Relationship between jumping to conclusions and clinical outcomes in people at clinical high-risk for psychosis
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2022-06-06
Source Title
Psychological Medicine
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CAMBRIDGE UNIV PRESS
Melbourne Authors
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Psychiatry
Centre for Youth Mental Health
Centre for Youth Mental Health
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Journal Article
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Catalan, A., Tognin, S., Kempton, M. J., Stahl, D., Salazar De Pablo, G., Nelson, B., Pantelis, C., Riecher-Rössler, A., Bressan, R., Barrantes-Vidal, N., Krebs, M. O., Nordentoft, M., Ruhrmann, S., Sachs, G., Rutten, B. P. F., Van Os, J., De Haan, L., Van Der Gaag, M., Valmaggia, L. R. ,... Monsonet, M. (2022). Relationship between jumping to conclusions and clinical outcomes in people at clinical high-risk for psychosis. Psychological Medicine, 52 (8), pp.1569-1577. https://doi.org/10.1017/S0033291720003396.
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Abstract
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.