The experience of cognitive functioning difficulties in psychosis

Section A is a review of the literature on cognitive functioning difficulties in psychosis. It focuses on these difficulties as they relate to cognitive models of psychosis. After outlining relevant cognitive models, the literature on cognitive functioning is critically reviewed. The review highlights methodological limitations; gaps in our understanding; and a need for research exploring people's experiences of cognitive functioning difficulties.
Section B describes a qualitative study investigating the experience of cognitive difficulties in people with psychosis. Background: An overview of research on cognitive functioning in psychosis reveals limitations in existing understandings, including the absence of a rigorous account of how people with psychosis experience cognitive functioning difficulties.
Aims: This study aimed to provide an account of the experience of cognitive functioning difficulties in people with psychosis, including how these difficulties are perceived and understood, how people respond to these difficulties, and what people’s perceptions are of others’ views of these difficulties.
Method: A semi-structured interview was carried out with eight participants, focusing on participants’ experience of cognitive difficulties, how they respond to these, how participants perceive others’ understandings, and available support. Interpretative Phenomenological Analysis (Smith, Flowers, & Larkin, 2009) was used.
Results: Cognitive impairment was understood in terms of master themes focusing on controlled and reflective thinking; physical experiences; explaining the origins of impairment; identity; and anticipating the future with fear and hope.
Conclusions: The findings had significant implications for clinical psychology, including staff and client education about cognitive difficulties, and the importance of cognitive functioning to formulation. New areas for research include interventions stimulating metacognition; managing identity changes in response to cognitive difficulties; and ascertaining staff understanding of cognitive difficulties.
Section C is a critical appraisal of the qualitative study 'The experience of cognitive functioning difficulties in people with psychosis: An investigation' described in section B. It provides critical and reflective answers to four questions on the following topic areas: research skills acquired; what one would do differently if repeating the study; clinical consequences of the study; and future research projects.