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A comparison of cognitive biases between schizophrenia patients with delusions and healthy individuals with delusion-like experiences

Published online by Cambridge University Press:  13 October 2015

Ł. Gawęda  and
K. Prochwicz
Ł. Gawęda*
Affiliation:
II Department of Psychiatry, Medical University of Warsaw8, ul. Kondratowicza, 03-242Warsaw, Poland
K. Prochwicz
Affiliation:
Institute of Psychology, Jagiellonian University, Krakow, Poland
*
⁎Corresponding author. Tel.: +48 22 326 58 92. E-mail address:lgaweda@wum.edu.pl (Ł. Gawęda).
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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.

Keywords

PsychosisDelusionsDelusion continuumCognitive biases

Information

Type
Original article
Information
European Psychiatry , Volume 30 , Issue 8 , November 2015 , pp. 943 - 949
Copyright
Copyright © European Psychiatric Association 2020

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References

Aakre, J.M.Seghers, J.P.St-Hilaire, A.Docherty, N.. Attributional style in delusional patients: a comparison of remitted paranoid, remitted nonparanoid, and current paranoid patients with nonpsychiatric controls. Schizophr Bull. 2009;35:994–1002.CrossRefGoogle ScholarPubMed
Andreou, C.Treszl, A.Roesch-Ely, D.Kother, U.Veckenstedt, R.Moritz, S.. Investigation of the role of the jumping-to-conclusions bias for short-term functional outcome in schizophrenia. Psychiatry Res. 2014;218:341–347.CrossRefGoogle Scholar
Bristow, E.Tabraham, P.Smedley, N.Ward, T.Peters, E.. Jumping to perceptions and to conclusions: specificity to hallucinations and delusions. Schizophr Res 2014;154:68–72.CrossRefGoogle ScholarPubMed
Corlett, P.R.Fletcher, P.C.. The neurobiology of schizotypy: frontostriatal prediction error signal correlates with delusion-like beliefs in healthy people. Neuropsychologia. 2012;50:3612–3620.CrossRefGoogle Scholar
Daalman, K.Sommer, I.E.Derks, E.M.Peters, E.R.. Cognitive biases and auditory verbal hallucinations in healthy and clinical individuals. Psychol Med. 2013;43:2339–2347.CrossRefGoogle ScholarPubMed
Dudley, R.Daley, K.Nicholson, M.Shaftoe, D.Spencer, H.Cavanagh, K., et al.“Jumping to conclusions” in first-episode psychosis: a longitudinal study. Br J Clin Psychol. 2013;52:380–393.CrossRefGoogle Scholar
Dudley, R.Shaftoe, D.Cavanagh, K.Spencer, H.Ormrod, J.Turkington, D., et al.“Jumping to conclusions” in first-episode psychosis. Early Interv Psychiatry. 2011;5:50–56.CrossRefGoogle Scholar
Falcone, M.A.Murray, R.M.Wiffen, B.D.O’Connor, J.A.Russo, M.Kolliakou, A., et al.Jumping to conclusions, neuropsychological functioning, and delusional beliefs in first episode psychosis. Schizophr Bull 2014.CrossRefGoogle ScholarPubMed
Falcone, M.A.Murray, R.M.Wiffen, B.D.O’Connor, J.A.Russo, M.Kolliakou, A., et al.Jumping to conclusions, neuropsychological functioning, and delusional beliefs in first episode psychosis. Schizophr Bull. 2015;41:411–418.CrossRefGoogle ScholarPubMed
Foster, C.Startup, H.Potts, L.Freeman, D.. A randomised controlled trial of a worry intervention for individuals with persistent persecutory delusions. J Behav Ther Exp Psych. 2010;41:45–51.CrossRefGoogle ScholarPubMed
Freeman, D.Emsley, R.Dunn, G.Fowler, D.Bebbington, P.Kuipers, E., et al.The stress of the street for patients with persecutory delusions: a test of the symptomatic and psychological effects of going outside into a busy urban area. Schizophr Bull 2014.Google ScholarPubMed
Freeman, D.Garety, P.A.. Connecting neurosis and psychosis: the direct influence of emotion on delusions and hallucinations. Behav Res Ther 2003;41:923–947.CrossRefGoogle ScholarPubMed
Freeman, D.Garety, P.. Advances in understanding and treating persecutory delusions: a review. Soc Psychiatry Psychiatr Epidemiol. 2014;49:1179–1189.CrossRefGoogle ScholarPubMed
Freeman, D.Garety, P.A.Fowler, D.Kuipers, E.Bebbington, P.E.Dunn, G.. Why do people with delusions fail to choose more realistic explanations for their experiences? An empirical investigation. J Consult Clin Psychol 2004;72:671.CrossRefGoogle ScholarPubMed
Freeman, D.Garety, P.A.Kuipers, E.Fowler, D.Bebbington, P.E.. A cognitive model of persecutory delusions. Br J Clin Psychol. 2002;41:331–347.CrossRefGoogle ScholarPubMed
Freeman, D.Pugh, K.Garety, P.. Jumping to conclusions and paranoid ideation in the general population. Schizophr Res. 2008;102:254–260.CrossRefGoogle ScholarPubMed
Freeman, D.Startup, H.Dunn, G.Cernis, E.Wingham, G.Pugh, K., et al.The interaction of affective with psychotic processes: a test of the effects of worrying on working memory, jumping to conclusions, and anomalies of experience in patients with persecutory delusions. J Psychiatr Res. 2013;47:1837–1842.CrossRefGoogle ScholarPubMed
Freeman, D.Startup, H.Dunn, G.Cernis, E.Wingham, G.Pugh, K., et al.Understanding jumping to conclusions in patients with persecutory delusions: working memory and intolerance of uncertainty. Psychol Med. 2014;44:3017–3024.CrossRefGoogle ScholarPubMed
Fusar-Poli, P.Deste, G.Smieskova, R., et al.Cognitive functioning in prodromal psychosis: a meta-analysis. Arch Gen Psychiatr 2012;69:562–571.CrossRefGoogle ScholarPubMed
Garety, P.A.Freeman, D.Jolley, S.Dunn, G.Bebbington, P.E.Fowler, D.G., et al.Reasoning, emotions, and delusional conviction in psychosis. J. Abnorm Psychol 2005;114:373–384.CrossRefGoogle ScholarPubMed
Garety, P.Hemsley, D.Wessely, S.. Reasoning in deluded schizophrenic and paranoid patients: biases in performance on a probabilistic inference task. J Nerv Ment Dis. 1991;179:194–201.CrossRefGoogle ScholarPubMed
Garety, P.A.Kuipers, E.Fowler, D.Freeman, D.Bebbington, P.E.. A cognitive model of the positive symptoms of psychosis. Psychol Med. 2001;31:189–195.CrossRefGoogle ScholarPubMed
Gawęda, Ł.. Polish version of the Psychotic Rating Scales (PSYRATS) [in Polish]. Psychiatria. 2012;9:100–107.Google Scholar
Gawęda, L.Prochwicz, K.Cella, M.. Cognitive biases mediate the relationship between temperament and character and psychotic-like experiences in healthy adults. Psychiatry Res. 2015;225:50–57.CrossRefGoogle ScholarPubMed
Haddock, G.McCarron, J.Tarrier, N.Faragher, E.. Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS). Psychol Med. 1999;29:879–889.CrossRefGoogle Scholar
Hartley, S.Haddock, G.Vasconcelos, E.S.D.Emsley, R.Barrowclough, C.. An experience sampling study of worry and rumination in psychosis. Psychol Med. 2014;44:1605–1614.CrossRefGoogle ScholarPubMed
Kaney, S.Bentall, R.P.. Persecutory delusions and attributional style. Br J Med Psychol 1989;62:191–198.CrossRefGoogle ScholarPubMed
Keogh, E.Asmundson, G.J.Negative affectivity, catastrophizing, and anxiety sensitivity. Underst Treat Fear Pain 2004;91–115.Google Scholar
Kumari, V.Antonova, E.Geyer, M.A.. Prepulse inhibition and “psychosis-proneness” in healthy individuals: An fMRI study. Eur Psychiatry. 2008;23:274–280.CrossRefGoogle Scholar
Langdon, R.Ward, P.B.Coltheart, M.. Reasoning anomalies associated with delusions in schizophrenia. Schizophr Bull. 2010;36:321–330.CrossRefGoogle Scholar
Lincoln, T.M.Mehl, S.Exner, C.Lindenmeyer, J.Rief, W.. Attributional style and persecutory delusions. Evidence for an event independent and state specific external-personal attribution bias for social situations. Cogn Ther Res. 2010;34:297–302.CrossRefGoogle Scholar
Linscott, R.J.van Os, J.. An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychol Med. 2013;43:1133–1149.CrossRefGoogle ScholarPubMed
Lomax, R.G.An introduction to statistical concepts for education and behavioral sciences. Mahwah, NJ: Lawrence Erlbaum Associates; 2001.Google Scholar
Martin, J.A.Penn, D.L.Attributional style in schizophrenia: an investigation in outpatients with and without persecutory delusions. Schizophr Bull. 2002;28:131–141.CrossRefGoogle ScholarPubMed
Martinelli, C.Cavanagh, K.Dudley, R.E.The impact of rumination on state paranoid ideation in a nonclinical sample. Behav Ther. 2013;44:385–394.CrossRefGoogle Scholar
McKay, R.Langdon, R.Coltheart, M.Need for closure, jumping to conclusions, and decisiveness in delusion-prone individuals. J Nerv Ment Dis. 2006;194:422–426.CrossRefGoogle ScholarPubMed
Meehl, P.E.Schizotaxia, schizotypy, schizophrenia. Am Psychol 1962;17:827.CrossRefGoogle Scholar
Menon, M.Quilty, L.C.Zawadzki, J.A.Woodward, T.S.Sokolowski, H.M.Boon, H.S., et al.The role of cognitive biases and personality variables in subclinical delusional ideation. Cogn Neuropsychiatry. 2013;18:208–218.CrossRefGoogle ScholarPubMed
Moritz, S.Andreou, C.Schneider, B.C.Wittekind, C.E.Menon, M.Balzan, R.P., et al.Sowing the seeds of doubt: a narrative review on metacognitive training in schizophrenia. Clin Psychol Rev. 2014;34:358–366.CrossRefGoogle Scholar
Moritz, S.Woodward, T.S.Jumping to conclusions in delusional and non-delusional schizophrenic patients. Br J Clin Psychol. 2005;44:193–207.CrossRefGoogle ScholarPubMed
Moritz, S.Woodward, T.S.A generalized bias against disconfirmatory evidence in schizophrenia. Psychiatry Res. 2006;142:157–165.CrossRefGoogle Scholar
Mortimer, P.Bentham, A.McKay, A.Quemada, I.Clare, L.Eastwood, N., et al.Delusions in schizophrenia: a phenomenological and psychological exploration. Cogn Neuropsychiatry. 1996;1:289–304.Google Scholar
Ochoa, S.Haro, J.M.Huerta-Ramos, E.Cuevas-Esteban, J.Stephan-Otto, C.Usall, J., et al.Relation between jumping to conclusions and cognitive functioning in people with schizophrenia in contrast with healthy participants. Schizophr Res. 2014;159:211–217.CrossRefGoogle ScholarPubMed
Peters, E.Joseph, S.Day, S.Garety, P.Measuring delusional ideation. Schizophr Bull. 2004;30:1005–1022.CrossRefGoogle ScholarPubMed
Peters, E.R.Joseph, S.A.Garety, P.A.Measurement of delusional ideation in the normal population: introducing the PDI (Peters et al., delusions inventory). Schizophr Bull. 1999;25:553–576.CrossRefGoogle Scholar
Peters, E.R.Moritz, S.Schwannauer, M.Wiseman, Z.Greenwood, K.E.Scott, J., et al.Cognitive Biases Questionnaire for psychosis. Schizophr Bull 2014;40:300–313.CrossRefGoogle Scholar
Saha, S.Scott, J.G.Varghese, D.McGrath, J.J.The association between general psychological distress and delusional-like experiences: a large population-based study. Schizophr Res. 2011;127:246–251.CrossRefGoogle ScholarPubMed
Sanford, N.Woodward, T.S.Lecomte, T.Leclerc, C.Wykes, T.Change in jumping to conclusions linked to change in delusions in early psychosis. Schizophr Res. 2013;147:207–208.CrossRefGoogle ScholarPubMed
Startup, H.Freeman, D.Garety, P.A.Persecutory delusions and catastrophic worry in psychosis: developing the understanding of delusion distress and persistence. Behav Res Ther. 2007;45:523–537.CrossRefGoogle ScholarPubMed
Startup, H.Freeman, D.Garety, P.A.Jumping to conclusions and persecutory delusions. Eur Psychiatry. 2008;23:457–459.CrossRefGoogle ScholarPubMed
Strauss, J.S.Hallucinations and delusions as points on continua function. Rating scale evidence. Arch Gen Psychiatry. 1969;21:581–586.CrossRefGoogle ScholarPubMed
Van Dael, F.Versmissen, D.Janssen, I.Myin-Germeys, I.van Os, J.Krabbendam, L.Data gathering: biased in psychosis? Schizophr Bull. 2006;32:341–351.CrossRefGoogle ScholarPubMed
van der Gaag, M.Schutz, C.Ten Napel, A.Landa, Y.Delespaul, P.Bak, M., et al.Development of the Davos assessment of cognitive biases scale (DACOBS). Schizophr Res. 2013;144:63–71.CrossRefGoogle Scholar
van Os, J.Hanssen, M.Bijl, R.V.Ravelli, A.Strauss (1969) revisited: a psychosis continuum in the general population?. Schizophr Res. 2000;45:11–20.CrossRefGoogle ScholarPubMed
van Os, J.Linscott, R.J.Introduction: the extended psychosis phenotype – relationship with schizophrenia and with ultrahigh risk status for psychosis. Schizophr Bull. 2012;38:227–230.CrossRefGoogle Scholar
van Os, J.Linscott, R.J.Myin-Germeys, I.Delespaul, P.Krabbendam, L.A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychol Med. 2009;39:179–195.CrossRefGoogle ScholarPubMed
Warman, D.M.Lysaker, P.H.Martin, J.M.Davis, L.Haudenschield, S.L.Jumping to conclusions and the continuum of delusional beliefs. Behav Res Ther. 2007;45:1255–1269.CrossRefGoogle ScholarPubMed
Warman, D.M.Martin, J.M.Jumping to conclusions and delusion proneness: the impact of emotionally salient stimuli. J Nerv Ment Dis. 2006;194:760–765.CrossRefGoogle ScholarPubMed
White, L.O.Mansell, W.Failing to ponder? Delusion-prone individuals rush to conclusions. Clin Psychol Psychother. 2009;16:111–124.CrossRefGoogle Scholar
Woodward, T.S.Buchy, L.Moritz, S.Liotti, M.A bias against disconfirmatory evidence is associated with delusion proneness in a nonclinical sample. Schizophr Bull. 2007;33:1023–1028.CrossRefGoogle Scholar
Woodward, T.S.Moritz, S.Chen, E.Y.The contribution of a cognitive bias against disconfirmatory evidence (BADE) to delusions: a study in an Asian sample with first episode schizophrenia spectrum disorders. Schizophr Res. 2006;83:297–298.CrossRefGoogle Scholar
Zawadzki, J.A.Woodward, T.S.Sokolowski, H.M.Boon, H.S.Wong, A.H.C.Menon, M.Cognitive factors associated with subclinical delusional ideation in the general population. Psychiatry Res. 2012;197:345–349.CrossRefGoogle ScholarPubMed
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