Core beliefs in psychosis: a systematic review and meta-analysis
Open accessAbstract
Increasing interest is growing for the identification of psychological mechanisms to account for the influence of trauma on psychosis, with core beliefs being proposed as a putative mediator to account for this relationship. A systematic review (n = 79 studies) was conducted to summarise the existing evidence base regarding the role of core beliefs/schemas in psychosis, Clinical High-Risk (CHR), and non-clinical samples with Psychotic-Like Experiences (PLEs). Compared to Healthy Controls (HCs), individuals with psychosis experiencing Auditory Hallucinations or Persecutory Delusions had significantly higher scores for negative self and negative other-beliefs and significantly lower scores for positive self and positive other-beliefs. This pattern of core beliefs was also observed for CHR individuals. In contrast, the core belief profile for grandiose delusions was in the opposite direction: higher positive self and positive other-beliefs and lower negative self-beliefs. In non-clinical samples, several factors mediated the relationship between Traumatic Life Events (TLEs) and PLEs, such as greater perceived stress, dissociation, external locus of control, and negative self and negative other-beliefs. Compared to HCs, meta-analyses revealed statistically significant large effects for negative self and negative other-beliefs in Schizophrenia. In CHR, statistically significant large and moderate effects were found for negative self and negative other-beliefs, respectively, along with a moderate negative effect for positive self-beliefs. Core beliefs were found to play a significant role in the development and maintenance of positive symptoms of psychosis. The development of psychosocial interventions that explicitly target negative self and other-beliefs, whilst also enhancing positive self-beliefs are warranted and would innovate CBTp practices.
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A recent systematic review and meta-analysis found that compared to healthy controls, SZ and CHR scored significantly higher for negative self and negative other-beliefs and significantly lower for positive self and positive other-beliefs.
“A recent systematic review and meta‐analysis found that compared to healthy controls, SZ and CHR scored significantly higher for negative self and negative other‐beliefs and significantly lower for positive self and positive other‐beliefs (Jorovat et al. 2025).”
From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Jorovat et al. 2025
The Results (Meta-analytic findings) report significantly higher negative self- and negative other-beliefs for both SZ and CHR versus healthy controls. But the pooled differences for positive other-beliefs were not significant in either group, and the pooled positive self-belief difference was not significant in SZ. The Results (Psychosis; CHR) describe individual studies finding significant differences on all four beliefs, but the claim overstates the meta-analytic findings. (LLM, conf=0.92)
Experimental — accuracy not yet measuredThe cognitive model of social functioning in psychosis proposes that childhood traumatic events such as physical, sexual and emotional abuse, and physical and emotional neglect, contribute to the formation of core beliefs such as negative self and other beliefs.
“Our model proposes that childhood traumatic events such as physical, sexual, and emotional abuse, as well as physical and emotional neglect contribute to the formation of core beliefs such as ‘I am a failure, inferior, weak/vulnerable, worthless, and/or unlovable/unlikeable’ and others are ‘untrustworthy, dangerous, uncaring and/or unreliable’.”
From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Jorovat et al. 2025
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The Role of Emotion in Psychosis Onset and Symptom Persistence: A Systematic Review
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- Authors
- Jorovat, A., Twumasi, R., Mechelli, A., & Georgiades, A.
- Affiliations
- King's College London (GB)
- Corresponding author
- Georgiades, A.
- Venue
- Schizophrenia
- Published
- 2025-03-06
- Volume
- 11
- Issue
- 1
- Pages
- 38-38
- ISSN
- 2754-6993 (ISSN-L)
- PMC
- PMC11885481
- OpenAlex
- W4408191264
- Cited by
- 11
- References
- 97
- Citations by year
- 2026: 9 · 2025: 2
- FWCI
- 1.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Schizophrenia (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Research Portal (King's College London) (submittedVersion, cc-by-sa)
- Funders
- Medical Research Council (MR/Y015436/1)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- core beliefs, psychosis, trauma, clinical high risk, psychotic-like experiences, auditory hallucinations, persecutory delusions, grandiose delusions, negative self-beliefs, traumatic life events, perceived stress, dissociation, locus of control, cognitive behavioural therapy for psychosis, psychosocial interventions
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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.
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