Appraisals, psychotic symptoms and affect in daily life

E. Peters*, T. Lataster, K. Greenwood, E. Kuipers, J. Scott, S. Williams, P. Garety, I. Myin-Germeys

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background. Psychological models of psychosis were examined using Experience Sampling Methods (ESM) to explore relationships between dimensions and appraisals of key symptoms and affect. Method. Individuals were signalled to complete ESM booklets 10 times per day for six consecutive days; 534 data points were obtained from 12 out-patients with psychosis. Results. Although only 3.6% of spontaneous thoughts were psychosis related, these predicted more negative and less positive affect. Delusions and hallucinations, when present, were rated at a moderate level of intensity, and intensity was associated with distress, interference and preoccupation. Symptom dimensions were related to each other, with weaker associations with delusional conviction, which, it is hypothesized, may represent a separate factor. Conviction and appraisals relating to insight and decentring ('my problems are something to do with the way my mind works') were highly variable. Decentring appraisals of delusions, but not insight, were associated with less distress. Appraisals about the power of voices were strong predictors of negative affect and symptom distress. Conclusions. This study demonstrates that ESM is a useful methodology to capture 'online' variability in psychotic phenomenology and provides evidence supporting cognitive models, which posit that psychotic symptoms are multi-dimensional phenomena, shaped by appraisals that, in turn, predict their emotional and behavioural sequelae.
Original languageEnglish
Pages (from-to)1013-1023
JournalPsychological Medicine
Issue number5
Publication statusPublished - May 2012


  • Cognitive models
  • delusions
  • Experience Sampling Method
  • hallucinations
  • insight psychosis

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