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Cognitive appraisals of dissociation in psychosis: a new brief measure
Behavioural and Cognitive Psychotherapy ( IF 2.467 ) Pub Date : 2020-12-28 , DOI: 10.1017/s1352465820000958
Emma Černis 1 , Jessica C Bird 1 , Andrew Molodynski 2 , Anke Ehlers 2, 3 , Daniel Freeman 1, 2
Affiliation  

Background:Catastrophic cognitive appraisals, similar to those in anxiety disorders, are implicated in depersonalisation, a form of dissociation. No scales exist to measure appraisals of dissociative experiences. Dissociation is common in psychosis. Misinterpretations of dissociative experiences may maintain psychotic symptoms. Therefore, assessing appraisals in this context may be valuable.Aims:The primary aim was to develop a measure of key appraisals of dissociation in psychosis. Secondary aims were to test the relationship between appraisals and psychotic experiences (paranoia and hallucinations), and determine whether appraisals explain additional variance in psychotic symptoms above dissociative symptoms.Method:Fifty items were generated from transcripts of interviews with patients. The measure was developed and psychometrically validated via factor analysis of data from 9902 general population participants and 1026 patients with psychosis. Convergent validity, test–re-test reliability, and internal reliability were assessed. Regression analyses tested relationships with psychotic symptoms.Results:A 13-item single-factor measure was developed. Factor analysis indicated good model fit [χ2(65) = 247.173, comparative fit index (CFI) = 0.960, root mean square error of approximation (RMSEA) = 0.052]. The scale had good convergent validity with a rumination (non-clinical: r = 0.71; clinical: r = 0.73) and dissociation measure (r = 0.81; r = 0.80), high internal consistency (α = 0.93; α = 0.93), and excellent 1-week test–re-test reliability [intraclass correlation (ICC) = 0.90]. It explained variance in psychotic symptoms (paranoia: 36.4%; hallucinations: 35.0%), including additional variance compared with dissociation alone (paranoia: 5.3%; hallucinations: 2.3%).Conclusions:The Cognitive Appraisals of Dissociation in Psychosis (CAD-P) measure is a psychometrically robust scale identifying appraisals of dissociative experiences in psychosis and is associated with the presence of psychotic experiences. It is likely to prove useful for clinical assessment and research.

中文翻译:

精神病分离的认知评估:一种新的简短测量

背景:与焦虑症相似的灾难性认知评估与人格解体有关,这是一种分离形式。没有量表来衡量对分离体验的评估。分离在精神病中很常见。对分离体验的误解可能会维持精神病症状。因此,在这种情况下评估评估可能是有价值的。目的:主要目的是制定对精神病分离关键评估的衡量标准。次要目的是测试评估和精神病经历(偏执狂和幻觉)之间的关系,并确定评估是否解释了精神病症状在分离症状之上的额外差异。方法:从与患者的访谈记录中生成了 50 个项目。该措施是通过对来自 9902 名普通人群参与者和 1026 名精神病患者的数据进行因子分析来开发和心理测量学验证的。评估了收敛效度、重测信度和内部信度。回归分析测试了与精神病症状的关系。结果:开发了一个 13 项单因素测量。因子分析表明模型拟合良好 [χ2(65) = 247.173,比较拟合指数 (CFI) = 0.960,近似均方根误差 (RMSEA) = 0.052]。该量表具有良好的收敛效度与反刍(非临床:r= 0.71; 临床:r= 0.73) 和解离测量 (r= 0.81;r= 0.80)、高内部一致性(α = 0.93;α = 0.93)和出色的 1 周重测信度 [组内相关性 (ICC) = 0.90]。它解释了精神病症状的差异(偏执:36.4%;幻觉:35.0%),包括与单独分离相比的额外差异(偏执:5.3%;幻觉:2.3%)。结论:精神病分离的认知评估(CAD-P ) 测量是一种心理测量学上稳健的量表,用于识别对精神病分离体验的评估,并与精神病体验的存在相关。它可能被证明对临床评估和研究有用。
更新日期:2020-12-28
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