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Klingbeil J, Mühlig M, Bahr E, Welle F, Ritter T, Stockert A, Wawrzyniak M, Saur D. Undoubtedly unaware of homonymous hemianopia: The contribution of overconfidence to anosognosia of hemianopia. Cortex 2024; 177:224-234. [PMID: 38875736 DOI: 10.1016/j.cortex.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/31/2024] [Accepted: 03/11/2024] [Indexed: 06/16/2024]
Abstract
A new functional deficit caused by a stroke can be understood as a situation of uncertainty that has to prompt deficit discovery and subsequent incorporation into an altered self-perception. Anosognosia for visual field deficits is frequent after stroke. For hemiplegia, patients' performance in a riddle test provided evidence that the inability to generate and adjust beliefs in face of uncertainty contributes to anosognosia for hemiplegia. In this prospective study, the same riddles are used in patients with homonymous hemianopia due to a first-ever stroke in the posterior cerebral artery territory and in an age-matched control cohort. The riddles create a situation of uncertainty that is resolved with five successive clues which progressively delimit the target word. After each clue, patients have to guess the target word and rate their confidence in the answer's correctness. Patients were tested once during the hospital stay. According to the Bisiach score for anosognosia, 12 out of 29 patients were unaware of their visual field deficits. All patients with anosognosia for hemianopia had right hemisphere lesions. Patients with and without anosognosia did not differ significantly in global cognitive impairment, mental flexibility or memory function. Importantly, patients with anosognosia showed higher confidence ratings than patients without anosognosia and controls in the first two clues (situations of uncertainty). This was demonstrated by a significant interaction effect in a mixed ANOVA with the factors group (anosognosia, nosognosia, controls) and riddle clues. An exploratory lesion subtraction analysis showed a high proportion of deficit unawareness in patients with lesions in the right fusiform and (para)hippocampal gyri. Our findings suggest that overconfidence in situations of uncertainty might contribute to the appearance of anosognosia for hemianopia. Because this has been demonstrated before in anosognosia for hemiplegia, we suggest that overconfidence is a supra-modal contributor to deficit unawareness.
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Affiliation(s)
- Julian Klingbeil
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany.
| | - Martin Mühlig
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Emma Bahr
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Florian Welle
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Tim Ritter
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Anika Stockert
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Max Wawrzyniak
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Dorothee Saur
- Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
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Pugliese V, de Filippis R, Aloi M, Carbone EA, Rania M, Segura-Garcia C, De Fazio P. Cognitive biases are associated with aberrant salience experience in schizophrenia spectrum disorders. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024; 17:154-159. [PMID: 38570903 DOI: 10.1016/j.sjpmh.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/02/2023] [Accepted: 07/12/2023] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Cognitive models suggest the co-occurrence of cognitive biases and aberrant salience is unique to psychosis, but their interaction is not yet fully understood. Therefore, we aimed to elucidate the relationship between subjective cognitive biases and aberrant salience in individuals with schizophrenia spectrum disorders (SSDs) in this study. METHODS A sample of 92 subjects with SSDs underwent an assessment using Davos Assessment Cognitive Biases (DACOBS) and the Aberrant Salience Inventory (ASI) in a cross-sectional design. We evaluated psychopathological differences based on ASI scores and conducted a linear regression analysis to examine the variables associated with aberrant salience. RESULTS Subjects with an ASI score ≥14 demonstrated significantly higher scores across all subscales and total score of ASI and DACOBS (p<0.001). ASI subscales were significantly positive correlated with all DACOBS subscales, ranging from 0.250 for Increased Significance and Safety Behavior to 0.679 for Heightened Emotionality and Social cognition problems. The linear regression analysis revealed a positive association between aberrant salience and the DACOBS subscales jumping to conclusions (JTC) (β=0.220), social cognition problems (β=0.442), subjective cognitive problems (β=0.405), and a negative association with the subscale belief inflexibility (β=-0.350). CONCLUSIONS Our findings suggest that JTC, social cognition problems and subjective cognitive problems may play a central role in the experience of aberrant salience in individuals with SSDs. This work informs about the need of developing prevention and intervention strategies that specifically target cognitive biases and aberrant salience in the treatment of psychosis.
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Affiliation(s)
- Valentina Pugliese
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Matteo Aloi
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy; Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Elvira Anna Carbone
- Psychiatry Unit, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Marianna Rania
- Center for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - Cristina Segura-Garcia
- Psychiatry Unit, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy; Center for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy.
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Jagtap S, Best MW. Examining the influence of self-referential thinking on aberrant salience and jumping to conclusions bias in individuals with schizophrenia-spectrum disorders. J Behav Ther Exp Psychiatry 2024; 83:101935. [PMID: 38064876 DOI: 10.1016/j.jbtep.2023.101935] [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: 06/09/2023] [Revised: 11/19/2023] [Accepted: 11/25/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND AND OBJECTIVES Cognitive processes such as aberrant salience and the jumping to conclusions (JTC) bias are implicated in the development of delusions. Self-referential thinking is implicated in this process; however, it is unknown how it may interact with aberrant salience and JTC bias in individuals with schizophrenia-spectrum disorders (SSDs). This study examined associations of self-referential thinking with aberrant salience, JTC bias, and delusion severity, and whether self-referential stimuli led to an increase in aberrant salience and JTC bias in SSDs (n = 20) relative to psychiatrically healthy controls (n = 20). METHODS To assess aberrant salience and JTC bias, participants were asked to complete both self-referential and neutral versions of the Salience Attribution Test (SAT) and the Beads Task, as well as self-report measures of aberrant salience and JTC bias. RESULTS Self-referential task condition interacted with clinical group to predict JTC beads task scores, such that participants with SSDs exhibited greater levels of JTC bias than psychiatrically healthy controls during the neutral task condition, when controlling for levels of motivation, cognitive insight, and functioning. Self-referential thinking was significantly associated with aberrant salience, JTC bias, and delusion severity. LIMITATIONS This experiment examined trait-level relationships between variables, so does not provide information about state-level interrelationships and would benefit from replication using more dynamic methods such as ecological momentary assessment. CONCLUSIONS These findings highlight the interrelationships between self-referential thinking, JTC bias, aberrant salience, and delusion severity, in individuals with SSDs, and support the interactive role of self-referential thinking in predicting JTC bias.
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Affiliation(s)
- Shreya Jagtap
- Department of Psychological Clinical Science, University of Toronto Scarborough, Canada; Centre for Addiction and Mental Health, Canada
| | - Michael W Best
- Department of Psychological Clinical Science, University of Toronto Scarborough, Canada; Centre for Addiction and Mental Health, Canada; Ontario Shores Centre for Mental Health Sciences, Canada.
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Tan N, Shou Y, Chen J, Christensen BK. A Bayesian model of the jumping-to-conclusions bias and its relationship to psychopathology. Cogn Emot 2024; 38:315-331. [PMID: 38078381 DOI: 10.1080/02699931.2023.2287091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 11/17/2023] [Indexed: 04/29/2024]
Abstract
The mechanisms by which delusion and anxiety affect the tendency to make hasty decisions (Jumping-to-Conclusions bias) remain unclear. This paper proposes a Bayesian computational model that explores the assignment of evidence weights as a potential explanation of the Jumping-to-Conclusions bias using the Beads Task. We also investigate the Beads Task as a repeated measure by varying the key aspects of the paradigm. The Bayesian model estimations from two online studies showed that higher delusional ideation promoted reduced belief updating but the impact of general and social anxiety on evidence weighting was inconsistent. The altered evidence weighting as a result of a psychopathological trait appeared insufficient in contributing to the Jumping-to-Conclusions bias. Variations in Beads Task aspects significantly affected subjective certainty at the point of decisions but not the number of draws to decisions. Repetitions of the Beads Task are feasible if one assesses the Jumping-to-Conclusions bias using number of draws to decisions.
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Affiliation(s)
- Nicole Tan
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
| | - Yiyun Shou
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Junwen Chen
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
| | - Bruce K Christensen
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
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Gawęda Ł, Kowalski J, Aleksandrowicz A, Bagrowska P, Dąbkowska M, Pionke-Ubych R. 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. Clin Psychol Rev 2024; 108:102391. [PMID: 38301343 DOI: 10.1016/j.cpr.2024.102391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 02/03/2024]
Abstract
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.
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Affiliation(s)
- Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.
| | - Joachim Kowalski
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Adrianna Aleksandrowicz
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Paulina Bagrowska
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Małgorzata Dąbkowska
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Renata Pionke-Ubych
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
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Pachi I, Papadopoulos V, Xenaki LA, Koros C, Simitsi AM, Bougea A, Bozi M, Papagiannakis N, Soldatos RF, Kolovou D, Pantes G, Scarmeas N, Paraskevas G, Voumvourakis K, Potagas C, Papageorgiou SG, Kollias K, Stefanis N, Stefanis L. Jumping to conclusions bias, psychosis and impulsivity in early stages of Parkinson's disease. J Neurol 2023; 270:5773-5783. [PMID: 37555925 PMCID: PMC10632276 DOI: 10.1007/s00415-023-11904-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/02/2023] [Accepted: 07/25/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVES The aim was to explore the correlations between Jumping to Conclusions (JtC) tendency and neuropsychiatric features in patients with early Parkinson's disease (PD). BACKGROUND According to few reports, PD patients with impulsive-compulsive behaviors (ICBs) are prone to working memory difficulties including JtC bias. The correlation of psychotic features and JtC tendency remains still unclear. METHODS Healthy controls and patients within 3 years of PD onset were recruited. Participants were examined for psychotic symptoms using a 10 question PD-specific psychosis severity scale. JtC was measured by a probalistic reasoning scenario (beads task). In PD group, medication use, motor and non-motor symptoms were documented. Impulsivity was evaluated using the Questionnaire for Impulsive-Compulsive Disorders in PD (QUIP). RESULTS The prevalence of JtC bias was 9% (6/70) in healthy individuals, compared to 32% (22/68) of PD group [p = 0.001]. No association was detected between the presence of JtC tendency and PD-associated psychosis (p = 0.216). Patients with JtC had shorter duration of PD, more tremor-dominant PD subtype and higher QUIP scores, regardless of the dopaminergic therapy (p = 0.043, p = 0.015, p = 0.007, respectively). A trend towards attention and inhibition control deficit was noticed in JtC patients. CONCLUSIONS We found a high prevalence of JtC bias in early, cognitively intact PD population and a potential link between subthreshold ICBs and poor performance on beads task. Additional studies are needed to confirm our results and elaborate on the mechanisms that correlate impulsivity with JtC tendency, which are likely to be different from those mediating psychotic features in early PD.
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Affiliation(s)
- Ioanna Pachi
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece
| | - Vassilis Papadopoulos
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece
| | - Lida Alkisti Xenaki
- 1st Department of Psychiatry, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., Athens, Greece
| | - Christos Koros
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece
- 1st Department of Psychiatry, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., Athens, Greece
- 2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 1 Rimini Str., Athens, Greece
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Athina Maria Simitsi
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece
| | - Anastasia Bougea
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece
| | - Maria Bozi
- 2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 1 Rimini Str., Athens, Greece
| | - Nikos Papagiannakis
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece
| | - Rigas Filippos Soldatos
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece
| | - Dimitra Kolovou
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece
| | - George Pantes
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Georgios Paraskevas
- 2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 1 Rimini Str., Athens, Greece
| | - Konstantinos Voumvourakis
- 2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 1 Rimini Str., Athens, Greece
| | - Constantin Potagas
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece
| | - Sokratis G Papageorgiou
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece
| | - Konstantinos Kollias
- 1st Department of Psychiatry, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., Athens, Greece
| | - Nikos Stefanis
- 1st Department of Psychiatry, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74, Vassilissis Sofias Av., 11528, Athens, Greece.
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Scheunemann J, Jelinek L, Biedermann SV, Lipp M, Yassari AH, Kühn S, Gallinat J, Moritz S. Can you trust this source? Advice taking in borderline personality disorder. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-022-01539-w. [PMID: 36629942 DOI: 10.1007/s00406-022-01539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023]
Abstract
Research suggests that patients with borderline personality disorder (BPD) share a range of cognitive biases with patients with psychosis. As the disorder often manifests in dysfunctional social interactions, we assumed associated reasoning styles would be exaggerated in a social setting. For the present study, we applied the Judge-Advisor System by asking participants to provide initial estimates of a person's age and presumed hostility based on a portrait photo. Afterwards, we presented additional cues/advice in the form of responses by anonymous previous respondents. Participants could revise their estimate, seek additional advice, or make a decision. Contrary to our preregistered hypothesis, patients with BPD (n = 38) performed similarly to healthy controls (n = 30). Patients sought the same number of pieces of advice, were equally confident, and used advice in similar ways to revise their estimates. Thus, patients with BPD did trust advice. However, patients gave higher hostility ratings to the portrayed persons. In conclusion, patients with BPD showed no cognitive biases in seeking, evaluating, and integrating socially provided information. While the study implies emotional rather than cognitive biases in the disorder, cognitive biases may still prove to be useful treatment targets in order to encourage delaying and reflecting on extreme emotional responses in social interactions.
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Affiliation(s)
- Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah V Biedermann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Lipp
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Amir H Yassari
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Jürgen Gallinat
- 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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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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Gregersen M, Rohd SB, Jepsen JRM, Brandt JM, Søndergaard A, Hjorthøj C, Knudsen CB, Andreassen AK, Veddum L, Ohland J, Wilms M, Krantz MF, Burton BK, Greve A, Bliksted V, Mors O, Clemmensen L, Nordentoft M, Thorup AAE, Hemager N. Jumping to Conclusions and Its Associations With Psychotic Experiences in Preadolescent Children at Familial High Risk of Schizophrenia or Bipolar Disorder-The Danish High Risk and Resilience Study, VIA 11. Schizophr Bull 2022; 48:1363-1372. [PMID: 35849023 PMCID: PMC9673250 DOI: 10.1093/schbul/sbac060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The jumping to conclusions (JTC) bias, ie, making decisions based on inadequate evidence, is associated with psychosis in adults and is believed to underlie the formation of delusions. Knowledge on the early manifestations of JTC and its associations with psychotic experiences (PE) in children and adolescents is lacking. DESIGN Preadolescent children (mean age 11.9 y, SD 0.2) at familial high risk of schizophrenia (FHR-SZ, n = 169) or bipolar disorder (FHR-BP, n = 101), and controls (n = 173) were assessed with the Beads Task to examine JTC. The number of beads drawn before making a decision, "draws to decision" (DTD) was used as a primary outcome. PE were ascertained in face-to-face interviews. General intelligence was measured with Reynolds Intellectual Screening Test. RESULTS Children at FHR-SZ took fewer DTD than controls (4.9 vs 5.9, Cohen's d = 0.31, P = .004). Differences were attenuated when adjusting for IQ (Cohen's d = 0.24, P = .02). Higher IQ was associated with a higher number of DTD (B = 0.073, P < .001). Current subclinical delusions compared with no PE were associated with fewer DTD in children at FHR-SZ (P = .04) and controls (P < .05). Associations between delusions and DTD were nullified when accounting for IQ. CONCLUSIONS JTC marks familial risk of psychosis in preadolescence, not reducible to general intelligence. JTC is associated with subclinical delusions, but this may be an expression of intellectual impairment. Future studies should establish temporality between JTC and delusion formation and examine JTC as a target for early intervention.
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Affiliation(s)
- Maja Gregersen
- To whom correspondence should be addressed; CORE–Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Gentofte Hospitalsvej 15, 4th Floor, 2900 Hellerup, Denmark; tel: +45 23 41 21 62, e-mail:
| | - Sinnika Birkehøj Rohd
- CORE–Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark
| | - Jens Richardt Møllegaard Jepsen
- CORE–Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Julie Marie Brandt
- CORE–Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Søndergaard
- CORE–Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Carsten Hjorthøj
- CORE–Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Christina Bruun Knudsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Anna Krogh Andreassen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Lotte Veddum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Jessica Ohland
- CORE–Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark
| | - Martin Wilms
- CORE–Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark
| | - Mette Falkenberg Krantz
- CORE–Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Klee Burton
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Vibeke Bliksted
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Lars Clemmensen
- CORE–Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Merete Nordentoft
- CORE–Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Nicoline Hemager
- CORE–Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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10
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Henquet C, van Os J, Pries LK, Rauschenberg C, Delespaul P, Kenis G, Luykx JJ, Lin BD, Richards AL, Akdede B, Binbay T, Altınyazar V, Yalınçetin B, Gümüş-Akay G, Cihan B, Soygür H, Ulaş H, Cankurtaran ES, Kaymak SU, Mihaljevic MM, Petrovic SS, Mirjanic T, Bernardo M, Mezquida G, Amoretti S, Bobes J, Saiz PA, García-Portilla MP, Sanjuan J, Aguilar EJ, Santos JL, Jiménez-López E, Arrojo M, Carracedo A, López G, González-Peñas J, Parellada M, Maric NP, Atbaşoğlu C, Ucok A, Alptekin K, Saka MC, Arango C, O'Donovan M, Rutten BP, Gülöksüz S. A replication study of JTC bias, genetic liability for psychosis and delusional ideation. Psychol Med 2022; 52:1777-1783. [PMID: 33046166 PMCID: PMC9280279 DOI: 10.1017/s0033291720003578] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND This study attempted to replicate whether a bias in probabilistic reasoning, or 'jumping to conclusions'(JTC) bias is associated with being a sibling of a patient with schizophrenia spectrum disorder; and if so, whether this association is contingent on subthreshold delusional ideation. METHODS Data were derived from the EUGEI project, a 25-centre, 15-country effort to study psychosis spectrum disorder. The current analyses included 1261 patients with schizophrenia spectrum disorder, 1282 siblings of patients and 1525 healthy comparison subjects, recruited in Spain (five centres), Turkey (three centres) and Serbia (one centre). The beads task was used to assess JTC bias. Lifetime experience of delusional ideation and hallucinatory experiences was assessed using the Community Assessment of Psychic Experiences. General cognitive abilities were taken into account in the analyses. RESULTS JTC bias was positively associated not only with patient status but also with sibling status [adjusted relative risk (aRR) ratio : 4.23 CI 95% 3.46-5.17 for siblings and aRR: 5.07 CI 95% 4.13-6.23 for patients]. The association between JTC bias and sibling status was stronger in those with higher levels of delusional ideation (aRR interaction in siblings: 3.77 CI 95% 1.67-8.51, and in patients: 2.15 CI 95% 0.94-4.92). The association between JTC bias and sibling status was not stronger in those with higher levels of hallucinatory experiences. CONCLUSIONS These findings replicate earlier findings that JTC bias is associated with familial liability for psychosis and that this is contingent on the degree of delusional ideation but not hallucinations.
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Affiliation(s)
- Cécile Henquet
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, UK
| | - Lotta K. Pries
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Christian Rauschenberg
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Gunter Kenis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jurjen J. Luykx
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- GGNet Mental Health, Apeldoorn, The Netherlands
| | - Bochao D. Lin
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Alexander L. Richards
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Berna Akdede
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Tolga Binbay
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Vesile Altınyazar
- Department of Psychiatry, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Berna Yalınçetin
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Güvem Gümüş-Akay
- Department of Physiology, School of Medicine, Ankara University, Ankara, Turkey
- Brain Research Center, Ankara University, Ankara, Turkey
| | - Burçin Cihan
- Department of Psychology, Middle East Technical University, Ankara, Turkey
| | - Haldun Soygür
- Turkish Federation of Schizophrenia Associations, Ankara, Turkey
| | - Halis Ulaş
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey (Discharged by statutory degree No: 701 at 8th July of 2018, because of signing “Peace Petition”)
| | | | - Semra U. Kaymak
- Atatürk Research and Training Hospital Psychiatry Clinic, Ankara, Turkey
| | - Marina M. Mihaljevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Psychiatry CCS, Belgrade, Serbia
| | | | - Tijana Mirjanic
- Special Hospital for Psychiatric Disorders Kovin, Kovin, Serbia
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Julio Bobes
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- Mental Health Services of Principado de Asturias, Oviedo, Spain
| | - Pilar A. Saiz
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- Mental Health Services of Principado de Asturias, Oviedo, Spain
| | - Maria P. García-Portilla
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- Mental Health Services of Principado de Asturias, Oviedo, Spain
| | - Julio Sanjuan
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - Eduardo J. Aguilar
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - Jose L. Santos
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Psychiatry, Hospital Virgen de la Luz, Cuenca, Spain
| | - Estela Jiménez-López
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Instituto de Investigación Sanitaria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Angel Carracedo
- Grupo de Medicina Genómica, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) Universidad de Santiago de Compostela, Santiago de Compostela, Spain
- Fundación Publica Galega de Medicina Xenómica (SERGAS), IDIS, Santiago de Compostela, Spain
| | - Gonzalo López
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Javier González-Peñas
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Mara Parellada
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Nadja P. Maric
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | - Cem Atbaşoğlu
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Alp Ucok
- Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Köksal Alptekin
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Meram C. Saka
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Celso Arango
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Michael O'Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Bart P.F. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Sinan Gülöksüz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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11
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Fouladirad S, Chen LV, Roes M, Chinchani A, Percival C, Khangura J, Zahid H, Moscovitz A, Arreaza L, Wun C, Sanford N, Balzan R, Moritz S, Menon M, Woodward TS. Functional brain networks underlying probabilistic reasoning and delusions in schizophrenia. Psychiatry Res Neuroimaging 2022; 323:111472. [PMID: 35405574 DOI: 10.1016/j.pscychresns.2022.111472] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/20/2022] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
Abstract
Delusions in schizophrenia are false beliefs that are assigned certainty and not afforded the scrutiny that normally gives rise to doubt, even under conditions of weak evidence. The goal of the current functional magnetic resonance imaging (fMRI) study is to identify the brain network(s) involved in gathering information under conditions of weak evidence, in people with schizophrenia experiencing delusions. fMRI activity during probabilistic reasoning in people with schizophrenia experiencing delusions (n = 29) compared to people with schizophrenia not experiencing delusions (n = 41) and healthy controls (n = 41) was observed when participants made judgments based on evidence that weakly or strongly matched (or mismatched) with the focal hypothesis. A brain network involved in visual attention was strongly elicited for conditions of weak evidence for healthy controls and patients not experiencing delusions, but this increase was absent for patients experiencing delusions. This suggests that the state associated with delusions manifests in fMRI as reduced activity in an early visual attentional process whereby weak evidence is incorrectly stamped as conclusive, manifestating as a feeling of fluency and misplaced certainty, short-circuiting the search for evidence, and providing a candidate neural process for 'seeding' delusions.
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Affiliation(s)
- Saman Fouladirad
- BC Mental Health and Substance Use Services, Vancouver, BC, Canada; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Linda V Chen
- BC Mental Health and Substance Use Services, Vancouver, BC, Canada; Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - Meighen Roes
- BC Mental Health and Substance Use Services, Vancouver, BC, Canada; Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Abhijit Chinchani
- BC Mental Health and Substance Use Services, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Chantal Percival
- BC Mental Health and Substance Use Services, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Jessica Khangura
- BC Mental Health and Substance Use Services, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Hafsa Zahid
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Aly Moscovitz
- BC Mental Health and Substance Use Services, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Leonardo Arreaza
- BC Mental Health and Substance Use Services, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Charlotte Wun
- BC Mental Health and Substance Use Services, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Nicole Sanford
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Ryan Balzan
- College of Education, Psychology & Social Work, Flinders University, Adelaide, SA, Australia
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mahesh Menon
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Todd S Woodward
- BC Mental Health and Substance Use Services, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
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12
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Catalan A, Tognin S, Kempton MJ, Stahl D, Salazar de Pablo G, Nelson B, Pantelis C, Riecher-Rössler A, Bressan R, Barrantes-Vidal N, Krebs MO, Nordentoft M, Ruhrmann S, Sachs G, Rutten BPF, van Os J, de Haan L, van der Gaag M, Valmaggia LR, McGuire P. Relationship between jumping to conclusions and clinical outcomes in people at clinical high-risk for psychosis. Psychol Med 2022; 52:1569-1577. [PMID: 33019957 PMCID: PMC9226382 DOI: 10.1017/s0033291720003396] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/18/2020] [Accepted: 09/01/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Psychosis is associated with a reasoning bias, which manifests as a tendency to 'jump to conclusions'. We examined this bias in people at clinical high-risk for psychosis (CHR) and investigated its relationship with their clinical outcomes. METHODS In total, 303 CHR subjects and 57 healthy controls (HC) were included. Both groups were assessed at baseline, and after 1 and 2 years. A 'beads' task was used to assess reasoning bias. Symptoms and level of functioning were assessed using the Comprehensive Assessment of At-Risk Mental States scale (CAARMS) and the Global Assessment of Functioning (GAF), respectively. During follow up, 58 (16.1%) of the CHR group developed psychosis (CHR-T), and 245 did not (CHR-NT). Logistic regressions, multilevel mixed models, and Cox regression were used to analyse the relationship between reasoning bias and transition to psychosis and level of functioning, at each time point. RESULTS There was no association between reasoning bias at baseline and the subsequent onset of psychosis. However, when assessed after the transition to psychosis, CHR-T participants showed a greater tendency to jump to conclusions than CHR-NT and HC participants (55, 17, 17%; χ2 = 8.13, p = 0.012). There was a significant association between jumping to conclusions (JTC) at baseline and a reduced level of functioning at 2-year follow-up in the CHR group after adjusting for transition, gender, ethnicity, age, and IQ. CONCLUSIONS In CHR participants, JTC at baseline was associated with adverse functioning at the follow-up. Interventions designed to improve JTC could be beneficial in the CHR population.
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Affiliation(s)
- Ana Catalan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Deparment of Mental Health, Biocruces Bizkaia Health Research Institute. Basurto University Hospital. Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU. Plaza de Cruces 12. 48903, Barakaldo, Bizkaia, Spain
| | - Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Outreach and Support in South London (OASIS) service, South London and Maudsley NHS Foundation Trust, Likondon, UK
| | - Matthew J. Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK
| | - Daniel Stahl
- Department of Biostatistics and Health Informatics, King´s College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
| | - Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton South, Victoria, Australia
| | | | - Rodrigo Bressan
- Depto Psiquiatria, LiNC – Lab Integrative Neuroscience, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, Brazil
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver, Spanish Mental Health Research Network (CIBERSAM), Madrid, Spain
| | - Marie-Odile Krebs
- INSERM, IPNP UMR S1266, Laboratoire de Physiopathologie des Maladies Psychiatriques, Université de Paris, Institut de Psychiatrie (CNRS GDR 3557), Paris, France
- Faculté de Médecine Paris Descartes, GHU Paris – Sainte-Anne, Pôle Hospitalo Universitaire PEPIT C'JAAD, Paris, France
| | - Merete Nordentoft
- Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bart P. F. Rutten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Lieuwe de Haan
- Early Psychosis Department, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mark van der Gaag
- VU University, Faculty of Behavioural and Movement Sciences, Department of Clinical Psychology and Amsterdam Public Mental Health research institute, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | | | - Lucia R. Valmaggia
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Outreach and Support in South London (OASIS) service, South London and Maudsley NHS Foundation Trust, Likondon, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK
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13
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Greenburgh A, Raihani NJ. Paranoia and conspiracy thinking. Curr Opin Psychol 2022; 47:101362. [DOI: 10.1016/j.copsyc.2022.101362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
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14
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Cavieres A, Acuña V, Wachtendorff C, Maldonado R. People with schizophrenia use less information to interpret ambiguous social situations. J Behav Ther Exp Psychiatry 2022; 74:101690. [PMID: 34753052 DOI: 10.1016/j.jbtep.2021.101690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/11/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVES The tendency of people with schizophrenia to gather insufficient information before making decisions or jumping to conclusions has been repeatedly reported. However, criticism has also been expressed regarding the ecological validity of this finding. Here we present the results obtained by a group of people with schizophrenia and a control group in a non-probabilistic task that requires obtaining items of information before interpreting an ambiguous social situation. METHODS Patients with schizophrenia (n = 48) and controls (n = 44) aged 18-50 years participated in the study. All subjects completed the Beads Task and the modified Social Information Preference Task. RESULTS Patients with schizophrenia showed a statistically significant tendency to jump to conclusions, including in the proposed novel social task. Unlike other studies, we were unable to find a relationship between this bias and greater severity of psychotic symptoms. LIMITATIONS We did not include patients with high levels of psychotic symptoms or a clinical control group. CONCLUSIONS The tendency to jump to conclusions in schizophrenia could be present in everyday interpersonal situations.
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Affiliation(s)
- Alvaro Cavieres
- Departamento de Psiquiatría, Universidad de Valparaíso, Valparaíso, Chile.
| | - Vanessa Acuña
- Departamento de Psiquiatría, Universidad de Valparaíso, Valparaíso, Chile
| | | | - Rocío Maldonado
- Departamento de Psiquiatría, Universidad de Valparaíso, Valparaíso, Chile
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15
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Xenaki LA, Stefanatou P, Ralli E, Hatzimanolis A, Dimitrakopoulos S, Soldatos RF, Vlachos II, Selakovic M, Foteli S, Kosteletos I, Nianiakas N, Ntigridaki A, Triantafyllou TF, Voulgaraki M, Mantonakis L, Tsapas A, Bozikas VP, Kollias K, Stefanis NC. The relationship between early symptom severity, improvement and remission in first episode psychosis with jumping to conclusions. Schizophr Res 2022; 240:24-30. [PMID: 34915248 DOI: 10.1016/j.schres.2021.11.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/22/2021] [Accepted: 11/26/2021] [Indexed: 11/29/2022]
Abstract
It is suggested that Jumping To Conclusions (JTC) reasoning bias might contribute to the distortion of external reality. However, the association between psychotic manifestations and JTC is obscure, especially if general intelligence is considered as a mediator. The aim of this study is to investigate the relation between severity, early clinical improvement and remission of symptoms in First Episode Psychosis (FEP) with JTC as an explanatory factor. One hundred seventy-one FEP individuals were evaluated with the Positive and Negative Syndrome Scale (PANSS) at baseline and one month after treatment initiation. Clinical improvement was ascribed as symptom change one-month post-baseline measurements. Symptomatic remission was assessed with the Andreasen severity criteria and JTC with the Beads Task, operationalized through Draws To Decision (DTD) (the lower the number of DTD, the higher the JTC bias). Regarding symptoms severity, total psychotic, total positive psychotic, and hallucinations-item PANSS scores showed a negative association with JTC after controlling for IQ. Regarding early clinical improvement, the association with JTC was non-significant. No significant association was detected between one month remission status of FEP and JTC. Our findings indicate that severity of positive symptoms is not associated with hastiness in decision-making, but rather with a heightened conservatism in terms of increased data gathering. Further research is required to replicate the results and clarify the cognitive processes involved.
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Affiliation(s)
- Lida Alkisti Xenaki
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece.
| | - Pentagiotissa Stefanatou
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Eirini Ralli
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Alex Hatzimanolis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Stefanos Dimitrakopoulos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece; Psychiatric Clinic, 414 Military Hospital of Athens, Palea Penteli, Greece
| | - Rigas Filippos Soldatos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Ilias I Vlachos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Mirjana Selakovic
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Stefania Foteli
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Ioannis Kosteletos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Nikos Nianiakas
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Aggeliki Ntigridaki
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | | | - Marina Voulgaraki
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Leonidas Mantonakis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Apostolos Tsapas
- 2nd Medical Clinic, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Vasilios P Bozikas
- 2nd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Konstantinos Kollias
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Nikos C Stefanis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
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16
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Zander-Schellenberg T, Kuhn SAK, Möller J, Meyer AH, Huber C, Lieb R, Andreou C. Is intuition allied with jumping to conclusions in decision-making? An intensive longitudinal study in patients with delusions and in non-clinical individuals. PLoS One 2021; 16:e0261296. [PMID: 34928987 PMCID: PMC8687575 DOI: 10.1371/journal.pone.0261296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 11/29/2021] [Indexed: 11/18/2022] Open
Abstract
Research suggests that a jumping-to-conclusions (JTC) bias, excessive intuition, and reduced analysis in information processing may favor suboptimal decision-making, both in non-clinical and mentally disordered individuals. The temporal relationship between processing modes and JTC bias, however, remains unexplored. Therefore, using an experience sampling methodology (ESM) approach, this study examines the temporal associations between intuitive/analytical information processing, JTC bias, and delusions in non-clinical individuals and patients with schizophrenia. Specifically, we examine whether a high use of intuitive and/or a low use of analytical processing predicts subsequent JTC bias and paranoid conviction. In a smartphone-based ESM study, participants will be prompted four times per day over three consecutive days to answer questionnaires designed to measure JTC bias, paranoid conviction, and preceding everyday-life intuition/analysis. Our hierarchical data will be analyzed using multilevel modelling for hypothesis testing. Results will further elucidate the role of aberrant human reasoning, particularly intuition, in (non-)clinical delusions and delusion-like experiences, and also inform general information processing models.
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Affiliation(s)
- Thea Zander-Schellenberg
- Faculty of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Sarah A. K. Kuhn
- Faculty of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Julian Möller
- Faculty of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
- Psychiatric University Hospital (UPK), University of Basel, Basel, Switzerland
| | - Andrea H. Meyer
- Faculty of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Christian Huber
- Psychiatric University Hospital (UPK), University of Basel, Basel, Switzerland
| | - Roselind Lieb
- Faculty of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Christina Andreou
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, University of Luebeck, Luebeck, Germany
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17
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Tripoli G, Quattrone D, Ferraro L, Gayer-Anderson C, Rodriguez V, La Cascia C, La Barbera D, Sartorio C, Seminerio F, Tarricone I, Berardi D, Szöke A, Arango C, Tortelli A, Llorca PM, de Haan L, Velthorst E, Bobes J, Bernardo M, Sanjuán J, Santos JL, Arrojo M, Del-Ben CM, Menezes PR, Selten JP, Jones PB, Jongsma HE, Kirkbride JB, Lasalvia A, Tosato S, Richards A, O’Donovan M, Rutten BPF, van Os J, Morgan C, Sham PC, Murray RM, Murray GK, Di Forti M. Jumping to conclusions, general intelligence, and psychosis liability: findings from the multi-centre EU-GEI case-control study. Psychol Med 2021; 51:623-633. [PMID: 32327005 PMCID: PMC8020493 DOI: 10.1017/s003329171900357x] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 10/07/2019] [Accepted: 11/21/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The 'jumping to conclusions' (JTC) bias is associated with both psychosis and general cognition but their relationship is unclear. In this study, we set out to clarify the relationship between the JTC bias, IQ, psychosis and polygenic liability to schizophrenia and IQ. METHODS A total of 817 first episode psychosis patients and 1294 population-based controls completed assessments of general intelligence (IQ), and JTC, and provided blood or saliva samples from which we extracted DNA and computed polygenic risk scores for IQ and schizophrenia. RESULTS The estimated proportion of the total effect of case/control differences on JTC mediated by IQ was 79%. Schizophrenia polygenic risk score was non-significantly associated with a higher number of beads drawn (B = 0.47, 95% CI -0.21 to 1.16, p = 0.17); whereas IQ PRS (B = 0.51, 95% CI 0.25-0.76, p < 0.001) significantly predicted the number of beads drawn, and was thus associated with reduced JTC bias. The JTC was more strongly associated with the higher level of psychotic-like experiences (PLEs) in controls, including after controlling for IQ (B = -1.7, 95% CI -2.8 to -0.5, p = 0.006), but did not relate to delusions in patients. CONCLUSIONS Our findings suggest that the JTC reasoning bias in psychosis might not be a specific cognitive deficit but rather a manifestation or consequence, of general cognitive impairment. Whereas, in the general population, the JTC bias is related to PLEs, independent of IQ. The work has the potential to inform interventions targeting cognitive biases in early psychosis.
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Affiliation(s)
- Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, LondonSE5 8AF, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Laura Ferraro
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - Caterina La Cascia
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Daniele La Barbera
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Crocettarachele Sartorio
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Fabio Seminerio
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126Bologna, Italy
| | - Domenico Berardi
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126Bologna, Italy
| | - Andrei Szöke
- INSERM, U955, Equipe 15, 51 Avenue de Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM (CIBERSAM), C/Doctor Esquerdo 46, 28007Madrid, Spain
| | - Andrea Tortelli
- Etablissement Public de Santé Maison Blanche, Paris75020, France
| | | | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZAmsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZAmsterdam, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/Julián Clavería s/n, 33006Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/Avda. Blasco Ibáñez 15, 46010Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz”, C/Hermandad de Donantes de Sangre, 16002Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, Sandifortdreef 19, 2333 ZZLeiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MDMaastricht, The Netherlands
| | | | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, UK
| | - Hannah E Jongsma
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road London, W1T 7NF, UK
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road London, W1T 7NF, UK
| | - Antonio Lasalvia
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Alex Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Michael O’Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Bart PF Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MDMaastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MDMaastricht, The Netherlands
- Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - Pak C Sham
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, LondonSE5 8AF, UK
- Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, LondonSE5 8AF, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
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18
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Corral L, Labad J, Ochoa S, Cabezas A, Muntané G, Valero J, Sanchez-Gistau V, Ahuir M, Gallardo-Pujol D, Crosas JM, Palao D, Vilella E, Gutierrez-Zotes A. Cognitive Biases Questionnaire for Psychosis (CBQp): Spanish Validation and Relationship With Cognitive Insight in Psychotic Patients. Front Psychiatry 2021; 11:596625. [PMID: 33679460 PMCID: PMC7935547 DOI: 10.3389/fpsyt.2020.596625] [Citation(s) in RCA: 3] [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: 08/19/2020] [Accepted: 12/28/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction: Cognitive biases are key factors in the development and persistence of delusions in psychosis. The Cognitive Biases Questionnaire for Psychosis (CBQp) is a new self-reported questionnaire of 30 relevant situations to evaluate five types of cognitive biases in psychosis. In the context of the validation of the Spanish version of the CBQp, our objectives were to (1) analyze the factorial structure of the questionnaire with a confirmatory factor analysis (CFA), (2) relate cognitive biases with a widely used scale in the field of delusion cognitive therapies for assessing metacognition, specifically, Beck's Cognitive Insight Scale (BCIS) (1), and, finally, (3) associate cognitive biases with delusional experiences, evaluated with the Peters Delusions Inventory (PDI) (2). Materials and Methods: An authorized Spanish version of the CBQp, by a translation and back-translation procedure, was obtained. A sample of 171 patients with different diagnoses of psychoses was included. A CFA was used to test three different construct models. Associations between CBQp biases, the BCIS, and the PDI were made by correlation and mean differences. Comparisons of the CBQp scores between a control group and patients with psychosis were analyzed. Results: The CFA showed comparative fit index (CFI) values of 0.94 and 0.95 for the models with one, two, and five factors, with root mean square error of approximation values of 0.031 and 0.029. The CBQp reliability was 0.87. Associations between cognitive biases, self-certainty, and cognitive insight subscales of the BCIS were found. Similarly, associations between total punctuation, conviction, distress, and concern subscales of the PDI were also found. When compared with the group of healthy subjects, patients with psychoses scored significantly higher in several cognitive biases. Conclusion: Given the correlation between biases, a one-factor model might be more appropriate to explain the scale's underlying construct. Biases were associated with a greater frequency of delusions, distress, conviction, and concern as well as worse cognitive insight in patients with psychosis.
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Affiliation(s)
- Lia Corral
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
| | - Javier Labad
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Instituto de Investigación e Innovación Parc Taulí (I3PT), Barcelona, Spain
| | - Susana Ochoa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Sant Joan de Déu Research Institute (IRSJD), Esplugues de Llobregat, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Angel Cabezas
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
| | - Gerard Muntané
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
| | - Joaquín Valero
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
| | - Vanessa Sanchez-Gistau
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
| | - Maribel Ahuir
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigación e Innovación Parc Taulí (I3PT), Barcelona, Spain
| | - David Gallardo-Pujol
- Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Josep María Crosas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Instituto de Investigación e Innovación Parc Taulí (I3PT), Barcelona, Spain
| | - Diego Palao
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Instituto de Investigación e Innovación Parc Taulí (I3PT), Barcelona, Spain
| | - Elisabet Vilella
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
| | - Alfonso Gutierrez-Zotes
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
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19
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Pytlik N, Soll D, Hesse K, Moritz S, Bechdolf A, Herrlich J, Kircher T, Klingberg S, Landsberg MW, Müller BW, Wiedemann G, Wittorf A, Wölwer W, Wagner M, Mehl S. Problems in measuring the JTC-bias in patients with psychotic disorders with the fish task: a secondary analysis of a baseline assessment of a randomized controlled trial. BMC Psychiatry 2020; 20:554. [PMID: 33228583 PMCID: PMC7685639 DOI: 10.1186/s12888-020-02959-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 11/16/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The jumping to conclusions bias (JTC) is considered to be an important causal factor in theoretical models for the formation and maintenance of delusions. However, recent meta-analytic findings show a rather equivocal pattern of results regarding associations between JTC and delusions. Thus, the present study aims to investigate in a large sample whether the JTC-bias is more pronounced in patients with psychotic disorders in comparison to controls and whether the JTC bias is associated with a more severe delusional conviction, persecutory delusions, and positive symptoms in general. METHODS Patients with psychotic disorders (n = 300) enrolled in a therapy trial and healthy controls (n = 51) conducted a variant of the beads task (fish task) as a measure for the JTC-bias at the start of the trial. Further, clinical interviews were used to assess patients' delusional severity and delusional conviction. RESULTS There were no statistically significant differences between patients with psychotic disorders (with 53% displaying the JTC-bias) and controls (41%). Furthermore, there were no statistically significant correlations between JTC measures and persecutory delusions, delusional conviction, and positive symptoms. CONCLUSIONS We found no differences in JTC between patients with psychotic disorders and healthy controls, which is in part in line with meta-analytic findings using a wide range of JTC task variants. Interestingly, patients with psychotic disorders displayed JTC rates commonly found in the literature, while healthy control subjects showed an unexpectedly high level of JTC. The task variant we used in the present study (fish task) is discussed as a potential reason for our results, as it may induce a more deliberative reasoning style in controls as compared to the traditional beads task. Furthermore, possible implications for the measurement of the JTC-bias, in general, are discussed. TRIAL REGISTRATION ISRCTN29242879 ( isrctn.com ), date of registration: April 12th 2006, retrospectively registered.
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Affiliation(s)
- Nico Pytlik
- Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior (MCMBB), Philipps-University, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany.
| | - Daniel Soll
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior (MCMBB), Philipps-University, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Klaus Hesse
- grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Steffen Moritz
- grid.9026.d0000 0001 2287 2617Department of Psychiatry and Psychotherapy, University of Hamburg, Hamburg, Germany
| | - Andreas Bechdolf
- grid.6190.e0000 0000 8580 3777Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany ,grid.433867.d0000 0004 0476 8412Department of Psychiatry and Psychotherapy, Vivantes Klinikum am Urban - Teaching Hospital Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jutta Herrlich
- grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatics and Psychotherapy, University of Frankfurt, Frankfurt, Germany
| | - Tilo Kircher
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior (MCMBB), Philipps-University, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Stefan Klingberg
- grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Martin W. Landsberg
- grid.10388.320000 0001 2240 3300Department of Psychiatry and Psychotherapy, Friedrich-Wilhelms University of Bonn, Bonn, Germany
| | - Bernhard W. Müller
- grid.5718.b0000 0001 2187 5445Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Georg Wiedemann
- Departmenf of Psychiatry and Psychotherapy, Hospital Fulda, Fulda, Germany
| | - Andreas Wittorf
- grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Wolfgang Wölwer
- grid.411327.20000 0001 2176 9917Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
| | - Michael Wagner
- grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatics and Psychotherapy, University of Frankfurt, Frankfurt, Germany
| | - Stephanie Mehl
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior (MCMBB), Philipps-University, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany ,grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatics and Psychotherapy, University of Frankfurt, Frankfurt, Germany
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Balzan R, Delfabbro P, Galletly C. Delusion‐proneness or miscomprehension? A re‐examination of the jumping‐to‐conclusions bias. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/j.1742-9536.2011.00032.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - Cherrie Galletly
- Discipline of Psychiatry, The University of Adelaide, Adelaide, South Australia, Australia
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21
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van Os J, Pries LK, Delespaul P, Kenis G, Luykx JJ, Lin BD, Richards AL, Akdede B, Binbay T, Altınyazar V, Yalınçetin B, Gümüş-Akay G, Cihan B, Soygür H, Ulaş H, Cankurtaran EŞ, Kaymak SU, Mihaljevic MM, Petrovic SA, Mirjanic T, Bernardo M, Cabrera B, Bobes J, Saiz PA, García-Portilla MP, Sanjuan J, Aguilar EJ, Santos JL, Jiménez-López E, Arrojo M, Carracedo A, López G, González-Peñas J, Parellada M, Maric NP, Atbaşoğlu C, Ucok A, Alptekin K, Saka MC, Arango C, O'Donovan M, Rutten BPF, Guloksuz S. Replicated evidence that endophenotypic expression of schizophrenia polygenic risk is greater in healthy siblings of patients compared to controls, suggesting gene-environment interaction. The EUGEI study. Psychol Med 2020; 50:1884-1897. [PMID: 31414981 DOI: 10.1017/s003329171900196x] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND First-degree relatives of patients with psychotic disorder have higher levels of polygenic risk (PRS) for schizophrenia and higher levels of intermediate phenotypes. METHODS We conducted, using two different samples for discovery (n = 336 controls and 649 siblings of patients with psychotic disorder) and replication (n = 1208 controls and 1106 siblings), an analysis of association between PRS on the one hand and psychopathological and cognitive intermediate phenotypes of schizophrenia on the other in a sample at average genetic risk (healthy controls) and a sample at higher than average risk (healthy siblings of patients). Two subthreshold psychosis phenotypes, as well as a standardised measure of cognitive ability, based on a short version of the WAIS-III short form, were used. In addition, a measure of jumping to conclusion bias (replication sample only) was tested for association with PRS. RESULTS In both discovery and replication sample, evidence for an association between PRS and subthreshold psychosis phenotypes was observed in the relatives of patients, whereas in the controls no association was observed. Jumping to conclusion bias was similarly only associated with PRS in the sibling group. Cognitive ability was weakly negatively and non-significantly associated with PRS in both the sibling and the control group. CONCLUSIONS The degree of endophenotypic expression of schizophrenia polygenic risk depends on having a sibling with psychotic disorder, suggestive of underlying gene-environment interaction. Cognitive biases may better index genetic risk of disorder than traditional measures of neurocognition, which instead may reflect the population distribution of cognitive ability impacting the prognosis of psychotic disorder.
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Affiliation(s)
- Jim van Os
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, King's Health Partners, London, UK
| | - Lotta-Katrin Pries
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Gunter Kenis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jurjen J Luykx
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Bochao D Lin
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Alexander L Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, UK
| | - Berna Akdede
- Department of Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Tolga Binbay
- Department of Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Vesile Altınyazar
- Department of Psychiatry, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Berna Yalınçetin
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | | | - Burçin Cihan
- Department of Psychology, Middle East Technical University, Çankaya, Ankara, Turkey
| | - Haldun Soygür
- Department of Psychiatry, School of Medicine, Dokuz Eylül University (discharged by decree 701 on July 8, 2018 because of signing "Peace Petition")
| | - Halis Ulaş
- Department of Psychiatry, School of Medicine, Dokuz Eylül University (discharged by decree 701 on July 8, 2018 because of signing "Peace Petition")
| | | | | | - Marina M Mihaljevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Psychiatry CCS, Belgrade, Serbia
| | | | - Tijana Mirjanic
- Special Hospital for Psychiatric Disorders Kovin, Kovin, Serbia
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - Julio Bobes
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain
- Mental Health Services of Principado de Asturias, SESPA, Oviedo, Spain
| | - Pilar A Saiz
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain
- Mental Health Services of Principado de Asturias, SESPA, Oviedo, Spain
| | - María Paz García-Portilla
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain
- Mental Health Services of Principado de Asturias, SESPA, Oviedo, Spain
| | - Julio Sanjuan
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, INCLIVA, Valencia, Spain
| | - Eduardo J Aguilar
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, INCLIVA, Valencia, Spain
| | - José Luis Santos
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Virgen de la Luz, Cuenca, Spain
| | - Estela Jiménez-López
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Instituto de Investigación Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela, SERGAS, Santiago de Compostela, Spain
| | - Angel Carracedo
- Fundación Publica Galega de Medicina Xenómica, Hospital Clínico Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Gonzalo López
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Javier González-Peñas
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Mara Parellada
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Nadja P Maric
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Psychiatry CCS, Belgrade, Serbia
| | - Cem Atbaşoğlu
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Alp Ucok
- Department of Psychiatry, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Köksal Alptekin
- Department of Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Meram Can Saka
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Celso Arango
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Michael O'Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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22
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Misattributing speech and jumping to conclusions: A longitudinal study in people at high risk of psychosis. Eur Psychiatry 2020; 30:32-7. [DOI: 10.1016/j.eurpsy.2014.09.416] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/29/2014] [Accepted: 09/30/2014] [Indexed: 11/18/2022] Open
Abstract
AbstractBiases in cognition such as Jumping to Conclusions (JTC) and Verbal Self-Monitoring (VSM) are thought to underlie the formation of psychotic symptoms. This prospective study in people with an At Risk Mental State (ARMS) for psychosis examined how these cognitive biases changed over time, and predicted clinical and functional outcomes. Twenty-three participants were assessed at clinical presentation and a mean of 31 months later. Performance on a JTC and VSM tasks were measured at both time points. Relationships to symptom severity, level of function and the incidence of psychotic disorder were then examined. The levels of symptoms, function and VSM all improved over time, while JTC was stable. Five participants (22%) developed a psychotic disorder during the follow-up period, but the risk of transition was not related to performance on either task at baseline, or to longitudinal changes in task performance. JTC performance correlated with symptom severity at baseline and follow-up. Similarly, performance on the two tasks was not related to the level of functioning at follow-up. Thus, while the ARMS is associated with both VSM and JTC biases, neither predict the onset of psychosis or the overall functional outcome.
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Delusional ideation, manic symptomatology and working memory in a cohort at clinical high-risk for psychosis: A longitudinal study. Eur Psychiatry 2020; 27:258-63. [DOI: 10.1016/j.eurpsy.2010.07.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 05/24/2010] [Accepted: 07/01/2010] [Indexed: 11/22/2022] Open
Abstract
AbstractWe followed up a cohort (n = 35) of clients with an “At Risk Mental State” (ARMS) for almost 2 years (mean 21.3 months). At baseline, these clients had taken part in research looking at the relationship between reasoning biases, memory, personality styles and delusional ideation. During the follow-up period, clients underwent a package of intervention from a specialist early detection team. Eighty percent (n = 28) of these clients were successfully re-interviewed. There was improvement across the cohort as a whole, however five participants (17.9%) had made the transition to psychosis at follow-up. Those who had become psychotic had lower levels of manic symptomatology at baseline than those who did not enter the first episode. Further, across the cohort, impaired working memory and delusional ideation at baseline combined to predict 45% of the delusional ideation at follow-up. These preliminary findings suggest that working memory impairments may be linked to the persistence of delusional ideation and that manic symptoms in someone with an ARMS may suggest that such an individual is less likely to develop a frank psychotic episode.
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Seiler N, Nguyen T, Yung A, O'Donoghue B. Terminology and assessment tools of psychosis: A systematic narrative review. Psychiatry Clin Neurosci 2020; 74:226-246. [PMID: 31846133 DOI: 10.1111/pcn.12966] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 12/05/2019] [Indexed: 12/20/2022]
Abstract
AIM Phenomena within the psychosis continuum that varies in frequency/duration/intensity have been increasingly identified. Different terms describe these phenomena, however there is no standardization within the terminology. This review evaluated the definitions and assessment tools of seven terms - (i) 'psychotic experiences'; (ii) 'psychotic-like experiences'; (iii) 'psychotic-like symptoms'; (iv) 'attenuated psychotic symptoms'; (v) 'prodromal psychotic symptoms'; (vi) 'psychotic symptomatology'; and (vii) 'psychotic symptoms'. METHODS EMBASE, MEDLINE, and CINAHL were searched during February-March 2019. Inclusion criteria included 1989-2019, full text, human, and English. Papers with no explicit definition or assessment tool, duplicates, conference abstracts, systematic reviews, meta-analyses, or no access were excluded. RESULTS A total of 2238 papers were identified and of these, 627 were included. Definitions and assessment tools varied, but some trends were found. Psychotic experiences and psychotic-like experiences were transient and mild, found in the general population and those at-risk. Psychotic-like symptoms were subthreshold and among at-risk populations and non-psychotic mental disorders. Attenuated psychotic symptoms were subthreshold but associated with distress, risk, and help-seeking. Prodromal psychotic symptoms referred to the prodrome of psychotic disorders. Psychotic symptomatology included delusions and hallucinations within psychotic disorders. Psychotic symptoms was the broadest term, encompassing a range of populations but most commonly involving hallucinations, delusions, thought disorder, and disorganization. DISCUSSION A model for conceptualizing the required terms is proposed and future directions needed to advance this field of research are discussed.
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Affiliation(s)
- Natalie Seiler
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,The University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Tony Nguyen
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,The University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Alison Yung
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Brian O'Donoghue
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
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25
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Di Plinio S, Arnò S, Perrucci MG, Ebisch SJH. The evolving sense of agency: Context recency and quality modulate the interaction between prospective and retrospective processes. Conscious Cogn 2020; 80:102903. [PMID: 32145388 DOI: 10.1016/j.concog.2020.102903] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 02/18/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022]
Abstract
Humans acquire a sense of agency through their interactions with the world and their sensory consequences. Previous studies have highlighted stable agency-related phenomena like intentional binding, which depend on both prospective, context-dependent and retrospective, outcome-dependent processes. In the current study, we investigated the interaction between prospective and retrospective processes underlying the adaptation of an ongoing sense of agency. The results showed that prospective intentional binding developed during a temporal window of up to 20 prior events was independent of the nature of the ongoing event. By contrast, the characteristics of the ongoing event retrospectively influenced prospective intentional binding developed during a temporal window narrower than 6 prior events. These findings characterize the interaction between prospective and retrospective mechanisms as a fundamental process to continuously update the sense of agency through sensorimotor learning. High psychosis-like experience traits weakened this interaction, suggesting that reduced adaption to the context contributes to altered self-experience.
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Affiliation(s)
- Simone Di Plinio
- Department of Neuroscience Imaging and Clinical Sciences, G. D'Annunzio University of Chieti-Pescara, Chieti 66100, Italy.
| | - Simone Arnò
- Department of Psychological Sciences, G d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Mauro Gianni Perrucci
- Department of Neuroscience Imaging and Clinical Sciences, G. D'Annunzio University of Chieti-Pescara, Chieti 66100, Italy; Institute for Advanced Biomedical Technologies (ITAB), G d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Sjoerd J H Ebisch
- Department of Neuroscience Imaging and Clinical Sciences, G. D'Annunzio University of Chieti-Pescara, Chieti 66100, Italy; Institute for Advanced Biomedical Technologies (ITAB), G d'Annunzio University of Chieti-Pescara, Chieti, Italy
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26
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Le TP, Fedechko TL, Cohen AS, Allred S, Pham C, Lewis S, Barkus E. Stress and cognitive biases in schizotypy: A two-site study of bias
against disconfirmatory evidence and jumping to conclusions. Eur Psychiatry 2020; 62:20-27. [DOI: 10.1016/j.eurpsy.2019.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/17/2019] [Accepted: 08/26/2019] [Indexed: 12/29/2022] Open
Abstract
Abstract
The dysfunctional cognitive and reasoning biases which underpin
psychotic symptoms are likely to present prior to the onset of a diagnosable
disorder and should therefore be detectable along the psychosis continuum in
individuals with schizotypal traits. Two reasoning biases, Bias Against
Disconfirmatory Evidence (BADE) and Jumping to Conclusions (JTC), describe
how information is selected and weighed under conditions of uncertainty
during decision making. It is likely that states such as elevated stress
exacerbates JTC and BADE in individuals with high schizotypal traits
vulnerable to displaying these information gathering styles. Therefore, we
evaluated whether stress and schizotypy interacted to predict these
reasoning biases using separate samples from the US (JTC) and England
(BADE). Generally speaking, schizotypal traits and stress were not
independently associated with dysfunctional reasoning biases. However,
across both studies, the interaction between schizotypy traits and stress
significantly predicted reasoning biases such that increased stress was
associated with increased reasoning biases, but only for individuals low in
schizotypal traits. These patterns were observed for positive schizotypal
traits (in both samples), for negative traits (in the England sample only),
but not for disorganization traits. For both samples, our findings suggest
that the presence of states such as stress is associated with, though not
necessarily dysfunctional, reasoning biases in individuals with low
schizotypy. These reasoning biases seemed, in some ways, relatively
immutable to stress in individuals endorsing high levels of positive
schizotypal traits.
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Rodriguez V, Ajnakina O, Stilo SA, Mondelli V, Marques TR, Trotta A, Quattrone D, Gardner-Sood P, Colizzi M, Wiffen BD, Dazzan P, Di Forti M, Falcone MA, David AS, Murray RM. Jumping to conclusions at first onset of psychosis predicts longer admissions, more compulsory admissions and police involvement over the next 4 years: the GAP study. Psychol Med 2019; 49:2256-2266. [PMID: 30392491 DOI: 10.1017/s0033291718003197] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Jumping to conclusions (JTC), which is the proneness to require less information before forming beliefs or making a decision, has been related to formation and maintenance of delusions. Using data from the National Institute of Health Research Biomedical Research Centre Genetics and Psychosis (GAP) case-control study of first-episode psychosis (FEP), we set out to test whether the presence of JTC would predict poor clinical outcome at 4 years. METHODS One-hundred and twenty-three FEP patients were assessed with the Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF) and the probabilistic reasoning 'Beads' Task at the time of recruitment. The sample was split into two groups based on the presence of JTC bias. Follow-up data over an average of 4 years were obtained concerning clinical course and outcomes (remission, intervention of police, use of involuntary treatment - the Mental Health Act (MHA) - and inpatient days). RESULTS FEP who presented JTC at baseline were more likely during the follow-up period to be detained under the MHA [adjusted OR 15.62, 95% confidence interval (CI) 2.92-83.54, p = 0.001], require intervention by the police (adjusted OR 14.95, 95% CI 2.68-83.34, p = 0.002) and have longer admissions (adjusted IRR = 5.03, 95% CI 1.91-13.24, p = 0.001). These associations were not accounted for by socio-demographic variables, IQ and symptom dimensions. CONCLUSIONS JTC in FEP is associated with poorer outcome as indicated and defined by more compulsion police intervention and longer periods of admission. Our findings raise the question of whether the implementation of specific interventions to reduce JTC, such as Metacognition Training, may be a useful addition in early psychosis intervention programmes.
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Affiliation(s)
- Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Olesya Ajnakina
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Simona A Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tiago Reis Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Antonella Trotta
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Diego Quattrone
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Poonam Gardner-Sood
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marco Colizzi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Benjamin D Wiffen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marta Di Forti
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M Aurora Falcone
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anthony S David
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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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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Vicario-Feliciano R, Wigton RL, White TP, Shergill SS, Averbeck BB. Dopamine manipulations drive changes in information sampling in healthy volunteers. J Psychopharmacol 2019; 33:670-677. [PMID: 30644326 PMCID: PMC6996051 DOI: 10.1177/0269881118822080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Information sampling is the cognitive process of accumulating information before committing to a decision. Patients across numerous disorders show decreased information sampling relative to controls. AIMS Here, we used the Beads and the Best Choice Tasks to study the role of dopamine signaling in information sampling. METHODS Participants were given placebo, amisulpride, or ropinirole in each session, in a double-blind cross-over design. RESULTS We found that ropinirole (agonist) increased the number of beads drawn in the Beads Task specifically when participants faced a loss, and decreased the rank of the chosen option in the Best Choice Task. CONCLUSIONS These effects are likely driven by a combination of effects at presynaptic D2 receptors, which affect dopamine release, and post-synaptic D2 receptors. Increased D2 relative to D1 receptor activation in the striatum leads to increased sampling in the loss condition in the Beads Task. It also leads to choice of a poorer ranked option in the Best Choice Task. Decreased D2 relative to D1 receptor activation leads to decreased sampling in the Beads Task in the loss condition.
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Affiliation(s)
| | - Rebekah L Wigton
- Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Thomas P White
- Institute of Psychiatry, Psychology and Neuroscience, London, UK,School of Psychology, University of Birmingham, Birmingham, UK
| | - Sukhi S Shergill
- Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Bruno B Averbeck
- Laboratory of Neuropsychology, National Institutes of Health, MD, USA
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Krężołek M, Pionke R, Banaszak B, Kokoszka A, Gawęda Ł. The relationship between jumping to conclusions and neuropsychological functioning in schizophrenia. Psychiatry Res 2019; 273:443-449. [PMID: 30684790 DOI: 10.1016/j.psychres.2019.01.035] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 01/10/2019] [Accepted: 01/10/2019] [Indexed: 12/20/2022]
Abstract
Jumping to conclusions (JTC) is defined as a tendency to make decisions based on insufficient information. JTC has been reported in patients with psychosis, but the mechanisms of this cognitive bias remain unknown. The main aim of our study was to investigate the relationship between JTC and neuropsychological functioning in schizophrenia. A total of 85 schizophrenia patients were assessed with neuropsychological tests, including executive functions, verbal memory, working memory, processing speed and attention. JTC was assessed with the Fish Task (probability 80:20 and 60:40) and a self-report scale (The Davos Assessment of Cognitive Biases Scale, DACOBS). Symptom severity was assessed with the Positive and Negative Syndrome Scale (PANSS). The relationship between JTC and neuropsychological functioning was investigated with correlation and regression analyses. The regression analyses model, when controlling for duration of illness, age and symptoms, showed that verbal memory and working memory were specifically related to JTC measured by Fish Task 60:40. JTC measured using Fish Task 60:40 was correlated only with severity of symptoms of disorganization (PANSS). The results from the present study suggest that the relationship between decision making during the reasoning task and neuropsychological functioning is modulated by task demands.
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Affiliation(s)
- Martyna Krężołek
- Psychopathology and Early Intervention Lab, II Department of Psychiatry, Medical University of Warsaw, Poland.
| | - Renata Pionke
- Psychopathology and Early Intervention Lab, II Department of Psychiatry, Medical University of Warsaw, Poland
| | | | - Andrzej Kokoszka
- II Department of Psychiatry, Medical University of Warsaw, Poland
| | - Łukasz Gawęda
- Psychopathology and Early Intervention Lab, II Department of Psychiatry, Medical University of Warsaw, Poland.
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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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de Bézenac CE, Swindells RA, Corcoran R. The Necessity of Ambiguity in Self-Other Processing: A Psychosocial Perspective With Implications for Mental Health. Front Psychol 2018; 9:2114. [PMID: 30455657 PMCID: PMC6231079 DOI: 10.3389/fpsyg.2018.02114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/12/2018] [Indexed: 12/04/2022] Open
Abstract
While distinguishing between the actions and physical boundaries of self and other (non-self) is usually straightforward there are contexts in which such differentiation is challenging. For example, self-other ambiguity may occur when actions of others are similar or complementary to those of the self. Even in the absence of such situational challenges, individuals experiencing hallucinations have difficulties with this distinction, often experiencing thoughts or actions of self as belonging to other agents. This paper explores the role of ambiguity in self-other differentiation, drawing from developmental, psychodynamic, and neurocognitive perspectives. A key proposal is that engagement in contexts that make distinctions between self and other challenging yet necessary allow reality-testing skills related to agency to develop. Attunement in typical caregiver-infant interactions is framed as a safe but inherently ambiguous environment that provides optimal condition for the infant to develop a coherent self-other sense. Vulnerability to psychosis may be related to limited access to such an environment in early development. However, the perceptual, cognitive, and social skills that contribution to attribution are likely to be malleable following infancy and improve though opportunities for boundary play in similarly ambiguous settings. Using music-making to illustrate, we postulate that engagement in intricate joint-actions that blurs agentic boundaries can contribute to the continued development of an adaptive sense of self and other essential to healthy social functioning. Increased insight into the self-other ambiguity may enhance our understanding of mechanisms underlying "self-disorders" such as schizophrenia and eventually extend the range of social and arts-based therapeutic possibilities.
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Affiliation(s)
| | - Rachel Ann Swindells
- Research Institute for Health and Social Change, Manchester Metropolitan University, Manchester, United Kingdom
| | - Rhiannon Corcoran
- Institute of Psychology Health and Society, University of Liverpool, Liverpool, United Kingdom
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Beta-Blocker Propranolol Modulates Decision Urgency During Sequential Information Gathering. J Neurosci 2018; 38:7170-7178. [PMID: 30006361 PMCID: PMC6083454 DOI: 10.1523/jneurosci.0192-18.2018] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/03/2018] [Accepted: 05/11/2018] [Indexed: 01/05/2023] Open
Abstract
Arbitrating between timely choice and extended information gathering is critical for effective decision making. Aberrant information gathering behavior is thought to be a feature of psychiatric disorders such as schizophrenia and obsessive-compulsive disorder, but we know little about the underlying neurocognitive control mechanisms. In a double-blind, placebo-controlled drug study involving 60 healthy human subjects (30 female), we examined the effects of noradrenaline and dopamine antagonism on information gathering during performance of an information sampling task. We show that modulating noradrenaline function with 40 mg of the β-blocker propranolol leads to decreased information gathering behavior. Modulating dopamine function via a single dose of 400 mg of amisulpride revealed some effects that were intermediate between those of propranolol and placebo. Using a Bayesian computational model, we show that sampling behavior is best explained by inclusion of a nonlinear urgency signal that promotes commitment to an early decision. Noradrenaline blockade promotes the expression of this decision-related urgency signal during information gathering. We discuss the findings with respect to psychopathological conditions that are linked to aberrant information gathering.SIGNIFICANCE STATEMENT Knowing when to stop gathering information and commit to a choice option is nontrivial. This is an important element in arbitrating between information gain and energy conservation. In this double-blind, placebo-controlled drug study, we investigated the role of catecholamines noradrenaline and dopamine on sequential information gathering. We found that blockade of noradrenaline led to a decrease in information gathering. Dopamine blockade showed an intermediate, but nonsignificant, effect. Using a Bayesian computational model, we show that this noradrenaline effect is driven by increased decision urgency, a signal that reflects an escalating subjective cost of sampling. The observation that noradrenaline modulates decision urgency suggests new avenues for treating patients that show information gathering deficits.
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González LE, López-Carrilero R, Barrigón ML, Grasa E, Barajas A, Pousa E, González-Higueras F, Ruiz-Delgado I, Cid J, Lorente-Rovira E, Pélaez T, Ochoa S. Neuropsychological functioning and jumping to conclusions in recent onset psychosis patients. Schizophr Res 2018; 195:366-371. [PMID: 28969933 DOI: 10.1016/j.schres.2017.09.039] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/13/2017] [Accepted: 09/24/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The reasoning bias of jumping to conclusions (JTC) consists of a tendency to make assumptions having little information. OBJECTIVE The aim of this study was to estimate the differences in neuropsychological functioning between recent onset psychotic patients who jump to conclusions and those who do not jump to conclusions. MATERIALS AND METHODS One hundred and twenty-two patients with a recent onset of a psychotic disorder were assessed with three JTC tasks and a neuropsychological battery exploring verbal learning, memory, attention, psychomotor speed, visuoperceptual abilities, working memory, problem solving, executive functioning. RESULTS A total of 29.7% (n=36) of the individuals jumped to conclusions in Task 1, 14.0% (n=17) in Task 2, and 15.7% (n=19) in Task 3. People who jump to conclusions in three tasks scored significantly worse in many neuropsychological domain deficits, including attention (p<0.001-0.020), psychomotor speed (p<0.001), working memory (p<0.001-0.040), and executive functioning (p<0.001-0.042). DISCUSSION The present study demonstrates that JTC is present even in early stages of the illness, and that there is a relationship between JTC and neuropsychological functioning.
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Affiliation(s)
- Lucas Elio González
- Hospital de Emergencias Psiquiátricas 'Torcuato de Alvear', Ciudad Autónoma de Buenos Aires, Argentina; Centro Integral de Psicoterapias con Soporte Empítico (CIPSE), Ciudad Autónoma de Buenos Aires, Argentina; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Maria Luisa Barrigón
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain; Autonoma University, Madrid, Spain; Psychiatry Service, Area de Gestión Sanitaria Sur Granada, Motril, Granada, Spain
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Spain
| | - Ana Barajas
- Centre d'Higiene Mental Les Corts, Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Esther Pousa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Salut Mental Parc Taulí, Sabadell (Barcelona), Hospital Universitari - UAB Universitat Autònoma de Barcelona, Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - Isabel Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Malaga Norte, UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud Málaga, Spain
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
| | - Esther Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Psychiatry Service, Hospital Clínico Universitario de Valencia, Spain
| | - Trinidad Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | | | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
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Freeman D, Garety P. Helping patients with paranoid and suspicious thoughts: a cognitive–behavioural approach. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.12.6.404] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Paranoid and suspicious thoughts are a significant clinical topic. They regularly occur in 10–15% of the general population, and persecutory delusions are a frequent symptom of psychosis. In the past, patients were discouraged from talking about paranoid experiences. In contrast, it is now recommended that patients are given time to talk about them, and cognitive–behavioural techniques are being used to reduce distress. In this article we present the theoretical understanding of paranoia that underpins this transformation in the treatment of paranoid thoughts and summarise the therapeutic techniques derived. Emphasis is placed on the clinician approaching the problem from a perspective of understanding and making sense of paranoid experiences rather than simply challenging paranoid thoughts. Ways of overcoming difficulties in engaging people with paranoid thoughts are highlighted.
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Caravaggio F, Gerretsen P, Mar W, Chung JK, Plitman E, Nakajima S, Kim J, Iwata Y, Patel R, Chakravarty MM, Remington G, Graff-Guerrero A, Menon M. Intranasal oxytocin does not modulate jumping to conclusions in schizophrenia: Potential interactions with caudate volume and baseline social functioning. Psychoneuroendocrinology 2017; 81:80-87. [PMID: 28431278 DOI: 10.1016/j.psyneuen.2017.03.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/21/2017] [Accepted: 03/18/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Patients with schizophrenia (SCZ) tend to sample less information when making a decision, jumping to conclusions (JTC) without sufficient evidence. This "JTC bias" may be a trait marker of the disease and may not improve with antipsychotic treatment. We conducted a double-blind, placebo-controlled trial to test whether intranasal oxytocin could reduce JTC in stable, medicated patients with SCZ and healthy controls (HCs). We also explored whether striatal volume, clinical symptoms, and baseline social functioning (SF) was related to JTC performance. METHODS Forty-three male, medicated SCZ patients (Mean Age: 40.81±11.44) and sixteen HCs (Mean Age: 30.38±9.85) participated in a double-blind, placebo-controlled, cross-over study. Participants completed the Beads Task on two separate visits (minimum 20days apart). Participants were randomized to receive either intranasal oxytocin (50IU in solution) or intranasal placebo (saline). Twenty of the SCZ patients and all sixteen HCs also provided T1 MRIs (3-T). RESULTS Patients with SCZ took fewer draws to decision (DTD) than HCs (t(57)=2.78, p=0.007). Oxytocin did not significantly change DTD in patients (t(42)=-1.11, p=0.27), nor in HCs (t(15)=-0.62, p=0.55). Exploratory analyses found ventral caudate volumes were negatively correlated with DTD (r(18)=-0.50, p=0.03) in patients. Moreover, oxytocin was more likely to improve JTC in patients with lower baseline SF. However, these exploratory findings did not survive correction for multiple comparisons. CONCLUSIONS We replicate increased JTC in SCZ. However, acute intranasal oxytocin did not modify JTC. Future studies with larger samples should explore how brain morphology and SF are related to JTC performance in patients with SCZ.
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Affiliation(s)
- Fernando Caravaggio
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Philip Gerretsen
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada.
| | - Wanna Mar
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Jun Ku Chung
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Eric Plitman
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University, School of Medicine, Tokyo Japan
| | - Julia Kim
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Yusuke Iwata
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Raihaan Patel
- Department of Biological & Biomedical Engineering, McGill University, Montreal, Quebec, H4H 1R3, Canada; Cerebral Imaging Centre, Douglas Mental Health Institute, McGill University, Montreal, Quebec, H4H 1R3, Canada
| | - M Mallar Chakravarty
- Department of Psychiatry, McGill University, Montreal, Quebec, H4H 1R3, Canada; Department of Biological & Biomedical Engineering, McGill University, Montreal, Quebec, H4H 1R3, Canada; Cerebral Imaging Centre, Douglas Mental Health Institute, McGill University, Montreal, Quebec, H4H 1R3, Canada
| | - Gary Remington
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Ariel Graff-Guerrero
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Mahesh Menon
- Department of Psychiatry, University of British Columbia, Detwiller Pavilion, 2255 Wesbrook Mall, Vancouver, British Columbia, V6T 2A1, Canada
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Abstract
BACKGROUND The symptom "delusions" is a central psychopathological symptom in psychiatric diseases. Since the beginning of psychiatry various disciplines have attempted to explain and understand delusions but even now no generally accepted definition of this phenomenon exists. AIM A comprehensive review of current psychopathological and neurobiological theories of delusions is given. MATERIAL AND METHODS PubMed and Google scholar searches were performed using the keywords "delusion", "psychodynamic" and "neurobiology", both in English and German. Relevant German textbooks of psychiatry were also included. DISCUSSION A differentiated perspective of the phenomenon of delusions appears to be necessary to approach this complex and fascinating symptom. A one-dimensional approach does not do justice to the complexity of delusions. The various explanatory approaches can increasingly be linked to each other and are no longer considered to be mutually exclusive.
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Affiliation(s)
- R Knorr
- Klinik für Psychiatrie und Psychotherapie, Zentrum für Psychiatrie Reichenau, Feursteinstraße 55, 78479, Reichenau, Deutschland.
| | - K Hoffmann
- Klinik für Forensische Psychiatrie und Psychotherapie, Zentrum für Psychiatrie Reichenau, Feursteinstraße 55, 78479, Reichenau, Deutschland
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Stuke H, Stuke H, Weilnhammer VA, Schmack K. Psychotic Experiences and Overhasty Inferences Are Related to Maladaptive Learning. PLoS Comput Biol 2017; 13:e1005328. [PMID: 28107344 PMCID: PMC5249047 DOI: 10.1371/journal.pcbi.1005328] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/20/2016] [Indexed: 12/04/2022] Open
Abstract
Theoretical accounts suggest that an alteration in the brain’s learning mechanisms might lead to overhasty inferences, resulting in psychotic symptoms. Here, we sought to elucidate the suggested link between maladaptive learning and psychosis. Ninety-eight healthy individuals with varying degrees of delusional ideation and hallucinatory experiences performed a probabilistic reasoning task that allowed us to quantify overhasty inferences. Replicating previous results, we found a relationship between psychotic experiences and overhasty inferences during probabilistic reasoning. Computational modelling revealed that the behavioral data was best explained by a novel computational learning model that formalizes the adaptiveness of learning by a non-linear distortion of prediction error processing, where an increased non-linearity implies a growing resilience against learning from surprising and thus unreliable information (large prediction errors). Most importantly, a decreased adaptiveness of learning predicted delusional ideation and hallucinatory experiences. Our current findings provide a formal description of the computational mechanisms underlying overhasty inferences, thereby empirically substantiating theories that link psychosis to maladaptive learning. Predictive coding theories represent a unifying account of psychosis, stating that the central psychosis-related alteration affects the interplay between prior predictions and incoming information. Since every incoming information is imprecise and potentially allows for different interpretations, prior expectations achieve the enforcement of interpretations with a higher prior probability. Disturbances in this basic framework might let unlikely interpretations come into effect, resulting in proneness for delusions and hallucinations. Here, we contribute to these theories by devising a novel computational model for behavior in a reasoning task that quantifies the participants' readiness to draw inferences from very surprising information. We thereby demonstrate that precisely this increased learning from surprising and thus potentially spurious information, as opposed to non-specific alterations in the general learning speed, predispose healthy individuals for delusions and hallucinations. The present results hence speak for the hypothesis that hallucinations and delusions arise when noisy information is considered as precise and is thus not suppressed by opposing prior beliefs. In this sense, our findings also tie with recent neurophysiological models of psychosis that posit aberrations in modulatory neurotransmitters such as dopamine (or its interactions with GABAergic interneurons) as a correlate of perturbed computations of information precision in the cortex.
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Affiliation(s)
- Heiner Stuke
- Department of Psychiatry and Psychotherapy, Charité–Universitätsmedizin Berlin Berlin, Germany
- * E-mail:
| | - Hannes Stuke
- Department of Mathematics, Freie Universität Berlin, Berlin, Germany
| | | | - Katharina Schmack
- Department of Psychiatry and Psychotherapy, Charité–Universitätsmedizin Berlin Berlin, Germany
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Goulet-Kennedy J, Labbe S, Fecteau S. The involvement of the striatum in decision making. DIALOGUES IN CLINICAL NEUROSCIENCE 2017. [PMID: 27069380 PMCID: PMC4826771 DOI: 10.31887/dcns.2016.18.1/sfecteau] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Decision making has been extensively studied in the context of economics and from a group perspective, but still little is known on individual decision making. Here we discuss the different cognitive processes involved in decision making and its associated neural substrates. The putative conductors in decision making appear to be the prefrontal cortex and the striatum. Impaired decision-making skills in various clinical populations have been associated with activity in the prefrontal cortex and in the striatum. We highlight the importance of strengthening the degree of integration of both cognitive and neural substrates in order to further our understanding of decision-making skills. In terms of cognitive paradigms, there is a need to improve the ecological value of experimental tasks that assess decision making in various contexts and with rewards; this would help translate laboratory learnings into real-life benefits. In terms of neural substrates, the use of neuroimaging techniques helps characterize the neural networks associated with decision making; more recently, ways to modulate brain activity, such as in the prefrontal cortex and connected regions (eg, striatum), with noninvasive brain stimulation have also shed light on the neural and cognitive substrates of decision making. Together, these cognitive and neural approaches might be useful for patients with impaired decision-making skills. The drive behind this line of work is that decision-making abilities underlie important aspects of wellness, health, security, and financial and social choices in our daily lives.
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Affiliation(s)
- Julie Goulet-Kennedy
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale. Centre de recherche de l'Institut universitaire en santé mentale de Québec; Faculté de médecine, Université Laval, Québec, Canada
| | - Sara Labbe
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale. Centre de recherche de l'Institut universitaire en santé mentale de Québec; Faculté de médecine, Université Laval, Québec, Canada
| | - Shirley Fecteau
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale. Centre de recherche de l'Institut universitaire en santé mentale de Québec; Faculté de médecine, Université Laval, Québec, Canada
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Welter S, Lücke C, Lam AP, Custal C, Moeller S, Sörös P, Thiel CM, Philipsen A, Müller HHO. Synthetic Cannabinoid Use in a Psychiatric Patient Population: A Pilot Study. Eur Addict Res 2017; 23:182-193. [PMID: 28848170 DOI: 10.1159/000479554] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/16/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Consumption of natural cannabis (NC) and synthetic cannabinoids (SCs) has been associated with psychotic disorders. We compared the prevalence of use, consumer profiles, and psychosis-inducing potential of NC and SCs in a specific high-risk population. METHODS This prospective pilot study included 332 patients (18-64 years, mean 36.83, SD 13.33). Patients' sociodemographics and medical histories as well as illicit substance use and psychiatric symptom histories were collected using a drug consumption survey that assessed the use of new psychoactive substances and the Psychotic Symptoms Interview. RESULTS In total, 7.2% of all patients, 10.6% of psychotic patients, and 4.5% of nonpsychotic patients reported SC consumption. Compared with SCs, NC was consumed much more frequently by its users (mean 222.73, SD 498.27). NC and SC use induced persistent psychosis. Psychotic symptoms were first experienced by patients with a history of NC or SC use during intoxication and persisted after cessation (>1 year) of drug use. Positive and negative symptoms tended to be more severe in SC and NC users, respectively. CONCLUSIONS NC and SCs may cause different symptom clusters. These relationships should be further evaluated.
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Affiliation(s)
- Stella Welter
- Department of Biological Psychology, Carl von Ossietzky University of Oldenburg, Faculty of Medicine and Health Sciences, Karl-Jaspers-Klinik, Bad Zwischenahn, Germany
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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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Batty RA, Francis A, Thomas N, Hopwood M, Ponsford J, Rossell SL. Who "jumps to conclusions"? A comprehensive assessment of probabilistic reasoning in psychosis following traumatic brain injury (PFTBI), and comparison with TBI, schizophrenia, and nonclinical controls. Cogn Neuropsychiatry 2016; 21:32-44. [PMID: 27031119 DOI: 10.1080/13546805.2015.1127221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The "jumping to conclusions" (JTC) bias has received significant attention in the schizophrenia and delusion literature as an important aspect of cognition characterising psychosis. The JTC bias has not been explored in psychosis following traumatic brain injury (PFTBI). METHODS JTC was investigated in 10 patients with PFTBI using the beads task (ratios 85:15 and 60:40). Probabilistic predictions, draws-to-decision, self-rated decision confidence, and JTC bias were recorded. Responses from 10 patients with traumatic brain injury (TBI), 23 patients with schizophrenia, and 23 nonclinical controls were compared. Relationships were explored between draws-to-decision and current intelligence quotient, affective state, executive function, delusions (severity and type), and illness chronicity (duration). RESULTS Groups were comparable on JTC measures. Delusion severity and type were not related to draws-to-decision for either trial. In the entire sample, executive function (reduced mental flexibility) was significantly related to more draws-to-decision on the 60:40 ratio trial. CONCLUSIONS We found no evidence for an elevated JTC bias in patients with PFTBI or TBI alone. The influence of executive dysfunction should be considered by future studies using the beads tasks in patient populations. These findings need to be replicated in larger PFTBI and TBI samples.
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Affiliation(s)
- Rachel A Batty
- a Brain and Psychological Sciences Research Centre (BPsyC) , Swinburne University of Technology , Melbourne , VIC , Australia.,b Monash-Alfred Psychiatry Research Centre (MAPrc) , Melbourne , VIC , Australia.,c Health Sciences, RMIT University , Bundoora , VIC , Australia
| | - Andrew Francis
- c Health Sciences, RMIT University , Bundoora , VIC , Australia
| | - Neil Thomas
- a Brain and Psychological Sciences Research Centre (BPsyC) , Swinburne University of Technology , Melbourne , VIC , Australia.,b Monash-Alfred Psychiatry Research Centre (MAPrc) , Melbourne , VIC , Australia
| | - Malcolm Hopwood
- d Department of Psychiatry , University of Melbourne , Albert Road Clinic, Melbourne , VIC , Australia
| | - Jennie Ponsford
- e Monash-Epworth Rehabilitation Research Centre , Epworth Hospital , Richmond , VIC , Australia
| | - Susan L Rossell
- a Brain and Psychological Sciences Research Centre (BPsyC) , Swinburne University of Technology , Melbourne , VIC , Australia.,b Monash-Alfred Psychiatry Research Centre (MAPrc) , Melbourne , VIC , Australia
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Rausch F, Eisenacher S, Elkin H, Englisch S, Kayser S, Striepens N, Lautenschlager M, Heinz A, Gudlowski Y, Janssen B, Gaebel W, Michel TM, Schneider F, Lambert M, Naber D, Juckel G, Krueger-Oezguerdal S, Wobrock T, Hasan A, Riedel M, Moritz S, Müller H, Klosterkötter J, Bechdolf A, Zink M, Wagner M. Evaluation of the 'Jumping to conclusions' bias in different subgroups of the at-risk mental state: from cognitive basic symptoms to UHR criteria. Psychol Med 2016; 46:2071-2081. [PMID: 27094404 DOI: 10.1017/s0033291716000465] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Patients with psychosis display the so-called 'Jumping to Conclusions' bias (JTC) - a tendency for hasty decision-making in probabilistic reasoning tasks. So far, only a few studies have evaluated the JTC bias in 'at-risk mental state' (ARMS) patients, specifically in ARMS samples fulfilling 'ultra-high risk' (UHR) criteria, thus not allowing for comparisons between different ARMS subgroups. METHOD In the framework of the PREVENT (secondary prevention of schizophrenia) study, a JTC task was applied to 188 patients either fulfilling UHR criteria or presenting with cognitive basic symptoms (BS). Similar data were available for 30 healthy control participants matched for age, gender, education and premorbid verbal intelligence. ARMS patients were identified by the Structured Interview for Prodromal Symptoms (SIPS) and the Schizophrenia Proneness Instrument - Adult Version (SPI-A). RESULTS The mean number of draws to decision (DTD) significantly differed between ARM -subgroups: UHR patients made significantly less draws to make a decision than ARMS patients with only cognitive BS. Furthermore, UHR patients tended to fulfil behavioural criteria for JTC more often than BS patients. In a secondary analysis, ARMS patients were much hastier in their decision-making than controls. In patients, DTD was moderately associated with positive and negative symptoms as well as disorganization and excitement. CONCLUSIONS Our data indicate an enhanced JTC bias in the UHR group compared to ARMS patients with only cognitive BS. This underscores the importance of reasoning deficits within cognitive theories of the developing psychosis. Interactions with the liability to psychotic transitions and therapeutic interventions should be unravelled in longitudinal studies.
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Affiliation(s)
- F Rausch
- Central Institute of Mental Health,Medical Faculty Mannheim,Heidelberg University,Germany
| | - S Eisenacher
- Central Institute of Mental Health,Medical Faculty Mannheim,Heidelberg University,Germany
| | - H Elkin
- Central Institute of Mental Health,Medical Faculty Mannheim,Heidelberg University,Germany
| | - S Englisch
- Central Institute of Mental Health,Medical Faculty Mannheim,Heidelberg University,Germany
| | - S Kayser
- Department of Psychiatry and Psychotherapy,University of Bonn,Germany
| | - N Striepens
- Department of Psychiatry and Psychotherapy,University of Bonn,Germany
| | - M Lautenschlager
- Department of Psychiatry and Psychotherapy,Charité University Medicine Campus Mitte,Berlin,Germany
| | - A Heinz
- Department of Psychiatry and Psychotherapy,Charité University Medicine Campus Mitte,Berlin,Germany
| | - Y Gudlowski
- Department of Psychiatry and Psychotherapy,Charité University Medicine Campus Mitte,Berlin,Germany
| | - B Janssen
- Department of Psychiatry and Psychotherapy,Heinrich-Heine-University Duesseldorf,Germany
| | - W Gaebel
- Department of Psychiatry and Psychotherapy,Heinrich-Heine-University Duesseldorf,Germany
| | - T M Michel
- Department of Psychiatry, Psychotherapy and Psychosomatics,University Aachen,Germany
| | - F Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics,University Aachen,Germany
| | - M Lambert
- Department for Psychiatry and Psychotherapy,University Medical Center Hamburg-Eppendorf,Germany
| | - D Naber
- Department for Psychiatry and Psychotherapy,University Medical Center Hamburg-Eppendorf,Germany
| | - G Juckel
- Department of Psychiatry, Psychotherapy, and Preventive Medicine,Ruhr University Bochum,Germany
| | - S Krueger-Oezguerdal
- Department of Psychiatry, Psychotherapy, and Preventive Medicine,Ruhr University Bochum,Germany
| | - T Wobrock
- Department of Psychiatry and Psychotherapy,Georg-August-University Goettingen,Goettingen,Germany
| | - A Hasan
- Department of Psychiatry and Psychotherapy,Ludwig-Maximilians-University,Munich,Germany
| | - M Riedel
- Department of Psychiatry and Psychotherapy,Ludwig-Maximilians-University,Munich,Germany
| | - S Moritz
- Department for Psychiatry and Psychotherapy,University Medical Center Hamburg-Eppendorf,Germany
| | - H Müller
- Department of Psychiatry and Psychotherapy,University of Cologne,Germany
| | - J Klosterkötter
- Department of Psychiatry and Psychotherapy,University of Cologne,Germany
| | - A Bechdolf
- Department of Psychiatry and Psychotherapy,University of Cologne,Germany
| | - M Zink
- Central Institute of Mental Health,Medical Faculty Mannheim,Heidelberg University,Germany
| | - M Wagner
- Department of Psychiatry and Psychotherapy,University of Bonn,Germany
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van Ommen MM, van Beilen M, Cornelissen FW, Smid HGOM, Knegtering H, Aleman A, van Laar T. The prevalence of visual hallucinations in non-affective psychosis, and the role of perception and attention. Psychol Med 2016; 46:1735-1747. [PMID: 26984533 DOI: 10.1017/s0033291716000246] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Little is known about visual hallucinations (VH) in psychosis. We investigated the prevalence and the role of bottom-up and top-down processing in VH. The prevailing view is that VH are probably related to altered top-down processing, rather than to distorted bottom-up processing. Conversely, VH in Parkinson's disease are associated with impaired visual perception and attention, as proposed by the Perception and Attention Deficit (PAD) model. Auditory hallucinations (AH) in psychosis, however, are thought to be related to increased attention. METHOD Our retrospective database study included 1119 patients with non-affective psychosis and 586 controls. The Community Assessment of Psychic Experiences established the VH rate. Scores on visual perception tests [Degraded Facial Affect Recognition (DFAR), Benton Facial Recognition Task] and attention tests [Response Set-shifting Task, Continuous Performance Test-HQ (CPT-HQ)] were compared between 75 VH patients, 706 non-VH patients and 485 non-VH controls. RESULTS The lifetime VH rate was 37%. The patient groups performed similarly on cognitive tasks; both groups showed worse perception (DFAR) than controls. Non-VH patients showed worse attention (CPT-HQ) than controls, whereas VH patients did not perform differently. CONCLUSIONS We did not find significant VH-related impairments in bottom-up processing or direct top-down alterations. However, the results suggest a relatively spared attentional performance in VH patients, whereas face perception and processing speed were equally impaired in both patient groups relative to controls. This would match better with the increased attention hypothesis than with the PAD model. Our finding that VH frequently co-occur with AH may support an increased attention-induced 'hallucination proneness'.
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Affiliation(s)
- M M van Ommen
- Department of Neurology,University of Groningen, University Medical Center Groningen,The Netherlands
| | - M van Beilen
- Department of Neurology,University of Groningen, University Medical Center Groningen,The Netherlands
| | - F W Cornelissen
- University of Groningen, University Medical Center Groningen,BCN NeuroImaging Center,The Netherlands
| | - H G O M Smid
- University of Groningen, University Medical Center Groningen,BCN NeuroImaging Center,The Netherlands
| | - H Knegtering
- University of Groningen, University Medical Center Groningen,BCN NeuroImaging Center,The Netherlands
| | - A Aleman
- University of Groningen, University Medical Center Groningen,BCN NeuroImaging Center,The Netherlands
| | - T van Laar
- Department of Neurology,University of Groningen, University Medical Center Groningen,The Netherlands
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van Os J, Reininghaus U. Psychosis as a transdiagnostic and extended phenotype in the general population. World Psychiatry 2016; 15:118-24. [PMID: 27265696 PMCID: PMC4911787 DOI: 10.1002/wps.20310] [Citation(s) in RCA: 342] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
A large body of research indicates that weak expressions of positive psychotic symptoms ("psychotic experiences") can be measured in the general population, and likely represent the behavioural manifestation of distributed multifactorial (genetic and non-genetic) risk for psychosis. Psychotic experiences are a transdiagnostic phenomenon: the majority of individuals with these experiences have a diagnosis of non-psychotic disorder, particularly common mental disorder, in which psychotic experiences predict greater illness severity and poorer treatment response. Some of the people with common mental disorder and psychotic experiences will present to mental health services meeting criteria for "clinical high risk". Treatment of the transdiagnostic dimension of psychosis in individuals with common mental disorder who meet "clinical high risk" criteria thus may improve outcome (which cannot be interpreted as prevention of "schizophrenia"). Subthreshold psychotic experiences are transitory in about 80% of individuals, while around 20% go on to develop persistent psychotic experiences and 7% a psychotic disorder, with an annual transition rate of 0.5-1%. Persistence is associated, on the one hand, with environmental exposures, particularly childhood trauma, and, on the other, with network-type dynamic interactions between psychotic experiences themselves (e.g., interactions between hallucinatory experiences and delusional ideation) and between symptom dimensions (e.g., interactions between affective symptoms and psychotic experiences, or interactions between subthreshold negative symptoms and psychotic experiences). The study of psychotic experiences is helping to elucidate the mechanisms by which environmental and genetic influences shape the transdiagnostic expression of psychosis proneness, that is mostly transitory but may first become persistent over time and eventually give rise to transition to a psychotic disorder.
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Affiliation(s)
- Jim van Os
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, P.O. Box 616 (DOT12), 6200 MD Maastricht, The Netherlands
- King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK
| | - Uli Reininghaus
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, P.O. Box 616 (DOT12), 6200 MD Maastricht, The Netherlands
- King's College London, King's Health Partners, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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46
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Albacete A, Contreras F, Bosque C, Gilabert E, Albiach Á, Menchón JM, Crespo-Facorro B, Ayesa-Arriola R. Counterfactual Reasoning in Non-psychotic First-Degree Relatives of People with Schizophrenia. Front Psychol 2016; 7:665. [PMID: 27242583 PMCID: PMC4860705 DOI: 10.3389/fpsyg.2016.00665] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 04/21/2016] [Indexed: 01/08/2023] Open
Abstract
Counterfactual thinking (CFT) is a type of conditional reasoning that enables the generation of mental simulations of alternatives to past factual events. Previous research has found this cognitive feature to be disrupted in schizophrenia (Hooker et al., 2000; Contreras et al., 2016). At the same time, the study of cognitive deficits in unaffected relatives of people with schizophrenia has significantly increased, supporting its potential endophenotypic role in this disorder. Using an exploratory approach, the current study examined CFT for the first time in a sample of non-psychotic first-degree relatives of schizophrenia patients (N = 43), in comparison with schizophrenia patients (N = 54) and healthy controls (N = 44). A series of tests that assessed the "causal order effect" in CFT and the ability to generate counterfactual thoughts and counterfactually derive inferences using the Counterfactual Inference Test was completed. Associations with variables of basic and social cognition, levels of schizotypy and psychotic-like experiences in addition to clinical and socio-demographic characteristics were also explored. Findings showed that first-degree relatives generated a lower number of counterfactual thoughts than controls, and were more adept at counterfactually deriving inferences, specifically in the scenarios related to regret and to judgments of avoidance in an unusual situation. No other significant results were found. These preliminary findings suggest that non-psychotic first-degree relatives of schizophrenia patients show a subtle disruption of global counterfactual thinking compared with what is normally expected in the general population. Due to the potential impact of such deficits, new treatments targeting CFT improvement might be considered in future management strategies.
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Affiliation(s)
- Auria Albacete
- Psychiatry Department, Bellvitge University Hospital – Institut d’Investigació Biomèdica de BellvitgeBarcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain
| | - Fernando Contreras
- Psychiatry Department, Bellvitge University Hospital – Institut d’Investigació Biomèdica de BellvitgeBarcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud MentalBarcelona, Spain
| | - Clara Bosque
- Fundació per a la Investigació i Docència María Angustias Giménez, Germanes HospitalàriesBarcelona, Spain
| | - Ester Gilabert
- Mental Health Unit L’Hospitalet, SAP Delta Llobregat – Catalan Institute of HealthBarcelona, Spain
| | - Ángela Albiach
- Mental Health Unit L’Hospitalet, SAP Delta Llobregat – Catalan Institute of HealthBarcelona, Spain
| | - José M. Menchón
- Psychiatry Department, Bellvitge University Hospital – Institut d’Investigació Biomèdica de BellvitgeBarcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud MentalBarcelona, Spain
| | - Benedicto Crespo-Facorro
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud MentalBarcelona, Spain
- Psychiatry Department, Marqués de Valdecilla University Hospital – Instituto de Investigación Marqués de ValdecillaSantander, Spain
| | - Rosa Ayesa-Arriola
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud MentalBarcelona, Spain
- Psychiatry Department, Marqués de Valdecilla University Hospital – Instituto de Investigación Marqués de ValdecillaSantander, Spain
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Dudley R, Taylor P, Wickham S, Hutton P. Psychosis, Delusions and the "Jumping to Conclusions" Reasoning Bias: A Systematic Review and Meta-analysis. Schizophr Bull 2016; 42:652-65. [PMID: 26519952 PMCID: PMC4838082 DOI: 10.1093/schbul/sbv150] [Citation(s) in RCA: 195] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We did a systematic review and meta-analysis to investigate the magnitude and specificity of the "jumping to conclusions" (JTC) bias in psychosis and delusions. We examined the extent to which people with psychosis, and people with delusions specifically, required less information before making decisions. We examined (1) the average amount of information required to make a decision and (2) numbers who demonstrated an extreme JTC bias, as assessed by the "beads task." We compared people with psychosis to people with and without nonpsychotic mental health problems, and people with psychosis with and without delusions. We examined whether reduced data-gathering was associated with increased delusion severity. We identified 55 relevant studies, and acquired previously unpublished data from 16 authors. People with psychosis required significantly less information to make decisions than healthy individuals (k= 33,N= 1935,g= -0.53, 95% CI -0.69, -0.36) and those with nonpsychotic mental health problems (k= 13,N= 667,g= -0.58, 95% CI -0.80, -0.35). The odds of extreme responding in psychosis were between 4 and 6 times higher than the odds of extreme responding by healthy participants and participants with nonpsychotic mental health problems. The JTC bias was linked to a greater probability of delusion occurrence in psychosis (k= 14,N= 770, OR 1.52, 95% CI 1.12, 2.05). There was a trend-level inverse association between data-gathering and delusion severity (k= 18;N= 794;r= -.09, 95% CI -0.21, 0.03). Hence, nonaffective psychosis is characterized by a hasty decision-making style, which is linked to an increased probability of delusions.
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Affiliation(s)
- Robert Dudley
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK; Early Intervention in Psychosis Service, Northumberland, Tyne and Wear NHS Foundation Trust, Gateshead, UK;
| | - Peter Taylor
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Sophie Wickham
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Paul Hutton
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
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van Oosterhout B, Smit F, Krabbendam L, Castelein S, Staring ABP, van der Gaag M. Metacognitive training for schizophrenia spectrum patients: a meta-analysis on outcome studies. Psychol Med 2016; 46:47-57. [PMID: 26190517 DOI: 10.1017/s0033291715001105] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Metacognitive training (MCT) for schizophrenia spectrum is widely implemented. It is timely to systematically review the literature and to conduct a meta-analysis. METHOD Eligible studies were selected from several sources (databases and expert suggestions). Criteria included comparative studies with a MCT condition measuring positive symptoms and/or delusions and/or data-gathering bias. Three meta-analyses were conducted on data gathering (three studies; 219 participants), delusions (seven studies; 500 participants) and positive symptoms (nine studies; 436 participants). Hedges' g is reported as the effect size of interest. Statistical power was sufficient to detect small to moderate effects. RESULTS All analyses yielded small non-significant effect sizes (0.26 for positive symptoms; 0.22 for delusions; 0.31 for data-gathering bias). Corrections for publication bias further reduced the effect sizes to 0.21 for positive symptoms and to 0.03 for delusions. In blinded studies, the corrected effect sizes were 0.22 for positive symptoms and 0.03 for delusions. In studies using proper intention-to-treat statistics the effect sizes were 0.10 for positive symptoms and -0.02 for delusions. The moderate to high heterogeneity in most analyses suggests that processes other than MCT alone have an impact on the results. CONCLUSIONS The studies so far do not support a positive effect for MCT on positive symptoms, delusions and data gathering. The methodology of most studies was poor and sensitivity analyses to control for methodological flaws reduced the effect sizes considerably. More rigorous research would be helpful in order to create enough statistical power to detect small effect sizes and to reduce heterogeneity. Limitations and strengths are discussed.
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Affiliation(s)
| | - F Smit
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction),PO Box 725,Utrecht,The Netherlands
| | - L Krabbendam
- Department of Educational Neuroscience and Research Institute Learn!,Faculty of Psychology and Education,VU University,Van der Boechorststraat 1,Amsterdam,The Netherlands
| | - S Castelein
- Lentis Psychiatric Institute,Lentis Research,PO Box 86,Groningen,The Netherlands
| | - A B P Staring
- Altrecht Psychiatric Institute,Mimosastraat 2-4,Utrecht,The Netherlands
| | - M van der Gaag
- Department of Clinical Psychology,EMGO Institute for Health and Care Research,VU University,PO Box 7057,Amsterdam,The Netherlands
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Factors contributing to social cognition impairment in borderline personality disorder and schizophrenia. Psychiatry Res 2015; 229:872-9. [PMID: 26257087 DOI: 10.1016/j.psychres.2015.07.057] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 06/03/2015] [Accepted: 07/19/2015] [Indexed: 11/23/2022]
Abstract
Social cognition (SC) deficits have been described both in patients with schizophrenia and borderline personality disorder (BPD). However, while the former tend towards simplistic mental state attributions (undermentalizing), the latter are more likely to make overly complex mental state inferences (overmentalizing). Performance on complex SC tasks has been shown to correlate with neurocognitive ability, emotion perception, a history of trauma, and overconfidence in errors. However, it is unclear how these factors relate to different aspects of SC deficits. Aim of the present study was to examine the pathways of SC impairment by investigating performance profiles and their predictors comparatively in BPD and schizophrenia. Participants were 44 patients with BPD, 36 patients with schizophrenia, and 38 healthy controls. Undermentalizing and overmentalizing were assessed with an ecologically valid SC task. Patients with BPD exhibited increased overmentalizing, whereas patients with schizophrenia showed a more extensive deficit pattern, their main error type being undermentalizing. Overconfidence in errors was the most important predictor for overmentalizing, while undermentalizing depended mainly on verbal memory and emotion perception. Thus, BPD und schizophrenia exhibited different SC impairment patterns, and different types of SC errors were predicted by different factors. These findings have implications for the optimization of treatment approaches.
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50
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A comparison of cognitive biases between schizophrenia patients with delusions and healthy individuals with delusion-like experiences. Eur Psychiatry 2015; 30:943-9. [PMID: 26647870 DOI: 10.1016/j.eurpsy.2015.08.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 08/08/2015] [Accepted: 08/11/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND The role of psychosis-related cognitive biases (e.g. jumping to conclusions) in a delusion continuum is well-established. Little is known about the role of types of cognitive biases. The aim of this study was to investigate the role of psychosis-related and "Beckian" (i.e. anxiety- and depression-related) cognitive biases assessed with a clinical questionnaire in the delusion continuum and its dimensions. METHODS Schizophrenia patients with (n=57) and without (n=35) delusions were compared to healthy subjects who had a low (n=53) and high (n=57) level of delusion-like experiences (DLEs) on the Cognitive Biases Questionnaire for Psychosis (CBQp). Delusion dimensions in the clinical sample were assessed with the semi-structured interview PSYRATS. DLEs were measured with the Peters Delusion Inventory (PDI). RESULTS High DLEs participants scored significantly higher than low DLEs, and patients with delusions scored higher than patients without delusions on the total scores of the CBQp. High DLEs participants scored significantly higher than low DLEs on catastrophisation and JTC. Schizophrenia patients with delusions scored significantly higher when compared to patients without delusions on intentionalising, dichotomous thinking, JTC and emotional reasoning. Patients with delusions and high DLEs participants scored similarly on JTC. Stepwise regression analysis revealed that catastrophising predicted total severity of clinical delusions and JTC predicted the cognitive dimension of clinical delusions. Both JTC and catastrophisation predicted the frequency and conviction associated with DLEs. CONCLUSIONS Both "Beckian" and psychosis-related cognitive biases may underlie delusions. Different aspects of clinical delusions and delusion-like experiences may be related to different cognitive biases.
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