Are cognitive symptoms of schizophrenia mediated by abnormalities in emotional arousal?

We tested 28 individuals with schizophrenia (SZ) and 16 healthy individuals on a test of logical reasoning and "cognitive gating," defined as the ability to discriminate between relevant and irrelevant information in confirming or disconfirming a given belief. The Logical Reasoning and Cognitive Gating Task tests both processes under neutral and affect-laden conditions. This is done by presenting formally identical constructs using benign and emotionally arousing language. When separated by symptom profiles, we found statistically significant differences for performance and arousal response between patients with delusions, patients with formal thought disorder, and patients with neither delusions nor formal thought disorder, as well as between patients and healthy controls. When analyzed by error type, we found that nearly all errors by delusional patients were caused by overly restrictive information choice, a pattern that may be related to a delusional patient's tendency to "jump to conclusions" on Bayesian probabilistic tasks. This is in contrast to patients with formal thought disorder, whose low performance resulted also from overly extensive information choice. The tendencies towards restriction were exacerbated by arousal, which is consistent with studies on cognition and arousal in healthy individuals. After briefly examining research on emotional arousal and SZ, and the interaction between emotional arousal and restriction of perceptual cues in healthy individuals, we conclude by suggesting a model which accounts for the distinctive cognitive characteristics of delusional patients by their possessing distinct vulnerabilities to emotional arousal. Specifically, these results suggest the possibility that delusional patients process information in a manner that is essentially intact. However, delusional patients may possess an acute vulnerability to emotional arousal that might cause delusional individuals to behave cognitively as if they were healthy individuals under significantly more severe forms of stress.     

Deconstructing delusions: A qualitative study examining the relationship between religious beliefs and religious delusions

Delusions have been conceptualized as forming in response to experience, yet the relationship between religious belief, and beliefs regarded as delusional, has received little research attention. This is despite the high prevalence of delusions featuring religious content. Semi-structured interviews were conducted with seven participants who had been diagnosed as experiencing delusions. Participants from a range of religious backgrounds were asked about their religious experiences and beliefs, family background and experiences of psychosis. These interviews were analysed qualitatively. Whilst religious background affected the content of delusions, the nature of delusions appeared to be influenced by other factors, such as early family experiences, particularly an absent parent and conflict within the family. Individuals often used a religious framework to understand unusual experiences, and there seemed to be a role for the process of identification and wish fulfilment in influencing delusional content. Whilst this research is clearly limited by its exploratory nature, it offers a possible framework of understanding which helps make sense of religious delusions, and suggests approaches which may be helpful in recovery.     

Early trauma,negative affect,and anxious attachment: the role of metacognition

Background and Objectives: Metacognition is linked to the etiology and maintenance of negative emotions and psychological disorder in the Self-Regulatory Executive Function Model. Although there is significant evidence supporting the model, little is currently known about the situational factors for developing dysfunctional metacognitions. The current study explored the hypothesis that early aversive experiences might be important and also tested if metacognitions could mediate the relationship between such experiences and psychological symptoms. Design and Methods: Three hundred and fifty non-clinical adults completed a retrospective early trauma measure, as well as measures of current metacognitive beliefs, negative affect, and anxious attachment. Results: Early emotional abuse positively and significantly correlated with several metacognitive belief dimensions but other forms of early trauma did not. Metacognition fully mediated the relationship between emotional abuse and negative affect. Anxious attachment was also positively and significantly associated with metacognitive beliefs and specific relationships remained after controlling for early emotional abuse and current negative affect. Conclusions: Findings are consistent with the ideas that: (i) early negative experiences, and emotional abuse in particular, could be a factor in the formation of problematic metacognitions and (ii) these metacognitions may be important in determining the effects of abuse on subsequent psychological symptoms.     

Effects of age on metacognitive efficiency

Humans have a capacity to become aware of thoughts and behaviours known as metacognition. Metacognitive efficiency refers to the relationship between subjective reports and objective behaviour. Understanding how this efficiency changes as we age is important because poor metacognition can lead to negative consequences, such as believing one is a good driver despite a recent spate of accidents. We quantified metacognition in two cognitive domains, perception and memory, in healthy adults between 18 and 84 years old, employing measures that dissociate objective task performance from metacognitive efficiency. We identified a marked decrease in perceptual metacognitive efficiency with age and a non-significant decrease in memory metacognitive efficiency. No significant relationship was identified between executive function and metacognition in either domain. Annual decline in metacognitive efficiency after controlling for executive function was ∼0.6%. Decreases in metacognitive efficiency may explain why dissociations between behaviour and beliefs become more marked as we age.     

Explaining delusions: a cognitive perspective

There is now considerable evidence for reasoning, attention, metacognition and attribution biases in delusional patients. Recently, these findings have been incorporated into a number of cognitive models that aim to explain delusion formation, maintenance and content. Although delusions are commonly conceptualized as beliefs, not all models make reference to models of normal belief formation. This review considers those models that explain delusions as a breakdown of normal belief formation (belief-positive models), approaches that explain the pathology only (belief-negative models) and approaches that view delusions as one end of a distribution of anomalous mental phenomena (the continuum view). A cognitive theory that includes the 'pragmatic pathology' of delusions will be able to address both the phenomenology and the treatment of delusion-related distress.     

元认知视角下的强迫症的特征、模型及干预

强迫症的元认知模型认为, 元认知是理解强迫症病理的关键。强迫症患者存在错误的元认知知识信念、消极的元认知体验及不恰当使用元认知策略等问题。强迫症的元认知疗法强调思维过程(如自我聚焦注意、对担忧不变的思维风格和威胁调节的注意策略等)的重要性, 而非思维的具体内容, 并在个体心理干预、团体心理干预等研究中显示出较好的疗效。未来研究应从认知神经科学等视角考查强迫症的记忆等元认知特征, 并进一步验证和修正强迫症的元认知模型。     

Hypnosis and belief: A review of hypnotic delusions

Hypnosis can create temporary, but highly compelling alterations in belief. As such, it can be used to model many aspects of clinical delusions in the laboratory. This approach allows researchers to recreate features of delusions on demand and examine underlying processes with a high level of experimental control. This paper reviews studies that have used hypnosis to model delusions in this way. First, the paper reviews studies that have focused on reproducing the surface features of delusions, such as their high levels of subjective conviction and strong resistance to counter-evidence. Second, the paper reviews studies that have focused on modelling underlying processes of delusions, including anomalous experiences or cognitive deficits that underpin specific delusional beliefs. Finally, the paper evaluates this body of research as a whole. The paper discusses advantages and limitations of using hypnotic models to study delusions and suggests some directions for future research.     

Beliefs, experiences and misplaced being: an interactionist account of delusional misidentification

This paper contrasts an interactionist account of delusional misidentification with more traditional one- and two-stage models. Unlike the unidirectional nature of these more traditional models, in which the aetiology of the disorder is said to “progress” from a neurological disruption via an anomalous experience to a delusional belief, the interactionist account posits the interaction of top-down and bottom-up processes to better explain the maintenance of the delusional belief. In addition, it places a greater emphasis on the patient’s underlying phenomenal experience in accounting for the specificity of the delusional content. The role played by patient phenomenology is examined in light of Ratcliffe’s recent phenomenological account. Similarities and differences are discussed. The paper concludes that a purely phenomenological account is unable to differentiate between non-delusional patient groups, who have what appear to be equivalent phenomenal experiences to patients suffering from delusional misidentification but without the delusional belief, and delusional groups, something the interactionist model is able to do.     

Domain-specific and domain-general processes underlying metacognitive judgments

Metacognition and self-awareness are commonly assumed to operate as global capacities. However, there have been few attempts to test this assumption across multiple cognitive domains and metacognitive evaluations. Here, we assessed the covariance between “online” metacognitive processes, as measured by decision confidence judgments in the domains of perception and memory, and error awareness in the domain of attention to action. Previous research investigating metacognition across task domains have not matched stimulus characteristics across tasks raising the possibility that any differences in metacognitive accuracy may be influenced by local task properties. The current experiment measured metacognition in perceptual, memorial and attention tasks that were closely matched for stimulus characteristics. We found that metacognitive accuracy across the three tasks was dissociated suggesting that domain specific networks support an individual’s capacity for accurate metacognition. This finding was independent of objective performance, which was controlled using a staircase procedure. However, response times for metacognitive judgments and error awareness were associated suggesting that shared mechanisms determining how these meta-level evaluations unfold in time may underlie these different types of decision. In addition, the relationship between these laboratory measures of metacognition and reports of everyday functioning from participants and their significant others (informants) was investigated. We found that informant reports, but not self reports, predicted metacognitive accuracy on the perceptual task and participants who underreported cognitive difficulties relative to their informants also showed poorer metacognitive accuracy on the perceptual task. These results are discussed in the context of models of metacognitive regulation and neuropsychological evidence for dissociable metacognitive systems. The potential for the refinement of metacognitive assessment in clinical populations is also discussed.     

The psychological processes underlying symptoms of thought interference in psychosis

Morrison and colleagues have proposed that auditory hallucinations are the result of cognitive intrusions being misattributed to an external source due to such thoughts being inconsistent with the person's beliefs about his or her own mental processes (metacognitive beliefs). The aim of this study was to investigate the applicability of this model to psychotic symptoms of thought interference. Fifty psychotic patients with and without thought interference were compared on (i) frequency of cognitive intrusions, (ii) metacognitive beliefs, (iii) source monitoring and (iv) appraisals of an unrelated anomalous event (a card trick). As predicted, individuals with thought interference had an increased frequency of cognitive intrusions and of maladaptive metacognitive appraisals, lower perceived cognitive control, and were more likely to endorse appraisals regarding 'permeability' of the mind, on the card trick task, in comparison to individuals without thought interference. No significant differences were found on any measure when the patient group was divided into hallucinators and non-hallucinators, once other variables were controlled for. These findings suggest that Morrison's model may be more parsimonious for symptoms of thought interference than for auditory hallucinations.     

Prospective Relations Between Dysfunctional Metacognitive Beliefs,Metacognitive Strategies,and Anxiety: Results From a Four-Wave Longitudinal Mediation Model

The metacognitive model of psychological disorders suggests that emotional disorders are related to maladaptive metacognitive strategies corresponding to underlying dysfunctional metacognitive beliefs. There is substantial empirical evidence supporting a role of metacognition in psychopathology, but fewer studies have evaluated the metacognitive model using longitudinal data and taken into consideration its differentiation between components and how they are hypothesized to be related to each other. Thus, more specific model evaluation is important as it relates to identifying mechanisms of disorder with a potential to provide clinical advances. In the present study, 868 participants took part in a 4-wave survey and reported on metacognitive beliefs and strategies and anxiety symptoms. Two longitudinal mediation models (forward and reversed causation) were run to test temporal precedence and bidirectional relations. The results indicated that metacognitive beliefs significantly predicted metacognitive strategies, which further predicted anxiety symptoms and mediated the indirect effect in the relationship between metacognitive beliefs and anxiety over time. The relationship between metacognitive beliefs and anxiety symptoms over time were bidirectional, but this relationship was not accounted for by metacognitive strategies. These findings largely support central predictions set forward by the metacognitive model and indicate that metacognitions play a preceding and maintaining role in anxiety.     

Examining the role of positive and negative metacognitive beliefs in depression

Many psychological models have been developed to explain the development and maintenance of depression. The most widely evaluated model is the cognitive model of depression, and it is against this model that emerging models should be compared. Accordingly, this cross‐sectional study examined whether metacognitive beliefs, as specified in the metacognitive model of depression, would explain additional variance in depressive symptoms over dysfunctional attitudes; the core feature of the cognitive model. Moreover, mediational relationships between metacognitive beliefs, rumination, and depressive symptoms, predicted by the metacognitive model were also explored, whilst controlling for dysfunctional attitudes. A sample of 715 students completed self‐report questionnaires measuring depressive symptoms, rumination, dysfunctional attitudes, and metacognitive beliefs. Regression analyses showed that metacognitive beliefs made a significant statistical contribution to depressive symptoms, after controlling for age, gender, rumination and dysfunctional attitudes. Furthermore, as predicted by the metacognitive model, the relationship between positive metacognitive beliefs and depressive symptoms was fully mediated by rumination, whilst the relationship between negative metacognitive beliefs about uncontrollability and danger and depressive symptoms was partially mediated by rumination. The results provide further empirical support for the metacognitive model of depression and indicate that positive and negative metacognitive beliefs play an integral role in the maintenance of depressive symptoms.     

Toward a Noninferentialist,Nonreliabilist Account of Perceptual Justification

While it may be a datum of common sense that perceptual experiences can justify beliefs, there is no clear consensus about how they can do so. According to what I call “inferentialism,” perceptual experiences can justify beliefs because perceptual experiences have propositional contents and thus can serve as reasons for belief. A critical commitment of inferentialism is that justification requires the obtaining of a nonarbitrary or nonaccidental semantic relation between justifier and justified, a requirement that I call semantic appropriateness (SA). By contrast, reliabilists reject SA and argue that perceptual experiences can justify beliefs because perceptual experiences are part of a reliable belief‐forming process. In this paper, I explore whether a commitment to SA inevitably leads to a commitment to inferentialism. This exploration is largely motivated by doubts over whether perceptual experiences have propositional contents. If those doubts prove to be well‐founded, then it seems either that perceptual experiences cannot justify beliefs or that some form of reliabilism is true. I argue that although we should take the doubts seriously, there is a way to make sense of SA that does not require inferentialism.     

Perceptual asymmetries in normal children and children with attention deficit/hyperactivity disorder

Perceptual asymmetries in normal right-handed children (7-12 years of age) and children with attention deficit/hyperactivity disorder (ADHD), combined type, were investigated using various chimeric stimuli in free-viewing conditions. In the face-matching task, participants indicated which of two symmetrical face chimeras more closely resembled the original; in the chimeric faces task, participants indicated which of a pair of faces appeared happier; and in the grey scales task participants indicated which of two shaded rectangles appeared to be darker overall. Leftward biases were found for normal children with no effects of age. Contrary to expectations, normal leftward biases were also found for ADHD children in the face-matching and the chimeric faces tasks; however, a significant leftward bias was not observed in the grey scales task. The absence of anomalous perceptual bias in ADHD children on these purely perceptual tasks, suggests that anomalous perceptual asymmetries observed in other tasks (line bisection and cancellation tasks) may have been confounded by the motor response, and/or the explicit spatial components of those tasks.     

Foundational beliefs and the structure of justification

I argue that our justification for beliefs about the external physical world need not be constituted by any justified beliefs about perceptual experiences. In this way our justification for beliefs about the physical world may be nondoxastic and this differentiates my proposal from traditional foundationalist theories such as those defended by Laurence BonJour, Richard Fumerton, and Timothy McGrew. On the other hand, it differs from certain non-traditional foundationalist theories such as that defended by James Pryor according to which perceptual experience is sufficient to justify beliefs about the external world. I propose that justification for propositions describing our perceptual experiences partially constitutes any justification we may possess for beliefs concerning the external world. In this way, our justification for beliefs about the physical world may only be inferential since it is grounded in any justification we have for at least one other proposition. This theory occupies an intermediate position between the two aforementioned foundationalist accounts, which allows it to sidestep problems that confront each of them.     

The self-attribution bias and paranormal beliefs

The present study investigated the relation between paranormal beliefs, illusory control and the self-attribution bias, i.e., the motivated tendency to attribute positive outcomes to oneself while negative outcomes are externalized. Visitors of a psychic fair played a card guessing game and indicated their perceived control over randomly selected cards as a function of the congruency and valence of the card. A stronger self-attribution bias was observed for paranormal believers compared to skeptics and this bias was specifically related to traditional religious beliefs and belief in superstition. No relation between paranormal beliefs and illusory control was found. Self-report measures indicated that paranormal beliefs were associated to being raised in a spiritual family and to anomalous experiences during childhood. Thereby this study suggests that paranormal beliefs are related to specific cognitive biases that in turn are shaped by socio-cultural factors.     

Individual differences in anger and displaced aggression: The role of metacognitive beliefs and anger rumination

Metacognitive model is a theoretical approach aimed to explain emotion dysregulation and others emotion-related issues, such anger, and aggressive behavior. From this model, people having higher maladaptive metacognitive beliefs (e.g., “I can't control my thoughts”) are more likely to activate and maintain anger rumination and, in turn, to experience higher levels of anger and to act aggressively. Preliminary evidence shows the role of metacognitive beliefs on anger rumination and anger levels, whereas no studies have examined its association with aggressive behavior. This study first examined the associations between metacognitive beliefs, anger rumination, anger levels, and the propensity to engage in displaced aggression, and second, the mediation role of anger rumination in the relations among metacognitive beliefs and anger and displaced aggression. Participants were 947 students and non-students from general population recruited in two different countries (Australia and Spain). Correlational analyses revealed a similar pattern of results in the Australian and Spanish sample, with participants having dysfunctional metacognitive beliefs also showing higher anger rumination, higher levels of anger and a higher tendency to act aggressively. Structural equation analyses revealed the associations of metacognitive beliefs with anger levels and displaced aggression was fully mediated by anger rumination in both samples. These results suggest that metacognitive beliefs should be considered in comprehensive models and in the therapy of anger problems and aggression.     

Irrational and Metacognitive Beliefs Mediate the Relationship Between Content Beliefs and GAD Symptoms: A Study on a Normal Population

Cognitive Behavioral Therapy (CBT), Rational Emotive Behavior Therapy (REBT) and Metacognitive Therapy (MCT) models show both similarities and differences in conceptualizing anxiety. This work assumes that REBT’s irrational and MCT’s metacognitive beliefs play a mediation role while CBT’s disorder specific content beliefs act as triggers. This hypothesis is tested using a regression model in which metacognitive and irrational beliefs play a mediation role while content disorder beliefs are independent variables. This paper applied this model to generalized anxiety disorder (GAD), a psychiatric diagnosis in which anxiety is the major feature. In GAD, the specific content beliefs are negative problem orientation and intolerance of uncertainty. Therefore, 149 non clinical subjects completed 4 self-report questionnaires: the Negative Orientation to the Problems Questionnaire and the Intolerance of Uncertainty Scale as measures for content cognitive beliefs, the Attitudes and Beliefs Scale for irrational beliefs, and the Metacognitive Questionnaire 30 Items Version for metacognitive beliefs. The generalized anxiety disorder questionnaire was chosen in order to measure anxiety as dependent variable. Regression analyses confirmed that irrational and metacognitive beliefs mediate the relation between cognitive content beliefs and GAD. We clinically interpret mediation as a second level regulation.     

Proneness to hallucinations and delusions in a non‐clinical sample: Exploring associations with metacognition and negative affect

Commonly, individuals prone to hallucinations and delusions hold dysfunctional metacognitive beliefs and report higher levels of negative affect, yet, these associations have not been clearly investigated in non‐clinical samples due to the failure to control for high intercorrelations between variables. The aim of the current study was to investigate how hallucination and delusion proneness are associated with dysfunctional metacognitions and negative affect. A cross‐sectional sample of 715 students free from psychiatric diagnoses (M_age = 28.1 years, SD = 10.9, range 18–65) completed the Launay‐Slade Hallucination Scale (LSHS‐R); Peters et al. Delusion Inventory (PDI‐21); Depression, Anxiety, and Stress Scale (DASS‐21); and the Metacognition Questionnaire (MCQ‐30). Findings that participants who were prone to both hallucinations and delusions reported elevated levels of negative affect support the need for targeted mental health treatment for individuals who experience psychological distress related to their hallucinatory and delusional experiences. While metacognition beliefs of need to control thoughts and cognitive self‐consciousness, along with the anxiety and stress DASS‐21 subscales appeared as significant cross‐sectional predictors of proneness to hallucinations and delusions, only metacognitions demonstrated any notable predictive value for delusion proneness. This finding questions the role of metacognitions in determining hallucination and delusion proneness in non‐clinical samples.