“The more you try to control them, the more they control you”: positive meta-cognitions about control of unwanted thoughts predict catastrophic worry in patients with first psychotic episode

Poster B20, Friday, October 21, 11:30 am - 1:00 pm, Le Baron

Andrea Pozza1, Maria Meliante2, Luisa Amato2, Anna Meneghelli2, Davide Dèttore3; 1Department of Experimental and Clinical Medicine, University of Florence, Italy, 2Department of Mental Health, Center for early detection and intervention in psychosis–Programma2000 ASST Grande Ospedale Metropolitano Niguarda Milan, Italy, 3Department of Health Sciences, University of Florence, Italy

Purpose. Previous research suggested that catastrophic worry could be a process involved into delusions. Obsessive beliefs, previously identified as a maintenance factor also in acute symptoms of psychosis, could predict worry in patients after a first psychotic episode (FEP). No research examined this aspect. The present study investigated which obsessive beliefs predicted more severe worry in a sample of patients with FEP. Materials and methods. Thirty patients with a FEP (mean age= 23.90, SD= 3.37, 73.30%= males) completed the Obsessive Beliefs Questionnaire-46 (OBQ-46) as a measure of obsessive beliefs about thoughts (Importance of thoughts control, Thought Action Fusion, Inflated responsibility for harm, Inflated responsibility for omission, Perfectionism/Intolerance for uncertainty) and the Penn State Worry Questionnaire (PSWQ) as a measure of worry. Multiple linear regression analysis was conducted entering OBQ-87 scores as predictors and PSWQ scores as outcomes. Results. Higher scores on the OBQ-46 Importance of thoughts control scale were the only significant predictors of higher scores on the PSWQ (β= 0.68, t= 4.94, p<.001, R2= 47%). The other beliefs had no significant effect on worry. Conclusion. Positive meta-cognitions about control of unwanted thoughts could have a role after FEP impeding recovery and leading to subsequent psychotic episodes. Case conceptualizations could address this aspect and require the integration of meta-cognitive and Acceptance and Commitment therapy interventions in the treatment of cases after FEP. Future prospective research should examine whether these beliefs predict the FEP in high risk individuals.

Topic Area: First Episode Psychosis

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