Social identity and psychosis: a systematic review of social identity in the context of psychosis and related experiences; and, An empirical research study examining the association between social identity and paranoia, through the mediators of trust and hostile attribution bias
BACKGROUND: It is theorised there are important social factors in the development and maintenance of psychosis. Social identity theory states our sense of belonging to groups is internalised into our personal identity and research has demonstrated social identity is protective against physical and mental health difficulties. There is sound rationale for social identity being associated with psychosis and related experiences, both clinically and in the general population. AIMS: This thesis firstly aimed to conduct a systematic review exploring what research has been done to date exploring social identity in the context of psychosis. The second part of this thesis aimed to conduct an empirical study investigating the association of family and friendship group identity on paranoia, through the mediators of trust and hostile attribution bias. METHOD: The systematic review searched nine databases using relevant key words for research papers and judged these against inclusion and exclusion criteria. The quality of the final papers was assessed. A cross-sectional quantitative empirical study was conducted. Adults from the general population, including individuals with and without psychosis, were recruited. RESULTS: The systematic review revealed fourteen papers relevant to the research question. A narrative synthesis found stronger evidence for direct associations between small group social identities and psychosis-related experiences, and indirect associations for larger group social identities. The quality of papers was moderate to good with strengths in theoretical frameworks and limitations in sample representation. Findings from the empirical study showed social identity was a significant predictor of both paranoia and schizotypy. A mediation analysis found trust and hostile attribution bias significantly mediated this relationship. CONCLUSIONS: The results suggest there is an association between social identity and psychosis-related experiences. The strength of this association seems to depend on the type of social identity and the specific psychosis-related experience. The mechanisms of this relationship appear to be important and vary depending on the precise social identities and experiences. This has implications for considering the importance of social identity. A systematic review of social identity in the context of psychosis and related experiences.
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