念方面，高/中稳定组的结论跳跃偏差比低稳定组更轻。
通过担忧和元担忧来预测妄想维度的不同轨迹。降低组和稳定组之间的差异具有临床意义。
