Prospects for a cognitive-developmental account of psychotic experiences

Durham University, Durham, England, United Kingdom
British Journal of Clinical Psychology (Impact Factor: 1.9). 07/2007; 46(Pt 2):155-73. DOI: 10.1348/014466506X123011
Source: PubMed

ABSTRACT It has recently been recognized that psychosis represents the end-point of abnormal developmental pathways. The neurodevelopmental framework, within which this observation has typically been interpreted, has a number of limitations, particularly its failure to take account of recent advances in our understanding of the psychology of unusual experiences, such as hallucinations and delusions. The purpose of the present review is to highlight the advantages of considering psychosis within the framework of mainstream developmental psychology. The approach we advocate integrates findings from neurodevelopmental research with research on typical cognitive and sociocognitive development and the psychology of psychotic symptoms.
We review selected research on the developmental precursors of psychosis and on the role of cognitive processes in psychotic symptoms, together with relevant literature addressing the development of these processes in healthy children.
Developmental psychology provides clues about the cognitive and sociocognitive abnormalities that may be involved in hallucinations and delusions. An integration of these findings with existing knowledge on the neurodevelopment of psychosis suggests new avenues of research for investigators working at both biological and psychological levels of explanation.
The literature on typical cognitive and sociocognitive development provides a rich source of hypotheses about the ontogenetic pathways leading to psychosis.

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    • "Cognitive models of psychosis describe a dynamic, multi-factorial pathway from anomalous experiences to positive symptoms involving social factors, pre-existing beliefs, maladaptive appraisals and affective and cognitive disturbances (Bentall et al., 2001; Garety et al., 2001; Morrison, 2001; Bentall et al., 2007; Garety et al., 2007). Cognitive and perceptual biases are viewed as causal in the development and maintenance of delusions in particular (Freeman, 2007). "
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    ABSTRACT: Background There is evidence that people with psychosis display a “jump-to-conclusions” (JTC) reasoning style, and that this bias may be specific to delusions. A “jump-to-perceptions” (JTP) cognitive bias has also been found and is typically linked to hallucinations. However, there is some evidence for an association between JTP and delusions, and its specificity to hallucinations remains unclear. It has been suggested that these biases are related and products of shared cognitive processes. Methods This study examined the symptom specificity of JTC and JTP, and the relationship between them, in a sample of 98 individuals with delusions divided into ‘hallucinators’ (n = 51) and ‘non-hallucinators’ (n = 47). Biases were assessed using the beads task and visual and auditory perceptual tasks. Results As predicted, both groups demonstrated a JTC bias, but the ‘hallucinators’ showed a more pronounced JTP style in both modalities. The presence of JTC and JTP biases did not co-occur: making a decision on the beads task after two or fewer draws was not related to visual JTP, and was associated with a less marked JTP bias in the auditory perceptual task. No differences were found in JTP or JTC between participants with and without a schizophrenia diagnosis. JTP, but not JTC, was associated with the presence of hallucinations. Conclusions These findings suggest that the JTC and JTP biases show specificity to delusions and hallucinations, respectively, and not to diagnosis. There was no evidence that they are the product of shared cognitive processes, further supporting their specificity.
    Schizophrenia Research 04/2014; 154(1-3). DOI:10.1016/j.schres.2014.02.004 · 4.43 Impact Factor
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    • "As far back as 1988, Huq et al. described biases in data gathering, also known as Jumping To Conclusions (JTC), which appear to be present in ongoing delusional psychosis (Garety et al., 2005) as well as in at-risk state for psychosis (Broome et al., 2007). Also, JTC-bias is found to be still detectable in people recovered from delusions (Peters and Garety, 2006; Bentall et al., 2007). Woodward et al. (2006a, 2006b) described a bias against disconfirmatory evidence (BADE), or a tendency not to take disconfirmatory information into account when assessing one's own beliefs, as a risk factor for delusion formation. "
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    ABSTRACT: OBJECTIVE: A large body of research has demonstrated the importance of cognitive biases in the development and maintenance of psychosis. Self-report scales for routine clinical practice have been developed only recently. Two new instruments on cognitive biases are evaluated: the Cognitive Biases Questionnaire for Psychosis and the Davos Assessment of Cognitive Biases Scale. METHODS: In a Flemish sample of 98 patients diagnosed with schizophrenia and 152 healthy controls, we investigated (1) the factor structure, (2) the reliability (internal consistency), (3) the discriminative power and (4) the convergent validity of the Dutch CBQ-P and the DACOBS. RESULTS: Using Confirmatory Factor Analysis, a 1-factor solution provided the best fit for the CBQ-P, and a 3-factor solution for the DACOBS. The CBQ-P Total Scale and the three scales of the DACOBS showed good internal consistencies. The CBQ-P Total Scale and all three DACOBS subscales were able to differentiate between healthy controls and patients diagnosed with schizophrenia, when controlling for age and years of education. The CBQ-P and DACOBS scales showed moderate correlations, confirming the convergent validity of both scales. CONCLUSIONS: The CPQ-P and DACOBS appear to be psychometrical sound instruments to assess general thinking bias in psychosis within a Flemish population. Implications for future research are discussed.
    Schizophrenia Research 07/2013; 147:310-314. DOI:10.1016/j.schres.2013.04.037 · 4.43 Impact Factor
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    • "Ten years after this study, there is still a lack of empirical evidence specifying which emotional and psychological processes could sustain and potentially exacerbate the expression of PS during adolescent development. One way to address this issue is to examine the factors associated with increased manifestations of early PS during adolescence (Bentall et al., 2007). Longitudinal prospective investigations examining transient auditory verbal hallucinations in adolescents observe that emotional disorders and anxiety-provoking PS symptom content play significant roles in the maintenance of such PS symptoms (Escher, 2004; Escher et al., 2002). "
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