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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Eisenacher S, Rausch F, Ainser F, Mier D, Veckenstedt R, Schirmbeck F, Lewien A, Englisch S, Andreou C, Moritz S, Meyer-Lindenberg A, Kirsch P, Zink M. Investigation of metamemory functioning in the at-risk mental state for psychosis. Psychol Med 2015; 45:3329-3340. [PMID: 26201365 DOI: 10.1017/s0033291715001373] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Metamemory describes the monitoring and knowledge about one's memory capabilities. Patients with schizophrenia have been found to be less able in differentiating between correct and false answers (smaller confidence gap) when asked to provide retrospective confidence ratings in previous studies. Furthermore, higher proportions of very-high-confident but false responses have been found in this patient group (high knowledge corruption). Whether and how these biases contribute to the early pathogenesis of psychosis is yet unclear. This study thus aimed at investigating metamemory function in the early course of psychosis. METHOD Patients in an at-risk mental state for psychosis (ARMS, n = 34), patients with a first episode of psychosis (FEP, n = 21) and healthy controls (HCs, n = 38) were compared on a verbal recognition task combined with retrospective confidence-level ratings. RESULTS FEP patients showed the smallest confidence gap, followed by ARMS patients, followed by HCs. All groups differed significantly from each other. Regarding knowledge corruption, FEP patients differed significantly from HCs, whereas a statistical trend was revealed in comparison of ARMS and FEP groups. Correlations were revealed between metamemory, measures of positive symptoms and working memory performance. CONCLUSIONS These data underline the presence of a metamemory bias in ARMS patients which is even more pronounced in FEP patients. The bias might represent an early cognitive marker of the beginning psychotic state. Longitudinal studies are needed to unravel whether metacognitive deficits predict the transition to psychosis and to evaluate therapeutic interventions.
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Affiliation(s)
- S Eisenacher
- Department of Psychiatry and Psychotherapy,Central Institute of Mental Health,University of Heidelberg/Medical Faculty Mannheim,Mannheim,Germany
| | - F Rausch
- Department of Psychiatry and Psychotherapy,Central Institute of Mental Health,University of Heidelberg/Medical Faculty Mannheim,Mannheim,Germany
| | - F Ainser
- Department of Psychiatry and Psychotherapy,Central Institute of Mental Health,University of Heidelberg/Medical Faculty Mannheim,Mannheim,Germany
| | - D Mier
- Department of Clinical Psychology,Central Institute of Mental Health,University of Heidelberg/Medical Faculty MannheimMannheim,Germany
| | - R Veckenstedt
- Department of Psychiatry and Psychotherapy,University Medical Centre Hamburg-Eppendorf,Hamburg,Germany
| | - F Schirmbeck
- Department of Psychiatry and Psychotherapy,Central Institute of Mental Health,University of Heidelberg/Medical Faculty Mannheim,Mannheim,Germany
| | - A Lewien
- Department of Psychiatry and Psychotherapy,Central Institute of Mental Health,University of Heidelberg/Medical Faculty Mannheim,Mannheim,Germany
| | - S Englisch
- Department of Psychiatry and Psychotherapy,Central Institute of Mental Health,University of Heidelberg/Medical Faculty Mannheim,Mannheim,Germany
| | - C Andreou
- Department of Psychiatry and Psychotherapy,University Medical Centre Hamburg-Eppendorf,Hamburg,Germany
| | - S Moritz
- Department of Psychiatry and Psychotherapy,University Medical Centre Hamburg-Eppendorf,Hamburg,Germany
| | - A Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy,Central Institute of Mental Health,University of Heidelberg/Medical Faculty Mannheim,Mannheim,Germany
| | - P Kirsch
- Department of Clinical Psychology,Central Institute of Mental Health,University of Heidelberg/Medical Faculty MannheimMannheim,Germany
| | - M Zink
- Department of Psychiatry and Psychotherapy,Central Institute of Mental Health,University of Heidelberg/Medical Faculty Mannheim,Mannheim,Germany
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