Using a semi-structured interview to explore imagery experienced during social anxiety for clients with a diagnosis of psychosis: an exploratory study conducted within an early intervention for psychosis service

Behav Cogn Psychother. 2012 Jan;40(1):55-68. doi: 10.1017/S1352465811000439. Epub 2011 Jul 5.

Abstract

Background: Social phobia frequently occurs as a comorbid condition, with high rates reported among people with psychosis. Little is known about the nature of social anxiety in this population or whether current psychological theories apply.

Aims: This paper aims to develop and pilot a suitable measure to explore imagery experienced by participants with comorbid psychosis and social anxiety and to provide preliminary indications as to its nature.

Method: A semi-structured interview exploring imagery was used with seven participants (adapted from Hackmann, Surawy and Clark, 1998) and the results were analysed using qualitative template analysis.

Results: Initial indications from this sample suggest that some participants experience typical social anxiety images, as identified by Hackmann et al. (1998). However, some experience images that appear more threatening, and may be related to residual psychotic paranoia. Image perspective was also explored: typical social anxiety images tended to be seen from an observer perspective, while those that may have been more related to psychosis tended to be seen from a field perspective.

Conclusions: This exploratory study has facilitated the careful adaptation and development of an imagery interview for use in this population and has suggested areas for further research and raised questions around clinical implications.

MeSH terms

  • Adolescent
  • Adult
  • Cognitive Behavioral Therapy*
  • Comorbidity
  • Early Medical Intervention
  • Female
  • Humans
  • Imagination*
  • Interview, Psychological / methods*
  • Male
  • Paranoid Disorders / diagnosis
  • Paranoid Disorders / psychology
  • Perceptual Distortion
  • Personality Assessment
  • Phobic Disorders / diagnosis*
  • Phobic Disorders / psychology*
  • Phobic Disorders / therapy
  • Pilot Projects
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / psychology*
  • Psychotic Disorders / therapy
  • Self Concept
  • Social Perception
  • Young Adult