Jumping to conclusions in the less-delusion-prone? Further evidence from a more reliable beads task.

BACKGROUND: A single meta-analysis has found that healthy people with higher delusion-proneness tend to gather less information (i.e., make fewer draws to decision, or DTD) on the beads task, although the findings of contributing studies were mixed, and the pooled effect size was small. However, using a new and more reliable "distractor sequences" beads task, we recently found a positive relationship between delusion-proneness and DTD in a healthy sample. In the current study, we re-tested this relationship in a new sample, and tested the possibility that the relationship is driven by participant's ability to understand and use odds or likelihood information ("odds literacy"). METHODS: Healthy participants (N = 167) completed the distractor sequences beads task, the Peters Delusions Inventory (PDI) which measures delusion-proneness, a measure of odds literacy, and the Depression, Anxiety, and Stress scale. RESULTS: PDI and DTD were positively correlated, and comparing PDI quartiles on DTD confirmed a statistically significant trend of increasing DTD with PDI quartile. Odds literacy was positively rather than negatively associated with both DTD and PDI. Anxiety was positively correlated with PDI and DTD. CONCLUSIONS: We replicated our earlier finding that DTD and delusion-proneness were positively related in a non-clinical sample, but found that increased odds-literacy did not drive lower PDI and DTD, and hence did not explain their covariance. It is possible however that anxiety and co-occurring risk aversion drive increased delusion-proneness and information-gathering, potentially accounting for the positive relationship between PDI and DTD.

Jumping to conclusions in the less-delusion-prone? Preliminary evidence from a more reliable beads task.

BACKGROUND AND OBJECTIVES: Several meta-analyses have shown that people with psychosis tend to gather less information (i.e., they make fewer draws to decision, or DTD) on the beads task than healthy controls. A single meta-analysis has also found a small negative association between delusion-proneness and DTD in healthy samples, but with considerable heterogeneity. METHODS: We used the new and more reliable "distractor sequences" beads task to clarify the nature of the relationship between delusion-proneness and DTD in a healthy sample. Healthy participants (N = 203) completed the distractor sequences beads task and the Peters Delusions Inventory (PDI), which measures delusion-proneness. RESULTS: PDI and DTD were positively correlated, and those who jumped to conclusions (DTD ≤ 2) had lower PDI than those who did not. Comparing PDI quartiles on DTD provided some evidence the positive association did not extend to the highest PDI quartile. We found that DTD and delusion-proneness were positively related in our non-clinical sample, which was unexpected. LIMITATIONS: Results need replication with a clinical sample. CONCLUSIONS: Considering the well-established association between the JTC bias and clinical delusions, the current finding may reflect a relationship that differs between non-clinical and clinically significant delusional groups, or one which reverses sign at some level of delusion-proneness.

The effect of a brief online self-compassion versus cognitive restructuring intervention on trait social anxiety.

We compared two brief online interventions of 2-week duration for individuals with elevated levels of social anxiety. Participants were randomized to self-compassion or cognitive restructuring conditions (N = 119) and assessed across five assessment points, including a 5-week follow-up. Mediators and moderators of outcome were also examined. Both interventions led to significant decreases in social anxiety (d's ranged from 0.26 to 0.58), which were maintained and improved at follow-up (d's from baseline ranged from 0.53 to 0.80). Of those who were above social anxiety cut-off at baseline (>75%), approximately 20% of participants in each group showed reliable and clinically significant changes in symptoms. No differences between the treatment conditions were found for social anxiety outcomes. Similarly, there were no measures that differentially mediated the effect of treatment condition on social anxiety. Furthermore, we did not find support for a theory-driven mediational model in which self-compassion reduced social anxiety through activation of the soothing system. Contrary to predictions and theory, neither self-criticism nor fear of self-compassion moderated the effect of the interventions. Although preliminary, the findings suggest that self-compassion techniques warrant further study as an additional means of reducing social anxiety.

Individualized Metacognitive Training (MCT+) Reduces Delusional Symptoms in Psychosis: A Randomized Clinical Trial.

Individualized metacognitive training (MCT+) is a novel psychotherapy that has been designed to specifically target delusional beliefs in people with psychosis. It works by developing an awareness of the implausible content of delusional beliefs, while also targeting the cognitive biases that contribute to their formation and maintenance. It was expected that MCT+ would lead to significantly greater reductions in delusional severity compared to a cognitive remediation (CR) active control condition. A total of 54 patients with a schizophrenia spectrum disorder and active delusions were randomized into four 2-hourly sessions of MCT+ (n = 27) or CR (n = 27). All participants completed posttreatment assessment, and only 2 participants did not complete 6-month follow-up assessment, resulting in MCT+ (n = 26) and CR (n = 26) for final analysis. The primary outcome measures of delusional and positive symptom severity were assessed rater-blind; secondary outcome assessment was non-blinded and included clinical and cognitive insight, the jumping to conclusions (JTC) bias, and cognitive functioning. Participants in the MCT+ condition showed significant reductions in delusional and overall positive symptom severity (large effect) and improved clinical insight (moderate effect) relative to CR controls. In contrast, CR controls showed moderate improvement in problem-solving ability relative to MCT+, but no other cognitive domain. Importantly, these findings were maintained at 6-month follow-up. The study adds further efficacy to the MCT program, and suggests that even brief psychotherapy can help to ameliorate the symptoms of psychosis.

Towards a reliable repeated-measures beads task for assessing the jumping to conclusions bias.

The jumping to conclusions bias (JTC), in which some people gather less information than others before making a decision, has been linked to delusions in psychosis. JTC is usually identified via the beads task, in which a sequence of beads (the "target" sequence) is used to measure the amount of evidence participants require before making a decision. Yet, despite its common use, the reliability of the task has never been properly investigated. We investigated its reliability, and tested an alternate version which used distractor sequences to obfuscate the target sequence. Healthy participants (N = 212) were randomised into two groups. One group completed ten trials using the target sequence, while the other completed ten trials of the target sequence and three distractor sequences. Our data indicated the standard task may not be reliable over repeated measures, but that by including distractor sequences, the task becomes more believable, repeatable, and reliable. Additionally, excluding first-trial data (a "silent" practice trial) also improves repeatability. These improvements to the task are relevant to single trial studies, and will be especially useful to repeated-measures longitudinal, experimental, and treatment studies. Such repeated-measures studies are important for investigating the causal link between JTC and delusions.

Association of the Jumping to Conclusions and Evidence Integration Biases With Delusions in Psychosis: A Detailed Meta-analysis.

We completed a meta-analysis to investigate the relationship between delusions in psychosis and 4 cognitive biases: "jumping to conclusions" (JTC), the "bias against disconfirmatory evidence" (BADE), the "bias against confirmatory evidence" (BACE), and "liberal acceptance" (LA). Building on recent meta-analyses we compared more narrowly defined groups. We identified 35 JTC, 8 BADE, 7 BACE, and 6 LA studies for inclusion. Groups with schizophrenia who were currently experiencing delusions demonstrated greater JTC, BADE, BACE, and LA than groups with schizophrenia who were not currently experiencing delusions, who in turn demonstrated no more JTC than healthy control groups. Hence JTC, BADE, BACE, and LA co-vary with delusions in cross-sectional samples of people with schizophrenia. Groups who were experiencing delusions due to other psychiatric illnesses also demonstrated greater JTC than healthy controls, and equivalent JTC to groups with schizophrenia currently experiencing delusions. Hence JTC is associated with delusions across a range of diagnoses. Groups with other, non-delusional psychiatric illnesses demonstrated less JTC, BADE, BACE, and LA than groups with schizophrenia currently experiencing delusions, less JTC than groups experiencing delusions due to other diagnoses, and no more JTC, BADE, BACE, or LA than healthy control groups. Hence JTC, BADE, BACE, and LA were not associated with psychiatric illnesses in general. Our results indicate all 4 biases are associated with delusions specifically rather than merely with a diagnosis of schizophrenia or with being psychiatrically ill, consistent with the possibility that they contribute to delusional severity.

Objective and subjective cognitive impairment following chemotherapy for cancer: a systematic review.

Evidence suggests that some cancer survivors experience cognitive difficulties following chemotherapy. However, perceived or subjective cognitive impairment is more frequently reported than prevalence revealed by objective assessments. The aim of this review was to examine the relationship between subjective and objective measures of cognitive impairment following treatment for cancer and to determine the number of studies that found a significant relationship between these measures of cognition. A comprehensive search for articles, published between 1980 and 2012, comparing subjective and objective cognition in cancer patients treated with chemotherapy was conducted. Of 818 potentially relevant articles, 23 studies met the inclusion criteria for the current review and one article was sourced from reference lists of included studies. Only eight of 24 included studies found a significant relationship between objective and subjective measures of cognitive performance. These studies were more likely to involve breast cancer patients and to assess the relationship between memory and perceived cognitive impairment. The failure to consistently find an association between subjective and objective measures of cognition could be explained by variations in assessment methods or the definition of impairment. Alternatively, objective and perceived cognitive impairment may be unrelated because perceived impairment may be an indicator of psychological distress rather than cognitive impairment. Despite these discrepancies, patients' perceptions of impairment are important due to its significant impact on quality of life. Further research is required to explore whether objective measures of everyday functioning better predict the impact of chemotherapy related cognitive impairment on daily functioning.