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A cognitive model of the positive symptoms of psychosis
Open accessAbstract
In the last 10 years a consensus has developed that the symptoms of psychosis may be better understood by linking the steps between the phenomenological experiences and social, psychological and neurobiological levels of explanation. Cognitive models of psychosis are an important link in this chain. They provide a psychological description of the phenomena from which hypotheses concerning causal processes can be derived and tested; social, individual, and neurobiological factors can then be integrated via their impact on these cognitive processes. In this paper, we set out the cognitive processes that we think lead to the formation and maintenance of the positive symptoms of psychosis and we attempt to integrate into our model research in social factors. If this model proves useful, a fuller integration with the findings of biological research will be required (Frith, 1992).
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“Stress-vulnerability and integrated cognitive models 21,22 posit a role for social, environmental and psychological factors in the aetiology of psychosis, in addition to genetic and neurodevelopmental features such as a family history of psychosis and low intelligence quotient (IQ).”
From Clinical, socio‐demographic and psychological characteristics in individuals with persistent psychotic experiences with and without a “need for care” (2016) · cites this paper as [21]
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“These results support biopsychosocial models 21,22,37 that emphasize the importance of environmental and psychological factors in the aetiology of psychosis and need for care.”
From Clinical, socio‐demographic and psychological characteristics in individuals with persistent psychotic experiences with and without a “need for care” (2016) · cites this paper as [21]
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“it is likely that persistent PEs only become problematic in the context of pre-existent vulnerabilities, as suggested by contemporary aetiological models of psychosis 21,22,37”
From Clinical, socio‐demographic and psychological characteristics in individuals with persistent psychotic experiences with and without a “need for care” (2016) · cites this paper as [21]
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“According to the cognitive model of positive symptoms of psychosis (Garety et al. 2001) and the Bio‐Psychosocial Model of Transition to Psychosis (Georgiades et al. 2023), avoidance and social withdrawal, as well as psychosocial stress and interpersonal sensitivity, contribute to the onset and maintenance of psychosis symptoms.”
From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Garety et al. 2001
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“Likewise, cognitive models of psychosis [23] emphasise the role of emotional processes, particularly anxiety, in the onset and maintenance cycle of psychotic symptoms [5, 24].”
From A brief CBT intervention for depersonalisation/derealisation in psychosis: Study protocol for a feasibility randomised controlled trial (2016) · cites this paper as [23]
In the citing paper
“the jumping to conclusions (JTC) bias is invoked as an explanatory mechanism in models of delusions.4”
From Computational psychiatry: a Rosetta Stone linking the brain to mental illness (2014) · cites this paper as [4]
In the citing paper
“When people with schizophrenia (who have or are prone to delusions) make decisions in an uncertain setting, they tend to draw on less information in reaching that decision than does a person without schizophrenia.”
From Computational psychiatry: a Rosetta Stone linking the brain to mental illness (2014) · cites this paper as [4]
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“They might also ignore pieces of evidence that contradict that decision.”
From Computational psychiatry: a Rosetta Stone linking the brain to mental illness (2014) · cites this paper as [4]
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Items 301–400 of 1,002
Dunn, G., Fowler, D. G., Rollinson, R., Freeman, D. H., Kuipers, E., Smith, B., Steel, C., Onwumere, J., Jolley, S., Garety, P. A., et al. (2011) · Psychological Medicine · doi:10.1017/s0033291711001954 · Cited by 65
Self-citationVass, V., Sitko, K., West, S. A., & Bentall, R. P. (2017) · Psychosis · doi:10.1080/17522439.2017.1300184 · Cited by 76
A Stratified Model for Psychosis Prediction in Clinical Practice
Michel, C., Ruhrmann, S., SCHIMMELMANN, B. G., Klosterkötter, J., & Schultze‐Lutter, F. (2014) · Schizophrenia Bulletin · doi:10.1093/schbul/sbu025 · Cited by 63
“Results: The final prediction model included (1) at-risk criteria (attenuated psychotic symptoms plus subjective cognitive disturbances) and (2) a processing speed deficit (digit symbol test).”
BackgroundMethodInfluentialGibson, L. E., Reeves, L. E., Cooper, S., Olino, T. M., & Ellman, L. M. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.02.005 · Cited by 66
“, that one is vulnerable to being harmed due to the hostile intentions of others), which are then thought to increase psychotic symptom development in those with genetic predispositions (Garety et al., 2001).”
Agency and Anxiety: Delusions of Control and Loss of Control in Schizophrenia and Agoraphobia
Gallagher, S., & Trigg, D. (2016) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2016.00459 · Cited by 63
“…the second factor consists of an attempt to explain or rationalize the anomalous experience, leading to what the DSM-5 defines as “fixed beliefs that are not amenable to change in light of conflicting evidence” (see, e.g., Ellis and Young, 1990; Davies et al., 2001; Garety et al., 2001).”
BackgroundInterpretation Bias in Paranoia: A Systematic Review and Meta-Analysis
Trotta, A., Kang, J., Stahl, D. R., & Yiend, J. (2020) · Clinical Psychological Science · doi:10.1177/2167702620951552 · Cited by 67
Loore, E. D., Drukker, M., Günther, N., FERON, F. J. M., Deboutte, D., Sabbe, B., Mengelers, R., van Os, J., & Myin‐Germeys, I. (2007) · Early Intervention in Psychiatry · doi:10.1111/j.1751-7893.2007.00027.x · Cited by 64
Vila‐Badia, R., Butjosa, A., Cacho, N. D., Serra‐Arumí, C., Esteban‐Sanjusto, M., Ochoa, S., & Usall, J. (2021) · Schizophrenia Research · doi:10.1016/j.schres.2020.11.047 · Cited by 62
Religious Delusions: Finding Meanings in Psychosis
Bhavsar, V., & Bhugra, D. (2008) · Psychopathology · doi:10.1159/000115954 · Cited by 64
“observe that the nature of the subjective experience of early psychosis was similar across Canadian and Indian interviewees, typified by a range of assaults on individual experience – interviewees reported extreme fear, confusion and a porosity of self-boundaries. Garety et al. [”
BackgroundValmaggia, L., Day, F., & Rus‐Calafell, M. (2016) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-016-1245-0 · Cited by 70
“onset and maintenance of psychosis [1-5].”
Dykxhoorn, J. L., Hollander, A., Lewis, G., Magnusson, C., Dalman, C., & Kirkbride, J. B. (2018) · Psychological Medicine · doi:10.1017/s0033291718003227 · Cited by 62
“, 2012; Selemon and Zecevic, 2015) and development of ‘theory of mind’ and general cognition during early childhood (Perner and Lang, 1999; Garety et al., 2001; Colvert et al., 2008).”
BackgroundLife hassles, experiential avoidance and distressing delusional experiences
Goldstone, E., Farhall, J., & Ong, B. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.02.002 · Cited by 60
On two kinds of delusion of reference
Startup, M., & Startup, S. (2005) · Psychiatry Research · doi:10.1016/j.psychres.2005.07.007 · Cited by 61
Korver‐Nieberg, N., Fett, A.-K. J., Meijer, C. J., Koeter, M. W. J., Shergill, S. S., de Haan, L., & Krabbendam, L. (2013) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867413484370 · Cited by 66
“Garety et al. (2001) suggested a cognitive model of psychosis according to which paranoia is maintained by negative beliefs about others and social withdrawal, which are also characteristics of avoidant attachment.”
BackgroundCavelti, M., Rüsch, N., & Vauth, R. (2014) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000000160 · Cited by 60
“Along with psychological models of psychosis (Garety et al., 2001), psychological strategies to cope with symptoms and impairments have been developed during the last years (e.”
BackgroundLow intensity cognitive behavioural therapy for psychosis: a pilot study.
Waller, H., Garety, P., Jolley, S., Fornells-Ambrojo, M., Kuipers, E., Onwumere, J., Woodall, A., Emsley, R., & Craig, T. (2013) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2012.07.013 · Cited by 62
Self-citationDo Antipsychotics Improve Reasoning Biases? A Review
So, S., Garety, P., Peters, E., & Kapur, S. (2010) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181e7cca6 · Cited by 75
“These reasoning processes have been proposed to play important roles in the development and maintenance of delusions (3,4) and are targets for change in cognitive behavioral therapy for psychosis (5) and the newly emerging reasoning training (6,7).”
BackgroundSelf-citationLincoln, T. M., Marín, N. M., & Jaya, E. S. (2017) · European Psychiatry · doi:10.1016/j.eurpsy.2016.12.010 · Cited by 63
Cognitive-Behavioral Therapy for Medication-Resistant Schizophrenia: A Review
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Codjoe, L., Byrne, M., Lister, M., McGuire, P. K., & Valmaggia, L. (2012) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465812000707 · Cited by 64
Romm, K. L., Røssberg, J. I., Hansen, C. F., Haug, E., Andreassen, O. A., & Melle, I. S. (2011) · BMC Psychiatry · doi:10.1186/1471-244x-11-136 · Cited by 59
“Garety’s cognitive model of psychosis [11] suggests that the experience of social adversity and lowered self-esteem can lead to the development of psychotic symptoms through an increased vulnerability to psychotic disorders.”
BackgroundInfluentialMetacognitive therapy in treatment-resistant psychosis: a multiple-baseline study.
Hutton, P., Morrison, A. P., Wardle, M., & Wells, A. (2014) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465812001026 · Cited by 58
“Although existing cognitive models clearly identify metacognition and worry as important factors in psychosis (Garety, Kuipers, Fowler, Freeman and Bebbington, 2001; Morrison, 2001), they also incorporate many non-metacognitive components, such as core beliefs (i.e., about self, others and the…”
BackgroundUnderstanding the clinical concept of delusion: from an estranged to an engaged epistemology
Gipps, R. G. T., & Fulford, K. W. M. (2004) · International Review of Psychiatry · doi:10.1080/09540260400003966 · Cited by 58
“…suggested in the literature—such as normal confirmation bias, ego-ideal-preserving motivated projection, a jumping-to-conclusions data gathering bias, a poor capacity to relate to others, a general externalising attributional style, and an inflexible cognitive attitude (cf. Garety et al., 2001).”
BackgroundGeorgiades, A., Almuqrin, A., Rubinic, P., Mouhitzadeh, K., Tognin, S., & Mechelli, A. (2023) · Schizophrenia · doi:10.1038/s41537-023-00362-z · Cited by 58
Ponizovsky, A. M., Vitenberg, E., Baumgarten‐Katz, I., & Grinshpoon, A. (2011) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/j.2044-8341.2011.02054.x · Cited by 67
Beliefs about Voices and Schemas about Self and Others in Psychosis
Thomas, N., Farhall, J., & Shawyer, F. (2013) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465813000817 · Cited by 58
Larkin, A., & Hutton, P. (2017) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.116.193458 · Cited by 57
CAMERON, D., KAPUR, R., & Campbell, P. (2005) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2004.00796.x · Cited by 57
Gayer-Anderson, C. E., Fisher, H. L., Fearon, P., Hutchinson, G. A., Morgan, K. D., Dazzan, P., Boydell, J. E., Doody, G. A., Jones, P. B., Murray, R. M., et al. (2015) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-015-1058-6 · Cited by 57
“At a critical developmental period, childhood physical and sexual abuse can create a lasting cognitive vulnerability in the form of negative schematic beliefs, resulting in low self-esteem, which in adulthood could lead to an inability to deal with stress and increase vulnerability to psychosis [48].”
BackgroundBordon, N., O’Rourke, S. J., & Hutton, P. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.01.014 · Cited by 56
“Howes and Murray (2014) attempt to integrate this with the perspective offered by cognitive models of psychosis (Garety et al., 2001; Morrison, 2001), that delusions develop as the affected individual tries to make sense of these and other odd, intrusive, experiences, and that this meaning-making process is strongly i…”
InfluentialBucci, S., Barrowclough, C., Ainsworth, J. D., Morris, R., Berry, K., Machin, M., Emsley, R., Lewis, S. W., Edge, D., Buchan, I. E., et al. (2015) · Trials · doi:10.1186/s13063-015-0943-3 · Cited by 56
“The Actissist intervention is grounded in the cognitive maintenance model of psychosis, which proposes that cognitive appraisals contribute to the emergence of un-helpful beliefs and influence the interpretation of psychotic experiences [31, 32].”
BackgroundFor Genetic Risk and Outcome in Psychosis (GROUP), van Dam, D. S., Korver‐Nieberg, N., Velthorst, E., Meijer, C. J., & de Haan, L. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-014-0894-0 · Cited by 56
“It is suggested that negative beliefs, reduced experience of internal control and higher levels of distress subsequently heighten the vulnerability to develop psychotic symptoms, such as paranoia [17–19].”
BackgroundCognitive and emotional associations to positive schizotypy during adolescence
Debbané, M., der Linden, M. V., Gex‐Fabry, M., & D, S. E. M. (2009) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2008.01961.x · Cited by 56
Childhood trauma and clinical outcome in patients at ultra-high risk of transition to psychosis
Kraan, T. C., van Dam, D. S., Velthorst, E., de Ruigh, E. L., Nieman, D. H., Durston, S., Schothorst, P. F., van der Gaag, M., & de Haan, L. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.10.030 · Cited by 60
“First, it is suggested that childhood trauma leads to the formation of negative schemas about self, others, and the world [37].”
InfluentialLongitudinal predictors of subjective recovery in psychosis
Law, H., Shryane, N., Bentall, R. P., & Morrison, A. P. (2016) · British Journal of Psychiatry · doi:10.1192/bjp.bp.114.158428 · Cited by 55
“Moreover, it supports previous research that suggests a key role for emotion in psychosis, 26–28 and extends these findings in terms of their relevance for subjective recovery.”
Edwards, C. J., Garety, P., & Hardy, A. (2019) · Psychological Medicine · doi:10.1017/s0033291719002381 · Cited by 54
“The role of depressive symptoms in driving psychosis has been discussed previously (Garety et al., 2001; Sarkar et al., 2015) and it may be that this is a more potent route to co-occurring negative symptoms.”
BackgroundInfluentialSelf-citationFeyaerts, J., & Sass, L. A. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbad169 · Cited by 60
Owens, K. A., Haddock, G., & Berry, K. (2012) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.1793 · Cited by 55
Dealing with feeling: Specific emotion regulation skills predict responses to stress in psychosis
Lincoln, T. M., Hartmann, M. M., Köther, U., & Moritz, S. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.04.003 · Cited by 57
“Accordingly, newer vulnerability-stress models of psychotic symptoms ascribe emotional distress a central role on the pathway from stress to psychosis (e.g. Garety et al., 2001; Preti and Celler, 2010).”
BackgroundProtective Factors for Psychotic Symptoms Among Poly-victimized Children
Crush, E., Arseneault, L., Jaffee, S. R., Danese, A., & Fisher, H. L. (2017) · Schizophrenia Bulletin · doi:10.1093/schbul/sbx111 · Cited by 55
Ensum, I., & Morrison, A. P. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(02)00102-x · Cited by 57
Family interventions in schizophrenia: evidence for efficacy and proposed mechanisms of change
Kuipers, E. (2006) · Journal of Family Therapy · doi:10.1111/j.1467-6427.2006.00338.x · Cited by 55
Self-citationCognitive and neural models of threat appraisal in psychosis: a theoretical integration
Underwood, R., Kumari, V., & Peters, E. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.03.016 · Cited by 51
“Reasoning, attentional, and attributional biases are thought to shape these threat-based appraisals (Garety et al., 2001).”
Changes in delusions in the early phase of antipsychotic treatment – An experience sampling study
So, S. H., PETERS, E. R., Swendsen, J. D., Garety, P. A., & Kapur, S. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.12.033 · Cited by 55
“It has been suggested (Garety et al., 2001; 2007) that the way patients form appraisals of experience may be characterised by reasoning biases, including ‘Jumping to Conclusions’ (JTC) bias and lack of belief flexibility, which may contribute to the development and maintenance of delusions.”
BackgroundSelf-citationGawęda, Ł., Prochwicz, K., & Cella, M. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.10.006 · Cited by 58
“According to the cognitive model of psychosis, cognitive biases play a key role in the development of psychotic symptoms (e.g. Garety et al., 2001).”
MethodBoulton, M. J. (2012) · Anxiety Stress & Coping · doi:10.1080/10615806.2012.662499 · Cited by 54
“Our findings for social exclusion, relational and verbal victimization support theories that propose a mediating role for self-blame in the development of psycho-social maladjustment (Garety et al., 2001; Morrison, 2001).”
BackgroundJaya, E. S., Ascone, L., & Lincoln, T. M. (2017) · Psychological Medicine · doi:10.1017/s003329171700277x · Cited by 58
“…for a unidirectional pathway from NSS to paranoia (Fowler et al. 2012; Oliver et al. 2012), we now have an increasing body of evidence pointing to a temporal precedence of NSS in the formation and maintenance of positive symptoms as postulated by the cognitive models (e.g. Garety et al. 2001).”
BackgroundMethodInfluentialBetz, L. T., Penzel, N., Kambeitz‐Ilankovic, L., Rosen, M., Chisholm, K., Stainton, A., Haidl, T. K., Wenzel, J., Bertolino, A., Borgwardt, S., et al. (2020) · Schizophrenia · doi:10.1038/s41537-020-00129-w · Cited by 54
Morrin, H., Nicholls, L., Levin, M., Yiend, J., Iyengar, U., DelGuidice, F., Bhattacharrya, S., Tognin, S., MacCabe, J. H., Twumasi, R., et al. (2026) · The Lancet Psychiatry · doi:10.1016/s2215-0366(25)00396-7 · Cited by 80
Hill, K., Varese, F., Jackson, M. C., & Linden, D. E. J. (2012) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.2012.02039.x · Cited by 53
Mehl, S., Landsberg, M. W., Schmidt, A.-C., Cabanis, M., Bechdolf, A., Herrlich, J., Loos-Jankowiak, S., Kircher, T. T. J., Kiszkenow-Bäker, S., Klingberg, S., et al. (2014) · Schizophrenia Bulletin · doi:10.1093/schbul/sbu040 · Cited by 53
Trauma and the content of hallucinations and post‐traumatic intrusions in first‐episode psychosis
Peach, N., Álvarez‐Jiménez, M., Cropper, S. J., Sun, P., Halpin, E., O’Connell, J., & Bendall, S. (2020) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12273 · Cited by 53
Recent approaches to psychological interventions for people at risk of psychosis
Bechdolf, A., Phillips, L., Francey, S. M., Leicester, S., Morrison, A. P., Veith, V., Klosterkötter, J., & McGorry, P. D. (2006) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-006-0623-0 · Cited by 53
Interpretation Biases in Paranoia
Savulich, G., Freeman, D., Shergill, S., & Yiend, J. (2015) · Behavior Therapy · doi:10.1016/j.beth.2014.08.002 · Cited by 53
Self-citationMigration and psychotic disorders
Veling, W., & Susser, E. (2010) · Expert Review of Neurotherapeutics · doi:10.1586/ern.10.91 · Cited by 56
Lincoln, T. M., Mehl, S., Ziegler, M., Kesting, M.-L., Exner, C., & Rief, W. (2009) · Behavior Therapy · doi:10.1016/j.beth.2009.02.004 · Cited by 56
Reasoning in Believers in the Paranormal
Lawrence, E., & PETERS, E. R. (2004) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000144691.22135.d0 · Cited by 52
“concept in psychosis (Escher et al., 2002; Garety et al., 2001),”
BackgroundLatent profile analysis of healthy schizotypy within the extended psychosis phenotype
Tabak, N. T., & de Mamani, A. W. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.08.006 · Cited by 55
“In line with the cognitive model of psychosis, the High UE group demonstrates that it may not be the anomalous experiences in and of themselves that are pathological, but one's cognitive interpretation of these aberrant experiences that differentiates between adaptive and pathological progression (Garety et al., 2001).”
de Bont, P. A. J. M., van den Berg, D. P. G., van der Vleugel, B. M., de Roos, C., Mulder, C. L., Becker, E. S., de Jongh, A., van der Gaag, M., & van Minnen, A. (2013) · Trials · doi:10.1186/1745-6215-14-151 · Cited by 52
Interpersonal processes in paranoia: a systematic review
Meisel, S. F., Garety, P. A., Stahl, D. R., & Valmaggia, L. (2018) · Psychological Medicine · doi:10.1017/s0033291718000491 · Cited by 56
“is related to emotional distress and paranoid ideation (Garety et al., 2001).”
BackgroundSelf-citationAgreeableness and Neuroticism as Predictors of Relapse After First-Episode Psychosis
Gleeson, J., Rawlings, D., Jackson, H. J., & McGorry, P. D. (2005) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000154841.99550.d3 · Cited by 52
“This should be based on an assessment that includes personality factors and premorbid adjustment (Garety et al., 2001).”
BackgroundThe role of aberrant salience and self-concept clarity in psychotic-like experiences.
Cicero, D. C., Becker, T. M., Martin, E. A., Docherty, A. R., & Kerns, J. G. (2013) · Personality Disorders: Theory, Research, and Treatment · doi:10.1037/a0027361 · Cited by 52
“Many theorists who have attempted to explain the origin of psychosis and PLEs have posited a role for cognitive mechanisms in the development and maintenance of these experiences (e.g., Bell, Halligan, & Ellis, 2006; Bentall, Corcoran, Howard, Blackwood, & Kinderman, 2001; Freeman, 2007; Garety et al., 2001).”
Nuevo, R., van Os, J., Arango, C., Chatterji, S., & Ayuso‐Mateos, J. L. (2012) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12010 · Cited by 53
Mehl, S., Rief, W., Lüllmann, E., Ziegler, M., Kesting, M.-L., & Lincoln, T. M. (2010) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3181e4c8d2 · Cited by 52
“Hence, ToM is considered as one of the cognitive factors triggering the onset and maintenance of delusions in psychological models of positive symptoms in general and PD in specific (Freeman et al., 2002; Garety et al., 2001).”
BackgroundEffects of online intervention for depression on mood and positive symptoms in schizophrenia
Moritz, S., Schröder, J., Klein, J. P., Lincoln, T. M., Andreou, C., Fischer, A., & Arlt, S. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.04.033 · Cited by 53
“Its psychometric properties can be judged as good with a sensitivity of 0.80 and a specificity of 0.92 (Gilbody et al., 2007).”
InfluentialKimhy, D., Wall, M. M., Hansen, M. C., Vakhrusheva, J., Choi, C. J., Delespaul, P., Tarrier, N., Sloan, R. P., & Malaspina, D. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw219 · Cited by 51
Kraan, T. C., Velthorst, E., Themmen, M., Valmaggia, L., Kempton, M. J., McGuire, P. K., van Os, J., Rutten, B. P. F., Smit, F., de Haan, L., et al. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw162 · Cited by 56
“For instance, it has been suggested that the experience of child maltreatment leads to the formation of negative self-schemas [30].”
BackgroundSmeets, F., Lataster, T., van Winkel, R., de Graaf, R., ten Have, M., & van Os, J. (2013) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2012.01888.x · Cited by 50
“Although theoretical frameworks commonly make a meaningful distinction between hallucinations and delusions in the development of psychotic disorder (7, 8, 10, 13, 20, 21), the majority of studies to date have focused on positive symptoms as a single class.”
BackgroundStigma and need for care in individuals who hear voices
Vilhauer, R. P. (2017) · International Journal of Social Psychiatry · doi:10.1177/0020764016675888 · Cited by 50
Misiak, B., Moustafa, A. A., Kiejna, A., & Frydecka, D. (2015) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2015.12.003 · Cited by 50
“An alternative, cognitivemodel explains that traumatic events lead to cognitive vulnerability that is characterized by negative schemes about the self and the world promoting the development of external attributions [50].”
BackgroundDualibe, A. L., & Osório, F. D. L. (2017) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000154 · Cited by 53
Barrantes‐Vidal, N., Ros‐Morente, A., & Kwapil, T. R. (2009) · Schizophrenia Research · doi:10.1016/j.schres.2009.09.021 · Cited by 50
Role of distress in delusion formation
Hanssen, M., Krabbendam, L., de Graaf, R., Vollebergh, W., & van Os, J. (2005) · The British Journal of Psychiatry · doi:10.1192/bjp.187.48.s55 · Cited by 49
Schizophrenia Course, Long-Term Outcome, Recovery, and Prognosis
Jobe, T. H., & Harrow, M. (2010) · Current Directions in Psychological Science · doi:10.1177/0963721410378034 · Cited by 49
The Use of Rescripting Imagery for People with Psychosis Who Hear Voices
Ison, R., Medoro, L., Keen, N., & Kuipers, E. (2013) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s135246581300057x · Cited by 49
Self-citationSmith, N., Freeman, D. H., & Kuipers, E. (2005) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000168235.60469.cc · Cited by 54
“With colleagues, we have previously argued that delusions arise from an interaction of anomalous experiences, reasoning biases, and emotional processes (Garety et al., 2001).”
BackgroundSelf-citationBullying victimisation and paranoid ideation in people at ultra high risk for psychosis
Valmaggia, L., Day, F., Kroll, J., Laing, J., Byrne, M., Fusar‐Poli, P., & McGuire, P. K. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.08.029 · Cited by 48
“This is also supported by the cognitive models of psychosis and persecutory delusions (Garety et al., 2001, Garety et al., 2007, Freeman et al., 2002, Bentall et al., 2007, Morrison and Wells, 2003) which suggests that early adverse life experiences such as bullying, can lead to an enduring…”
BackgroundResultSönmez, N., Romm, K. L., Østefjells, T., Grande, M., Jensen, L. H., Hummelen, B., Tesli, M., Melle, I. S., & Røssberg, J. I. (2019) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2019.152157 · Cited by 52
“This has been related to the development and duration of psychotic symptoms [14,15] and a poorer clinical outcome [16–18].”
BackgroundDescribing the indescribable: A qualitative study of dissociative experiences in psychosis
Černis, E., Freeman, D. H., & Ehlers, A. (2020) · PLoS ONE · doi:10.1371/journal.pone.0229091 · Cited by 48
“Whilst the exact pattern of causal relationships between dissociative and psychotic experiences is unknown (whatever the extent of their overlap), these results appear to support the Garety et al [9] model of the development of positive psychotic symptoms.”
BackgroundResultInfluentialSelf-citationDelusional evidence-responsiveness
Flores, C. (2021) · Synthese · doi:10.1007/s11229-021-03070-2 · Cited by 33
Burnout in early course psychosis caregivers: the role of illness beliefs and coping styles
Onwumere, J., Lotey, G., Schulz, J., James, G., Afsharzadegan, R., Harvey, R., Man, L. C. E., Kuipers, E., & Raune, D. (2015) · Early Intervention in Psychiatry · doi:10.1111/eip.12227 · Cited by 48
“Many individuals with psychosis will live with or maintain regular contact with informal carers(11); a picture that is particularly evident during the early illness phase.(12) Patient outcomes can be improved with carer support.”
BackgroundSelf-citationCan an ‘Extreme Female Brain’ be characterised in terms of psychosis?
Brosnan, M., Ashwin, C., Walker, I. O., & Donaghue, J. (2010) · Personality and Individual Differences · doi:10.1016/j.paid.2010.06.018 · Cited by 48
Lincoln, T. M., Köther, U., Hartmann, M. M., Kempkensteffen, J., & Moritz, S. (2014) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2014.11.011 · Cited by 51
Insight in individuals with an At Risk Mental State☆
Lappin, J., Morgan, K. D., Valmaggia, L., Broome, M. R., Woolley, J., Johns, L., Tabraham, P., Bramon, E., & McGuire, P. K. (2007) · Schizophrenia Research · doi:10.1016/j.schres.2006.11.018 · Cited by 48
“These models suggest that it is when experiences are appraised as “externally caused and personally significant” that the subject is more likely to develop a psychotic illness (Garety et al., 2001; Morrison, 2001).”
BackgroundResultInfluentialAppraisals, psychotic symptoms and affect in daily life
PETERS, E. R., Lataster, T., Greenwood, K., Kuipers, E., Scott, J. L., Williams, S., Garety, P. A., & Myin‐Germeys, I. (2011) · Psychological Medicine · doi:10.1017/s0033291711001802 · Cited by 49
“A number of cognitive models have emerged, ranging from general models of positive symptoms of psychosis (Garety et al. 2001, 2007 ; Morrison, 2001 ; Bentall et al. 2007), to more specific models of hallucinations (Bentall, 1990 ; Chadwick & Birchwood, 1994 ; Morrison, 1998) and delusions (Garety &…”
Self-citationKilbride, M., Byrne, R. E., Price, J., Wood, L., Barratt, S., Welford, M., & Morrison, A. P. (2012) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465812000495 · Cited by 48
Childhood abuse and schizotypal personality
Steel, C., Marzillier, S. L., Fearon, P. R. M., & Ruddle, A. (2009) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-009-0038-0 · Cited by 47
“These early events may also set up negative beliefs about oneself and others, which result in a negative and distressing interpretation of such perceptual anomalies [13].”
BackgroundJumping to conclusions: the psychology of delusional reasoning
Garety, P., Freeman, D., Jolley, S., Ross, K., Waller, H., & Dunn, G. (2011) · Advances in Psychiatric Treatment · doi:10.1192/apt.bp.109.007104 · Cited by 47
Self-citationGawęda, Ł., Prochwicz, K., Krężołek, M., Kłosowska, J., Staszkiewicz, M., & Moritz, S. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2017.05.042 · Cited by 48
Lawlor, C., Hepworth, C., Smallwood, J., Carter, B., & Jolley, S. (2019) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2408 · Cited by 51
Gibbs-Dean, T., Katthagen, T., Tsenkova, I., Ali, R., Liang, X., Spencer, T. J., & Diederen, K. M. J. (2023) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2023.105087 · Cited by 52
Xu, Z.-Y., Zu, S., Xiang, Y., Wang, N., Guo, Z.-H., Kilbourne, A. M., Brabban, A., Kingdon, D., & Li, Z.-J. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.02.012 · Cited by 46
“Garety et al. (2001) also found that emotional processes in people with schizophrenia were related to early adverse experiences.”
Campbell, M. L. C., & Morrison, A. P. (2007) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.510 · Cited by 48
Boyda, D., McFeeters, D., Dhingra, K., & Rhoden, L. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22690 · Cited by 45
Delusions are associated with low self-reflectiveness in first-episode psychosis
Buchy, L., MALLA, A. K., Joober, R., & Lepage, M. (2009) · Schizophrenia Research · doi:10.1016/j.schres.2009.03.019 · Cited by 45
“…patients may begin to entertain the possibility of being mistaken (i.e., show greater self-reflection), an important reasoning process in delusional belief persistence and change (Garety et al., 2001), after being repeatedly given negative feedback regarding the false nature of their beliefs.”
BackgroundWigman, J. T. W., Collip, D., Wichers, M., Delespaul, P., Derom, C. A., Thiery, E. W., Vollebergh, W., Lataster, T., Jacobs, N., Myin‐Germeys, I., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0054653 · Cited by 45
“Examples of such mental states may be [8,9]: peculiar experience of personal significance of certain events, heightened perception, sense of threat, actions experienced as unintended, racing thoughts, thoughts appearing to be broadcasted, thoughts experienced as voices, two unconnected events appearing to be causally…”
Self-voice perception and its relationship with hallucination predisposition
Pinheiro, A. P., Farinha‐Fernandes, A., Roberto, M. S., & Kotz, S. A. (2019) · Cognitive Neuropsychiatry · doi:10.1080/13546805.2019.1621159 · Cited by 45
Martin, A. K., Robinson, G. A., Dzafic, I., Reutens, D. C., & Mowry, B. J. (2013) · Genes Brain & Behavior · doi:10.1111/gbb.12066 · Cited by 52
“Attributional bias is another key social cognitive aspect, especially for the formation of persecutory or paranoid delusions (Garety et al. 2001).”
BackgroundLanda, Y., Mueser, K. T., Wyka, K., Shreck, E., Jespersen, R., Jacobs, M. A., Griffin, K. W., van der Gaag, M., Reyna, V. F., Beck, A. T., et al. (2015) · Early Intervention in Psychiatry · doi:10.1111/eip.12204 · Cited by 44
“GF-CBT is grounded in socio-cultural(16) and ecological systems theories,(17) psychosocial resilience models,(18) a fuzzy-trace theory of emotion, memory and reasoning, and research on information processing in delusions.(14,22,23) The guiding theory for the GF-CBT intervention is that gist memories (bottom-line meani…”
BackgroundCarol, E. E., & Mittal, V. A. (2015) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2015.03.018 · Cited by 44
“…(i.e., the development of beliefs about the self) occurs during childhood and adolescence (Cole et al., 2001), and cognitive theorist have posited that the development of negative beliefs about the self can result in maladaptive responses and mental states (Beck, 1979; Garety et al., 2001).”
Background
Metadata
- Authors
- GARETY, P. A., KUIPERS, E., FOWLER, D., FREEMAN, D., & BEBBINGTON, P. E.
- Affiliations
- University of East Anglia (GB)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2001-02
- Volume
- 31
- Issue
- 2
- Pages
- 189-195
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2162176680
- Cited by
- 1,546
- References
- 46
- Citations by year
- 2026: 62 · 2025: 68 · 2024: 48 · 2023: 66 · 2022: 62 · 2021: 77 · 2020: 72 · 2019: 77 · 2018: 76 · 2017: 87 · 2016: 67 · 2015: 74 · 2014: 86 · 2013: 90 · 2012: 65
- FWCI
- 16.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Keywords
- psychosis, positive symptoms, cognitive models, cognitive processes, symptom maintenance, social factors, neurobiological factors, levels of explanation, phenomenology
- MeSH terms
- Cognition Disorders, Humans, Psychological Theory, Psychotic Disorders, Self Concept, Social Environment
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