Developing a Culturally Adapted Cognitive Model of Psychosis for Nigerian Populations: A Grounded Theory Study

Existing cognitive models of psychosis, largely derived from Western populations, may inadequately capture the cultural determinants that shape psychotic experience and recovery in Nigerian contexts. This study develops a culturally adapted cognitive model of psychosis for Nigerian populations using a grounded theory methodology. Purposive and theoretical sampling will recruit 40 individuals with schizophrenia spectrum disorders, 20 family caregivers, and 15 mental health professionals across six Nigerian geopolitical zones. In-depth interviews and focus groups will explore illness appraisals, metacognitive processes, socio-spiritual attributions, and recovery narratives. Constant comparative analysis will guide iterative data collection and theory construction until theoretical saturation is achieved. The emerging model will map cultural variants in beliefs about voices, agency, shame, and spiritual causality onto the established cognitive framework of Garety and colleagues. Preliminary literature from Nigeria suggests that delusional ideation is heavily shaped by sociocultural context, particularly beliefs in witchcraft and divine intervention, which existing Western cognitive models do not accommodate. The grounded theory model generated will serve as a theoretical foundation for culturally adapted cognitive behavioral therapy for psychosis (CBTp) in Nigerian clinical settings and constitute an original scientific contribution. Keywords: psychosis, cognitive model, cultural adaptation, grounded theory, Nigeria