Date of Degree

9-2017

Document Type

Dissertation

Degree Name

Ph.D.

Program

Psychology

Advisor

Deidre Anglin

Committee Members

Elliot Jurist

Glen Milstein

Tiffany Floyd

Lina Jandorf

Subject Categories

Clinical Psychology

Keywords

Spirituality, Psychosis, Trauma, Appraisals, Cognition

Abstract

Background: A substantial portion of the general population (2.5% to 31.4% internationally) reports psychotic-like experiences, which are paranormal, psychic or bizarre perceptual experiences such as voice hearing, or holding strong beliefs (i.e. superstitions) that are neither experienced as pathological nor indicative of a psychotic disorder. Cognitive models of psychosis suggest that the cognitive appraisal (i.e. personal interpretation) of the experience may help distinguish non-clinical psychotic-like experiences from clinical psychotic symptoms. This dissertation attempted to add to cognitive models by assessing whether cultural and personal factors such as spirituality and trauma inform the appraisals of anomalous experiences. This study used a moderated-mediation model to explore associations between degree of spirituality, appraisals of anomalous experiences, and trauma. This dissertation tested the hypothesis that spirituality informs the content, valence, and emotional valence attributed to psychotic experiences among individuals who endorse such experiences. Trauma was suggested as a moderator of the relationship between spirituality and the valence of appraisals. High spirituality was expected to be associated with positive spiritual appraisals and positive emotional responses, while a history of trauma was expected to modify the relationship between appraisals and valence, such that high spirituality was expected be associated with negative spiritual appraisals and negative emotional responses in the context of a trauma history. Method: In this mixed-methods study, 29 undergraduate students enrolled at the City College of New York who endorsed lifetime anomalous experiences, completed self-report measures assessing psychotic symptoms, appraisal style, spirituality and trauma history. Participants were also interviewed to assess anomalous experiences, their appraisals and their spiritual history. Hypotheses were tested by conducting bivariate correlational analyses to test associations between level of spirituality, number of traumatic events, psychotic symptoms and appraisals of experiences. A qualitative analysis of appraisals of lifetime anomalous experiences was also conducted to test the hypotheses. Results: Overall, participants were more likely to have mixed emotional reactions to their experience, regardless of whether they appraised the experience as positive or negative. Spiritual appraisals were made across all spiritual identity categories. Spiritual individuals were more likely to make negative appraisals. Family spirituality was found to have a significant influence over spiritual appraisals. Distressing psychotic symptoms were positively associated with the number of traumatic events, negative appraisal style and negative emotional responses. The majority of the sample (86%) reported a history of trauma. The moderation effect therefore could not be tested, but this may also explain why spiritual appraisals were positively associated with negative religious coping in this highly traumatized sample. Emotional distress was a significant situational context for the onset of anomalous experiences. Conclusion: Specific aspects of spirituality, such as religious coping and family spirituality should be incorporated into cognitive models of psychosis, as they inform the nature of appraisals of anomalous experiences. The situational context and the type of experience should also be considered as factors that inform the nature of appraisals. Future studies should compare clinical and non-clinical samples to explore the nature of appraisals and emotional responses among individuals who report psychotic experiences.

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