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

AIM: Psychotic-like experiences (PLEs) are experiences in the general population that, in their extreme form, are attributed to clinical psychosis. They are correlated with general psychopathology and increased risk of developing psychosis. Previous research show a multitude of measuring tools which most often lack psychometric validation. This study aimed to examine both categorical and metacognitive measures of PLEs. METHODS: Confirmatory Factor Analysis (CFA) was used in seven online studies with n's ranging from 259 to 6772 to explore factor structures of Prodromal Questionnaire 16 item (PQ-16), Revised Green et al. Paranoid Thoughts Scale (R-GPTS), Multi-Modality Unusual Sensory Experiences Questionnaire (MUSEQ), Beliefs about Paranoia Scale (BAPS) and Interpretation of Voices Inventory (IVI). Additionally, we explored measurement invariance between diagnosed with psychiatric disorders and undiagnosed individuals in PQ-16, R-GPTS and BAPS. RESULTS: We confirmed the factor structures of all questionnaires except IVI. We confirmed configural, threshold and metric measurement invariance in R-GPTS and BAPS and partially PQ-16. CONCLUSIONS: The current results demonstrate structural validity and measurement invariance of several categorical and metacognitive measures of PLEs.

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

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

Cognitive correlates of auditory hallucinations in schizophrenia spectrum disorders.

Auditory hallucinations (AHs) are one of the central symptoms of schizophrenia spectrum disorders (SSD). Current cognitive models of AH implicate source monitoring, top-down processes, and inhibitory control. However, research combining these processes is limited. Our study aimed to examine how source monitoring bias, top-down processes, and inhibitory control contribute to AHs in individuals with SSD. Eighty seven patients (aged 18-45 years) with SSD were included in the analyses. Participants completed cognitive tasks assessing source monitoring (Action Memory Task), top-down processes (False Perception Task; FPT), and inhibitory control (Auditory Go/NoGo task). AH was positively associated with response bias on the FPT. Correlations between AH and the other cognitive tasks were nonsignificant. Source monitoring errors correlated positively with response bias measures and negatively with Hits on the FPT. PANSS total score was positively correlated with source monitoring bias and False Alarms on the Go/NoGo task. The severity of disorganized symptoms was related to Source Monitoring Errors and False Alarms in the Go/NoGo task. Negative symptoms were associated with Hits and False Alarms in the Go/NoGo task. Future studies are necessary to further elucidate the relationships between different cognitive processes that may be related to clinical symptoms of psychosis.

A review of selected psychotherapies for PTSD, their efficacy and treatment guidelines in adults. / Przeglad wybranych psychoterapii PTSD, ich skutecznosci i zalecen terapeutycznych w terapii osób doroslych.

AIM: Around 2.5% of Poles will develop post-traumatic stress disorder (PTSD) during their lifetime. Recent events, i.e. the pandemic and the war in Ukraine, are the factors that will increase the number of people dealing with PTSD. Owing to that, this paper aims to review and familiarise readers with the available scientific evidence on psychotherapies of PTSD provided in Poland. MATERIAL AND METHODS: A review of meta-analyses of randomised controlled trials and a review of the most recent treatment guidelines concerning PTSD. RESULTS: The best available evidence points to high efficacy of cognitive-behavioural therapy (CBT) with prolonged exposure and Eye Movement Desensitization and Reprocessing (EMDR). Humanistic therapy also proves effective to a certain degree, but not as effective as therapies that use exposure to stimuli and memories associated with trauma. There is no evidence of the efficacy of psychodynamic therapy and methods based on polyvagal theory. Organisations preparing guidelines recommend primarily CBT and EMDR. CONCLUSIONS: Efficacious treatment of PTSD should include a protocol with a component of exposure to trauma-related memories and stimuli. It is recommended to use such therapies in the psychotherapeutic treatment of PTSD.

Phantom phone signals and other hallucinatory-like experiences: Investigation of similarities and differences.

Phantom Phone Signals (PPS) and other hallucinatory-like experiences (HLEs) are perceptual anomalies that are commonly reported in the general population. Both phenomena concern the same sensory modality, but PPS are restricted to smartphone use. The current study aimed to assess similarities and differences between these types of anomalies in relation to general psychopathology, metacognitive beliefs about perception, smartphone dependence, and susceptibility to top-down influences on perception. We analyzed data from a Polish community sample (N = 236, aged 18-69). We used questions pertaining to PPS, a questionnaire pertaining to HLEs (Multi-Modality Unusual Sensory Experiences Questionnaire), and other variables of interest (Symptom Checklist-27-plus, Mobile Phone Problematic Use Scale, and the Beliefs about Perception Questionnaire). Additionally, a false-perception task manipulating cognitive expectancy (i.e., a visual cue associated with auditory stimuli vs. no visual cue) was devised to measure top-down influences on perception. Regression analyses showed that only top-down beliefs about perception predicted both PPS and HLEs. Smartphone dependency proved to be a stronger predictor of PPS than other measured variables, whereas for HLEs, general psychopathology was the strongest predictor. Current results suggest that despite sharing some mechanisms, PPS and HLEs may have independent underlying factors.

Cognitive-Attentional Syndrome Moderates the Relationship Between Fear of Coronavirus and Symptoms of Coronavirus-Specific Health Anxiety.

This study was aimed at exploring the possible roles of the cognitive attentional syndrome (CAS) and metacognitive beliefs in moderating the relationships between fear of coronavirus during the pandemic and health anxiety. Because some symptoms of health anxiety may overlap with symptoms of other anxiety disorders, we also tried to ascertain whether our hypothesized relations would be maintained when taking other anxiety disorder symptoms into account. We hypothesized that CAS strategies and meta-beliefs would play a role in the progression from fears of the coronavirus to coronavirus health anxiety. The method done was a cross-sectional study with n = 783 participants who completed questionnaires on fear of coronavirus, coronavirus-specific health anxiety, CAS, and symptoms of anxiety disorders. Fear of coronavirus and coronavirus health anxiety are correlated with medium effect size. CAS and metacognitive beliefs moderate the relationship between fear of coronavirus and symptoms of coronavirus-specific health anxiety. CAS predicts a unique part of health anxiety symptoms variance above symptoms of other anxiety disorders. The results of this cross-sectional study preclude causal inferences but tentatively suggest that CAS strategies may play a role in moderating the relationship between fear of coronavirus and coronavirus-related health anxiety. These relationships were obtained after controlling for variance shared with agoraphobia, social phobia, and general physical symptoms of anxiety.

Visual worry in patients with schizophrenia.

OBJECTIVE: Worrying is a pervasive transdiagnostic symptom in schizophrenia. It is most often associated in the literature with verbal modality due to many studies of its presence in generalised anxiety disorder. The current study aimed to elucidate worry in different sensory modalities, visual and verbal, in individuals with schizophrenia. METHOD: We tested persons with schizophrenia (n = 92) and healthy controls (n = 138) in a cross-sectional design. We used questionnaires of visual and verbal worry (original Worry Modality Questionnaire), trait worry (Penn State Worry Questionnaire) and general psychopathology symptoms (General Functioning Questionnaire-58 and Brief Psychiatric Rating Scale). RESULTS: Both visual and verbal worry were associated with psychotic, anxiety and general symptoms of psychopathology in both groups with medium to large effect sizes. Regression analyses indicated that visual worry was a single significant predictor of positive psychotic symptoms in a model with verbal and trait worry, both in clinical and control groups (ß's of 0.49 and 0.38, respectively). Visual worry was also a superior predictor of anxiety and general psychopathology severity (ß's of 0.34 and 0.37, respectively) than verbal worry (ß's of 0.03 and -0.02, respectively), under control of trait worry, in the schizophrenia group. We also proposed two indices of worry modality dominance and analysed profiles of dominating worry modality in both groups. CONCLUSIONS: Our study is the first to demonstrate that visual worry might be of specific importance for understanding psychotic and general psychopathology symptoms in persons with schizophrenia.

'Thinking about Them is only making me feel worse'. The mediating role of metacognitive factors in the relationship between paranoia-like beliefs and psychopathology symptoms in a community sample.

INTRODUCTION: Paranoia in community samples is associated with higher levels of depression, anxiety symptoms and suicidality. The metacognitive model assumes the role of metacognitive factors in these associations. Positive and negative metacognitive beliefs (PMB and NMB, respectively) and cognitive-attentional syndrome (CAS) are to mediate between paranoia-like beliefs and psychopathology symptoms. The current study is an attempt to test this prediction. METHODS: A cross-sectional community study with n = 840 participants. We used R-GPTS's persecutory subscale to measure paranoia-like beliefs, CAS-1 for CAS and metacognitive beliefs and SCL-27-plus for psychopathology symptoms. RESULTS: Indirect effects of PMB, CAS and NMB accounted for 22% to 56% (CI 95%) of total effects of relationships between paranoia-like beliefs and vegetative symptoms, symptoms of social phobia, agoraphobia, depression and suicidality screening. CONCLUSIONS: We demonstrated that PMB, CAS and NMB mediate between paranoia-like beliefs and various psychopathological symptoms, as predicted by the metacognitive model of psychopathology. We also uncovered other indirect effects, including negative mediation effect of PMB on the relationship between paranoia-like beliefs and depressive symptoms and suicidality.

Neural functional connectivity during rumination in individuals with adverse childhood experiences.

Background: Childhood adversity has been associated with greater risk of developing psychopathology, altered processing of emotional stimuli, and changes in neural functioning. Although the neural correlates of rumination have been previously described, little is known about how adverse childhood experiences are related to brain functioning during rumination. Objective: This study explored differences in neural functional connectivity between participants with and without histories of childhood adversity, controlling for tendency to ruminate, during resting-state and induction of rumination. Method: A total of 86 adults (51 women) took part. Based on a diagnostic clinical interview, participants were divided into groups with and without adverse childhood experiences. All participants underwent resting-state imaging and a functional magnetic resonance imaging scan where they performed a rumination induction task. Results: Individuals with childhood adversities differed from those without adverse experiences in seed-based functional connectivity from right angular gyrus and left superior frontal gyrus during the rumination task. There were also group differences during resting-state in seed-based functional connectivity from the right angular gyrus, left middle temporal gyrus, and left superior frontal gyrus. Conclusions: Childhood adversity is associated with altered brain functioning during rumination and resting-state, even after controlling for tendency to ruminate. Our results shed light on the consequences of early adversity. People who experienced childhood adversities differ from those with no adverse experiences in brain functional connectivity when engaged in negative repetitive self-referential thinking.

Antecedentes: La adversidad en la infancia se ha asociado con un mayor riesgo de desarrollar psicopatología, alteración del procesamiento de estímulos emocionales y cambios en el funcionamiento neuronal. Aunque los correlatos neuronales de la rumiación se han descrito previamente, se sabe poco acerca de cómo las experiencias adversas en la infancia se relacionan con el funcionamiento del cerebro durante la rumiación.Objetivo: Este estudio exploró las diferencias en la conectividad neuro funcional entre participantes con y sin antecedentes de adversidad en la infancia, controlando la tendencia a rumiar, durante el estado de reposo y la inducción de la rumiación.Método: Participaron un total de 86 adultos (51 mujeres). Basado en una entrevista clínica de diagnóstico, los participantes se dividieron en grupos con y sin experiencias adversas en infancia. Todos los participantes se sometieron a imágenes en estado de reposo y a una resonancia magnética funcional en la que realizaron una tarea de inducción de la rumiación.Resultados: Los individuos con adversidades en la infancia diferían de aquellos sin experiencias adversas en la conectividad funcional basada en semillas de la circunvolución angular derecha y la circunvolución frontal superior izquierda durante la tarea de rumiación. También hubo diferencias de grupo durante el estado de reposo en la conectividad funcional basada en semillas de la circunvolución angular derecha, la circunvolución temporal media izquierda y la circunvolución frontal superior izquierda.Conclusiones: La adversidad en la infancia se asocia con un funcionamiento cerebral alterado durante la rumiación y el estado de reposo, incluso después de controlar la tendencia a rumiar. Nuestros resultados aclaran las consecuencias de la adversidad temprana. Las personas que experimentaron adversidades en la infancia difieren de aquellas que no tuvieron experiencias adversas en la conectividad funcional del cerebro cuando se dedican al pensamiento autorreferencial repetitivo negativo.

Brain structural correlates of cognitive-attentional syndrome - a Voxel-Based Morphometry Study.

Cognitive-attentional syndrome (CAS) is in the self-regulatory executive function model a set of cognitive and behavioural strategies aimed at regulating cognition and emotion originating from maladaptive metacognitive beliefs. Investigating the brain structure of people with high levels of CAS enables a better understanding of the syndrome and bridging between the metacognitive model of psychopathology and previous results on structural abnormalities in various psychological disorders. Participants with high (n=40) and low levels of CAS (n=44) underwent structural Magnetic Resonance Imaging session. Voxel-Based Morphometry analytical approach was used to compute grey matter volume (GMV) differences between the groups. The group with a high level of CAS had lower GMV in the dorsal part of the anterior cingulate cortex. Our results are in line with the self-regulatory executive function model of psychopathology, showing a link between CAS and lowered GMV in the brain region associated with the regulation of cognition and emotion. They are also in agreement with meta-analytical results on structural correlates of various psychological disorders.

Neural Correlates of Aberrant Salience and Source Monitoring in Schizophrenia and At-Risk Mental States-A Systematic Review of fMRI Studies.

Cognitive biases are an important factor contributing to the development and symptom severity of psychosis. Despite the fact that various cognitive biases are contributing to psychosis, they are rarely investigated together. In the current systematic review, we aimed at investigating specific and shared functional neural correlates of two important cognitive biases: aberrant salience and source monitoring. We conducted a systematic search of fMRI studies of said cognitive biases. Eight studies on aberrant salience and eleven studies on source monitoring were included in the review. We critically discussed behavioural and neuroimaging findings concerning cognitive biases. Various brain regions are associated with aberrant salience and source monitoring in individuals with schizophrenia and the risk of psychosis. The ventral striatum and insula contribute to aberrant salience. The medial prefrontal cortex, superior and middle temporal gyrus contribute to source monitoring. The anterior cingulate cortex and hippocampus contribute to both cognitive biases, constituting a neural overlap. Our review indicates that aberrant salience and source monitoring may share neural mechanisms, suggesting their joint role in producing disrupted external attributions of perceptual and cognitive experiences, thus elucidating their role in positive symptoms of psychosis. Account bridging mechanisms of these two biases is discussed. Further studies are warranted.

Adherence to safety and self-isolation guidelines, conspiracy and paranoia-like beliefs during COVID-19 pandemic in Poland - associations and moderators.

BACKGROUND: Due to coronavirus pandemic, governments have ordered a nationwide isolation. In this situation, we hypothesised that people holding conspiracy beliefs are less willing to adhere to medical guidelines. Furthermore, we explored what possible factors may modify relationships between conspiracy, paranoia-like beliefs, and adherence to epidemiological guidelines. Also, we examined the prevalence of different coronavirus conspiracy beliefs. METHODS: Two independent internet studies. Study 1 used a proportional quota sample that was representative of the population of Poles in terms of gender and settlement size (n=507). Study 2 employed a convenience sample (n=840). RESULTS: Coronavirus conspiracy beliefs are negatively related to safety guidelines. Mixed results suggest that paranoia-like beliefs are related negatively to safety guidelines. Prevalence of firmly held coronavirus conspiracy beliefs is rare. Nevertheless, certain percentage of participants agree with conspiracy beliefs at least partially. Coronavirus related anxiety, trust in media, and internal motivation to isolation moderate the relationship between conspiracy beliefs and adherence to safety guidelines. Paranoia-like beliefs partially mediate between boredom and conspiracy beliefs. CONCLUSIONS: Conspiracy beliefs concerning coronavirus are present in the population and are negatively related to adherence to safety guidelines. Conspiracy beliefs originate partially from boredom and paranoia proneness. Certain factors - trust in media and internal motivation to isolation - are potentially worthwhile to address to enhance adherence to safety guidelines. Non-probabilistic sampling suggests caution in interpretation of the present findings.

Effects of attention training technique on brain function in high- and low-cognitive-attentional syndrome individuals: Regional dynamics before, during, and after a single session of ATT.

OBJECTIVE: Attention Training Technique (ATT) is a key therapeutic tool in metacognitive therapy. There are numerous studies on the behavioral effects of ATT, however the neural mechanisms at work in the training are yet to be uncovered. To date there have been no controlled fMRI studies of ATT. METHOD: We conducted a randomized double-blind controlled study of two groups with varying levels of cognitive-attentional syndrome (CAS). Groups with high (n = 43) and low (n = 46) levels of CAS underwent a single session of ATT or a control condition (CON) in an MRI scanner. Participants underwent resting state functional MRI (rsfMRI) sessions and rumination induction sessions both pre- and post-intervention Functional connectivity analyses and inter-subject correlations analyses were computed. We also collected data on emotion and attention functioning pre- and post-intervention. RESULTS: We did not observe any behavioral effects of ATT. However, direct comparison between ATT and CON sessions revealed greater inter-subject correlations in almost all hubs belonging to the studied functional networks. Moreover, subjects who received ATT showed diminished connectivity in the fronto-parietal network during ruminations and diminished connectivity of the precuneus with lateral occipital cortices and the intraparietal sulcus in abstract thinking and rsfMRI, respectively. Furthermore, some of the observed effects in functional connectivity and inter-subject correlations were specific to different levels of CAS. CONCLUSIONS: Our results may support a proposed neural mechanism for ATT: disengagement of attention from CAS-type processing in either low- or high-CAS individuals. It is also possible that some neural effects of ATT are specific to individuals with different levels of CAS.

Psychometric properties of the General Functioning Questionnaire (GFQ-58) used for screening for symptoms of psychopathology and overall level of functioning. / Wlasciwosci psychometryczne Kwestionariusza Ogólnej Oceny Funkcjonowania (KOOF-58) sluzacego do przesiewowego pomiaru nasilenia objawów psychopatologicznych i poziomu ogólnego funkcjonowania.

OBJECTIVES: Measuring severity of psychopathological symptoms using self-assessment questionnaires is important for clinical and scientific research. However, there is no widely-available Polish tool which measures both overall functioning and severity of a broad spectrum of psychopathological symptoms. This paper describesthe designing of such a tool -the General Functioning Questionnaire (GFQ-58). METHODS: Three studies were conducted to verify the validity and reliability of the GFQ-58: (1)a study comparing 30 individuals diagnosed with schizophrenia and 30 with no psychiatric diagnosis; (2) a correlational study on 602 individuals exploring relationships between the GFQ-58 and tendency for rumination and quality of life; and (3) a study on 37 patients from a ward which treats neurotic and personality disorders, exploring the relationships between the GFQ-58 and tools for measuring severity of psychopathological symptoms, overall functioning and neurotic personality. RESULTS: The first study revealed large differences between individuals suffering from schizophrenia and healthy individuals in the overall score of the questionnaire (p < 0.001; d = 1.30) and some of its subscales. The second study showed strong relations between the GFQ-58 and both severity of rumination (p < 0.001; . = 0.64) and quality of life (p < 0.001; .=-0.81). The third study identified relationships between the GFQ-58 and tools measuring various psychopathological symptoms, overall functioning and neurotic personality. These relationships were moderate or strong (all p . 0.001; r =0.43-0.86). Reliability of the overall score was satisfactory in all studies (Cronbach's . = 0.89-0.92). CONCLUSIONS: The GFQ-58 has satisfactory validity and reliability. It can be used in both scientific and clinical research as a screening tool for measuring overall functioning and severity of psychopathological symptoms.

Neural Correlates of Cognitive-Attentional Syndrome: An fMRI Study on Repetitive Negative Thinking Induction and Resting State Functional Connectivity.

AIM: Cognitive-attentional syndrome (CAS) is the main factor underlying depressive and anxiety disorders in the metacognitive approach to psychopathology and psychotherapy. This study explore neural correlates of this syndrome during induced negative thinking, abstract thinking, and resting states. METHODS: n = 25 people with high levels of CAS and n = 33 people with low levels of CAS were chosen from a population-based sample (N = 1225). These groups filled-in a series of measures of CAS, negative affect, and psychopathology; they also underwent a modified rumination induction procedure and a resting state fMRI session. Resonance imaging data were analyzed using static general linear model and functional connectivity approaches. RESULTS: The two groups differed with large effect sizes on all used measures of CAS, negative affect, and psychopathology. We did not find any group differences in general linear model analyses. Functional connectivity analyses showed that high levels of CAS were related to disrupted patterns of connectivity within and between various brain networks: the default mode network, the salience network, and the central executive network. CONCLUSION: We showed that low- and high-CAS groups differed in functional connectivity during induced negative and abstract thinking and also in resting state fMRI. Overall, our results suggest that people with high levels of CAS tend to have disrupted neural processing related to self-referential processing, task-oriented processing, and emotional processing.

Cognitive-attentional syndrome - The psychometric properties of the CAS-1 and multi-measure CAS-based clinical diagnosis.

The Cognitive-attentional Syndrome Questionnaire (CAS-1) is a short self-descriptive measure developed to provide information regarding the severity of cognitive-attentional syndrome, a key construct in metacognitive therapy. The three presented studies explore the psychometric properties of the CAS-1. Study 1 was based on a community sample (N = 1225) and explored the factor structure of the CAS-1, its relations with measures of rumination and metacognitive beliefs, and its demographic structure. Study 2, performed on an internet-based sample (N = 602), explored relations of the CAS-1 with measures of rumination, psychopathology, and quality of life. This study also dealt with the validity of the CAS-1. Study 3 was conducted on participants selected from study 1 (n = 98), based on the results of the CAS-1 and other measures. It explored the predictive validity of the questionnaire's diagnosis through ascertaining clinical diagnoses. All three studies confirm the reliability of the CAS-1. Its validity was confirmed by significant associations with measures of rumination, metacognitive beliefs, psychopathology, and quality of life. Two-factor and four-factor structures of the CAS-1 were confirmed, with the two-factor model better fitting the data. The results obtained show that the CAS-1 has good psychometric properties; its current form is deemed most acceptable for clinical use and we advise use of combined measures of CAS or development of a more expanded measure of CAS for research purposes.

Relationship of emotional distress and physical concerns with fatigue severity in sarcoidosis.

Background: Fatigue is one of the most common and disabling symptoms of sarcoidosis. The cause of fatigue remains unclear and is usually multifactorial. The majority of previous studies evaluated clinical parameters with only few of them including assessment of psychological factors as contributing to the severity of the symptoms. Objective: The aim of this study was to evaluate the relationship of emotional distress, physical concerns, and dyspnea in explaining fatigue in patients with sarcoidosis. Methods: Fifty-seven patients with sarcoidosis were enrolled to the study and filled out measures of fatigue (FAS), dyspnea (MRC), anxiety sensitivity (ASI-3), and anxiety and depression (HADS). Results: Linear regression revealed that distress and physical concerns subscale of ASI are significant predictors of fatigue explaining jointly 53.5% of fatigue variance. Conclusions: The results of the study emphasize the importance of including emotional distress and physical concerns into the diagnostic procedures and management of fatigue in sarcoidosis. (Sarcoidosis Vasc Diffuse Lung Dis 2018; 35: 160-164).

Letter to Editor. In search of definition of the term "psychotic process" - thoughts and doubts. / List do Redakcji. W poszukiwaniu definicji "procesu psychotycznego" ­ refleksje i watpliwosci.

no summary.