Gillies, Liam Andrew (2012)
Ph.D. thesis, University of Birmingham.
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Influential cognitive models of distressing symptoms in psychosis have been informed by evolutionary-based Social Ranking Theory. Social ranking theory views the formation and maintenance of symptoms as being significantly defined by ‘social mentalities’ that are operational during everyday social processes, such as when we compare ourselves to others. One framework of psychotic symptoms which has incorporated this social evolutionary perspective is the cognitive model of voices. The introduction of this thesis gives an overview of the nature of psychosis, and argues affective dysfunction and emotional factors are now included as a dimension of psychosis. It also draws attention to auditory hallucinations and persecutory beliefs and models of these symptoms are outlined. The cognitive model of voices is described and beliefs about the nature of voices, including their supposed omnipotence and power, are argued to be the critical determinants of affective and behavioural outcomes in voice hearers. For persecutory delusions, the deservedness of persecution is highlighted as a pertinent construct. The evolutionary basis of social defeat and rank is also outlined. Particular attention is drawn to the Involuntary Defeat Strategy (IDS) which is argued to automatically escalate when an individual encounters defeat and they perceive their social status to be lowered. The IDS is argued to be a dynamic mechanism, which may be attenuated when defeat is accepted. The current thesis is based on the rationale that the IDS is implemented in psychotic onset, affective dysfunction arising from the experience of psychosis, positive symptomology and relapse. Specifically, it argues that the specific nature of the IDS within the cognitive model of voices remains underdeveloped: there is a paucity of behavioural and ecologically valid support for the role of the core elements of the IDS contributing to beliefs and behavioural outcomes in relation to voices.
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