Delusion formation and reasoning biases in those at clinical
                        high risk for psychosis

Broome, Matthew R.; Johns, Louise; Valli, Isabel; Woolley, James B.; Tabraham, Paul; Brett, Caroline; Valmaggia, Lucia; Peters, Emmanuelle; Garety, Philippa; McGuire, Philip

doi:10.1192/bjp.191.51.s38

Cited by 174 publications

(155 citation statements)

References 31 publications

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“…The Intolerance of Uncertainty Scale (IUS) was developed to assess the concept (Freeston et al 1994). Consistent with the idea that JTC is a motivated strategy to reduce the occurrence of distressing uncertainty, Broome et al (2007) found higher levels of intolerance of uncertainty to be associated with less data gathering in the beads task in a combined high risk of psychosis (n = 35) and non-clinical control (n = 23) group.…”

Section: Introductionmentioning

confidence: 96%

Understanding jumping to conclusions in patients with persecutory delusions: working memory and intolerance of uncertainty

et al. 2014

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Background. Persecutory delusions are a key psychotic experience. A reasoning style known as 'jumping to conclusions' (JTC) -limited information gathering before reaching certainty in decision making -has been identified as a contributory factor in the occurrence of delusions. The cognitive processes that underpin JTC need to be determined in order to develop effective interventions for delusions. In the current study two alternative perspectives were tested: that JTC partially results from impairment in information-processing capabilities and that JTC is a motivated strategy to avoid uncertainty.Method. A group of 123 patients with persistent persecutory delusions completed assessments of JTC (the 60:40 beads task), IQ, working memory, intolerance of uncertainty, and psychiatric symptoms. Patients showing JTC were compared with patients not showing JTC.Results. A total of 30 (24%) patients with delusions showed JTC. There were no differences between patients who did and did not jump to conclusions in overall psychopathology. Patients who jumped to conclusions had poorer working memory performance, lower IQ, lower intolerance of uncertainty and lower levels of worry. Working memory and worry independently predicted the presence of JTC.Conclusions. Hasty decision making in patients with delusions may partly arise from difficulties in keeping information in mind. Interventions for JTC are likely to benefit from addressing working memory performance, while in vivo techniques for patients with delusions will benefit from limiting the demands on working memory. The study provides little evidence for a contribution to JTC from top-down motivational beliefs about uncertainty.

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Section: Introductionmentioning

confidence: 96%

Understanding jumping to conclusions in patients with persecutory delusions: working memory and intolerance of uncertainty

et al. 2014

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“…Knowledge of neurocognitive function in this group is growing rapidly. Neuropsychological studies point to an impairment of executive and memory functions (Brewer et al 2005) with some deficits only evident when the task demands are relatively high (Broome et al 2007). In general, neuropsychological performance in ARMS subjects has been found to be at an intermediate level relative to patients with schizophrenia and controls Brewer et al 2005 ;Lencz et al 2006 ;Wagner et al 2006 ;Pukrop et al 2007), with evidence suggesting that spatial working memory (SWM) is impaired.…”

Section: Introductionmentioning

confidence: 99%

Neural correlates of visuospatial working memory in the ‘at-risk mental state’

et al. 2010

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Background. Impaired spatial working memory (SWM) is a robust feature of schizophrenia and has been linked to the risk of developing psychosis in people with an at-risk mental state (ARMS). We used functional magnetic resonance imaging (fMRI) to examine the neural substrate of SWM in the ARMS and in patients who had just developed schizophrenia.Method. fMRI was used to study 17 patients with an ARMS, 10 patients with a first episode of psychosis and 15 agematched healthy comparison subjects. The blood oxygen level-dependent (BOLD) response was measured while subjects performed an object-location paired-associate memory task, with experimental manipulation of mnemonic load.Results. In all groups, increasing mnemonic load was associated with activation in the medial frontal and medial posterior parietal cortex. Significant between-group differences in activation were evident in a cluster spanning the medial frontal cortex and right precuneus, with the ARMS groups showing less activation than controls but greater activation than first-episode psychosis (FEP) patients. These group differences were more evident at the most demanding levels of the task than at the easy level. In all groups, task performance improved with repetition of the conditions. However, there was a significant group difference in the response of the right precuneus across repeated trials, with an attenuation of activation in controls but increased activation in FEP and little change in the ARMS. Conclusions.Abnormal neural activity in the medial frontal cortex and posterior parietal cortex during an SWM task may be a neural correlate of increased vulnerability to psychosis.

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“…Several studies analyzed the JTC bias and its association with neurocognitive abilities in ARMS patients. [22][23][24][25] Most of these studies characterized ARMS patients according to APS and BLIPS. 23 However, including cognitive basic symptoms 26 in the characterization of patients seems to be a necessary and complementary approach to ultra-high risk (UHR) criteria, allowing for the detection of earlier stages of ARMS.…”

Section: J Psychiatry Neurosci 2015;40(3)mentioning

confidence: 99%

“…[22][23][24][25] Most of these studies characterized ARMS patients according to APS and BLIPS. 23 However, including cognitive basic symptoms 26 in the characterization of patients seems to be a necessary and complementary approach to ultra-high risk (UHR) criteria, allowing for the detection of earlier stages of ARMS. 27,28 Yet, the importance of metacognition in early prodromal stages and the interaction with cognitive basic symptoms is still unclear.…”

Section: J Psychiatry Neurosci 2015;40(3)mentioning

confidence: 99%

Reduced activation in the ventral striatum during probabilistic decision-making in patients in an at-risk mental state

Rausch

Mier

Eifler

et al. 2015

jpn

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Delusion formation and reasoning biases in those at clinical high risk for psychosis

Abstract: People with an at-risk mental state display a jumping to conclusions reasoning style, associated with impaired working memory and intolerance of uncertainty. This may underlie a tendency to develop abnormal beliefs and a vulnerability to psychosis.

Cited by 174 publications

References 31 publications

Understanding jumping to conclusions in patients with persecutory delusions: working memory and intolerance of uncertainty

Understanding jumping to conclusions in patients with persecutory delusions: working memory and intolerance of uncertainty

Neural correlates of visuospatial working memory in the ‘at-risk mental state’

Reduced activation in the ventral striatum during probabilistic decision-making in patients in an at-risk mental state

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