Translating affective and cognitive mechanisms of psychotic symptoms into better therapies

Abstract

For a long time, psychotic symptoms were seen as too different from normal experiences to be explicable by psychological theories, let alone modifiable by psychological therapy. In the 1990s, the epidemiological research pointing to a continuum of psychotic symptoms and the clinical success in using cognitive approaches for psychosis strongly challenged this view. This inspired the field – along with my own work – to focus on a better understanding of the psychological mechanisms of psychotic symptoms in order to develop increasingly effective interventions. Together with other researchers, I have found that negative affect and aberrant arousal play a crucial role in the formation of delusions where they appear to interact with more fundamental problems in belief updating. While our understanding of the basic mechanisms that drive psychotic symptoms is gaining precision, the challenge remains to find the most suitable ways of targeting these mechanisms.