ABSTRACT

Heavy cannabis use is associated with an increased risk of psychosis. However, the psychological mechanisms involved, and interactions with established risk factors for cannabis-related psychosis, remain unclear. This study examined the role of cognitive fusion, a candidate vulnerability factor for psychosis, during acute THC intoxication, and the interaction with key risk factors – developmental trauma and schizotypy. Twenty general population cannabis-using participants were administered THC or placebo in a within-participants, double-blinded randomised study. Developmental trauma, schizotypy and cognitive fusion were all associated with psychotic experiences during intoxication. Cognitive fusion accounted for increased psychotic experiences in those with developmental trauma and high schizotypy. Cognitive fusion may be a key mechanism by which developmental trauma and schizotypy increase risk of psychosis from cannabis use. This initial study is limited by a small sample and correlational design; a larger scale mediation study is now needed to support a causal argument. The findings have implications for psychological treatments and identifying those at risk of cannabis-related psychosis. Psychological interventions that target cognitive fusion may be more effective than generic approaches. People prone to cognitive fusion, particularly those with a history of developmental trauma and high in schizotypy, may be at higher risk for cannabis-related psychosis.

摘要

大量使用大麻与精神病风险增加有关。然而，所涉及的心理机制以及与大麻相关精神病的既定风险因素的相互作用仍不清楚。该研究检查了认知融合（精神病的候选易感因素）在急性 THC 中毒期间的作用，以及与关键风险因素（发育创伤和分裂症）的相互作用。在一项参与者内部双盲随机研究中，20 名使用大麻的普通人群接受了 THC 或安慰剂治疗。发育创伤、分裂症和认知融合都与中毒期间的精神病经历有关。认知融合导致发育性创伤和高度分裂症患者的精神病经历增加。认知融合可能是发育创伤和精神分裂症增加使用大麻导致精神病风险的关键机制。这项初步研究受到小样本和相关设计的限制；现在需要进行更大规模的调解研究来支持因果论点。这些发现对心理治疗和识别那些有大麻相关精神病风险的人有影响。针对认知融合的心理干预可能比通用方法更有效。容易发生认知融合的人，特别是那些有发育创伤史和高度分裂症的人，患大麻相关精神病的风险可能更高。现在需要进行更大规模的调解研究来支持因果论点。这些发现对心理治疗和识别那些有大麻相关精神病风险的人有影响。针对认知融合的心理干预可能比通用方法更有效。容易发生认知融合的人，特别是那些有发育创伤史和高度分裂症的人，患大麻相关精神病的风险可能更高。现在需要进行更大规模的调解研究来支持因果论点。这些发现对心理治疗和识别那些有大麻相关精神病风险的人有影响。针对认知融合的心理干预可能比通用方法更有效。容易发生认知融合的人，特别是那些有发育创伤史和高度分裂症的人，患大麻相关精神病的风险可能更高。