The Benefits of Doubt: Cognitive Bias Correction Reduces Hasty Decision-Making in Schizophrenia

Abstract

Many patients with schizophrenia display neuropsychological deficits in concert with cognitive biases, particularly the tendency to jump to conclusions (JTC). The present study examined the effects of a generic psychoeducational cognitive bias correction (CBC) program. We hypothesized that demonstrating the fallibility of human cognition to patients would diminish their susceptibility to the JTC bias. A total of 70 participants with schizophrenia were recruited online. At baseline, patients were asked to fill out a JTC task (primary outcome) and the Paranoia Checklist before being randomized to either the CBC or a waitlist control condition. The CBC group received six successive pdf-converted PowerPoint presentations teaching them about cognitive biases; we neither placed any emphasis on psychosis-related cognitive distortions nor addressed psychosis. Six weeks after inclusion, subjects were re-administered the JTC task and the Paranoia Checklist. At a medium-to-large effect size the JTC bias was significantly improved under the CBC condition in comparison to controls for both the per protocol and the intention to treat analysis. The Paranoia Checklist remained essentially unchanged over time. No effects were observed for depression. Psychoeducational and cognitive programs are urgently needed as many patients are still deprived of any psychological treatment despite recommendations of most guidelines. Self-help may bridge the large treatment gap in schizophrenia and motivate patients to seek help. The study asserts both the feasibility and effectiveness of self-help programs in schizophrenia.

The role of expectancies and emotional load in false auditory perceptions among patients with schizophrenia spectrum disorders

“…self-monitoring) that may influence severe reality distortions in SSD [ 19 , 21 ]. Hence, linking existing clinical interventions, targeting cognitive biases to ameliorate delusions as well as other dysfunctional beliefs [ 40 , 41 ], and developing new techniques to work directly with perceptual anomalies may be beneficial in developing new therapeutic protocols for patients. Addressing the impact of strong priors, i.e.…”

Is metacognitive training for psychosis effective?

“…At this point, however, it is too early to say whether MCT is efficient in non-psychotic disorders as well. There is also good evidence for efficacy from other bias correction programs [13,14], some of which have evolved from MCT, that the approach is both feasible and effective.…”

“…difficulties with comprehension) used to assess and measure these biases may be contributing to this [18]. There is preliminary evidence that the MCT works by 'sowing the seeds of doubt', that is, overconfidence is reduced when patients gain insight into the fallibility of everyday human cognition [7,14].…”

Remote Cognitive Assessment in Severe Mental Illness: A Scoping Review

“…Cognitive biases were primarily assessed using scales rather than tasks, which are more amenable to remote administration via online survey platforms. Importantly, most cognitive bias scales and all cognitive bias tasks identified were designed to address individual biases, such as jumping to conclusions 45,[52][53][54] . The most general measure of cognitive biases identified was the Davos Assessment of Cognitive Biases Scale 55 , though it does not measure all biases reported in psychiatric disorders.…”