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A longitudinal mediation analysis of the effect of negative-self-schemas on positive symptoms via negative affect

Published online by Cambridge University Press:  28 September 2017

E. S. Jaya ,
L. Ascone  and
T. M. Lincoln
E. S. Jaya*
Affiliation:
Faculty of Psychology, Universitas Indonesia, Depok, Indonesia Clinical Psychology and Psychotherapy, Institute of Psychology, University of Hamburg, Hamburg, Germany
L. Ascone
Affiliation:
Clinical Psychology and Psychotherapy, Institute of Psychology, University of Hamburg, Hamburg, Germany
T. M. Lincoln
Affiliation:
Clinical Psychology and Psychotherapy, Institute of Psychology, University of Hamburg, Hamburg, Germany
*
Author for correspondence: Edo S. Jaya, E-mail: edo.jaya@ui.ac.id
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Abstract

Background

Cognitive models postulate that negative-self-schemas (NSS) cause and maintain positive symptoms and that negative affect mediates this link. However, only few studies have tested the temporal mediation claim systematically using an appropriate design.

Methods

A longitudinal cohort design in an online community sample (N = 962) from Germany, Indonesia, and the USA was used. NSS, negative affect and positive symptoms were measured at four time-points (T0–T3) over a 1-year period. Cross-lagged panel and longitudinal mediation analyses with structural equation modeling were used to test the temporal mediation.

Results

Independent cross-lagged panel models showed a significant unidirectional longitudinal path from NSS to positive symptoms (T2–T3, β = 0.18, p < 0.01) and bidirectional longitudinal associations from NSS to negative affect (T0–T1, γ = 0.14, p < 0.01) and vice versa (T0–T1, γ = 0.19, p < 0.01). There was also a significant indirect pathway from NSS at baseline via negative affect at T1 and T2 to positive symptoms at T3 (unstandardized indirect effect coefficient = 0.020, p < 0.05, BCa CI 0.004–0.035), indicating mediation.

Conclusions

Our findings support the postulated affective pathway from NSS to positive symptoms via negative affect. Specifically, our data indicate that NSS and negative affect influence each other and build up over the course of several months before leading on to positive symptoms. We conclude that interrupting this process by targeting NSS and negative affect early in the process could be a promising strategy to prevent the exacerbation of positive symptoms.

Keywords

Anxietydepressionemotion regulationmechanismmediationlongitudinalpsychotic experiencesschizophrenia

Information

Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 8 , June 2018 , pp. 1299 - 1307
Copyright
Copyright © Cambridge University Press 2017 

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References

Baron, RM, Kenny, DA (1986) The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology 51, 1173–1182.CrossRefGoogle ScholarPubMed
Beck, AT, Rector, NA (2002) Delusions: a cognitive perspective. Journal of Cognitive Psychotherapy 16, 455–468.Google Scholar
Beck, AT, Rector, NA (2003) A cognitive model of hallucinations. Cognitive Therapy and Research 27, 19–52.Google Scholar
Bentall, RP, de Sousa, P, Varese, F, Wickham, S, Sitko, K, Haarmans, M, Read, J (2014) From adversity to psychosis: pathways and mechanisms from specific adversities to specific symptoms. Social Psychiatry and Psychiatric Epidemiology 49, 1011–1022.CrossRefGoogle ScholarPubMed
Bentler, PM, Bonett, DG (1980) Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin 88, 588.Google Scholar
Ben-Zeev, D, Ellington, K, Swendsen, J, Granholm, E (2011) Examining a cognitive model of persecutory ideation in the daily life of people with schizophrenia: a computerized experience sampling study. Schizophrenia Bulletin 37, 1248–1256.Google Scholar
Brenner, K, Schmitz, N, Pawliuk, N, Fathalli, F, Joober, R, Ciampi, A, King, S (2007) Validation of the English and French versions of the Community Assessment of Psychic Experiences (CAPE) with a Montreal community sample. Schizophrenia Research 95, 86–95.CrossRefGoogle ScholarPubMed
Buhrmester, M, Kwang, T, Gosling, SD (2011) Amazon's mechanical Turk: a new source of inexpensive, yet high-quality, data? Perspectives on Psychological Science 6, 3–5.Google Scholar
Cheung, GW, Lau, RS (2008) Testing mediation and suppression effects of latent variables bootstrapping with structural equation models. Organizational Research Methods 11, 296–325.Google Scholar
Cole, DA, Maxwell, SE (2003) Testing mediational models with longitudinal data: questions and tips in the use of structural equation modeling. Journal of Abnormal Psychology 112, 558–577.Google Scholar
Fergusson, DM, McLeod, GFH, Horwood, LJ (2013) Childhood sexual abuse and adult developmental outcomes: findings from a 30-year longitudinal study in New Zealand. Child Abuse & Neglect 37, 664–674.Google Scholar
Fowler, D, Freeman, D, Smith, B, Kuipers, E, Bebbington, P, Bashforth, H, Coker, S, Hodgekins, J, Gracie, A, Dunn, G, Garety, PA (2006) The Brief Core Schema Scales (BCSS): psychometric properties and associations with paranoia and grandiosity in non-clinical and psychosis samples. Psychological Medicine 36, 749–759.Google Scholar
Fowler, D, Hodgekins, J, Garety, PA, Freeman, D, Kuipers, E, Dunn, G, Smith, B, Bebbington, P (2012) Negative cognition, depressed mood, and paranoia: a longitudinal pathway analysis using structural equation modeling. Schizophrenia Bulletin 38, 1063–1073.CrossRefGoogle ScholarPubMed
Freeman, D, Dunn, G, Startup, H, Pugh, K, Cordwell, J, Mander, H, Černis, E, Wingham, G, Shirvell, K, Kingdon, D (2015) Effects of cognitive behaviour therapy for worry on persecutory delusions in patients with psychosis (WIT): a parallel, single-blind, randomised controlled trial with a mediation analysis. The Lancet Psychiatry 2, 305–313.Google Scholar
Freeman, D, Pugh, K, Dunn, G, Evans, N, Sheaves, B, Waite, F, Černis, E, Lister, R, Fowler, D (2014) An early Phase II randomised controlled trial testing the effect on persecutory delusions of using CBT to reduce negative cognitions about the self: the potential benefits of enhancing self confidence. Schizophrenia Research 160, 186–192.Google Scholar
Fusar-Poli, P, Nelson, B, Valmaggia, L, Yung, AR, McGuire, PK (2014) Comorbid depressive and anxiety disorders in 509 individuals with an at-risk mental state: impact on psychopathology and transition to psychosis. Schizophrenia Bulletin 40, 120–131.Google Scholar
Fusar-Poli, P, Rutigliano, G, Stahl, D, Davies, C, Bonoldi, I, Reilly, T, McGuire, P (2017) Development and validation of a clinically based risk calculator for the transdiagnostic prediction of psychosis. JAMA Psychiatry 74, 493–500.Google Scholar
Garety, PA, Bebbington, P, Fowler, D, Freeman, D, Kuipers, E (2007) Implications for neurobiological research of cognitive models of psychosis: a theoretical paper. Psychological Medicine 37, 1377–1391.CrossRefGoogle ScholarPubMed
Garety, PA, Kuipers, E, Fowler, D, Freeman, D, Bebbington, P (2001) A cognitive model of the positive symptoms of psychosis. Psychological Medicine 31, 189–195.Google Scholar
Gevonden, MJ, Myin-Germeys, I, van den Brink, W, van Os, J, Selten, JP, Booij, J (2015) Psychotic reactions to daily life stress and dopamine function in people with severe hearing impairment. Psychological Medicine 45, 1665–1674.Google Scholar
Häfner, H, Maurer, K, an der Heiden, W (2013) ABC schizophrenia study: an overview of results since 1996. Social Psychiatry and Psychiatric Epidemiology 48, 1021–1031.Google Scholar
Henrich, J, Heine, SJ, Norenzayan, A (2010) The weirdest people in the world? Behavioral and Brain Sciences 33, 61–83.CrossRefGoogle ScholarPubMed
Howes, OD, Murray, RM (2014) Schizophrenia: an integrated sociodevelopmental-cognitive model. The Lancet 383, 1677–1687.Google Scholar
Hu, L, Bentler, PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal 6, 1–55.Google Scholar
Jaspers, K (1963) General Psychopathology. 7th edn (trans. Hoenig, J. & Hamilton, M.W.). Manchester University Press: Manchester.Google Scholar
Jaya, ES, Ascone, L, Lincoln, TM (2017) Social adversity and psychosis: the mediating role of cognitive vulnerability. Schizophrenia Bulletin 43, 557–565.Google ScholarPubMed
Johnson, JA (2005) Ascertaining the validity of individual protocols from Web-based personality inventories. Journal of Research in Personality 39, 103–129.CrossRefGoogle Scholar
Kapur, S, Mizrahi, R, Li, M (2005) From dopamine to salience to psychosis-linking biology, pharmacology and phenomenology of psychosis. Schizophrenia Research 79, 59–68.Google Scholar
Kessler, RC, Demler, O, Frank, RG, Olfson, M, Pincus, HA, Walters, EE, Wang, P, Wells, KB, Zaslavsky, AM (2005) Prevalence and treatment of mental disorders, 1990 to 2003. New England Journal of Medicine 352, 2515–2523.CrossRefGoogle ScholarPubMed
Kesting, M-L, Bredenpohl, M, Klenke, J, Westermann, S, Lincoln, TM (2013) The impact of social stress on self-esteem and paranoid ideation. Journal of Behavior Therapy and Experimental Psychiatry 44, 122–128.Google Scholar
Kesting, M-L, Lincoln, TM (2013) The relevance of self-esteem and self-schemas to persecutory delusions: a systematic review. Comprehensive Psychiatry 54, 766–789.CrossRefGoogle ScholarPubMed
Kramer, I, Simons, CJP, Wigman, JTW, Collip, D, Jacobs, N, Derom, C, Thiery, E, van Os, J, Myin-Germeys, I, Wichers, M (2014) Time-lagged moment-to-moment interplay between negative affect and paranoia: new insights in the affective pathway to psychosis. Schizophrenia Bulletin 40, 278–286.Google Scholar
Kroenke, K, Spitzer, RL, Williams, JBW (2001) The PHQ-9. Journal of General Internal Medicine 16, 606–613.Google Scholar
Lincoln, TM, Lange, J, Burau, J, Exner, C, Moritz, S (2009) The effect of state anxiety on paranoid ideation and jumping to conclusions. An experimental investigation. Schizophrenia Bulletin 36, 1140–1148.Google Scholar
Lincoln, TM, Marin, N, Jaya, ES (2017) Childhood trauma and psychotic experiences in a general population sample: a prospective study on the mediating role of emotion regulation. European Psychiatry 42, 111–119.Google Scholar
Löwe, B, Decker, O, Müller, S, Brähler, E, Schellberg, D, Herzog, W, Herzberg, PY (2008) Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical Care 46, 266–274.Google Scholar
Luhrmann, TM, Padmavati, R, Tharoor, H, Osei, A (2015) Differences in voice-hearing experiences of people with psychosis in the USA, India and Ghana: interview-based study. The British Journal of Psychiatry: The Journal of Mental Science 206, 41–44.Google Scholar
Martin, A, Rief, W, Klaiberg, A, Braehler, E (2006) Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population. General Hospital Psychiatry 28, 71–77.Google Scholar
Mayer, A, Thoemmes, F, Rose, N, Steyer, R, West, SG (2014) Theory and analysis of total, direct, and indirect causal effects. Multivariate Behavioral Research 49, 425–442.Google Scholar
Morgan, C, Charalambides, M, Hutchinson, G, Murray, RM (2010) Migration, ethnicity, and psychosis: toward a sociodevelopmental model. Schizophrenia Bulletin 36, 655–664.Google Scholar
Morgan, C, Reininghaus, U, Fearon, P, Hutchinson, G, Morgan, K, Dazzan, P, Boydell, J, Kirkbride, J, Doody, GA, Jones, PB, Murray, RM, Craig, T (2014) Modelling the interplay between childhood and adult adversity in pathways to psychosis. Psychological Medicine 44, 407–419.Google Scholar
Moritz, S, Schröder, J, Klein, JP, Lincoln, TM, Andreou, C, Fischer, A, Arlt, S (2016) Effects of online intervention for depression on mood and positive symptoms in schizophrenia. Schizophrenia Research 175, 216–222.Google Scholar
Morrison, AP (2001) The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy 29, 257–276.Google Scholar
National Institute for Health and Clinical Excellence (2009) Schizophrenia: Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care (Update). National Institute for Health and Clinical Excellence: Guidance. British Psychological Society: Leicester, UK.Google Scholar
Oliver, JE, O'Connor, JA, Jose, PE, McLachlan, K, Peters, E (2012) The impact of negative schemas, mood and psychological flexibility on delusional ideation – mediating and moderating effects. Psychosis 4, 6–18.Google Scholar
Preacher, KJ (2015) Advances in mediation analysis: a survey and synthesis of new developments. Annual Review of Psychology 66, 825–852.Google Scholar
Reininghaus, U, Depp, CA, Myin-Germeys, I (2016) Ecological interventionist causal models in psychosis: targeting psychological mechanisms in daily life. Schizophrenia Bulletin 42, 264–269.CrossRefGoogle ScholarPubMed
Rosseel, Y (2012) Lavaan: an R package for structural equation modeling. Journal of Statistical Software 48, 1–36.Google Scholar
Schlier, B, Jaya, ES, Moritz, S, Lincoln, TM (2015) The community assessment of psychic experience measures nine clusters of psychosis-like experiences: a validation of the German version of CAPE. Schizophrenia Research 169, 274–279.Google Scholar
Schmitt, M, Eid, M (2007) Richtlinien für die Übersetzung fremdsprachlicher Messinstrumente. Diagnostica 53, 1–2.Google Scholar
Spitzer, RL, Kroenke, K, Williams, JW, Löwe, B (2006) A brief measure for assessing generalized anxiety disorder: The gad-7. Archives of Internal Medicine 166, 1092–1097.Google Scholar
Stefanis, NC, Hanssen, M, Smirnis, NK, Avramopoulos, DA, Evdokimidis, IK, Stefanis, CN, Verdoux, H, van Os, J (2002) Evidence that three dimensions of psychosis have a distribution in the general population. Psychological Medicine 32, 347–358.CrossRefGoogle ScholarPubMed
Thewissen, V, Bentall, RP, Oorschot, M, à Campo, J, van Lierop, T, van Os, J, Myin-Germeys, I (2011) Emotions, self-esteem, and paranoid episodes: an experience sampling study. British Journal of Clinical Psychology 50, 178–195.CrossRefGoogle ScholarPubMed
Vandenbroucke, JP, Elm, E von, Altman, DG, Gøtzsche, PC, Mulrow, CD, Pocock, SJ, Poole, C, Schlesselman, JJ, Egger, M, STROBE Initiative (2007) Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. PLoS Medicine 4, e297.Google Scholar
van der Gaag, M, Nieman, DH, Rietdijk, J, Dragt, S, Ising, HK, Klaassen, RMC, Koeter, M, Cuijpers, P, Wunderink, L, Linszen, DH (2012a) Cognitive behavioral therapy for subjects at ultrahigh risk for developing psychosis: a randomized controlled clinical trial. Schizophrenia Bulletin 38, 1180–1188.CrossRefGoogle ScholarPubMed
van der Gaag, M, van Oosterhout, B, Daalman, K, Sommer, IE, Korrelboom, K (2012b) Initial evaluation of the effects of competitive memory training (COMET) on depression in schizophrenia-spectrum patients with persistent auditory verbal hallucinations: a randomized controlled trial. British Journal of Clinical Psychology 51, 158–171.CrossRefGoogle ScholarPubMed
van Os, J, Kenis, G, Rutten, BPF (2010) The environment and schizophrenia. Nature 468, 203–212.CrossRefGoogle ScholarPubMed
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