Beliefs about the world and psychosis-spectrum experiences

Background and Hypothesis: Primal world beliefs (‘primals’) are newly conceptualised schemas individuals form about the world’s overarching qualities. Primals fit to a hierarchical structure, e.g. the primary primal belief that the world is Good (vs. bad), and secondary primals; the beliefs the world is Safe (vs. dangerous), Enticing (vs. dull) and Alive (vs. mechanistic). Primals can be assessed empirically with self-report measures, appear stable over time, and are associated with wellbeing. There is currently no research investigating primals in psychosis-spectrum disorders (PSD). We aimed to investigate possible differences in primary and secondary primals between PSD and non-psychotic controls, and understand associations between primals and PSD-related experiences.Study Design: This online, self-report, observational study included 99 participants (47 PSD, 53 non-PSD). Participants were screened for psychosis using the Prodromal Questionnaire-16 (PQ-16). PSD experiences were assessed with the Multi-Modality Unusual Sensory Experiences Questionnaire (MUSEQ) and Peters’ Delusion Inventory-21 (PDI). Primals were measured using the Primals Inventory (PI-18).Study Results: Individuals with PSD reported more negative primals than controls. Beliefs the world is less Safe were associated with more psychotic symptoms, subjective distress about symptoms, and preoccupation with delusions. Context of delusions also mattered, whereby inflated-self and magical thinking were associated with more positive primals. Presence and frequency of hallucinations and delusional ideation were not associated with primals. Conclusions: The role of primals at different stages of PSD is not clear; future research would benefit from longitudinal investigations to understand the potential role of primals in psychological interventions to reduce symptom-related distress.