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  • Essay / A plan for everyone? Transdiagnostic comparison of...

    IntroductionSchemas can be defined as a condensation of experience into an internal working model of self, other, and world. The schema concept has been successfully applied to a wide variety of psychiatric (bed) disorders. To a much lesser extent, schema construction has been applied to psychotic disorders. As paranoid ideation is by far the most common delusional theme in psychotic disorders [1], it would be useful to better understand the contribution of schemas to the development of paranoid ideation. Over the past two decades, cognitive models have been developed that predict that negative cognitive schemas are involved in the formation and maintenance of persecutory delusions [2,3]. And it has been proposed that negative schemas about oneself and negative schemas about others independently contribute to paranoid ideation [4,5]. Additionally, some authors suggest that there is a specific activation phase of the negative self and other schemas in paranoid ideation [6,7]. In particular, Bentall et al., 2008 predicted that the transition from risk states to clinical paranoia during the first psychotic episode or recurrent psychotic episode is marked by a shift from negative beliefs about the self to negative beliefs about others [6]. Thus, to better understand schema activation in association with paranoid ideation, it would be useful to compare people at risk for psychosis to people with psychosis. A measure that covers negative schemas of self and others is the Brief Core Schema Scale (BCSS, [8]). Since its publication, the BCSS has proven successful and has given rise to numerous publications based on non-clinical populations for example [9-11] which summarize a large corpus of participants. In contrast, there are only a limited number of...... middle of paper ...... clinical groups, particularly between people with psychotic symptoms and people at risk compared to people with affective disorders and non-clinical controls.Hypothesis on the association of paranoid schemas and ideationsNegative evaluations of self and others are associated with distrust and persecution in people with CHR [20,21] and in people suffering from psychosis [8,15-17]. Although there is no clear trend, whether it is high negative self-expression or other schemas, or low positive self-expression or other schemas that predict paranoid ideas. The dynamic model of schema activation proposed by Bentall et al. may explain these mixed results. According to Bentall et al. we hypothesize that paranoid ideation is predicted by negative beliefs about self in low-risk states and by negative beliefs about others in full-blown psychosis..