A Cognitive Model of the Positive A Cognitive Model of the Positive Symptoms of PsychosisSymptoms of Psychosis (Garety et al 2001)(Garety et al 2001)

Maintaining factors•reasoning & attributions•schemas, emotions & safety behaviours

•appraisal of psychosis•adverse environments

Bio-psycho-social

vulnerability

Trigger

Positive Symptoms

Basic cognitive dysfunction Anomalous experience

Emotional changes

Appraisal of

experience

Appraisal influenced by:• reasoning & attributions• dysfunctional schemas of self & world

• isolation & adverse environments

Ms Doris JonesMs Doris Jones

Anomalous experience• Ideas of reference• Perceptions of bad smell and bowel movements•Voices with no clear speaker

Emotion changes

• Depressed and socially anxious

Positive Symptoms• Abusive voices • The neighbours want to harm me

• Everyone can smell me

Vulnerability•Disrupted childhood•View of self as:- unlovable/bad- different•Worrying about how others see me•Family history of schizophrenia

Triggers• Left school – social difficulty at work

•IBS - flatulence

Appraisal

I smell bad and people are commenting on me

•Self-consciousness• Vigilance for signals from others and confirmatory bias• Jumping to conclusions (JTC)• Social isolation• Negative schemas re self

Appraisal influenced by: Maintenance• Avoidant safety behaviours• Hypervigilance, JTC & confirmatory bias

• Worry re lack of control• Depression and low self-esteem