Effects of cognitive behaviour therapy for worry on persecutory delusions in patients with psychosis (WIT): a parallel, single-blind, randomised controlled trial with a mediation analysis.
Open accessAbstract
BACKGROUND: Worry might be a contributory causal factor in the occurrence of persecutory delusions in patients with psychotic disorders. Therefore we postulated that reducing worry with cognitive behaviour therapy (CBT) would reduce persecutory delusions. METHODS: For our two-arm, assessor-blinded, randomised controlled trial (Worry Intervention Trial [WIT]), we recruited patients aged 18-65 years with persistent persecutory delusions but non-affective psychosis from two centres: the Oxford Health National Health Service (NHS) Foundation Trust (Oxford, UK) and the Southern Health NHS Foundation Trust (Southampton, UK). The key inclusion criteria for participants were a score of at least 3 on the Psychotic Symptoms Rating Scale (PSYRATS) denoting a current persecutory delusion; that the delusion had persisted for at least 3 months; a clinical diagnosis of schizophrenia, schizoaffective disorder, or delusional disorder; and a clinically significant level of worry. We randomly assigned (1:1) eligible patients, using a randomly permuted block procedure with variable block sizes and division by four strata, to either six sessions of worry-reduction CBT intervention done over 8 weeks added to standard care (the CBT-intervention group), or to standard care alone (the control group). The assessors were masked to patient allocations and did their assessments at week 0 (baseline), 8 weeks (end of treatment), and 24 weeks, follow-up. The primary outcomes were worry measured by the Penn State Worry Questionnaire (PSWQ) and delusions measured by the PSYRATS-delusion scale; we did the analyses in the intention-to-treat population, and also did a planned mediation analysis. This trial is registered with the ISRCTN Registry (number ISRCTN23197625) and is closed to new participants. FINDINGS: From Nov 1, 2011, to Sept 9, 2013, we recruited 150 eligible participants and randomly assigned 73 to the CBT intervention group, and 77 to the control group. 143 patients (95%) provided primary outcome follow-up data. Compared with standard care alone, at 8 weeks the CBT intervention significantly reduced worry (mean difference 6·35 [SE 1·56] PSWQ units, 95% CI 3·30-9·40; p<0·001) and persecutory delusions (2·08 [SE 0·73] PSYRATS units, 95% CI 0·64-3·51; p=0·005). The reductions were maintained to 24 weeks follow-up. The mediation analysis suggested that the change in worry accounted for 66% of the change in delusion. No patients died or were admitted to secure units during our study. Six suicide attempts (two in the CBT intervention group, and four in the control group) and two serious violent incidents (one in each group) were noted, but no adverse events were deemed related to the treatments or the assessments. INTERPRETATION: To our knowledge, this is the first large trial focused on persecutory delusions. We have shown that long-standing delusions were significantly reduced by a brief intervention targeted on worry, although the limitations for our study include no determination of the key elements within the intervention. Our results suggest that worry might cause paranoia, and that worry intervention techniques might be a beneficial addition to the standard treatment of psychosis. FUNDING: Efficacy and Mechanism Evaluation programme, which is a UK Medical Research Council and National Institute of Health Research partnership.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A controlled trial found that an intervention targeting rumination in patients with psychosis significantly reduced paranoid delusions relative to standard care over 8 weeks.
“A controlled trial also found that an intervention targeting rumination in patients with psychosis significantly reduced paranoid delusions relative to standard care over 8 weeks.18”
From Dispositional Mindfulness and Psychotic Symptoms in Schizophrenia Spectrum Disorders: The Mediating Roles of Rumination and Negative Emotion (2022) · cites this paper as [18]
The Methods (Randomisation and masking) describe an intervention targeting worry, not rumination. The Abstract (Findings) reports that it significantly reduced persecutory delusions compared with standard care at 8 weeks. Rumination improved as a secondary outcome (Results), but it was not the intervention’s stated target. (LLM, conf=0.87)
Experimental — accuracy not yet measuredA different working group could have created a different needs analysis and chosen a different treatment focus, change methods and practical applications.
“A different working group could have created a different needs analysis and chosen a different treatment focus, change methods and practical applications (see for example the CRISIS-, the WIT- or the OASIS-study) (150–152).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [151]
Single-symptom therapies have some promising early results.
“with some promising early results [12–15]”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.51.6.1173 · Cited by 91,542 · see citing works
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.51.6.1173 · Cited by 91,532 · see citing works
Statistical Analysis With Missing Data
Lahiff, M., Little, R. J. A., & Rubin, D. B. (1989) · Journal of the American Statistical Association · doi:10.2307/2289883 · Cited by 17,384 · see citing works
Wechsler Abbreviated Scale of Intelligence
Dumont, R., Willis, J. O., Veizel, K., & Zibulsky, J. (2014) · Wiley eBooks · doi:10.1002/9781118660584.ese2519 · Cited by 5,547 · see citing works
Development and validation of the Penn State Worry Questionnaire
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990) · Behaviour Research and Therapy · doi:10.1016/0005-7967(90)90135-6 · Cited by 5,099 · see citing works
The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation
Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J., & Stewart-Brown, S. (2007) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-5-63 · Cited by 5,031 · see citing works
Statistical Analysis With Missing Data
Lazar, N. A. (2003) · Technometrics · doi:10.1198/tech.2003.s167 · Cited by 2,479 · see citing works
Latent Variable Modeling of Differences and Changes with Longitudinal Data
McArdle, J. J. (2009) · Annual Review of Psychology · doi:10.1146/annurev.psych.60.110707.163612 · Cited by 1,952 · see citing works
Weinman, J. A., Petrie, K. J., Moss-Morris, R. E., & Horne, R. (1996) · Psychology and Health · doi:10.1080/08870449608400270 · Cited by 1,557 · see citing works
HADDOCK, G., McCARRON, J., TARRIER, N., & FARAGHER, E. B. (1999) · Psychological Medicine · doi:10.1017/s0033291799008661 · Cited by 1,461 · see citing works
Yes, but what’s the mechanism? (don’t expect an easy answer).
Bullock, J. G., Green, D. P., & Ha, S. E. (2010) · Journal of Personality and Social Psychology · doi:10.1037/a0018933 · Cited by 1,063 · see citing works
Ehring, T., Zetsche, U., Weidacker, K., Wahl, K., Schönfeld, S., & Ehlers, A. (2011) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2010.12.003 · Cited by 888 · see citing works
Costing psychiatric interventions.
Beecham, J. K., & Knapp, M. R. J. (1992) · Kent Academic Repository (University of Kent) · Cited by 710 · see citing works
Slade, M., & Thornicroft, G. (2025) · doi:10.1093/med/9780198898818.003.0007 · Cited by 679 · see citing works
The Cement of the Universe: A Study of Causation.
Berofsky, B., & Mackie, J. L. (1977) · The Journal of Philosophy · doi:10.2307/2025574 · Cited by 637 · see citing works
The revised cognitive therapy scale (CTS-R): psychometric properties.
Blackburn, I.-M., James, I. A., Milne, D. L., Baker, C., Standart, S., Garland, A., & Reichelt, F. K. (2001) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465801004040 · Cited by 568 · see citing works
The Maudsley Addiction Profile (MAP): a brief instrument for assessing treatment outcome
Marsden, J., Gossop, M., Stewart, D., Best, D. W., Farrell, M., Lehmann, P., Edwards, C., & Strang, J. (1998) · Addiction · doi:10.1046/j.1360-0443.1998.9312185711.x · Cited by 487 · see citing works
Reasoning, Emotions, and Delusional Conviction in Psychosis.
Garety, P. A., Freeman, D. H., Jolley, S., Dunn, G., Bebbington, P., Fowler, D. G., Kuipers, E., & Dudley, R. E. J. (2005) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.114.3.373 · Cited by 438 · see citing works
Self-citationWorry and its Psychological Disorders
Adrian Wells, A., & Davey, G. C. L. (2006) · Wiley eBooks · doi:10.1002/9780470713143 · Cited by 418 · see citing works
Green, C. E. L., Freeman, D., Kuipers, E., Bebbington, P., Fowler, D., Dunn, G., & Garety, P. A. (2008) · Psychological Medicine · doi:10.1017/s0033291707001638 · Cited by 401 · see citing works
Self-citationvan der Gaag, M., Smit, F., Bechdolf, A., French, P., Linszen, D. H., Yung, A. R., McGorry, P., & Cuijpers, P. (2013) · Schizophrenia Research · doi:10.1016/j.schres.2013.07.004 · Cited by 384 · see citing works
Emsley, R., Dunn, G., & White, I. R. (2010) · Statistical Methods in Medical Research · doi:10.1177/0962280209105014 · Cited by 356 · see citing works
Self-citationAdvances in understanding and treating persecutory delusions: a review
Freeman, D., & Garety, P. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-014-0928-7 · Cited by 348 · see citing works
Self-citationComments on the content of persecutory delusions: Does the definition need clarification?
Freeman, D. H., & Garety, P. A. (2000) · British Journal of Clinical Psychology · doi:10.1348/014466500163400 · Cited by 334 · see citing works
Self-citationVirtual reality study of paranoid thinking in the general population
Freeman, D. H., Pugh, K., Antley, A., Slater, M., Bebbington, P., Gittins, M., Dunn, G., Kuipers, E., Fowler, D. G., & Garety, P. A. (2008) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.107.044677 · Cited by 305 · see citing works
Self-citationvan der Gaag, M., Valmaggia, L. R., & Smit, F. (2014) · Schizophrenia Research · doi:10.1016/j.schres.2014.03.016 · Cited by 271 · see citing works
Freeman, D., Stahl, D., McManus, S., Meltzer, H., Brugha, T., Wiles, N., & Bebbington, P. (2012) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-011-0433-1 · Cited by 246 · see citing works
Self-citationFreeman, D. H., & Garety, P. A. (1999) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s135246589927107x · Cited by 218 · see citing works
Self-citationStartup, H. M., Freeman, D. H., & Garety, P. A. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2006.04.006 · Cited by 205 · see citing works
Self-citationTesting the continuum of delusional beliefs: An experimental study using virtual reality.
Freeman, D. H., Pugh, K., Vorontsova, N., Antley, A., & Slater, M. (2010) · Journal of Abnormal Psychology · doi:10.1037/a0017514 · Cited by 198 · see citing works
Self-citationInterventionist causal models in psychiatry: repositioning the mind–body problem
Kendler, K. S., & Campbell, J. (2009) · Psychological Medicine · doi:10.1017/s0033291708004467 · Cited by 173 · see citing works
Foster, C., Startup, H. M., Potts, L. C., & Freeman, D. H. (2009) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2009.09.001 · Cited by 139 · see citing works
Self-citationAn experience sampling study of worry and rumination in psychosis
Hartley, S., Haddock, G., Vasconcelos e Sa, D., Emsley, R., & Barrowclough, C. (2014) · Psychological Medicine · doi:10.1017/s0033291713002080 · Cited by 138 · see citing works
A meta-analysis of cognitive therapy for worry in generalized anxiety disorder
Hanrahan, F., Field, A. P., Jones, F. W., & Davey, G. C. L. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2012.10.008 · Cited by 135 · see citing works
Greenwood, K., Sweeney, A., Williams, S., Garety, P. A., Kuipers, E., Scott, J. L., & PETERS, E. R. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbp117 · Cited by 128 · see citing works
The Penn State Worry Questionnaire (PSWQ)
Startup, H. M., & Erickson, T. M. (2006) · Worry and its Psychological Disorders · doi:10.1002/9780470713143.ch7 · Cited by 124 · see citing works
Self-citationStatistical Evaluation of Measurement Errors: Design and Analysis of Reliability Studies
Dunn, G. D. (2004) · Cited by 115 · see citing works
Self-citationCognitive factors maintaining persecutory delusions in psychosis: The contribution of depression.
Vorontsova, N., Garety, P., & Freeman, D. (2013) · Journal of Abnormal Psychology · doi:10.1037/a0034952 · Cited by 107 · see citing works
Self-citationMorrison, A., & Wells, A. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2006.11.010 · Cited by 90 · see citing works
Freeman, D., Thompson, C., Vorontsova, N., Dunn, G., Carter, L.-A., Garety, P., Kuipers, E., Slater, M., Antley, A., Glucksman, E., et al. (2013) · Psychological Medicine · doi:10.1017/s003329171300038x · Cited by 79 · see citing works
Self-citationFreeman, D. H., Startup, H. M., Dunn, G., Černis, E., Wingham, G., Pugh, K., Cordwell, J., Mander, H., & Kingdon, D. (2014) · Psychological Medicine · doi:10.1017/s0033291714000592 · Cited by 59 · see citing works
Self-citationPositive and negative syndromes in schizophrenia
Tandon, R., & Greden, J. F. (1989) · American Journal of Psychiatry · doi:10.1176/ajp.146.3.407 · Cited by 38 · see citing works
Freeman, D. H., Dunn, G., Startup, H. M., & Kingdon, D. (2012) · Trials · doi:10.1186/1745-6215-13-223 · Cited by 20 · see citing works
Self-citationFreeman, D. H., & Freeman, J. (2013) · CERN Document Server (European Organization for Nuclear Research) · Cited by 3 · see citing works
Self-citation
Flagged first, then by citations
2 of the 46 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- [31]Wechsler D Wechsler Adult Intelligence Scale-III/Wechsler Memory Scale Third edition technical manual 1997 The Psychological Corporation San Antonio, TX
Cited by
Sorted by citations
Reflecting on rumination: Consequences, causes, mechanisms and treatment of rumination
Watkins, E. R., & Roberts, H. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103573 · Cited by 862 · see citing works
Freeman, D., Sheaves, B., Goodwin, G. M., Yu, L.-M., Nickless, A., Harrison, P. J., Emsley, R., Luik, A. I., Foster, R. G., Wadekar, V., et al. (2017) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30328-0 · Cited by 652 · see citing works
Self-citationThe Lancet Psychiatry Commission on psychological treatments research in tomorrow's science
Holmes, E. A., Ghaderi, A., Harmer, C. J., Ramchandani, P. G., Cuijpers, P., Morrison, A. P., Roiser, J. P., Bockting, C. L. H., O'Connor, R. C., Shafran, R., et al. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30513-8 · Cited by 624 · see citing works
Persecutory delusions: a cognitive perspective on understanding and treatment.
Freeman, D. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)00066-3 · Cited by 356 · see citing works
Self-citationAdvances in understanding and treating persecutory delusions: a review
Freeman, D., & Garety, P. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-014-0928-7 · Cited by 348 · see citing works
Self-citationFreeman, D. H., Loe, B. S., Kingdon, D., Startup, H. M., Molodynski, A., Rosebrock, L. E., Brown, P., Sheaves, B., Waite, F., & Bird, J. C. (2019) · Psychological Medicine · doi:10.1017/s0033291719003155 · Cited by 308 · see citing works
Self-citationLaws, K. R., Darlington, N., Kondel, T. K., McKenna, P. J., & Jauhar, S. (2018) · BMC Psychology · doi:10.1186/s40359-018-0243-2 · Cited by 233 · see citing works
The role of emotion regulation in the characterization, development and treatment of psychopathology
Lincoln, T. M., Schulze, L., & Renneberg, B. (2022) · Nature Reviews Psychology · doi:10.1038/s44159-022-00040-4 · Cited by 234 · see citing works
Freeman, D., Waite, F., Startup, H., Myers, E., Lister, R., McInerney, J., Harvey, A. G., Geddes, J., Zaiwalla, Z., Luengo-Fernandez, R., et al. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(15)00314-4 · Cited by 219 · see citing works
Self-citationBighelli, I., Salanti, G., Huhn, M., Schneider‐Thoma, J., Krause, M., Reitmeir, C., Wallis, S., Schwermann, F., Pitschel‐Walz, G., Barbui, C., et al. (2018) · World Psychiatry · doi:10.1002/wps.20577 · Cited by 199 · see citing works
Moffa, G., Catone, G., Kuipers, J., Kuipers, E., Freeman, D. H., Marwaha, S., Lennox, B., Broome, M. R., & Bebbington, P. (2017) · Schizophrenia Bulletin · doi:10.1093/schbul/sbx013 · Cited by 151 · see citing works
Self-citationMei, C., van der Gaag, M., Nelson, B., Smit, F., Yuen, H. P., Berger, M., Krcmar, M., French, P., Amminger, G. P., Bechdolf, A., et al. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102005 · Cited by 143 · see citing works
Ludwig, L., Werner, D., & Lincoln, T. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.101746 · Cited by 126 · see citing works
Mehl, S., Werner, D., & Lincoln, T. M. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01450 · Cited by 129 · see citing works
Relating Therapy for distressing auditory hallucinations: A pilot randomized controlled trial
Hayward, M., Jones, A.-M., Bogen-Johnston, L., Thomas, N., & Strauss, C. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2016.11.019 · Cited by 128 · see citing works
Freeman, D. H., Pugh, K., Dunn, G., Evans, N., Sheaves, B., Waite, F., Černis, E., Lister, R., & Fowler, D. G. (2014) · Schizophrenia Research · doi:10.1016/j.schres.2014.10.038 · Cited by 127 · see citing works
Self-citationFreeman, D., Emsley, R., Diamond, R., Collett, N., Bold, E., Chadwick, E., Isham, L., Bird, J. C., Edwards, D., Kingdon, D., et al. (2021) · The Lancet Psychiatry · doi:10.1016/s2215-0366(21)00158-9 · Cited by 127 · see citing works
Self-citationTreatable clinical intervention targets for patients with schizophrenia
Freeman, D., Taylor, K. M., Molodynski, A., & Waite, F. (2019) · Schizophrenia Research · doi:10.1016/j.schres.2019.07.016 · Cited by 125 · see citing works
Self-citationA systematic review and meta-analysis of low intensity CBT for psychosis
Hazell, C. M., Hayward, M., Cavanagh, K., & Strauss, C. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.03.004 · Cited by 120 · see citing works
Lincoln, T. M., & PETERS, E. R. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2017.12.014 · Cited by 114 · see citing works
Oldershaw, A., Startup, H. M., & Lavender, T. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00219 · Cited by 114 · see citing works
Self-citationTreating Sleep Problems in Patients with Schizophrenia
Waite, F., Myers, E., Harvey, A. G., Espie, C. A., Startup, H., Sheaves, B., & Freeman, D. H. (2015) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465815000430 · Cited by 103 · see citing works
Self-citationMoritz, S., Pfuhl, G., Lüdtke, T., Menon, M., Balzan, R. P., & Andreou, C. (2016) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2016.07.004 · Cited by 99 · see citing works
Garety, P. A., Ward, T., Emsley, R., Greenwood, K., Freeman, D. H., Fowler, D. G., Kuipers, E., Bebbington, P., Rus‐Calafell, M., McGourty, A., et al. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.0326 · Cited by 98 · see citing works
Self-citationHarvey, A. G., Dong, L., Hein, K., Yu, S. H., Martinez, A. J., Gumport, N. B., Smith, F. L., Chapman, A., Lisman, M., Mirzadegan, I. A., et al. (2021) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000650 · Cited by 99 · see citing works
The paranoia as defence model of persecutory delusions: a systematic review and meta-analysis
Murphy, P., Bentall, R. P., Freeman, D. H., O’Rourke, S. J., & Hutton, P. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(18)30339-0 · Cited by 84 · see citing works
Self-citationNaeem, F., Khoury, B., Munshi, T., Ayub, M., Lecomte, T., Kingdon, D., & Farooq, S. (2016) · International Journal of Cognitive Therapy · doi:10.1521/ijct_2016_09_04 · Cited by 80 · see citing works
Self-citationTransdiagnostic Extension of Delusions: Schizophrenia and Beyond
Bebbington, P., & Freeman, D. H. (2017) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw191 · Cited by 80 · see citing works
Self-citationGarety, P. A., Ward, T., Freeman, D. H., Fowler, D. G., Emsley, R., Dunn, G., Kuipers, E., Bebbington, P., Waller, H., Greenwood, K., et al. (2017) · Trials · doi:10.1186/s13063-017-2242-7 · Cited by 65 · see citing works
Self-citationMcDonagh, M. S., Dana, T., Kopelovich, S. L., Monroe‐DeVita, M., Blazina, I., Bougatsos, C., Grusing, S., & Selph, S. (2021) · Psychiatric Services · doi:10.1176/appi.ps.202000649 · Cited by 65 · see citing works
Nittel, C. M., Lincoln, T. M., Lamster, F., Leube, D., Rief, W., Kircher, T. T. J., & Mehl, S. (2018) · British Journal of Clinical Psychology · doi:10.1111/bjc.12174 · Cited by 59 · see citing works
Establishing how psychological therapies work: the importance of mediation analysis
Windgassen, S., Goldsmith, K., Moss-Morris, R. E., & Chalder, T. (2016) · Journal of Mental Health · doi:10.3109/09638237.2015.1124400 · Cited by 60 · see citing works
Understanding, treating, and renaming grandiose delusions: A qualitative study
Isham, L., Griffith, L., Boylan, A. R., Hicks, A., Wilson, N., Byrne, R. E., Sheaves, B., Bentall, R. P., & Freeman, D. H. (2019) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12260 · Cited by 56 · see citing works
Self-citationLiu, J., Chua, J. J.-X., Chong, S. A., Subramaniam, M., & Mahendran, R. (2020) · Journal of Clinical Psychology · doi:10.1002/jclp.22915 · Cited by 59 · see citing works
Adapted CBT to stabilize sleep on psychiatric wards: a transdiagnostic treatment approach
Sheaves, B., Isham, L., Bradley, J., Espie, C., Barrera, A., Waite, F., Harvey, A. G., Attard, C., & Freeman, D. (2018) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465817000789 · Cited by 55 · see citing works
Self-citationSzymczyńska, P., Walsh, S., Greenberg, L., & Priebe, S. (2017) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2017.02.009 · Cited by 56 · see citing works
Nightmares in the general population: identifying potential causal factors
Rek, S. V., Sheaves, B., & Freeman, D. H. (2017) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-017-1408-7 · Cited by 55 · see citing works
Self-citationBelief Updating and Paranoia in Individuals With Schizophrenia
Sheffield, J. M., Suthaharan, P., Leptourgos, P., & Corlett, P. R. (2022) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2022.03.013 · Cited by 54 · see citing works
Jaya, E. S., Ascone, L., & Lincoln, T. M. (2017) · Psychological Medicine · doi:10.1017/s003329171700277x · Cited by 54 · see citing works
Understanding the mental health burden of COVID-19 in the United Kingdom.
Lopes, B., & Jaspal, R. (2020) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000632 · Cited by 52 · see citing works
CBT for schizophrenia: a critical viewpoint
Jauhar, S., Laws, K. R., & McKenna, P. J. (2019) · Psychological Medicine · doi:10.1017/s0033291718004166 · Cited by 52 · see citing works
Kuipers, J., Moffa, G., Kuipers, E., Freeman, D., & Bebbington, P. (2018) · Psychological Medicine · doi:10.1017/s0033291718000879 · Cited by 50 · see citing works
Self-citationFreeman, D., Bradley, J., Waite, F., Sheaves, B., DeWeever, N., Bourke, E., McInerney, J., Evans, N., Černis, E., Lister, R., et al. (2016) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465816000060 · Cited by 50 · see citing works
Self-citationDeveloping an automated VR cognitive treatment for psychosis: gameChange VR therapy
Lambe, S., Knight, I., Kabir, T., West, J., Patel, R., Lister, R., Rosebrock, L., Rovira, A., Garnish, B., Freeman, J., et al. (2020) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2019.12.001 · Cited by 48 · see citing works
Self-citationMoment-to-moment associations between negative affect, aberrant salience, and paranoia
So, S. H., Chau, A. K. C., PETERS, E. R., Swendsen, J. D., Garety, P. A., & Kapur, S. (2018) · Cognitive Neuropsychiatry · doi:10.1080/13546805.2018.1503080 · Cited by 48 · see citing works
Brief Coping Strategy Enhancement for Distressing Voices: an Evaluation in Routine Clinical Practice
Hayward, M., Edgecumbe, R., Bibby-Jones, A.-M., Berry, C., & Strauss, C. (2017) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465817000388 · Cited by 48 · see citing works
Bird, J. C., Waite, F., Rowsell, E., Fergusson, E. C., & Freeman, D. H. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.07.023 · Cited by 48 · see citing works
Self-citationCognitive behavioural therapy plus standard care versus standard care for people with schizophrenia
Jones, C. R., Hacker, D., Xia, J., Meaden, A., Irving, C. B., Zhao, S., Chen, J., & Shi, C. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007964.pub2 · Cited by 48 · see citing works
The Dunn Worry Questionnaire and the Paranoia Worries Questionnaire: new assessments of worry
Freeman, D. H., Bird, J. C., Loe, B. S., Kingdon, D., Startup, H. M., Clark, D. M., Ehlers, A., Černis, E., Wingham, G., Evans, N., et al. (2019) · Psychological Medicine · doi:10.1017/s0033291719000588 · Cited by 48 · see citing works
Self-citationWorry processes in patients with persecutory delusions.
Startup, H., Pugh, K., Dunn, G., Cordwell, J., Mander, H., Černis, E., Wingham, G., Shirvell, K., Kingdon, D., & Freeman, D. (2016) · British Journal of Clinical Psychology · doi:10.1111/bjc.12109 · Cited by 42 · see citing works
Self-citationLandau, S., Emsley, R., & Dunn, G. (2018) · Clinical Trials · doi:10.1177/1740774518760300 · Cited by 43 · see citing works
Self-citationTraumatic loss and psychosis – Reconceptualising the role of trauma in psychosis.
Vallath, S., Ravikanth, L., Regeer, B., Borba, P. C., Henderson, D. C., & Scholte, W. F. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2020.1725322 · Cited by 42 · see citing works
Individualized metacognitive therapy for delusions: A randomized controlled rater-blind study
Andreou, C., Wittekind, C. E., Fieker, M., Heitz, U., Veckenstedt, R., Bohn, F., & Moritz, S. (2016) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2016.11.013 · Cited by 42 · see citing works
Visually Perceiving the Intentions of Others
Helton, G. (2017) · The Philosophical Quarterly · doi:10.1093/pq/pqx051 · Cited by 41 · see citing works
Blodgett, J. M., Birch, J. M., Musella, M., Harkness, F., & Kaushal, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192315845 · Cited by 43 · see citing works
Developmental Aspects of Schizotypy and Suspiciousness: a Review
Wong, K. K., & Raine, A. (2018) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-018-0144-y · Cited by 41 · see citing works
Lewandowski, K. E., Öngür, D., & Keshavan, M. S. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.06.010 · Cited by 40 · see citing works
Unravelling psychosis: psychosocial epidemiology, mechanism, and meaning.
Bebbington, P. (2015) · Europe PMC (PubMed Central) · doi:10.11919/j.issn.1002-0829.215027 · Cited by 38 · see citing works
Barnby, J. M., Deeley, Q., Robinson, O. J., Raihani, N., Bell, V., & Mehta, M. A. (2020) · Royal Society Open Science · doi:10.1098/rsos.191525 · Cited by 38 · see citing works
Awareness and rumination moderate the affective pathway to paranoia in daily life
Ludwig, L., Mehl, S., Schlier, B., Krkovic, K., & Lincoln, T. M. (2019) · Schizophrenia Research · doi:10.1016/j.schres.2019.12.007 · Cited by 36 · see citing works
Freeman, D., Sheaves, B., Goodwin, G. M., Yu, L.-M., Harrison, P. J., Emsley, R., Bostock, S., Foster, R. G., Wadekar, V., Hinds, C., et al. (2015) · Trials · doi:10.1186/s13063-015-0756-4 · Cited by 35 · see citing works
Self-citationDelusional disorder and schizophrenia: a comparative study across multiple domains
Peralta, V., & Cuesta, M. J. (2016) · Psychological Medicine · doi:10.1017/s0033291716001501 · Cited by 35 · see citing works
Opoka, S. M., & Lincoln, T. M. (2017) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2017.08.005 · Cited by 33 · see citing works
PETERS, E. R., Crombie, T., Agbedjro, D., Johns, L., Stahl, D. R., Greenwood, K., Keen, N., Onwumere, J., Hunter, E. C. M., Smith, L., et al. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01658 · Cited by 34 · see citing works
Capturing behavioral indicators of persecutory ideation using mobile technology
Buck, B., Hallgren, K. A., Scherer, E. A., Brian, R., Wang, R., Wang, W., Campbell, A. T., Choudhury, T., Hauser, M., Kane, J. M., et al. (2019) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2019.06.002 · Cited by 32 · see citing works
Sellers, R., Wells, A., & Morrison, A. P. (2018) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2132 · Cited by 32 · see citing works
Oh, H. Y., Singh, F., Koyanagi, A., Jameson, N. D., Schiffman, J. E., & DeVylder, J. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.01.018 · Cited by 31 · see citing works
Do depressive symptoms predict paranoia or vice versa?
Moritz, S., Göritz, A. S., McLean, B., Westermann, S., & Brodbeck, J. (2017) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2016.10.002 · Cited by 30 · see citing works
Kopelovich, S. L., Strachan, E. D., Sivec, H. J., & Kreider, V. A. L. (2019) · Community Mental Health Journal · doi:10.1007/s10597-018-00365-6 · Cited by 30 · see citing works
Freeman, D. H., Waite, F., Emsley, R., Kingdon, D., Davies, L. M., Fitzpatrick, R. M., & Dunn, G. (2016) · Trials · doi:10.1186/s13063-016-1245-0 · Cited by 29 · see citing works
Self-citationMorrison, A. P., Shryane, N. M., Fowler, D. G., Birchwood, M. J., Gumley, A. I., Taylor, H. E., French, P., Stewart, S., Jones, P. B., Lewis, S. W., et al. (2015) · Psychological Medicine · doi:10.1017/s0033291715000689 · Cited by 28 · see citing works
Motive-oriented therapeutic relationship building for patients diagnosed with schizophrenia
Westermann, S., Cavelti, M., Heibach, E., & Caspar, F. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01294 · Cited by 26 · see citing works
The Perseverative Thinking Questionnaire in Patients with Persecutory Delusions
Černis, E., Dunn, G., Startup, H. M., Kingdon, D., Wingham, G., Evans, N., Lister, R., Pugh, K., Cordwell, J., Mander, H., et al. (2015) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465815000533 · Cited by 26 · see citing works
Self-citationKonsztowicz, S., Schmitz, N., & Lepage, M. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.02.055 · Cited by 26 · see citing works
Muñoz-Negro, J. E., Gómez-Sierra, F. J., Peralta, V., González-Rodríguez, A., & Cervilla, J. A. (2020) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000306 · Cited by 26 · see citing works
Premature commitment to uncertain decisions during human NMDA receptor hypofunction
Salvador, A., Arnal, L. H., Vinckier, F., Domenech, P., Raphaël Gaillard, B., & Wyart, V. (2022) · Nature Communications · doi:10.1038/s41467-021-27876-3 · Cited by 24 · see citing works
Greenwood, K., Gurnani, M., Ward, T., Vogel, E., Vella, C., McGourty, A., Robertson, S., Sacadura, C., Hardy, A., Rus‐Calafell, M., et al. (2022) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12393 · Cited by 22 · see citing works
Self-citationRunning acceptance and commitment therapy groups for psychosis in community settings
Butler, L., Johns, L., Byrne, M., Joseph, C., O’Donoghue, E., Jolley, S., Morris, E. M. J., & Oliver, J. E. (2015) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2015.12.001 · Cited by 25 · see citing works
Hazell, C. M., Greenwood, K., Fielding-Smith, S. F., Rammou, A., Bogen‐Johnston, L., Berry, C., Bibby-Jones, A.-M., & Hayward, M. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.00727 · Cited by 25 · see citing works
Guo, Z.-H., Li, Z.-J., Ma, Y., Sun, J., Guo, J.-H., Li, W.-X., Wang, Z.-Q., Xu, H.-L., Ng, R. M. K., Turkington, D., et al. (2017) · British Journal of Psychiatry · doi:10.1192/bjp.bp.116.183285 · Cited by 24 · see citing works
Self-citationRetractedSellers, R., Gawęda, Ł., Adrian Wells, A., & Morrison, A. P. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.10.029 · Cited by 23 · see citing works
Hutton, P., Rienzo, F. D., Turkington, D., Spencer, H. M., & Taylor, P. J. (2018) · Schizophrenia Bulletin · doi:10.1093/schbul/sby153 · Cited by 22 · see citing works
Waller, H., Landau, S., Fornells-Ambrojo, M., Jolley, S., McCrone, P., Halkoree, R., Basit, N., Iredale, C., Tunnard, C., Zala, D., et al. (2018) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2017.12.004 · Cited by 21 · see citing works
Conceptualising paranoia in ASD: A systematic review and development of a theoretical framework
Spain, D., Sin, J., & Freeman, D. H. (2016) · Research in Autism · doi:10.1016/j.rasd.2016.02.002 · Cited by 22 · see citing works
Self-citationSheffield, J. M., Brinen, A. P., & Freeman, D. H. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.668152 · Cited by 21 · see citing works
Self-citationGawęda, Ł., Staszkiewicz, M., & Balzan, R. P. (2016) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2016.08.003 · Cited by 21 · see citing works
Howells, F. M., Kingdon, D., & Baldwin, D. S. (2017) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.2628 · Cited by 21 · see citing works
Self-citationBrown, P., Waite, F., & Freeman, D. H. (2018) · Clinical Psychology Review · doi:10.1016/j.cpr.2018.12.003 · Cited by 20 · see citing works
Self-citationGarety, P. A., Ward, T., Emsley, R., Greenwood, K., Freeman, D. H., Fowler, D. G., Kuipers, E., Bebbington, P., Dunn, G., & Hardy, A. (2021) · Efficacy and Mechanism Evaluation · doi:10.3310/eme08110 · Cited by 18 · see citing works
Self-citationDifferent learning aberrations relate to delusion-like beliefs with different contents
Rossi-Goldthorpe, R. A., Silverstein, S. M., Gold, J. M., Schiffman, J. E., Waltz, J. A., Williams, T. F., Powers, A. R., Woods, S. W., Zinbarg, R. E., Mittal, V. A., et al. (2024) · Brain · doi:10.1093/brain/awae122 · Cited by 19 · see citing works
Taylor, C. D. J., Bee, P., KELLY, J. A., & Haddock, G. (2018) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2018.10.002 · Cited by 19 · see citing works
Cognitive Behavior Therapy for Psychosis
Kingdon, D., & Turkington, D. (2022) · Springer eBooks · doi:10.1007/978-3-031-10239-4_44 · Cited by 19 · see citing works
Self-citationRefining Suicide Prevention: a Narrative Review on Advances in Psychotherapeutic Tools
Calati, R., Courtet, P., & López‐Castromán, J. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0876-0 · Cited by 18 · see citing works
Steel, C., Korrelboom, K., Baksh, M. F., Kingdon, D., Simon, J., Wykes, T., Phiri, P., & van der Gaag, M. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103734 · Cited by 17 · see citing works
Self-citationThe Pandemic Paranoia Scale (PPS): factor structure and measurement invariance across languages
Kingston, J., Schlier, B., Ellett, L., So, S., Gaudiano, B., Morris, E., & Lincoln, T. (2021) · Psychological Medicine · doi:10.1017/s0033291721004633 · Cited by 16 · see citing works
Cognitive therapy of psychosis: Research and implementation
Kingdon, D., & Turkington, D. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.09.023 · Cited by 17 · see citing works
Self-citationFreeman, D. H., Morrison, A. P., Bird, J. C., Chadwick, E., Bold, E., Taylor, K. M., Diamond, R., Collett, N., Černis, E., Isham, L., et al. (2019) · BJPsych Open · doi:10.1192/bjo.2019.67 · Cited by 16 · see citing works
Self-citationCotter, J., Bucci, S., Drake, R., Yung, A. R., Carney, R., & Edge, D. (2018) · Early Intervention in Psychiatry · doi:10.1111/eip.12560 · Cited by 17 · see citing works
A Systematic Review of Trials Targeting Depression and Anxiety in Patients With Delusions
Opoka, S. M., Ludwig, L., & Lincoln, T. M. (2018) · Zeitschrift für Psychologie · doi:10.1027/2151-2604/a000331 · Cited by 16 · see citing works
Switzer, F., & Harper, S. F. (2019) · Psychosis · doi:10.1080/17522439.2019.1578400 · Cited by 16 · see citing works
- Authors
- Freeman, D., Dunn, G., Startup, H., Pugh, K., Cordwell, J., Mander, H., Černis, E., Wingham, G., Shirvell, K., & Kingdon, D.
- Affiliations
- University of Oxford (GB)
- University of Liverpool (GB)
- Sussex Partnership NHS Foundation Trust (GB)
- University of Southampton (GB)
- Corresponding author
- Freeman, Daniel
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2015-04
- Volume
- 2
- Issue
- 4
- Pages
- 305-313
- ISSN
- 2215-0366 (ISSN-L)
- PMC
- PMC4698664
- OpenAlex
- W2135509506
- Cited by
- 295
- References
- 46
- Citations by year
- 2026: 27 · 2025: 20 · 2024: 19 · 2023: 17 · 2022: 19 · 2021: 27 · 2020: 27 · 2019: 31 · 2018: 36 · 2017: 32 · 2016: 24 · 2015: 13 · 2014: 3
- FWCI
- 28.38
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- The Lancet Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Funders
- UK MRC Senior Clinical Fellowship (G0902308)
- MRC (MR/K006185/1)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- cognitive behavioral therapy, worry reduction, persecutory delusions, psychosis, schizophrenia, schizoaffective disorder, delusional disorder, Penn State Worry Questionnaire, mediation analysis, medication adherence, relapse prevention, relapse prevention training
- MeSH terms
- Adolescent, Adult, Aged, Anxiety, Delusions, Female, Humans, Male, Middle Aged, Paranoid Disorders, Psychiatric Status Rating Scales, Psychotic Disorders, Schizophrenia, Schizophrenia, Paranoid, Cognitive Behavioral Therapy, Single-Blind Method
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
