A systematic review of performance-based assessment studies on cognitive biases in schizophrenia spectrum psychoses and clinical high-risk states: A summary of 40 years of research

Cognitive models of psychosis have stimulated empirical studies on cognitive biases involved in schizophrenia spectrum psychoses and their symptoms. This systematic review aimed to summarize the studies on the role of cognitive biases as assessed in different performance-based tasks in schizophrenia spectrum psychoses and clinical high-risk states. We focused on five cognitive biases linked to psychosis, i.e., aberrant salience, attentional biases, source monitoring biases, jumping to conclusions, and bias against disconfirmatory evidence. We identified N = 324 studies published in N = 308 articles fulfilling inclusion criteria. Most studies have been cross-sectional and confirmed that the schizophrenia spectrum psychoses are related to exaggerated cognitive biases compared to healthy controls. On the contrary, less evidence suggests a higher tendency for cognitive biases in the UHR sample. The only exceptions were source monitoring and jumping to conclusions, which were confirmed to be exaggerated in both clinical groups. Hallucinations and delusions were the most frequent symptoms studied in the context of cognitive biases. Based on the findings, we presented a hypothetical model on the role of interactions between cognitive biases or additive effects of biases in shaping the risk of psychosis. Future research is warranted for further development of cognitive models for psychosis.

Assessing psychotic-like experiences using categorical and metacognitive approaches: A validation of polish self-report measures

AIM

Psychotic-like experiences (PLEs) are experiences in the general population that, in their extreme form, are attributed to clinical psychosis. They are correlated with general psychopathology and increased risk of developing psychosis. Previous research show a multitude of measuring tools which most often lack psychometric validation. This study aimed to examine both categorical and metacognitive measures of PLEs.

METHODS

Confirmatory Factor Analysis (CFA) was used in seven online studies with n's ranging from 259 to 6772 to explore factor structures of Prodromal Questionnaire 16 item (PQ-16), Revised Green et al. Paranoid Thoughts Scale (R-GPTS), Multi-Modality Unusual Sensory Experiences Questionnaire (MUSEQ), Beliefs about Paranoia Scale (BAPS) and Interpretation of Voices Inventory (IVI). Additionally, we explored measurement invariance between diagnosed with psychiatric disorders and undiagnosed individuals in PQ-16, R-GPTS and BAPS.

RESULTS

We confirmed the factor structures of all questionnaires except IVI. We confirmed configural, threshold and metric measurement invariance in R-GPTS and BAPS and partially PQ-16.

CONCLUSIONS

The current results demonstrate structural validity and measurement invariance of several categorical and metacognitive measures of PLEs.

Do they make these sounds to hurt me? The mediating role of emotion regulation, anxiety and hostile attributions in the relationship between misophonia and paranoia-like thoughts

Misophonia is a complex syndrome in which selective auditory stimuli, such as sounds of breathing, sniffing or eating, trigger an intense, negative emotional response. Previous studies have shown that the symptoms of misophonia coexist with a number of mental disorders, such as OCD, depression and anxiety. However, still little is known about other mental states that may be present in this context. A total of 312 people from the non-clinical sample participated in an online correlational study, which aimed at investigating whether there is a significant association between misophonia symptoms and paranoia-like thoughts, as well as to examine what factors might underlie this potential relationship. The results revealed that misophonia positively correlates with paranoia-like thoughts. A serial mediation analysis showed that difficulties in regulating emotions, anxiety and hostile attributions are significant mediators in the relationship between misophonia and paranoia-like thoughts. Importantly, these mediators, above all, form a potential coherent explanatory mechanism underlying this association. Hence, our results highlight the important role of socio-cognitive factors in the conceptualization of misophonia and its relation to paranoia-like thoughts.

Bridging the gap between body image and paranoia-like thoughts

A feeling of vulnerability is believed to be one of the foundations upon which paranoia is built. Factors that may increase vulnerability include negative affective states, low self-esteem and high social rejection sensitivity. Body image, which is one aspect of the overall self-esteem, has recently been shown to be associated with paranoia. However, little is known about factors underlying this association. In this online study conducted on a non-clinical sample (n = 539, 65.5% of female), self-report data assessing paranoia-like thoughts, body image, self-esteem, negative emotions, rejection sensitivity as well as various attitudes and beliefs related to body appearance were collected. The results revealed a significant serial mediation effect of negative emotions, self-esteem and rejection sensitivity in the relationship between body image and paranoia-like thoughts. Parallel mediation analysis showed an effect of social criticism as the only one of four studied groups of beliefs related to body appearance in the relationship between paranoia-like thoughts and body image. Moreover, paranoia-like thoughts were increased in people who were not satisfied with their body, both as a result of feeling too thin and overweight. To conclude, body image is an important factor related to paranoia-like thoughts, through its association with increased vulnerability and negative general self-view. The findings highlight the importance of negative emotions, low self-esteem and high rejection sensitivity, as well as the role of critical comments and lack of perceived acceptance as potential (socially-focused) mechanisms paving the way from negative body image to paranoia-like thoughts.

The mediating effect of negative emotions on the relationship between subjective sleep quality and paranoia-like thoughts

Sleep quality has been found to play an important role in paranoia-like thoughts both in clinical and non-clinical populations. Previous studies have shown that the presence of negative emotional states can mediate the link between sleep and paranoia, however, their role in the linkage is still not entirely clear. Hence, our study aimed to investigate further the mediating effect of negative emotions on the relationship between sleep quality and paranoia-like thoughts on a relatively large Polish sample drawn from the general population. We collected questionnaire data assessing paranoia-like thoughts, sleep quality and quantity, and negative affect from 604 Polish adults. We performed the correlation analysis and examined the mediating role of negative emotions in the relationship between sleep quality and paranoia. The results revealed significant moderate relationships between sleep quality and paranoia-like thoughts, negative emotions and paranoia-like thoughts, as well as between negative emotions and sleep quality. A mediation model for the relationship between sleep quality and paranoia-like thoughts revealed a complementary mediation by negative affect. The findings contribute to understanding the interrelatedness between sleep quality, negative emotions, and paranoia-like thoughts, as well as emphasize the importance of negative affect in the relationship between sleep and paranoia. Future research is needed to determine other factors that contribute to understanding the linkage as well as to determine the cause and effect.

Long term effects of cueing procedural memory reactivation during NREM sleep

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A single night of TMR benefits procedural memories up to 10 days later.

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Spindle density and SO-spindle coupling strength increase immediately upon cue onset.

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Time spent in N2 but not N3 predicts cueing benefit.

Targeted memory reactivation (TMR) has recently emerged as a promising tool to manipulate and study the sleeping brain. Although the technique is developing rapidly, only a few studies have examined how the effects of TMR develop over time. Here, we use a bimanual serial reaction time task (SRTT) to investigate whether the difference between the cued and un-cued sequence of button presses persists long-term. We further explore the relationship between the TMR benefit and sleep spindles, as well as their coupling with slow oscillations. Our behavioural analysis shows better performance for the dominant hand. Importantly, there was a strong effect of TMR, with improved performance on the cued sequence after sleep. Closer examination revealed a significant benefit of TMR at 10 days post-encoding, but not 24 h or 6 weeks post-encoding. Time spent in stage 2, but not stage 3, of NREM sleep predicted cueing benefit. We also found a significant increase in spindle density and SO-spindle coupling during the cue period, when compared to the no-cue period. Together, our results demonstrate that TMR effects evolve over several weeks post-cueing, as well as emphasising the importance of stage 2, spindles and the SO-spindle coupling in procedural memory consolidation.