Content Of Thoughts Research Articles

What is it like to think about oneself? De Se thought and phenomenal intentionality

The topic of the paper is at the intersection of recent debates on de se thought and phenomenal intentionality. An interesting problem for phenomenal intentionality is the question of how to account for the intentional properties of de se thought-contents---i.e., thoughts about oneself as oneself. Here, I aim to describe and consider the significance of a phenomenological perspective on self-consciousness in its application to de se thought. I argue that having de se thoughts can be explained in terms of the ways that subjects consciously attend to themselves in experiences of thinking. Therefore, a strong form of first-person persectivalness, in which the subject is capable of self-directed control of the focus of conscious attention, is required for de se thought. But no constraints on the semantic content of such thoughts are required. The outcome of the question therefore bears importantly on both on the problem of self-reflexive self-reference and the wider problem of self-consciousness. My model suggests phenomenologically-derived conceptual constraints for the extension of minimal, background forms of self-awareness to robust, cognitive forms of self-awareness that have been of interest in recent empirical studies on self-consciousness. The framework therefore provides a way of operationalizing the concept of self-reflexive consciousness by deploying widely deployed notions from the empirical literature such as attention and minimal phenomenal selfhood, enabling a framework for empirically falsifiable hypotheses about the neural mechanisms underlying the structure of self-consciousness. What Is it Like to Think about Oneself? De Se Thought and Phenomenal Intentionality.

"Settling for less out of fear of being single": Correction to Spielmann et al. (2013).

Reports an error in "Settling for less out of fear of being single" by Stephanie S. Spielmann, Geoff MacDonald, Jessica A. Maxwell, Samantha Joel, Diana Peragine, Amy Muise and Emily A. Impett (Journal of Personality and Social Psychology, 2013[Dec], Vol 105[6], 1049-1073). In the article, the Fear of Being Single Scale used in Study 3 was in fact a version adapted for those currently involved in relationships. In error, it was reported that participants completed the exact same Fear of Being Single Scale as in the other studies in the manuscript, with items generally worded as though participants were currently single (e.g., "I feel it is close to being too late for me to find the love of my life"). The scale items in Study 3 were the same as those in the original scale but included qualifiers such as "If I were single, it would be close to being too late for me to find the love of my life." (The following abstract of the original article appeared in record 2013-36062-001.) The present research demonstrates that fear of being single predicts settling for less in romantic relationships, even accounting for constructs typically examined in relationship research such as anxious attachment. Study 1 explored the content of people's thoughts about being single. Studies 2A and 2B involved the development and validation of the Fear of Being Single Scale. Study 2C provided preliminary support for the hypothesis that fear of being single predicts settling for less in ongoing relationships, as evidenced by greater dependence in unsatisfying relationships. Study 3 replicated this effect in a longitudinal study demonstrating that fear of being single predicts lower likelihood of initiating the dissolution of a less satisfying relationship. Studies 4A and 4B explored the predictive ability of fear of being single for self-reported dating standards. Across both samples, fear of being single was unrelated to self-reported standards for a mate, with the exception of consistently higher standards for parenting. Studies 5 and 6 explored romantic interest in targets that were manipulated to vary in responsiveness and physical attractiveness. These studies found that fear of being single consistently predicted romantic interest in less responsive and less attractive dating targets. Study 7 explored fear of being single during a speed-dating event. We found that fear of being single predicted being less selective in expressing romantic interest but did not predict other daters' romantic interest. Taken together, the present research suggests that fear of being single is a meaningful predictor of settling for less in relationships. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Self-critical rumination as a mediator between attachment orientations and perceived stress: Evidence from a cross-cultural validation of the self-critical rumination scale

This study aimed to examine whether attachment orientations (anxiety and avoidance) were associated with perceived stress through self-critical rumination (a specific type of rumination focused on the content of self-critical thoughts). It also aimed to examine the factor structure of the Portuguese version of the Self-Critical Rumination Scale (SCRS) and to present additional evidence on its construct validity and reliability. A sample of 317 Portuguese women from the general community was recruited online. Participants completed the SCRS and measures of self-compassion, perceived stress, difficulties in emotion regulation, and adult attachment. The results of the mediation analyses showed that self-critical rumination mediated the association between attachment anxiety and perceived stress but not the association between attachment avoidance and perceived stress. In addition, the SCRS showed good psychometric properties. Specifically, the scale showed adequate reliability (Cronbach’s alpha was .933 and composite reliability was .932) and construct validity. Significant correlations were found between the SCRS and measures assessing constructs expected to be associated with self-critical rumination (self-compassion, perceived stress, difficulties in emotion regulation, and attachment anxiety and avoidance). Confirmatory factor analyses confirmed the one-factor structure of the Portuguese SCRS. This study identifies a new mechanism underlying the association between adult attachment and perceived stress. In addition, the results of the present study provide further evidence of the internal consistency and construct validity of the SCRS and indicate that the Portuguese version is a psychometrically robust and adequate measure of self-critical rumination.

Task-unrelated thought depends on the phonological short-term memory system more than the visual short-term memory system

This study examined which type of short-term memory (STM), phonological or visual, is involved in and more important for representing contents of task-unrelated thoughts (TUTs). Three experiments consistently showed that TUTs were less likely to be reported during phonological STM tasks than either visual STM or control tasks. In contrast, the number of TUT responses did not considerably differ between visual STM tasks and control tasks even for TUTs with many visual images. This difference cannot be explained by the differential involvement of executive control processes because task difficulty was controlled for in the multi-level logistic regression analysis. These results, together with the finding that most TUT responses contained verbal images, suggest that phonological STM plays an important role in representing verbal images in TUTs, while visual STM is less or not involved in representing TUTs, even for those with many visual images.

Indirect effects of parental and peer attachment on bullying and victimization among adolescents: The role of negative automatic thoughts.

The association between parental and peer attachment and youths' bullying involvement is well documented. However, there is little research examining mechanisms linking the quality of relationships with parents and peers to bullying perpetration and victimization. The present study investigated the indirect effects of attachment to the mother, the father, and peers on bullying and victimization through children's negative automatic thoughts in a sample of 476 adolescents (10-17 years). Path analysis indicated that attachment to both parents as well as attachment to peers was indirectly related to both bullying and victimization through their relationship with adolescents' negative automatic thoughts. When particular cognitive contents of negative automatic thoughts were examined, only hostile thoughts emerged as a mechanism explaining the association between poor relationships with parents and peers and bullying involvement as perpetrator, whereas poor attachment with each socialization agent had an indirect effect on bullying victimization via hostility and social threat thoughts.

Association between uncooperativeness and the glucose metabolism of patients with chronic behavioral disorders after severe traumatic brain injury: a cross-sectional retrospective study

BakgroundPatients with behavioral disorders following severe traumatic brain injury (sTBI) often have disorders of consciousness that make expressing their emotional distress difficult. However, no standard method for assessing the unsettled and unforeseen responses that are associated with behavioral disorders has yet to be established. Because the thalamus is known to play a role in maintaining consciousness and cognition, we used 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) to examine the association between brain glucose metabolism in the thalamus and behavioral disorders.MethodsWe retrospectively analyzed 70 consecutive patients with sTBI who had been involved in motor vehicle accidents. To assess behavioral disorders, we evaluated 18 symptoms using the Brief Psychiatric Rating Scale (BPRS): Emotional Withdrawal, Conceptual Disorganization, Tension, Mannerisms and Posturing, Motor Retardation, Uncooperativeness, Blunted Affect, Excitement, Somatic Concern, Anxiety, Feeling of Guilt, Grandiosity, Depressive Mood, Hostility, Suspiciousness, Hallucinatory Behavior, Unusual Thought Content, and Disorientation. First, we identified clinical characteristics of sTBI patients with behavioral disorders. Next, we retrospectively analyzed 18F-FDG-PET/CT data to assess how thalamic activity was related with abnormal behaviors.ResultsTwenty-six patients possessed the minimum communicatory ability required for psychiatric interview. Among them, 15 patients (57.7%) were diagnosed with behavioral disorder, 14 of whom had reached a stable psychiatric state after about 426.6 days of treatment. Excitement (13 patients) and uncooperativeness (10 patients) were the most frequently observed symptoms. Available 18F-FDG-PET/CT data indicated that thalamic glucose metabolism was imbalanced and lateralized (p = 0.04) in 6 patients who exhibited uncooperativeness.ConclusionsBehavioral symptoms of excitement and uncooperativeness were common in patients with sTBI, although most symptoms improved as the chronic stage continued. Our data support the idea that imbalanced laterality of glucose metabolism in the thalamus might be related to behavioral disorders characterized by uncooperativeness.Trial registrationUMIN 000029531. Registered 27 March 2017, retrospectively registered.

F208. COGNITION, POSITIVE SYMPTOMS, AND INTERNET USE FOR MENTAL HEALTH IN PEOPLE WITH PSYCHOSIS

BackgroundPeople with severe mental illness are increasingly using digital resources for mental health, including social media and online interventions. However, individuals’ ability to engage with or benefit from such resources may be impaired by deficits in cognition and insight, and experiences of psychotic symptoms, including paranoia about cyber-security or motives of others in online social interactions. This study aimed to explore the association between cognition, positive symptoms, and internet use for mental health information in adults with psychosis.MethodsThis study used baseline data collected as part of a broader research program investigating a digital recovery-focused intervention for psychosis. Participants completed a questionnaire on their existing internet use, both in general and for mental health information, and a range of cognitive and functioning measures. Cognitive variables included premorbid IQ, estimated using the Wechsler Test of Adult Reading, and composite scores for processing speed, working memory, and executive functioning. The Positive and Negative Syndrome Scale was also administered, with five items used to examine the relationship between mental health-related internet use and psychopathology: Delusions, Grandiosity, Suspiciousness & Persecution, Unusual Thought Content, and Lack of Judgment & Insight. Logistic regressions were used to identify unique predictors of internet use for mental health information, controlling for age and frequency of general internet use.Results179 adults with psychosis (mean age = 39.82 years; range = 18–65; SD = 11.0) took part in this study, of whom 157 (87.7%) were regular internet users. Of these, 107 (68.2%) reported regularly using the internet for mental health information, with 33 (20.9%) doing so daily, 28 (17.7%) weekly, and 46 (29.3%) monthly or less. General websites were most commonly used for this purpose (n = 92; 58.6%), followed by video streaming sites (n = 62; 39.5%), social networking sites (n = 52; 33.2%), and forums (n = 34; 21.7%). When age and frequency of general internet use were controlled for, use of any type of website for mental health information was predicted by lower scores on Grandiosity (Exp(B) = .675, 95% CI = .513, .886, p = .005); mental health-related social media use was significantly predicted by lower estimated premorbid IQ (Exp(B) = .964, 95% CI = .937, .991, p = .010); lower scores on Unusual Thought Content predicted use of both video networking sites (Exp(B) = .629, 95% CI = .403, .981, p = 041) and forums (Exp(B) = .576, 95% CI = .379, .876, p = .010) for mental health information; while use of general websites for mental health information was not uniquely predicted by any cognitive or symptom variables.DiscussionWhile internet use for mental health information is now common among people with severe mental illness, the presence of psychotic symptoms may inhibit such information-seeking behaviour, particularly when using interactive websites such as video streaming sites and forums. Cognitive functioning may also affect how online sources of mental health information are selected. However, using general websites for mental health information is common regardless of cognition and symptom severity, with implications for how such resources should be designed.

T165. ULTRA-HIGH FIELD MORPHOMETRY IN DRUG-NAïVE FIRST EPISODE PSYCHOSIS

BackgroundStructural neuroimaging studies report distributed grey matter volume (GMV) deficits in drug-naïve first episode psychosis (FEP), though their relevance to symptom burden and cognitive deficits is currently unclear. When compared to studies in medicated patients and/or patients with established later-stage of psychosis, the GMV deficits reported have been limited in both spatial distribution and effect size, indicating the possibility of stage-specific progression during the clinical course of psychosis. TOPSY (Tracking Outcomes of Psychosis) is one of the first studies intending to track the neurobiological trajectory using ultra-high field (7T) imaging starting from a drug-naïve first episode state. Here, we report the initial findings from the voxel-based morphometry (VBM) of GMV. To our knowledge, this is the first VBM report from drug-naïve FEP subjects obtained using a 7T MRI acquisition.MethodsWe used ultra-high field (7 Tesla) MRI in 28 patients with FEP (satisfying criterion A of DSM-5 schizophrenia) and 18 controls, to evaluate differences in the grey matter. Volume in a voxelwise manner. FEP and controls were matched for age, sex and parental socioeconomic status. Patients were recruited at an early intervention unit (PEPP, London Ontario) and had active psychotic symptoms at the time of scanning. We also obtained abbreviated PANSS (8 items) scores to index the severity of psychosis. Analysis was done using SPM12, after DARTEL based registration and segmentation but without spatial smoothing. 2-tailed voxelwise T-test with FDR correction (p=0.05, 5% rate for false positives) was used. We used multiple regression analysis to predict the scores from processing speed measure (modified Symbol Substitution Test) and the severity of Delusions and Unusual Thought Content (P1 and G9), the 2 symptoms for which most subjects sought treatment in the first place.ResultsPatients had a significant reduction in GMV in left fusiform gyrus (Hedge’s g = 1.98, T= 6.7), and increased GMV in the right precuneus (Hedge’s g = 1.63, T= 5.5) and lingual cortex (Hedge’s g = 1.19, T= 4.0). We did not find any other areas of significant GMV change. Of these 3 circumscribed GMV changes, reduced fusiform GMV was found among FEP patients with lower processing speed (ß=0.45, p=0.04), higher severity of delusions (ß=-0.43, p=0.049) and unusual thought content (ß=-0.59, p=0.01). Increased precuneus GMV was found among FEP patients with higher severity of delusions (ß=0.62, p=0.008) and unusual thought content (ß=0.50, p=0.03). Right lingual changes were not related to the severity of delusions or processing speed scores.DiscussionOur findings suggest that (1) GMV deficits are minimal in drug-naïve FEP subjects, with large effect-size changes concentrated around face processing (fusiform) region (2) GMV increases co-occur with GMV reduction especially in those with most severe delusions and cognitive deficits indicating a role for compensatory plasticity. Subtle early brain structural changes appear to predict symptom burden and cognitive deficits at the time of first clinical presentation with psychosis. Focusing on treatments that manipulate the structure of fusiform cortex could potentially reduce the severity of some of the early symptoms in FEP.

The Association Between Self-Critical Rumination and Parenting Stress: The Mediating Role of Mindful Parenting

Self-critical rumination is a type of rumination focused on the content of self-critical thoughts. Although self-criticism and rumination are two maladaptive psychological processes with a negative effect on parenting, including parenting stress, the role of self-critical rumination on parenting outcomes has never been explored. The aim of this study is to analyze the role of self-critical rumination on parenting stress and examine whether mindful parenting dimensions (listening with full attention, compassion for the child, non-judgmental acceptance of parental functioning, emotional awareness of the child, and self-regulation in parenting) mediate this association. The moderating role of child’s age in the direct and indirect effects was also examined. A sample of 265 Portuguese mothers of children/adolescents from the general community completed measures of self-critical rumination, mindful parenting, and parenting stress. Self-critical rumination was negatively associated with all mindful parenting dimensions and positively associated with parenting stress. However, only non-judgmental acceptance of parental functioning and emotional awareness of the child dimensions were significant mediators of the relationship between self-critical rumination and parenting stress. The link between self-critical rumination and parenting stress as well as the indirect effects were not moderated by the child’s age. This study identifies an important maladaptive psychological process (self-critical rumination) that explains individual differences in parenting and a mechanism that may account for the link between self-critical rumination and parenting stress, which can both be modified through intervention.

Exploring the Fear of Birth Scale in a mixed population of women of childbearing age-A Swedish pilot study.

The aim of this pilot study was to explore the Fear of Birth Scale in a mixed sample of women of childbearing age, by investigating the levels of childbirth fear and the content of women's thoughts when completing the scale. A cross-sectional mixed method study of 179 women who completed a short questionnaire and a think aloud interview. The mean score of the Fear of Birth Scale was 40.80 (SD 27.59) and 28.5% were classified as having fear of childbirth (≥60). The internal consistency showed a Cronbach's α>0.92, and a mean inter-item correlation of 0.85.The highest scores were found in women younger than 25 years (mean 60.10), foreign-born women (mean 54.30) and women who did not have any previous children (48.72). The lowest scores were found in women who had recently given birth (mean 34.82) and women older than 35 years (mean 34.85). The content analysis categorization matrix clearly accommodated all 436 statements into the five pre-existing categories. The largest categories were: the content of fear and worry with 138 statements and strategies to cope with fear or worry (122 statements). The Fear of Birth Scale seems to be a useful instrument for different subgroups of women. The construct of fear of childbirth may be universally understood and experienced by women of childbearing age irrespective of whether they are currently pregnant, have recently given birth or do not have children. Identifying fear of birth is important in clinical practice in order to support women's reproductive needs.

Attenuated first-rank symptoms and conversion to psychosis in a clinical high-risk cohort.

We sought to examine attenuated first-rank symptoms (FRS) and subcomponents of the Unusual Thought Content (P.1.) section of the Structured Interview for Psychosis-Risk Syndromes (SIPS) to investigate the robust relationship between total P.1. and conversion. We hypothesized that attenuated FRS would drive the association and, additionally, be most predictive of a schizophrenia diagnosis. We assessed 189 clinical high-risk participants. Two independent raters separately scored attenuated FRS and each subcomponent of P.1. as if each were the only symptom reported. Total P.1. was also scored. Participants were evaluated for conversion up to 2 years. While total P.1. score significantly predicted conversion in the 54 converters, attenuated FRS, which were relatively uncommon in this sample, nor any subcomponent of P.1., was independently predictive. FRS did not predict conversion to schizophrenia among 35 subjects. Although attenuated FRS, and subcomponents of P.1. of the SIPS, did not significantly predict transition to psychosis, our results support previous research affirming the value of total P.1. score as a tool for predicting conversion to psychosis.

Assessing criminal thought content: preliminary validation of the criminal thought content inventory (CTCI)

ABSTRACTThe purpose of this study was to evaluate a measure of criminal thought content entitled the Criminal Thought Content Inventory (CTCI). The 30-item CTCI generates a total score and scores for three individual dimensions or scales: Negative Attitudes toward Authority (NAA), Positive Attitudes toward Deviance (PAD), and Criminal Identity (CID). Students from two universities (N = 335 and 456) completed the CTCI, along with measures of criminal thought process and delinquent behavior. According to the results of several analyses, the CTCI possesses adequate internal consistency, good test-retest reliability, and adequate concurrent validity. Confirmatory factor analyses performed on both samples offered support for the three-dimensional structure of the CTCI and an item response theory analysis indicated that over 80% of the items loaded at least moderately on a single latent trait. These results suggest that the CTCI possesses the requisite psychometric properties to warrant inclusion in studies investigating criminal thought content.

Impact of lifetime traumatic experiences on suicidality and likelihood of conversion in a cohort of individuals at clinical high-risk for psychosis

Recent research suggests that trauma history (TH) is a strong socio-environmental risk factor for the development of psychosis. While reported rates of childhood trauma are higher among individuals at clinical high-risk (CHR) for psychosis than in the general population, little research has explored the effects of trauma upon the severity of attenuated positive symptoms. We aimed to explore the specific relationships between TH and baseline symptom severity; likelihood of conversion to full-blown psychosis; suicidal ideation (SI); and suicidal behavior (SB) in a cohort of 200 help-seeking CHR individuals. Participants were evaluated every three months for up to two years using the Structured Interview for Psychosis-Risk Syndromes (SIPS). More trauma history was reported by females and Hispanic/Latino participants, while age and race did not significantly distinguish those with and without TH. Individuals with TH reported higher rates of SI and SB than those without. While TH was positively associated with several SIPS subscales, including Unusual Thought Content, Perceptual Abnormalities/Hallucinations, Bizarre Thinking, Sleep Disturbances, and Dysphoric Mood, and negatively associated with Expressed Emotion, results indicated that TH was not significantly related to conversion to psychosis. Moreover, baseline SI was unrelated to conversion and baseline DSM diagnosis, with the exception of Post-Traumatic Stress Disorder (PTSD). These results suggest that traumatic experiences may significantly impact the severity of attenuated positive symptoms and suicidality in the CHR state, providing new windows for further research and potential intervention.

Rumination is associated with diminished performance monitoring.

Rumination is a construct that cuts across a variety of disorders, including anxiety and depression. It has been associated with deficits in cognitive control thought to confer risk for psychopathology. One aspect of cognitive control that is especially relevant to the content of ruminative thoughts is error processing. We examined the relation of rumination and 2 electrophysiological indices of error processing, error-related negativity (ERN), an early index of error detection, and error positivity (Pe), a later index of error awareness. Consistent with prior work, ERN was negatively correlated with anxiety (i.e., more anxious individuals were characterized by larger ERNs). After controlling for anxiety, rumination-but not worry-predicted ERN attenuation. No significant relation between rumination and Pe emerged. Findings suggest that rumination may diminish resources early in the processes of performance monitoring and the recruitment of cognitive control. (PsycINFO Database Record

Intrusive thoughts and images of intentional harm to infants in the context of maternal postnatal depression, anxiety, and OCD.

Intrusive thoughts are key features of depression, anxiety, and obsessive-compulsive disorder (OCD).1 Such thoughts are also common in the general population, where their content is the same as found in those with a psychiatric disorder. Intrusive thoughts comprise unwanted negative thoughts and images that frequently intrude, are difficult to dismiss, and, when dismissed, recur. Furthermore, they lead to a narrowed focus of attention that, in turn, can impair a person’s ability to respond to the external world. They can play an important role in maintaining the disorders in which they occur.2 One form of intrusive thoughts that is particularly distressing in the postnatal period is of intentionally harming one’s infant (Box 1). Such thoughts and images have been reported to occur in very nearly half of parents of infants in the general population.3 Although such intrusions are not in themselves indicative of risk, they are likely to be of particular significance when they occur as part of depression, anxiety disorders, or OCD, where they are often associated with great distress and shame. Although much of the research in this area has been with mothers, these intrusive thoughts also frequently occur in fathers.4 Box 1. ### Specific content of intrusive thoughts of intentionally harming one’s infant

Assessment of Automatic Thoughts in Patients with Depressive Illness at a Tertiary Hospital in Nepal

Cognitive functions have significant influence on psycho-social and general wellbeing. The quality, content and processing of negative thoughts initiate depressive symptoms; i.e. low mood, decreased self-worth and diminished interest in pleasurable activities. The study assessed the automatic thoughts of patients having depressive illness and evaluated and compared the changes after therapy; i.e. Psychotherapy and pharmacotherapy. Diagnosed cases of depressive illness (n=135), according to ICD-10 and study criteria, attending the out-patient clinic of Department of Psychiatry and Mental Health, Tribhuvan University Teaching Hospital, were included. Beck Depression Inventory was used to screen level of depressive symptoms. Automatic thoughts were assessed by the Automatic Thought Questionnaire-Revised before initiating therapy and after completion of therapy for comparison. Depressive patients received either of the three treatment procedures after randomization of the study sample into three different treatment groups; i.e. Cognitive behavior therapy, pharmacotherapy or combined therapy receiving both cognitive behavior therapy and pharmacotherapy. Among the total 135 patients, 53 (39.3%) had moderate, 47 (34.8%) had severe depressive and 35 (25.9%) had mild depressive symptoms before therapeutic interventions. Negative automatic thoughts were significantly present in depressed patients and reduced after all three interventions. Negative automatic thoughts of hopelessness, anxiety and inability coping were significantly reduced after therapy. Automatic negative thoughts were significantly correlated with depressive disorder. Combined therapy CBT with pharmacotherapy or CBT alone was found to be more effective in modifying automatic negative thoughts than pharmacotherapy alone, ultimately reducing depressive symptoms to a significant degree.

Thoughts, images, and appraisals associated with acting and not acting on the urge to self-injure

ObjectivesThe aim of this study was to examine the frequency, content, and appraisals of thoughts and images occurring during urges to engage in non-suicidal self-injury (NSSI). MethodUndergraduates (N = 154) with a history of NSSI completed an online survey of their thoughts, images, and appraisals when they acted on urges to engage in NSSI as well as when they resisted urges to self-injure. ResultsMost (>90%) participants reported experiencing both thoughts and images during urges to engage in NSSI. During urges that resulted in self-injury, self-critical and hopeless thoughts were most distressing, and thoughts about relief from emotional distress were most comforting. Images of the anticipated injury were most common. During urges that did not result in self-injury themes of the futility of NSSI, positive self-talk, and the impact on others were most common. Images were most frequently of the negative impact on self and others, and the anticipated injury. Appraisals encouraging NSSI occurred when individuals did and did not act on their urges, but concurrent strong discouraging appraisals appeared to be protective on occasions when urges did not result in self-injury. LimitationsRetrospective self-report was used to assess cognitive content. Generalisability of findings to non-student samples needs to be assessed. ConclusionsFindings from this study may inform comprehensive assessment of thoughts and images associated with urges to engage in NSSI. NSSI interventions may need to promote thoughts, imagery and appraisals that discourage NSSI whilst simultaneously modifying cognitions that encourage NSSI.

Primary psychosis with comorbid drug abuse and drug-induced psychosis: Diagnostic and clinical evolution at follow up.

The study reports a follow-up assessment of 48 patients with concomitant drug abuse at the first admission for psychosis. We focused on the diagnostic distinction between primary psychosis with concomitant drug abuse and drug induced psychosis, to observe whether the diagnoses are stable over time and whether the clinical course significantly differs. The study examined 25 primary psychotic disorder with comorbid drug abuse and 23 drug-induced psychotic disorder patients. Diagnostic and psychopathological assessments were made at baseline and at follow-up. Mean follow-up period was 4.96 years. Patients with comorbid Drug Abuse exhibited higher scores in the item Unusual Content of Thought at baseline than drug-induced psychotic disorder patients: 5.48 vs 4.39 while the two patients groups did not differ in any of the BPRS items evaluated at follow-up. The primary psychosis with comorbid drug abuse and the substance induced psychosis groups were similar regarding diagnostic stability, and a diagnosis of schizophrenia at follow-up occurred similarly. There was no evidence that Drug Induced psychotic patients' symptoms tend to improve more after cessation of drug abuse. An earlier age of onset was found in primary psychotic patients, particularly for patients diagnosed as affected by schizophrenia at follow up. These results might reflect the uncertainty of the distinction between Primary and Drug Induced Psychosis and the difficulties in applying the DSM IV-TR criteria for diagnosing comorbid drug use disorders and psychotic disorders.

Singular truth-conditions without singular propositions

In this paper I argue that propositionalism (the doctrine that the contents of thoughts and utterances are propositions to be evaluated with respect to possible worlds) is what generates a tension between referentialism and harmony (the traditional idea that cognitive values can be fully explained by means of truth-conditional contents). Harmony can be preserved if we replace propositionalism by centred referentialism, according to which referential thoughts and utterances about an object have descriptive contents that must be evaluated relative to a world centred on that object at the relevant time. By disentangling (absolute) truth-conditions and (relative) contents, this move allows us to dissolve the tension between referentialism (taken as a thesis about truth-conditions) and descriptivism (taken as a thesis about contents). The view that emerges has three main components: (i) the (absolute) truth-conditions of a referential utterance or thought involves its referent (referentialism); (ii) its reference is determined by causal relations of acquaintance in the context of use (pragmatic picture); and (iii) its cognitive value is fully explained by associated descriptions or (relative) truth-conditional contents (harmony).

Baseline demographics, clinical features and predictors of conversion among 200 individuals in a longitudinal prospective psychosis-risk cohort.

DSM-5 proposes an Attenuated Psychosis Syndrome (APS) for further investigation, based upon the Attenuated Positive Symptom Syndrome (APSS) in the Structured Interview for Psychosis-Risk Syndromes (SIPS). SIPS Unusual Thought Content, Disorganized Communication and Total Disorganization scores predicted progression to psychosis in a 2015 NAPLS-2 Consortium report. We sought to independently replicate this in a large single-site high-risk cohort, and identify baseline demographic and clinical predictors beyond current APS/APSS criteria. We prospectively studied 200 participants meeting criteria for both the SIPS APSS and DSM-5 APS. SIPS scores, demographics, family history of psychosis, DSM Axis-I diagnoses, schizotypy, and social and role functioning were assessed at baseline, with follow-up every 3 months for 2 years. The conversion rate was 30% (n = 60), or 37.7% excluding participants who were followed under 2 years. This rate was stable across time. Conversion time averaged 7.97 months for 60% who developed schizophrenia and 15.68 for other psychoses. Mean conversion age was 20.3 for males and 23.5 for females. Attenuated odd ideas and thought disorder appear to be the positive symptoms which best predict psychosis in a logistic regression. Total negative symptom score, Asian/Pacific Islander and Black/African-American race were also predictive. As no Axis-I diagnosis or schizotypy predicted conversion, the APS is supported as a distinct syndrome. In addition, cannabis use disorder did not increase risk of conversion to psychosis. NAPLS SIPS findings were replicated while controlling for clinical and demographic factors, strongly supporting the validity of the SIPS APSS and DSM-5 APS diagnosis.