Cognitive Biases Questionnaire for Psychosis

Abstract

Objective: The Cognitive Biases Questionnaire for psychosis (CBQp) was developed to capture 5 cognitive distortions (jumping to conclusions, intentionalising, catastrophising, emotional reasoning, and dichotomous thinking), which are considered important for the pathogenesis of psychosis. Vignettes were adapted from the Cognitive Style Test (CST), 1 relating to "Anomalous Perceptions" and "Threatening Events" themes. Method: Scale structure, reliability, and validity were investigated in a psychosis group, and CBQp scores were compared with those of depressed and healthy control samples. Results: The CBQp showed good internal consistency and test-retest reliability. The 5 biases were not independent, with a 2-related factor scale providing the best fit. This structure suggests that the CBQp assesses a general thinking bias rather than distinct cognitive errors, while Anomalous Perception and Threatening Events theme scores can be used separately. Total CBQp scores showed good convergent validity with the CST, but individual biases were not related to existing tasks purporting to assess similar reasoning biases. Psychotic and depressed populations scored higher than healthy controls, and symptomatic psychosis patients scored higher than their nonsymptomatic counterparts, with modest relationships between CBQp scores and symptom severity once emotional disorders were partialled out. Anomalous Perception theme and Intentionalising bias scores showed some specificity to psychosis. Conclusions: Overall, the CBQp has good psychometric properties, although it is likely that it measures a different construct to existing tasks, tentatively suggested to represent a bias of interpretation rather than reasoning, judgment or decision-making processes. It is a potentially useful tool in both research and clinical arenas. Key words: schizophrenia/thinking errors/delusions/ hallucinations/cognitive behavior therapy for psychosis IntroductionRecent biopsychosocial models of psychosis have emphasized the central role of cognitive factors, 2-5 both in terms of the content of appraisals 6,7 and the process of reasoning and metacognition. 8,9 Specifically, there is a large body of work demonstrating that cognitive biases play a key role in the formation and maintenance of delusions. 10 The strongest evidence base relates to the "jumping to conclusions" (JTC) 8 and attributional biases. 11 The JTC bias refers to the tendency to gather little information before making a decision, thereby increasing the likelihood of inaccurate beliefs being formed hastily. It is present in schizotypal, 12,13 at-risk, 14 symptomatic, 8 and remitted 15 psychotic populations and is stable over time. 16 Attributional biases have been investigated mainly in persecutory 17,18 and, to a lesser extent, in grandiose delusions. 19 Deluded participants make external attributions for negative events 20 and, more specifically, favor personalizing attributions, 21 whereby other people, rather than circumstances, are blamed for negative events. 6,7 While the researc...

Worry processes in patients with persecutory delusions

“…However, it may be that individuals with paranoia make fewer leaps but each one of a more threatening variety. Indeed, this is what has been found in a previous study of catatsrophizing and paranoia (Peters et al ., ). Intriguingly, in the case of two of the psychological mechanisms – intolerance of uncertainty and the need to control thoughts metacognitive belief, paranoia had a unique association that was independent of levels of anxiety and worry.…”

Sleep problems and worrying precede psychotic symptoms during an online intervention for psychosis

“…However, even if it had been, the scale would nonetheless differ from experimental paradigms such as the beads task (Ross, McKay, Coltheart, & Langdon, 2015). Even established self‐report scales show no correlation (CBQp; Peters et al, 2014) or only moderate correlation with the beads task (DACOBS; van der Gaag et al, 2013). This inconsistency of self‐report and objective measures could be due to the lack of metacognitive awareness of cognitive deficits and biases in psychosis (Peters et al, 2014).…”

Interpretation Bias in Paranoia: A Systematic Review and Meta-Analysis

“…Questionnaire for Psychosis (Catastrophizing) (Peters et al, 2014) The Cognitive Biases Questionnaire for psychosis is a 30-vignette task that aims to examine five types of cognitive biases in psychosis using self-report: "intentionalizing," "catastrophizing," "dichotomous thinking," "jumping to conclusions," and "emotional reasoning." Fifteen vignettes were about anomalous perception, and 15 vignettes were about threatening situations.…”

“…Questionnaire for psychosis (Peters et al, 2014); GPTS = Paranoid Thoughts Scale (Green et al, 2008); IPSAQ = Internal, Personal, and Situational Attributions Questionnaire (Kinderman & Bentall, 1996); LSHS = Launay-Slade Hallucinations Scale (Larøi et al, 2004); PANSS = Positive and Negative Syndrome Scale (Kay et al, 1987); PS = Paranoia Scale (Fenigstein & Vanable, 1992); SANS = Scale for the Assessment of Negative Symptoms; SAPS = Scale for the Assessment of Positive Symptoms (Andreasen, 1984); SCL90R = Symptom Checklist-90 Revised (Derogatis & Savitz, 1999); SRT = similarity-rating task (Mathews & Mackintosh, 2000); SST = scrambled-sentences task (Wenzlaff, 1993). Kinderman & Bentall, 1996), the Ambiguous Intentions Hostility Questionnaire (AIHQ; Combs, Penn, Wicher, & Waldheter 2007), individually designed vignette-based questionnaires, and self-report measures regarding virtual-reality experiences.…”