The Effect of Reducing the “Jumping to Conclusions” Bias on Treatment Decision-Making Capacity in Psychosis: A Randomized Controlled Trial With Mediation Analysis

Turner, David T.; MacBeth, Angus; Larkin, Amanda; Moritz, Steffen; Livingstone, Karen; Campbell, Alison; Hutton, Paul

doi:10.1093/schbul/sby136

Cited by 7 publications

(6 citation statements)

References 41 publications

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“…It has been suggested that JTC bias is related to the decision-making process (Turner et al, 2018), and the decision-making process based on weak evidence might be linked with a worse functioning outcome in the long term. However, the formation of delusions needs other concurrent factors, such as the necessity of closure (McKay, Langdon, & Coltheart, 2007) and overconfidence in errors (Moritz et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Since some therapeutic strategies have demonstrated to be useful in the treatment of JTC (Moritz et al, 2014; Roberts et al, 2014; Waller, Freeman, Jolley, Dunn, & Garety, 2011), it would be recommendable incorporating these strategies in the early treatment of CHR population. For example, recently Turner et al (2018) reported the benefits of a specific intervention derived from the meta-cognitive treatment manual developed by Moritz et al (Moritz, Woodward, & Burlon, 2007) in reducing JTC bias.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between jumping to conclusions and clinical outcomes in people at clinical high-risk for psychosis

et al. 2020

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Background Psychosis is associated with a reasoning bias, which manifests as a tendency to ‘jump to conclusions’. We examined this bias in people at clinical high-risk for psychosis (CHR) and investigated its relationship with their clinical outcomes. Methods In total, 303 CHR subjects and 57 healthy controls (HC) were included. Both groups were assessed at baseline, and after 1 and 2 years. A ‘beads’ task was used to assess reasoning bias. Symptoms and level of functioning were assessed using the Comprehensive Assessment of At-Risk Mental States scale (CAARMS) and the Global Assessment of Functioning (GAF), respectively. During follow up, 58 (16.1%) of the CHR group developed psychosis (CHR-T), and 245 did not (CHR-NT). Logistic regressions, multilevel mixed models, and Cox regression were used to analyse the relationship between reasoning bias and transition to psychosis and level of functioning, at each time point. Results There was no association between reasoning bias at baseline and the subsequent onset of psychosis. However, when assessed after the transition to psychosis, CHR-T participants showed a greater tendency to jump to conclusions than CHR-NT and HC participants (55, 17, 17%; χ2 = 8.13, p = 0.012). There was a significant association between jumping to conclusions (JTC) at baseline and a reduced level of functioning at 2-year follow-up in the CHR group after adjusting for transition, gender, ethnicity, age, and IQ. Conclusions In CHR participants, JTC at baseline was associated with adverse functioning at the follow-up. Interventions designed to improve JTC could be beneficial in the CHR population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Relationship between jumping to conclusions and clinical outcomes in people at clinical high-risk for psychosis

et al. 2020

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“…When vSZ patients are in the actual violent situations, how the moral processes guide their decision-making is incorporated into a new framework, which draws upon the concepts and findings from other moral psychology and social cognition. It is evident that patients with schizophrenia have broader reasoning biases and cognitive limitation, such as inability to fully understand goals of the task [ 49 ], difficulty in inferring what others are thinking, and having reasoning biases towards jumping to conclusions [ 50 , 51 , 52 ]. Therefore, moral reasoning represents a necessary prerequisite for information processing and, in turn, for decision-making.…”

Section: Discussionmentioning

confidence: 99%

Effects of Integrated Moral Reasoning Development Intervention for Management of Violence in Schizophrenia: A Randomized Controlled Trial

Hsu

Ouyang

2022

JCM

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Moral cognition is an important and multidimensional, but often overlooked, determinant of violence. Very few interventions have systematically examined the role of moral reasoning, anger management and problem-solving together in violence. A randomized controlled trial was conducted to comprehensively evaluate the sustained effects of an integrated Moral Reasoning Development Intervention (MRDI) in the management of repetitive violence in schizophrenia. This study placed special emphasis on essential components related to moral reasoning and violence in patients with schizophrenia. Evaluations, including measures of violence, moral reasoning, ethical valuation and judgement, decision-making, conflict management style, and personality traits, were performed at baseline, end of intervention, and 1-month follow-up after intervention. We found that MRDI was superior to treatment-as-usual, in improving moral reasoning and related variables and violence outcomes (p < 0.05). In comparison with the treatment-as-usual group (n = 22), patients in the MRDI group (n = 21) showed improved levels of moral reasoning, with decreased levels of violent behaviors. The MRDI participants also experienced significantly greater improvements or changes (p < 0.05) in their ethical valuation and judgement, decision-making style and preferences, and conflict management style. Our findings provide important implications for risk assessment and violence management and prevention.

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“…The JTC is the most frequently used cognitive bias that is associated with delusional processes, and some recent studies test the hypothesis that it is a mediator of change in the treatment of psychosis (e.g., [31]). For example, in a single session intervention, JTC was reduced through cognitive therapy [31] and mediated change in overall cognitive capacity, which is assumed to be a requisite for effective nonpharmacological treatment of psychosis [32]. In the present study, JTC was targeted from a different angle, that is, on the backdrop of phenomenological assumptions on the role of disembodiment in psychosis.…”

Section: Discussionmentioning

confidence: 99%

Reduced Jumping to Conclusion Bias after Experimentally Induced Enhancement of Subjective Body Boundaries in Psychosis

et al. 2021

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Introduction: A disturbed sense of self is frequently discussed as an etiological factor for delusion symptoms in psychosis. Phenomenological approaches to psychopathology posit that lacking the sense that the self is localized within one’s bodily boundaries (disembodiment) is one of the core features of the disturbed self in psychosis. The present study examines this idea by experimentally manipulating the sense of bodily boundaries. Methods: Seventy-three patients with psychosis were randomly assigned to either a 10-min, guided self-massage in the experimental group (EG) to enhance the sense of bodily boundaries or a control group (CG), which massaged a fabric ring. Effects on an implicit measure (jumping to conclusion bias; JTC) and an explicit measure (Brief State Paranoia Checklist; BSPC) of delusion processes were assessed. The JTC measures the tendency to make a decision with little evidence available, and the BSPC explicitly measures the approval of paranoid beliefs. Results: Patients in the EG showed a lower JTC (M = 4.11 draws before decision) than the CG (M = 2.43; Cohen’s d = 0.64). No significant difference in the BSPC was observed. Discussion/Conclusion: Our results indicate that enhancing the sense of body boundaries through a self-massage can reduce an implicit bias associated with delusional ideation and correspondingly support the idea that disembodiment might be a relevant factor in the formation of psychotic symptoms.

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The Effect of Reducing the “Jumping to Conclusions” Bias on Treatment Decision-Making Capacity in Psychosis: A Randomized Controlled Trial With Mediation Analysis

Cited by 7 publications

References 41 publications

Relationship between jumping to conclusions and clinical outcomes in people at clinical high-risk for psychosis

Relationship between jumping to conclusions and clinical outcomes in people at clinical high-risk for psychosis

Effects of Integrated Moral Reasoning Development Intervention for Management of Violence in Schizophrenia: A Randomized Controlled Trial

Reduced Jumping to Conclusion Bias after Experimentally Induced Enhancement of Subjective Body Boundaries in Psychosis

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