Sleep problems and worrying precede psychotic symptoms during an online intervention for psychosis

Lüdtke, Thies; Pfuhl, Gerit; Moritz, Steffen; Rüegg, Nina Lee; Berger, Thomas; Westermann, Stefan (2021). Sleep problems and worrying precede psychotic symptoms during an online intervention for psychosis. British journal of clinical psychology, 60(1), pp. 48-67. Wiley-Blackwell 10.1111/bjc.12270

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Objective:
Experience sampling assessments (multiple assessments per day for approximately one week) indicate that positive symptoms fluctuate over time in psychosis. Precursors, such as sleep problems or worrying, predict these fluctuations. To date, it remains unclear whether the same precursors predict symptom variability also during treatment in an online intervention for psychosis, using assessments lying temporally further apart.

Methods:
Participants completed brief intermediate online self‐report assessments on their computers (up to every 7 days during a 2‐month waiting period and up to twice every 6 days during a 2‐month intervention period) within a randomized controlled trial. We monitored the course of paranoia, auditory verbal hallucinations, and their theory‐driven precursors worrying, negative affect, self‐esteem, self‐reported cognitive biases, and quality of sleep in n = 124 participants (M = 10.32 assessments per participant; SD = 6.07). We tested group differences regarding the course of the composite of precursors, group differences regarding the effect of the composite on subsequent momentary psychotic symptoms, and the effect of each individual precursor on subsequent psychotic symptoms, using (lagged) linear mixed models.

Results:
The course composite precursors over time and their lagged effect on subsequent momentary psychotic symptoms did not differ between groups. During the intervention, increased worrying and decreased quality of sleep preceded heightened momentary psychotic symptoms.

Conclusion:
The regression‐based design does not allow drawing causal conclusions. However, worrying and sleep problems likely represent underlying mechanisms of psychotic symptom variability during online psychosis treatment, indicating that experience sampling findings from everyday life generalize to interventions with assessments lying several days apart.

Item Type:

Journal Article (Original Article)

Division/Institute:

07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy

UniBE Contributor:

Rüegg, Nina Lee and Berger, Thomas

Subjects:

600 Technology > 610 Medicine & health
100 Philosophy > 150 Psychology

ISSN:

0144-6657

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Melanie Best

Date Deposited:

09 Apr 2021 16:49

Last Modified:

09 Apr 2021 16:49

Publisher DOI:

10.1111/bjc.12270

PubMed ID:

33305386

BORIS DOI:

10.48350/154529

URI:

https://boris.unibe.ch/id/eprint/154529

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