Background:Cognitive behavioural therapy (CBT) for psychosis currently yields modest outcomes and must be improved. Attachment imagery may be an effective means of reducing severity of paranoid beliefs and associated affect. Experimental studies have demonstrated these effects in non-clinical groups. The impact in clinical populations remains untested.Aims:This study assessed the impact of a brief attachment imagery task on paranoia and mood, in two people with a diagnosis of schizophrenia.Method:Two single case studies are presented. Both participants were working age adults with persecutory delusions. The study utilised an A-B-A design. Participants were recruited for a 6-week period, with a 2- and 3-week baseline respectively, 1-week intervention phase, and follow-up phase matched to duration of baseline. Trait paranoia and attachment were measured at the start of the baseline. State paranoia and affect were measured daily over the 6-week period.Results:For both participants, the baseline phase was characterised by high and variable levels of paranoia, which reduced during the intervention phase, with a return to baseline scores at follow-up. We found a similar pattern for negative affect, and the reverse pattern for positive affect.Conclusions:Attachment imagery may function as an effective emotion regulation strategy for people with psychosis. Continued use is likely to be needed to maintain gains. This brief task could prove valuable to people needing skills to manage paranoia and mood, and give clinicians confidence that people can manage short-term distress in CBT for psychosis, for example when addressing past trauma.

中文翻译：

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依恋意象对偏执和情绪的影响：来自两个单一案例研究的证据

背景：精神病的认知行为疗法（CBT）目前产生的结果并不理想，必须加以改进。依恋意象可能是降低偏执信念和相关影响严重程度的有效手段。实验研究已经在非临床组中证明了这些效果。对临床人群的影响仍未得到检验。目的：本研究评估了两个被诊断为精神分裂症的人的简短附件意象任务对偏执狂和情绪的影响。方法：提出了两个单一的案例研究。两名参与者都是有被害妄想的工作年龄成年人。该研究采用 ABA 设计。参与者被招募了 6 周，基线分别为 2 周和 3 周，干预阶段为 1 周，随访阶段与基线持续时间相匹配。在基线开始时测量特质偏执狂和依恋。在 6 周内每天测量状态偏执和影响。结果：对于两名参与者，基线阶段的特点是偏执的水平高且多变，在干预阶段降低，随访时恢复到基线分数. 我们发现消极情绪的模式相似，积极情绪的模式相反。结论：依恋意象可能作为精神病患者的有效情绪调节策略。可能需要继续使用以保持收益。这项简短的任务对于需要技能来管理偏执和情绪的人来说可能是有价值的，并使临床医生相信人们可以在 CBT 中管理精神病的短期痛苦，例如在解决过去的创伤时。