Author:

Keywords:

Social Sciences, Science & Technology, Life Sciences & Biomedicine, Psychology, Clinical, Psychiatry, Psychology, Cognitive models, jumping to conclusions, persistence, progression, psychosis, psychotic experiences, reasoning bias, transdiagnostic phenotype, PERSECUTORY DELUSIONS, EXPERIENCES, DISORDERS, RELEVANCE, SYMPTOMS, PEOPLE, MODELS, ONSET, CARE, NEED, Adult, Affective Symptoms, Anxiety, Bias, Cognition, Decision Making, Depression, Female, Humans, Male, Middle Aged, Netherlands, Neuropsychological Tests, Prospective Studies, Psychotic Disorders, Risk, Surveys and Questionnaires, 1109 Neurosciences, 1117 Public Health and Health Services, 1701 Psychology, 3202 Clinical sciences, 5202 Biological psychology, 5203 Clinical and health psychology

Abstract:

BACKGROUND: Contemporary models of psychosis implicate the importance of affective dysregulation and cognitive factors (e.g. biases and schemas) in the development and maintenance of psychotic symptoms, but studies testing proposed mechanisms remain limited. This study, uniquely using a prospective design, investigated whether the jumping to conclusions (JTC) reasoning bias contributes to psychosis progression and persistence. METHODS: Data were derived from the second Netherlands Mental Health Survey and Incidence Study (NEMESIS-2). The Composite International Diagnostic Interview and an add-on instrument were used to assess affective dysregulation (i.e. depression, anxiety and mania) and psychotic experiences (PEs), respectively. The beads task was used to assess JTC bias. Time series analyses were conducted using data from T1 and T2 (N = 8666), excluding individuals who reported high psychosis levels at T0. RESULTS: Although the prospective design resulted in low statistical power, the findings suggest that, compared to those without symptoms, individuals with lifetime affective dysregulation were more likely to progress from low/moderate psychosis levels (state of 'aberrant salience', one or two PEs) at T1 to high psychosis levels ('frank psychosis', three or more PEs or psychosis-related help-seeking behaviour) at T2 if the JTC bias was present [adj. relative risk ratio (RRR): 3.8, 95% confidence interval (CI) 0.8-18.6, p = 0.101]. Similarly, the JTC bias contributed to the persistence of high psychosis levels (adj. RRR: 12.7, 95% CI 0.7-239.6, p = 0.091). CONCLUSIONS: We found some evidence that the JTC bias may contribute to psychosis progression and persistence in individuals with affective dysregulation. However, well-powered prospective studies are needed to replicate these findings.