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Lavigne KM, Deng J, Raucher-Chéné D, Hotte-Meunier A, Voyer C, Sarraf L, Lepage M, Sauvé G. Transdiagnostic cognitive biases in psychiatric disorders: A systematic review and network meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2024; 129:110894. [PMID: 37956787 DOI: 10.1016/j.pnpbp.2023.110894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/13/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023]
Abstract
Psychiatric disorders are characterized by cognitive deficits, which have been proposed as a transdiagnostic feature of psychopathology ("C" factor). Similarly, cognitive biases (e.g., in attention, memory, and interpretation) represent common tendencies in information processing that are often associated with psychiatric symptoms. However, the question remains whether cognitive biases are also transdiagnostic or are specific to certain psychiatric disorders/symptoms. The current systematic review sought to address whether the proposed "C" factor of transdiagnostic cognitive dysfunction in psychopathology can be extended to cognitive biases. Overall, 31 studies comprising 4401 participants (2536 patients, 1865 non-clinical controls) met inclusion criteria, assessing 19 cognitive biases across 20 diagnostic categories, with most studies focusing on interpretation (k = 22) and attention (k = 11) biases and only 2 assessing memory biases. Traditional meta-analyses found a moderate effect size (g = 0.32) for more severe cognitive biases in all patients relative to non-clinical controls, as well as small but significant associations between interpretation biases and transdiagnostic symptom categories (general psychopathology: r = 0.20, emotion dysfunction: r = 0.17, psychotic symptoms: r = 0.25). Network meta-analyses revealed significant patient versus non-clinical control differences on attention and interpretation biases across diagnoses, as well as significant differences between diagnoses, with highest severity in panic disorder for attention biases and obsessive-compulsive disorder for interpretation biases. The current findings extend the big "C" interpretation of transdiagnostic cognitive dysfunction in psychiatric disorders to cognitive biases and transdiagnostic symptom dimensions. Results also suggest that while the presence of cognitive biases is transdiagnostic, bias severity differs across diagnoses, as in traditional neurocognitive deficits.
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Affiliation(s)
- Katie M Lavigne
- Department of Psychiatry, McGill University, Montreal, QC, Canada; Douglas Research Centre, Montreal, QC, Canada.
| | | | - Delphine Raucher-Chéné
- Department of Psychiatry, McGill University, Montreal, QC, Canada; Douglas Research Centre, Montreal, QC, Canada
| | | | - Chloe Voyer
- Douglas Research Centre, Montreal, QC, Canada
| | - Lisa Sarraf
- Douglas Research Centre, Montreal, QC, Canada; Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, QC, Canada; Douglas Research Centre, Montreal, QC, Canada
| | - Geneviève Sauvé
- Douglas Research Centre, Montreal, QC, Canada; Département d'éducation et pédagogie, Université de Québec à Montréal, Montréal, QC, Canada
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Li J, Chen L, Zhou D, Tang E, Zheng J, Huang X, Zhong BL, Guan C, Liu H, Shen M, Chen H. Flexibility Retained: Unimpaired Updating of Expectations in Schizophrenia. Behav Sci (Basel) 2024; 14:41. [PMID: 38247693 PMCID: PMC10812936 DOI: 10.3390/bs14010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/20/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024] Open
Abstract
Flexibly and actively updating expectations based on feedback is crucial for navigating daily life. Previous research has shown that people with schizophrenia (PSZ) have difficulty adjusting their expectations. However, there are studies suggesting otherwise. To explore this further, we used a novel trial-based expectation updating paradigm called attribute amnesia. In the task, the participants needed to report the location of a target stimulus among distractors in pre-surprise trials. In the surprise trial, they were unexpectedly asked to report the identity of the target before reporting its location. Afterward, control trials were conducted whereby the participants were asked the same questions as in the surprise trial. Notably, the surprise trial and control trials were nearly identical, except that the participants expected to be asked about identity information in the control trials but not in the surprise trial. Thus, an improvement in identity reporting accuracy in the control trials in comparison with the surprise trial indicated active updating of expectations. In the current study, a total of 63 PSZ and 60 healthy control subjects (HCS) were enrolled. We found that both the PSZ and the HCS were unable to report information that they had fully attended to (i.e., identity) in the surprise trial. However, both groups showed a significant improvement in reporting identity information even in the first control trial. Critically, there was no significant difference in the magnitude of improvement between the two groups. The current findings indicate that PSZ have the ability to update their expectations as quickly and flexibly as HCS, at least in the context of the current task. The possible factors that might contribute to the discrepancy regarding expectation updating are discussed.
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Affiliation(s)
- Jian Li
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Luo Chen
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | | | - Enze Tang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Jiewei Zheng
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Xiaoqi Huang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan 430022, China
| | - Chenxiao Guan
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Huiying Liu
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Mowei Shen
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
| | - Hui Chen
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310030, China
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Cesur E, Moritz S, Balzan RP, Scheunemann J, Gabbert T, Aleksandrowicz A, Fischer R. Hasty decision making and belief inflexibility in the more delusion prone? A modified disambiguating-scenarios paradigm assessing cognitive biases implicated in delusions. Schizophr Res 2023; 260:41-48. [PMID: 37611329 DOI: 10.1016/j.schres.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/11/2023] [Accepted: 07/05/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Contemporary models of psychosis imply that cognitive biases such as the jumping to conclusions (JTC), the bias against disconfirmatory evidence (BADE), and the liberal acceptance (LA) bias play a role in the pathogenesis of delusions. Most of the studies investigating the role of cognitive biases, however, have been conducted with socially neutral or abstract stimuli and have assessed patients with established psychoses. For the present study, we aimed to concurrently investigate multiple biases (i.e., the JTC, BADE, and LA biases) in a community sample with a new paradigm using more socially engaging stimuli. METHODS A large sample of participants (N = 874) recruited via Amazon Mechanical Turk was subdivided into two groups based on the frequency of their psychotic-like experiences (PLEs) according to the positive subscale score of the Community Assessment of Psychic Experiences (CAPE) and matched based on major demographics variables, resulting in two equally sized groups called High-PLE (at least 2 SD above the mean) and Low-PLE (maximum 0.5 above the mean; n = 46 for each group). Using a modified version of the written-scenarios BADE task, which emphasized social interactions between agents embedded in the scenario, participants rated the plausibility of response options in the face of new information. RESULTS In line with previous findings, the High-PLE group demonstrated the JTC, BADE, and LA biases. That is, the members of this group made more decisions after the initial piece of information, were less likely to revise their beliefs in light of new information, and provided higher plausibility ratings for implausible response options compared to the Low-PLE group. CONCLUSIONS Results corroborate prior findings suggesting that the JTC, BADE, and LA biases may be contributing factors in delusional ideation and that metacognitive biases extend to social situations.
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Affiliation(s)
- Esra Cesur
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Ryan P Balzan
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA, Australia; Flinders University Institute for Mental Health and Wellbeing, SA, Australia
| | - Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tana Gabbert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Adrianna Aleksandrowicz
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Rabea Fischer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Krkovic K, Nowak U, Kammerer MK, Bott A, Lincoln TM. Aberrant adapting of beliefs under stress: a mechanism relevant to the formation of paranoia? Psychol Med 2023; 53:1881-1890. [PMID: 34517931 DOI: 10.1017/s0033291721003524] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Difficulties in the ability to adapt beliefs in the face of new information are associated with psychosis and its central symptom - paranoia. As cognitive processes and psychotic symptoms are both known to be sensitive to stress, the present study investigated the exact associations between stress, adapting of beliefs [reversal learning (RL), bias against disconfirmatory evidence (BADE), and jumping to conclusions (JTC)] and paranoia. We hypothesized that paranoia would increase under stress and that difficulties in adapting of beliefs would mediate or moderate the link between stress and paranoia. Furthermore, we hypothesized that the investigated effects would be strongest in the group of individuals diagnosed with a psychotic disorder. METHODS We exposed 155 participants (38 diagnosed with a psychotic disorder, 40 individuals with attenuated psychotic symptoms, 39 clinical controls diagnosed with an obsessive-compulsive disorder, and 38 healthy controls) to a control condition and a stress condition, in which we assessed their levels of paranoia and their ability to adapt beliefs. We applied multilevel models to analyze the data. RESULTS Paranoia was higher in the stress condition than in the control condition, b = 1.142, s.e. = 0.338, t(150) = 3.381, p < 0.001. RL, BADE, and JTC did not differ between conditions and did not mediate or moderate the association between stress and paranoia (all ps > 0.05). CONCLUSIONS The results support the assumption that stress triggers paranoia. However, the link between stress and paranoia does not seem to be affected by the ability to adapt beliefs.
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Affiliation(s)
- Katarina Krkovic
- Department of Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Ulrike Nowak
- Department of Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Mathias K Kammerer
- Department of Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Antonia Bott
- Department of Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Tania M Lincoln
- Department of Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
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Tenconi E, Meregalli V, Buffa A, Collantoni E, Cavallaro R, Meneguzzo P, Favaro A. Belief Inflexibility and Cognitive Biases in Anorexia Nervosa-The Role of the Bias against Disconfirmatory Evidence and Its Clinical and Neuropsychological Correlates. J Clin Med 2023; 12:1746. [PMID: 36902532 PMCID: PMC10003469 DOI: 10.3390/jcm12051746] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
The aim of this study was to explore, in a sample of patients with a diagnosis of AN, the ability to question their first impression and, in particular, the willingness to integrate their prior ideas and thoughts with additional progressive incoming information. A total of 45 healthy women and 103 patients with a diagnosis of AN, consecutively admitted to the Eating Disorder Padova Hospital-University Unit, underwent a broad clinical and neuropsychological assessment. All participants were administered the Bias Against Disconfirmatory Evidence (BADE) task, which specifically investigates belief integration cognitive bias. Acute AN patients showed a significantly greater bias toward disconfirming their previous judgment, in comparison to healthy women (BADE score, respectively, 2.5 ± 2.0 vs. 3.3 ± 1.6; Mann-Whitney test, p = 0.012). A binge-eating/purging subtype of AN individuals, compared to restrictive AN patients and controls, showed greater disconfirmatory bias and also a significant propensity to uncritically accept implausible interpretations (BADE score, respectively, 1.55 ± 1.6 and 2.70 ± 1.97 vs. 3.33 ± 1.63; Kruskal-Wallis test, p = 0.002 and liberal acceptance score, respectively, 1.32 ± 0.93 and 0.92 ± 1.21 vs. 0.98 ± 0.75; Kruskal-Wallis test p = 0.03). Abstract thinking skills and cognitive flexibility, as well as high central coherence, are neuropsychological aspects positively correlated with cognitive bias, in both patients and controls. Research into belief integration bias in AN population could enable us to shed light on hidden dimensional aspects, facilitating a better understanding of the psychopathology of a disorder that is so complex and difficult to treat.
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Affiliation(s)
- Elena Tenconi
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
| | - Valentina Meregalli
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
| | - Adriana Buffa
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | - Enrico Collantoni
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | - Roberto Cavallaro
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
- IRCCS San Raffaele Turro, Scientific Institute Hospital, 20127 Milan, Italy
| | - Paolo Meneguzzo
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
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Moritz S, Göritz AS, Franz C, Sibilis A, Voßberger H, Balzan R, Scheunemann J. Whodunit - A novel video-based task for the measurement of jumping to conclusions in the schizophrenia spectrum. Psychiatry Res 2022; 317:114862. [PMID: 36228437 DOI: 10.1016/j.psychres.2022.114862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 01/04/2023]
Abstract
Jumping to conclusions (JTC) is implicated in the formation and maintenance of the positive symptoms of psychosis and over the years has become a prominent treatment target. Yet, measures designed to detect JTC are compromised by a number of limitations. We aimed to address some of these shortcomings with a new video-based "Whodunit task" among participants scoring high and low on the Community Assessment of Psychic Experiences (CAPE). We recruited a large sample (N = 979) from the general population who were divided into subgroups high vs. low on psychotic-like experiences (PLE), matched for depression and background characteristics. In the Whodunit task, participants were asked to rate the likelihood that one out of six suspects was the perpetrator of a crime (deliberately ambiguous with no clear clues until the end). The primary measure was the number of sequences-to-decision (STD). In line with the hypothesis, participants scoring high on the CAPE positive subscale displayed significantly lower STD and a higher rate of JTC. Response confidence in the assessments was elevated in the PLE-High group. The number of overall decisions was also significantly elevated for the PLE-High group. No group differences were found when comparing those scoring high versus low on depression. The STD index correlated significantly with a corresponding index from another JTC task. The study presents a new paradigm for the measurement of data gathering in the schizophrenia spectrum. Speaking to its validity, the Whodunit task was correlated with another JTC measure. Future research should test abbreviated versions of the paradigm, preferably using multiple trials with differing topics/emotional themes.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Anja S Göritz
- Occupational and Consumer Psychology, University of Freiburg, Germany
| | - Cynthia Franz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Arne Sibilis
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Henry Voßberger
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ryan Balzan
- College of Education, Psychology & Social Work, Flinders University, Australia
| | - Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Acar K, Horntvedt O, Cabrera A, Olsson A, Ingvar M, Lebedev AV, Petrovic P. COVID-19 conspiracy ideation is associated with the delusion proneness trait and resistance to update of beliefs. Sci Rep 2022; 12:10352. [PMID: 35725585 PMCID: PMC9208343 DOI: 10.1038/s41598-022-14071-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 06/01/2022] [Indexed: 11/09/2022] Open
Abstract
The rapid spread of conspiracy ideas associated with the recent COVID-19 pandemic represents a major threat to the ongoing and coming vaccination programs. Yet, the cognitive factors underlying the pandemic-related conspiracy beliefs are not well described. We hypothesized that such cognitive style is driven by delusion proneness, a trait phenotype associated with formation of delusion-like beliefs that exists on a continuum in the normal population. To probe this hypothesis, we developed a COVID-19 conspiracy questionnaire (CCQ) and assessed 577 subjects online. Their responses clustered into three factors that included Conspiracy, Distrust and Fear/Action as identified using principal component analysis. We then showed that CCQ (in particular the Conspiracy and Distrust factors) related both to general delusion proneness assessed with Peter's Delusion Inventory (PDI) as well as resistance to belief update using a Bias Against Disconfirmatory Evidence (BADE) task. Further, linear regression and pathway analyses suggested a specific contribution of BADE to CCQ not directly explained by PDI. Importantly, the main results remained significant when using a truncated version of the PDI where questions on paranoia were removed (in order to avoid circular evidence), and when adjusting for ADHD- and autistic traits (that are known to be substantially related to delusion proneness). Altogether, our results strongly suggest that pandemic-related conspiracy ideation is associated with delusion proneness trait phenotype.
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Affiliation(s)
- K Acar
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden.
| | - O Horntvedt
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Cabrera
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - M Ingvar
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A V Lebedev
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - P Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
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Ward T, Hardy A, Holm R, Collett N, Rus‐Calafell M, Sacadura C, McGourty A, Vella C, East A, Rea M, Harding H, Emsley R, Greenwood K, Freeman D, Fowler D, Kuipers E, Bebbington P, Garety P. SlowMo therapy, a new digital blended therapy for fear of harm from others: An account of therapy personalisation within a targeted intervention. Psychol Psychother 2022; 95:423-446. [PMID: 35019210 PMCID: PMC9306634 DOI: 10.1111/papt.12377] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 12/06/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES SlowMo therapy is a pioneering blended digital therapy for paranoia, augmenting face-to-face therapy with an interactive 'webapp' and a mobile app. A recent large-scale trial demonstrated small-moderate effects on paranoia alongside improvements in self-esteem, worry, well-being and quality of life. This paper provides a comprehensive account of therapy personalisation within this targeted approach. DESIGN Case examples illustrate therapy delivery and descriptive data are presented on personalised thought content. METHOD Thought content was extracted from the webapp (n = 140 participants) and coded using newly devised categories: Worries: (1) Persecutory, (2) Negative social evaluation, (3) Negative self-concept, (4) Loss/life stresses, (5) Sensory-perceptual experiences and (6) Health anxieties. Safer thoughts: (1) Safer alternative (specific alternatives to worries), (2) Second-wave (generalised) coping, (3) Positive self-concept, (4) Positive activities and (5) Third-wave (mindfulness-based) coping. Data on therapy fidelity are also presented. RESULTS Worries: 'Persecutory' (92.9% of people) and 'Negative social evaluation' (74.3%) were most common. 'General worries/ life stresses' (31.4%) and 'Negative self-concept' (22.1%) were present in a significant minority; 'Health anxieties' (10%) and 'Sensory-perceptual' (10%) were less common. Safer thoughts: 'Second-wave (general) coping' (85%), 'Safer alternatives' (76.4%), 'Positive self-concept' (65.7%) and 'Positive activities' (64.3%) were common with 'Third-wave' (mindfulness) coping observed for 30%. Fidelity: Only three therapy withdrawals were therapy related. Session adherence was excellent (mean = 15.2/16; SD = 0.9). Behavioural work was conducted with 71% of people (119/168). CONCLUSION SlowMo therapy delivers a targeted yet personalised approach. Potential mechanisms of action extend beyond reasoning. Implications for cognitive models of paranoia and causal interventionist approaches are discussed.
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Affiliation(s)
- Thomas Ward
- Department of PsychologyInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK,South London and Maudsley NHS Foundation TrustLondonUK
| | - Amy Hardy
- Department of PsychologyInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK,South London and Maudsley NHS Foundation TrustLondonUK
| | - Rebecca Holm
- Department of PsychologyInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
| | - Nicola Collett
- Department of PsychiatryOxford UniversityOxfordUK,Oxford Health NHS Foundation TrustOxfordUK,Oxford Institute of Clinical Psychology Training and ResearchOxford UniversityOxfordUK
| | - Mar Rus‐Calafell
- Department of PsychiatryOxford UniversityOxfordUK,Oxford Health NHS Foundation TrustOxfordUK,Mental Health Research and Treatment CenterFaculty of PsychologyRuhr‐Universität BochumBochumGermany
| | | | | | - Claire Vella
- Sussex Partnership NHS Foundation TrustWorthingUK,School of PsychologyUniversity of SussexBrightonUK
| | - Anna East
- Department of PsychiatryOxford UniversityOxfordUK,Oxford Health NHS Foundation TrustOxfordUK
| | - Michaela Rea
- Department of PsychologyInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
| | - Helen Harding
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Richard Emsley
- Department of Biostatistics and Health InformaticsInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
| | | | - Daniel Freeman
- Department of PsychiatryOxford UniversityOxfordUK,Oxford Health NHS Foundation TrustOxfordUK
| | - David Fowler
- Sussex Partnership NHS Foundation TrustWorthingUK,School of PsychologyUniversity of SussexBrightonUK
| | - Elizabeth Kuipers
- Department of PsychologyInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
| | | | - Philippa Garety
- Department of PsychologyInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK,South London and Maudsley NHS Foundation TrustLondonUK
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9
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Bansal S, Bae GY, Robinson BM, Hahn B, Waltz J, Erickson M, Leptourgos P, Corlett P, Luck SJ, Gold JM. Association Between Failures in Perceptual Updating and the Severity of Psychosis in Schizophrenia. JAMA Psychiatry 2022; 79:169-177. [PMID: 34851373 PMCID: PMC8811632 DOI: 10.1001/jamapsychiatry.2021.3482] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Recent accounts suggest that delusions and hallucinations may result from alterations in how prior knowledge is integrated with new information, but experimental evidence supporting this idea has been complex and inconsistent. Evidence from a simpler perceptual task would make clear whether psychotic symptoms are associated with overreliance on prior information and impaired updating. OBJECTIVE To investigate whether individuals with schizophrenia or schizoaffective disorder (PSZ) and healthy control individuals (HCs) differ in the ability to update their beliefs based on evidence in a relatively simple perceptual paradigm. DESIGN, SETTING, AND PARTICIPANTS This case-control study included individuals who met DSM-IV criteria for PSZ and matched HC participants in 2 independent samples. The PSZ group was recruited from the Maryland Psychiatric Research Center, Yale University, and community clinics, and the HC group was recruited from the community. To test perceptual updating, a random dot kinematogram paradigm was implemented in which dots moving coherently in a single direction were mixed with randomly moving dots. On 50% of trials, the direction of coherent motion changed by 90° midway through the trial. Participants were asked to report the direction perceived at the end of the trial. The Peters Delusions Inventory and Brief Psychiatric Rating Scale (BPRS) were used to quantify the severity of positive symptoms. Data were collected from September 2018 to March 2020 and were analyzed from approximately March 2020 to March 2021. MAIN OUTCOMES AND MEASURES Critical measures included the proportion of responses centered around the initial direction vs the subsequent changed direction and the overall precision of motion perception and reaction times. RESULTS A total of 48 participants were included in the PSZ group (31 [65%] male; mean [SD] age, 36.56 [9.76] years) and 36 in the HC group (22 [61%] male; mean [SD] age, 35.67 [10.74] years) in the original sample. An independent replication sample included 42 participants in the PSZ group (29 [69%] male; mean [SD] age, 33.98 [11.03] years) and 34 in the HC group (20 [59%] male; mean [SD] age, 34.29 [10.44] years). In line with previous research, patients with PSZ were less precise and had slower reaction times overall. The key finding was that patients with PSZ were significantly more likely (original sample: mean, 27.88 [95% CI, 24.19-31.57]; replication sample: mean, 26.70 [95% CI, 23.53-29.87]) than HC participants (original sample: mean, 18.86 [95% CI, 16.56-21.16]; replication sample: mean, 15.67 [95% CI, 12.61-18.73]) to report the initial motion direction rather than the final one. Moreover, the tendency to report the direction of initial motion correlated with the degree of conviction on the Peters Delusions Inventory (original sample: r = 0.32 [P = .05]; replication sample: r = 0.30 [P = .05]) and the Brief Psychiatric Rating Scale Reality Distortion score (original sample: r = 0.55 [P = .001]; replication sample: r = 0.35 [P = .03]) and severity of hallucinations (original sample: r = 0.39 [P = .02]; replication sample: r = 0.30 [P = .05]). CONCLUSIONS AND RELEVANCE The findings of this case-control study suggest that the severity of psychotic symptoms is associated with a tendency to overweight initial information over incoming sensory evidence. These results are consistent with predictive coding accounts of the origins of positive symptoms and suggest that deficits in very elementary perceptual updating may be a critical mechanism in psychosis.
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Affiliation(s)
- Sonia Bansal
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Gi-Yeul Bae
- Department of Psychology, Arizona State University, Tempe
| | - Benjamin M. Robinson
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Britta Hahn
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - James Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Molly Erickson
- Department of Psychiatry, University of Chicago, Chicago, Illinois
| | - Pantelis Leptourgos
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, Connecticut
| | - Phillip Corlett
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, Connecticut
| | - Steven J. Luck
- Center for Mind and Brain and Department of Psychology, University of California, Davis
| | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
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10
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Conspiracy theory beliefs, scientific reasoning and the analytical thinking paradox. APPLIED COGNITIVE PSYCHOLOGY 2021. [DOI: 10.1002/acp.3885] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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11
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Lebedev AV, Acar K, Garzón B, Almeida R, Råback J, Åberg A, Martinsson S, Olsson A, Louzolo A, Pärnamets P, Lövden M, Atlas L, Ingvar M, Petrovic P. Psychedelic drug use and schizotypy in young adults. Sci Rep 2021; 11:15058. [PMID: 34301969 PMCID: PMC8302700 DOI: 10.1038/s41598-021-94421-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
Despite recently resurrected scientific interest in classical psychedelics, few studies have focused on potential harms associated with abuse of these substances. In particular, the link between psychedelic use and psychotic symptoms has been debated while no conclusive evidence has been presented. Here, we studied an adult population (n = 1032) with a special focus on young (18–35 years) and healthy individuals (n = 701) to evaluate the association of psychedelic drug use with schizotypy and evidence integration impairment typically observed in psychosis-spectrum disorders. Experimental behavioural testing was performed in a subsample of the subjects (n = 39). We observed higher schizotypy scores in psychedelic users in the total sample. However, the effect size was notably small and only marginally significant when considering young and healthy subjects (Cohen’s d = 0.13). Controlling for concomitant drug use, none of our analyses found significant associations between psychedelic use and schizotypal traits. Results from experimental testing showed that total exposure to psychedelics (frequency and temporal proximity of use) was associated with better evidence integration (Cohen’s d = 0.13) and a higher sensitivity of fear responses (Cohen’s d = 1.05) to the effects instructed knowledge in a reversal aversive learning task modelled computationally with skin conductance response and pupillometry. This effect was present even when controlling for demographics and concomitant drug use. On a group level, however, only difference in sensitivity of fear responses to instructed knowledge reached statistical significance. Taken together, our findings suggest that psychedelic drug use is only weakly associated with psychosis-like symptoms, which, in turn, is to a large extent explained by psychiatric comorbidities and use of other psychoactive substances. Our results also suggest that psychedelics may have an effect on flexibility of evidence integration and aversive learning processes, that may be linked to recently suggested therapeutic effects of psychedelic drugs in non-psychotic psychiatric populations.
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Affiliation(s)
- Alexander V Lebedev
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden.
| | - K Acar
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - B Garzón
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Department of Psychology, University of Gothenburg, Göteborg, Sweden
| | - R Almeida
- Stockholm University Brain Imaging Center (SUBIC), Stockholm University, Stockholm, Sweden
| | - J Råback
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Åberg
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - S Martinsson
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Louzolo
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - P Pärnamets
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden.,Department of Psychology, New York University, New York, USA
| | - M Lövden
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Department of Psychology, University of Gothenburg, Göteborg, Sweden
| | - L Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA.,National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA.,National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Martin Ingvar
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - P Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
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12
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Abstract
INTRODUCTION In accounts of the two-factor theory of delusional belief, the second factor in this theory has been referred to only in the most general terms, as a failure in the processes of hypothesis evaluation, with no attempt to characterise those processes in any detail. Coltheart and Davies ([2021]. How unexpected observations lead to new beliefs: A Peircean pathway. Consciousness and Cognition, 87, 103037. https://doi.org/10.1016/j.concog.2020.103037) attempted such a characterisation, proposing a detailed eight-step model of how unexpected observations lead to new beliefs based on the concept of abductive inference as introduced by Charles Sanders Peirce. METHODS In this paper, we apply that model to the explanation of various forms of delusional belief. RESULTS We provide evidence that in cases of delusion there is a specific failure of the seventh step in our model: the step at which predictions from (delusional) hypotheses are considered in the light of relevant evidence. CONCLUSIONS In the two-factor theory of delusional belief, the second factor consists of a failure to reject hypotheses in the face of disconfirmatory evidence.
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Affiliation(s)
- Max Coltheart
- Department of Cognitive Science, Macquarie University, Sydney, 2109 NSW, Australia
| | - Martin Davies
- Corpus Christi College, Oxford OX1 4JF, UK.,Philosophy Department, Monash University, Clayton, 3800 VIC, Australia
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13
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Zhu C, Kwok NTK, Chan TCW, Chan GHK, So SHW. Inflexibility in Reasoning: Comparisons of Cognitive Flexibility, Explanatory Flexibility, and Belief Flexibility Between Schizophrenia and Major Depressive Disorder. Front Psychiatry 2021; 11:609569. [PMID: 33584376 PMCID: PMC7874185 DOI: 10.3389/fpsyt.2020.609569] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/18/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Inflexibility in reasoning has been suggested to contribute to psychiatric disorders, such as explanatory flexibility in depression and belief flexibility in schizophrenia. However, studies tended to examine only one of the flexibility constructs, which could be related to each other, within a single group of patients. As enhancing flexibility in thinking has become one of the psychological treatment goals across disorders, this study aimed to examine three constructs of flexibility (cognitive flexibility, explanatory flexibility, and belief flexibility) in two psychiatric groups. Methods: We compared three groups of participants: (i) 56 outpatients with a schizophrenia-spectrum disorder and active delusions, (ii) 57 outpatients with major depressive disorder and at least a moderate level of depression, and (iii) 30 healthy controls. Participants were assessed on symptom severity and flexibility, using the Trail-Making Task, the Attributional Style Questionnaire, the Maudsley Assessment of Delusions Scale (MADS) and the Bias Against Disconfirmatory Evidence (BADE) Task. Results: Cognitive flexibility was reduced in the two clinical groups compared to controls. Explanatory flexibility was comparable across groups. The three groups differed in belief flexibility measured by MADS but not by the BADE task. Response to hypothetical contradiction was reduced in the delusion group than the other two groups, and the ability to generate alternative explanations was reduced in the delusion group than healthy controls. Discussion: We found an effect of diagnosis on cognitive flexibility, which might be confounded by differences in intellectual functioning. Reduced belief flexibility tended to be specific to delusions.
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Affiliation(s)
- Chen Zhu
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Tracey Chi-wan Chan
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Suzanne Ho-wai So
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
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14
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A randomised controlled trial of metacognitive training for psychosis, depression, and belief flexibility. J Affect Disord 2021; 279:388-397. [PMID: 33099054 DOI: 10.1016/j.jad.2020.09.126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/11/2020] [Accepted: 09/27/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Metacognitive training (MCT) has been shown to be effective in reducing psychotic symptoms, including delusions. However, less is known on whether MCT, or its specific modules, are effective in ameliorating reasoning biases e.g. belief flexibility. As inflexibility in appraisal has been associated with psychosis and major depressive disorder (MDD), this study examined the efficacy of a 4-session MCT on delusions, depression, and belief flexibility, in two clinical groups (Psychosis and Depression). METHODS This study adopted a single-blind randomised controlled design, with patients with schizophrenia spectrum disorders (and delusions) and patients with MDD being randomised, respectively, into the MCT condition or a treatment-as-usual (TAU) condition. The MCT intervention consisted of specific modules targeting belief flexibility. Participants were assessed before and after treatment, and at 1- and 6-month follow-ups. RESULTS Among the 113 participants, 27 patients with psychosis and 29 patients with MDD attended MCT. There were significant improvements in psychotic symptoms, especially delusions, for the Psychosis group, and in depressive symptoms for the MDD group. Symptom improvements following MCT were of large effect sizes, were significantly greater than TAU, and persisted at 6-month. Belief flexibility also improved in both groups, although changes were smaller in size and were not significantly greater than TAU. LIMITATIONS An active control condition was not included. CONCLUSIONS This study demonstrated large and stable symptom reductions in delusions and depression, and smaller (yet stable) improvement in belief flexibility across groups, following a 4-session MCT, carrying implications for transdiagnostic process-based interventions and their mechanisms of change.
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15
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Scheunemann J, Fischer R, Moritz S. Probing the Hypersalience Hypothesis-An Adapted Judge-Advisor System Tested in Individuals With Psychotic-Like Experiences. Front Psychiatry 2021; 12:612810. [PMID: 33746792 PMCID: PMC7969715 DOI: 10.3389/fpsyt.2021.612810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/29/2021] [Indexed: 11/13/2022] Open
Abstract
Individuals with psychotic-like experiences and psychosis gather and use information differently than controls; in particular they seek and rely on less information or over-weight currently available information. A new paradigm, the judge-advisor system, has previously been used to investigate these processes. Results showed that psychosis-prone individuals tend to seek less advice but at the same time use the available advice more. Some theoretical models, like the hypersalience of evidence-matching hypothesis, predict that psychosis-prone individuals weight recently available information to a greater extent and thus provide an explanation for increased advice-weighting scores in psychosis-prone individuals. To test this model, we adapted the previously used judge-advisor system by letting participants receive consecutively multiple pieces of advice. To meet this aim, we recruited a large MTurk community sample (N = 1,396), which we split in a group with high levels of psychotic-like experiences (at least 2 SD above the mean, n = 80) and a group with low levels of psychotic-like experiences (maximum 0.5 SD above the mean, n = 1,107), using the Community Assessment of Psychic Experiences' positive subscale. First, participants estimated five people's age based on photographs. Then, they received consecutive advice in the form of manipulated age estimates by allegedly previous participants, with outliers in some trials. After each advice, participants could adjust their estimate. This procedure allowed us to investigate how participants weighted each currently presented advice. In addition to being more confident in their final estimates and in line with our preregistered hypothesis, participants with more frequent psychotic-like experiences did weight currently available advice more than participants with less frequent psychotic-like experiences. This effect was especially pronounced in response to outliers, as fine-grained post-hoc analysis suggested. Result thus support models predicting an overcorrection in response to new incoming information and challenges an assumed general belief inflexibility in people with psychotic experiences.
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Affiliation(s)
- Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rabea Fischer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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16
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Prolonged rather than hasty decision-making in schizophrenia using the box task. Must we rethink the jumping to conclusions account of paranoia? Schizophr Res 2020; 222:202-208. [PMID: 32507550 DOI: 10.1016/j.schres.2020.05.056] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/23/2020] [Accepted: 05/25/2020] [Indexed: 02/08/2023]
Abstract
UNLABELLED Jumping to conclusions (JTC) is the best established cognitive bias in schizophrenia and is increasingly targeted in interventions aimed to improve positive symptoms. To address shortcomings of the standard measure to capture JTC, the beads task, we developed a new variant-the box task-which was subsequently validated in people with elevated psychotic-like experiences. For the first time, the box task was administered in a sample of individuals with manifest schizophrenia. We hypothesized that patients with schizophrenia would display an elevated JTC bias relative to controls. METHOD We recruited a large sample of 101 patients with schizophrenia and matched them to an online sample recruited from the general population. In the box task, participants must decide which of two kinds of colored balls are presented more often. Participants are told that the task may end prematurely, and that task performance will be counted as an error if no decision had been made before that point. The primary measure was the number of draws to decision (DTD), where fewer DTD corresponds to greater JTC. RESULTS In contrast to expectations, participants with schizophrenia showed significantly higher DTD (i.e., reduced JTC). Consistent with our previous findings, patients also displayed a lowered decision threshold compared to controls. Response confidence for the final decision was lower in patients and correlated with self-esteem and positive symptoms. While there was evidence that previous knowledge of the box task lowered DTD, exclusion of participants with experience on the box task did not substantially change results. DISCUSSION The study fits a growing body of experiments casting doubt on the generalizability of the JTC effect in schizophrenia across different tasks. While the study tentatively supports a liberal acceptance account of psychosis, caution is warranted and we recommend that research should explore and control for potentially important mediators (e.g., task difficulty, stress, test-taking attitudes).
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17
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Sauvé G, Lavigne KM, Pochiet G, Brodeur MB, Lepage M. Efficacy of psychological interventions targeting cognitive biases in schizophrenia: A systematic review and meta-analysis. Clin Psychol Rev 2020; 78:101854. [DOI: 10.1016/j.cpr.2020.101854] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 04/01/2020] [Accepted: 04/04/2020] [Indexed: 12/14/2022]
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18
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Lavigne KM, Menon M, Moritz S, Woodward TS. Functional brain networks underlying evidence integration and delusional ideation. Schizophr Res 2020; 216:302-309. [PMID: 31839549 DOI: 10.1016/j.schres.2019.11.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/07/2019] [Accepted: 11/22/2019] [Indexed: 12/26/2022]
Abstract
Cognitive biases affecting evidence integration contribute to delusions and delusional ideation in the psychosis continuum. In previously published work we observed hyperactivity in a visual attention network (VsAN) during confirmatory evidence integration, and hypoactivity in a cognitive evaluation network (CEN) during disconfirmatory evidence integration in schizophrenia patients with delusions, suggesting that a task-specific imbalance of these networks may contribute to delusion maintenance. In the current study, we investigated whether patterns of aberrant functional connectivity observed in past work were associated with delusional ideation in 41 healthy individuals by examining associations between cognitive biases, subclinical schizotypal traits, and functional brain activity during evidence integration. Behaviourally, we replicated positive associations between schizotypal traits and cognitive biases and further showed that this association was driven by delusional ideation specifically. Constrained principal component analysis for fMRI (fMRI-CPCA) revealed recruitment of the brain networks observed in our previous clinical and non-clinical evidence integration studies: default-mode network (DMN); cognitive evaluation network (CEN); and visual attention (VsAN) network. Moreover, as with clinically-significant delusions, delusional ideation was associated with decreased CEN activity during the processing of disconfirmatory evidence and increased VsAN activity during the processing of confirmatory evidence. These findings suggest that this altered pattern of activation across networks during evidence integration may underlie delusional ideation and delusions in the psychosis continuum.
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Affiliation(s)
- Katie M Lavigne
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada
| | - Mahesh Menon
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada.
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19
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Lavigne KM, Menon M, Woodward TS. Functional Brain Networks Underlying Evidence Integration and Delusions in Schizophrenia. Schizophr Bull 2020; 46:175-183. [PMID: 31050762 PMCID: PMC6942156 DOI: 10.1093/schbul/sbz032] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Integrating evidence that contradicts a belief is a fundamental aspect of belief revision and is closely linked to delusions in schizophrenia. In a previous functional magnetic resonance imaging (fMRI) study on healthy individuals, we identified functional brain networks underlying evidence integration as visual attention network (VsAN; dorsal anterior cingulate cortex, insula, occipital regions), default-mode network (DMN), and cognitive evaluation network (CEN; orbitofrontal cortex, inferior frontal gyrus, parietal cortex). In the current clinical fMRI study, we compared network-based activity during evidence integration between healthy controls (n = 41), nondelusional (n = 37), and delusional (n = 33) patients with schizophrenia, and related this activity to cognitive processing involved in evidence integration measured outside the scanner. Task-induced coordinated activation was measured using group-constrained principal component analysis for fMRI. Increased VsAN activation, reduced DMN deactivation, and reduced CEN activation were observed for schizophrenia, with this pattern being most pronounced for the delusional group. Importantly, poor evidence integration comprehensively measured outside the scanner was significantly associated with increased VsAN activation and reduced DMN deactivation when processing confirmatory evidence, and with reduced CEN activation when processing disconfirmatory evidence. This is the first comprehensive study of the functional brain networks associated with evidence integration in schizophrenia and highlights how an imbalance of functional brain networks responding to confirmatory and disconfirmatory evidence may underlie delusions in schizophrenia.
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Affiliation(s)
- Katie M Lavigne
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada,BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - Mahesh Menon
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada,BC Children’s Hospital Research Institute, Vancouver, BC, Canada,To whom correspondence should be addressed; BC Children's Hospital Research Institute, Translational Research Building, Room A3-A117, 3rd Floor, 938 West 28th Avenue, Vancouver, BC V5Z 4H4, Canada; tel: 604-875-2000 x 4724, fax: 604-875-3871,
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20
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Everaert J, Bronstein MV, Castro AA, Cannon TD, Joormann J. When negative interpretations persist, positive emotions don't! Inflexible negative interpretations encourage depression and social anxiety by dampening positive emotions. Behav Res Ther 2019; 124:103510. [PMID: 31734567 DOI: 10.1016/j.brat.2019.103510] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 10/07/2019] [Accepted: 11/02/2019] [Indexed: 12/18/2022]
Abstract
Research on emotion regulation difficulties has been instrumental in understanding hallmark features of depression and social anxiety. Yet, the cognitive mechanisms that give rise to maladaptive patterns of emotion regulation strategy use remain underspecified. This investigation examined the association of negative interpretation inflexibility and interpretation biases with the use of common emotion regulation strategies in response to negative and positive emotional experiences (repetitive negative thinking, positive reappraisal, and dampening). Study 1 (N = 250) found that inflexibility in revising negative interpretations in response to disconfirmatory positive information was related to the dampening of positive emotions, but not to repetitive negative thinking or positive reappraisal. Importantly, dampening mediated the relation between inflexible negative interpretations and symptoms of both depression and social anxiety. This mediation model was further supported by the data from Study 2 (N = 294). Across both studies, negative interpretation bias was related to repetitive negative thinking and dampening, whereas positive interpretation bias was related to positive reappraisal. Collectively, these results suggest that both interpretation inflexibility and interpretation biases may contribute to difficulties in emotion regulation related to depression and social anxiety.
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Affiliation(s)
| | | | - Ariana A Castro
- Yale University, USA; University of Illinois at Urbana-Champaign, USA
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21
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Bronstein MV, Pennycook G, Joormann J, Corlett PR, Cannon TD. Dual-process theory, conflict processing, and delusional belief. Clin Psychol Rev 2019; 72:101748. [PMID: 31226640 DOI: 10.1016/j.cpr.2019.101748] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/25/2019] [Accepted: 06/11/2019] [Indexed: 01/10/2023]
Abstract
Many reasoning biases that may contribute to delusion formation and/or maintenance are common in healthy individuals. Research indicating that reasoning in the general population proceeds via analytic processes (which depend upon working memory and support hypothetical thought) and intuitive processes (which are autonomous and independent of working memory) may therefore help uncover the source of these biases. Consistent with this possibility, recent studies imply that impaired conflict processing might reduce engagement in analytic reasoning, thereby producing reasoning biases and promoting delusions in individuals with schizophrenia. Progress toward understanding this potential pathway to delusions is currently impeded by ambiguity about whether any of these deficits or biases is necessary or sufficient for the formation and maintenance of delusions. Resolving this ambiguity requires consideration of whether particular cognitive deficits or biases in this putative pathway have causal primacy over other processes that may also participate in the causation of delusions. Accordingly, the present manuscript critically evaluates whether impaired conflict processing is the primary initiating deficit in the generation of reasoning biases that may promote the development and/or maintenance of delusions. Suggestions for future research that may elucidate mechanistic pathways by which reasoning deficits might engender and maintain delusions are subsequently offered.
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Affiliation(s)
- Michael V Bronstein
- Department of Psychology, Yale University, 2 Hillhouse Ave, New Haven, CT, USA.
| | - Gordon Pennycook
- Hill/Levene Schools of Business, University of Regina, Regina, Saskatchewan, Canada
| | - Jutta Joormann
- Department of Psychology, Yale University, 2 Hillhouse Ave, New Haven, CT, USA
| | - Philip R Corlett
- Department of Psychiatry, Yale University, 300 George Street, New Haven, CT, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, 2 Hillhouse Ave, New Haven, CT, USA; Department of Psychiatry, Yale University, 300 George Street, New Haven, CT, USA
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22
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Watt A, Skillicorn D. Negative schizotypy is associated with impaired episodic but not semantic coding in a conditional learning task. JOURNAL OF COGNITIVE PSYCHOLOGY 2019. [DOI: 10.1080/20445911.2019.1629446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Andrew Watt
- Department of Applied Psychology, Cardiff School of Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Deiniol Skillicorn
- Department of Applied Psychology, Cardiff School of Health Sciences, Cardiff Metropolitan University, Cardiff, UK
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23
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Validation du biais contre les indices infirmatoires chez un échantillon francophone de patients schizophrènes. Encephale 2019; 45:147-151. [DOI: 10.1016/j.encep.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 06/19/2018] [Accepted: 07/04/2018] [Indexed: 11/19/2022]
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24
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de Vos C, Leanza L, Mackintosh A, Lüdtke T, Balzan R, Moritz S, Andreou C. Investigation of sex differences in delusion-associated cognitive biases. Psychiatry Res 2019; 272:515-520. [PMID: 30616118 DOI: 10.1016/j.psychres.2018.12.121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 12/21/2018] [Accepted: 12/22/2018] [Indexed: 11/19/2022]
Abstract
In the past few decades, sex differences have been identified in a number of clinical, cognitive and functional outcomes in patients with schizophrenia spectrum disorders. However, to date, sex differences in higher-order cognitive biases have not been systematically studied. The present study aimed to examine sex differences in jumping-to-conclusions and evidence integration impairment based on data collected in two previous studies in patients with schizophrenia spectrum disorders and healthy controls. For this purpose, data from n = 58 patients and n = 60 healthy controls on the Fish Task (as a measure of jumping to conclusions) and bias against disconfirmatory evidence (BADE; as a measure of evidence integration) task were analyzed. Results indicated a lack of sex differences in jumping-to-conclusions and evidence integration impairment both in patients with schizophrenia spectrum disorders and healthy controls. Although the present study was adequately powered to detect sex differences of a low medium effect size, larger studies are warranted to exclude differences of a smaller magnitude between men and women regarding delusion-associated cognitive biases.
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Affiliation(s)
- Chloé de Vos
- Center for Psychotic Disorders, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland
| | - Letizia Leanza
- Center for Psychotic Disorders, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland
| | - Amatya Mackintosh
- Center for Psychotic Disorders, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland
| | - Thies Lüdtke
- Neuropsychology Unit, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Ryan Balzan
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia; ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia
| | - Steffen Moritz
- Neuropsychology Unit, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Christina Andreou
- Center for Psychotic Disorders, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland.
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Bronstein MV, Everaert J, Castro A, Joormann J, Cannon TD. Pathways to paranoia: Analytic thinking and belief flexibility. Behav Res Ther 2019; 113:18-24. [DOI: 10.1016/j.brat.2018.12.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/23/2018] [Accepted: 12/10/2018] [Indexed: 01/30/2023]
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Ward T, Garety PA. Fast and slow thinking in distressing delusions: A review of the literature and implications for targeted therapy. Schizophr Res 2019; 203:80-87. [PMID: 28927863 PMCID: PMC6336980 DOI: 10.1016/j.schres.2017.08.045] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/16/2017] [Accepted: 08/21/2017] [Indexed: 12/21/2022]
Abstract
The recent literature on reasoning biases in psychosis and delusions is reviewed. The state-of-the-art knowledge from systematic reviews and meta-analyses on the evidence for jumping to conclusions is briefly summarised, before a fuller discussion of the more recent empirical literature on belief flexibility as applied to delusions. The methodology and evidence in relation to studies of belief flexibility and the Bias Against Disconfirmatory Evidence (BADE) across the delusional continuum will be critically appraised, and implications drawn for improving cognitive therapy. It will be proposed that dual process models of reasoning, which Kahneman (Kahneman, 2011) popularised as 'fast and slow thinking', provide a useful theoretical framework for integrating further research and informing clinical practice. The emergence of therapies which specifically target fast and slow thinking in people with distressing delusions will be described.
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Affiliation(s)
- Thomas Ward
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom
| | - Philippa A Garety
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom.
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Abstract
The 2016 U.S. presidential election brought considerable attention to the phenomenon of "fake news": entirely fabricated and often partisan content that is presented as factual. Here we demonstrate one mechanism that contributes to the believability of fake news: fluency via prior exposure. Using actual fake-news headlines presented as they were seen on Facebook, we show that even a single exposure increases subsequent perceptions of accuracy, both within the same session and after a week. Moreover, this "illusory truth effect" for fake-news headlines occurs despite a low level of overall believability and even when the stories are labeled as contested by fact checkers or are inconsistent with the reader's political ideology. These results suggest that social media platforms help to incubate belief in blatantly false news stories and that tagging such stories as disputed is not an effective solution to this problem. It is interesting, however, that we also found that prior exposure does not impact entirely implausible statements (e.g., "The earth is a perfect square"). These observations indicate that although extreme implausibility is a boundary condition of the illusory truth effect, only a small degree of potential plausibility is sufficient for repetition to increase perceived accuracy. As a consequence, the scope and impact of repetition on beliefs is greater than has been previously assumed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
- Gordon Pennycook
- Department of Psychology, Yale University, 1 Prospect Street, New Haven, CT 06511, USA
| | - Tyrone D. Cannon
- Department of Psychology, Yale University, 1 Prospect Street, New Haven, CT 06511, USA
| | - David G. Rand
- Department of Psychology, Yale University, 1 Prospect Street, New Haven, CT 06511, USA
- Department of Economics, Yale University, 1 Prospect Street, New Haven, CT 06511, USA
- School of Management, Yale University, 1 Prospect Street, New Haven, CT 06511, USA
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Prike T, Arnold MM, Williamson P. The relationship between anomalistic belief and biases of evidence integration and jumping to conclusions. Acta Psychol (Amst) 2018; 190:217-227. [PMID: 30145485 DOI: 10.1016/j.actpsy.2018.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/08/2018] [Accepted: 08/09/2018] [Indexed: 10/28/2022] Open
Abstract
Biases in the assessment and integration of evidence are likely contributors to anomalistic (e.g., paranormal, extra-terrestrial) beliefs because of the non-evidence based nature of these beliefs. However, little research has examined the relationship between anomalistic beliefs and evidence integration biases. The current study addressed this gap by examining the relationship between anomalistic belief and four such biases; bias against disconfirmatory evidence (BADE), bias against confirmatory evidence (BACE), liberal acceptance bias, and the jumping to conclusions bias (JTC). Standard BADE scenarios were used to measure BADE, BACE, and the liberal acceptance bias: Participants were given three pieces of evidence, one at a time, and required to rate several alternative explanations. The JTC was measured using two draws-to-decisions tasks (beads and emotionally salient), and participants also completed measures of anomalistic belief and delusion-proneness. Results showed that liberal acceptance was the only evidence integration bias that significantly predicted greater overall anomalistic belief. However, this relationship was no longer significant once delusion proneness was controlled for. Additionally, BADE significantly predicted experiential (but not other types of) anomalistic beliefs even after controlling for delusion proneness. We propose that liberal acceptance may lead people to form anomalistic beliefs on the basis of little evidence, and that stronger BADE may make these beliefs highly resistant to change.
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Riemer M. Delusions of control in schizophrenia: Resistant to the mind's best trick? Schizophr Res 2018; 197:98-103. [PMID: 29208423 DOI: 10.1016/j.schres.2017.11.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 11/05/2017] [Accepted: 11/24/2017] [Indexed: 11/29/2022]
Abstract
The existence of a free will is fiercely debated in neuroscience and philosophy. The debate has great impact on society and our self-understanding as human beings. Behavioral and electrophysiological data have challenged the intuitive assumption that human behavior is the result of conscious intentions. This notion has important implications for delusions of control in schizophrenia, where patients experience bodily movements as not being controlled by themselves. Current theories explain control delusions as a deficit to perceive certain aspects of motor control, but many findings are inconsistent with this idea. Here, an alternative view is proposed: Control delusions might be triggered by an even more veridical perception of the temporal order of intentions and actions. This hypothesis is supported by evidence that (a) conscious intentions in healthy subjects are often based on retrospective inferences, (b) temporal recalibrations of conscious percepts occur in healthy subjects and are disturbed in schizophrenia and (c) basic perceptual functions of schizophrenic patients are less influenced by expectations and therefore they can sometimes be closer to physical reality than those of healthy subjects.
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Affiliation(s)
- Martin Riemer
- German Center for Neurodegenerative Diseases (DZNE), Aging & Cognition Research Group, 39120 Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), 39106 Magdeburg, Germany.
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Luk J, Underhill K, Woodward TS. Psychotic Symptoms Predicting Evidence Integration in Schizophrenia. ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2018. [DOI: 10.1027/2151-2604/a000334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. A bias against disconfirmatory evidence (BADE) is a cognitive bias associated with delusions in schizophrenia. Previous studies reporting an association between reduced evidence integration and delusions used a single measure of delusion severity, typically to form patient groups. In the current study we perform an exploratory analysis to investigate whether BADE is specific to delusions or extends to other symptoms of psychosis. To address this, we used constrained principal component analysis (CPCA) on four merged BADE studies on schizophrenia to explore the component structure in the BADE task measures that is predictable from symptoms. A component reflecting evidence integration emerged, and was predicted by delusions as expected, but also by thought disorder. This provides novel methodology for cognitive neuropsychiatric investigations into the underpinnings of the symptoms of schizophrenia by enabling investigators to consider a range of symptoms alongside the one that is the target of their investigation.
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Affiliation(s)
- Jessica Luk
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada
| | - Kendra Underhill
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada
| | - Todd S. Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada
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Howe J, Ross R, McKay R, Balzan RP. How Do Delusion-Prone Individuals Respond to Disconfirmatory Evidence? ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2018. [DOI: 10.1027/2151-2604/a000333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Research employing the beads task suggests that people with delusional tendencies over-adjust to disconfirmatory evidence compared to low-delusion-prone individuals. This interpretation is in tension with studies using the bias against disconfirmatory evidence (BADE) task, which provide evidence that people with delusional tendencies are less receptive to disconfirmatory evidence. It has been suggested that over-adjustment on the beads task may be driven by miscomprehension of the task. The current preliminary study aimed to minimize miscomprehension on the beads task and determine how high-delusion-prone people respond to disconfirmatory evidence on both tasks. Fifty-one undergraduate participants completed the BADE task and an adapted version of the beads task. We expected that corrective feedback on the beads task would reduce miscomprehension, and that high-delusion-prone participants would be less receptive to disconfirmatory evidence on both tasks. Our results suggest this version of the beads task improved rates of comprehension relative to previous research. However, we found no evidence that the high-delusion-prone group demonstrated elevated over-adjustment or belief inflexibility in either task. The theoretical implications of these findings are discussed.
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Affiliation(s)
- Jessica Howe
- College of Education, Psychology & Social Work, Flinders University, Adelaide, Australia
| | - Robert Ross
- ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia
- Department of Psychology, Royal Holloway, University of London, UK
| | - Ryan McKay
- ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia
- Department of Psychology, Royal Holloway, University of London, UK
| | - Ryan P. Balzan
- College of Education, Psychology & Social Work, Flinders University, Adelaide, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia
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Andreou C, Veckenstedt R, Lüdtke T, Bozikas VP, Moritz S. Differential relationship of jumping-to-conclusions and incorrigibility with delusion severity. Psychiatry Res 2018; 264:297-301. [PMID: 29660572 DOI: 10.1016/j.psychres.2018.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 02/05/2018] [Accepted: 04/03/2018] [Indexed: 10/17/2022]
Abstract
Reasoning biases such as jumping-to-conclusions (JTC) and incorrigibility have been suggested to contribute to the generation and maintenance of delusions. However, it is still debated whether these biases represent stable traits of patients with delusions, or are related to state fluctuations of delusion severity. The present study aimed to elucidate this question by combining a cross-sectional with a longitudinal approach. JTC, incorrigibility and delusion severity were assessed in 79 patients with a history of delusions over a 6-month period. To allow for a differentiated look into effects of time vs. symptom changes, patients were divided into patients with (D+) and without (D-) current delusions at baseline. Significant improvement of delusions was noted in D+ at follow-up. JTC did not differ between the two patient groups either at baseline or over time. In contrast, incorrigibility was significantly higher in D+ than D- at baseline; this difference remained stable throughout the 6-month follow-up period. The two biases did not significantly co-vary over time. Our results suggest a dissociation between incorrigibility and JTC as regards their relation to current presence of delusions, and tentatively support theoretical accounts attributing different roles to the two biases in the generation (JTC) and maintenance (incorrigibility) of delusions.
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Affiliation(s)
- Christina Andreou
- Center for Psychotic Disorders, University of Basel Psychiatric Clinics, Basel, Switzerland; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Ruth Veckenstedt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thies Lüdtke
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vasilis P Bozikas
- 1st Department of Psychiatry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Bronstein MV, Cannon TD. Measuring bias against disconfirmatory evidence: An evaluation of BADE task scoring methods and the case for a novel method. Psychiatry Res 2018; 261:535-540. [PMID: 29407719 DOI: 10.1016/j.psychres.2018.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 01/05/2018] [Accepted: 01/06/2018] [Indexed: 11/17/2022]
Abstract
Research suggests that bias against disconfirmatory evidence (BADE) may help maintain delusions in the face of overwhelming evidence against them. Much of this research has employed Woodward and colleagues' BADE task. Different methods of scoring this task, many of which have significant drawbacks, are currently used by researchers, making it difficult to compare results across studies of BADE. Continued advancement of BADE research demands a scoring method with more favorable psychometric properties that is used more consistently by researchers. Here, we take a data-driven but theory-informed approach to the development of a new method for scoring the BADE task. This new scoring procedure is more parsimonious than previous metrics of BADE but captures the vast majority of their predictive variance in relation to delusions. This new method may therefore be capable of inspiring consensus use among BADE researchers. If so, it could significantly increase the ease of comparing future studies of BADE.
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Affiliation(s)
- Michael V Bronstein
- Department of Psychology, Yale University, 2 Hillhouse Ave, New Haven, CT, USA.
| | - Tyrone D Cannon
- Department of Psychology, Yale University, 2 Hillhouse Ave, New Haven, CT, USA
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Picardi A, Fonzi L, Pallagrosi M, Gigantesco A, Biondi M. Delusional Themes Across Affective and Non-Affective Psychoses. Front Psychiatry 2018; 9:132. [PMID: 29674982 PMCID: PMC5895977 DOI: 10.3389/fpsyt.2018.00132] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/27/2018] [Indexed: 02/01/2023] Open
Abstract
The current debate about the diagnostic significance of delusion revolves around two positions. The neurocognitive position conceives delusion as a non-specific, though polymorphic, symptom. The psychopathological position views features of delusion such as content and structure as having meaningful connections with diagnostic entities. This study aims at contributing to this debate by examining the association between delusional themes and diagnosis in a sample of 830 adult psychotic patients. All diagnoses were made by experienced psychiatrists according to DSM-IV or ICD-10 criteria, and in 348 patients were established with the SCID-I. All patients were administered the Brief Psychiatric Rating Scale (BPRS). In each patient, the presence of somatic delusions and delusions of guilt, grandiosity, and persecution was determined by examining the scores on relevant BPRS items. Delusions of guilt were almost pathognomonic for a psychotic depressive condition (psychotic major depression 40%; psychotic bipolar depression 30%; depressed schizoaffective disorder 8%; bipolar and schizoaffective mixed states 6 and 7%, respectively). Only 1% of patients with schizophrenia and no patient with delusional disorder or bipolar or schizoaffective manic state showed such delusions. The difference between unipolar and bipolar depression and the other diagnostic groups was highly significant. Delusions of grandiosity characterized mostly patients with manic symptoms (bipolar mania 20%; bipolar mixed states 19%; manic schizoaffective disorder 10%). They were observed significantly more often in bipolar mania than in schizophrenia (7%). Persecutory delusions were broadly distributed across diagnostic categories. However, they were significantly more frequent among patients with schizophrenia and delusional disorder compared with depressed and manic patients. Somatic delusions were also observed in all diagnostic groups, with no group standing out as distinct from the others in terms of an increased prevalence of somatic delusions. Our findings suggest a middle position in the debate between the neurocognitive and the psychopathological approaches. On the one hand, the widespread observation of persecutory delusions suggests the usefulness of searching for non-specific pathogenic mechanisms. On the other hand, the association between some delusional contents and psychiatric diagnosis suggests that a phenomenological analysis of the delusional experience may be a helpful tool for the clinician in the diagnostic process.
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Affiliation(s)
- Angelo Picardi
- Centre of Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy
| | - Laura Fonzi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Mauro Pallagrosi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Antonella Gigantesco
- Centre of Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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Moritz S, Pfuhl G, Lüdtke T, Menon M, Balzan RP, Andreou C. A two-stage cognitive theory of the positive symptoms of psychosis. Highlighting the role of lowered decision thresholds. J Behav Ther Exp Psychiatry 2017; 56:12-20. [PMID: 27501907 DOI: 10.1016/j.jbtep.2016.07.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 07/02/2016] [Accepted: 07/05/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We outline a two-stage heuristic account for the pathogenesis of the positive symptoms of psychosis. METHODS A narrative review on the empirical evidence of the liberal acceptance (LA) account of positive symptoms is presented. HYPOTHESIS At the heart of our theory is the idea that psychosis is characterized by a lowered decision threshold, which results in the premature acceptance of hypotheses that a nonpsychotic individual would reject. Once the hypothesis is judged as valid, counterevidence is not sought anymore due to a bias against disconfirmatory evidence as well as confirmation biases, consolidating the false hypothesis. As a result of LA, confidence in errors is enhanced relative to controls. Subjective probabilities are initially low for hypotheses in individuals with delusions, and delusional ideas at stage 1 (belief formation) are often fragile. In the course of the second stage (belief maintenance), fleeting delusional ideas evolve into fixed false beliefs, particularly if the delusional idea is congruent with the emotional state and provides "meaning". LA may also contribute to hallucinations through a misattribution of (partially) normal sensory phenomena. Interventions such as metacognitive training that aim to "plant the seeds of doubt" decrease positive symptoms by encouraging individuals to seek more information and to attenuate confidence. The effect of antipsychotic medication is explained by its doubt-inducing properties. LIMITATIONS The model needs to be confirmed by longitudinal designs that allow an examination of causal relationships. Evidence is currently weak for hallucinations. CONCLUSIONS The theory may account for positive symptoms in a subgroup of patients. Future directions are outlined.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Gerit Pfuhl
- Department of Psychology, UiT The Arctic University of Norway, N-9037, Tromsø, Norway
| | - Thies Lüdtke
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mahesh Menon
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; Vancouver Coastal Health, Vancouver, BC, Canada
| | - Ryan P Balzan
- School of Psychology, Flinders University Adelaide, SA, Australia
| | - Christina Andreou
- Center for Gender Research and Early Detection, University of Basel, University Psychiatric Clinics, Basel, Switzerland
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36
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Zhu C, Sun X, So SHW. Associations between belief inflexibility and dimensions of delusions: A meta-analytic review of two approaches to assessing belief flexibility. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2017; 57:59-81. [DOI: 10.1111/bjc.12154] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 06/27/2017] [Indexed: 01/16/2023]
Affiliation(s)
- Chen Zhu
- Department of Psychology; The Chinese University of Hong Kong; Shatin New Territories Hong Kong SAR China
| | - Xiaoqi Sun
- Department of Psychology; The Chinese University of Hong Kong; Shatin New Territories Hong Kong SAR China
| | - Suzanne Ho-wai So
- Department of Psychology; The Chinese University of Hong Kong; Shatin New Territories Hong Kong SAR China
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Abstract
INTRODUCTION Biases in causal attributions and evidence integration have been implicated in delusions, but have not been investigated simultaneously to examine additive or multiplicative effects. It was hypothesised that paranoid delusions would correlate with self-serving and personalising biases ("defence" model of paranoia), particularly when these biases were disconfirmed. METHODS Constrained principal component analysis was used to investigate differences between schizophrenia patients (paranoid vs. non-paranoid), bipolar disorder patients, and healthy controls, as well as to examine the extent to which psychotic symptoms could predict patterns of responding on a novel attributional bias task (Attributional Style BADE, or ASB) that requires integrating contextual information. RESULTS Although no group differences were found, disorganisation and manic symptoms correlated with situation attributions and self-blame when such attributions were unsupported by the available evidence, and depression and anxiety correlated with other-person and self attributions (not situation attributions) when confirmed by the available evidence, regardless of diagnosis. CONCLUSIONS While group differences accounted for little variance in responses on the ASB task, a transdiagnostic association between symptoms of psychosis and the ASB task was observed. This highlights the importance of considering symptom profiles rather than diagnostic groupings when investigating cognitive biases and related non-pharmacological treatments.
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Affiliation(s)
- Nicole Sanford
- a Department of Psychiatry , University of British Columbia , Vancouver , Canada.,b BC Children's Hospital Research Institute , Vancouver , Canada
| | - Todd S Woodward
- a Department of Psychiatry , University of British Columbia , Vancouver , Canada.,b BC Children's Hospital Research Institute , Vancouver , Canada
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McLean BF, Mattiske JK, Balzan RP. Association of the Jumping to Conclusions and Evidence Integration Biases With Delusions in Psychosis: A Detailed Meta-analysis. Schizophr Bull 2017; 43:344-354. [PMID: 27169465 PMCID: PMC5605251 DOI: 10.1093/schbul/sbw056] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We completed a meta-analysis to investigate the relationship between delusions in psychosis and 4 cognitive biases: "jumping to conclusions" (JTC), the "bias against disconfirmatory evidence" (BADE), the "bias against confirmatory evidence" (BACE), and "liberal acceptance" (LA). Building on recent meta-analyses we compared more narrowly defined groups. We identified 35 JTC, 8 BADE, 7 BACE, and 6 LA studies for inclusion. Groups with schizophrenia who were currently experiencing delusions demonstrated greater JTC, BADE, BACE, and LA than groups with schizophrenia who were not currently experiencing delusions, who in turn demonstrated no more JTC than healthy control groups. Hence JTC, BADE, BACE, and LA co-vary with delusions in cross-sectional samples of people with schizophrenia. Groups who were experiencing delusions due to other psychiatric illnesses also demonstrated greater JTC than healthy controls, and equivalent JTC to groups with schizophrenia currently experiencing delusions. Hence JTC is associated with delusions across a range of diagnoses. Groups with other, non-delusional psychiatric illnesses demonstrated less JTC, BADE, BACE, and LA than groups with schizophrenia currently experiencing delusions, less JTC than groups experiencing delusions due to other diagnoses, and no more JTC, BADE, BACE, or LA than healthy control groups. Hence JTC, BADE, BACE, and LA were not associated with psychiatric illnesses in general. Our results indicate all 4 biases are associated with delusions specifically rather than merely with a diagnosis of schizophrenia or with being psychiatrically ill, consistent with the possibility that they contribute to delusional severity.
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Affiliation(s)
- Benjamin F. McLean
- School of Psychology, Flinders University, Adelaide, Australia;,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia
| | | | - Ryan P. Balzan
- School of Psychology, Flinders University, Adelaide, Australia;,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia
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Both bias against disconfirmatory evidence and political orientation partially explain the relationship between dogmatism and racial prejudice. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.09.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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40
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Moritz S, Scheu F, Andreou C, Pfueller U, Weisbrod M, Roesch-Ely D. Reasoning in psychosis: risky but not necessarily hasty. Cogn Neuropsychiatry 2016; 21:91-106. [PMID: 26884221 DOI: 10.1080/13546805.2015.1136611] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION A liberal acceptance (LA) threshold for hypotheses has been put forward to explain the well-replicated "jumping to conclusions" (JTC) bias in psychosis, particularly in patients with paranoid symptoms. According to this account, schizophrenia patients rest their decisions on lower subjective probability estimates. The initial formulation of the LA account also predicts an absence of the JTC bias under high task ambiguity (i.e., if more than one response option surpasses the subjective acceptance threshold). METHODS Schizophrenia patients (n = 62) with current or former delusions and healthy controls (n = 30) were compared on six scenarios of a variant of the beads task paradigm. Decision-making was assessed under low and high task ambiguity. Along with decision judgments (optional), participants were required to provide probability estimates for each option in order to determine decision thresholds (i.e., the probability the individual deems sufficient for a decision). RESULTS In line with the LA account, schizophrenia patients showed a lowered decision threshold compared to controls (82% vs. 93%) which predicted both more errors and less draws to decisions. Group differences on thresholds were comparable across conditions. At the same time, patients did not show hasty decision-making, reflecting overall lowered probability estimates in patients. CONCLUSIONS Results confirm core predictions derived from the LA account. Our results may (partly) explain why hasty decision-making is sometimes aggravated and sometimes abolished in psychosis. The proneness to make risky decisions may contribute to the pathogenesis of psychosis. A revised LA account is put forward.
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Affiliation(s)
- Steffen Moritz
- a Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Florian Scheu
- b Department of General Psychiatry , Center for Psychosocial Medicine , Heidelberg , Germany
| | - Christina Andreou
- a Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Ute Pfueller
- b Department of General Psychiatry , Center for Psychosocial Medicine , Heidelberg , Germany.,c Department of Psychiatry , SRH Klinikum Karlsbad-Langensteinbach , Karlsbad , Germany
| | - Matthias Weisbrod
- b Department of General Psychiatry , Center for Psychosocial Medicine , Heidelberg , Germany.,c Department of Psychiatry , SRH Klinikum Karlsbad-Langensteinbach , Karlsbad , Germany
| | - Daniela Roesch-Ely
- b Department of General Psychiatry , Center for Psychosocial Medicine , Heidelberg , Germany
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41
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Moritz S, Balzan RP, Bohn F, Veckenstedt R, Kolbeck K, Bierbrodt J, Dietrichkeit M. Subjective versus objective cognition: Evidence for poor metacognitive monitoring in schizophrenia. Schizophr Res 2016; 178:74-79. [PMID: 27591821 DOI: 10.1016/j.schres.2016.08.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/18/2016] [Accepted: 08/19/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients with schizophrenia display a number of cognitive biases, particularly a tendency to jump to conclusions, which are implicated in the pathogenesis of the disorder. The present study contrasted the degree of objective reasoning biases with subjective cognitive insight. We expected that patients with schizophrenia would display greater objective than subjective impairment suggestive of poor metacognitive awareness. METHODS Patients with schizophrenia (n=140) and healthy controls (n=60) underwent a test battery encompassing a cognitive bias paradigm (beads task) as well as neurocognitive tests (story recall, trail-making tests). In addition, they were administered the Beck Cognitive Insight Scale (BCIS), a subjective measure of (meta)cognitive awareness. RESULTS Corroborating prior research on decision making, draws to decisions were significantly delayed in controls relative to patients, whereas the core jumping to conclusion parameter (i.e., decision after one or two pieces of information) bordered significance. Patients with schizophrenia showed a lowered decision threshold and impaired neurocognition relative to nonclinical controls. Despite poor cognitive performance and prior psychotic episodes, patients with schizophrenia showed similar scores on the self-confidence subscale of the BCIS and reported even higher levels of self-reflectiveness relative to healthy controls. DISCUSSION The study demonstrates that patients with schizophrenia show severe cognitive biases and neurocognitive deficits but display only partial awareness herein. Raising cognitive insight in a non-insulting fashion and elevating patients' corrigibility as well as willingness to consider others' feedback and advice may help to narrow this gap and improve psychiatric symptomatology.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Ryan P Balzan
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Francesca Bohn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ruth Veckenstedt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katharina Kolbeck
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Bierbrodt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mona Dietrichkeit
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Moritz S, Woodward TS, Balzan R. Is metacognitive training for psychosis effective? Expert Rev Neurother 2016; 16:105-7. [PMID: 26694013 DOI: 10.1586/14737175.2016.1135737] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Steffen Moritz
- a Department of Psychiatry and Psychotherapy , University Medical Center Hamburg , Hamburg , Germany
| | - Todd S Woodward
- b Department of Psychiatry , University of British Columbia , Vancouver , Canada.,c BC Mental Health and Addictions Research Institute , Provincial Health Services Authority , Vancouver , Canada
| | - Ryan Balzan
- d School of Psychology , Flinders University , Adelaide , Australia
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Andreou C, Schneider BC, Braun V, Kolbeck K, Gallinat J, Moritz S. Dopamine effects on evidence gathering and integration. J Psychiatry Neurosci 2015; 40. [PMID: 26197302 PMCID: PMC4622641 DOI: 10.1503/jpn.140306] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Disturbances in evidence gathering and disconfirmatory evidence integration have been associated with the presence of or propensity for delusions. Previous evidence suggests that these 2 types of reasoning bias might be differentially affected by antipsychotic medication. We aimed to investigate the effects of a dopaminergic agonist (L-dopa) and a dopaminergic antagonist (haloperidol) on evidence gathering and disconfirmatory evidence integration after single-dose administration in healthy individuals. METHODS The study used a randomized, double-blind, placebo-controlled, 3-way crossover design. Participants were healthy individuals aged 18-40 years. We administered a new data-gathering task designed to increase sensitivity to change compared with traditional tasks. The Bias Against Disconfirmatory Evidence (BADE) task was used as a measure of disconfirmatory evidence integration. RESULTS We included 30 individuals in our study. In the data-gathering task, dopaminergic modulation had no significant effect on the amount of evidence gathered before reaching a decision. In contrast, the ability of participants to integrate disconfirmatory evidence showed a significant linear dopaminergic modulation pattern (highest with haloperidol, intermediate with placebo, lowest with L-dopa), with the difference between haloperidol and L-dopa marginally reaching significance. LIMITATIONS Although the doses used for haloperidol and L-dopa were similar to those used in previous studies, drug plasma level measurements would have added to the validity of findings. CONCLUSION Evidence gathering and disconfirmatory evidence integration might be differentially influenced by dopaminergic agents. Our findings are in support of a dual-disturbance account of delusions and provide a plausible neurobiological basis for the use of interventions targeted at improving reasoning biases as an adjunctive treatment in patients with psychotic disorders.
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Affiliation(s)
- Christina Andreou
- Correspondence to: C. Andreou, University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistrasse 52, 20246 Hamburg, Germany;
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Ross RM, McKay R, Coltheart M, Langdon R. Jumping to Conclusions About the Beads Task? A Meta-analysis of Delusional Ideation and Data-Gathering. Schizophr Bull 2015; 41:1183-91. [PMID: 25616503 PMCID: PMC4535629 DOI: 10.1093/schbul/sbu187] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
It has been claimed that delusional and delusion-prone individuals have a tendency to gather less data before forming beliefs. Most of the evidence for this "jumping to conclusions" (JTC) bias comes from studies using the "beads task" data-gathering paradigm. However, the evidence for the JTC bias is mixed. We conducted a random-effects meta-analysis of individual participant data from 38 clinical and nonclinical samples (n = 2,237) to investigate the relationship between data gathering in the beads task (using the "draws to decision" measure) and delusional ideation (as indexed by the "Peters et al Delusions Inventory"; PDI). We found that delusional ideation is negatively associated with data gathering (r(s) = -0.10, 95% CI [-0.17, -0.03]) and that there is heterogeneity in the estimated effect sizes (Q-stat P = .03, I(2) = 33). Subgroup analysis revealed that the negative association is present when considering the 23 samples (n = 1,754) from the large general population subgroup alone (r(s) = -0.10, 95% CI [-0.18, -0.02]) but not when considering the 8 samples (n = 262) from the small current delusions subgroup alone (r(s) = -0.12, 95% CI [-0.31, 0.07]). These results provide some provisional support for continuum theories of psychosis and cognitive models that implicate the JTC bias in the formation and maintenance of delusions.
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Affiliation(s)
- Robert Malcolm Ross
- ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, Australia; Department of Cognitive Science, Macquarie University, Sydney, NSW, Australia;
| | - Ryan McKay
- ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, Australia;,Department of Psychology, Royal Holloway, University of London, Egham, Surrey, UK
| | - Max Coltheart
- ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, Australia;,Department of Cognitive Science, Macquarie University, Sydney, NSW, Australia;
| | - Robyn Langdon
- ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, Australia;,Department of Cognitive Science, Macquarie University, Sydney, NSW, Australia;
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Lavigne KM, Metzak PD, Woodward TS. Functional brain networks underlying detection and integration of disconfirmatory evidence. Neuroimage 2015; 112:138-151. [DOI: 10.1016/j.neuroimage.2015.02.043] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 01/11/2015] [Accepted: 02/20/2015] [Indexed: 11/26/2022] Open
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Sowing the seeds of doubt: a narrative review on metacognitive training in schizophrenia. Clin Psychol Rev 2014; 34:358-66. [DOI: 10.1016/j.cpr.2014.04.004] [Citation(s) in RCA: 230] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 04/22/2014] [Accepted: 04/29/2014] [Indexed: 11/23/2022]
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