title: Subjective competence breeds overconfidence in errors in psychosis. A hubris account of paranoia.
abstract: OBJECTIVE
  Overconfidence in errors is a well-replicated cognitive bias in psychosis. However, prior studies have sometimes failed to find differences between patients and controls for more difficult tasks. We pursued the hypothesis that overconfidence in errors is exaggerated in participants with a liability to psychosis relative to controls only when they feel competent in the respective topic and/or deem the question easy. Whereas subjective competence likely enhances confidence in those with low psychosis liability as well, we still expected to find more 'residual' caution in the latter group.
  
  
  METHODS
  We adopted a psychometric high-risk approach to circumvent the confounding influence of treatment. A total of 2321 individuals from the general population were administered a task modeled after the "Who wants to be a millionaire" quiz. Participants were requested to endorse one out of four response options, graded for confidence, and were asked to provide ratings regarding subjective competence for the knowledge domain as well as the subjective difficulty of each item.
  
  
  RESULTS
  In line with our assumption, overconfidence in errors was increased overall in participants scoring high on the Paranoia Checklist core paranoia subscale (2 SD above the mean). This pattern of results was particularly prominent for items for which participants considered themselves competent and which they rated as easy.
  
  
  CONCLUSIONS
  Results need to be replicated in a clinical sample.
  
  
  CONCLUSIONS
  In support of our hypothesis, subjective competence and task difficulty moderate overconfidence in errors in psychosis. Trainings that teach patients the fallibility of human cognition may help reduce delusional ideation.
authors: University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Germany. Electronic address: moritz@uke.uni-hamburg.de.
authors: Steffen
authors: S
authors: Moritz
authors: Occupational and Consumer Psychology, Freiburg University, Freiburg, Germany.
authors: Anja S
authors: AS
authors: Göritz
authors: University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Germany.
authors: Jürgen
authors: J
authors: Gallinat
authors: University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Germany.
authors: Milena
authors: M
authors: Schafschetzy
authors: Department of Management and Economics, Kuehne Logistics University, Hamburg, Germany.
authors: Niels
authors: N
authors: Van Quaquebeke
authors: Clinical Psychological Science, Section Forensic Psychology, Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands.
authors: Maarten J V
authors: MJ
authors: Peters
authors: University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Germany.
authors: Christina
authors: C
authors: Andreou
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D000067489:Metacognition / Q000502:physiology*; D008875:Middle Aged; D010259:Paranoid Disorders / Q000503:physiopathology*; D011618:Psychotic Disorders / Q000503:physiopathology*; D012559:Schizophrenia / Q000503:physiopathology*; D013850:Thinking / Q000502:physiology*
keywords: Confidence; Conviction; Inference; Metacognition; Reasoning; Schizophrenia